CAPD

Introducing the 2018 Emerging Research Grantees

By Lauren McGrath

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Hearing Health Foundation (HHF) is pleased to present our Emerging Research Grants (ERG) awardees for the 2018 project cycle.

Grantee Tenzin Ngodup, Ph.D., will investigate neuronal activity in the ventral cochlear nucleus to help prevent and treat tinnitus.

Grantee Tenzin Ngodup, Ph.D., will investigate neuronal activity in the ventral cochlear nucleus to help prevent and treat tinnitus.

15 individuals at various institutions nationwide—including Johns Hopkins School of Medicine, University of Minnesota, and the National Cancer Institute—will conduct innovative research in the following topic areas:

  • Central Auditory Processing Disorder (CAPD)

  • General Hearing Health

  • Hearing Loss in Children

  • Hyperacusis

  • Tinnitus

  • Usher Syndrome

Our grantees’ research investigations seek to solve specific auditory and vestibular problems such as declines in complex sound processing in age-related hearing loss (presbycusis), ototoxicity caused by the life-saving chemotherapy drug cisplatin, and noise-induced hearing loss.

HHF looks forward to the advancements that will come about from these promising scientific endeavors. The foundation owes many thanks to the General Grand Chapter Royal Arch Masons International, Cochlear, Hyperacusis Research, the Les Paul Foundation, and several generous, anonymous donors who have collectively empowered this important work.

We are currently planning for our 2019 ERG grant cycle, for which applications will open September 1. Learn more about the application process.

WE NEED YOUR HELP IN FUNDING THE EXCITING WORK OF HEARING AND BALANCE SCIENTISTS. DONATE TODAY TO HEARING HEALTH FOUNDATION AND SUPPORT GROUNDBREAKING RESEARCH: HHF.ORG/DONATE.

Grantee Rachael R. Baiduc, Ph.D., will identify  cardiovascular disease risk factors that may contribute to hearing loss.

Grantee Rachael R. Baiduc, Ph.D., will identify
cardiovascular disease risk factors that may contribute to hearing loss.

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New Research Shows Hearing Aids Improve Brain Function and Memory in Older Adults

By University of Maryland Department of Hearing and Speech Sciences

One of the most prevalent health conditions among older adults, age-related hearing loss, can lead to cognitive decline, social isolation and depression. However, new research from the University of Maryland (UMD) Department of Hearing and Speech Sciences (HESP) shows that the use of hearing aids not only restores the capacity to hear, but can improve brain function and working memory.

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The UMD-led research team monitored a group of first-time hearing aid users with mild-to-moderate hearing loss over a period of six months. The researchers used a variety of behavioral and cognitive tests designed to assess participants’ hearing as well as their working memory, attention and processing speed. They also measured electrical activity produced in response to speech sounds in the auditory cortex and midbrain.

At the end of the six months, participants showed improved memory, improved neural speech processing, and greater ease of listening as a result of the hearing aid use. Findings from the study were published recently in Clinical Neurophysiology and Neuropsychologia.

“Our results suggest that the benefits of auditory rehabilitation through the use of hearing aids may extend beyond better hearing and could include improved working memory and auditory brain function,” says HESP Assistant Professor Samira Anderson, Ph.D., who led the research team. “In effect, hearing aids can actually help reverse several of the major problems with communication that are common as we get older.”

According to the National Institutes of Health, as many as 28.8 million Americans could benefit from wearing hearing aids, but less than a third of that population actually uses them. Several barriers prevent more widespread use of hearing aids—namely, their high cost and the fact that many people find it difficult to adjust to wearing them. A growing body of evidence has demonstrated a link between hearing loss and cognitive decline in older adults. Aging and hearing loss can also lead to changes in the brain’s ability to efficiently process speech, leading to decreased ability to understand what others are saying, especially in noisy backgrounds.

The UMD researchers say the results of their study provide hope that hearing aid use can at least partially restore deficits in cognitive function and auditory brain function in older adults.

“We hope our findings underscore the need to not only make hearing aids more accessible and affordable for older adults, but also to improve fitting procedures to ensure that people continue to wear them and benefit from them,” Anderson says.

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The research team is working on developing better procedures for fitting people with hearing aids for the first time. The study was funded by Hearing Health Foundation and the National Institutes of Health (NIDCD R21DC015843).

This is republished with permission from the University of Maryland’s press office. Samira Anderson, Au.D., Ph.D., is a 2014 Emerging Research Grants (ERG) researcher generously funded by the General Grand Chapter Royal Arch Masons International. We thank the Royal Arch Masons for their ongoing support of research in the area of central auditory processing disorder. These two new published papers and an earlier paper by Anderson all stemmed from Anderson’s ERG project.

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Read more about Anderson in Meet the Researcher and “A Closer Look,” in the Winter 2014 issue of Hearing Health.

WE NEED YOUR HELP IN FUNDING THE EXCITING WORK OF HEARING AND BALANCE SCIENTISTS. DONATE TODAY TO HEARING HEALTH FOUNDATION AND SUPPORT GROUNDBREAKING RESEARCH: HHF.ORG/DONATE.

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Hearing—With Difficulty Understanding: Life With Auditory Processing Disorder

By Lauren McGrath

This April, Hearing Health Foundation (HHF) draws your attention to Auditory Processing Disorder (APD), a condition that causes impairments in sound localization—the ability to identify sound sources—and has been closely linked to autism. April 4 is recognized as APD Awareness Day in some regions of the U.S. and April is Autism Awareness Month nationwide.

APD occurs when the central nervous system has difficulty processing verbal or auditory information, specifically in noisy, social environments. Individuals with APD do not necessarily have a diagnosed hearing loss; in fact, many have normal audiogram results. With APD and typical hearing, the inner ear properly sends signals to the brain, but, once received, the brain fails to interpret and analyze these sounds accurately, resulting in jumbled messages.

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In the U.S., it is estimated five percent of school-age children, or 2.5 million children, have APD. Individuals with APD are often unable to hear sounds as words and have learning problems, including difficulty in reading, spelling, and language comprehension. It is vital to review the symptoms, demographics, and treatments of APD, should you suspect it in yourself or a loved one.

Individuals with APD have trouble distinguishing between words or syllables that sound alike (auditory discrimination) and recalling what they heard (poor auditory memory). They show delayed responses to verbal requests and instructions and will often ask someone to repeat what has been said. APD is commonly misdiagnosed as ADD/ADHD, dyslexia, or hearing loss.

Demographically, APD is a common secondary diagnosis for children with autism; most children diagnosed with autism have auditory processing disorders or auditory difficulties. HHF Emerging Research Grants (ERG) recipient Elizabeth McCullagh, Ph.D.’s 2017 published work in The Journal of Comparative Neurology examines the strong connection between Fragile X Syndrome (FXS), the most common genetic form of autism, and difficulties with sound localization.

Additionally, APD is prevalent in individuals with neurological problems, including those who have experienced head injuries or strokes. Older adults, who are more susceptible to some cognitive decline, are also at greater risk for APD.

Military veterans who have been repeatedly exposed to blasts are another community disproportionately affected by APD. An estimated 15% of all returning military personnel live with APD. HHF’s ERG recipient Edward Bartlett, Ph.D., explains that the changes to the central auditory system may account for the behavioral issues that veterans experience, such as problems with memory, learning, communication, and emotional regulation.

Retired U.S. Army Colonel John Dillard of HHF’s Board of Directors remarks, “It is truly unfortunate that our veterans, after making such honorable sacrifices, are forced to live with APD, often alongside tinnitus and/or hearing loss. I am hopeful that future scientific advancements will better the lives of veterans and all Americans.”

There are no cures for APD, but there are many treatments that aim to improve the effectiveness of everyday communication. These include environmental modifications, addressing functional deficits, and improving listening and spoken language comprehension. Pursuing treatment for APD as early as possible is imperative, McCullagh explains, because hearing is vital to social and educational interactions. “Those with APD often develop issues with language development, hearing in noise, and sound localization. Risks associated include not being able to participate in noisy environments which can often result in depression and anxiety.”

Much more research of APD is needed to improve the accuracy of methodologies for diagnosis and to determine the best interventions for each child or adult. Even though there are available strategies to treat APD, researchers, including those funded by HHF, largely through the generosity of the Royal Arch Masons Research Assistance, are hard at work finding alternative treatments that will improve the lives of those with APD.

We need your help supporting innovative hearing and balance science through our Emerging Research Grants program. Please make a contribution today.

 
 
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Studying Difficulties in Sound Localization

HHF partner Clarke Schools for Hearing and Speech published briefings on three Emerging Research Grants (ERG) recipients’ projects that investigate Central Auditory Processing Disorder (CAPD).

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CAPD causes one to have trouble with sound localization, specifically in their ability to isolate a sound source in social environments. Individuals with CAPD also have difficulty decoding the meaning of language, even though they do not necessarily have a hearing loss. CAPD occurs when the part of the brain that translates what the ear delivers does not function properly.

The individual works of ERG recipients Elizabeth McCullagh, Ph.D., Andrew Dimitrijevic, Ph.D., and Yoojin Chung, Ph.D. are summarized in the Clarke news piece.

Combined, their research efforts and related studies will lead the way to possible CAPD medical intervention, including that for children and cochlear implant recipients.

Read full piece from Clarke Schools for Hearing and Speech here.

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A Tribute to Our Nation’s Veterans

By Laura Friedman

Each year on Veterans Day, November 11, we proudly honor the men and women who have bravely served our country and fought to protect our freedoms.

Veterans Day is important because it honors our soldiers and it is a time to raise awareness about their experiences on and off the battlefield. Noise-induced hearing loss (NIHL) and tinnitus (ringing in the ears) are the top two health conditions among military veterans, according to the U.S. Department of Veterans Affairs (VA). By the end of fiscal year 2016 over 1 million veterans received disability compensation as a result of hearing loss, and about 1.6 million received compensation for tinnitus.

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In addition to being disproportionately affected by hearing loss and tinnitus, our soldiers and veterans are also more susceptible to developing central auditory processing disorders (CAPD). CAPD occurs when one can hear sounds but is unable to understand the words. It is sometimes caused by intense exposure to sudden and loud noises from improvised explosive devices (IEDs), ammunition and engine noise.

"Both post-blast trauma and CAPD are difficult, diffuse disorders where more work is needed, particularly on people working in extreme conditions, acoustic and otherwise, such as veterans." —Edward Bartlett, Ph.D., Associate Professor, Biological Sciences and Biomedical Engineering Purdue University

Blasts can result in temporary hearing loss and put military personnel at risk. However, the word “temporary” should be approached with caution: Repeated short-term hearing loss can damage the sensitive hair cells in the inner ear, leading to permanent hearing loss.

Hearing loss and tinnitus as a result of noise is largely preventable. There’s a misconception that not using hearing protection would inhibit vital communication and mission readiness. With today’s increasingly sophisticated technology, soldiers no longer need to choose between protecting their ears or their lives. Wearing hearing protection such as noise-attenuating helmets, which use ear cups to protect against hazardous sound, or Tactical Communication and Protective Systems, which protect against loud noises while amplifying soft ones, can go a long way to reduce overall exposure, while ensuring vital communications.

Any form of hearing loss can be detrimental to soldiers on duty, as the ability to hear signs of danger and to communicate with fellow soldiers is crucial for mission success and survival. Off-duty, hearing loss and tinnitus can also impact one’s well-being.

Regardless of age, type of hearing loss, or cause, if left untreated or undetected hearing loss can lead to considerable, negative social, psychological, cognitive, and health effects. As a result, it can seriously impact professional and personal life, potentially leading to isolation and depression. Treating hearing loss can also decrease one’s risk of acquiring other serious medical conditions, such as cardiovascular disease, dementia, and diabetes.

Veterans who have acquired hearing loss and tinnitus, either as a result of war or through other causes, can seek treatment at their local Department of Veterans Affairs (VA) medical center. Through partnerships with local community providers, the VA offers comprehensive hearing health services including screening, evaluation, treatment, and/or management of hearing, tinnitus, and balance disorders.

While it may be daunting to take the initial step of having a hearing test, it is important to know there are many different treatment options available. Some forms of hearing loss, such as those that affect the middle ear, are treatable through surgery. Damage to the inner ear and auditory nerve can cause permanent hearing loss; however technologies such as hearing aids, assistive/alerting devices, TV and telephone amplifiers, and cochlear and other auditory implants can optimize residual hearing by amplifying sounds.

As for tinnitus treatments, many patients have seen improvements with counseling and sound therapy, cognitive behavioral therapy (CBT), and the use of white-noise machines. Be sure to discuss the cause of your hearing loss and tinnitus and various treatment options with your audiologist or ear, nose, and throat specialist (ENT).

“On this and every Veterans Day, HHF sincerely thanks our military and our veterans for their brave service and sacrifice. I would also encourage all members, past and present, to have their hearing tested and monitored by a hearing health professional on a regular basis.” —Nadine Dehgan, CEO, Hearing Health Foundation.

Please visit va.gov/directory/guide to find your local VA medical facility. Please also see our Fall 2017 issue of Hearing Health magazine, whose theme is Veterans & Seniors, available at hhf.org/magazine.

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Cortical Alpha Oscillations Predict Speech Intelligibility

By Andrew Dimitrijevic, Ph.D.

Hearing Health Foundation Emerging Research Grants recipient Andrew Dimitrijevic, Ph.D., and colleagues recently published “Cortical Alpha Oscillations Predict Speech Intelligibility” in the journal Frontiers in Human Neuroscience.

The scientists measured brain activity that originates from the cortex, known as alpha rhythms. Previous research has linked these rhythms to sensory processes involving working memory and attention, two crucial tasks for listening to speech in noise. However, no previous research has studied alpha rhythms directly during a clinical speech in noise perception task. The purpose of this study was to measure alpha rhythms during attentive listening in a commonly used speech-in-noise task, known as digits-in-nose (DiN), to better understand the neural processes associated with speech hearing in noise.

Fourteen typical-hearing young adult subjects performed the DiN test while wearing electrode caps to measure alpha rhythms. All subjects completed the task in active and passive listening conditions. The active condition mimicked attentive listening and asked the subject to repeat the digits heard in varying levels of background noise. In the passive condition, the subjects were instructed to ignore the digits and watch a movie of their choice, with captions and no audio.

Two key findings emerged from this study in regards to the influence of attention, individual variability, and predictability of correct recall.

First, the authors concluded that the active condition produced alpha rhythms, while passive listening yielded no such activity. Selective auditory attention can therefore be indexed through this measurement. This result also illustrates that these alpha rhythms arise from neural processes associated with selective attention, rather than from the physical characteristics of sound. To the authors’ knowledge, these differences between passive and active conditions have not previously been reported.

Secondly, all participants showed similar brain activation that predicted when one was going to make a mistake on the DiN task. Specifically, a greater magnitude in one particular aspect of alpha rhythms was found to correlate with comprehension; a larger magnitude on correct trials was observed relative to incorrect trials. This finding was consistent throughout the study and has great potential for clinical use.

Dimitrijevic and his colleagues’ novel findings propel the field’s understanding of the neural activity related to speech-in-noise tasks. It informs the assessment of clinical populations with speech in noise deficits, such as those with auditory neuropathy spectrum disorder or central auditory processing disorder (CAPD).

Future research will attempt to use this alpha rhythms paradigm in typically developing children and those with CAPD. Ultimately, the scientists hope to develop a clinical tool to better assess listening in a more real-world situation, such as in the presence of background noise, to augment traditional audiological testing.

Andrew Dimitrijevic, Ph.D., is a 2015 Emerging Research Grantee and General Grand Chapter Royal Arch Masons International award recipient. Hearing Health Foundation would like to thank the Royal Arch Masons for their generous contributions to Emerging Research Grants scientists working in the area of central auditory processing disorders (CAPD). We appreciate their ongoing commitment to funding CAPD research.

We need your help supporting innovative hearing and balance science through our Emerging Research Grants program. Please make a contribution today.

 
 
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Understanding Auditory Processing Disorder

 By Frankie Huang

April 4 is Auditory Processing Disorder Awareness Day and the Hearing Health Foundation is highlighting the effects and challenges associated with living with APD.

Auditory processing disorder (APD), also known as central auditory processing disorder (CAPD), is an auditory deficit affecting how the central nervous system interprets verbal information. Those living with APD show impairments in sound localization, specifically their ability to isolate a sound source in social environments.

Approximately 5% of school-age children have APD. Children with APD often are uncertain about what they hear and have difficulty listening in loud background noises as well as understanding rapid speech. Often distracted, they can struggle to keep up with conversations which impedes their ability to read, spell, and follow oral directions.

Researchers found a correlation between working memory capacity, which is the ability to retain and manipulate information, and speech development. They found that working memory capacity was significantly lower in children with APD and may be the cause of their inability to separate and group incoming information and, in turn, lead to poor speech perception in noisy environments.

Other researchers found that peripheral hearing loss may affect performance in certain APD tests in older adults. Older adults with mild to moderate hearing loss did significantly poorer on tests that require recalling words, identifying high and low tone patterns, and repeating short sentences.

Although APD can be difficult to diagnose, there are telltale signs: poor auditory memory, difficulty identifying sounds, and a delayed response to verbal requests and instructions. APD is sometimes misdiagnosed as ADD/ADHD or dyslexia, so if you suspect you or a loved one may have APD, it is advised that they go through an individual comprehensive assessment with an audiologist for a more accurate diagnosis.

It is important to understand that research is still needed to understand auditory processing disorders, accurate methodologies for diagnosis, and the best interventions for each child or adult. Even though there are available strategies to treat children with APD, researchers are hard at work finding alternative treatments that will improve the lives of those suffering from APD.

Learn about Hearing Health Foundation’s 2016 Emerging Research Grants recipients who are conducting research to improve the lives of those affected by APD. These grantees are General Grand Chapter Royal Arch Masons International award recipients and we are grateful to the Masons for their ongoing support.

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Introducing HHF's 2016 Emerging Research Grant Recipients

By Morgan Leppla

We are excited to announce the 2016 Emerging Research Grant recipients. This year, HHF funded five research areas:

  • Central Auditory Processing Disorder (CAPD): research investigating a range of disorders within the ear and brain that affect the processing of auditory information. HHF thanks the General Grand Chapter Royal Arch Masons International for enabling us to fund four grants in the area of CAPD. 
     
  • Hyperacusis: research that explores the mechanisms, causes, and diagnosis of loudness intolerance. One grant was generously funded by Hyperacusis Research.
     
  • Méniere’s Disease: research that investigates the inner ear and balance disorder. One grant was funded by the Estate of Howard F. Schum.
     
  • Stria: research that furthers our understanding of the stria vascularis, strial atrophy, and/or development of the stria. One grant was funded by an anonymous family foundation interested in this research.
     
  • Tinnitus: research to understand the perception of sound in the ear in the absence of an acoustic stimulus. Two grants were awarded, thanks to the generosity the Les Paul Foundation and the the Barbara Epstein Foundation.

To learn more about our 2016 ERG grantees and their research goals, please visit hhf.org/2016_researchers

HHF is also currently planning for our 2017 ERG grant cycle. If you're interested in naming a research grant in any discipline within the hearing and balance space, please contact development@hhf.org.

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Neural sensitivity to binaural cues with bilateral cochlear implants

By Massachusetts Eye and Ear/Harvard Medical School

Many profoundly deaf people wearing cochlear implants (CIs) still face challenges in everyday situations, such as understanding conversations in noise. Even with CIs in both ears, they have difficulty making full use of subtle differences in the sounds reaching the two ears (interaural time difference, [ITD]) to identify where the sound is coming from. This problem is especially acute at the high stimulation rates used in clinical CI processors.

 A team of researchers from Massachusetts Eye and Ear/Harvard Medical School, including past funded Emerging Research Grantee, Yoojin Chung, Ph.D., studied how the neurons in the auditory midbrain encode binaural cues delivered by bilateral CIs in an animal model. They found that the majority of neurons in the auditory midbrain were sensitive to ITDs, however, their sensitivity degraded with increasing pulse rate. This degradation paralleled pulse-rate dependence of perceptual limits in human CI users.

This study provides a better understanding of neural mechanisms underlying the limitation of current clinical bilateral CIs and suggests directions for improvement such as delivering ITD information in low-rate pulse trains.

The full paper was published in The Journal of Neuroscience and is available here. This article was republished with permission of the Massachusetts Eye and Ear/Harvard Medical School.

Dr. Yoojin Chung, Ph.D. was a 2012 and 2013 General Grand Chapter Royal Arch Masons International award recipient through our Emerging Research Grants program. Hearing Health Foundation would like to thank the Royal Arch Masons for their generous contributions to Emerging Research Grantees working in the area of central auditory processing disorders (CAPD). We appreciate their ongoing commitment to funding CAPD research.

We need your help supporting innovative hearing and balance science through our Emerging Research Grants program. Please make a contribution today.

 
 
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Defining Auditory-Visual Objects

By Molly McElroy, PhD

If you've ever been to a crowded bar, you may notice that it's easier to hear your friend if you watch his face and mouth movements. And if you want to pick out the melody of the first violin in a string quartet, it helps to watch the strokes of the players' bow.

I-LABS faculty member Adrian KC Lee and co-authors use these examples to illustrate auditory-visual objects, the topic of the researchers' recently published opinion paper in the prestigious journal Trends in Neurosciences.

Lee, who is an associate professor in the UW Department of Speech & Hearing Sciences, studies brain mechanisms that underlie hearing. With an engineering background, Lee is particularly interested in understanding how to improve hearing prosthetics.

Previous I-LABS research has shown that audio-visual processing is evident as early as 18 weeks of age, suggesting it is a fundamental part of how the human brain processes speech. Those findings, published in 1982 by the journal Science, showed that infants understand the correspondence between sight and the sound of language movements.

In the new paper, Lee and co-authors Jennifer Bizley, of University College London, and Ross Maddox, of I-LABS, discuss how the brain integrates auditory and visual information—a type of multisensory processing that has been referred to by various terms but with no clear delineation.

The researchers wrote the paper to provide their field with a more standard nomenclature for what an audio-visual object is and give experimental paradigms for testing it.

“That we combine sounds and visual stimuli in our brains is typically taken for granted, but the specifics of how we do that aren’t really known," said Maddox, a postdoctoral researcher working with Lee. “Before we can figure that out we need a common framework for talking about these issues. That’s what we hoped to provide in this piece.”

Trends in Neurosciences is a leading peer-reviewed journal that publishes articles it invites from leading experts in the field and focuses on topics that are of current interest or under debate in the neuroscience field.

Multisensory, especially audio-visual, work is of importance for several reasons, Maddox said. Being able to see someone talking offers huge performance improvements, which is relevant to making hearing aids that take visual information into account and in studying how people with developmental disorders like autism spectrum disorders or central auditory processing disorders (CAPD) may combine audio-visual information differently.

"The issues are debated because we think studying audio-visual phenomena would benefit from new paradigms, and here we hoped to lay out a framework for those paradigms based on hypotheses of how the brain functions," Maddox said.

Read the full paper onlineThis article was republished with permission of the Institute for Learning & Brain Sciences at the University of Washington

Ross Maddox, Ph.D. was a 2013 General Grand Chapter Royal Arch Masons International award recipient. Hearing Health Foundation would like to thank the Royal Arch Masons for their generous contributions to Emerging Research Grantees working in the area of central auditory processing disorders (CAPD). We appreciate their ongoing commitment to funding CAPD research.

We need your help supporting innovative hearing and balance science through our Emerging Research Grants program. Please make a contribution today.

 
 
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