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Conductive hearing loss caused by external or middle ear problems prevents the transmission of sound waves from the external auditory canal to the cochlea, and it is a common condition, especially in pediatric patients aged 1–5 years. The most common etiological factors are otitis media and cerumen during childhood. In some patients, external and middle ear functions and structures may be normal bilaterally despite the air-bone gap on the audiogram. This condition, which is often a missed diagnosis in children, is defined as a pseudo-conductive hearing loss (PCHL) caused by third window syndromes (TWSs) such as semicircular canal dehiscence, inner ear malformations with third window effect, and perilymphatic fistula. In this review of the literature, the authors emphasize the pitfalls of pediatric audio-vestibular evaluation on TWSs as well as the key aspects of this evaluation for the differential diagnosis of PCHL brought on by TWSs. This literature review will provide audiologists and otologists with early diagnostic guidance for TWSs in pediatric patients.

Purpose: The purpose of this study was to develop a novel teacher-reported pediatric voice outcome measure and to investigate its psychometric properties. Method: In the first stage, a new instrument, the Teacher-Reported Pediatric Voice Handicap Index (TRPVHI), was developed. After item generation, a panel of experts evaluated the items to assess the content validity. Subsequently, the final version of the preliminary instrument was applied to teachers of 306 children (57 dysphonic and 249 vocally healthy) between the ages of 4 and 11 years. Eventually, the construct validity, criterion-related validity, test-retest reliability, and internal consistency of the developed instrument were examined. Results: The items with a content validity ratio less than 0.8 were modified or removed, and accordingly, the preliminary version of the index was finalized. After the application of the preliminary version, item reduction was made based on the factor analysis. The index is composed of 27 questions and three subscales: Functional, Physical, and Emotional. A significant difference was observed between the dysphonic and vocally healthy children for the TRPVHI scores (p < 0.001). A positive moderate correlation was determined between the Pediatric Voice Handicap Index and TRPVHI scores. Correlation coefficients between the test and retest scores of the TRPVHI were in the range of 0.92-0.98. Cronbach's alpha values computed to assess the internal consistency were in the range of 0.94-0.98. Conclusions: The TRPVHI is the only valid and reliable teacher-reported outcome measure of the effects of voice disorders on children. It is anticipated that the deployment of the TRPVHI in conjunction with other subjective tools, both in the initial evaluation and the follow-up of the treatment results, will allow a better understanding of the physical, functional, and emotional effects of voice disorders on children. Furthermore, it can potentially lead further research to enable the use of the TRPVHI for screening purposes.

Posterior reversible encephalopathy syndrome (PRES) is a syndrome characterized by various neurological findings such as headache, visual disturbances, seizures and altered consciousness, and imaging findings of edema in the posterior cerebral regions. Clinical and radiological findings are often reversible. Etiology may include hypertension, cytotoxic drugs, and autoimmune diseases. It often develops on the background of eclampsia and high blood pressure in the postpartum period. In this article, two cases of PRES, which developed under normal blood pressure values during pregnancy and postpartum period and characterized by seizure, are presented.

The purpose of this study was to assess the effects of transverse friction massage (TFM) on the electromechanical delay components and complexity of the surface electromechanical activity in the rectus femoris (RF) and vastus medialis (VM) muscles and to identify possible mechanisms behind TFM-induced alterations in the dynamics of RF and VM activity. Seven female and five male healthy subjects participated in this study. The subjects generated five maximal voluntary isometric contractions (MVICs) consecutively before and after TFM. Meanwhile, electromyography (EMG), mechanomyography (MMG), and force were recorded. The onset times of the recorded signals were detected offline by setting the threshold to three times the SD of the baseline. The delays between EMG and MMG (Δt(EMG–MMG)), MMG and force (Δt(MMG–Force)), and EMG and force (Δt(EMG–Force)) were computed from the detected onsets. The fractal dimension (FD) of the EMG time series was computed using the correlation dimension method. TFM increased Δt(MMG–Force) and Δt(EMG–Force) significantly in the RF but decreased Δt(EMG–MMG) and increased Δt(MMG–Force) in the VM. TFM decreased the FD in the RF and increased it in the VM. The results imply that TFM decreased the stiffness of both the RF and VM and decreased the duration of the electrochemical processes in the VM. It is proposed that the decrease in EMG complexity in the RF may be associated with the decreased stiffness of the RF, and the increase in EMG complexity in the VM may be associated with the decreased electrochemical processes in this muscle. It is also suggested that the opposite changes in EMG complexity in the RF and VM can be used as a discriminating parameter to search for the effects of an intervention in the quadriceps muscles. The present study also demonstrates how to discriminate the nonlinear dynamics of a complex muscle system from a noisy time series.

An archer requires a well-balanced and highly reproducible release of the bowstring to attain high scores in competition. Recurve archers use a mechanical device called the “clicker” to check the draw length. The fall of the clicker that generates an auditory stimulus should evoke a response in the brain. The purpose of this study is to evaluate the event-related potentials during archery shooting as a response to the fall of the clicker. Fifteen high-level archers participated. An electro cap was placed on the archers’ scalps, and continuous EEG activity was recorded (digitized at 1000 Hz) and stored for off-line analysis. The EEG data were epoched beginning 200 ms before and lasting 800 ms after stimulus marker signals. An operational definition has been developed for classifying hits corresponding to hit and/or miss areas. The hit area enlarged gradually starting from the centre of the target (yellow: 10) to blue (6 score) by creating ten hit area indexes. It is found that the snap of the clicker during archery shooting evokes N1–P2 components of long-latency evoked brain potentials. N1 amplitudes are significantly higher in hit area than that of miss areas for the 2nd and 4th indexes with 95% confidence intervals and 90% confidence intervals for the 1st and 3rd indexes with 90% confidence intervals. We conclude that the fall of the clicker in archery shooting elicits an N1 response with higher amplitude. Although evoked potential amplitudes were higher in successful shots, their latencies were not significantly different from the unsuccessful ones.

An acoustic stimulus elicits an electroencephalographic response called auditory event-related potential (ERP). When some members of a stream of standard auditory stimuli are replaced randomly by a deviant stimulus and this stream is presented to a subject who ignores the stimuli, two different ERPs to deviant and standard stimuli are recorded. If the ERP to standard stimuli is subtracted from the ERP to deviant stimuli, the difference potential (DP) waveform typically exhibits a series of negative-positive-negative deflections called mismatch negativity (MMN), P3a, and reorienting negativity (RON), which are associated with pre-attentive change detection, involuntary attention switching, and reorienting of attention, respectively. The aim of the present study was to investigate how these pre-attentive processes are affected if the change occurs earlier than its usual timing implied by isochronous standard stimuli. In the MMN paradigm employed, 15% of the standards were randomly replaced by deviant stimuli which differed either in their pitch, their earlier onset time, or in both. Event-related responses to these three deviants [timely pitch change (RTP), earlier onset (REO), earlier pitch change (REP)] and to standards (RS) were recorded from 10 reading subjects. To maintain identical stimulation histories for the responses subtracted from each other, “deviant-standard” difference potentials (DP) for “timely” and “early” pitch deviances were derived as follows: DPTP = RTP − RS and DPEP = REP − REO. Interestingly, the MMN components of the DPs to timely and early pitch deviances had similar amplitudes, indicating that regularity of stimulus timing does not provide any benefit for the pre-attentive auditory change detection mechanism. However, different scalp current density (SCD) dynamics of the MMN/P3a complexes, elicited by timely and early pitch deviances, suggested that an auditory change in a stimulus occurring earlier-than-usual initiates a faster and more effective call-for-attention and causes stronger attention switching than a timely change. SCD results also indicated that the temporal, frontal, and parietal MMN components are simultaneously present rather than emerging sequentially in time, supporting the MMN models based on parallel deviance processing in the respective cortices. Similarity of the RONs to timely and early pitch deviances indicated that reorienting of attention is of the same strength in two cases.

ABSTRACT INTRODUCTION: Keeping balance of the upright stance is a highly practiced daily task for healthy adults and is effectively performed without overt attentional control in most. OBJECTIVE: The purpose of this study was to examine the influence of concurrent cognitive tasks on postural sway in healthy participants. METHODS: This was a prospective study. 20 healthy volunteer subjects were included. The cognitive and balance tasks were performed separately and then, concurrently. Postural control task consisted of 6 conditions (C) of the Sensory Organization Test. The cognitive task consisted of digit rehearsal task of varying presentation and varying levels of difficulty. RESULTS: A statistically significant difference was noted between dual task and no task for C1, C2, C3 and C4 Sensory Organization Test scores ( p < 0.05). There was no statistically significant difference between dual task versus non-task for C5, C6 and combined Sensory Organization Test scores ( p > 0.05). CONCLUSION: During dual task, increase has been determined in postural sway for C1, C2, C3 and C4 for all presentation modes and difficulty levels of the cognitive tasks.

In this paper we question key terms which appear frequently in discussions of language teaching and learning: "language" and "heritage". The paper draws on empirical data from one of four linked case studies in a larger project funded by the UK Economic and Social Research Council (ESRC), "Investigating Multilingualism in Complementary Schools in Four Communities" (RES-000-23-1180). In our analysis we argue that the relationships between "language" and "heritage", far from being straightforward, are complex in the way they play out in classroom interactions. The data raise a number of questions in our attempts to understand how the linguistic practices of students and teachers in Bengali schools are used to negotiate young people's multilingual and multicultural identities. First, participants articulate attitudes and values which raise questions about what constitutes "language". Second, participants express views and attitudes, and perform interactional practices, which raise questions about what constitutes "heritage". Our analysis finds that multilingual young people in complementary school classrooms use linguistic resources in sophisticated and creative ways to negotiate subject positions which appear to contest and subvert schools' attempts to impose upon them "heritage" identities (Creese, A., A. Bhatt, N. Bhojani, and P. Martin. 2006. "Multicultural, heritage and learner identities in complementary schools," "Language and Education" 20/1: 23-44).

Developing artificial learning systems that can understand and generate natural language has been one of the long-standing goals of artificial intelligence. Recent decades have witnessed an impressive progress on both of these problems, giving rise to a new family of approaches. Especially, the advances in deep learning over the past couple of years have led to neural approaches to natural language generation (NLG). These methods combine generative language learning techniques with neural-networks based frameworks. With a wide range of applications in natural language processing, neural NLG (NNLG) is a new and fast growing field of research. In this state-of-the-art report, we investigate the recent developments and applications of NNLG in its full extent from a multidimensional view, covering critical perspectives such as multimodality, multilinguality, controllability and learning strategies. We summarize the fundamental building blocks of NNLG approaches from these aspects and provide detailed reviews of commonly used preprocessing steps and basic neural architectures. This report also focuses on the seminal applications of these NNLG models such as machine translation, description generation, automatic speech recognition, abstractive summarization, text simplification, question answering and generation, and dialogue generation. Finally, we conclude with a thorough discussion of the described frameworks by pointing out some open research directions. [ABSTRACT FROM AUTHOR]

Introduction: Clopidogrel and ticagrelor are commonly used, antiplatelet agents. Ticagrelor has an effect of enhancing the plasma level of adenosine that may alter the autonomic function. The aim of this study is to compare the effects of ticagrelor and clopidogrel on heart rate variability (HRV) and heart rate turbulence (HRT). Methods: Thirty subjects who performed percutaneous coronary intervention (PCI) were included in the randomized, crossover study. These patients were divided into two groups. Clopidogrel or ticagrelor was administered in two different testing sessions (1-month treatment for each session). In group 1, clopidogrel and ticagrelor treatment were used while in group 2, ticagrelor and clopidogrel treatment were used respectively. Three times rhythm Holter recording (baseline, 1st and 2nd month) was performed. The HRV (time domain and frequency domain) and HRT (turbulence onset (TO) and turbulence slope (TS)) parameters were analyzed from the Holter recordings. Results: According to baseline Holter recording, pNN50 (5.82 ± 5.83 vs 10.56 ± 8.28; p = 0.03) and HF(nu) (6.85 ± 9.33 vs 9.53 ± 7.41; p = 0.04) parameters were higher in group 2 than in group 1, while TO(0.004 ± 0.02 vs -0.01 ± 0.02; p = 0.01) parameter was positive and higher in group 1 than in group 2. In the second month, the LF/HF ratio (4.47 ± 2.43 vs 3.18 ± 2.45; p = 0.04) was higher in group 1 than in group 2. However, when the evaluation was done within the groups themselves, there were no statistically significant differences in HRV and HRT parameters obtained before and after clopidogrel and ticagrelor administration in group 1 and group 2. Conclusion: Ticagrelor and clopidogrel treatments did not have a significant effect on HRV and HRT parameters. [ABSTRACT FROM AUTHOR]

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• Solvent extraction and supported liquid membrane was applied to SA recovery. • Extraction of SA tremendously decreased as pH was increased from 2 to 5. • Initial SA flux of 9.65 g/m2h doubled that of lactic acid. • All the volatile components were completely removed by vacuum distillation. • Extraction of SA without coextraction LA was not achieved in pH range 2−5. Fermentative production of succinic acid (SA) from renewable resources such as whey is environmentally sustainable compared to petroleum-based synthesis. However, a major drawback of fermentation is the concurrent production of SA with byproducts such as lactic acid (LA), formic acid (FA) and acetic acid (AA). Therefore, appropriate downstream SA recovery and purification steps are significant in ensuring sustainable SA production. In this study, SA was fermented by Actinobacillus succinogenes and recovered in an integrated process consisting of ultrafiltration, vacuum distillation and reactive extraction. The extractant used was tri-n-octylamine (TOA) with 1-octanol as a diluent for both liquid-liquid (LLE) extraction and supported liquid membrane (SLM). The produced SA titer and yield was 11.16 g/L and 0.44 g/g, respectively. The steady state ultrafiltration permeate flux ranged from 31.18 to 33.42 L/m2h, and complete decolorization of the fermentation broth was achieved with 10 % (w/v) of powdered activated carbon. The extraction efficiency for LLE was 51.5 %, whereas SLM achieved 57.3 % recovery. SA exhibited transport and permeability coefficient of 0.00697 h−1 (R2 > 0.92) and 0.08605 cm h−1, respectively. Extraction of SA tremendously decreased as the aqueous pH was increased from 2 to 5. In SLM, initial SA flux was calculated as 9.65 g/m2h and doubled that of lactic acid. Selective extraction of only SA was not achieved; however, residue biological material and macromolecular substances were effectively removed. Herein, we clearly demonstrated that process integration applied in reactive extraction is a promising approach for recovery of SA from fermentation broth. [ABSTRACT FROM AUTHOR]

Aim: Coronary artery ectasia (CAE) is commonly defined as local or generalized dilatation of a coronary vessel up to 1,5 times the diameter of an adjacent vessel. Tp-Te interval and Tp-Te/QT ratio have emerged as a novel electrocardiographic (ECG) markers of increased dispersion of ventricular repolarization. The aim of this study was to evaluate ventricular repolarization by using Tp-Te interval and Tp-Te/QT ratio in patients with CAE.Materials and methods: Patient records were retrospectively analyzed. ECG of 28 patients, who were diagnosed as CAE were obtained and scanned.Tp-Te, QT and corrected QT intervals and some other ECG intervals were measured. ECGs of age and sex matched 22 healthy control individuals were also analyzed for comparison.Results: Baseline characteristics and QT, QTc intervals were similar in both group. Tp-Te (97,71±8,7 vs 85,23±7,1; p<0,001) and Tp-Te/QT (0,22±0,0 vs 0,20±0,0; p<0,001) were significantly worse in CAE group.Conclusions: :Tp-Te is a measure of transmural dispersion of repolarization in the left ventricle and accepted as a surrogate for increased ventricular arrhythmogenesis risk. Tp-Te and Tp-Te/QT are relatively new markers which also indicate repolarization defects. Our results show that CAE patients significantly higher values of Tp-Te and Tp-Te/QT than controls. These measurements may indicate increased arrhythmogenesis risk for individuals with CAE.ParametersPatientsControlsp valueLVEDD (mm)45±843±100.59LVESD (mm)28±526±60.48LVEF (%)62.9±4.465.9±5.10.03QT max383.43±30375.91±230.35QTc max421.32±26409.95±180.09TPe97.71±8.785.23±7.1<0.001TPe/QT ratio0.22±0.00.20±0.0<0.001QT disp26.89±9.924.41±6.50.31Echocardiographic and electrocardiographic parameters between the patient group with the control group. [ABSTRACT FROM PUBLISHER]

Aim: Coronary artery ectasia (CAE) is commonly defined as local or generalized dilatation of a coronary vessel up to 1.5 times the diameter of an adjacent vessel. Tp-Te interval and Tp-Te/QT ratio have emerged as novel electrocardiographic markers of increased dispersion of ventricular repolarization. The aim of this study was to evaluate ventricular repolarization by using Tp-Te interval and Tp-Te/QT ratio in patients with CAE., Materials and Methods: Patients' records were retrospectively analyzed. Electrocardiogram of 28 patients, who were diagnosed as CAE were obtained and scanned. T wave peak to end interval, QT and corrected QT intervals and some other ECG intervals were measured. Electrocardiograms of age and sex matched 22 control individuals were also analyzed for comparison. Patients with critical coronary stenosis, moderate or severe valve disease, left and/or right heart failure, left and/or right ventricle hypertrophy, atrial fibrillation, moderate or severely abnormal electrolytes, right or left bundle block or patients who got pacemaker or ICD implanted and who undergo hemodialyses were excluded., Results: Baseline characteristics and QT, QTc intervals were similar in both groups. Tp-Te (97.71 ± 8.7 vs 85.23 ± 7.1; p < 0.001) and Tp-Te/QT (0.22 ± 0.0 vs 0.20 ± 0.0; p < 0.001) were significantly worse in CAE group., Conclusions: T wave peak to end interval is a measure of transmural dispersion of repolarization in the left ventricle and accepted as a surrogate for increased ventricular arrhythmogenesis risk. Tp-Te and Tp-Te/QT are relatively new markers which also indicate repolarization defects. Our results show that CAE patients significantly higher values of Tp-Te and Tp-Te/QT than controls. These measurements may indicate increased arrhythmogenesis risk for individuals with CAE.