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.

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.

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.

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.

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.

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.

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.

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.

Detection of electrically neutral and nonpolar molecules in ionic solutions using silicon nanowires.

We report on a technique that can extend the use of nanowire sensors to the detection of interactions involving nonpolar and neutral molecules in an ionic solution environment. This technique makes use of the fact that molecular interactions result in a change in the permittivity of the molecules involved. For the interactions taking place at the surface of nanowires, this permittivity change can be determined from the analysis of the measured complex impedance of the nanowire. To demonstrate this technique, histidine was detected using different charge polarities controlled by the pH value of the solution. This included the detection of electrically neutral histidine at a sensitivity of 1 pM. Furthermore, it is shown that nonpolar molecules, such as hexane, can also be detected. The technique is applicable to the use of nanowires with and without a surface-insulating oxide. We show that information about the changes in amplitude and the phase of the complex impedance reveals the fundamental characteristics of the molecular interactions, including the molecular field and the permittivity.

Working Memory Capacity as a Factor Influencing the Relationship between Language Outcome and Rehabilitation in Mandarin-Speaking Preschoolers with Congenital Hearing Impairment.

Memory processes could account for a significant part of the variance in language performances of hearing-impaired children. However, the circumstance in which the performance of hearing-impaired children can be nearly the same as the performance of hearing children remains relatively little studied. Thus, a group of pre-school children with congenital, bilateral hearing loss and a group of pre-school children with normal hearing were invited to participate in this study. In addition, the hearing-impaired participants were divided into two groups according to their working memory span. A language disorder assessment test for Mandarin-speaking preschoolers was used to measure the outcomes of receptive and expressive language of the two groups of children. The results showed that the high-span group performed as good as the hearing group, while the low-span group showed lower accuracy than the hearing group. A linear mixed-effects analysis showed that not only length of rehabilitation but also the memory span affected the measure of language outcome. Furthermore, the rehabilitation length positively correlated with the measure of expressive language only among the participants of the high-span group. The pattern of the results indicates that working memory capacity is one of the factors that could support the children to acquire age-equivalent language skills.

Should We Stop Developing Heuristics and Only Rely on Mixed Integer Programming Solvers in Automated Test Assembly? A Rejoinder to van der Linden and Li (2016).

This rejoinder responds to the commentary by van der Linden and Li entiled "Comment on Three-Element Item Selection Procedures for Multiple Forms Assembly: An Item Matching Approach" on the article "Three-Element Item Selection Procedures for Multiple Forms Assembly: An Item Matching Approach" by Chen. Van der Linden and Li made a strong statement calling for the cessation of test assembly heuristics development, and instead encouraged embracing mixed integer programming (MIP). This article points out the nondeterministic polynomial (NP)-hard nature of MIP problems and how solutions found using heuristics could be useful in an MIP context. Although van der Linden and Li provided several practical examples of test assembly supporting their view, the examples ignore the cases in which a slight change of constraints or item pool data might mean it would not be possible to obtain solutions as quickly as before. The article illustrates the use of heuristic solutions to improve both the performance of MIP solvers and the quality of solutions. Additional responses to the commentary by van der Linden and Li are included.

Screening and Identification of Yeasts Antagonistic to Pathogenic Fungi Show a Narrow Optimal pH Range for Antagonistic Activity.

Microbes have evolved ways of interference competition to gain advantage over their ecological competitors. The use of secreted antagonistic compounds by yeast cells is one of the prominent examples. Although this killer behavior has been thoroughly studied in laboratory yeast strains, our knowledge of the antagonistic specificity of killer effects in nature remains limited. In this study, yeast strains were collected from various niches and screened for antagonistic activity against one toxin-sensitive strain of Saccharomyces cerevisiae and three pathogenic fungi. We demonstrate that some strains with antagonistic activity against these pathogenic fungi can be found in antagonist culture tests. These yeasts were identified as members of Trichosporon asahii, Candida stellimalicola, Wickerhamomyces anomalus, Ustilago esculenta, Aureobasidium pullulans, and Pichia kluyveri. The results indicated that the antagonistic activity of these killer yeasts has a narrow optimal pH range. Furthermore, we found that the antagonistic activity of some species is strain-dependent.

Association of oral endothelin receptor antagonists with risks of cardiovascular events and mortality: meta-analysis of randomized controlled trials.

BACKGROUND: Endothelin receptor antagonists (ERAs) are widely used in a variety of disorders, including pulmonary artery hypertension, systemic sclerosis, diabetic and kidney diseases, and several tumors. However, reported adverse events, especially increased risks of cardiovascular disease (CVD) morbidity and mortality, have cast doubt on their potential clinical application. Therefore, we conducted this meta-analysis to confirm whether ERAs increased CVD risk and mortality. METHODS: We systematically searched PubMed (1966-2015), EMBASE (1974-2015), ClinicalTrials.gov, and the Cochrane Controlled Clinical Trials Register Database for randomized controlled trials published between Jan 1, 1990 and Mar 18, 2015. Inclusion criteria included a study duration of more than 3 weeks, the use of a randomized control group receiving an oral ERA or placebo, and the availability of outcome data for cardiovascular events and all-cause death. RESULTS: A total of 33 trials met the inclusion criteria. There were 8098 cases in the ERA group and 5074 cases in the placebo group. Compared with the control group, the risk ratio (RR) for all-cause death in the ERA group was 0.983 [95% confidence interval (CI), 0.883 to 1.094, P = 0.754]. The summary RR for cardiovascular events was 1.651 in the ERA group (95% CI, 1.164 to 2.34, P = 0.005). The pooled results showed that ERAs treatment could lead to more edema, anemia, and abnormal transaminase levels. Also, there was an increased proportion of discontinued therapy in the ERA treatment because of side effects (RR = 1.322, 95% CI, 1.036 to 1.686, P = 0.025). There were no significant differences in the experienced episodes of headache and dyspnea between the active therapy and control groups. CONCLUSIONS: ERAs therapy is not significantly associated with increased all-cause death, but there are more cardiovascular events and edema or fluid retention, anemia, and liver enzymes disorder. Large clinical randomized controlled studies are needed to further confirm the safety of the clinical application of ERAs.

Three-Element Item Selection Procedures for Multiple Forms Assembly: An Item Matching Approach.

In educational measurement, building multiple alternate test forms is usually highly desirable in practice. Test assembly problems are classified as NP-hard (Non-deterministic Polynomial-time hard) problems, and their computation time increases exponentially as the problem size grows. The purpose of this study was to construct parallel forms item-by-item based on a seed test, using two proposed item selection heuristic methods (random item sequence assigned to maximum distance form with content balance [R-MD-B] and random item sequence assigned to random form with content balancing [R-R-B]) incorporating a flexible content balancing method. The results were compared with two modified versions of the Armstrong, Jones, and Wu heuristics (random item sequence assigned to maximum distance form with Armstrong's replacement [R-MD-R] and random item sequence assigned to random form with Armstrong's replacement [R-R-R]) and two models incorporating mixed integer programming (MIP) methods. The results showed that the R-MD-B and R-R-B methods yielded results comparable with the two MIP methods with less computation time in terms of the item information functions, test characteristic curves, and content coverage. The results also showed that R-MD-B and R-R-B can be extended to handle test assembly constraints in practical settings.