THE USE OF CLASSIFIERS IN VIETNAMESE IN TYPICAL AND ATYPICAL LANGUAGE DEVELOPMENT.

The acquisition of numeral classifiers and their associated syntactic structures has been documented and studied in a broad range of East and Southeast Asian languages among typically-developing (TD) young speakers. However, little research has considered how classifiers are acquired by children with developmental language disorder (DLD). The current paper compares and analyzes the development of numeral classifier patterns among a set of Vietnamese speakers, TD and DLD, studied over three years, from kindergarten to second grade. The investigation highlights differences in the performance of children with TD and DLD and describes the areas of classifier use that seem to be most challenging. Children with DLD produced more errors of classifier omission in kindergarten, showed more random alternations in representational forms, and delays in the development of three element classifier structures. Findings are discussed in terms of future directions in the study of classifier use in Vietnamese speakers with DLD.

Third-party virus specific T cells for the treatment of double stranded DNA viral reactivation and PTLD after solid organ transplant.

Reactivation or primary infection with double stranded DNA viruses is common in recipients of solid organ transplants and is associated with significant morbidity and mortality. Treatment with conventional anti-viral medications is limited by toxicities, resistance, and lack of effective options for adenovirus and BKPyV. Virus-specific T-cells (VSTs) have been shown to be an effective treatment for infections with adenovirus, BKPyV, cytomegalovirus (CMV), and Epstein-Barr virus (EBV). Most of these studies have been conducted in stem cell recipients and no large studies have been published in the solid organ transplant population to date. In this study we report on the outcome of quadrivalent third party VST infusions in 98 recipients of solid organ transplants in the context of an open label phase 2 trial. The ninety-eight patients received a total of 181 infusions, with a median of 2 infusions per patient. The overall response rate was 45% for BKPyV, 65% for CMV, 68% for Adenovirus, and 61% for EBV. Twenty percent of patients with PTLD had a complete response and 40% a partial response. All the VST infusions were well tolerated. We conclude that VSTs are safe and effective in the treatment of viral infections in solid organ transplant recipients.

Genomic Insights for Personalized Care: Motivating At-Risk Individuals Toward Evidence-Based Health Practices.

Lung cancer and tobacco use pose significant global health challenges and require a comprehensive translational roadmap for improved prevention strategies. We propose the GREAT care paradigm ( G enomic Informed Care for Motivating High R isk Individuals E ligible for Evidence-b a sed Prevention), which employs polygenic risk scores (PRSs) to stratify disease risk and personalize interventions, such as lung cancer screening and tobacco treatment. We developed PRSs using large-scale multi-ancestry genome-wide association studies and adjusted for genetic ancestry for standardized risk stratification across diverse populations. We applied our PRSs to over 340,000 individuals of diverse ethnic background and found significant odds ratios for lung cancer and difficulty quitting smoking. These findings enable the evaluation of PRS-based interventions in ongoing trials aimed at motivating health behavior changes in high-risk patients. This pioneering approach enhances primary care with genomic insights, promising improved outcomes in cancer prevention and tobacco treatment, and is currently under assessment in clinical trials.

Marine Bromotyrosine Derivatives in Spotlight: Bringing Discoveries and Biological Significance.

The Verongida order comprises several sponge families, such as Aplysinellidae, Aplysinidae, Ianthellidae, and Pseudoceratinidae, reported for producing bromotyrosine-derived compounds. First identified in 1913, bromotyrosine derivatives have since captivated interest notably for their antitumor and antimicrobial properties. To date, over 360 bromotyrosine derivatives have been reported. Our review focuses specifically on bromotyrosine derivatives newly reported from 2004 to 2023, by summarizing current knowledge about their chemical diversity and their biological activities.

Circulating Tumor Reactive KIR+CD8+ T cells Suppress Anti-Tumor Immunity in Patients with Melanoma.

Effective anti-tumor immunity is largely driven by cytotoxic CD8+ T cells that can specifically recognize tumor antigens. However, the factors which ultimately dictate successful tumor rejection remain poorly understood. Here we identify a subpopulation of CD8+ T cells which are tumor antigen-specific in patients with melanoma but resemble KIR+CD8+ T cells with a regulatory function (Tregs). These tumor antigen-specific KIR+CD8+ T cells are detectable in both the tumor and the blood, and higher levels of this population are associated with worse overall survival. Our findings therefore suggest that KIR+CD8+ Tregs are tumor antigen-specific but uniquely suppress anti-tumor immunity in patients with melanoma.

Health system barriers to the implementation of the national action plan to combat antimicrobial resistance in Vietnam: a scoping review.

BACKGROUND: Vietnam is among 11 countries in the Western Pacific region that has developed a National Action Plan for Antimicrobial Resistance (NAPCA). METHODS: This scoping review characterises health system barriers to the implementation of the Vietnam NAPCA, with reference to the WHO Health Systems Framework. RESULTS: Over 7 years, between 2013 and 2020, the Ministry of Health (MOH) of Vietnam has been implementing activities to achieve the six NAPCA objectives. They include revision of regulations needed for antimicrobial resistance (AMR) prevention programs; formation and operation of national management bodies; improvement of antimicrobial stewardship (AMS) in hospitals; maintenance of surveillance systems for AMR; provision of trainings on AMR and antibiotics use to doctors and pharmacists; and organization of nation-wide educational campaigns. Limited cooperation between MOH management bodies, shortages of human resource at all health system levels, a low degree of agreement between national and hospital guidelines on antibiotic use, low capability in the domestic supply of standardised drugs, and unequal training opportunities for lower-level health professionals present ongoing challenges. Actions suggested for the next period of the NAPCA include a final review of what has been achieved by the plan so far and evaluating the effectiveness of the different components of the plan. Different options on how to improve coordination across sectors in the development of a new NAPCA should be put forward. CONCLUSIONS: The 6-year implementation of the Vietnam NAPCA has yielded valuable lessons for AMS in Vietnam, guiding the development of future national plans, with a central focus on scaling up AMS in hospitals and promoting community AMS programs to combat AMR.

Pathogenic/likely pathogenic mutations identified in Vietnamese children diagnosed with autism spectrum disorder using high-resolution SNP genotyping platform.

Among the most prevalent neurodevelopmental disorders, Autism Spectrum Disorder (ASD) is highly diverse showing a broad phenotypic spectrum. ASD also couples with a broad range of mutations, both de novo and inherited. In this study, we used a proprietary SNP genotyping chip to analyze the genomic DNA of 250 Vietnamese children diagnosed with ASD. Our Single Nucleotide Polymorphism (SNP) genotyping chip directly targets more than 800 thousand SNPs in the genome. Our primary focus was to identify pathogenic/likely pathogenic mutations that are potentially linked to more severe symptoms of autism. We identified and validated 23 pathogenic/likely pathogenic mutations in this initial study. The data shows that these mutations were detected in several cases spanning multiple biological pathways. Among the confirmed SNPs, mutations were identified in genes previously known to be strongly associated with ASD such as SLCO1B1, ACADSB, TCF4, HCP5, MOCOS, SRD5A2, MCCC2, DCC, and PRKN while several other mutations are known to associate with autistic traits or other neurodevelopmental disorders. Some mutations were found in multiple patients and some patients carried multiple pathogenic/likely pathogenic mutations. These findings contribute to the identification of potential targets for therapeutic solutions in what is considered a genetically heterogeneous neurodevelopmental disorder.

Measuring children's sustained selective attention and working memory: validity of new minimally linguistic tasks.

This study introduces visual tasks using nonlinguistic stimuli that measure sustained selective attention (SSA) and working memory (WM), two constructs foundational to learning and associated with developmental disorders in children. Using an argument-based approach to validation, we examine whether each task (a) measures distinct constructs, (b) shows internal consistency, (c) captures a range of performance, and (d) relates to development as indexed by age. Participants included 71 children, ages 4-10, of whom 12 had parental concern for language/learning. The SSA task presented spatial locations within a long and uninteresting task, following the continuous performance task paradigm. The WM task presented paired location sequences of increasing length, incorporating key elements of the n-back and complex span paradigms. Controlling for age, tasks were found to be minimally associated with each other (r = .26), suggesting related but distinct constructs. Internal consistency was high, with split-half reliability of .94 (SSA) and .92 (WM); the stability of these estimates was supported by bootstrapping simulations. Task performance was evenly distributed, with minimal floor or ceiling effects within this age range. Performance was positively related to age (SSA r = .49; WM r = .53). Exploratory correlations with a measure of parental concern were significant for SSA but not WM. The results show that these new tasks can be used to measure children's SSA and WM in a visual domain with minimal linguistic influence. These tasks capture developmental changes in the early school years. Further investigation can examine their utility for classifying children with developmental disorders.

Favorable outcome of a histiocytic sarcoma patient treated with immune checkpoint inhibitor: a case report.

Introduction and Importance: Histiocytic sarcoma (HS) is an extremely rare malignancy in which there has been no standard treatment approach. Some preclinical studies have provided rationales for the application of immunotherapy in advanced HS. Case Presentation: The authors reported a case of a 61-year-old patient with metastatic HS who had a rapid progression on ifosfamide, carboplatin, and etoposide chemotherapy. The authors performed PD-L1 testing, which showed a strong positivity in 90% of tumor cells. The patient was then treated with pembrolizumab 200 mg every 3 weeks. He refused palliative radiotherapy. A dramatic response in all sites was recorded on the PET-CT scan after three cycles. He was maintained on pembrolizumab, reaching over 30 months without disease progression. Clinical Discussion: Recent molecular data suggests there could be a role of immunotherapy in HS. In our patient, the disease was refractory to chemotherapy and pembrolizumab has been given based on the strong PD-L1 expression. Response to immunotherapy has also been recorded in several cases with malignant histiocytic neoplasm. Conclusion: Immunotherapy might bring sustained disease remission in PD-L1 high expression HS and further studies evaluating the role of immune checkpoint inhibitor in this disease are warranted.

Kruppel-like factor 2+ CD4 T cells avert microbiota-induced intestinal inflammation.

Intestinal colonization by antigenically foreign microbes necessitates expanded peripheral immune tolerance. Here we show commensal microbiota prime expansion of CD4 T cells unified by the Kruppel-like factor 2 (KLF2) transcriptional regulator and an essential role for KLF2+ CD4 cells in averting microbiota-driven intestinal inflammation. CD4 cells with commensal specificity in secondary lymphoid organs and intestinal tissues are enriched for KLF2 expression, and distinct from FOXP3+ regulatory T cells or other differentiation lineages. Mice with conditional KLF2 deficiency in T cells develop spontaneous rectal prolapse and intestinal inflammation, phenotypes overturned by eliminating microbiota or reconstituting with donor KLF2+ cells. Activated KLF2+ cells selectively produce IL-10, and eliminating IL-10 overrides their suppressive function in vitro and protection against intestinal inflammation in vivo. Together with reduced KLF2+ CD4 cell accumulation in Crohn's disease, a necessity for the KLF2+ subpopulation of T regulatory type 1 (Tr1) cells in sustaining commensal tolerance is demonstrated.

Reproductive outcomes after pregnancy-induced displacement of preexisting microchimeric cells.

Pregnancy confers partner-specific protection against complications in future pregnancy that parallel persistence of fetal microchimeric cells (FMcs) in mothers after parturition. We show that preexisting FMcs become displaced by new FMcs during pregnancy and that FMc tonic stimulation is essential for expansion of protective fetal-specific forkhead box P3 (FOXP3)-positive regulatory T cells (Treg cells). Maternal microchimeric cells and accumulation of Treg cells with noninherited maternal antigen (NIMA) specificity are similarly overturned in daughters after pregnancy, highlighting a fixed microchimeric cell niche. Whereas NIMA-specific tolerance is functionally erased by pregnancy, partner-specific resiliency against pregnancy complications persists in mothers despite paternity changes in intervening pregnancy. Persistent fetal tolerance reflects FOXP3 expression plasticity, which allows mothers to more durably remember their babies, whereas daughters forget their mothers with new pregnancy-imprinted immunological memories.

A Narrative Approach to Synthesizing Research on Vietnamese Bilingual and Monolingual Children.

PURPOSE: This review article offers a narrativized synthesis of my research over the past 15+ years with Vietnamese-speaking children based on data collected from individual bilingual and monolingual children in preschool and elementary schools. METHOD: I begin with a positionality narrative to describe who I am in relation to the research conducted. I provide an overview of the research program including tool building and how my research with bilinguals in the United States led me to international collaborations in Vietnam. RESULTS: I present main findings from this body of work in three areas: typical bilingual development, reading performance in Vietnam, and characteristics of developmental language disorder in the Vietnamese language. Implications within each area are discussed in terms of clinical application and future research directions. Practitioners and researchers alike can freely access the Vietnamese assessment tools created and validated to date from our website, https://vietslp.sdsu.edu/. CONCLUSIONS: This research overview aims to offer clinicians and researchers the sociocultural context for understanding the relevance of this body of research. It also serves as an invitation for new generations of scholars, particularly scholars of color, to see their own unique positionings and perspectives as valuable and necessary for scientific innovation and progress. PRESENTATION VIDEO: https://doi.org/10.23641/asha.23929491.

Systemic chemotherapy combined with radiofrequency ablation for colorectal cancer with liver metastasis: a retrospective cohort study.

This study aims to evaluate the efficacy of systemic chemotherapy combined with radiofrequency ablation in the treatment of inoperable colorectal cancer with liver metastasis. Materials and methods: The authors conducted a retrospective cohort analysis on 30 patients diagnosed as colorectal cancer with liver metastasis who underwent systemic chemotherapy combined with radiofrequency ablation of the liver lesions from January 2017 to August 2020 at our institution. Responses was evaluated by International Working Group on Image-guided Tumor Ablation criteria, along with progression-free survival. Results: The response rate after 4 cycles and 8 cycles of chemotherapy were 73.3% and 85.2%, respectively. All patients achieved responses after of radiofrequency therapy, with the rates of complete response and partial response were 63.3% and 36.7%. The median progression-free survival was 16.7 months. After radiotherapy ablation, all patients had mild to moderate hepatic pain, 10% of patients had fever and increased liver enzymes occurred in 90% of patients. Conclusions: Systemic chemotherapy combined with radiofrequency ablation was safe and effective in colorectal cancer with liver metastasis and warrants further large-scale studies.

What predicts individual response to language treatment in bilingual children with developmental language disorder?

Purpose: For bilingual children with developmental language disorder (DLD), language treatment response is the degree to which an individual child progresses in both of their languages. Understanding what predicts language treatment response for an individual child can help clinicians plan treatment more effectively. Methods: This study is a retrospective analysis of data from Ebert et al. (2014). Participants included 32 school-age Spanish-English bilingual children with DLD who completed an intensive language treatment program. Gains in Spanish and English were measured using raw test scores in each language. Predictors of language gains include language, cognitive, and demographic variables. To examine which predictors were significant, we calculated partial correlations between the potential predictors and the posttreatment language test scores, controlling for the effects of pretreatment test scores. Results: In Spanish, several predictors correlated with the outcome measures. After controlling for pretreatment scores, English grammaticality, female sex, processing speed, age, and fluid reasoning were related to Spanish posttreatment scores. In English, correlations with individual predictors were minimal. After controlling for pretreatment scores, only one variable was associated with one English posttreatment score: English grammaticality. Conclusions: The original study reported limited gains in Spanish compared to robust gains in English (Ebert et al., 2014). Treatment response in Spanish is more variable given the lack of environmental support for Spanish in the US. As a result, individual factors (including nonverbal cognition, pretreatment language levels, and demographic variables) influence treatment gains in Spanish. In contrast, strong environmental support for English supports a more consistent treatment response, with a smaller role for individual factors.

Exploring the potential of ZnO-Ag@AgBr/SBA-15 Z-scheme heterostructure for efficient wastewater treatment: synthesis, characterization, and real-world applications.

This study reports on the synthesis and characterization of ZnO-Ag@AgBr/SBA-15 composites using natural halloysite clay from Yenbai Province, Vietnam, as a silica aluminum source. The synthesized materials demonstrated visible light absorption with a band gap energy range of 2.63-2.98 eV. The dual Z-scheme ZnO-Ag@AgBr/SBA-15 heterojunction exhibited superior catalytic performance compared to ZnO/SBA-15 and Ag@AgBr/SBA-15, owing to its improved electron transfer and reduced electron and hole recombination rate. In particular, the photocatalytic efficiency of ZnO-Ag@AgBr/SBA-15 was evaluated for the removal of harmful phenol red from wastewater under visible light irradiation. The photocatalytic process was optimized by varying the phenol red concentration, pH, and catalyst dosage, and showed that 98.8% of phenol red in 100 mL wastewater (pH = 5.5) can be removed using 40 mg of 20%ZnO-Ag@AgBr/SBA-15 within 120 min. Furthermore, the degradation pathway of phenol red was predicted using liquid chromatographic-mass spectrometry (LC-MS). Finally, the photocatalytic process was successfully tested using water samples collected from the four main domestic waste sources in Hanoi, including the To Lich River, the Hong River, the Hoan Kiem Lake, and the West Lake, demonstrating the high potential of the ZnO-Ag@AgBr/SBA-15 photocatalyst for phenol red degradation in real-world wastewater treatment applications.

Remote First-Language Assessment: Feasibility Study With Vietnamese Bilingual Children and Their Caregivers.

PURPOSE: There is a shortage of bilingual speech-language pathologists (SLPs) in the United States. For Vietnamese, less than 1% of SLPs speak the language compared with a Vietnamese American population of > 2.1 million. This study examines the feasibility and social validity of remote child language assessment with the help of a caregiver to address the need for first language assessments among Vietnamese-speaking children. METHOD: Twenty-one dyads of caregivers and typically developing children (aged 3-6 years) completed two assessment sessions in their first language, Vietnamese, using Zoom videoconferencing. Sessions were counterbalanced between two conditions in which either the clinician or the caregiver was the task administrator. Children's language samples were elicited using narrative tasks. Social validity was also assessed through caregiver and child questionnaires at the end of each session. RESULTS: There were no significant differences between conditions on language sample measures nor the measures of social validity. Both caregivers and their children felt positively about the sessions. The caregivers' feelings were related to their perception of children's feelings about the sessions. Children's feelings were related to their Vietnamese language proficiency, caregiver-reported language ability, and whether they were born outside of the United States. CONCLUSIONS: Findings build the evidence base for telepractice as an effective and socially valid service delivery model for bilingual children in the United States. This study supports the potential for caregivers as task administrators in a telepractice setting, making assessment in a child's first language more feasible and accessible. Future investigation is needed to extend results to bilingual populations with disorders.

Sequential Organ Failure Assessment (SOFA) Score for predicting mortality in patients with sepsis in Vietnamese intensive care units: a multicentre, cross-sectional study.

OBJECTIVES: To compare the accuracy of the Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) Scores in predicting mortality among intensive care unit (ICU) patients with sepsis in a low-income and middle-income country. DESIGN: A multicentre, cross-sectional study. SETTING: A total of 15 adult ICUs throughout Vietnam. PARTICIPANTS: We included all patients aged ≥18 years who were admitted to ICUs for sepsis and who were still in ICUs from 00:00 to 23:59 of the specified study days (ie, 9 January, 3 April, 3 July and 9 October of the year 2019). PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was hospital all-cause mortality (hospital mortality). We also defined the secondary outcome as all-cause deaths in the ICU (ICU mortality). RESULTS: Of 252 patients, 40.1% died in hospitals, and 33.3% died in ICUs. SOFA Score (areas under the receiver operating characteristic curve (AUROC): 0.688 (95% CI 0.618 to 0.758); cut-off value≥7.5; PAUROC<0.001) and APACHE II Score (AUROC: 0.689 (95% CI 0.622 to 0.756); cut-off value ≥20.5; PAUROC<0.001) both had a poor discriminatory ability for predicting hospital mortality. However, the discriminatory ability for predicting ICU mortality of SOFA (AUROC: 0.713 (95% CI 0.643 to 0.783); cut-off value≥9.5; PAUROC<0.001) was fair and was better than that of APACHE II Score (AUROC: 0.672 (95% CI 0.603 to 0.742); cut-off value≥18.5; PAUROC<0.001). A SOFA Score≥8 (adjusted OR (AOR): 2.717; 95% CI 1.371 to 5.382) and an APACHE II Score≥21 (AOR: 2.668; 95% CI 1.338 to 5.321) were independently associated with an increased risk of hospital mortality. Additionally, a SOFA Score≥10 (AOR: 2.194; 95% CI 1.017 to 4.735) was an independent predictor of ICU mortality, in contrast to an APACHE II Score≥19, for which this role did not. CONCLUSIONS: In this study, SOFA and APACHE II Scores were worthwhile in predicting mortality among ICU patients with sepsis. However, due to better discrimination for predicting ICU mortality, the SOFA Score was preferable to the APACHE II Score in predicting mortality.Clinical trials registry - India: CTRI/2019/01/016898.

Vietnamese children with and without DLD: Classifier use and grammaticality over time.

INTRODUCTION: One way to identify Developmental Language Disorder (DLD) is to establish clinical markers in a language to serve as reliable indicators of the disorder. This study embarks on the search for clinical markers for Vietnamese using longitudinal data from children with and without DLD. METHODS: We matched ten children previously classified with DLD to ten with typical development (TD) by age and gender. Participants completed a story generation task at three time points: kindergarten, first, and second grade. Overall grammatical development was measured using mean length of utterance, MLU, and proportion of grammatical utterances, PGU. We examined a language-specific feature, classifiers, in terms of accuracy (omission errors), diversity (number of different classifiers), and productivity, or the use of classifiers in constructions of two-to-three elements (classifier+noun, numeral+classifier+noun). Longitudinal change and group differences were examined using linear mixed modeling, supplemented by linguistic analysis. RESULTS: Both groups increased in MLU and PGU over time. The DLD group performed lower in kindergarten and continued to show lower performance over time on these measures. Classifier omission errors decreased over time with no group differences. Classifier diversity increased across groups, with lower performance by the DLD group in kindergarten and over time. For classifier productivity, TD children used classifiers in multiple constructions in kindergarten and maintained the same level over time. In contrast, children with DLD had minimal use of three-element constructions in kindergarten but increased in productivity over time. CONCLUSIONS: Children with DLD produce shorter utterances with relatively more grammatical errors compared to their TD peers in the early school years. Though no longer committing classifier omission errors, children with DLD showed more restricted use of classifiers in terms of the number of different classifiers and constructions produced. Findings inform the search for Vietnamese clinical markers of DLD.

Characterization of thymol derivatives from Eupatorium fortunei Turcz. aerial parts.

From the aerial parts of Eupatorium fortunei, four thymol derivatives (1-4) were isolated and structurally elucidated by NMR and mass spectroscopic methods. Of which, a new dimeric thymol derivative (1) was characterized and its absolute configuration was established by electronic circular dichroism quantum method. In addition, the 1D and 2D NMR as well as HR-ESI mass spectral data of 2 were provided for the first time. Compounds 2-4 were evaluated for their inhibitory activity against α-glucosidase and acetylcholinesterase enzymes. All tested compounds showed weak inhibition at the concentration range of 1-256 µg/mL in both enzymatic assays.

Understanding (un)grammaticality in context: Evidence from young Spanish-English bilinguals over time.

PURPOSE: Percent grammatical utterances (PGU) provides clinicians and researchers with meaningful information on young children's grammatical abilities (Eisenberg & Guo, 2016). However, work is still needed to place PGU within the context of conventional language sample measures and understand how PGU reflects grammatical development in bilingual populations. The current study focuses on Spanish-English bilingual preschoolers to examine: 1) change in Spanish and English PGU over one year of preschool English instruction, 2) associations between PGU and other language sample measures within each language and across time, and 3) the types and frequency of error patterns in each language. METHOD: Play-based language samples were elicited in English and Spanish from bilingual children (n = 19) at the beginning and end of an instructional preschool year in English. PGU was derived from each sample along with other language sample measures (e.g., mean length of utterance). We examined change in PGU from Time 1 to Time 2, and correlations between Time 1 PGU and Time 2 PGU for each language. Specific grammatical errors were described in terms of their frequency in each language and stability across time. RESULTS: Average English PGU increased from Time 1 to Time 2, and correlated with other language sample measures. Conversely, average Spanish PGU did not increase from Time 1 to Time 2, nor did PGU correlate with any other Spanish measure. Error patterns in each language reflected grammatical differences across English and Spanish. CONCLUSIONS: Our results revealed distinct developmental patterns in bilingual children's first and second languages. Associations between time points and measures in English contrasted with disassociations in Spanish. Error patterns revealed more detailed information as to how bilingual children begin to acquire grammatical structures in each of their languages. We provide a case example to illustrate how grammaticality and error patterns can be used to characterize children's language abilities. We conclude with clinical implications of grammaticality in Spanish-English bilingual children.