Formant frequency characteristics of elderly speakers in contextual speech

The present study measured F1 and F2 formant frequency levels of elderly and young male and female speakers producing the /i/, /ae/, [symbol: see text], /u/, and /a/ vowels in two carrier phrases. Results of a series of ANOVAs showed significant interactions of speaker age x vowel for both F1 and F2 formant frequencies for the male and female speakers. Results suggested that while elderly male speakers exhibit significant alterations in vowel production during contextual speech, elderly female speakers generally maintain formant frequency integrity or appropriate articulatory posturing during contextual vowel productions.

Word recognition in continuous and interrupted broadband noise by young normal-hearing, older normal-hearing, and presbyacusic listeners

OBJECTIVE

Word recognition performance in continuous and interrupted broadband noise was examined in young normal-hearing (YNH), older normal-hearing (ONH), and presbyacusic (older hearing-impaired [OHI]) listeners.

DESIGN

Participants (N = 36) were presented with identical Northwestern University Auditory Test No. 6 stimuli at 30 dB sensation level re their respective speech reception thresholds. The speech stimuli were presented in quiet and in both competing noise conditions with signal to noise ratios (S/Ns) of 10, 5, 0, -5, -10, -15, and -20 dB.

RESULTS

In general performance was superior in quiet, improved with increasing S/N, and was greater in the interrupted broadband noise than in the continuous broadband noise. Significant main effects of group and S/N were found in both competing noises (p < 0.0001). Post hoc pairwise comparisons revealed all groups performed differently, with superior performance being displayed by the YNH group followed by the ONH and OHI groups, respectively (p < 0.05). A significant group by S/N interaction was observed in only the interrupted noise condition (p = 0.019). The degree of change in word recognition performance as a function of S/N was greatest in the OHI group followed by the ONH group and the YNH group.

CONCLUSIONS

Group effects observed in the interrupted noise would imply that the two older groups of listeners had an auditory temporal deficit relative to the YNH listeners. The paradigm reveals the patency of the temporal processes that are responsible for the perceptual advantage (i.e., a release from masking) a listener has in interrupted competing stimulus.

Effect of instruction to sing on stuttering frequency at normal and fast rates

Singing as a fluency-enhancing mechanism is well-established. The fluency derived by singing has been attributed to a reduced speech rate, memorized material, semantically reduced content, and an imposed rhythm. In this study, we attempted to address each of these explanations. 12 participants who stuttered were instructed to read or sing each of four different passages under the following conditions: reading at a normal rate, reading at a fast rate, singing at a normal rare, and singing at a fast rate. Participants exhibited a statistically significant increase in disfluencies while reading, i.e., participants displayed a 75% reduction in disfluency in the singing condition relative to the reading condition. There was no difference in stuttering frequency with rate conditions. Current findings suggest that stutterers are capable of internally generating fluent speech production by imposing idiosyncratic melodic structures or some derivation of melody when asked simply to sing. There is no claim that these participants were singing, as skills and capabilities varied tremendously, only that participants achieved dramatic enhancement of fluency after they were just asked to sing. Thus, the only intervening variable was the instruction to sing, which suggests the attempt to follow the instruction, no matter how futile, generated fluent speech. Since fluency was maintained in both the normal and fast rates of production, alternate central mechanisms must be held accountable for these findings.

Fluency effect of frequency alterations of plus/minus one-half and one-quarter octave shifts in auditory feedback of people who stutter

The effect of frequency alterations in auditory feedback of people who stutter on stuttering frequency was investigated. Twelve participants who stutter read aloud under nonaltered auditory feedback (NAF) and four conditions of frequency-altered feedback ([FAF], plus/minus one-half and one-quarter octaves) at normal and fast speech rates. Stuttering frequency was significantly higher while reading aloud with NAF relative to the four conditions of FAF (p < 0.05). There were no differences among participants' stuttering frequency between the four FAF conditions (p > 0.05). Reductions in stuttering frequency of approximately 50% to 60% were found with FAF relative to NAF. More disfluencies occurred with the fast versus the normal speech rate condition (p = .0007) irrespective of auditory feedback condition. These findings suggest that slight alterations in the frequency of auditory feedback of people who stutter are fluency-enhancing.

Neonatal auditory brainstem responses recorded from four electrode montages

Simultaneous auditory brainstem responses (ABRs) to click stimuli at 30 and 60 dB nHL were recorded from 16 full term neonates with four electrode arrays: vertical (Cz-Nape of neck), ipsilateral (Cz-Mi), contralateral (Cz-Mc), and horizontal (Mc-Mi). Results indicated that ABR waveforms were morphologically similar to those recorded in adults: Waves I, III, and V were clearly identifiable and of the same polarity in 15 of 16 subjects 60 dB nHL and Wave V was clearly identifiable in 14 of 16 subjects at 30 dB nHL. Although ABR waves were identified in most cases, waveforms expression was variable with different electrode recording montages. It is suggested that if a clinician must choose one montage array for recording neonatal ABRs at high intensity levels for neurodiagnostic evaluations, the ipsilateral recording array is indicated since it displays the highest expression of wave components. For screening applications or threshold searching at lower stimulus levels, however, either the ipsilateral or vertical montage would be justified. Further, caution should be employed when interpreting ABR results in neonates recorded with unconventional montages due to the variable expression of wave components.

Fluent speech, fast articulatory rate, and delayed auditory feedback: creating a crisis for a scientific revolution?

In 1970 Kuhn argued that science does not progress through a process of accretion. It is typified, rather, by the successive emergence of different paradigms which during their reign dictate the direction of normal science's puzzle-solving activity. Normal science inevitably exposes an anomaly which violates expectations predicted by the reigning paradigm. The "crisis" evoking anomaly may induce a destructive/constructive paradigm change. Transformations from one paradigm to another constitute a scientific revolution and dictate the growth and maturation of a field. This paper suggests the recent finding, that stutterers experience enhancement of fluency while speaking under delayed auditory feedback at a fast articulatory rate, be viewed as an anomaly. By challenging the notion that a slowed speech rate is necessary for amelioration of stuttering, the anomalous finding may be perceived as a crisis in the study of stuttering.

Stuttering amelioration at various auditory feedback delays and speech rates

The primary purpose of this study was to determine if the finding of Kalinowski et al. (1993) of dramatic reductions in stuttering under delayed auditory feedback (DAF) at normal and fast speech rates could be replicated. The second purpose was to determine if stuttering frequency is differentially affected by various delays in an attempt to identify the optimal delay for fluency enhancement for both normal and fast speech rates. Fourteen adult stutterers read eight different passages at either a normal or fast speech rate under non-altered auditory feedback (NAF) and DAF with delays of 25, 50 and 75 ms. Results showed that significant fluency enhancement occurred under DAF at both normal and fast speech rates at all DAF settings (p < 0.05). This finding corroborates the notion that a slowed rate of speech is not a necessary antecedent for fluency improvement under conditions of altered auditory feedback. In addition, the results indicated that 50 ms appears to be the shortest delay producing the maximum reduction in stuttering frequency.

Hemispheric picture-naming hierarchies in stuttering subjects

The present study was done to investigate the linguistic organization of the right hemisphere of stuttering subjects and the interhemispheric interactions that underlie verbal output in this population. Naming reaction times of 14 stuttering adults were measured to unilaterally presented pictures corresponding to vocabulary levels of < 5.5, 9.5-10.5, and > 18.0 years of age. An analysis of variance of latencies showed a significant main effect for picture vocabulary-age. Post hoc tests were interpreted as suggesting that the right hemisphere of stuttering subjects was capable of differential picture-encoding operations in a manner similar to the left hemisphere of normal speakers. Also, naming latencies favored left visual-field stimulations by 34 msec. Taken with significant and high correlations between visual fields for each level of picture vocabulary score, the right hemispheres of the stuttering subjects appeared responsible for picture-encoding operations. Left-hemispheric stimulus processing was not predicted, suggesting differences may exist in interhemispheric interactions underlying picture-naming functions in stuttering populations.

A randomized trial of an education and support program for HIV-infected individuals

OBJECTIVES

To assess the effectiveness of an intervention for providing information and support to HIV-positive donors on changes in their sexual behavior, and to assess which donor characteristics are predictive of behavior change.

DESIGN

Subjects were randomly assigned to a structured intervention or community referral group. Follow-up assessments were conducted every 6 months.

SETTING

New York City, New York, USA.

PARTICIPANTS

A cohort of 271 HIV-infected persons who donated blood to the New York Blood Center.

INTERVENTION

Donors randomized to the structured intervention program met individually with a nurse for counseling and were offered a six-session support group. The program was designed to provide information, encourage safer sexual behavior and provide support.

MAIN OUTCOME MEASURES

Sexual behavior, psychological distress and psychological help seeking, and immune function.

RESULTS

In both groups there was a large decrease over time in reports of unsafe sexual activity. However, more than 30% of participants in both groups reported unsafe sexual activity at the 1-year follow-up visit. Donors randomized to the structured intervention program did not report significantly more behavior change at the 1-year follow-up.

CONCLUSIONS

Better programs to promote behavior change in seropositive individuals are needed.

Cytokines in proliferative diabetic retinopathy and proliferative vitreoretinopathy

We determined whether interleukin-8, monocyte chemotactic protein-1, and macrophage-colony stimulating factor are present in the vitreous of patients with proliferative diabetic retinopathy (PDR) or proliferative vitreoretinopathy (PVR). The levels of these cytokines were measured by specific enzyme-linked immunoassays in vitreous from 30 patients with PDR, 13 patients with PVR, and 26 control individuals, including 10 cadaver eyes and 16 patients with idiopathic macular holes, idiopathic macular puckers, vitreous hemorrhages, or uncomplicated retinal detachments. Detectable levels of interleukin-8 were found in 90% of vitreous samples of patients with PDR, 85% with PVR, and 58% of control samples. IL-8 was significantly increased in PDR (mean +/- SEM; 25.0 +/- 5.3 ng/ml; p = 0.01), but not in PVR (11.9 +/- 3.9 ng/ml; p = 0.50) compared to control human vitreous (8.5 +/- 2.5 2.5 ng/ml). MCP-1 was detected in 90% of vitreous samples of patients with PDR, 92% with PVR, and 81% of control samples. MCP-1 was significantly increased in PDR (6.2 +/- 0.9 ng/ml, p = 0.001) and PVR (7.7 +/- 2.5 ng/ml, p = 0.001) over the levels in control vitreous (1.2 +/- 0.2 ng/ml). M-CSF was detected in 94% of vitreous samples of patients with PDR, 88% with PVR, and 92% from control vitreous. M-CSF was significantly elevated in PDR (32.3 +/- 8.3 ng/ml, p = 0.03), but not in PVR (23.6 +/- 12.8 ng/ml, p = 0.4) compared to control (10.7 +/- 3.5 ng/ml). Our results suggest that IL-8, MCP-1, and M-CSF participate in the pathogenesis of PDR and PVR.

Word recognition performance in continuous and interrupted broad-band noise by normal-hearing and simulated hearing-impaired listeners

Word recognition performance was investigated in 12 normal-hearing young adults in continuous and interrupted broad-band noise as a function of signal-to-noise ratio (S:N) with and without a simulated high frequency hearing loss (i.e., low-pass filtered at 2000 Hz). Subjects exhibited conventional sigmoid performance-intensity functions in continuous noise, for both unfiltered and filtered conditions. In contrast, subjects demonstrated shallower performance-intensity functions in the interrupted noise conditions with overall superior performance under adverse signal-to-noise ratios relative to the continuous noise conditions. Separate two-way analyses of variances investigating mean word recognition performance differences as a function of normal listening (unfiltered) versus the simulated hearing loss (filtered). Signal-to-noise ratio for both continuous and interrupted noise conditions revealed a significant main effects for S:N with both noise conditions (p < .05) and a significant main effect for the simulated hearing loss only in the interrupted noise condition (p < .05). It was hypothesized that subjects' diminished performance in the interrupted noise condition with the stimulated high frequency hearing loss reflected a reduced ability to temporally resolve auditory information between the gaps of noise.

Effect of single and combined altered auditory feedback on stuttering frequency at two speech rates

The purpose of this study was to determine if combining delayed auditory feedback (DAF) and frequency altered feedback (FAF) would enhance fluency more than either DAF or FAF alone. Ten stutterers read at normal and fast speech rates under nonaltered auditory feedback (NAF), DAF (i.e., a 50 ms delay), FAF (i.e., a one half octave downward shift), and a combination of DAF and FAF [(COMBO), i.e., a 50 ms delay plus a one half octave downward shift]. Results indicated that stuttering frequency was significantly reduced under all altered auditory conditions at high speech rates relative to the NAF condition. There were, however, no significant differences between the altered auditory feedback conditions (i.e., DAF, FAF, and COMBO). It is suggested that further studies be undertaken to explore the combination of altered auditory feedback conditions, as it may be the case that a floor effect was demonstrated with the singular presentations of DAF and FAF and further improvements in fluency enhancement could not be exhibited in the combined condition. Finally, these findings support the notion that a slowed rate of speech is not necessary for fluency enhancement under conditions of altered auditory feedback.

Source localization for template implants with particular reference to stepping-source afterloaders

Source localization from radiographs can be very difficult for template-guided implants if the needle images overlap. At UCSF several techniques to make this task easier have been developed. The techniques include selection of an optimum simulator gantry angle, use of different types of dummies, and differential dummy loading. In addition, several modifications have been made in our brachytherapy planning computer program to facilitate source entry. As a result of these improvements, source localization is now accomplished in much less time with improved accuracy.

Protection against chemotherapy-induced alopecia by cyclosporin A in the newborn rat animal model

BACKGROUND

We have previously shown that several agents will protect against chemotherapy-induced alopecia in the newborn rat animal model. Such protective agents render the hair follicle keratinocytes resistant to chemotherapy possibly by the expression of P-glycoprotein (Pgp). Cyclosporin A (CSA) is a potent inhibitor of Pgp.

METHODS AND RESULTS

Efficacy of CSA was tested in its effects on chemotherapy-induced alopecia in the newborn rat animal model. CSA, when applied topically, protected rats from local alopecia induced by various agents.

CONCLUSION

The mechanism of protection by CSA and its relationship to Pgp remain uncertain. The potential clinical applicability of this observation remains to be determined.

Effect of frequency-altered feedback on stuttering frequency at normal and fast speech rates

The purpose of this study was to determine the effect of the magnitude and direction of the frequency shift of frequency-altered auditory feedback (FAF) on stuttering frequency at both normal and fast speech rates. Twelve adult male and 2 adult female subjects who stutter read 10 different passages at either a normal or fast speech rate under nonaltered auditory feedback (NAF) and each of four FAF conditions in which the feedback signal was shifted: up one-half octave; up one octave; down one-half octave; and down one octave. Mean stuttering frequency for NAF was significantly higher than mean stuttering frequencies for all FAF conditions (p < 0.05). There were no statistically significant differences between the FAF conditions (p > 0.05). Subjects exhibited significantly more disfluencies under the fast speech rate condition relative to the normal speech rate condition. Future research should examine the relationship between frequency shifts of less than one-half octave and stuttering amelioration.

Neonatal auditory brainstem response thresholds to air- and bone-conducted clicks: 0 to 96 hours postpartum

Auditory brainstem response (ABR) thresholds to air- and bone-conducted clicks were investigated in 40 full-term neonates. Subjects were divided into two groups of 20 according to postpartum age: less than 48 hours and between 49 and 96 hours. Mean ABR thresholds to air- and bone-conducted clicks for neonates less than 48 hours postpartum were 14.5 dB nHL (51.5 dB peak SPL) and 1.8 dB nHL (36.8 peak re: 1 microN), respectively, while those for neonates between 49 and 96 hours were 3.8 dB nHL (40.8 dB peak SPL) and 1.5 dB nHL (36.5 dB peak re: 1 microN), respectively. A significant difference was found between the two group mean ABR thresholds to air-conducted stimuli (p < .0001) but not for the bone-conducted stimuli (p < .8959). A statistically significant within-group difference was found between the ABR thresholds to air- and bone-conducted stimuli for only the neonates less than 48 hours of age (p < .0001). When the data was collapsed across groups, simple linear regression analyses revealed a statistically significant relation between postpartum age and ABR threshold to air-conducted stimuli (p < .0001) and a nonsignificant relation between postpartum age and ABR threshold to bone-conducted stimuli (p < .9744). These findings support the notion that some resolution of fluids and residuals in the middle ear occurs during the first 48 hours postpartum and that air-conducted stimuli are attenuated during that period. As such, a physiologic conductive deficit among the younger neonates is suggested.

Effect of high-pass filtering on the neonatal auditory brainstem response to air- and bone-conducted clicks

The effect of standard high-pass analog filtering on the neonatal auditory brainstem response (ABR) to air- and bone-conducted clicks at low intensity screening levels was investigated. Simultaneous three channel recorded ABRs were obtained from 20 neonates with filter settings of 30-3000, 100-3000, and 150-3000 Hz at intensity levels of 20, 30, and 40 dB nHL. Statistically significant reductions in wave V amplitude and decreases in wave V latency were observed for both transducers across all three low level stimulus intensities with the progressive increase in the high-pass filter cutoff (p < .05). These data support the advocacy of less restrictive high-pass filtering (e.g., 30 Hz) for neonatal and infant ABR screening to air- and bone-conducted clicks.

Applicability of standard irregular field calculations for high-energy photon beams

Irregular-field calculations are usually based on a sector-summation technique. This technique typically involves separating the dose into primary and scatter components. While the conceptual basis for this procedure is valid at lower energies, it becomes suspect at higher energies. However, despite this limitation, a straightforward application of the technique yields good accuracy for 18 MV X-rays if certain limitations are observed. This work describes the calculational formalism used and the approximations made. Computed results are compared with measurements. The levels of uncertainty in both are discussed.

Auditory brain stem responses to air- and bone-conducted clicks in the audiological assessment of at-risk infants

Auditory brain stem responses (ABRs) to air- and bone-conducted clicks were used to assess the auditory status of 170 at-risk neonates. During the perinatal period, 20.6% (35/170 cases) of the at-risk infants failed ABRs to air-conducted clicks at 30 dB nHL in at least one ear. Ear-specific results indicated an initial failure rate of 15.0% (51/340 ears). Approximately two-thirds (32/51 ears) of these initial failures showed purely conductive deficits, whereas the remaining one-third (19/51 ears) involved suspected sensorineural components. Follow-up audiological evaluations were performed for 87.1% (148 cases) of these at-risk infants at 4 mo and/or 1 yr corrected age. Based on the initial tests and follow-up assessments, the tentative operating characteristics of ABRs to both air- and bone-conducted clicks for identification of sensorineural deficits in at-risk neonates were calculated. It was found that the ABR to bone-conducted clicks yielded better specificity, predictive value of positive results, and overall efficiency. It is suggested that the ABR to bone-conducted stimuli should be viewed as a valuable addition in the assessment of cochlear reserve in infants who fail a newborn auditory screening to air-conducted stimuli.

Depressive symptoms in blood donors notified of HIV infection

OBJECTIVES

Understanding more about the psychological state of persons notified of human immunodeficiency virus (HIV) infection is critical for designing notification and counseling programs that will have the most positive effect.

METHODS

The subjects were blood donors who had been notified of HIV infection by the New York Blood Center. A nurse elicited a medical history, performed a limited medical examination, and asked the subjects to complete a questionnaire that included questions about drug use, sexual behavior, and psychological characteristics. The subjects completed another questionnaire approximately 2 weeks later.

RESULTS

The average depressive symptom scores for both men and women were substantially higher than scores typically found in representative population samples. More than a quarter of the men and more than a third of the women reported seeking psychological or psychiatric services in the first few weeks following notification.

CONCLUSIONS

Anticipating and meeting individuals' psychological needs may be necessary if HIV screening programs are to address effectively the needs of persons infected with HIV.

Auditory brainstem response thresholds to air and bone conducted clicks in neonates and adults

Auditory brainstem response (ABR) thresholds to air and bone conducted clicks were investigated in 20 full-term neonates and 20 normal-hearing young adults. Results showed mean ABR thresholds to air and bone conducted clicks for neonates to be 3.75 dB nHL (40.75 peak SPL) and 1.25 dB nHL (36.25 dB peak re: 1 microN), respectively, and for adults 3.75 dB nHL (40.75 peak SPL) and 18.75 dB nHL (53.75 peak re: 1 microN), respectively. A significant difference was observed in mean ABR thresholds to bone conducted stimuli between neonates and adults (p < 0.0001) and among mean adult ABR thresholds to air and bone conducted stimuli (p < 0.0001). Nonsignificant differences were observed in mean ABR thresholds to air and bone conducted stimuli among neonates (p > 0.05) and in mean ABR thresholds to air conducted stimuli between neonates and adults (p = 1.00). It is speculated that the dissimilarity in the relationship of thresholds to air and bone conducted stimuli between neonates and adults reflects, in part, a difference in efficiency of signal delivery to the cochlea.