Impact of Hearing Aids on Language Outcomes in Preschool Children With Mild Bilateral Hearing Loss.

This study aimed to investigate the role of hearing aid (HA) usage in language outcomes among preschool children aged 3-5 years with mild bilateral hearing loss (MBHL). The data were retrieved from a total of 52 children with MBHL and 30 children with normal hearing (NH). The association between demographical, audiological factors and language outcomes was examined. Analyses of variance were conducted to compare the language abilities of HA users, non-HA users, and their NH peers. Furthermore, regression analyses were performed to identify significant predictors of language outcomes. Aided better ear pure-tone average (BEPTA) was significantly correlated with language comprehension scores. Among children with MBHL, those who used HA outperformed the ones who did not use HA across all linguistic domains. The language skills of children with MBHL were comparable to those of their peers with NH. The degree of improvement in audibility in terms of aided BEPTA was a significant predictor of language comprehension. It is noteworthy that 50% of the parents expressed reluctance regarding HA use for their children with MBHL. The findings highlight the positive impact of HA usage on language development in this population. Professionals may therefore consider HAs as a viable treatment option for children with MBHL, especially when there is a potential risk of language delay due to hearing loss. It was observed that 25% of the children with MBHL had late-onset hearing loss. Consequently, the implementation of preschool screening or a listening performance checklist is recommended to facilitate early detection.

Cross-modal digit span and vocabulary proficiency in deaf or hard-of-hearing children.

This study aims to examine the relationship between vocabulary proficiency and short-term memory capacity in deaf or hard-of-hearing (DHH) children. We test the hypothesis that the relationship between vocabulary skills and digit span performance could be strengthened when the digit span task encompasses cross-modal integration processes. A group of DHH children performed two types of auditory digit span tasks. Furthermore, they participated in a standardized vocabulary proficiency test, comprising two subtests: Receptive Vocabulary and Expressive Vocabulary. The verbal digit span served as a significant predictor of Expressive Vocabulary among the DHH children. Simultaneously, the auditory-pointing digit span accounted for a substantial portion of performance variation in both Receptive and Expressive Vocabulary. After considering the impact of the duration of auditory-verbal intervention through regression models, likelihood ratio tests demonstrated that the auditory-pointing digit span persisted as a significant determinant of both receptive and expressive vocabulary skills. A positive influence of the intervention was also confirmed by the present results. This study provides evidence that memory span and the ability to integrate cross-modal information could serve as significant cognitive correlates of vocabulary proficiency in DHH children.

Women's experiences with Centering-Based Group Care in Zhejiang China: A pilot study.

BACKGROUND: The group prenatal care model, which caters to women with low medical needs but high support needs, has become a highly prevalent and innovative approach implemented globally. For Centering-Based Group Care (CBGC) to remain effective, women's evaluations of the quality of care and perspectives about the model are crucial. AIM: This study aimed to describe women's appraisal of CBGC quality and explore the experiences of women in the mixed-methods pilot study conducted in Zhejiang, China. METHODS: From August 2021 to December 2022, 20 women provided complete quantitative data using the Quality of Prenatal Care Questionnaire before hospital discharge. Semi-structured interviews were conducted at 6 months postpartum. Qualitative data were analysed using Colaizzi's method. FINDINGS: The mean (standard deviation) total score (of the 5) of the questionnaire was 4.43 (0.1) with a good quality of CBGC. Qualitative research identified five themes: motivations and concerns for participation, the appeal of interactive learning, the development of community ties and social support, healing from psychological trauma with CBGC, and suggestions for CBGC enhancement. DISCUSSION: Women rated CBGC quality as good and benefited significantly from it in the study. As a new alternative option, the women's accounts suggested that CBGC performed excellently in enhancing knowledge, strengthening social bonds, and providing psychological support. CONCLUSION: CBGC quality cannot be determined based on limited the sample size. This pilot study provides evidence regarding the beneficial effects of knowledge, socialization, and psychological healing on CBGC. Further research is suggested to measure CBGC effectiveness and quality.

Hearing aid wear time and its impact on vocabulary in preschoolers with moderately severe to profound hearing loss.

OBJECTIVE: This study aimed to explore how the consistency of hearing aid (HA) use impacts vocabulary performance in children with moderately severe to profound hearing loss and determine the amount of HA use time associated with better vocabulary outcomes. DESIGN: Personal wear time percentage (WTP) was an indicator of HA use consistency, and the information on HA wear time was collected from both parent reports and datalogs. Pearson's correlations were performed to investigate the associations between hearing loss severity, WTP and vocabulary performance. Standard vocabulary scores among children below and above three WTP cutoff values (80%, 85%, and 90%) were examined to determine the WTP amount that yielded significantly better vocabulary outcomes. STUDY SAMPLE: Forty-seven children aged 36-79 months and their caregivers. RESULTS: Both parent reports and datalogs WTP significantly correlated with vocabulary outcomes. Parent-reported WTP were found to be predictive of datalogs WTP. Apart from hearing thresholds, HA fitting age and maternal education level, datalogs WTP was a significant independent predictor of vocabulary performance. Children with ≥ 90% WTP were more likely to perform better on vocabulary tests than those with < 90% WTP. CONCLUSION: The findings support the potential benefits of consistent HA use for vocabulary development.

Effect of sample length on MLU in Mandarin-speaking hard-of-hearing children.

This study investigated the impact of language sample length on mean length of utterance (MLU) and aimed to determine the minimum number of utterances required for a reliable MLU. Conversations were collected from Mandarin-speaking, hard-of-hearing and typical-hearing children aged 16-81 months. The MLUs were calculated using sample sizes ranging from 25 to 200 utterances. The results showed that for an MLU between 1.0 and 2.5, 25 and 50 utterances were sufficient for reliable MLU calculations for hard-of-hearing and typical-hearing children, respectively. For an MLU between 2.5 and 3.75, 125 utterances were required for both groups. For an MLU greater than 3.75, 150 and 125 utterances were required for hard-of-hearing and typical-hearing children, respectively. These findings suggest that a greater number of utterances are required for a reliable MLU as language complexity increases. Professionals working with hard-of-hearing children should consider collecting different numbers of utterances based on the children's language complexity levels.

Does the duration matter? Effect of cochlear implantation on language development in Mandarin-speaking children with hearing loss.

OBJECTIVE: Several studies have shown that cochlear implantation (CI) can influence language development in children with severe-to-profound hearing loss. However, whether the age of implantation and duration of CI use influence language development remains unclear, particularly in Mandarin-speaking children with hearing loss. Therefore, this study investigated the effects of CI-related variables on language development in these children. METHODS: The present study recruited 133 Mandarin-speaking children with hearing loss, aged between 36 and 71 months chronologically, from a nonprofit organisation in Taiwan. The Revised Preschool Language Assessment (RPLA) was used to evaluate the children's language performance. RESULTS: Children with hearing loss demonstrated delayed language comprehension and oral expression. Among them, 34% achieved age-appropriate language development. The duration of CI use had a significant direct effect on language-related abilities. Conversely, the age of implantation did not have a significant direct effect. Furthermore, the age of initial interventions (auditory-oral) had a significant direct effect only on language comprehension. Compared with the age of implantation, the duration of CI use was a significant mediator of language-related abilities. CONCLUSION: In Mandarin-speaking children with late CIs, the duration of CI use is a more effective mediator of language development than the age of implantation.

Bio-Based PLA/PBS/PBAT Ternary Blends with Added Nanohydroxyapatite: A Thermal, Physical, and Mechanical Study.

The physical and mechanical properties of novel bio-based polymer blends of polylactic acid (PLA), poly(butylene succinate) (PBS), and poly (butylene adipate-co-terephthalate) (PBAT) with various added amounts of nanohydroxyapatite (nHA) were investigated in this study. The formulations of PLA/PBS/PBAT/nHA blends were divided into two series, A and B, containing 70 or 80 wt% PLA, respectively. Samples of four specimens per series were prepared using a twin-screw extruder, and different amounts of nHA were added to meet the regeneration needs of bone graft materials. FTIR and XRD analyses were employed to identify the presence of each polymer and nHA in the various blends. The crystallization behavior of these blends was examined using DSC. Tensile and impact strength tests were performed on all samples to screen feasible formulations of polymer blends for bone graft material applications. Surface morphology analyses were conducted using SEM, and the dispersion of nHA particles in the blends was further tested using TEM. The added nHA also served as a nucleating agent aimed at improving the crystallinity and mechanical properties of the blends. Through the above analyses, the physical and mechanical properties of the polymer blends are reported and the most promising bone graft material formulations are suggested. All blends were tested for thermal degradation analysis using TGA and thermal stability was confirmed. The water absorption experiments carried out in this study showed that the addition of nHA could improve the hydrophilicity of the blends.

Perspectives and performance changes of parents in aural-oral rehabilitation: From in-person to telepractice.

INTRODUCTION: The coronavirus disease 2019 pandemic has reinforced the necessity and importance of telepractice. Although studies suggest frameworks to facilitate telepractice implementation, how parents learn related therapeutic skills via telepractice remains unexplored. The purpose of this study was to explore the perspectives and performance changes of parents with children enrolled in aural-oral rehabilitation who transition from in-person sessions to telepractice. METHODS: A total of 456 parents were enrolled in an aural-oral rehabilitation program with different online session formats [telepractice (n = 392), consultation (n = 23), and hybrid (n = 41)] during the pandemic. The Parental Teaching Skil Scale and the Parental Behavioral Skills Scale were used to examine parent performance changes before and during the lockdown. Furthermore, semi-structured interviews were conducted with 10 parents. RESULTS: Parents who scored higher in in-person courses were more likely to enrol in telepractice and make steady progress. Parents who participated in hybrid sessions tended to score lower on Parental Teaching Skill Scale before lockdown and reported that the dual-track, parallel learning method provided them with a set amount of time to discuss teaching difficulties with their therapists without being disturbed by their children. Parents who attended the consultation sessions scored higher on Parental Behavioral Skills Scale than on Parental Teaching Skill Scale during the in-person courses. DISCUSSION: Parents who continued online courses during the lockdown showed consistent and significant gains in most skills related to aural-oral rehabilitation, regardless of session format. Moreover, parents who scored better on Parental Behavioral Skills Scale than in Parental Teaching Skill Scale during in-person courses tended to request consultation sessions during the lockdown.

Children With Unilateral Hearing Loss After Newborn Hearing Screening in Taiwan.

PURPOSE: We explored the intervention characteristics and language outcomes of children with unilateral hearing loss (UHL) in Taiwan after the implementation of universal newborn hearing screening (UNHS) to highlight changes in attitudes and actions toward hearing-related treatments. METHOD: Data of 132 children with UHL in birth cohorts from 2012 to 2019 were included. This retrospective study examined differences in age at identification, hearing aid (HA) fitting, and seeking supportive services. Commonly requested attributes of services, reasons for HA rejection, and children's language performance were investigated. RESULTS: The age at identification decreased from 50.3 months in 2012 to 2.6 months in 2019. Similar trends of declining age were obtained for the age at HA fitting and age at first service contact. In addition, 40% of the parents did not seek support until the child became older (M = 30.5 months) and showed more noticeable behaviors related to hearing loss, and only 64% of the children were consistent HA users. Children with UHL enrolled in the intervention programs approximated the average language performance of the assessment norm; however, they showed depressed language levels when compared to the norm group at the 75th percentile. CONCLUSIONS: UNHS had a positive impact on early identification and intervention in children with UHL. Compared to parents of children with all types of hearing loss, parents of children with UHL seemed to be more uncertain about aural habilitation at the early stage.

Determination of language performance by discriminant function analysis in Mandarin-speaking preschoolers with auditory neuropathy spectrum disorder.

OBJECTIVE: Characteristics of the audiological performance of children with auditory neuropathy spectrum disorder (ANSD) have been identified; however, studies regarding factors influencing their language development, especially those related to aural-oral rehabilitation, are relatively few. This study aimed to investigate classification functions among the factors regarding audiological, interventional (rehabilitation) and demographic variables that can help determine group membership in language performance for Mandarin-speaking preschoolers with ANSD. METHODS: Children with ANSD aged 3-6 years (n = 27) enrolled in an auditory-verbal therapy were recruited. The combination of factors that could be used to predict memberships of children regarding whether they achieved age-appropriate language performance or were at risk of language delay were explored using discriminant function analysis. RESULTS: Maternal education level, age at initial hearing aid fitting, and duration of rehabilitation were all significant factors in predicting the membership of children with ANSD and whether they could achieve an age-appropriate language level or were at risk for language delay. The correct rate for predicting the memberships ranged from 70.4% to 83.3%. Duration of rehabilitation accounted for the greatest effect on discriminant membership regarding achieving age-appropriate language performance and being at risk of language delay. Effect of maternal education level tended to centralize on language comprehension. CONCLUSIONS: Differences were observed in the quantifiable effects of predictors in discriminant functions for language ability domains. Except for using suitable hearing devices, adequate duration of enrollment in aural and oral rehabilitation would also be important for children with ANSD to develop better language abilities.

Intestinal microbiota modulates adrenomedullary response through Nod1 sensing in chromaffin cells.

The intestinal microbiota closely interacts with the neuroendocrine system and exerts profound effects on host physiology. Here, we report that nucleotide-binding oligomerization domain 1 (Nod1) ligand derived from intestinal bacteria modulates catecholamine storage and secretion in mouse adrenal chromaffin cells. The cytosolic peptidoglycan receptor Nod1 is involved in chromogranin A (Chga) retention in dense core granules (DCGs) in chromaffin cells. Mechanistically, upon recognizing its ligand, Nod1 localizes to DCGs, and recruits Rab2a, which is critical for Chga and epinephrine retention in DCGs. Depletion of Nod1 ligand or deficiency of Nod1 leads to a profound defect in epinephrine storage in chromaffin cells and subsequently less secretion upon stimulation. The intestine-adrenal medulla cross talk bridged by Nod1 ligand modulates adrenal medullary responses during the immobilization-induced stress response in mice. Thus, our study uncovers a mechanism by which intestinal microbes modulate epinephrine secretion in response to stress, which may provide further understanding of the gut-brain axis.

Measurement of intact quantal packet of transmitters released from single nerve terminal by loose-patch amperometry.

Neuronal information is majorly encoded chemically at synapses and the elementary unit of synaptic transmission is the contents of neurotransmitter released from single vesicle. However, the contents of quantal neurotransmitter have never been precisely estimated at synapses, which largely prevent our understanding the nature of quantal neurotransmitter release and its impact on neuronal information processing. In order to break through the technical bottleneck of precisely counting quantal neurotransmitter molecules, we developed a new approach in combination of electrophysiology and electrochemistry to measure intact quantal content of single vesicles. An etched submicro-carbon fiber electrode for electrochemical detection was designed to be enclosed in an electrophysiologically used glass pipette. The glass pipette allowed the electrochemical electrode to access the release site, and amperometric recordings were made within the enclosed space at the electrophysiological loose-patch mode. Our study showed that the intact quantal release could be successfully detected at the dopaminergic varicosities by this loose-patch amperometric measurement in real time with negligible leakage.

Developing new scales for assessing parents' aural and oral rehabilitation skills to interact with children with hearing loss.

OBJECTIVE: Scales for evaluating the teaching and behavioural skills of parents enrolled in aural and oral rehabilitation programs for children with hearing loss are lacking. This study developed and validated scales for assessing parental teaching and behavioural skills of those parents for use in guiding their child to develop language and communication skills. DESIGN: Scales were constructed and evaluated using exploratory and confirmatory factor analysis. The performance of parents in teaching and behavioural skills was also explored. STUDY SAMPLE: The teaching and behavioural skills of 344 parents (179 for scale development and 165 for validation) were rated by their intervention therapists using parental teaching skill (PTS) and parental behavioural skill (PBS) scales. RESULTS: Good reliability and model fit (validity) were observed for both scales, which ultimately included 13 and 10 items, respectively. Maternal educational level was a significant indicator of their performance ratings. CONCLUSIONS: The PTS and PBS scales were validated and can be used by early intervention professionals to evaluate the relative interaction and behavioural skills of parents of children with hearing loss, and enrolled in listening and spoken language intervention programs.

Loss of Dysbindin Implicates Synaptic Vesicle Replenishment Dysregulation as a Potential Pathogenic Mechanism in Schizophrenia.

The schizophrenia-susceptibility gene, dystrobrevin-binding protein 1 (DTNBP1), encodes the dysbindin protein and mediates neurotransmission and neurodevelopment in normal subjects. Functional studies show that DTNBP1 loss may cause deficient presynaptic vesicle transmission, which is related to multiple psychiatric disorders. However, the functional mechanism of dysbindin-mediated synaptic vesicle transmission has not been investigated systematically. In this study, we performed electrophysiological recordings in calyx of Held synapses. We found that excitatory postsynaptic current (EPSC) and miniature EPSC (mEPSC) amplitudes were unchanged in dysbindin-deficient synapses, but readily releasable pool (RRP) size and calcium dependent vesicle replenishment were affected during high-frequency stimulation. Moreover, dysbindin loss accompanied slightly decreases in Munc18-1 and snapin expression levels, which are associated with vesicle priming and synaptic homeostasis under high-frequency stimulation. Together, we inferred that dysbindin directly interacts with Munc18-1 and snapin to mediate calcium dependent RRP replenishment. Dysbindin loss may lead to RRP replenishment dysregulation during high-frequency stimulation, potentially causing cognitive impairment in schizophrenia.

Newborn hearing screening and early auditory-based treatment in Taiwan: action trends of families with children who are hearing impaired.

OBJECTIVE: To explore the trends in actions and factors influencing families of children with hearing loss, regarding early treatment following the implementation of a newborn hearing screening (NHS) in Taiwan. DESIGN: A retrospective study was conducted by extracting data from the treatment histories of families with children who had hearing loss and who were contacted and assessed by the non-profit organisation (NPO). Children born between 2012 and 2018 were included. The time lapse between initial NHS and early treatment sought by each family was documented and the factors predicting the timing of those actions were identified. STUDY SAMPLE: Data of 2095 families of children with hearing loss and who received treatment from an NPO for the annual birth cohort of 2012 through 2018 were included. RESULTS: The median age at treatments initiation improved through the years. Parental educational level and the child's degree of hearing loss were significant indicators of the child's initial age at treatment intervention, age when hearing aids were fitted, and days taken to contact the organisation. CONCLUSION: The NHS in Taiwan promoted earlier treatment for children with hearing loss. Furthermore, patient instructions and education may be important to enable parents to take actions for early intervention.

Auditory memory span in Mandarin-speaking preschoolers with congenital hearing loss: Impact of task structure.

Objective: The current research was conducted to test the prediction that children who have hearing loss and are developing spoken language can perform at the same level as hearing children in an auditory memory span task if actual production of speech is excluded from task requirement.Method: A listen-and-point digit span task and two sub-tests of Wechsler Intelligence Scale for Children-IV (Verbal Digit Span and Matrix Reasoning) were administered to thirty hearing children and thirty-three children with hearing loss. A language assessment instrument for Mandarin-speaking preschool children was also administered to the participants with hearing loss.Results: The listen-and-point task not only correlated with the Verbal Digit Span sub-test, but also correlated with the comprehension sub-test of the language assessment instrument. The size of auditory memory span was similar in both groups of participants in the listen-and-point task. Moreover, the memory span estimated in the listen-and-point task was smaller than that estimated in the Verbal Digit Span task. The correlation coefficients between chronological age and the listen-and-point task were also similar in both groups of children.Conclusions: When speech processes are not required in an auditory working memory task, demand for the phonological loop is reduced and the children with hearing loss are able to perform as well as the hearing children. Moreover, the auditory memory span develops at the same rate for the children with hearing loss as for the hearing children.

Comparison of prognosis between emergency and scheduled hemodialysis.

BACKGROUND: The survival rate of patients undergoing hemodialysis and other renal replacement therapies has been extensively studied, but comparative studies of emergency and scheduled hemodialysis are limited. METHODS: This study included 312 patients who underwent emergency hemodialysis and 274 who received scheduled hemodialysis. We investigated the prognostic differences between these two groups of patients, including the short-term and long-term survival rates. RESULTS: The overall survival rate was significantly better among the patients in the scheduled hemodialysis group than emergency hemodialysis group. The mortality rate within 3 months of emergency hemodialysis was 4.8%, while that within 3 months of scheduled hemodialysis was 1.1%. CONCLUSIONS: Significant differences were present between emergency and scheduled hemodialysis, especially the levels of serum creatinine and hemoglobin.

Impact of timing of initiation of dialysis on long-term prognosis of patients undergoing hemodialysis.

There are a lot of controversies pertaining to correctness of timing for the initiation of dialysis in chronic kidney disease (CKD) patients. The present study was conducted to examine the potential association of initiation timing of dialyses with long-term prognosis in CKD patients. In total, 294 patients confirmed as end-stage renal disease (ESRD) were included as study subjects. According to the estimated glomerular filtration rate (eGFR) at initiation time, the patients were classified into four groups based on eGFR: ≥10.5, 8-10.4, 6-8 and <6 ml/min × (1.73 m2)-1. The primary outcomes were defined by all-cause mortality. The median eGFR of the 294 patients at initiation time was 5.43 (2.27-13.92) ml/min × (1.73 m2)-1. The patients with lower eGFR at the start of hemodialysis had a higher proportion of Charlson comorbidity index (CCI) scores of 0-2 and had lower hematocrit. The multivariate Cox regression analysis indicated that CCI, cerebrovascular diseases and chronic obstructive pulmonary disease were significantly associated with all-cause mortality, but not eGFR at the dialysis initiation. Furthermore, stratified analyses confirmed elevated eGFR that had no advantage on long-term prognosis. The present findings have shown that the prevalence of anemia, hyperuricemia and calcium and phosphorus metabolism disorders of patients with low eGFRs at the initiation of hemodialysis was higher in comparison to the patients with high eGFRs. Therefore, the long-term prognosis of patients with high eGFRs prior to hemodialysis was not improved.

Screening and Evaluation of Yeast Antagonists for Biological Control of Botrytis cinerea on Strawberry Fruits.

Gray mold (Botrytis cinerea) is one of the most common diseases of strawberries (Fragaria × ananassa Duchesne) worldwide. Although many chemical fungicides are used for controlling the growth of B. cinerea, the risk of the fungus developing chemical resistance together with consumer demand for reducing the use of chemical fungicides have necessitated an alternative method to control this pathogen. Various naturally occurring microbes aggressively attack plant pathogens and benefit plants by suppressing diseases; these microbes are referred to as biocontrol agents. However, screening of potent biocontrol agents is essential for their further development and commercialization. In this study, 24 strains of yeast with antagonistic ability against gray mold were isolated, and the antifungal activity of the volatile and diffusible metabolites was evaluated. Putative mechanisms of action associated with the biocontrol capacity of yeast strains against B. cinerea were studied through in vitro and in vivo assays. The volatile organic compounds produced by the Galactomyces candidum JYC1146 could be useful in the biological control of plant pathogens and therefore are potential alternative fungicides with low environmental impact.