领先的IMAP测试电池和“国际卫生条例”STAR的研究和开发是由英国医学研究理事会（MRC）和从奥迪康基金会的赠款。感谢洛娜哈利迪，萨利后和艾莉森 - 莱利，在工作和宋佳Ratib和测试期间，人口众多，基础研究或听觉处理IMAP测试电池的团队规划阶段提供帮助。 “国际卫生条例”的技术和支持人员提供了宝贵的援助项目 - 尤其是，我们承认，戴维维克多Chilekwa添Folkard，布洛克和约翰钱伯斯的贡献。

此协议的目的是在研究人员和临床医生。它简要概括：（一）IMAP（“多中心”国际卫生条例“听觉处理的研究”）测试电池使用非语言的AP考试，主要是基于，（二）引入到电池，以确保成功的因素的信息孩子中心的方法，和（三）指导一步一步来形容6岁或以上的儿童使用的测试程序。 1。 IMAP测试电池 IMAP的电池提供了一个全面的听觉和认知评估，可以在一小时左右管理。它包括一个共10个测试：5个AP考试，非语言材料的基础上，讲话在噪音测试，持续的注意力测试，旨在评估在听觉和视觉的方式，既注意，和四个认知任务，评估阅读，语言短期记忆，工作记忆和非语言智力（NVIQ）。在附录A中提供这些测试的简要说明在测试过程中，通过舒适，高品质耳机提供听觉刺激（如森海塞尔HD25），孩子通过丰富多彩的，三个按钮盒（图1）响应。 IMAP测试电池是通过“国际卫生条例之星”（“国际卫生条例”听觉反应测试系统）平台的测试。该软件平台包括套房的计划产生刺激，控制AP和认知测试的介绍秩序，并确保测试协议得到遵守。 <img src="/files/ftp_upload/2139/2139fig1.jpg" alt="图1" /> 图1。一个孩子在IMAP测试电池测试的主要特点要注意的是五颜六色的按钮盒，使用耳机，通过声音，电脑屏幕上的儿童友好的图像。 两个“跟踪”是为每个AP考试。的曲目，各有20项试验，其中一项试验是一种刺激（刺激间的时间间隔为400 ms）的序列：两个相同的“标准”的刺激和不同，“目标”刺激。目标刺激的位置是不同的随机序列内，孩子需要来确定的“奇一出”。这就是所谓的三个区间，三个备用被迫选择（3I 3AFC）古怪响应模式（图2）。 <img src="/files/ftp_upload/2139/2139fig2.jpg" alt="图2" /> 图2。在测试频率的歧视审判。插图有三个，即时间间隔，三种色调。两个音调相同（1000赫兹），而第三个是不同的（1500赫兹）。这是目标。 IMAP标准音调为1000赫兹的所有测试。 “目标”音参数取决于AP测试，表1中提供的详细资料。在测试过程中的“目标”的相关参数，根据以前孩子的反应，使用“适应性”，楼梯的方法，其目的是快速收敛估计的阈值（即最低检出差异）是多种多样的。为AP测试步长变化的不同规则的摘要，请参阅表1。 刺激和反应的数据存储电子以后的提取和分析。 <table border="1"><tbody><tr><td> 测试 </td><td> 轨道规则（步长，楼梯） </td><td> 目标频率，持续时间;初期表现水平 </td><td> 屏蔽噪音型，中心频率，宽度;水平;期限 </td></tr><tr><td>向后掩蔽 （MS差距） </td><td> 1。 15分贝，1式1 2。 10分贝，1式1 3。 5分贝，3下1 线性刻度</td><td> 1000赫兹，20毫秒（10毫秒余弦匝道）; 90 dB声压级</td><td>带通滤波器; 1000赫兹，800赫兹，30 dB / Hz的300毫秒</td></tr><tr><td>向后掩蔽 （50毫秒差距） </td><td>如上所述</td><td> 1000赫兹，20毫秒（10毫秒余弦坡道） 75分贝SPL </td><td>如上所述</td></tr><tr><td>同时掩蔽（无缺口） </td><td>如上所述</td><td> 1000赫兹，20毫秒（10毫秒余弦坡道） 95分贝SPL </td><td>如上所述</td></tr><tr><td>同时掩蔽 （缺口） </td><td>如上所述</td><td> 1000赫兹，20毫秒（10MS余弦匝道） 90 dB声压级</td><td>带阻; 1000赫兹，1200赫兹（400赫兹的频谱缺口）; 30 dB / Hz的300毫秒</td></tr><tr><td>频率鉴别</td><td> 1。 2δHz，1式1 2。 2δHz1式1 3。 1.41δHz3式1 对数刻度</td><td> S = 1000赫兹 T = 1500赫兹（δ= 50％） 200毫秒; 70分贝SPL </td><td>不适用</td></tr><tr><td> VCV讲话中噪声</td><td> 1。 10分贝，1式1 2。 5分贝，1式1 3。 3分贝，3下1 </td><td> T =辅音在VCV例如，AGA 80分贝</td><td> ICRA - 5（男，一个喇叭）; 60分贝</td></tr></tbody></table> 表1。刺激参数和规则 ; T =目标AP和VCV测试 S =标准的适应性。 2。儿童友好的方法用于内部和外部软件的具体内容，以加强和最大限度地提高孩子的参与的协议。 通信。关键是要建立一个测试仪和孩子之间的良好关系。这包括使用适当的年龄，语言，介绍一系列“游戏玩”而不是“测试，以执行”测试会议，直接对话的孩子（不只是父），并使用适当的儿童友好的肢体语言。每个测试（见附录B），以确保指示是明确和适当的年龄已发展为一个标准化的对话。测试人员还必须检查，孩子已经完全理解的说明。 测试环境。在一个安静的房间里没有听觉或视觉分心，应进行测试。这最大限度地减小了屏蔽背景噪音的影响，并避免混淆，由于孩子的注意力远离测试。理想的情况下，只有儿童和测试应在测试过程中。 熟悉。一个熟悉阶段纳入该协议。它是事先进行测试，包括演示易于识别旁边不可能检测的刺激阈上刺激。这确保了古怪的范式和被迫选择的测试格式是可以理解的。然后，测试人员可以提供进一步的澄清，如果必要的话。熟悉是进一步促进了每个测试开始容易识别靶刺激，让孩子拥有一个成功的即时感。 失误的关注。早在关注的临时失效是由于在轨道的一个不正确的反应可能会导致在一个人为升高的门槛。为了尽量减少这种情况，这条赛道是自动放弃了一个不正确的响应时发生在头两个试验。曲目可以重新启动测试是为特定测试中止之前，最多三次。 尽量减少无聊。美联社的轨道持续时间短（20项试验），每个1.5至2分钟才能完成。听力和认知测试，测试序列内交错，以保持孩子感新奇。最后，“被迫选择”的方法让孩子在他/她自己的步伐。 参与。测试是为乐趣，电脑游戏玩。它们包括对儿童友好的图形，每场比赛的变化。卡通动物或人类角色移动动态与每个刺激呈现和反应（图3）。每个字符和声音，它是由一个弹跳球“的手段使得孩子的注意力。球也表示对孩子何时作出回应。听觉和视觉反馈给每个响应后，有一个指标，显示通过的“游戏”的孩子有多远进展。 <img src="/files/ftp_upload/2139/2139fig3.jpg" alt="图3" /> 图3。从IMAP测试电池的一个屏幕快照显示在程序界面已设计的不同功能，以维护儿童参与。 激励和奖励。虽然在IMAP电池测试演示程序方面是由“国际卫生条例”- STAR控制，这是必要的测试仪也参与整个测试的孩子。这涉及到测试之间的激励提供积极的反馈，以产生一种成功的感觉。卡通贴纸和证书完成测试，并贴可作为奖励，如果必要的测试过程中使用。 会议PROTocol <ol><li>为研究而研究，为孩子和家长都适合年龄的信息表发送了之前的测试会话。 </li><li>测试人员欢迎的儿童及家长（如果存在），并简要介绍了会发生什么。在研究方面进行测试，告知父母的书面同意的情况下，如果没有得到。也得到孩子的同意。 </li><li>一个匿名的参与者ID号进入相应的框的ID屏幕上，这是然后自动追加到测试会话的一部分收集的所有数据文件。 </li><li>其中10种可能的伪随机测试序列自动选择，并开始测试。 </li><li>测试仪介绍的第一个AP游戏显示孩子和解释测试程序之前，放在孩子的耳机，并开始熟悉测试阶段。这个阶段是自动完成的，当达到预设标准（如积极响应4 / 5的试验）。孩子，然后进入测试阶段。 </li><li>测试自动根据计算机控制序列。每个测试之前，测试仪指示适当的儿童，并给出了积极的反馈，并进一步鼓励，并在必要时。 </li><li>在完成测试序列，孩子是奖励贴纸和证书。如果存在，家长提供了一个口头总结他们的孩子的结果。这些都是比较年龄儿童发展之间的差异的具体规范。进一步的管理是适当的讨论。 </li></ol> 3。代表性的成果图4提供了两种不同的儿童和表现不佳的例子。在良好的性能（左侧面板），孩子始终标识“奇一出”两个轨道迅速收敛到相同的阈值的强度水平。换句话说，两者之间的轨道内反应是高度一致，以最小的偏差。这样的业绩表明任务的注意力一直维持整个这两项测试。 右侧的面板显示响应轨道，从一个年轻的孩子。很显然，从快速收敛的第一首曲目的门槛，这孩子已经理解的任务。然而，在任务的注意力的变化也是显而易见的（蓝色）的第一和第二（红色）的轨道。在第一首曲目，孩子的响应与合理的一致性，那里的孩子提供了一个错误的继承，最终在一个更高的门槛可能已经比早先的预报轨道的最后四个试验。在第二轨道，孩子无法达到的性能与最低水平的检测，在第一次运行的早期部分。有一个连续6个不正确的反应，导致一个目标的演示水平的逐步提高到约40分贝以上的第一首曲目，。然后按照正确的反应，在试验13左右，和孩子的一系列正确的反应继续进行，直到完成轨道。大轨道间的反应变化，结合第二轨道的轨道内与大差异，建议在关注失效，而不是AP本身的问题。 <img src="/files/ftp_upload/2139/2139fig4.jpg" alt="图4" /> 图4。两个有代表性的图形性能表明即使在程序的影响降到最小，可以得到。左侧面板第一（蓝色）和第二（红色）跟踪的例子是一致的，性能可靠。 （蓝色）的轨道相比，第二轨道（红色），右侧面板注意失误后最初良好的性能提供的证据。 <a href="http://www.jove.com/files/ftp_upload/2139/2139Appendix_A.pdf">点击这里附录A。</a> <a href="http://www.jove.com/files/ftp_upload/2139/2139Appendix_B.pdf">点击这里附录B。</a>

<ol>
	<li>Tallal, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Fine-grained+discrimination+deficits+in+language-learning+impaired+children+are+specific+neither+to+the+auditory+modality+nor+to+speech+perception.">Fine-grained discrimination deficits in language-learning impaired children are specific neither to the auditory modality nor to speech perception.</a> J Speech, Lang, Hearing Res. 33, 616-621 (1990).</li><li>Tallal, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Improving+language+and+literacy+is+a+matter+of+time.">Improving language and literacy is a matter of time.</a> Nature Reviews: Neuroscience. 5, 721-728 (2004).</li><li>Wright, B. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Deficits+in+auditory+temporal+and+spectral+resolution+in+language-impaired+children.">Deficits in auditory temporal and spectral resolution in language-impaired children.</a> Nature. 387, 176-178 (2008).</li><li>Bishop, D. V. M., Carlyon, R. P., Deeks, J. M., Bishop, S. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Auditory+temporal+processing+impairment:+Neither+necessary+nor+sufficient+for+causing+language+impairment+in+children.">Auditory temporal processing impairment: Neither necessary nor sufficient for causing language impairment in children.</a> J Speech, Lang, Hearing Res. 42, 1295-1310 (1999).</li><li>Moore, D. R., Ferguson, M. A., Edmondson-Jones, A. M., Ratib, S., Riley, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> The nature of auditory processing disorder in children. , (2010).</li><li>Strait, D. L., Kraus, N., Parbery-Clark, A., Ashley, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Musical+experience+shapes+top-down+auditory+mechanisms:+Evidence+from+masking+and+auditory+attention+performance.">Musical experience shapes top-down auditory mechanisms: Evidence from masking and auditory attention performance.</a> Hear Res. , (2009).</li><li>McArthur, G. M. &. a. m. p. ;. a. m. p., Bishop, D. V. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Frequency+discrimination+deficits+in+people+with+specific+language+impairment:+reliability,+validity,+and+linguistic+correlates.">Frequency discrimination deficits in people with specific language impairment: reliability, validity, and linguistic correlates.</a> J Speech, Lang, Hearing Res. 47, 527-541 (2004).</li><li>Ferguson, M. A., Hall, R. L., Riley, A., Moore, D. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Communication,+listening,+speech+and+cognition+in+children+with+auditory+processing+disorder+(APD)+or+specific+language+impairment+(SLI).">Communication, listening, speech and cognition in children with auditory processing disorder (APD) or specific language impairment (SLI).</a> J Speech, Lang, Hearing Res. , .</li><li>Wechsler, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> WISC-IV(UK). , (2004).</li><li>Korkman, M., Kirk, U., Kemp, S. I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> NEPSY: A developmental neuropsychological assessment. , (1998).</li><li>Bishop, D. V. M., North, T., Donlan, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Nonword+repetition+as+a+behaviour+marker+for+inherited+language+impairment:+Evidence+from+a+twin+study.">Nonword repetition as a behaviour marker for inherited language impairment: Evidence from a twin study.</a> J Child Psychol Psyc. 37, 391-403 (1996).</li><li>Barry, J. G., Yasin, I., Bishop, D. V. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Heritable+risk+factors+associated+with+language+impairments.">Heritable risk factors associated with language impairments.</a> Genes Brain Behav. 6, 66-76 (2007).</li><li>Wechsler, D., Chen, H. -. Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Wechsler Abbreviated Scale of Intelligence. , (1999).</li><li>Torgesen, J. K., Wagner, R., Rashotte, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Test of Word Reading Efficiency (TOWRE). , (1999).</li><li>Bishop, D. V. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> The Children's Communication Checklist-2. , (2003).</li><li>Smoski, W. J., Brunt, M. A., Tannahill, J. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Children's Auditory Processing Performance Scale. , (1998).</li></ol>

相信良好的倾听技能（即AP）的重要讲话，语言和识字1-3等认知技能的进一步发展提供了坚实的基础。然而，有很多争论相关的听力技能的性质，如果他们确实是相关的，必要的，或者足以造成语言或识字4困难。部分了解听认知发展中的技能的作用的问题，反映了一个事实，儿童是非常变量在执行征税的能力，并从他们的角度来看，沉闷的AP测试（“心理物理学任务”）。这使得难以分离出来，从中枢听觉处理途径的运作，更根本的变化过程的影响，如无聊，。正如我们在我们的协议的详细，IMAP测试电池进行了精心设计，以尽量减少与测试程序有关的问题所产生的困惑。 在图4中，我们提供的两个孩子上一个落后的掩蔽任务的性能比较。由于IMAP最大限度地减少程序上的困惑，和孩子不能开始测试，直到他们证明他们理解，我们可以在测试的具体因素归咎于这两个孩子的不同表演，为每个孩子的信心。列入配对AP的测试5 IMAP电池和一系列认知测试中，进一步使我们能够探索这种个体差异的原因。我们最近完成了一个英国的人口为基础的研究， 使用 IMAP 5。这表明，在AP上测试的性能如何响应变异性和性能上的窃听，如注意力，认知技能的测试解释大部分的变化。基于人口的研究也为我们提供了性能的标准化措施。这些措施是必要的，以个人绩效评估在门诊。他们目前正在使用中的倾听技能相同和异卵双胞胎的遗传调查研究。后者的研究将使我们能够开发适用于在美国的儿童使用的标准化措施。 虽然目前儿童集中在设计，IMAP可以也可以使用证明成年人，海峡等人，6人从音乐训练，听觉处理能力的发展磨练的认知能力的一个重要贡献。

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<td>IHR-STAR2</td>
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<td>presentation platform</td>
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<td>IHR-Runner program</td>
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<td>for pseudo-random order of presentation of tests</td>
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<td>Laptop</td>
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<td>Processor speed &#x2013; 2 GigaHz; 
RAM &#x2013; 1 Gigabyte; 
Operating system - Windows XP</td>
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<td>USB IHR-audio-device</td>
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<td>&nbsp;</td>
<td>&nbsp;</td>
<td>to control sound presentation level and spectrum content</td>
</tr>
<tr>
<td>Response button box</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<tr>
<td>Headphones</td>
<td>&nbsp;</td>
<td>Sennheiser</td>
<td>HD25-1</td>
<td>&nbsp;</td>		</tbody>
		</table>
		</div>

making sense of listening: the imap test battery

能够听到的是只对听觉信号所包含的信息范围感的第一步。同样重要的是能力，提取和使用的听觉信号的编码信息。我们参考这些听力技巧（或听觉处理AP）。在这些技能的赤字与延迟的语言和识字发展，虽然有关赤字和这些延误的因果关系的性质是激烈的辩论。 当一个孩子被称为正常的听力和不明原因的困难，在听，或语言或识字发展相关的延迟，以卫生专业人士，他们应该理想地评估与心理声学（AP）测试的组合，适合儿童在使用诊所，连同认知测试来衡量的注意，工作记忆，智商，和语言技能。这种详细的检查，需要相对较短，并在任何适当的合资格的专业技术能力。当前AP的赤字存在测试往往是缺乏建造和在正常人群中的不足验证。他们很少或根本没有提及孩子的表现症状，通常包括一个语言的组成部分。因此，业绩不佳可能反映与语言，而不是与AP的问题。为了协助听方面有困难的儿童进行评估，小儿听力学家需要一个单一的，标准化的儿童适当的测试电池的基础上，使用的语言无刺激。 我们目前是听力研究，以补充目前使用的调查例疑似美联社赤字测试MRC研究所开发的IMAP测试电池。 IMAP评估相关的听觉和认知技能的范围，大约需要一小时才能完成。已在1500年的标准化常听到来自英国各地的儿童，年龄6-11岁。由于其发展，它已成功地用于无论是在英国和美国的大型研究。 IMAP提供分离出从听证会的认知捐款感官的措施。这进一步限制了困惑，由于程序的影响，提出一种有利于儿童的游戏格式的测试。刺激生成，测试协议的管理和控制的测试演示，是介导的“国际卫生条例之星软件平台。这提供了一种标准化方法的应用范围，并确保整个测试人员的复制过程。 “国际卫生条例”- STAR提供一个灵活的，用户可编程的，目前有听力筛查的额外的应用程序的环境，映射人工耳蜗植入电极，学术研究或教学。

Watch this Scientific Journal Video about Making Sense of Listening: The IMAP Test Battery at JoVE.com

Making Sense of Listening: The IMAP Test Battery

听觉和促进听力技能的认知能力进行深入评估一个测试电池（IMAP）的描述。它是快速管理，有利于儿童和语言混淆。激励生成和协议管理是通过一个软件平台（“国际卫生条例”星），以确保复制过程控制。

听力：IMAP测试电池的决策意识

The ability to hear is only the first step towards making sense of the range of information contained in an auditory signal. Of equal importance are the ...

making-sense-of-listening-the-imap-test-battery

Research

JoVE Journal

Medicine

15.6K 次观看.  MRC Institute of Hearing Research. 听觉和促进听力技能的认知能力进行深入评估一个测试电池（IMAP）的描述。它是快速管理，有利于儿童和语言混淆。激励生成和协议管理是通过一个软件平台（“国际卫生条例”星），以确保复制过程控制。

视频: Making Sense of Listening: The IMAP Test Battery

The Trier Social Stress Test Protocol for Inducing Psychological Stress

This article demonstrates a psychological stress protocol for use in a laboratory setting. Protocols that allow researchers to study the biological pathways of the stress response in health and disease are fundamental to the progress of research in stress and anxiety.1 Although numerous protocols exist for inducing stress response in the laboratory, many neglect to provide a naturalistic context or to incorporate aspects of social and psychological stress. Of psychological stress protocols, meta-analysis suggests that the Trier Social Stress Test (TSST) is the most useful and appropriate standardized protocol for studies of stress hormone reactivity.2 In the original description of the TSST, researchers sought to design and evaluate a procedure capable of inducing a reliable stress response in the majority of healthy volunteers.3 These researchers found elevations in heart rate, blood pressure and several endocrine stress markers in response to the TSST (a psychological stressor) compared to a saline injection (a physical stressor).3 Although the TSST has been modified to meet the needs of various research groups, it generally consists of a waiting period upon arrival, anticipatory speech preparation, speech performance, and verbal arithmetic performance periods, followed by one or more recovery periods. The TSST requires participants to prepare and deliver a speech, and verbally respond to a challenging arithmetic problem in the presence of a socially evaluative audience.3 Social evaluation and uncontrollability have been identified as key components of stress induction by the TSST.4 In use for over a decade, the goal of the TSST is to systematically induce a stress response in order to measure differences in reactivity, anxiety and activation of the hypothalamic-pituitary-adrenal (HPA) or sympathetic-adrenal-medullary (SAM) axis during the task.1 Researchers generally assess changes in self-reported anxiety, physiological measures (e.g. heart rate), and/or neuroendocrine indices (e.g. the stress hormone cortisol) in response to the TSST. Many investigators have adopted salivary sampling for stress markers such as cortisol and alpha-amylase (a marker of autonomic nervous system activation) as an alternative to blood sampling to reduce the confounding stress of blood-collection techniques. In addition to changes experienced by an individual completing the TSST, researchers can compare changes between different treatment groups (e.g. clinical versus healthy control samples) or the effectiveness of stress-reducing interventions.1

This article describes a protocol for inducing psychological stress in participants, which enables researchers to measure psychological, physiological and neuroendocrine responses to stress within single participants or between groups.

特里尔社会压力诱发心理应激的测试协议

This article demonstrates a psychological stress protocol for use in a laboratory setting.  Protocols that allow researchers to study the biological ...

科研

医学

The &alpha;-test: Rapid Cell-free CD4 Enumeration Using Whole Saliva

There is an urgent need for affordable CD4 enumeration to monitor HIV disease. CD4 enumeration is out of reach in resource-limited regions due to the time and temperature restrictions, technical sophistication, and cost of reagents, in particular monoclonal antibodies to measure CD4 on blood cells, the only currently acceptable method. A commonly used cost-saving and time-saving laboratory strategy is to calculate, rather than measure certain blood values. For example, LDL levels are calculated using the measured levels of total cholesterol, HDL, and triglycerides1. Thus, identification of cell-free correlates that directly regulate the number of CD4+ T cells could provide an accurate method for calculating CD4 counts due to the physiological relevance of the correlates.
The number of stem cells that enter blood and are destined to become circulating CD4+ T cells is determined by the chemokine CXCL12 and its receptor CXCR4 due to their influence on locomotion2. The process of stem cell locomotion into blood is additionally regulated by cell surface human leukocyte elastase (HLECS) and the HLECS-reactive active &alpha;1proteinase inhibitor (&alpha;1PI, &alpha;1antitrypsin, SerpinA1)3. In HIV-1 disease, &alpha;1PI is inactivated due to disease processes 4. In the early asymptomatic categories of HIV-1 disease, active &alpha;1PI was found to be below normal in 100% of untreated HIV-1 patients (median=12 &mu;M, and to achieve normal levels during the symptomatic categories4, 5. This pattern has been attributed to immune inactivation, not to insufficient synthesis, proteolytic inactivation, or oxygenation. We observed that in HIV-1 subjects with &gt;220 CD4 cells/&mu;l, CD4 counts were correlated with serum levels of active &alpha;1PI (r2=0.93, p&lt;0.0001, n=26) and inactive &alpha;1PI (r2=0.91, p&lt;0.0001, n=26) 5. Administration of &alpha;1PI to HIV-1 infected and uninfected subjects resulted in dramatic increases in CD4 counts suggesting &alpha;1PI participates in regulating the number of CD4+ T cells in blood 3.
With stimulation, whole saliva contains sufficient serous exudate (plasma containing proteinaceous material that passes through blood vessel walls into saliva) to allow measurement of active &alpha;1PI and the correlation of this measurement is evidence that it is an accurate method for calculating CD4 counts. Briefly, sialogogues such as chewing gum or citric acid stimulate the exudation of serum into whole mouth saliva. After stimulating serum exudation, the activity of serum &alpha;1PI in saliva is measured by its capacity to inhibit elastase activity. Porcine pancreatic elastase (PPE) is a readily available inexpensive source of elastase. PPE binds to &alpha;1PI forming a one-to-one complex that prevents PPE from cleaving its specific substrates, one of which is the colorimetric peptide, succinyl-L-Ala-L-Ala-L-Ala-p-nitroanilide (SA3NA). Incubating saliva with a saturating concentration of PPE for 10 min at room temperature allows the binding of PPE to all the active &alpha;1PI in saliva. The resulting inhibition of PPE by active &alpha;1PI can be measured by adding the PPE substrate SA3NA. (Figure 1). Although CD4 counts are measured in terms of blood volume (CD4 cells/&mu;l), the concentration of &alpha;1PI in saliva is related to the concentration of serum in saliva, not to volume of saliva since volume can vary considerably during the day and person to person6. However, virtually all the protein in saliva is due to serum content, and the protein content of saliva is measurable7. Thus, active &alpha;1PI in saliva is calculated as a ratio to saliva protein content and is termed the &alpha;1PI Index. Results presented herein demonstrate that the &alpha;1PI Index provides an accurate and precise physiologic method for calculating CD4 counts.

The &amp;#945;-test: Rapid Cell-free CD4 Enumeration Using Whole Saliva

A CD4 enumeration method, the &#x03B1;-test, is described which uses whole saliva to provide rapid and accurate CD4 counts. The &alpha;-test costs pennies and eliminates the need for technical training, costly reagents such as monoclonal antibodies, instrumentation, refrigeration, transport of samples, as well as collection and handling of blood.

测试：α-细胞快速免费的CD4计数，使用全唾液

There is an urgent need for affordable CD4 enumeration to monitor HIV disease. CD4 enumeration is out of reach in resource-limited regions due to the time ...

The Multiple Sclerosis Performance Test (MSPT): An iPad-Based Disability Assessment Tool

Precise measurement of neurological and neuropsychological impairment and disability in multiple sclerosis is challenging. We report a new test, the Multiple Sclerosis Performance Test (MSPT), which represents a new approach to quantifying MS related disability. The MSPT takes advantage of advances in computer technology, information technology, biomechanics, and clinical measurement science. The resulting MSPT represents a computer-based platform for precise, valid measurement of MS severity. Based on, but extending the Multiple Sclerosis Functional Composite (MSFC), the MSPT provides precise, quantitative data on walking speed, balance, manual dexterity, visual function, and cognitive processing speed. The MSPT was tested by 51 MS patients and 49 healthy controls (HC). MSPT scores were highly reproducible, correlated strongly with technician-administered test scores, discriminated MS from HC and severe from mild MS, and correlated with patient reported outcomes. Measures of reliability, sensitivity, and clinical meaning for MSPT scores were favorable compared with technician-based testing. The MSPT is a potentially transformative approach for collecting MS disability outcome data for patient care and research. Because the testing is computer-based, test performance can be analyzed in traditional or novel ways and data can be directly entered into research or clinical databases. The MSPT could be widely disseminated to clinicians in practice settings who are not connected to clinical trial performance sites or who are practicing in rural settings, drastically improving access to clinical trials for clinicians and patients. The MSPT could be adapted to out of clinic settings, like the patient&#8217;s home, thereby providing more meaningful real world data. The MSPT represents a new paradigm for neuroperformance testing. This method could have the same transformative effect on clinical care and research in MS as standardized computer-adapted testing has had in the education field, with clear potential to accelerate progress in clinical care and research.

The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool

Precise measurement of neurological and neuropsychological impairment and disability in multiple sclerosis is challenging. We report methodologic details on a new test, the Multiple Sclerosis Performance Test (MSPT). This new approach to the objective of quantification of MS related disability provides a computer-based platform for precise, valid measurement of MS severity.

多发性硬化症性能测试（MSPT）：一个iPad为基础的残疾评估工具

Precise measurement of neurological and neuropsychological impairment and disability in multiple sclerosis is challenging. We report a new test, the ...

Determining The Electromyographic Fatigue Threshold Following a Single Visit Exercise Test

Theoretically, the electromyographic (EMG) fatigue threshold is the exercise intensity an individual can maintain indefinitely without the need to recruit more motor units which is associated with an increase in the EMG amplitude. Although different protocols have been used to estimate the EMG fatigue threshold they require multiple visits which are impractical for a clinical setting. Here, we present a protocol for estimating the EMG fatigue threshold for cycle ergometry which requires a single visit. This protocol is simple, convenient, and completed within 15-20 min, therefore, has the potential to be translated into a tool that clinicians can use in exercise prescription.

This protocol describes the electromyographic fatigue threshold which demarcates between nonfatiguing and fatiguing exercise workloads. This information could be used to develop a more individualized training program.

确定肌电疲劳阈值以下单次访问运动试验

Theoretically, the electromyographic (EMG) fatigue threshold is the exercise intensity an individual can maintain indefinitely without the need to recruit ...

Characterization of Metabolic Status in Nonhuman Primates with the Intravenous Glucose Tolerance Test

The intravenous glucose tolerance test (IVGTT) plays a key role in the characterization of glucose homeostasis. When taken together with serum biochemical profiles, inclusive of blood glucose levels in both the fed and fasted state, HbA1c, insulin levels, clinical history of diet, body composition, and body weight status, an assessment of normal and abnormal glycemic control can be made. Interpretation of an IVGTT is done through measurement of changes in glucose and insulin levels over time in relation to the dextrose challenge. Critical components to be considered are: peak glucose and insulin levels reached in relation to T0 (end of glucose infusion), the glucose clearance rate K derived from the slope of rapid glucose clearance in the first 20 min (T1 to T20), the time to return to glucose baseline, and the area under the curve (AUC). These IVGTT measures will show characteristic changes as glucose homeostasis moves from a healthy to a diseased metabolic state5. Herein we will describe the characterization of nonhuman primates (Rhesus and Cynomolgus macaques), which are the most relevant animal model of Type II diabetes (T2D) in humans and the IVGTT and clinical profiles of these animals from a lean healthy, to obese dysmetabolic, and T2D state 8, 10, 11.

The goal of this protocol is to present a standard method to perform intravenous glucose tolerance tests (IVGTTs) to assess glycemic control in nonhuman primates and assess their metabolic status from healthy to dysmetabolic.

代谢状态的表征非人灵长类动物与静脉葡萄糖耐量试验

The intravenous glucose tolerance test (IVGTT) plays a key role in the characterization of glucose homeostasis. When taken together with serum biochemical ...

Design, Fabrication, and Administration of the Hand Active Sensation Test (HASTe)

The concept of personalizing neurologic rehabilitation, based on individual impairments, has experienced a recent surge. In parallel, the number of outcome measures of upper extremity motor performance has grown. However, clinicians and researchers lack practical, quantitative measures of the hand&#8217;s natural role as a receptor of the environment. The Hand Active Sensation Test (HASTe), developed by Williams and colleagues in 2006, is a valid and reliable measure of haptic performance. Though not available commercially, the HASTe can be fabricated from inexpensive materials, and it has been used successfully to identify impairments in haptic touch in individuals with stroke. (Williams, 2006). This paper presents the methods of design and fabrication of the HASTe testing kit, as well as a visual screen to be used during administration, and instructions for the tests administration and scoring.

Design, Fabrication, and Administration of the Hand Active Sensation Test HASTe

The Hand Active Sensation Test (HASTe) is a valid and reliable measure of haptic performance, which has been used successfully to identify impaired haptic touch in individuals with stroke. The purpose of this paper is to describe the design, fabrication and administration of the HASTe.

设计，制造管理的手，和活动感觉测试（急速）

The concept of personalizing neurologic rehabilitation, based on individual impairments, has experienced a recent surge. In parallel, the number of ...

A Battery of Motor Tests in a Neonatal Mouse Model of Cerebral Palsy

As the sheer number of transgenic mice strains grow and rodent models of pediatric disease increase, there is an expanding need for a comprehensive, standardized battery of neonatal mouse motor tests. These tests can validate injury or disease models, determine treatment efficacy and/or assess motor behaviors in new transgenic strains. This paper presents a series of neonatal motor tests to evaluate general motor function, including ambulation, hindlimb foot angle, surface righting, negative geotaxis, front- and hindlimb suspension, grasping reflex, four limb grip strength and cliff aversion. Mice between the ages of post-natal day 2 to 14 can be used. In addition, these tests can be used for a wide range of neurological and neuromuscular pathologies, including cerebral palsy, hypoxic-ischemic encephalopathy, traumatic brain injury, spinal cord injury, neurodegenerative diseases, and neuromuscular disorders. These tests can also be used to determine the effects of pharmacological agents, as well as other types of therapeutic interventions. In this paper, motor deficits were evaluated in a novel neonatal mouse model of cerebral palsy that combines hypoxia, ischemia and inflammation. Forty-eight hours after injury, five tests out of the nine showed significant motor deficits: ambulation, hindlimb angle, hindlimb suspension, four limb grip strength, and grasping reflex. These tests revealed weakness in the hindlimbs, as well as fine motor skills such as grasping, which are similar to the motor deficits seen in human cerebral palsy patients.

Presented is a concise battery of mouse neonatal motor tests. Using these tests, neonatal motor deficits can be demonstrated in a variety of neonatal motor disorders. By having a standardized set of tests, results from different studies can be compared, allowing for better and accurate reporting between groups.

汽车测试的脑瘫新生儿小鼠模型电池

As the sheer number of transgenic mice strains grow and rodent models of pediatric disease increase, there is an expanding need for a comprehensive, ...

Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test

Cardiovascular disease is the primary cause of mortality and a major cause of disability worldwide. The dysfunction of the vascular endothelium is a pathological condition characterized mainly by a disruption in the balance between vasodilator and vasoconstrictor substances and is proposed to play an important role in the development of atherosclerotic cardiovascular disease. Therefore, a precise evaluation of endothelial function in humans represents an important tool that could help better understand the etiology of multiple cardio-centric pathologies.
Over the past twenty-five years, many methodological approaches have been developed to provide an assessment of endothelial function in humans. Introduced in 1989, the FMD test incorporates a forearm occlusion and subsequent reactive hyperemia that promotes nitric oxide production and vasodilation of the brachial artery. The FMD test is now the most widely utilized, non-invasive, ultrasonic assessment of endothelial function in humans and has been associated with future cardiovascular events.
Although the FMD test could have clinical utility, it is a physiological assessment that has inherited several confounding factors that need to be considered. This article describes a standardized protocol for determining FMD including the recommended methodology to help minimize the physiological and technical issues and improve the precision and reproducibility of the assessment.

The flow mediated dilation (FMD) test is the most commonly utilized, non-invasive, ultrasound assessment of endothelial function in humans. Although the FMD test has been related with the prediction of future cardiovascular disease and events, it is a physiological assessment with many inherent confounding factors that need to be considered.

血管内皮功能的超声评估：血流介导的舒张试验的技术指导原则

Cardiovascular disease is the primary cause of mortality and a major cause of disability worldwide. The dysfunction of the vascular endothelium is a ...

Regenerative Therapy by Suprachoroidal Cell Autograft in Dry Age-related Macular Degeneration: Preliminary In Vivo Report

This study is aimed at examining whether a suprachoroidal graft of autologous cells can improve best corrected visual acuity (BCVA) and responses to microperimetry (MY) in eyes affected by dry Age-related Macular Degeneration (AMD) over time through the production and secretion of growth factors (GFs) on surrounding tissue. Patients were randomly assigned to each study group. All patients were diagnosed with dry AMD and with BCVA equal to or greater than 1 logarithm of the minimum angle of resolution (logMAR). A suprachoroidal autologous graft by Limoli Retinal Restoration Technique (LRRT) was carried out on group A, which included 11 eyes from 11 patients. The technique was performed by implanting adipocytes, adipose-derived stem cells obtained from the stromal vascular fraction, and platelets from platelet-rich plasma in the suprachoroidal space. Conversely, group B, including 14 eyes of 14 patients, was used as a control group. For each patient, diagnosis was verified by confocal scanning laser ophthalmoscope and spectral domain-optical coherence tomography (SD-OCT). In group A, BCVA improved by 0.581 to 0.504 at 90 days and to 0.376 logMAR at 180 days (+32.20%) postoperatively. Furthermore, MY test increased by 11.44 dB to 12.59 dB at 180 days. The different cell types grafted behind the choroid were able to ensure constant GF secretion in the choroidal flow. Consequently, the results indicate that visual acuity (VA) in the grafted group can increase more than in the control group after six months.

Regenerative Therapy by Suprachoroidal Cell Autograft in Dry Age-related Macular Degeneration: Preliminary In Vivo Report

The goal of this study is to assess whether the suprachoroidal graft of adipose-derived stem cells included in the stromal vascular fraction and platelets derived from platelet-rich plasma by the Limoli Retinal Restoration Technique can improve visual acuity and retinal sensitivity responses in eyes affected by dry age-related macular degeneration.

脉络细胞自体移植治疗老年性黄斑变性的再生疗法: 初步体内报告

This study is aimed at examining whether a suprachoroidal graft of autologous cells can improve best corrected visual acuity (BCVA) and responses to ...

Taste Exam: A Brief and Validated Test

The emerging importance of taste in medicine and biomedical research, and new knowledge about its genetic underpinnings, has motivated us to supplement classic taste-testing methods in two ways. First, we explain how to do a brief assessment of the mouth, including the tongue, to ensure that taste papillae are present and to note evidence of relevant disease. Second, we draw on genetics to validate taste test data by comparing reports of perceived bitterness intensity and inborn receptor genotypes. Discordance between objective measures of genotype and subjective reports of taste experience can identify data collection errors, distracted subjects or those who have not understood or followed instructions. Our expectation is that fast and valid taste tests may persuade researchers and clinicians to assess taste regularly, making taste testing as common as testing for hearing and vision. Finally, because many tissues of the body express taste receptors, taste responses may provide a proxy for tissue sensitivity elsewhere in the body and, thereby, serve as a rapid, point-of-care test to guide diagnosis and a research tool to evaluate taste receptor protein function.

This protocol measures human taste responses and includes a brief anatomical assessment, a short taste test, and a validation method using the subject&#39;s reported sensation and taste receptor genotype.

味觉考试: 一个简短的验证测试

The emerging importance of taste in medicine and biomedical research, and new knowledge about its genetic underpinnings, has motivated us to supplement ...