Τρίτη 24 Νοεμβρίου 2020

Clinical features of COVID-19 and influenza

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Clinical features of COVID-19 and influenza: a comparative study on Nord Franche-Comte cluster.

Microbes Infect. 2020 10;22(9):481-488

Authors: Zayet S, Kadiane-Oussou NJ, Lepiller Q, Zahra H, Royer PY, Toko L, Gendrin V, Klopfenstein T

Abstract
Clinical descriptions about influenza-like illnesses (ILI) in COVID-19 seem non-specific. We aimed to compare the clinical features of COVID-19 and influenza. We retrospectively investigated the clinical features and outcomes of confirmed cases of COVID-19 and influenza in Nord Franche-Comté Hospital between February 26th and March 14th 2020. We used SARS-CoV-2 RT-PCR and influenza virus A/B RT-PCR in respiratory samples to confirm the diagnosis. We included 124 patients. The mean age was 59 (±19 [19-98]) years with 69% female. 70 patients with COVID-19 and 54 patients with influenza A/B. Regarding age, sex and comorbidities, no differences were found between the two groups except a lower Charlson index in COVID-19 group (2 [±2.5] vs 3 [±2.4],p = 0.003). Anosmia (53% vs 17%,p < 0.001), dysgeusia (49% vs 20%,p = 0.001), diarrhea (40% vs 20%,p = 0.021), frontal headache (26% vs 9%,p = 0.021) and bilateral cracklings sound s (24% vs 9%,p = 0.034) were statistically more frequent in COVID-19. Sputum production (52% vs 29%,p = 0.010), dyspnea (59% vs 34%,p = 0.007), sore throat (44% vs 20%,p = 0.006), conjunctival hyperhemia (30% vs 4%,p < 0.001), tearing (24% vs 6%,p = 0.004), vomiting (22% vs 3%,p = 0.001) and rhonchi sounds (17% vs 1%,p = 0.002) were more frequent with influenza infection. We described several clinical differences which can help the clinicians during the co-circulation of influenza and SARS-CoV-2.

PMID: 32561409 [PubMed - indexed for MEDLINE]

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Evaluation of the clinical profile, laboratory parameters and outcome of two hundred COVID-19

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Evaluation of the clinical profile, laboratory parameters and outcome of two hundred COVID-19 patients from a tertiary centre in India.

Monaldi Arch Chest Dis. 2020 Nov 09;90(4):

Authors: Gupta N, Ish P, Kumar R, Dev N, Yadav SR, Malhotra N, Agrawal S, Gaind R, Sachdeva H, Covid Working Group OMOTSH

Abstract
COVID-19 is a pandemic with over 5 million cases worldwide. The disease has imposed a huge burden on health resources. Evaluation of clinical and epidemiological profiles of such patients can help in understanding and managing the outbreak more efficiently. This study was a prospective observational analysis of 200 diagnosed COVID-19 patients admitted to a tertiary care center from 20th march to 8th May 2020. All these patients were positive for COVID-19 by an oro-nasopharyngeal swab-rtPCR based testing. Analyses of demographic factors, clinical characteristics, comorbidities, laboratory parameters, and the outcomes were performed. The mean age of the population was 40 years with a slight male predominance (116 patients out of 200, 58%). A majority of the patients (147, 73.5 %) were symptomatic, with fever being the most common symptom (109, 54.5%), followed by cough (91, 45.5%). An older age, presence of symptoms and their duration, leukocytosis, a high quick SOFA score, a h igh modified SOFA score, need for ventilator support, an AST level more than 3 times the upper limit of normal (ULN), and a serum creatinine level of 2 mg/dl or greater were at a significantly higher risk of ICU admission and mortality. Presence of diabetes mellitus, AST > three times ULN, serum creatinine 2 mg/dl or higher, and a qSOFA score of 1 or higher were all associated with significantly greater odds of critical care requirement. Triage and severity assessment helps in deciding the requirement for a hospital stay and ICU admission for COVID-19 which can easily be done using clinical and laboratory parameters. A mild, moderate and severe category approach with defined criteria and treatment guidelines will help in judicious utilization of health-care resources, especially for developing countries like India.   *Other members of the Safdarjung Hospital COVID-19 working group: Balvinder Singh (Microbiology), MK Sen (Pulmonary Medicine), Shibdas Chakrabarti (Pulmona ry Medicine), NK Gupta (Pulmonary medicine), AJ Mahendran (Pulmonary Medicine), Ramesh Meena (Medicine), G Usha (Anaesthesiology), Santvana Kohli (Anaesthesiology), Sahil Diwan (Anaesthesiology), Rushika Saksena (Microbiology), Vikramjeet Dutta (Microbiology), Anupam Kr Anveshi (Microbiology).

PMID: 33169598 [PubMed - indexed for MEDLINE]

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The use of negative-pressure wound therapy over a cultured epithelial autograft for full-thickness wounds secondary to purpura fulminans in an infant.

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The use of negative-pressure wound therapy over a cultured epithelial autograft for full-thickness wounds secondary to purpura fulminans in an infant.

Arch Plast Surg. 2020 Nov 20;:

Authors: Goh BKL, Chua AWC, Chew KY, Kang GC, Chiang LW, Tan BK, Ramachandran S

Abstract
Purpura fulminans is a serious condition that can result in severe morbidity in the pediatric population. Although autologous skin grafts remain the gold standard for the coverage of partial- to full-thickness wounds, they have several limitations in pediatric patients, including the lack of planar donor sites, the risk of hemodynamic instability, and the limited graft thickness. In Singapore, an in-house skin culture laboratory has been available since 2005 for the use of cultured epithelial autografts (CEAs), especially in burn wounds. However, due to the fragility of CEAs, negative-pressure wound therapy (NPWT) dressings have been rarely used with CEAs. With several modifications, we report a successful case of NPWT applied over a CEA in an infant who sustained 30% total body surface area full-thickness wounds over the anterior abdomen, flank, and upper thigh secondary to purpura fulminans. We also describe the advantages of using NPWT dressing over a CEA, particularly in pediatric patients.

PMID: 33207856 [PubMed - as supplied by publisher]

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Covid-19–Associated Myopathy Caused by Type I Interferonopathy

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To the Editor: The syndrome of Covid-19 infection includes myalgias and elevated creatine kinase levels in at least a third of patients. Whether the elevation in creatine kinase level is caused by viral infection of muscle, toxic effects of cytokines, or another mechanism is unclear. There are few…
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Analysis of Etiologic Factors in Pediatric Rhegmatogenous Retinal Detachment With Genetic Testing.

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Analysis of Etiologic Factors in Pediatric Rhegmatogenous Retinal Detachment With Genetic Testing.

Am J Ophthalmol. 2020 10;218:330-336

Authors: Chen C, Huang S, Sun L, Li S, Huang L, Wang Z, Luo X, Ding X

Abstract
PURPOSE: The purpose of this study was to investigate the etiology and clinical features of nontraumatic rhegmatogenous retinal detachment (RRD) in children.
DESIGN: Consecutive, cross-sectional study.
METHODS: In this study, 112 operative eyes of 102 patients ≤18 years of age with nontraumatic RRD were included. Comprehensive ophthalmic examinations were performed in all patients. Genetic testing was performed in 34 patients with hereditary congenital/developmental diseases. The etiology of RRD was analyzed.
RESULTS: The average age was 12.2 ± 4.5 years (range, 1-18 years). The percentages of male and female patients were 74.5% (76/102) and 25.5% (26/102), respectively. The most common etiologic factors were congenital/developmental anomalies (51/102, 50%), followed by simple myopia (34/102, 33.3%) and previous intraocular surgery (6/102, 5.9%). More than half (31/51, 60.8%) of the patients with congenital/developmental anomalies had familial exudative vitreoretinopathy. Further analysis of the underlying etiologic factors based on age revealed that the most common etiology of RRD in patients ≤12 years of age was congenital/developmental anomalies (28/48, 58.3%); however, simple myopia was the major etiologic factor in patients >12 years of age (27/54, 50%).
CONCLUSIONS: Congenital/developmental diseases were the most common etiologies of pediatric nontraumatic RRD in China. Familial exudative vitreoretinopathy accounted for most of the congenital/developmental anomalies.

PMID: 32112773 [PubMed - indexed for MEDLINE]

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Generation of a human induced pluripotent stem cell line (CPGHi001-A) from a hearing loss patient with the TMC1 p.M418K mutation.

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Generation of a human induced pluripotent stem cell line (CPGHi001-A) from a hearing loss patient with the TMC1 p.M418K mutation.

Stem Cell Res. 2020 Sep 03;49:101982

Authors: Wang H, Wu K, Guan J, Wang Q

Abstract
By using a nonintegrating plasmid delivery system, we generated induced pluripotent stem cells (iPSCs) from the urine cells of a male patient from the family carrying the TMC1 p.M418K mutation. This mutation is homologous to that in Beethoven mice, which were treated by gene editing successfully. The resulting iPSCs had a normal karyotype, showed pluripotency by immunofluorescence staining, and differentiated into the three germ layers in vivo. This cellular model will provide a useful platform for investigating the pathogenic mechanisms of TMC1-related deafness, further laying the foundation for clinical transformation applications and providing a reference for the final gene therapy in humans.

PMID: 33217648 [PubMed - as supplied by publisher]

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[Application of iPS Cell-Derived NKT Cells to Cancer Immunotherapy].

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[Application of iPS Cell-Derived NKT Cells to Cancer Immunotherapy].

Gan To Kagaku Ryoho. 2020 Oct;47(10):1411-1414

Authors: Motohashi S, Iinuma T, Kurokawa T, Koseki H

Abstract
NKT cells are innate lymphocytes that express an invariant T cell receptor. Since activated NKT cells exert strong anti-tumor responses, NKT cells have been intensively studied for the purpose of their application to cancer immunotherapeutic approaches. Although human peripheral blood contained a very low fraction of NKT cells, and decreased number of NKT cells was also demonstrated in cancer-bearing patients, peripheral blood NKT cells can be activated by ligand-pulsed antigen presenting cells, and can produce a large amount of interferon-γ upon activation. The clinical trials of adoptive transfer of autologous NKT cells were already performed in patients with non-small cell lung cancer, and with head and neck cancer at Chiba University to show its effectiveness and limitation. Meanwhile, RIKEN reported NKT cell regeneration using iPS cell technology in mice, and subsequently established a protocol for regenerating NKT cells from human peripheral blood NKT cells using iPS c ell technology. It was confirmed that the iPS cell-derived NKT cells (iPS-NKT) have sufficient expansion c apacity and potent direct and indirect cytotoxic activity in the humanized mice models, which suggests their therapeutic competence. We are currently planning an investigator-initiated clinical trial of allogeneic iPS-NKT cell therapy for head and neck cancer.

PMID: 33130731 [PubMed - indexed for MEDLINE]

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Routine restaging after primary non-surgical treatment of laryngeal squamous cell carcinoma-a review.

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Routine restaging after primary non-surgical treatment of laryngeal squamous cell carcinoma-a review.

Strahlenther Onkol. 2020 Nov 20;:

Authors: Seebauer CT, Hackenberg B, Grosse J, Rennert J, Jung EM, Ugele I, Michaelides I, Mehanna H, Hautmann MG, Bohr C, Künzel J

Abstract
PURPOSE: Treatment of patients with laryngeal squamous cell carcinoma with radiotherapy or chemoradiation is an established alternative to laryngeal surgery in many cases, but particularly for advanced tumors without cartilage invasion. Imaging modalities face the challenge of distinguishing between posttherapeutic changes and residual disease in the complex anatomic subsite of the larynx. Guidelines concerning restaging of head and neck squamous cell carcinomas (HNSCC) are presented by the National Comprehensive Cancer Network (NCCN) and other national guidelines, but clearly defined recommendations for routine restaging particularly for laryngeal cancer are lacking.
METHODS: A systematic search was carried out in PubMed to identify studies evaluating routine restaging methods after primary non-surgical treatment of laryngeal squamous cell carcinoma from 2009 to 2020.
RESULTS: Only three studies were deemed eligible, as they included at least ≥50% patients with laryngeal squamous cell carcinoma and evaluated imaging modalities to detect residual cancer. The small number of studies in our review suggest restaging with fluoro-deoxy-glucose positron-emission tomography/computed tomography (FDG PET/CT) 3 months after initial treatment, followed by direct laryngoscopy with biopsy of the lesions identified by FDG PET/CT.
CONCLUSION: Studies evaluating restaging methods after organ-preserving non-surgical treatment of laryngeal carcinoma are limited. As radiotherapy (RT), chemoradiotherapy (CRT), systemic therapy followed by RT and radioimmunotherapy are established alternatives to surgical treatment, particularly in advanced laryngeal cancers, further studies are needed to assess and compare different imaging modalities (e.g. PET/CT, MRI, CT, ultrasound) and clinical diagnostic tools (e.g., video laryngoscopy, direct laryngoscopy) to offer patients safe and efficient restaging strategies. PET or PET/CT 3 months after initial treatment followed by direct laryngoscopy with biopsy of the identified lesions has the potential to reduce the number of unnecessary laryngoscopies.

PMID: 33216194 [PubMed - as supplied by publisher]

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speech and language; +32 new citations

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1
Acta Otolaryngol
2020 Jan;140(1):14-21. doi: 10.1080/00016489.2019.1692147. Epub 2019 Nov 25.
Electrically evoked ABR during cochlear implantation and postoperative development of speech and hearing abilities in infants with common cavity deformity as a type of inner ear malformation
Kimitaka Kaga 1 2, Shujiro Minami 3, Chieko Enomoto 3
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PMID: 31762359 DOI: 10.1080/00016489.2019.1692147
Abstract
Background: The electrically evoked auditory brainstem response (eABR) during cochlear implantation in common cavity (CC) deformity has not been clinically well studied.Aim/Objective: To investigate the eABR wave configuration during cochlear implantation, the postoperative development of hearing, and educational settings in infants with CC deformity.Materials and Methods: Nine infants who were congenitally deaf and found to have CC deformity and suspected cochlear nerve deficiency by temporal bone CT and MRI were studied. All of them underwent sequential and unilateral cochlear implantation and their eABRs were recorded during the surgery. The postoperative development was followed up.Results: eABRs of all the nine infants with CC deformity showed that the mean peak of the evoked wave V (eV) was the same as that in controls at latencies but was twofold higher than that in controls at thresholds and their postoperative hearing thresholds improved markedly.Conclusion and Significance: The brainstem auditory pathways of the infants were considered intact on the basis of the eV peak latencies in the eABRs. The postoperative development of their speech and hearing abilities and their educational settings varied, probably because of the twofold higher thresholds of their eABRs and limited number of auditory neural units.

Keywords: common cavity; eABR; educational settings; inner ear malformation; speech.

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Braz J Otorhinolaryngol
Nov-Dec 2020;86(6):720-726. doi: 10.1016/j.bjorl.2019.05.006. Epub 2019 Jun 18.
Development of auditory and language skills in children using cochlear implants with two signal processing strategies
Tatiana Mendes de Melo 1, Elisabete Honda Yamaguti 2, Adriane Lima Mortari Moret 3, Orozimbo Alves Costa 4, Natália Barreto Frederigue Lopes 3
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PMID: 31324459 DOI: 10.1016/j.bjorl.2019.05.006
Free article
Abstract
Introduction: The increase in the spectral information offered by the sound processing strategy HiRes 120 has led to great expectations for the pediatric population. Due to a shorter duration of auditory deprivation and higher neural plasticity, children could benefit more substantially from the spectral information of this sound processing strategy.

Objective: To compare auditory and language skills in Brazilian children with cochlear implants using the HiRes and HiRes 120 sound processing strategies.

Methods: Thirty children, aged 1-3 years, with congenital hearing loss, were divided into two groups, according to the signal processing strategy adjusted at the time of the cochlear implant activation. The assessed children were matched according to chronological age and the time of the cochlear implant use. The auditory and language skills were evaluated longitudinally through the Infant-Toddler Meaningful Auditory Integration Scale and Production Infant Scale Evaluation, carried out before surgery, and 3, 6 and 12 months after device implantation. The Mann-Whitney test was applied for the comparison between the two groups with a 5% significance level.

Results: The findings indicated development of hearing and language skills in the first year of cochlear implant use; however, there was no statistically significant difference in the evolution of such skills due to the adjusted processing strategy in the activation of the cochlear implant electrodes.

Conclusion: The development of auditory and language skills in the assessed children was similar during the entire study period, regardless of which signal processing strategy was used.

Keywords: Auditory perception; Child; Cochlear implant; Criança; Hearing loss; Implante coclear; Language; Linguagem; Percepção auditiva; Perda auditiva.

Copyright © 2019 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

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Trends Hear
Jan-Dec 2020;24:2331216520960601. doi: 10.1177/2331216520960601.
Audiovisual Speech Recognition With a Cochlear Implant and Increased Perceptual and Cognitive Demands
Anna R Tinnemore 1, Sandra Gordon-Salant 1, Matthew J Goupell 1
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PMID: 33054620 PMCID: PMC7575283 DOI: 10.1177/2331216520960601
Free PMC article
Abstract
Speech recognition in complex environments involves focusing on the most relevant speech signal while ignoring distractions. Difficulties can arise due to the incoming signal's characteristics (e.g., accented pronunciation, background noise, distortion) or the listener's characteristics (e.g., hearing loss, advancing age, cognitive abilities). Listeners who use cochlear implants (CIs) must overcome these difficulties while listening to an impoverished version of the signals available to listeners with normal hearing (NH). In the real world, listeners often attempt tasks concurrent with, but unrelated to, speech recognition. This study sought to reveal the effects of visual distraction and performing a simultaneous visual task on audiovisual speech recognition. Two groups, those with CIs and those with NH listening to vocoded speech, were presented videos of unaccented and accented talkers with and without visual distractions, and with a secondary task. It was hypothesized that, compa red with those with NH, listeners with CIs would be less influenced by visual distraction or a secondary visual task because their prolonged reliance on visual cues to aid auditory perception improves the ability to suppress irrelevant information. Results showed that visual distractions alone did not significantly decrease speech recognition performance for either group, but adding a secondary task did. Speech recognition was significantly poorer for accented compared with unaccented speech, and this difference was greater for CI listeners. These results suggest that speech recognition performance is likely more dependent on incoming signal characteristics than a difference in adaptive strategies for managing distractions between those who listen with and without a CI.

Keywords: attention; cochlear implants; perceptual masking; speech perception; visual perception.

64 references2 figures
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4
Guideline Anaesthesia
2020 Dec;75(12):1659-1670. doi: 10.1111/anae.15120. Epub 2020 Jun 5.
Multidisciplinary guidance for safe tracheostomy care during the COVID-19 pandemic: the NHS National Patient Safety Improvement Programme (NatPatSIP)
B A McGrath 1, N Ashby 2, M Birchall 3, P Dean 4, C Doherty 5, K Ferguson 6, J Gimblett, M Grocott 7, T Jacob 8, C Kerawala 9, P Macnaughton 10, P Magennis 11, R Moonesinghe 12, P Twose 13, S Wallace 14, A Higgs 15
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PMID: 32396986 PMCID: PMC7272992 DOI: 10.1111/anae.15120
Free PMC article
Abstract
The COVID-19 pandemic is causing a significant increase in the number of patients requiring relatively prolonged invasive mechanical ventilation and an associated surge in patients who need a tracheostomy to facilitate weaning from respiratory support. In parallel, there has been a global increase in guidance from professional bodies representing staff who care for patients with tracheostomies at different points in their acute hospital journey, rehabilitation and recovery. Of concern are the risks to healthcare staff of infection arising from tracheostomy insertion and caring for patients with a tracheostomy. Hospitals are also facing extraordinary demands on critical care services such that many patients who require a tracheostomy will be managed outside established intensive care or head and neck units and cared for by staff with little tracheostomy experience. These concerns led NHS England and NHS Improvement to expedite the National Patient Safety Improvement Programme's 'Safe Tracheostomy Care' workstream as part of the NHS COVID-19 response. Supporting this workstream, UK stakeholder organisations involved in tracheostomy care were invited to develop consensus guidance based on: expert opinion; the best available published literature; and existing multidisciplinary guidelines. Topics with direct relevance for frontline staff were identified. This consensus guidance includes: infectivity of patients with respect to tracheostomy indications and timing; aerosol-generating procedures and risks to staff; insertion procedures; and management following tracheostomy.

Keywords: COVID-19; coronavirus; personal protective equipment; tracheostomy.

© 2020 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists.

Cited by 8 articles64 references
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Review Can Fam Physician
2020 Nov;66(11):803-809.
Approach to hearing loss
Daniel Newsted 1, Emily Rosen 2, Bonnie Cooke 2, Michael M Beyea 3, Matthew T W Simpson 4, Jason A Beyea 5
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PMID: 33208419
Free article
Abstract
Objective: To provide family physicians with a practical evidence-based approach to the management of patients with hearing loss.

Sources of information: MEDLINE and PubMed databases were searched for English-language hearing loss research, review articles, and guidelines published between 1980 and 2020. Most of the retrieved articles provided level II or III evidence.

Main message: Hearing loss is one of the most common sensory impairments worldwide and causes great detriment to a patient's overall well-being by affecting physical health, finances, social inclusion, and mental health. A robust clinical assessment of hearing loss includes a history and physical examination that effectively characterizes the deficit as conductive, sensorineural, or mixed. Patients presenting with red flags (such as sudden unilateral sensorineural hearing loss) must be urgently referred to otolaryngology-head and neck surgery or immediately assessed in the emergency department. Many nonurgent presentations of hearing loss will also require referral for further audiological assessment, diagnosis, and management.

Conclusion: As primary care providers, family physicians are well equipped to manage the psychological concerns associated with hearing loss and to reinforce conservative treatment strategies. Frequently, referral or urgent workup, including imaging, is necessary to confirm a patient's diagnosis and initiate management in order to prevent further complications.

Copyright© the College of Family Physicians of Canada.

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Randomized Controlled Trial Behav Cogn Psychother
2020 Sep;48(5):557-571. doi: 10.1017/S135246582000017X. Epub 2020 Apr 17.
Exploring the impact of safety behaviour use on cognitive, psychophysiological, emotional and behavioural responses during a speech task
Jessica S Tutino 1, Allison J Ouimet 1, Ryan J Ferguson 1
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PMID: 32301412 DOI: 10.1017/S135246582000017X
Abstract
Background: There is a debate among researchers and clinicians regarding whether the judicious use of safety behaviours (SBs) during exposure therapy is helpful or detrimental. Central to this debate is the premise that SBs may interfere with one's ability to gather disconfirmatory evidence.

Aims: No study to date has assessed how SB use may impact cognitive mechanisms implicated during an exposure-like task. We investigated multiple cognitive, emotional, psychophysiological and behavioural underpinnings of exposure with and without SBs.

Method: Speech anxious participants (n = 111) were randomly assigned to deliver an evaluated speech with or without SBs. Self-reported anxiety ratings and psychophysiological arousal measures were recorded at baseline, in anticipation of the speech, and following the speech. Measures of working memory, ability to gather disconfirmatory evidence, speech duration, objective and subjective speech performance, and speech task acceptability were administered.

Results: There were no differences between conditions on working memory, self-reported anxiety, psychophysiological arousal, ability to gather disconfirmatory evidence, speech duration, or objective and subjective speech performance. All participants were able to gather disconfirmatory evidence. However, condition did influence willingness to deliver future speeches. Our sample was largely female undergraduate students, and we offered only a small number of specific safety behaviours.

Conclusions: Judicious SB use may not necessarily be detrimental, but clients may believe them to be more helpful than they actually are.

Keywords: anxiety; cognitive behavioural therapy; exposure therapy; safety behaviours.

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7
Review Int J Semiot Law
2020 Oct 24;1-41. doi: 10.1007/s11196-020-09794-7. Online ahead of print.
La terminologie juridique
Pierre Lerat 1
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PMID: 33214740 PMCID: PMC7585489 DOI: 10.1007/s11196-020-09794-7
Free PMC article
Abstract
There are many ways to approach and analyze juridical terminology. Every approach is useful, even though for a great number of linguists juridical vocabulary is not really considered as a terminology. The first part of this paper is devoted to the presentation of the state of art in the field under scrutiny, including traditional approaches (savant language, technical language, pure language, 'general' theory of terminology) and more recent approaches (socioterminology, text mining terminology, communicative theory of terminology, frame terminology, sociocognitive approach, pragmaterminological approach). The second part explains how the philosophy of language can shed some light on juridical terminology. For this branch of human sciences, legal words and groups of words are lexical units used in legal discourses. Thus, relevant analysis perspectives include enunciation, reference, extension, predication and speech acts.

Keywords: Discourse; Language; Law; Terminology.

© Springer Nature B.V. 2020.

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8
Trends Hear
Jan-Dec 2020;24:2331216519896908. doi: 10.1177/2331216519896908.
Benefits of Beamforming With Local Spatial-Cue Preservation for Speech Localization and Segregation
Le Wang 1, Virginia Best 2, Barbara G Shinn-Cunningham 3
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PMID: 31931677 PMCID: PMC6961143 DOI: 10.1177/2331216519896908
Free PMC article
Abstract
A study was conducted to examine the benefits afforded by a signal-processing strategy that imposes the binaural cues present in a natural signal, calculated locally in time and frequency, on the output of a beamforming microphone array. Such a strategy has the potential to combine the signal-to-noise ratio advantage of beamforming with the perceptual benefit of spatialization to enhance performance in multitalker mixtures. Participants with normal hearing and with hearing loss were tested on both speech localization and speech-on-speech masking tasks. Performance for the spatialized beamformer was compared with that for three other conditions: a reference condition with no processing, a beamformer with no spatialization, and a hybrid beamformer that operates only in the high frequencies to preserve natural binaural cues in the low frequencies. Beamforming with full-bandwidth spatialization supported speech localization and produced better speech reception thresholds than the other c onditions.

Keywords: binaural hearing; cocktail party; hearing aids; hearing loss.

35 references5 figures
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9
Review HNO
2020 Nov;68(11):817-827. doi: 10.1007/s00106-020-00898-x.
[Computer-based auditory training for hearing rehabilitation of adult cochlear implant users]
[Article in German]
C Völter 1, C Schirmer 2 3, C Stöckmann 2, S Dazert 2
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PMID: 32647960 DOI: 10.1007/s00106-020-00898-x
Abstract
Background: Digitalization has become a part of everyday life and digital applications offer an opportunity to promote health. In Germany, hearing rehabilitation after cochlear implantation (CI) typically takes place in specialized audiology centers. However, a variety of new auditory training programs have been developed and although most are for hearing aid users, some are suitable for CI patients. The purpose of this study is to give an overview of CBAT schedules and their effectiveness.

Materials and methods: Currently available English and German CBAT programs for adult CI users identified in searches of Google, Google App Store, and Google Play Store were analyzed. A systematic literature search on studies dealing with CBAT in adult CI recipients from 2000 to 2019 was performed in PubMed, LIVIVO, and Google Scholar.

Results: German and English CBAT for adult hearing aid and CI users are generally intended to complement face-to-face therapies. The content of the programs differs primarily in terms of complexity and quantity of tasks, graphic design, allowed time and the device used. In contrast to the nine available German programs, some of the English CBAT include advanced concepts of adaptivity and feedback. Studies on the effectiveness of CBAT have mainly been conducted for the English versions and generally analyze only individual therapeutic subfunctions. All investigations show a short-term improvement of the auditory subfunction shortly after training. Unfortunately, the quality of the studies is low and follow-up results are only available in two cases.

Conclusion: CBAT programs might be an effective option for auditory rehabilitation in CI patients. However, suitable German-language programs conceived as an alternative to face-to-face training and studies on longterm effects of CBAT are still lacking.

Keywords: Auditory training; CBAT; Cochlear implantation; Rehabilitation.

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Dysphagia
2020 Nov 19. doi: 10.1007/s00455-020-10215-x. Online ahead of print.
High-Volume Billing and Reimbursement Trends for Endoscopic Swallowing Studies in the Medicare Population
David A Kasle 1, Sina J Torabi 1, Emily L Savoca 1, Michael Lerner 1, R Peter Manes 2
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PMID: 33215264 DOI: 10.1007/s00455-020-10215-x
Abstract
The aim of this study is to delineate the reimbursement trends in fiberoptic endoscopic evaluation of swallowing with sensory testing (FEESST) and without sensory testing (FEES) in relation to that of speech-language pathology's (SLP) portion of modified barium swallow studies (MBS), as well as to document the types of providers billing for these procedures. We performed descriptive analyses of the volume of FEES/FEESST and MBS, and total reimbursements data obtained from 2013-2018 Medicare Part B National Summary files. We also utilized the 2017 Medicare Provider Utilization and Payment Data to analyze the higher volume providers (> 10 procedures annually) of either FEES and/or FEESST. From 2003 to 2018, there has been an average, annual increase of approximately 318 FEES/FEESST performed within the Medicare fee-for-service population (R = 0.9505 [95% CI 0.860-0.983]; p < 0.001) covered under Part B (which is largely outpatient coverage). Similarly, there was an increase in Medicare -specific FEES/FEESST reimbursement from $302,840 in 2003 to $1.2 million in 2018 (R = 0.9721 [95% CI 0.920-0.990; p < 0.001]). Prior to 2010, FEESST was performed more frequently than FEES (maximum annual difference of 1174), though from 2010 onward, relatively more annual FEES was performed. From 2003-2018, the reimbursement per procedure increased by $16.79 and $35.36 for FEESST and FEES, respectively, and by $32.84 for the SLP portion of the MBS. Among high-volume FEES/FEESST billers, 65.4% were otolaryngologists and 32.3% were independently billing SLPs. From 2003 to 2018, there has been a significant rise in the number of performed and reimbursed FEES/FEESST. From 2014 onward, compared to SLP-involved MBS, there has been a relative increase in performance of FEES/FEESST.

Keywords: Billing; FEES; FEESST; MBS; Medicare; Reimbursement.

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11
Review J Voice
2020 Nov 17;S0892-1997(20)30415-X. doi: 10.1016/j.jvoice.2020.11.003. Online ahead of print.
Factors Associated With the Limitation at Work Because of the Voice: Study With Teachers of Basic Education In Brazil
Bárbara Antunes Rezende 1, Mery Natali Silva Abreu 2, Ada Ávila Assunção 3, Adriane Mesquita de Medeiros 4
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PMID: 33214005 DOI: 10.1016/j.jvoice.2020.11.003
Abstract
Introduction: The voice disorder can cause limitations at work, as it affects the communication and the performance of the teaching function.

Objective: To analyze the limitation at work because of the voice and to examine possible associations with sociodemographic characteristics, life and health habits and work conditions among Basic Education teachers in Brazil.

Methods: Cross-sectional epidemiological study, with a representative sample, carried out between October 2015 and March 2016, with 6,324 teachers working in Basic Education in Brazil. Data collection was carried out through the application of a questionnaire via telephone with questions regarding health and working conditions. The "limitation at work because of the voice" was considered a dependent variable, whose response options were a scale with four Likert items that varied from frequently to never. The independent variables were grouped in blocks for ordinal logistic regression analysis with hierarchical entry. The magnitude of the association was assessed by the Odds Ratio (OR) with the respective confidence intervals (95% CI).

Results: One third of Brazilian teachers (32.7%) reported some frequency of limitation at work (sometimes; rarely, frequently) because of the voice at some moment in the month before the survey and, of these, 5% declared high frequency. The factors that increased the chance of a greater frequency of limitation at work because of the voice were: being female (OR = 1.32; 95% CI = 1.15-1.51); teaching for elementary school (OR = 1.35; 95% CI = 1.02-1.78); use anxiolytic or antidepressant medications (OR = 1.46; 95% CI = 1.20-1.78); losing sleep due to concerns (OR = 1.69; CI = 95% = 1.46-1.95); high noise at school (OR = 2.09; 95% CI = 1.78-2.46); agitated environment by students' indiscipline (OR = 1.37; 95% CI =1.15-1.63); high demands at work (OR = 1.18; 95% CI = 1.02-1.36); not having social support (OR = 1.19; 95% CI = 1.04-1.38); having suffered verbal violence by the students (OR = 1.43; 95% CI = 1.23-1.67). On the other hand, the practice of regular physical activity (OR = 0.86; 95% CI = 0.75-1.00) and the fact of having enough time to complete work tasks (OR = 0.71; 95% CI = 0,62-0.82) decreased the chance of a higher frequency of limitation at work due to vocal problems. The perception that the work limits the teaching performance because of the voice was more frequent among teachers in the North (OR=1.41; 95% CI = 1.17-1.71) and Northeast (OR=1.46; 95% CI = 1.22-1.76) compared to the Southeast region.

Conclusion: Factors associated with an increase in the chance of higher frequency of reporting work limitations due to the voice: being female, lack of physical activity, losing sleep due to concern, using anxiolytic or antidepressant medication, school location in the North and Northeast, teaching for the elementary school stage, high noise at school and psychosocial aspects of work organization. The Brazilian educational sector needs public policies that take into account regional inequalities and the health and work conditions of teachers.

Keywords: Working conditions—Occupational health—Voice disorders—School teachers—Epidemiological Surveys.

Copyright © 2020 The Voice Foundation. All rights reserved.

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12
Int J Pediatr Otorhinolaryngol
2020 Nov 4;110484. doi: 10.1016/j.ijporl.2020.110484. Online ahead of print.
A new training package (3Cs: Connect, Communicate and Collaborate) for improving family responsive service delivery in early intervention for children with hearing loss: A proof of concept study
Alyaa Alduhaim 1, Alison Purcell 2, Steven Cumming 2, Maree Doble 2
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PMID: 33213962 DOI: 10.1016/j.ijporl.2020.110484
Abstract
Background: An objective of early intervention for children with hearing loss is to enhance family engagement in therapy to maximise a child's speech and language potential. However, requiring a service provider to work collaboratively with a child's family can create problems in developing and underdeveloped countries, where skilled service providers and services for children with hearing loss are lacking and where an expert model of intervention prevails.

Objectives: To determine the preliminary effectiveness of a new training package Connect, Communicate and Collaborate (3Cs), in improving the knowledge and confidence of service providers in the delivery of family responsive services in an early intervention program for children with hearing loss.

Methods: Five learning modules were developed based on service provider experience working with children with hearing loss, and parents of children with hearing loss. Six participants completed the training package comprising five training modules and an introductory session over a 6-week period. Participants' confidence and knowledge in providing family responsive practice was measured pre and post training using visual analogue scales, and participants were also invited to provide their reflections on the program.

Results: Pre- and post-training confidence ratings revealed significant improvements in the perceptions of participants in the implementation of responsive family practice across four of five of programme learning modules (p < 0.002). Participant reflection statements indicate they became more considerated in their family responsive practice. Despite positive experiences working with parents, participants stated they had ongoing difficulties guiding families through the decision-making processes of habilitation. The reflection process assisted learning and improved practice by supporting participants to build on their strengths.

Conclusion: The 3Cs package improved the confidence in and knowledge of delivery of responsive family services for six participants in Kuwait. It also improved the participant's self-evaluation skills. The 3Cs provides professional development that meets the needs of service providers working with children with hearing loss to improve inclusion of families in the therapy process.

Keywords: Children; Developing country; Hearing loss; Parental engagement; Service delivery; Training programme.

Crown Copyright © 2020. Published by Elsevier B.V. All rights reserved.

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13
BMJ Open
2020 Nov 18;10(11):e040495. doi: 10.1136/bmjopen-2020-040495.
Predicting treatment outcomes for bilinguals with aphasia using computational modeling: Study protocol for the PROCoM randomised controlled trial
Claudia Peñaloza 1, Maria Dekhtyar 2, Michael Scimeca 2, Erin Carpenter 2, Nishaat Mukadam 2, Swathi Kiran 2
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PMID: 33208330 DOI: 10.1136/bmjopen-2020-040495
Free article
Abstract
Introduction: Bilinguals with aphasia (BWA) present varying degrees of lexical access impairment and recovery across their two languages. Because both languages may benefit from therapy, identifying the optimal target language for treatment is a current challenge for research and clinical practice. Prior research has demonstrated that the BiLex computational model can accurately simulate lexical access in healthy bilinguals, and language impairment and treatment response in bilingual aphasia. Here, we aim to determine whether BiLex can predict treatment outcomes in BWA in the treated and the untreated language and compare these outcome predictions to determine the optimal language for rehabilitation.

Methods and analysis: The study involves a prospective parallel-group, double-blind, randomised controlled trial. Forty-eight Spanish-English BWA will receive 20 sessions of semantic treatment for lexical retrieval deficits in one of their languages and will complete assessments in both languages prior and after treatment. Participants will be randomly assigned to an experimental group receiving treatment in the optimal language determined by the model or a control group receiving treatment in the language opposite to the model's recommendation. Primary treatment outcomes include naming probes while secondary treatment outcomes include tests tapping additional language domains. Treatment outcomes will be compared across the two groups using 2×2 mixed effect models for repeated measures Analysis of variance (ANOVA) on metrics of treatment effects commonly employed in rehabilitation studies (ie, effect size and percentage change).

Ethics and dissemination: All procedures included in this protocol (protocol number 29, issue date: 19 March 2019) were approved by the Boston University Charles River Campus Institutional Review Board at Boston, Massachusetts (reference number: 4492E). The results of this study will be published in peer-reviewed scientific journals and will be presented at national and international conferences.

Trial registration number: NCT02916524.

Keywords: adult neurology; anomia therapy; bilingual aphasia; clinical trials; computational modeling; internal medicine; neurology; randomized controlled trial; rehabilitation; rehabilitation medicine; semantic treatment; stroke; therapeutics.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Conflict of interest statement
Competing interests: SK serves as a consultant for The Learning Corporation with no scientific overlap with the present study. Claudia Peñaloza, Michael Scimeca and Erin Carpenter are currently employed by Boston University under NIH/NIDCD grant number U01DC014922 awarded to SK.

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14
Psychophysiology
2020 Nov 18;e13714. doi: 10.1111/psyp.13714. Online ahead of print.
The effects of age on resting-state BOLD signal variability is explained by cardiovascular and cerebrovascular factors
Kamen A Tsvetanov 1 2, Richard N A Henson 3 4, P Simon Jones 2, Henk Mutsaerts 5, Delia Fuhrmann 3, Lorraine K Tyler 2, Cam-CAN; James B Rowe 1 3
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PMID: 33210312 DOI: 10.1111/psyp.13714
Abstract
Accurate identification of brain function is necessary to understand neurocognitive aging, and thereby promote health and well-being. Many studies of neurocognitive aging have investigated brain function with the blood-oxygen level-dependent (BOLD) signal measured by functional magnetic resonance imaging. However, the BOLD signal is a composite of neural and vascular signals, which are differentially affected by aging. It is, therefore, essential to distinguish the age effects on vascular versus neural function. The BOLD signal variability at rest (known as resting state fluctuation amplitude, RSFA), is a safe, scalable, and robust means to calibrate vascular responsivity, as an alternative to breath-holding and hypercapnia. However, the use of RSFA for normalization of BOLD imaging assumes that age differences in RSFA reflecting only vascular factors, rather than age-related differences in neural function (activity) or neuronal loss (atrophy). Previous studies indicate that two vasc ular factors, cardiovascular health (CVH) and cerebrovascular function, are insufficient when used alone to fully explain age-related differences in RSFA. It remains possible that their joint consideration is required to fully capture age differences in RSFA. We tested the hypothesis that RSFA no longer varies with age after adjusting for a combination of cardiovascular and cerebrovascular measures. We also tested the hypothesis that RSFA variation with age is not associated with atrophy. We used data from the population-based, lifespan Cam-CAN cohort. After controlling for cardiovascular and cerebrovascular estimates alone, the residual variance in RSFA across individuals was significantly associated with age. However, when controlling for both cardiovascular and cerebrovascular estimates, the variance in RSFA was no longer associated with age. Grey matter volumes did not explain age differences in RSFA, after controlling for CVH. The results were consistent between voxel-level ana lysis and independent component analysis. Our findings indicate that cardiovascular and cerebrovascular signals are together sufficient predictors of age differences in RSFA. We suggest that RSFA can be used to separate vascular from neuronal factors, to characterize neurocognitive aging. We discuss the implications and make recommendations for the use of RSFA in the research of aging.

Keywords: aging; cerebral vascular reactivity; functional magnetic resonance imaging (fMRI); individual differences.

© 2020 The Authors. Psychophysiology published by Wiley Periodicals LLC on behalf of Society for Psychophysiological Research.

129 references
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15
Int J Semiot Law
2020 Aug 25;1-28. doi: 10.1007/s11196-020-09765-y. Online ahead of print.
"You are in Trouble!": A Discursive Psychological Analysis of Threatening Language in Chinese Cellphone Fraud Interactions
Jinshi Chen 1
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PMID: 33214738 PMCID: PMC7447206 DOI: 10.1007/s11196-020-09765-y
Free PMC article
Abstract
Currently cellphone fraudsters often use language to threaten and bully victims. From discursive psychological perspective, the present study applies conversation analysis to discuss fraudsters' threatening language in Chinese cellphone fraud conversations. The authentic data are collected from Chinese media which report legal news or conduct public legal education on the battle against cellphone frauds. Results of the study show that: (1) cellphone fraudsters construct their false identities through information gap and information sharing in their turn-taking designs, which brings victims into the threatening fraud interactions; (2) fraudsters use such conversational skills in a threatening tone as repetition, interruption, higher pitch, louder speech and so on to trigger victims' psychological panic; (3) fraudsters' discursive practices are situated for the threatening actions based on prepared and designed scripts. The findings of the study are expected to provide references for p reventing cellphone fraud and fighting against fraudsters' threats and bullies.

Keywords: Cellphone fraud; Conversation analysis; Discursive psychology; Threatening language.

© Springer Nature B.V. 2020.

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16
Dysphagia
2020 Nov 19. doi: 10.1007/s00455-020-10216-w. Online ahead of print.
Effects of Tongue-Strengthening Self-Exercises in Healthy Older Adults: A Non-Randomized Controlled Trial
Jitsuro Yano 1, Shinsuke Nagami 2, Tomonori Yokoyama 3 4, Katsuya Nakamura 5 6, Miyu Kobayashi 7, Yuki Odan 7, Miyako Hikasa 8, Kozo Hanayama 9, Shinya Fukunaga 2
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PMID: 33215265 DOI: 10.1007/s00455-020-10216-w
Abstract
Tongue-strengthening exercises (TSE) using a device have been proposed as an intervention for improving tongue strength and endurance. However, devices for TSE have been expensive and difficult to manipulate and are not commonly used in home or clinical settings. This study therefore aimed to investigate whether tongue-strengthening self-exercises (TSsE) using a tongue-strengthening self-exercise tool at home can improve tongue strength in healthy older adults. This study included 27 participants (exercise group, η = 16, 7 men, 9 women, median age 84.5 years; control group, n = 11, 2 men, 9 women, median age 79.0 years). Exercises in the exercise group consisted of pushing the anterior tongue against the hard palate 30 times, 3 times a day, 5 days a week, for 8 weeks using a tongue-strengthening self-exercise tool. This tool is available in five levels of hardness. The most suitable hardness of the tool for each participant was calculated based on 60% of maximum tongue pressure (MTP ) during the first 2 weeks of the training period and 80% of MTP for the remainder of the training period, as assessed using a tongue pressure-measuring device. The exercise group showed a significant improvement of 4.1 kPa in MTP (an 11.53% increase) and 4.53 s in endurance of tongue pressure (ETP) (a 99.86% increase). Furthermore, adherence in the exercise group was 99.2%. In conclusion, performing TSsE for 8 weeks was effective for increasing MTP and ETP in healthy older adults. This indicates that TSsE may be useful in older individuals at home to prevent age-related tongue muscle weakness.

Keywords: Dysphagia; Home-based exercise; Self-exercise; Swallow; Tongue pressure; Tongue strength.

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17
Int J Audiol
2020 Nov 18;1-9. doi: 10.1080/14992027.2020.1846088. Online ahead of print.
Validation of the Brief International Classification of Functioning, Disability and Health (ICF) core set for hearing loss: an international multicentre study
Elin Karlsson 1 2 3, Elina Mäki-Torkko 1 3 4, Stephen Widén 1 2 3, Johanna Gustafsson 1 2 3, Vinaya Manchaiah 5, Faheema Mahomed-Asmail 6, De Wet Swanepoel 6, Krishna Yerraguntla 7, Sarah Granberg 1 2 3
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PMID: 33207960 DOI: 10.1080/14992027.2020.1846088
Abstract
Objective: Hearing loss (HL) affects the everyday functioning of millions of people worldwide. The Brief International Classification of Functioning Disability and Health (ICF) core sets for HL was developed to meet the complex health care needs of adults with HL. Because the brief core set for HL has not yet been validated internationally, this study aimed to investigate its validity from an international perspective.

Design: A cross-sectional validation study based on data from structured interviews with adults with HL.

Study sample: Participants (n = 571) from India, South Africa, Sweden and the US were included.

Results: A six-factor solution explained 71% of the variance, focussing on issues related to communication, the social environment, participation in society, health care services, support, relationships and emotions (α = 0.915). Three ICF categories demonstrated low reliability - temperament and personality functions, seeing functions and school education.

Conclusion: The Brief ICF core set for HL is valid for adults with HL internationally. However, to further increase its international validity, we recommend adding the categories d920 recreation and leisure and replacing d850 school education with the more inclusive block, d810-d839 education.

Keywords: Disability and Health; Hearing loss; International Classification of Functioning; core set; outcome measure; psychometrics; validation.

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18
Dev Sci
2020 Nov 20;e13065. doi: 10.1111/desc.13065. Online ahead of print.
Remediation of a Phonological Representation Deficit in Chinese Children with Dyslexia: A Comparison between Metalinguistic Training and Working Memory Training
Jie Wang 1, Ka Chun Wu 2, Jianhong Mo 2, Wai Leung Wong 2, Tik Sze Carrey Siu 3, Catherine McBride 2 4, Kevin Kien Hoa Chung 3, Patrick C M Wong 4 5, Urs Maurer 2 4
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PMID: 33217109 DOI: 10.1111/desc.13065
Abstract
A form-preparation task in the language production field was adopted to examine output phonological representations in Chinese dyslexia and their susceptibility to training. Forty-one Chinese children with dyslexia (7-11 years old) and thirty-six chronological age controls completed this task. The controls demonstrated a marginally significant syllable facilitation effect (d = -0.13), indicating their use of syllable-sized phonological representations during speech production, while the group with dyslexia showed a significantly different pattern (d = 0.04), opposite to the direction of a facilitation effect. The children with dyslexia were then randomly assigned to either metalinguistic training (N = 22) or working memory training (N = 19). Only the metalinguistic training subgroup demonstrated a significant syllable facilitation effect afterward (metalinguistic: d = -0.13; working memory: d = -0.01). The results suggest the presence of a phonological representation deficit at the s yllable level in Chinese dyslexia and its possible remediation by metalinguistic training. Such a phonological deficit in readers of a logographic script strongly supports the impaired phonological representations view of developmental dyslexia.

Keywords: Dyslexia; Phonological deficit; Training.

This article is protected by copyright. All rights reserved.

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19
J Autism Dev Disord
2020 Nov 20. doi: 10.1007/s10803-020-04796-7. Online ahead of print.
Lifelong Tone Language Experience does not Eliminate Deficits in Neural Encoding of Pitch in Autism Spectrum Disorder
Joseph C Y Lau 1 2 3 4 5, Carol K S To 6, Judy S K Kwan 1 7, Xin Kang 1 2, Molly Losh 3, Patrick C M Wong 8 9
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PMID: 33216279 DOI: 10.1007/s10803-020-04796-7
Abstract
Atypical pitch processing is a feature of Autism Spectrum Disorder (ASD), which affects non-tone language speakers' communication. Lifelong auditory experience has been demonstrated to modify genetically-predisposed risks for pitch processing. We examined individuals with ASD to test the hypothesis that lifelong auditory experience in tone language may eliminate impaired pitch processing in ASD. We examined children's and adults' Frequency-following Response (FFR), a neurophysiological component indexing early neural sensory encoding of pitch. Univariate and machine-learning-based analytics suggest less robust pitch encoding and diminished pitch distinctions in the FFR from individuals with ASD. Contrary to our hypothesis, results point to a linguistic pitch encoding impairment associated with ASD that may not be eliminated even by lifelong sensory experience.

Keywords: Autism Spectrum Disorder; Frequency-following responses; Machine-learning; Neural pitch encoding; Tone language.

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20
Neuropsychology
2020 Nov 19. doi: 10.1037/neu0000708. Online ahead of print.
Alterations of procedural memory consolidation in children with developmental dyslexia
Martina Hedenius 1, Jarrad A G Lum 2, Sven Bölte 3
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PMID: 33211512 DOI: 10.1037/neu0000708
Abstract
Objective: The objective of the present study was to determine if consolidation of procedural memory in developmental dyslexia (DD) may be supported by prolonging the initial learning session. Method: Children with DD (n = 31) and typically developing (TD) children (n = 34) were given a procedural (implicit sequence) learning task over two sessions, separated by a 24-hr interval. Session 1 was prolonged with 50% compared with previous studies of procedural memory consolidation in DD. Results: The amount of sequence learning was similar in the two groups at the end of Session 1 (p = .797, ηρ² = .001). At the follow-up session after 24 hr, performance in the DD group was poorer compared with the TD group (p = .003, ηρ² = .129). The amount of sequence knowledge in Session 2 predicted unique variance in reading fluency (p = .024, ηρ² = 0.083), independent of children's phoneme awareness and inattention symptoms. Conclusion: The present study shows that consolidation of procedura l memory is impaired in DD, even when the initial learning session is prolonged. The findings encourage further research on the mechanisms supporting procedural memory consolidation in children with DD, and how these may be strengthened. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

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