Infant mismatch responses to speech-sound changes predict language development in preschoolers at risk for dyslexia.

OBJECTIVE: We investigated how infant mismatch responses (MMRs), which have the potential for providing information on auditory discrimination abilities, could predict subsequent development of pre-reading skills and the risk for familial dyslexia. METHODS: We recorded MMRs to vowel, duration, and frequency deviants in pseudo-words at birth and 28 months in a sample over-represented by infants with dyslexia risk. We examined MMRs' associations with pre-reading skills at 28 months and 4-5 years and compared the results in subgroups with vs. without dyslexia risk. RESULTS: Larger positive MMR (P-MMR) at birth was found to be associated with better serial naming. In addition, increased mismatch negativity (MMN) and late discriminative negativity (LDN), and decreased P-MMR at 28 months overall, were shown to be related to better pre-reading skills. The associations were influenced by dyslexia risk, which was also linked to poor pre-reading skills. CONCLUSIONS: Infant MMRs, providing information about the maturity of the auditory system, are associated with the development of pre-reading skills. Speech-processing deficits may contribute to deficits in language acquisition observed in dyslexia. SIGNIFICANCE: Infant MMRs could work as predictive markers of atypical linguistic development during early childhood. Results may help in planning preventive and rehabilitation interventions in children at risk of learning impairments.

Documentation of human rights abuses among Rohingya refugees from Myanmar.

BACKGROUND: Decades of persecution culminated in a statewide campaign of organized, systematic, and violent eviction of the Rohingya people by the Myanmar government beginning in August 2017. These attacks included the burning of homes and farms, beatings, shootings, sexual violence, summary executions, burying the dead in mass graves, and other atrocities. The Myanmar government has denied any responsibility. To document evidence of reported atrocities and identify patterns, we interviewed survivors, documented physical injuries, and assessed for consistency in their reports. METHODS: We use purposive and snowball sampling to identify survivors residing in refugee camps in Bangladesh. Interviews and examinations were conducted by trained investigators with the assistance of interpreters based on the Istanbul Protocol - the international standard to investigate and document instances of torture and other cruel, inhuman, and degrading treatment. The goal was to assess whether the clinical findings corroborate survivors' narratives and to identify emblematic patterns. RESULTS: During four separate field visits between December 2017 and July 2018, we interviewed and where relevant, conducted physical examinations on a total of 114 refugees. The participants came from 36 villages in Northern Rakhine state; 36 (32%) were female, 26 (23%) were children. Testimonies described several patterns in the violence prior to their flight, including the organization of the attacks, the involvement of non-Rohingya civilians, the targeted and purposeful destruction of homes and eviction of Rohingya residents, and the denial of medical care. Physical findings included injuries from gunshots, blunt trauma, penetrating trauma such as slashings and mutilations, burns, and explosives and from sexual and gender-based violence. CONCLUSIONS: While each survivor's experience was unique, similarities in the types and organization of attacks support allegations of a systematic, widespread, and premeditated campaign of forced displacement and violence. Physical findings were consistent with survivors' narratives of violence and brutality. These findings warrant accountability for the Myanmar military per the Rome Statute of the International Criminal Court (ICC), which has jurisdiction to try individuals for serious international crimes, including crimes against humanity and genocide. Legal accountability for these crimes should be pursued along with medical and psychological care and rehabilitation to address the ongoing effects of violence, discrimination, and displacement.

Renal markers cystatin C and neutrophil gelatinase-associated lipocalin (NGAL) in postmortem samples.

PURPOSE: Renal markers may provide valuable information for cause of death (CoD) investigation when assessing the influence of impaired kidney function. A commonly used marker, creatinine (Cr), increases due to kidney injury and is known to be reasonably stable in postmortem (PM) samples. More sensitive markers are needed, as the increase of serum Cr level only occurs after relatively severe renal damage. We evaluated two markers, cystatin C and neutrophil gelatinase-associated lipocalin (NGAL), in addition to Cr. To the best of our knowledge this was the first study to investigate cystatin C and NGAL in a postmortem (PM) context. METHODS: Cr, cystatin C, and NGAL were measured from PM blood in 39 autopsy cases. NGAL was also measured from urine in 16 cases. Cystatin C and NGAL were analyzed using ELISA, Cr measurements were performed with Jaffe method. Correlations of these markers were evaluated. RESULTS AND CONCLUSIONS: Both, blood cystatin C and NGAL, levels showed significant correlation with Cr (p = 0.05 and p = 0.01, respectively). Cystatin C and NGAL in blood are promising markers for further studies with PM samples.

The relationship between visual function, duration and main causes of vision loss and falls in older people with low vision.

BACKGROUND: Falls are an alarming health problem and a major cause of injury among the elderly. The healthcare cost associated with falls is considerable. Visual acuity has been found to be an independent risk factor for falls; however, the results are not unanimous. Moreover, other aspects of visual function such as visual field, contrast sensitivity and depth perception have not been adequately investigated in relation to falls. The aim of this study, therefore, was to determine the relationship between visual function, duration, and main causes of visual impairment, and falls in individuals with low vision. METHODS: This was a cross-sectional study involving participants attending a public tertiary eye care hospital. Participants were mobile, aged 60 years or above, and had low vision (visual acuity >0.3 LogMAR in the better eye). Details about falls in the previous 12 months and other information were collected, and patients completed a questionnaire about activities of daily living. The duration and main causes of visual impairment, visual acuity, contrast sensitivity, depth perception, and visual field were assessed. Descriptive statistical analyses were performed to characterize the participants' sociodemographic and clinical data. RESULTS: One hundred and twenty seven patients (53%; 67 males) with a mean age of 76.3+/-8.3 years were recruited. Thirty seven percent of the participants (n=47) had mild, 50% (n=64) moderate and 13% (n=16) severe visual impairment (>0.3-0.5; >0.5-1.0; and >1.0 LogMAR respectively). The frequencies of single and multiple falls were 42.5% and 12.6% respectively. Visual acuity, contrast sensitivity, depth perception, visual field, main cause, and duration of visual impairment were not significantly associated with falls (p>0.05). In multiple regression analyses, physical inactivity remained the only variable independently associated with falls in all models except for visual field. Overall, visually impaired people were three times more likely to fall if they were physically inactive. CONCLUSIONS: Visual function, duration and main causes of visual impairment are not independently associated with falls in people with low vision. However, a significant relationship between non-participation in physical activity and falls was found. Further work is required to investigate the association between vision-related factors and falls in older people with visual impairment.