Cochlear Implants or Hearing Aids: Speech Perception, Language, and Executive Function Outcomes.

OBJECTIVES: We aimed to determine whether children with severe hearing loss (HL) who use hearing aids (HAs) may experience added value in the perception of speech, language development, and executive function (EF) compared to children who are hard of hearing (HH) or children who are deaf and who use cochlear implants (CIs) and would benefit from CIs over HAs. The results contribute to the ongoing debate concerning CI criteria. We addressed the following research question to achieve this aim: Do children who are HH or deaf with CIs perform better than children with severe HL with HAs with respect to auditory speech perception, and receptive vocabulary and/or EF? DESIGN: We compared two groups of children with severe HL, profound HL or deafness, with CIs or HAs, matched for gender, test age (range, 8 to 15 years), socioeconomic status, and nonverbal intelligence quotient. Forty-three children had CIs (pure-tone average at 2000 and 4000 Hz >85 dB HL), and 27 children had HAs (mean pure-tone average: 69 dB HL). We measured speech perception at the conversational level (65 dB SPL) and the soft speech perception level (45 dB SPL). We established receptive vocabulary using the Peabody Picture Vocabulary Test-III-NL. We tested EF using the Delis Kaplan Executive Function System battery and the Dutch Rey Auditory Verbal Learning Test. We employed the Mann-Whitney U test to compare data between the CI and HA groups. We used Chi-square goodness of fit tests to contrast the CI and HA group distributions with the norm data of children who are typically developing (TD). We harnessed Kendall's Tau-b to investigate relationships between the study variables. RESULTS: Both groups of children, with CIs and Has, obtained ceiling scores for perception of speech on a conversational level. However, the HA group exhibited significantly lower perception on a soft speech level scores (68 %) than the CI group (87%). No difference was present between the receptive vocabulary distributions of the CI and HA groups. The median receptive vocabulary standard scores for both groups were well within the normal range (CI group: 93; HA group: 96). In addition, we did not find any difference in EF between the CI and HA groups. For planning and verbal memory, the distributions of observed scores for children with CIs were different from the expected distributions of children who are TD. In both groups, a large proportion of children obtained below-average scores for planning (CI: 44%; HA: 33%) and for long-term verbal memory (CI: 44%; HA: 35%). In the HA group, perception at a soft speech level was associated with receptive vocabulary and planning. In the CI group, we did not find any associations. CONCLUSIONS: Both groups of children with severe and profound HL with HAs exhibit less favorable auditory perception on the soft speech level, but not at a conversational level, compared to children who are HH or deaf with CIs. Both groups, children with CIs and HAs, only exhibit more problems in planning and verbal memory than the norm groups of children who are TD. The results indicate that to obtain age-appropriate levels of receptive vocabulary and EF, the perception at the soft speech level is a necessary but not sufficient prerequisite.

(Mitigating) the self-fulfillment of gender stereotypes in teams: The interplay of competence attributions, behavioral dominance, individual performance, and diversity beliefs.

We challenge the social categorization perspective in the team diversity literature by arguing that stereotypes and not favoritism for members of the same social category govern processes and dynamics in gender-diverse teams. We posit that team members' gender and task stereotypes generate competence attributions that shape individual team members' dominance behavior and performance in a self-fulfilling way: Team members who are attributed more competence behave more dominantly and outperform those who are attributed less competence. We further argue that pro-diversity beliefs may prevent this self-fulfilling tendency of stereotypes by inhibiting individuals' stereotype-confirming behavior. Hypotheses were tested with 97 gender-heterogeneous four-person student teams working on stereotypically masculine- or feminine-typed problems. Team members estimated each other's competence prior to collaboration. Diversity beliefs were manipulated to be either pro-diversity or pro-similarity and dominance was observed with behavioral coding. Multilevel path modeling showed that competence attributions mediated the effects of stereotypical gender-task fit on individual dominance behavior and performance under pro-similarity beliefs but not under pro-diversity beliefs. Our study thus shows that the self-fulfilling tendencies of gender stereotypes in teams can be mitigated by instituting pro-diversity beliefs. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Bilateral synchronous gamma range firing of bulbar motor units during tonic seizures.

We present a patient with tonic seizures of the bulbar muscles. Video-EEG recording during the multiple attacks showed no ictal EEG abnormalities. The tonic seizures were clearly visible as EMG artefacts on the EEG recording and consisted of 3-6 symmetric tonic bursts of EMG activity of 2-4 seconds and an interval of 2-6 seconds. Spectral analysis showed a very distinct, bilateral synchronous, dominant gamma peak on the EMG spectra during the seizures with a cross correlation of 0.67 between left and right without a time lag. We discuss whether this peak originates from the firing frequencies of the bulbar motor units, and whether this is consistent with the Piper rhythm described during maximal voluntary contraction in controls and related to firing in the gamma range of the cortical motor neurons. We conclude that the EMG artefacts recorded on EEG during seizures can be informative with regards to the type and pathophysiology of epilepsy.

Standards for quantification of EMG and neurography.

This document is an update and extension of ICCN Standards published in 1999. It is the consensus of experts on the current status of EMG and Neurography methods. A panel of authors from different countries with different approach to routines in neurophysiological methods was chosen based on their particular interest and previous publications. Each member of the panel submitted a section on their particular area of interest and these submissions were circulated among the panel members for edits and comments. This process continued until a consensus was reached. The document covers EMG topics such as conventional EMG, Macro EMG, applications of surface EMG and electrical impedance myography. Single Fiber EMG is not included, since it is the topic in a separate IFCN document. A neurography section covers topics such as motor and sensory neurography, F wave recordings, H-reflex, short segment recordings, CMAP scan and motor unit number methods. Other sections cover repetitive nerve stimulation and Pediatric electrodiagnostic testing. Each method includes a description of methodologies, pitfalls, and the use of reference values. Clinical applications accompany some of these sections.

The Flywheel Effect of Gender Role Expectations in Diverse Work Groups.

Popular press suggests that gender diversity benefits the performance of work groups. However, decades of research indicate that such performance benefits of gender diversity are anything but a given. To account for this incongruity, in this conceptual paper we argue that the performance of gender-diverse work groups is often inhibited by self-reinforcing gender role expectations. We use the analogy of a flywheel to illustrate how gender role expectations tend to reinforce themselves via three mechanisms. Specifically, we argue that gender role expectations shape (1) the allocation of jobs, tasks, and responsibilities, (2) the behavior of perceivers, and (3) the behavior of target women and men. In turn, these three consequences of gender role expectations tend to confirm the initial gender role expectations, thus creating an automatic, self-reinforcing flywheel effect. Such self-reinforcing gender role expectations provide superficial impressions of individual women's and men's actual knowledge and abilities at best. We therefore further propose that each of the three mechanisms of the flywheel of gender role expectations negatively affects group performance to the extent that gender role expectations inaccurately capture group members' actual knowledge and abilities. Because the extent to which work group members rely on gender role expectations depends on how they form impressions of others, we propose that individuals' motivation to form accurate impressions is crucial for inhibiting the flywheel of gender role expectations. We close by advancing an agenda for future research on each of the three areas of interest in our conceptual analysis: the flywheel effect of gender role expectations, the consequences of this flywheel effect for group functioning, and ways to motivate group members to form accurate impressions.

If it doesn't help, it doesn't hurt? Information elaboration harms the performance of gender-diverse teams when attributions of competence are inaccurate.

Information elaboration-the act of exchanging, discussing, and integrating information and perspectives through verbal communication-tends to be considered as the silver bullet that drives the performance of diverse teams. We challenge this notion by proposing that the effect of information elaboration on team performance depends on the accuracy of within-group competence attributions, i.e. the extent to which attributions of task competence among team members correspond with members' actual task competence. We argue that information elaboration may actually harm performance when within-group competence attributions are inaccurate, given that in such teams decisions are likely to be based on suggestions from members who have much influence but little competence. We conducted an experiment with 97 gender-heterogeneous teams working on gender-typical problems and coded their interactions. Our findings support our hypotheses that members who are perceived as more competent are more influential in the information elaboration process, and that information elaboration harms performance when competence attributions are not accurate. In contrast to our expectations, pro-diversity beliefs did not mitigate this negative effect of inaccurate competence attributions. We argue that this speaks to the robustness of our findings regarding the detrimental effects of information elaboration when competence attributions are inaccurate.

Medical photography: a reliable and objective method for documenting the results of reconstructive surgery of pectus excavatum.

Patients with a pectus excavatum frequently experience medical problems such as dyspnoea, fatigue and palpitations. After surgical intervention most patients are alleviated of their symptoms. Pectus excavatum can easily be diagnosed by a proper inspection of the chest. In the Atrium Medical Center photographic documentation of the deformation of the chest is part of the treatment protocol before and after surgical correction of a pectus excavatum. In addition to the normal photographic routine two special recording techniques are applied: measuring the depth of the excavation with a rule, and documenting the depth of the excavation in a 3-D grid-projection image. The applied 3-D technique (raster stereography) can also be an asset to other medical specialty areas in which changes in body shape and appearance play a major role.

Hemolytic assay for the measurement of functional human mannose-binding lectin: a modification to avoid interference from classical pathway activation.

Diagnostic assays for measurement of functional mannose-binding lectin (MBL) in serum are widely performed as part of immune status assessment. Classical pathway mediated complement activity can interfere in these functional MBL assays. Here we describe classical pathway interference incidentally occurring in a previously described hemolytic MBL assay and the modification of this assay to prevent this artifact by addition of anti-C1q antibodies. Classical pathway interference in functional MBL assays can and should be inhibited to prevent that MBL deficiency is overlooked and patients are misdiagnosed.

Priority organic micropollutants in water sources in Flanders and the Netherlands and assessment of removal possibilities with nanofiltration.

The occurrence of organic micropollutants in ground- and surface waters has become an important concern for the drinking water industry, mainly because of possible related health effects. Due to the polar nature of some of these pollutants, they are not completely removed by traditional water treatment barriers. This paper offers an overview of priority organic micropollutants and their occurrence in Flemish and Dutch water sources. Furthermore, rejection by nanofiltration is qualitatively predicted for the selected priority micropollutants. The qualitative prediction is based on the values of key solute and membrane parameters in nanofiltration. Predicted values are then compared with experimental values obtained from literature. Overall, the qualitative predictions are roughly in agreement with literature values. Prediction based on key parameters may thus prove to be a very quick and useful technique to assess the implementation of nanofiltration as a treatment step for organic micropollutants in drinking water plant design.

Direct binding of respiratory syncytial virus to pneumococci: a phenomenon that enhances both pneumococcal adherence to human epithelial cells and pneumococcal invasiveness in a murine model.

In a previous study we showed that pneumococcal adherence to epithelial cells was enhanced by a preceding respiratory syncytial virus (RSV) infection. RSV-glycoproteins, expressed on the infected cell surface, may play a role in this enhanced pneumococcal binding, by acting as bacterial receptors. In the current study, it was attempted to analyze the capacity of pneumococci to interact directly with RSV virions. By flow-cytometry, a direct interaction between RSV and pneumococci could be detected. Heparin, an inhibitor of RSV infectivity that interacts with RSV protein-G, blocked RSV-pneumococcal binding, indicating that the latter interaction is indeed mediated by protein-G. RSV-pneumococcal complexes showed enhanced adherence to uninfected human epithelial cells, compared with pneumococcal adherence without bound RSV, and this enhancement was also blocked by heparin. In addition, the significance of these findings in vitro was explored in vivo in a murine model. Both mice that were pretreated with RSV at day 4 before pneumococcal challenge and mice infected with both agents simultaneously showed significantly higher levels of bacteraemia than controls. Simultaneous infection with both agents enhanced the development of pneumococcal bacteraemia most strongly. It was hypothesized that direct viral binding is another mechanism by which RSV can induce enhanced pneumococcal binding to epithelial cells, a phenomenon that is translated in vivo by a higher invasiveness of pneumococci when administered simultaneously with RSV to mice. Apparently, RSV acts in this process as a direct coupling particle between bacteria and uninfected epithelial cells, thereby increasing colonization by and enhancing invasiveness of pneumococci.

Enhanced adherence of Streptococcus pneumoniae to human epithelial cells infected with respiratory syncytial virus.

In the present study, we analyzed the effect of a preceding respiratory syncytial virus (RSV) infection of human respiratory epithelial cells on the adherence of Streptococcus pneumoniae tested by means of a cytometric fluorescence assay. Adherence of clinically relevant pneumococcal serotypes 3, 9, 14, 18, 19, and 23 was studied using uninfected and RSV-infected monolayers. To this end, monolayers of both human nasopharyngeal cells (HEp-2) and pneumocyte type II cells (A549) were infected with RSV serotype A. Adherence to uninfected epithelial cells varied between pneumococcal serotypes. After RSV infection of the monolayers, all serotypes showed a strongly (2- to 10- fold) and significantly increased adherence when compared with adherence to uninfected monolayers. Enhanced adherence was observed with both cell lines. By fluorescence and scanning electron microscopy, we observed redistribution of pneumococcal adherence over the epithelial surface due to RSV infection, with dense bacterial accumulations near to epithelial syncytia.

Addition of glucose to an oral fat load reduces postprandial free fatty acids and prevents the postprandial increase in complement component 3.

BACKGROUND: Elevated fasting plasma concentrations of complement component 3 (C3) are associated with elevated fasting and postprandial triacylglycerol concentrations, insulin resistance, obesity, and coronary artery disease. C3 is the central component of the complement system and the precursor of acylation-stimulating protein (ASP). Insulin and ASP are principal determinants of free fatty acid (FFA) trapping by adipose tissue. OBJECTIVE: Because controversy exists concerning postprandial changes in C3 and because meal composition may influence complement activation, we studied postprandial lipemia in relation to changes in plasma C3. DESIGN: After an overnight fast, 6 healthy men ( +/- SD age: 23 +/- 2 y) underwent 4 oral liquid challenges: fat (50 g/m(2) body surface), glucose (37.5 g/m(2)), fat and glucose (mixed test), and water (as a control test) in a random, crossover design. RESULTS: Plasma ASP concentrations did not change postprandially in any test. Changes in C3 concentration were observed only after the fat challenge: elevated concentrations occurred between 1 and 3 h, and a maximum increase of 11% occurred at 2 h (P = 0.05). Postprandial triacylglycerolemia did not differ significantly between the fat and mixed tests. The FFA response after the fat challenge was the highest of all the tests (P < 0.05 for all comparisons) and was accompanied by an increase in ketone bodies (maximum at 6 h); this increase did not occur after the mixed test, which suggests less hepatic FFA delivery. CONCLUSIONS: When glucose is added to an oral fat load, the postprandial FFA response is reduced, and the fat-specific increase in C3 is prevented. After ingestion of fat without glucose, the lack of insulin response may lead to C3-mediated peripheral FFA trapping, which probably serves as a backup system in case of insufficient or inefficient insulin-dependent FFA trapping.

Differential microorganism-induced mannose-binding lectin activation.

Mannose-binding lectin (MBL) is a serum complement factor playing a dominant role in first-line defense. When MBL binds to specific sugar moieties on microorganisms, the lectin complement pathway (LCP) is activated. Changes in the mbl gene and promotor may result in MBL with less activity, predisposing the individual to recurrent infections. Using a functional MBL assay, we investigated at what concentration different microbes activated MBL. Less than 1 colony-forming unit (CFU) of Neisseria meningitidis groups B and C still activated MBL, which may be ascribed to filterable blebs. Nocardia farcinica and Legionella pneumophila activated MBL well, which raises new questions about host susceptibility. In contrast to other research, Pseudomonas aeruginosa activated the LCP potently.

A hemolytic assay for the estimation of functional mannose-binding lectin levels in human serum.

A simple assay was developed to estimate functional mannose-binding lectin (MBL) levels in serum based on the principle of yeast-induced bystander lysis of chicken erythrocytes (ChE). The assay is sensitive to inhibition by ethylene glycol bis-(beta-aminoethyl ether)-N,N,N',N'-tetraacetic acid (EGTA) (which allows alternative pathway activation), ethylene diamine tetraacetic acid (EDTA), mannose, N-acetylglucosamine and C1 esterase inhibitor (C1-INH), whereas it was not inhibited by galactose. A high-titer human anti-mannan antibody-containing serum with 0.06 microg MBL/ml gave a functional signal corresponding to 0.12 microg equivalents MBL/ml, indicating that anti-mannan antibodies are poorly hemolytic in the assay. The assay is well suited for the large-scale testing of patient samples for a functional MBL pathway of complement activation.

Moraxella catarrhalis: from emerging to established pathogen.

Moraxella catarrhalis (formerly known as Branhamella catarrhalis) has emerged as a significant bacterial pathogen of humans over the past two decades. During this period, microbiological and molecular diagnostic techniques have been developed and improved for M. catarrhalis, allowing the adequate determination and taxonomic positioning of this pathogen. Over the same period, studies have revealed its involvement in respiratory (e.g., sinusitis, otitis media, bronchitis, and pneumonia) and ocular infections in children and in laryngitis, bronchitis, and pneumonia in adults. The development of (molecular) epidemiological tools has enabled the national and international distribution of M. catarrhalis strains to be established, and has allowed the monitoring of nosocomial infections and the dynamics of carriage. Indeed, such monitoring has revealed an increasing number of B-lactamase-positive M. catarrhalis isolates (now well above 90%), underscoring the pathogenic potential of this organism. Although a number of putative M. catarrhalis virulence factors have been identified and described in detail, their relationship to actual bacterial adhesion, invasion, complement resistance, etc. (and ultimately their role in infection and immunity), has been established in a only few cases. In the past 10 years, various animal models for the study of M. catarrhalis pathogenicity have been described, although not all of these models are equally suitable for the study of human infection. Techniques involving the molecular manipulation of M. catarrhalis genes and antigens are also advancing our knowledge of the host response to and pathogenesis of this bacterial species in humans, as well as providing insights into possible vaccine candidates. This review aims to outline our current knowledge of M. catarrhalis, an organism that has evolved from an emerging to a well-established human pathogen.