Normal Readers Research Articles

To Investigate the Prevalence of White Coat Hypertension in Community Dwelling Older Adults Referred for a Falls Assessment

Abstract Background Falls and frailty are the main focus in our integrated care programme for older persons (ICPOP). Office blood pressure (OBP) measurements are commonly used in practice although out of office recordings are proven to be a better predictor of cardiovascular risk (Myers et al, 2018). The European Society of Cardiology guidelines (ESC, 2018) have proposed BP values for the classification of hypertension (HTN). Methods We retrospectively completed a chart review on older adults’ who attended ICPOP with a referral for a falls assessment from November 2021 to April 2024. OBP were obtained after the patient was in the hub for approximately one hour following their comprehensive geriatric assessment (CGA). The OBP was documented following a supine period of 5 minutes. We compared the OBP and ambulatory blood pressure monitor (ABPm) average readings to assess the prevalence of HTN based on the ESC guidelines. Results 75 charts were reviewed. 3 ABPm recordings were unsuccessful due to cognitive impairment or not tolerating the ABPm. These were excluded from the audit. No patient had hypotension on either their OBP or ABPm recordings. On their OBP recordings, 29/72 (40%) had a normal reading while 43/72 (60%) had HTN. On their ABPm 54/72 (75%) had a normal reading while 18/72 (25%) had HTN. When we looked at antihypertensive medication use in those who had a normal reading on their ABPm, 47/54 (87%) were on antihypertensive treatment. All patients with HTN on their ABPM were on antihypertensive treatment. Conclusion Our findings suggest that OBP readings greatly increase the numbers of patients diagnosed with HTN compared to ABPm (60% versus 25%). Therefore, we suggest that all patients should have an ABPm as a gold standard to falls assessment to avoid over-treating white coat HTN.

Exploring the Literacy Experiences of Preservice Early Childhood Teachers: Social and Contextual Influences, and Implications for Teacher Education

Considering that early literacy (reading and writing) is critical for later literacy and academic success, this study investigated the social and contextual influences on the early and current literacy experiences of 70 preservice early childhood teachers in the United States through a questionnaire. Analyses of both quantitative and qualitative data revealed eight key findings: First, the strongest influence on these individuals’ early literacy development was parents, followed by teachers. Second, their current literacy experiences were shaped primarily by professors/academic work followed by self-motivation. Third, nearly half of the preservice teachers regarded themselves as average readers and writers. While the majority of them enjoyed reading and more than half also enjoyed writing, those who lacked such enjoyment provided various reasons, especially citing insufficient intrinsic motivation, limited time for reading, and inadequate writing skills or ideas. Fourth, most of them prioritized their literacy time to fulfill academic requirements. Fifth, most devoted a limited amount of time to literacy activities. Sixth, there was a relatively strong positive correlation between reading fluency and writing fluency. Seventh, a positive correlation was found between years in college and writing fluency. Eighth, there was a negative correlation between grade point average and time spent writing per week.

The cryptic complex rearrangements involving the DMD gene: etiologic clues about phenotypical differences revealed by optical genome mapping

BackgroundDeletion or duplication in the DMD gene is one of the most common causes of Duchenne and Becker muscular dystrophy (DMD/BMD). However, the pathogenicity of complex rearrangements involving DMD, especially segmental duplications with unknown breakpoints, is not well understood. This study aimed to evaluate the structure, pattern, and potential impact of rearrangements involving DMD duplication.MethodsTwo families with DMD segmental duplications exhibiting phenotypical differences were recruited. Optical genome mapping (OGM) was used to explore the cryptic pattern of the rearrangements. Breakpoints were validated using long-range polymerase chain reaction combined with next-generation sequencing and Sanger sequencing.ResultsA multi-copy duplication involving exons 64–79 of DMD was identified in Family A without obvious clinical symptoms. Family B exhibited typical DMD neuromuscular manifestations and presented a duplication involving exons 10–13 of DMD. The rearrangement in Family A involved complex in-cis tandem repeats shown by OGM but retained a complete copy (reading frame) of DMD inferred from breakpoint validation. A reversed insertion with a segmental repeat was identified in Family B by OGM, which was predicted to disrupt the normal structure and reading frame of DMD after confirming the breakpoints.ConclusionsValidating breakpoint and rearrangement pattern is crucial for the functional annotation and pathogenic classification of genomic structural variations. OGM provides valuable insights into etiological analysis of DMD/BMD and enhances our understanding for cryptic effects of complex rearrangements.

Synergistic Effects of Total Ionizing Dose and Single-Event Upset in 130 nm 7T Silicon-on-Insulator Static Random Access Memory

The exposure of spaceborne devices to high-energy charged particles in space results in the occurrence of both a total ionizing dose (TID) and the single-event effect (SEE). These phenomena present significant challenges for the reliable operation of spacecraft and satellites. The rapid advancement of semiconductor fabrication processes and the continuous reduction in device feature size have led to an increase in the significance of the synergistic effects of TID and SEE in static random access memory (SRAM). In order to elucidate the involved physical mechanisms, the synergistic effects of TID and single-event upset (SEU) in a new kind of 130 nm 7T silicon-on-insulator (SOI) SRAM were investigated by means of cobalt-60 gamma-ray and heavy ion irradiation experiments. The findings demonstrate that 7T SOI SRAM is capable of maintaining normal reading and writing functionality when subjected to TID irradiation at a total dose of up to 750 krad(Si). In general, the TID was observed to reduce the SEU cross-section of the 7T SOI SRAM. However, the extent of this reduction was influenced by the heavy ion LET value and the specific writing data pattern employed. Based on the available evidence, it can be proposed that TID preirradiation represents a promising avenue for enhancing the resilience of 7T SOI SRAMs to SEU.

From selfish silo to collaborative culture – embracing data-enabled cancer research

From selfish silo to collaborative culture – embracing data-enabled cancer research Aedin Culhane and Mark Lawler, Co-Leads of the eHealth Hub for Cancer, reflect on their data-enabled cancer research journeys, how their collaborative team science approach has reaped significant dividends in cancer research and policy and how the hub is inducing a paradigm shift in how health data are deployed on the island of Ireland. An article in The Wall Street Journal (not the normal reading material for scientists) in 2011 highlighted a new approach to performing scientific research that was gaining significant credence at the time. Entitled ‘The New Einsteins Will Be Scientists Who Share’ (with the strapline ‘From cancer to cosmology, researchers could race ahead by working together – online and in the open’), the article presaged an unprecedented change in how scientists interact with each other, ushering in a culture of collaboration and cross-disciplinary research. Nowhere was this change more obvious than in the genomics and data science community, where a bottom-up movement led to the creation of the Global Alliance for Genomics and Health (GA4GH), bringing together researchers from around the world to work together to address some of human health’s greatest challenges through the deployment of data and data tools.

Emotion processing in concrete and abstract words: evidence from eye fixations during reading

ABSTRACT We replicated and extended the findings of Yao et al. [(2018). Differential emotional processing in concrete and abstract words. Journal of Experimental Psychology: Learning, Memory, and Cognition, 44(7), 1064–1074] regarding the interaction of emotionality, concreteness, and imageability in word processing by measuring eye fixation times on target words during normal reading. A 3 (Emotion: negative, neutral, positive) × 2 (Concreteness: abstract, concrete) design was used with 22 items per condition, with each set of six target words matched across conditions in terms of word length and frequency. (e.g. shocking, reserved, fabulous) and concrete (e.g. massacre, calendar, treasure) target words appeared (separately) within contextually neutral, plausible sentences. Sixty-three participants each read all 132 experimental sentences while their eye movements were recorded. Analyses using Gamma generalised linear mixed models revealed significant effects of both Emotion and Concreteness on all fixation measures, indicating faster processing for emotional and concrete words. Additionally, there was a significant Emotion × Concreteness interaction which, critically, was modulated by Imageability in early fixation time measures. Emotion effects were significantly larger in higher-imageability abstract words than in lower-imageability ones, but remained unaffected by imageability in concrete words. These findings support the multimodal induction hypothesis and highlight the intricate interplay of these factors in the immediate stages of word processing during fluent reading.

Unraveling Brain Synchronisation Dynamics by Explainable Neural Networks using EEG Signals: Application to Dyslexia Diagnosis

The electrical activity of the neural processes involved in cognitive functions is captured in EEG signals, allowing the exploration of the integration and coordination of neuronal oscillations across multiple spatiotemporal scales. We have proposed a novel approach that combines the transformation of EEG signal into image sequences, considering cross-frequency phase synchronisation (CFS) dynamics involved in low-level auditory processing, with the development of a two-stage deep learning model for the detection of developmental dyslexia (DD). This deep learning model exploits spatial and temporal information preserved in the image sequences to find discriminative patterns of phase synchronisation over time achieving a balanced accuracy of up to 83%. This result supports the existence of differential brain synchronisation dynamics between typical and dyslexic seven-year-old readers. Furthermore, we have obtained interpretable representations using a novel feature mask to link the most relevant regions during classification with the cognitive processes attributed to normal reading and those corresponding to compensatory mechanisms found in dyslexia.Graphical

Electrophysiological markers of orthographic pattern learning in school-aged children with reading challenges: An ERP investigation

BackgroundPrevious studies suggested that children with reading difficulty have impaired statistical learning ability in extracting distributional orthographic regularities. However, the neural mechanisms underlying have not been fully investigated. AimsThe current study aimed to identify the electrophysiological markers and to examine the neural underpinnings of statistical learning of orthographic regularities in children with reading difficulties. Methods and proceduresUsing the event-related potentials (ERPs) and the orthographic learning task, 157 children were exposed to a sequence of artificial pseudocharacters with varying levels of positional and semantic consistency (low at 60 %, moderate at 80 %, and high at 100 %). Outcomes and resultsPoor readers elicited an increased N170 response in the low consistency and a lack of left-lateralized P300 effect when learning positional regularities of radicals. Similarly, larger N170 effects were observed in poor readers, while similar N400 effects were found in both poor and average readers when learning semantic regularities of radicals. Conclusions and implicationsOur findings indicate that poor readers may have trouble using statistical information for early-stage orthographic pattern extraction, yet they can identify semantic inconsistencies after sufficient exposure. These results deepen our understanding of the neural mechanisms involved in statistical learning for poor readers and aid in improving criteria for differentiating between typically developing children and those with reading challenges.

Screen‐shooting resistant robust document watermarking in the Discrete Fourier Transform domain

AbstractMetaverse's augmented reality (AR) function allows virtual information to be seamlessly superimposed onto real scenes through the camera of a head‐mounted device. However, this raises concerns about privacy protection and copyright authentication when transmitting cross‐media information. Additionally, there is a risk of secret information leakage due to screen candid shooting in the real world. Ensuring information security and copyright authentication in case of unauthorized screen capturing is crucial. To prevent information loss and interference from cross‐media transfer between screens and cameras, we implement digital watermarking for copyright protection. We have proposed an innovative framework for automatic document watermarking that can resist screen‐shooting. Our approach involves embedding a ring watermark in the document underlay. On the extraction side, the watermark extraction process is divided into three key steps: automatic location, automatic correction, and automatic extraction. First, the document image is located in the covert photography. Then, perspective correction is performed based on the text line features of the document. Finally, the watermark information is extracted by combining the ring watermark features. Our method is capable of automatically extracting watermarks from covert photography while considering aspects such as concealment, robustness, and visual quality. The watermark is embedded in the document underlay, which ensures good visual quality and does not affect the normal reading and editing. We also propose various embedding strength schemes that can adapt to different usage scenarios, providing resistance to screen‐shooting or screenshot attacks, as well as various noise attacks. Through extensive experiments, we have demonstrated the feasibility of the proposed automated framework and the robustness of the watermarking algorithm, as well as the superiority and broad application prospects of our method.

No, Bionic Reading does not work

It has recently been claimed that presenting text with the first half of each word printed in bold (as is done in this example), so-called Bionic Reading, facilitates reading. However, empirical tests of this claim are lacking, and theoretically one might expect a cost rather than a benefit. Here I tested participants' reading speed of 100 paragraphs that were presented either in ‘Bionic’ or in normal font. Statistical analyses revealed no significant difference in reading times between Bionic and normal reading. I conclude that Bionic Reading does not facilitate reading.

Literary history as bestseller: the life and opinions of a fraudulent philologue

In this article we reveal the publishing ventures of Octav Minar (1886-1967), one of the Romanian authors that was disesteemed by fellow literary historians on account of his counterfeiting acts such as forgery, plagiarism, plastography or trick photography. Related to the book market of interbellum Romania, Minar was frequently branded as the “man-of-the-day” while his publications followed the logic of the “hand-in-glove” ephemerides Notwithstanding the challenges of the term “bestseller,” we turned to it so as to better describe Minar’s cultural products as multiple-layered offers, catering for both low-brow and high-brow readership and seizing signals from both public’s expectations (myth-making, melodrama, sensation, narrative simplicity) and enormous patrimonial gaps (editing the classics, writing the recent authors’ biographies). After a careful examination of Minar’s works, we reached the conclusion that he was an exceptional entrepreneur of letters and, nonetheless, a literary historian endowed with a “melodramatic imagination” as well as with a playwright’s and a genre novelist’s plume. A swift intuition of marketing basics helped him realize, quite rapidly, that historical facts and documents could be merchandized: this is how his impressive collection of Romanian writers’ miscellanea was wrapped as a commodity for the public. If the juridical and moral aspects of his literary ventures were put in between brackets, we would discover an astonishing and ingenious personality who glided between different speech registers, and popularized literary history as a genre belonging to the big tent of mass culture. We should thus take into consideration that the logic of the paraliterary circuit can also be applied to literary history. Boiled down to essentials, counting on citations and on minimal critical comments, spiced with images (facsimile and pictures), Minar’s literary histories had their share in speeding the process of cultural literacy of average Romanian readers and in institutionalizing literary ideas.

The processing of spatial frequencies through time in visual word recognition

This study examined the temporal profile of spatial frequency processing in a word reading task in 16 normal adult readers. They had to report the word presented in a 200 ms display using a four-alternative forced-choice task (4AFC). The stimuli were made of an additive combination of the signal (i.e. the target word) and of a visual white noise patch wherein the signal-to-noise ratio varied randomly across stimulus duration. Four spatial frequency conditions were defined for the signal component of the stimulus (bandpass Butterworth filters with center frequencies of 1.2, 2.4, 4.8 and 9.6 cycles per degree). In contrast to the coarse-to-fine theory of visual recognition, the results show that the highest spatial frequency range dominates early processing, with a shift toward lower spatial frequencies at later points during stimulus exposure. This pattern interacted in a complex way with the temporal frequency content of signal-to-noise oscillations. The outcome of individual data patterns classification by a machine learning algorithm according to the corresponding spatial frequency band further shows that the most salient spatial frequency signature is obtained when the time dimension within data patterns is recoded into its Fourier transform.

Current trends in Nigella sativa L. (Black seed) from traditional to modern medicine with advances in extraction, formulation, quality control, regulatory status, and pharmacology

For the first time ever, this novel review enters the enigmatic world of the L. (black seed), known for centuries as a potent source of healing including their relevance to the food and pharmaceutical industries. Written at professional and reference level, it is directed at normal readers with more professional scientists in pharmacy and food science affiliations to serve as a rich source of data on black seed. We embark on an exploration that encompasses the background, significance, and objectives guiding our exploration. Detailed botanical and chemical profiles unravel the mysteries of the black seed, providing insight into its taxonomy, morphology, and chemical composition. Traditional uses, extraction methods, and formulation approaches paint a comprehensive picture of the versatile ways in which the black seed has been employed throughout history. Quality control and standardization practices ensure the integrity of black seed-derived products, while a global regulatory overview brings into focus the challenges and triumphs of incorporating this botanical powerhouse into mainstream pharmacopeias. As we delve into the pharmacological activities, clinical studies, and efficacy of the black seed, we confront safety considerations and potential side effects. The exploration extends into the future, addressing the challenges in commercialization, identifying research gaps, and concluding with the implications of our findings for both healthcare and industry. It should therefore be of special value to researchers affiliated with food science and technology, pharmacy, and pharmaceutical producers requiring up-to-date information on their raw materials, which will probably already have been processed, at least in part.

100 years of James Joyce’s women: wife, daughter and friend

ABSTRACT One hundred years after the publication of Ulysses (1922), the novel that would immortalize James Joyce, his ouvre continues to attract readers, intellectuals and artists as much as his private life still fascinates Joyceans, writers and a general public. The present contribution analyses three recent additions to the so-called ‘Joyce industry’, studying a series of fictional texts that feature the allegedly inexhaustible topic of the Irish writer’s complex relationship with women. Annabel Abbs’s The Joyce Girl (2016), Nuala O’Connor’s Nora (2021) and Kerri Maher’s The Paris Bookseller (2022) are the focus of the present contribution, three biofictions of, respectively, Joyce’s daughter, his wife Nora and of Sylvia Beach, the woman who published Ulysses in book form. It is our intention to assess the extent to which these narratives offer a retrieval of three women’s stories, to study them in the context of recent vindications of biofiction as a subgenre that must be distinguished from both biography and historical fiction and, above all, to account for the undeniable interest and even popularity of women related to Joyce among Joycean scholars but also among average readers.

Standardized Russian reading chart for assessing reading parameters

BACKGROUND: A number of charts based on checking reading parameters are increasingly being used to assess visual functions. These charts are standardized, translated into many languages. The development of a Russian chart based on international standards and the determination of age norms of clinical reading parameters will allow it to be used for a more accurate assessment of the dynamics of diseases and treatment results. AIM: The aim is to determine the normal reading parameters in patients of different age groups. MATERIALS AND METHODS: Based on international standards, two Russian charts have been developed to study reading parameters. Reading parameters were determined during one session in 135 subjects, divided into 3 groups: I — 18–39 years, II — 40–59 years, and III — 60–81 years. Three main parameters were studied: maximum reading speed, critical print size, and reading acuity (RA). RESULTS: As a result of the study, age norms for basic reading parameters were determined. Maximum reading speed in group I was 192.5 ± 1.2, in group II — 180.6 ± 1.1 and in group III — 168.9 ± 0.8 words/min. Critical print size in group I was 0.14 ± 0.01, in group II — 0.24 ± 0.01, and in group III — 0.36 ± 0.01 logMAR. The reading acuity in group I was 0.009 ± 0.006, in group II — 0.075 ± 0.04, in group III — 0.143 ± 0.005 logMAR. The differences between the studied parameters in groups I/II, I/III and II/III were statistically significant (p 0.05). CONCLUSIONS: The indicators of reading parameters obtained during the study can be used as approximate age norms.

Investigating the Relationship Between the Scores of the Persian Reading Comprehension Assessment Task and the Reading and Dyslexia Test

Background and Objectives: Today, comparing the scores of tests and evaluation scales with each other and the correlation between them is done to check and compare the test’s accuracy in diagnosing reading problems. The present study investigated the correlation between the scores of the Persian reading comprehension assessment task (PRCAT) and the text comprehension subtest of the reading and dyslexia test (NEMA) in fourth and fifth-grade elementary school students. Methods: In this study, 24 students from the fourth and fifth grades of elementary schools in Tehran City, Iran with normal reading skills participated. The set of items for the Persian reading comprehension assessment task and the text comprehension subtest of the NEMA test were taken from the students. Results: The results showed a positive correlation between the scores of the PRCAT and the text comprehension subtest of NEMA, and the correlation coefficient between them is 0.622 (r=0.622, P<0.01). Conclusion: The results showed that the PRCAT has an acceptable validity compared to the text comprehension subtest of the NEMA test.

Integrating Cognitive Factors and Eye Movement Data in Reading Predictive Models for Children with Dyslexia and ADHD-I.

This study reports on several specific neurocognitive processes and eye-tracking predictors of reading outcomes for a sample of children with Developmental Dyslexia (DD) and At-tention-Deficit/Hyperactivity Disorder - inattentive subtype (ADHD-I) compared to typical readers. Participants included 19 typical readers, 21 children diagnosed with ADHD-I and 19 children with DD. All participants were attending 4th grade and had a mean age of 9.08 years. The psycholinguistic profile of each group was assessed using a battery of neuropsy-chological and linguistic tests. Participants were submitted to a silent reading task with lex-ical manipulation of the text. Multinomial logistic regression was conducted to evaluate the predictive capability of developing dyslexia or ADHD-I based on the following measures: (a) a linguistic model that included measures of phonological awareness, rapid naming, and reading fluency and accuracy; (b) a cognitive neuropsychological model that included measures of memory, attention, visual processes, and cognitive or intellectual functioning, and (c) an additive model of lexical word properties with manipulation of word-frequency and word-length effects through eye-tracking. The additive model in conjunction with the neuropsychological model classification improved the prediction of who develops dyslexia or ADHD-I having as baseline normal readers. Several of the neuropsychological and eye-tracking variables have power to predict the degree of reading outcomes in children with learning disabilities.

Automated Think-Aloud Protocol for Identifying Students with Reading Comprehension Impairment Using Sentence Embedding

The think-aloud protocol is a valuable tool for investigating readers’ cognitive processes during reading. However, its reliance on experienced human evaluators poses challenges in terms of efficiency and scalability. To address this limitation, this study proposes a novel application of natural language processing to automate the think-aloud protocol. Specifically, we use a sentence embedding technique to encode the stimulus text and corresponding readers’ responses into high-dimensional vectors, and the similarity between these embeddings serves as a feature. The properties of the feature are investigated for word-frequency-based and contextualized embedding models. Differences in the sentence embedding-based feature between poor comprehenders and normal readers are investigated. Using these features, seven machine learning models were trained to classify readers into normal and abnormal groups. The highest F1 score of 0.74 was achieved with the contextualized embedding and random forest classifier. This highlights the effectiveness of the embedding technique in extracting useful features for automating the think-aloud protocol for assessing reading comprehension abilities. The potential benefits of this automated approach include increased efficiency and scalability, ultimately facilitating the early diagnosis of reading comprehension impairment and individualized interventions.

Imagery Recognition and Semantic Analysis Techniques in Chinese Literary Texts

Abstract Chinese literary texts contain a sizeable vivid imagery vocabulary, which makes it difficult for average readers to judge the boundaries between words, and the current pre-trained language model is also difficult for them to learn its implicit knowledge effectively, which brings troubles to machine semantic analysis. The study uses CRF training to obtain a semantic analysis model of Chinese literary texts that recognizes the semantic relationship between two words. SVM is used to train classifiers for confusing categories, and the two semantic relations in the output of the CRF model are further recognized to determine the final semantic relations between word pairs. Finally, the LCQMC dataset is used as the experimental data, and the semantic analysis technique based on CRF and SVM is employed to obtain the participle, lexical, and dependent syntactic annotations. According to the results, the model’s correct rates on the LAS for paraphrase recognition and dependency analysis of Chinese literary texts are 74.83% and 92.05%, respectively. The study enhances the efficiency of semantic analysis of relevant Chinese texts and is crucial for the study on the semantic analysis of terms.

Screening of New-Born through Otoacoustic Emission Device in a Rural Setting for Early Detection of Hearing Impairment - An Observational Study

BACKGROUND
 Hearing is a special sense needed for proper speech, language, mental development and academic performance. The objectives of our study were to screen neonates at rural area with otoacoustic emission device for detecting hearing impairment and develop a comprehensive rehabilitation model for hearing impaired children in rural areas. Hearing loss initial signs are subtle and therefore for early detection routine neonatal hearing screening is the most effective tool. At first otoacoustic emissions are done, failing which neonates undergo BERA as final screening method to identify hearing impairment as a confirmatory test. In a country like India where neonatal hearing tests are not a part of the routine screening program, the chances of missing early detection and possible rehabilitation are large. In this context, the current project envisages to develop a practical and pragmatic screening model for detecting early neonatal hearing impairment using otoacoustic emission technique in a rural sector reaching every door step possible.
 METHODS
 From the government health records collected for a duration of one and half years, all babies delivered in PHC were included for the screening. The babies were screened every Thursday (Immunisation day) with OAE devices by an audiologist at the PHC. The total number of infants screened were 1737. The first screening test done was otoacoustic emission, failing which patient was referred for BERA as a confirmatory test.
 RESULTS
 The total number of babies screened by OAE in our study was 1737. Out of the total infants screened, 1st OAE referrals were 327 babies. All the 327 infants were screened by OAE for the 2nd time, out of which 10 infants were referred for the 2nd consecutive time. 317 infants were passed on 2nd OAE screening. All the 10 infants who were referred for the 2nd time were subjected to BERA at Ramaiah medical Hospital. Out of these 10 infants, BERA showed severe to profound bilateral hearing loss in 7 infants (Confirmed Hearing loss). Other 3 infants had normal BERA reading hence normal hearing. The statistics showed that the overall rate of hearing loss prevalence was 4.03 per thousand.
 CONCLUSIONS
 In order to diagnose hearing loss in neonates, it is critical to identify hearing loss at birth and provide a screening test for it. OAE screening of neonates should be done at the earliest to detect hearing impairment so that hearing and speech rehabilitation can be started at the earliest. It should be done at each & every health care centre on a large-scale basis to cover all the babies.