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AbstractObjectiveDesignStudy sampleResultsConclusionsWe recently demonstrated that learning abilities among school-age children vary following frequency discrimination (FD) training, with some exhibiting mature adult-like learning while others performing poorly (non-adult-like learners). This study tested the hypothesis that children’s post-training generalisation is related to their learning maturity. Additionally, it investigated how training duration influences children’s generalisation, considering the observed decrease with increased training in adults.Generalisation to the untrained ear and untrained 2000 Hz frequency was assessed following single-session or nine-session 1000 Hz FD training, using an adaptive forced-choice procedure. Two additional groups served as controls for the untrained frequency.Fifty-four children aged 7–9 years and 59 adults aged 18–30 years.(1) Only adult-like learners generalised their learning gains across frequency or ear, albeit less efficiently than adults; (2) As training duration increased children experienced reduced generalisation, similar to adults; (3) Children’s performance in the untrained tasks correlated strongly with their trained task performance after the first training session.Auditory skill learning and its generalisation do not necessarily mature contemporaneously, although mature learning is a prerequisite for mature generalisation. Furthermore, in children, as in adults, more practice makes rather specific experts. These findings should be considered when designing training programs. [ABSTRACT FROM AUTHOR]

Background and purpose: Motoric cognitive risk syndrome (MCR) is a predementia condition that combines slow gait and subjective cognitive concerns. As the earliest markers of MCR are relatively unknown, the role of subjective cognitive concerns was investigated to predict incident MCR in a well‐characterized prospective cohort of non‐demented older adults. Methods: Non‐demented MCR‐free older adults (n = 476) from the Central Control of Mobility in Aging cohort completed gait, subjective cognition and neuropsychological assessment at baseline and follow‐up. Subjective concerns were analyzed via responses to 12 items from three validated measures, the Late‐Life Function and Disability Instrument – Disability Component, the Activities of Daily Living Prevention Instrument and the Geriatric Depression Scale, and were independent of items utilized to diagnose MCR. Cox proportional hazard models examined the association between cognitive concerns and incident MCR. Results: After 2.36 ± 1.4 years, 28 participants developed MCR. Executive functioning (adjusted hazard ratio 2.458, 95% confidence interval 1.094–5.524, P = 0.029) and mental clarity concerns (adjusted hazard ratio 3.917, 95% confidence interval 1.690–9.077, P = 0.001) were associated with incident MCR, controlling for age, sex, education and gait speed. Conclusions: Subjective cognitive concerns in non‐memory cognitive domains predict incident MCR. Although most MCR studies assess cognitive concerns about memory, our findings suggest the need to broaden the scope of subjective cognitive assessment to enhance the accuracy of diagnosis and prediction of future cognitive decline. [ABSTRACT FROM AUTHOR]

Objective: To determine whether World Trade Center (WTC)‐exposure intensity and post‐traumatic stress disorder (PTSD) are associated with subjective cognitive change in rescue/recovery workers. Method: The population included 7875 rescue/recovery workers who completed a subjective cognition measure, the Cognitive Function Instrument (CFI), between 3/1/2018 and 2/28/2019 during routine monitoring, indicating whether they had experienced cognitive and functional difficulties in the past year. Higher scores indicated greater self‐perceived cognitive change. Probable PTSD, depression, and alcohol abuse were evaluated by validated mental health screeners. Logistic regression assessed the associations of WTC exposure and current PTSD with top‐quartile (≥2) CFI score, and of early post‐9/11 PTSD with top‐quartile CFI in a subpopulation (N = 6440). Models included demographics, smoking, depression, and alcohol abuse as covariates. Results: Mean age at CFI completion was 56.7 ± 7.7 (range: 36–81). Participants with high‐intensity WTC exposure had an increased likelihood of top‐quartile CFI score (odds ratio[OR] vs. low exposure: 1.32, 95%CI: 1.07–1.64), controlling for covariates. Current and early PTSD were both associated with top‐quartile CFI (OR: 3.25, 95%CI: 2.53–4.19 and OR: 1.56, 95%CI: 1.26–1.93) respectively. Conclusions: High‐intensity WTC exposure was associated with self‐reported cognitive change 17 years later in rescue/recovery workers, as was PTSD. Highly WTC‐exposed subgroups may benefit from additional cognitive evaluation and monitoring of cognition over time. [ABSTRACT FROM AUTHOR]

Purpose: Older adults have an increased likelihood of requiring rehabilitative care due to cognitive and physical risk factors. Research has found a link between executive functioning performance and functional outcomes; however, there is a dearth of research on the assessment of judgement ability. In the current pilot study, we investigated the clinical utility of the Test of Practical Judgment (TOP-J) in an older adult rehabilitation sample. Methods: Inpatients of mixed diagnoses (n = 25, mean age = 72.60) completed the TOP-J and Functional Independence Measure (FIM). We assessed TOP-J performance in the entire sample and in those with intact vs. impaired global cognition (on the Mini-Mental State Examination; MMSE). Correlational analyses were conducted between the TOP-J, MMSE and relevant FIM items. Results: TOP-J performance fell between the means typically observed in individuals with mild cognitive impairment and mild Alzheimer's disease. Participants with intact global cognition obtained significantly higher TOP-J scores than those with impaired global cognition. Moderate to strong positive correlations emerged between TOP-J, MMSE and FIM items of problem solving, comprehension and memory. Conclusions: Results provide support for the clinical utility and validity of the TOP-J among older adults in the rehabilitation setting. Administering the TOP-J may help identify patients at risk for future injury and facilitate role transitions. [ABSTRACT FROM AUTHOR]

The article describes the malformation of the ductal plate in a six-year-old, male African Green monkey. According to the authors, light microscopic examination of the liver showed several spindle cells dispersed within interconnecting, broad bands of collagen, up to 200μm in width, which often spanned and connected portal areas. They add that ductal plate malformation is a basic feature of bile duct disorders, which can be divided into diseases characterized by biliary dilation or ectasia or those characterized by involution or destructive cholangitis.

A 32-year-old male diagnosed with transverse myelitis in 2013 came to our clinic in 2015 with complaints of paraplegia, sensory disturbances, pain, exertional dyspnea, poor quality of sleep, emotional instability, and depression. This was a recurrent attack that had been exacerbated by post-traumatic stress. Owing to pain and functional disabilities, he was struggling to actively participate in the treatment modalities offered at our center. A modified protocol of electroacupuncture was planned for a period of 21 days, every day, with each session lasting for 30 minutes. Assessments based on the brief version of World Health Organization Brief Quality of Life (WHO Brief QOL) questionnaire, Pittsburgh sleep quality index, visual analog scale, and a disease-specific physical examination showed momentous improvement in functional health status as well as mental well-being. The quality of life showed significant improvement particularly in the physical and psychological dimensions of WHO Brief QOL. The patient reported a reduction in pain, dyspnea, and fatigue accompanied by an improvement in the quality of sleep and mood. This case report suggests that acupuncture can play a vital role in amelioration of symptoms, thereby improving the health status in patients with transverse myelitis.

Managed care organizations (MCOs) use the concept of "medical necessity" to decide whether a prescribed treatment is warranted for a given medical condition. Because mental disorders lack the objective disease criteria common to medical illness, behavioral health administrators need a validated means to identify and quantify the severity of "medically important" aspects of mental disorders. The authors developed and tested a brief medical necessity scale for mental disorders in 205 patients presenting for initial evaluation. The scale had a factor structure with four subscales; good internal consistency, interrater reliability, and concurrent and predictive validity; and modest ability to identify patients requiring hospitalization and, in hospitalized patients, those requiring involuntary hospitalization. The authors propose use of the scale to better clarify decisions about level of care assignments and to better assess patient characteristics predictive of good outcome. [ABSTRACT FROM AUTHOR]

Three hundred and fifty-two patients with alcoholic hepatitis were evaluated for protein-calorie malnutrition (PCM). In order to facilitate data analysis of nutritional status, a PCM score was calculated for each patient using eight nutritional parameters. The PCM score correlated significantly with mortality, clinical severity of the liver disease, and biochemical liver dysfunction. When 30 day changes in the PCM scores were compared with 30 day caloric intake (expressed as percent basal energy expenditure (BEE)), a marginally significant correlation was observed (p = 0.05). However, those patients who showed improvement in their PCM score over 30 days of hospitalization also improved their 6-mo and 1-yr survival. These data indicate that nutrition, as determined by the PCM score, has prognostic significance. Additional studies are needed to establish the beneficial role for vigorous protein-calorie nutritional therapy in the management of alcoholic hepatitis. [ABSTRACT FROM AUTHOR]

As part of a large multicenter Veterans Administration Cooperative Study of Alcoholic Hepatitis, 89 patients with clinically mild biopsy-proven disease were followed for at least 30 months. Although clinical and laboratory abnormalities were minimal, cirrhosis was present in 38%, and mortality was 22% at 30 months. Clinical features suggesting more advanced disease (i.e., ascites and encephalopathy) and laboratory parameters for the diagnosis of alcoholic hepatitis and/or cirrhosis were imprecise and frequently misleading. The histologic diagnosis of cirrhosis correlated best with changes in immunoglobulin A, prothrombin time, and SGOT/ SGPT. However, by using logistic discriminant analysis on 26 commonly available laboratory tests to diagnose cirrhosis, only a 72% sensitivity and 88% specificity could be obtained. Mortality in the patients with cirrhosis (10/34) was significantly higher at 1 and 2 yr compared with patients without cirrhosis (10/55, p < 0.01). The high mortality in noncirrhotics may have resulted from progression to cirrhosis subsequent to the initial evaluation. Thus, liver biopsy in this population with minimal disease seems necessary to establish both an accurate diagnosis and the reversibility of the disease. [ABSTRACT FROM AUTHOR]

Two patients developed a syndrome closely simulating the 'lupoid' form of chronic active hepatitis during prolonged therapy with macrocrystalline nitrofurantoin. Symptoms and biochemical indices of hepatocellular necrosis abated rapidly after discontinuation of drug therapy, but smooth muscle and antinuclear antibodies remained detectable more than 1 year later. The serologic features of the disease and a strongly positive lymphocyte transformation test in one of the patients suggest that the disorder may have been immunologically mediated. [ABSTRACT FROM AUTHOR]

Carcinoid tumors of the biliary tree are rare. To the best of our knowledge, this is the first reported case of an intrahepatic ductal carcinoid and the thirteenth reported case of biliary carcinoid. The radiographic appearance is variable. A brief review of the previously described cases is presented. [ABSTRACT FROM AUTHOR]

The few studies that compared auditory skill learning between children and adults found variable results, with only some children reaching adult-like thresholds following training. The present study aimed to assess auditory skill learning in children as compared with adults during single- and multisession training. It was of interest to ascertain whether children who do not reach adult-like performance following a single training session simply require additional training, or whether different mechanisms underlying skill learning need to reach maturity in order to become adult-like performers. Forty children (7–9 years) and 45 young adults (18–35 years) trained in a single session. Of them, 20 children and 24 adults continued training for eight additional sessions. Each session included six frequency discrimination thresholds at 1000 Hz using adaptive forced-choice procedure. Retention of the learning-gains was tested 6 to 8 months posttraining. Results showed that (a) over half of the children presented similar performance and time course of learning as the adults. These children had better nonverbal reasoning and working memory abilities than their non-adult-like peers. (b) The best predicting factor for the outcomes of multisession training was a child's performance following one training session. (c) Performance gains were retained for all children with the non-adult-like children further improving, 6 to 8 months posttraining. Results suggest that mature auditory skill learning can emerge before puberty, provided that task-related cognitive mechanisms and task-specific sensory processing are already mature. Short-term training is sufficient, however, to reflect the maturity of these mechanisms, allowing the prediction of the efficiency of a prolonged training for a given child. [ABSTRACT FROM AUTHOR]

The current preliminary report describes the utilization of low-resolution electromagnetic tomography (LORETA) in a small group of highly performing children using the Nucleus 22 cochlear implant (CI) and in normal-hearing (NH) adults. LORETA current density estimations were performed on an averaged target P3 component that was elicited by non-speech and speech oddball discrimination tasks. The results indicated that, when stimulated with tones, patients with right implants and NH adults (regardless of stimulated ear) showed enhanced activation in the right temporal lobe, whereas patients with left implants showed enhanced activation in the left temporal lobe. When stimulated with speech, patients with right implants showed bilateral activation of the temporal and frontal lobes, whereas patients with left implants showed only left temporal lobe activation. NH adults (regardless of stimulated ear) showed enhanced bilateral activation of the temporal and parietal lobes. The differences in activation patterns between patients with CI and NH subjects may be attributed to the long-term exposure to degraded input conditions which may have resulted in reorganization in terms of functional specialization. The difference between patients with right versus left implants, however, is intriguing and requires further investigation. [ABSTRACT FROM AUTHOR]

Background: Certain environmental exposures have been linked to the development of parkinsonism. We report four cases in which the onset of chronic parkinsonism occurred immediately or soon after surgery or childbirth. Results: Exposure to certain anesthetic agents in susceptible individuals or the physiological changes associated with surgery or childbirth may have contributed to or precipitated the development of parkinsonism. Conclusion: Clinicians should be aware that postoperative or postpartum settings are potential precipitants of chronic parkinsonism. More research is needed to clarify contributing factors.

Older adults with subjective cognitive decline (SCD) have a higher risk of developing future cognitive decline than those without SCD. However, the association between SCD and objective cognitive performance remains unclear. This PRISMA 2020-compliant systematic review aims to provide a qualitative assessment of the longitudinal and cross-sectional relationship between SCD and objective cognitive performance in different cognitive domains, in neuropsychologically healthy, community-dwelling older adults (average age of 55 or older). To identify pertinent studies, a comprehensive search was conducted from seven databases. The National Heart, Lung and Blood Institute Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess the quality of included studies. Inclusion criteria were met by 167 studies, which were full-text and published between 1 January 1982 and 16 May 2023 (inclusive) in the languages of English, French, or Spanish and presenting data on objective cognitive performance in older adults with SCD. Overall, we found that SCD was associated with poorer objective cognitive performance on measures of global cognition and memory longitudinally compared to non-SCD status, but this association was inconsistent in cross-sectional studies. This association became stronger with the use of continuous measures of SCD as opposed to dichotomous measures. Additionally, results highlight the known lack of consistency in SCD assessment among studies and comparatively small number of longitudinal studies in SCD research., (© 2024 The Author(s). Journal of Neuropsychology published by John Wiley & Sons Ltd on behalf of The British Psychological Society.)

Proper biobanking is essential for obtaining reliable data, particularly for next-generation sequencing approaches. Diseased vascular tissues, having extended atherosclerotic pathologies, represent a particular challenge due to low RNA quality. In order to address this issue, we isolated RNA from vascular samples collected in our Swiss Vascular Biobank (SVB); these included abdominal aortic aneurysm (AAA), peripheral arterial disease (PAD), healthy aorta (HA), and muscle samples. We used different methods, investigated various admission solutions, determined RNA integrity numbers (RINs), and performed expression analyses of housekeeping genes ( ACTB, GAPDH ), ribosomal genes ( 18S , 28S ), and long non-coding RNAs ( MALAT1 , H19 ). Our results show that RINs from diseased vascular tissue are low (2-4). If the isolation of primary cells is intended, as in our SVB, a cryoprotective solution is a better option for tissue preservation than RNAlater. Because RNA degradation proceeds randomly, controls with similar RINs are recommended. Otherwise, the data might convey differences in RNA degradation rather than the expressions of the corresponding genes. Moreover, since the 18S and 28S genes in the diseased vascular samples were degraded and corresponded with the low RINs, we believe that DV200, which represents the total RNA's disintegration state, is a better decision-making aid in choosing samples for omics analyses.

The present study assessed LENA's suitability as a tool for monitoring future language interventions by evaluating its reliability, construct validity, and criterion validity in infants learning Hebrew and Arabic, across low and high levels of maternal education. Participants were 32 infants aged 3 to 11 months (16 in each language) and their mothers, whose socioeconomic status (SES) was determined based on their years of education (H-high or L-low ME-maternal education). The results showed (1) good reliability for the LENA's automatic count on adult word count (AWC), conversational turns (CTC), and infant vocalizations (CVC), based on the positive associations and fair to excellent agreement between the manual and automatic counts; (2) good construct validity based on significantly higher counts for HME vs. LME and positive associations between LENA's automatic vocal assessment (AVA) and developmental questionnaire (DA) and age; and (3) good concurrent criterion validity based on the positive associations between the LENA counts for CTC, CVC, AVA, and DA and the scores on the preverbal parent questionnaire (PRISE). The present study supports the use of LENA in early intervention programs for infants whose families speak Hebrew or Arabic. The LENA could be used to monitor the efficacy of these programs as well as to provide feedback to parents on the amount of language experience their infants are getting and their progress in vocal production. The results also indicate a potential utility of LENA in assessing linguistic environments and interactions in Hebrew- and Arabic-speaking infants with developmental disorders, such as hearing impairment and cerebral palsy., (© 2022. The Psychonomic Society, Inc.)

Background: Mental Health Literacy (MHL) has become a focus of research in recent decades, as a prerequisite for early identification and intervention for mental health problems. Although several instruments have been developed for assessing MHL, there is a need for brief and psychometrically sound measures to capture important aspects of MHL in large and diverse adult samples. The present study aimed to: (1) provide a revised and shorter version of a previously validated questionnaire for assessing MHL; and (2) examine the psychometric properties of the MHLq-SVa in student samples from six different countries (China, India, Indonesia, Portugal, Thailand, and United States)., Methods: The study involved 2180 senior school and undergraduate students, aged between 17 and 25 years old, from China, India, Indonesia, Portugal, Thailand, and the United States. Participants responded to the Mental Health Literacy Questionnaire for young adults (MHLq-ya), in their native language, following its translation and adaptation for each culture. The MHLq-ya comprises 29 items, organized into four dimensions: Knowledge of mental health problems; Erroneous beliefs/stereotypes; First-aid skills and help-seeking behavior; Self-help strategies. Confirmatory factor analyses and internal consistency analyses were performed on the combined data., Results: Data from the different countries supported a shorter version of the questionnaire (MHLq-SVa), composed of 16 items that fit with previously defined dimensions. Internal consistency and between-factor correlations further supported the adequacy of the instrument's psychometric properties., Conclusion: The study provided preliminary support for the construct validity and reliability of the MHLq-SVa as a measure for assessing MHL in young adults from six different countries and languages. Future studies are needed to further validate the measure and undertake multicultural comparisons of MHL in diverse samples from around the globe., (© 2022. The Author(s).)

Memory lapses are a type of daily challenge that are common to most people and are associated with negative mood outcomes. How daily challenges are associated and linked to broad domains, like life satisfaction and well-being, has been underexamined. Life satisfaction is often assessed from a macro-level that emphasizes average differences over longer timeframes, yet daily experiences (i.e., micro-level) may accumulate to shape these characteristics. In the current study, we examined if daily memory lapses (e.g., difficulties with word-finding or forgetting a meeting) were associated with life satisfaction, and whether this relationship was mediated by the associated changes in positive and negative affect due to daily memory lapses. In a coordinated analysis of two datasets ( N = 561, ages 25-93 years), we used multilevel structural equation modeling to assess how daily memory lapses may influence the broader outcome of global life satisfaction. The pattern of results was similar across datasets: memory lapses were associated with reduced positive affect and increased negative affect. Further, the daily affect associated with daily memory lapses significantly mediated the relationship between lapses and life satisfaction, while the direct relationship between memory lapses and life satisfaction was non-significant. This study provides support for the role of daily challenges, specifically memory lapses, influencing broader constructs such as psychological well-being by identifying the key factor of affective responses. Future work should identify other salient daily challenges, as well as explore if reducing the affective response to challenges through targeted interventions would mitigate impacts on distal functioning., Competing Interests: Conflicts of Interest The authors declare they have no financial or non-financial interests to disclose.

Purpose: Processing narrow focus (NF), the stressed word in the sentence, includes both the perceptual ability to identify the stressed word in the sentence and the pragmatic-semantic ability to comprehend the nonexplicit linguistic message. NF and its underlying meaning can be conveyed only via the auditory modality. Therefore, NF can be considered as a measure for assessing the efficacy of the hearing aid (HA) and cochlear implants (CIs) for acquiring nonexplicit language skills. The purpose of this study was to assess identification and comprehension of NF by HA and CI users who are native speakers of Arabic and to associate NF outcomes with speech perception and cognitive and linguistic abilities., Method: A total of 46 adolescents (age range: 11;2-18;8) participated: 18 with moderate-to-severe hearing loss who used HAs, 10 with severe-to-profound hearing loss who used CIs, and 18 with typical hearing (TH). Test materials included the Arabic Narrow Focus Test (ANFT), which includes three subtests assessing identification (ANFT1), comprehension of NF in simple four-word sentences (ANFT2), and longer sentences with a construction list at the clause or noun phrase level (ANFT3). In addition, speech perception, vocabulary, and working memory were assessed., Results: All the participants successfully identified the word carrying NF, with no significant difference between the groups. Comprehension of NF in ANFT2 and ANFT3 was reduced for HA and CI users compared with TH peers, and speech perception, hearing status, and memory for digits predicted the variability in the overall results of ANFT1, ANFT2, and ANFT3, respectively., Conclusions: Arabic speakers who used HAs or CIs were able to identify NF successfully, suggesting that the acoustic cues were perceptually available to them. However, HA and CI users had considerable difficulty in understanding NF. Different factors may contribute to this difficulty, including the memory load during the task as well as pragmatic-linguistic knowledge on the possible meanings of NF.

Human listeners are assumed to apply different strategies to improve speech recognition in background noise. Young listeners with normal hearing (NH), e.g., have been shown to follow the voice of a particular speaker based on the fundamental (F0) and formant frequencies, which are both influenced by the gender, age, and size of the speaker. However, the auditory and cognitive processes that underlie the extraction and discrimination of these voice cues across speakers may be subject to age-related decline. The present study aimed to examine the utilization of F0 and formant cues for voice discrimination (VD) in older adults with hearing expected for their age. Difference limens (DLs) for VD were estimated in 15 healthy older adults (65-78 years old) and 35 young adults (18-35 years old) using only F0 cues, only formant frequency cues, and a combination of F0 + formant frequencies. A three-alternative forced-choice paradigm with an adaptive-tracking threshold-seeking procedure was used. Wechsler backward digit span test was used as a measure of auditory working memory. Trail Making Test (TMT) was used to provide cognitive information reflecting a combined effect of processing speed, mental flexibility, and executive control abilities. The results showed that (a) the mean VD thresholds of the older adults were poorer than those of the young adults for all voice cues, although larger variability was observed among the older listeners; (b) both age groups found the formant cues more beneficial for VD, compared to the F0 cues, and the combined (F0 + formant) cues resulted in better thresholds, compared to each cue separately; (c) significant associations were found for the older adults in the combined F0 + formant condition between VD and TMT scores, and between VD and hearing sensitivity, supporting the notion that a decline with age in both top-down and bottom-up mechanisms may hamper the ability of older adults to discriminate between voices. The present findings suggest that older listeners may have difficulty following the voice of a specific speaker and thus implementing doing so as a strategy for listening amid noise. This may contribute to understanding their reported difficulty listening in adverse conditions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zaltz and Kishon-Rabin.)

Purpose This study aims to examine the development of auditory selective attention to speech in noise by examining the ability of infants to prefer child-directed speech (CDS) over time-reversed speech (TRS) presented in "on-channel" and "off-channel" noise. Method A total of 32 infants participated in the study. Sixteen typically developing infants were tested at 7 and 11 months of age using the central fixation procedure with CDS and TRS in two types of noise at +10 dB signal-to-noise ratio. One type of noise was an "on-channel" masker with a spectrum overlapping that of the CDS (energetic masking), and the second was an "off-channel" masker with frequencies that were outside the spectrum of the CDS (distractive masking). An additional group of sixteen 11-month-old infants were tested in quiet and served as controls for the "off-frequency" masker condition. Results Infants preferred CDS over TRS in both age groups, but this preference was more pronounced with "off-channel" masker regardless of age. Also, older infants demonstrated longer looking time for the target stimuli when presented with an "off-channel" masker compared to the "on-channel" masker. Looking time in quiet was similar to looking time in the "off-channel" condition, and looking time for CDS was longer in quiet compared to the "on-channel" condition. Conclusions These findings support the notion that (a) infants as young as 7 months of age are already showing preference for speech in noise, regardless of type of masker; (b) by 11 months of age, listening with the "off-channel" condition did not yield different results than in quiet. Thus, by 11 months of age, infants' cognitive-attentional abilities may be more developed.

Judgment is the ability to make sound decisions after consideration of relevant information, possible solutions, likely outcomes, and contextual factors. Loss of judgment is common in patients with mild cognitive impairment (MCI) and dementia. The Test of Practical Judgment (TOP-J) evaluates practical judgment in adults and the elderly, with 15- and 9-item versions that require individuals to listen to scenarios about everyday problems and report their solutions., Objective: Adaptation of TOP-J for a Brazilian sample, preparation of a reduced version and verification of the accuracy of both., Methods: Eighty-five older adults, including 26 with MCI, 20 with Alzheimer's disease (AD), 15 with frontotemporal dementia behavioral variant (FTDbv) and 24 controls, underwent neuropsychological assessment including the Brazilian adaptation of the TOP-J (TOP-J-Br)., Results: On both TOP-J-Br versions, controls outperformed MCI, AD and FTDbv patients (p<0.001) and MCI outperformed AD and FTDbv (p<0.001). For the TOP-J/15-Br, the best cutoff for distinguishing controls and patients had a sensitivity of 91.7%, specificity of 59.0% and area under the curve of 0.8. For the TOP-J/9-Br, the best cutoff for distinguishing controls and patients had a sensitivity of 79.9%, specificity of 72.1% and area under the curve of 0.82., Conclusion: The TOP-J/15-Br, and particularly the TOP-J/9-Br, showed robust psychometric properties and the potential for clinical utility in Brazilian older adults at various stages of neurodegenerative cognitive decline., Competing Interests: Disclosure: The authors report no conflicts of interest.

Hypothesis: Hearing via soft tissue stimulation involves an osseous pathway., Background: A recent study that measured both hearing thresholds and skull vibrations found that vibratory stimulation of soft tissue led to hearing sensation that correlated with skull vibrations, supporting the hypothesis of an osseous pathway. It is possible, however, that a lower application force of the vibrator on the stimulated soft tissue would not be sufficient to elicit skull vibration suggesting hearing via a nonosseous pathway. The purpose of the present study was to confirm the osseous pathway by measuring skull vibrations and behavioral thresholds using a low application force on a layer of ultrasound gel. Gel was used to mimic soft tissue because of its similar acoustic impedance and to control for variability between participants., Methods: Hearing thresholds and the skull vibrations of five patients who were implanted with bone-anchored implants were assessed in two conditions when the bone vibrator was applied on the forehead: 1) direct application with 5N force; 2) through a layer of ultrasound gel with minimal application force. Skull vibrations were measured in both conditions by a laser Doppler vibrometer focused on the bone-anchored implant., Results: Skull vibrations were present even when minimal application force was applied on soft tissue. The difference in skull vibrations when the vibrator was directly on the forehead compared with the gel condition was consistent with the variability in hearing thresholds between the two conditions., Conclusion: These results reinforce the hypothesis that skull vibrations are involved in hearing when sound is transmitted via either soft tissue or bone., Competing Interests: The authors disclose no conflicts of interest., (Copyright © 2020, Otology & Neurotology, Inc.)

Introduction: Composite scores may be useful to summarize overall language or visuospatial functioning in studies of older adults., Methods: We used item response theory to derive composite measures for language (ADNI-Lan) and visuospatial functioning (ADNI-VS) from the cognitive battery administered in the Alzheimer's Disease Neuroimaging Initiative (ADNI). We evaluated the scores among groups of people with normal cognition, mild cognitive impairment (MCI), and Alzheimer's disease (AD) in terms of responsiveness to change, association with imaging findings, and ability to differentiate between MCI participants who progressed to AD dementia and those who did not progress., Results: ADNI-Lan and ADNI-VS were able to detect change over time and predict conversion from MCI to AD. They were associated with most of the pre-specified magnetic resonance imaging measures. ADNI-Lan had strong associations with a cerebrospinal fluid biomarker pattern., Discussion: ADNI-Lan and ADNI-VS may be useful composites for language and visuospatial functioning in ADNI., Competing Interests: The authors declare that they have no conflicts of interest., (© 2020 The Authors. Alzheimer's & Dementia: Translational Research & Clinical Interventions published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

Background: Investigating variables associated with mental health literacy in the college-age population takes us one step closer to providing intervention for this vulnerable group, where growing rates of psychological disorders are a serious public concern. This study adds to the existing literature by incorporating, within a single model, multi-faceted variables (demographic, psychological, and academic) that contribute to mental health literacy in demographically and ethnically diverse college students., Methods: Participants were undergraduate students enrolled at nine different colleges that are part of a large, urban, public university system. A total of 1213 respondents (62.0% female, 73.3% non-white) completed an in-person assessment of mental health literacy and answered questions about demographics, college experience, and mental health experience. Data were analyzed to identify which variables best discriminated between high, mid-level, and low performers on this assessment., Results: Discriminant correspondence analysis revealed that the difference between high and low performers (accounting for 90.27% of the total variance) was driven by participants who had taken at least one course related to clinical psychology and who typically majored in psychology and applied health science fields. These participants were more likely to report being white, female, between the ages of 28-32, and in the fourth year or later of their undergraduate program. In addition, high performers were more likely to have been diagnosed and/or treated for a psychological disorder, have more experience with psychological disorders through personal, family, or peer history, and have families who are open to discussing mental health issues., Conclusion: The main contributor to variation in mental health literacy scores was having taken a clinical psychology course, followed by majoring in psychology. Importantly, our findings identified not only the high performers, but also the low performers, for whom an increase in knowledge and awareness of mental health is crucial to overall psychological well-being. These results have important implications for the design of educational interventions aimed at improving mental health literacy at the college level, especially for students who otherwise would not have been exposed to this information from coursework or their major.

Background: Evidence from motor and visual studies suggests that the ability to generalize learning gains to untrained conditions decreases as the training progresses. This decrease in generalization was suggested to reflect a shift from higher to lower levels of neuronal representations of the task following prolonged training. In the auditory modality, however, the few studies that tested the influence of prolonging training on generalization ability showed no decrease and sometimes even an increase in generalization., Objective: To test the impact of extending training in a basic psychoacoustic task on the ability to generalize the gains attained in training to untrained conditions., Design: Eighty-two young adults participated in two experiments that differed in the specific training regimen. In both experiments, training was conducted using a difference limen for frequency (DLF) task with an adaptive forced-choice procedure, for either a single- or nine-session training. Following training, generalization to the untrained ear and to an untrained frequency was assessed., Results: (a) Training induced significant learning (i.e., smaller DLF thresholds) following a single session of training, and more so following nine training sessions; (b) results from the combined data from both experiments showed that the ability to generalize the learning gains to the untrained ear and frequency was limited after the extended DLF training; (c) larger improvements under the trained condition resulted in smaller generalization to the untrained conditions., Conclusions: The findings of increased specificity with training in the auditory modality support the notion that gradual changes, both quantitative and qualitative, occur in the neural representations of an auditory task during its acquisition. These findings suggest common underlying mechanisms in basic skill learning across different modalities.

We observed that World Trade Center (WTC) exposure, post-traumatic stress disorder (PTSD) symptoms and depressive symptoms were associated with subjective cognitive concerns in Fire Department of the City of New York (FDNY) rescue/recovery workers. This follow-up study examined whether PTSD symptoms and/or depressive symptoms mediate the observed association between WTC exposure and subjective cognitive concerns. We included WTC-exposed FDNY workers who completed the Cognitive Function Instrument (CFI), measuring self-perceived cognitive decline ( N = 9516). PTSD symptoms and depressive symptoms were assessed using the PCL-S and CES-D, respectively. Multivariable linear regression estimated the association between WTC exposure and CFI score, adjusting for confounders. Mediation analyses followed the methods of Vanderweele (2014). Participants' average age at CFI assessment was 56.6 ± 7.6 years. Higher-intensity WTC exposure was associated with worse CFI score, an effect that was entirely mediated by PTSD symptoms (%mediated: 110.9%; 95%CI: 83.1-138.9). When substituting depressive symptoms for PTSD symptoms, the WTC exposure-CFI association was largely mediated (%mediated: 82.1%; 95%CI: 60.6-103.7). Our findings that PTSD symptoms and depressive symptoms mediate the association between WTC exposure and subjective cognitive concerns indicate that in the absence of these symptoms, WTC exposure in rescue/recovery workers would not be associated with subjective cognition. Interventions targeting PTSD and depression may have additional value in mitigating cognitive decline in WTC-exposed populations.

Cochlear implants (CIs) are the state-of-the-art therapy for individuals with severe to profound hearing loss, providing them with good functional hearing. Nevertheless, speech understanding in background noise remains a significant challenge. The purposes of this study were to: (1) conduct a novel within-study comparison of speech-in-noise performance across ages in different populations of CI and normal hearing (NH) listeners using an adaptive sentence-in-noise test, and (2) examine the relative contribution of sensory information and cognitive-linguistic factors to performance. Forty CI users (mean age 20 years) were divided into "early-implanted" <4 years ( n = 16) and "late-implanted" >6 years ( n = 11), all prelingually deafened, and "progressively deafened" ( n = 13). The control group comprised 136 NH subjects (80 children, 56 adults). Testing included the Hebrew Matrix test, word recognition in quiet, and linguistic and cognitive tests. Results show poorer performance in noise for CI users across populations and ages compared to NH peers, and age at implantation and word recognition in quiet were found to be contributing factors. For those recognizing 50% or more of the words in quiet ( n = 27), non-verbal intelligence and receptive vocabulary explained 63% of the variance in noise. This information helps delineate the relative contribution of top-down and bottom-up skills for speech recognition in noise and can help set expectations in CI counseling.