Language disorder: a functional linguistic perspective

This paper explores the issues involved in the linguistic characterisation of disordered discourse and the ways in which a Systemic Functional Linguistic framework addresses these issues. For many years, language disorders were described in terms of formal grammars, with "breakdown" discussed in terms of one or more of the traditional levels of language, i.e., phonology, syntax, and semantics. While it was acknowledged that an individual could have difficulty at one or more of these levels, each was viewed quite separately, with semantics viewed largely from a referential perspective. More recent approaches using functional grammar have broadened this view of language and have provided a model of language that re-conceptualizes the notion of meaning and embraces context as integral to its organisation. Such a model has introduced a different perspective on language into clinical fields, and has enabled researchers and clinicians to explore the skills of speakers with language disorders across a variety of situations and contextual variables, examining the linguistic resources still available to them. This paper introduces principles involved in a functional framework and provides an overview of how these principles have been applied to language disorders to date. In addition, the notion of "disorder" itself is discussed as it is situated in this alternative model.

Performance of a UASB-digester system treating domestic wastewater

The anaerobic treatment of raw domestic wastewater by a novel technology consisting of an Up-flow Anaerobic Sludge Bed (UASB) reactor combined with a completely mixed digester for the stabilisation of the UASB sludge was assessed. A pilot-scale plant of the so-called UASB-Digester system was located at the municipal wastewater treatment facility of Santiago de Compostela (Northwest of Spain). The main aim of the Digester was to enhance the biodegradation of influent solids retained in the UASB reactor at low temperatures, then increasing its specific methanogenic activity. The sludge drawn from the middle zone of the UASB entered the upper zone of the Digester and then circulated from the bottom of the Digester to the UASB bottom. Circulating in an automated semi-continuous way, the flow of this sludge stream was selected in order to set a previously defined hydraulic retention time (HRT) (16-27 d) in the digester. The Digester temperature was set at an optimum value ranging from 25 to 35 degrees C. The steady state efficiency of the UASB system, at 6-8 h of HRT, 15-16 degrees C of temperature and 330-360 mg l(-1) of influent total chemical oxygen demand (TCOD) was 79% of total suspended solids (TSS) removal, 52% of TCOD removal and 60% of biological oxygen demand (BOD5) removal. The hydrolysis of retained solids reached 85%, while excess sludge generation was only 7% of influent TCOD. A stable anaerobic (pre)treatment of diluted domestic wastewater was reached as the sludge concentration in the reactor remained mainly constant and the specific methanogenic activity showed a slight increase.

Simultaneous detection of high-resolution R-banding and fluorescence in situ hybridization signals after fluorouracil-induced cellular synchronization

A method for simultaneous detection of fluorescence in situ hybridization of DNA probes and high resolution fluorescent R banding is described. Human lymphocytes were stimulated with phytohemagglutinin and synchronized using a fluorouracil block followed by exposure to bromodeoxyuridine and Hoechst 33258 prior to harvest. Metaphase preparations were treated with Hoechst 33258 and exposed to UV light. Thereafter they were incubated in sodium phosphate buffer and dried prior to in situ hybridization with a biotin-labelled centromere-specific alpha-satellite DNA probe for chromosome 1 (pUCl.77) and two digoxigenin-labelled probes, i.e., a PCR-generated chromosome 8-specific alphoid probe (#8) and a cosmid probe for FLT4 gene on 5q33-qter (class III receptor tyrosine kinase). Hybridization signals were detected by an indirect immunofluorescence method using fluorescein isothiocyanate. The chromosomes were counterstained with propidium iodide and 4',6-diamidino-2-phenylindole dihydrochloride. This simple method allows unambiguous chromosome band identification simultaneously with detection of the hybridized probes.

Risk and prevention of anti-factor IX formation in AAV-mediated gene transfer in the context of a large deletion of F9

The safety of several gene therapy approaches for treatment of the severe, X-linked bleeding disorder hemophilia is currently being evaluated in early phase clinical trials. One strategy seeks to correct deficiency of functional coagulation factor IX (hemophilia B) by intramuscular (IM) administration of an adeno-associated viral (AAV) vector. A potentially serious complication of any treatment for hemophilia is formation of inhibitory antibodies against the coagulation factor protein, a risk that increases in the setting of null mutations in the factor IX gene (F9). Here, we describe hemophilia B mice with a large F9 deletion that form inhibitors within 1 to 2 months after IM administration of an AAV vector expressing mouse F9 or after repeated intravenous infusion of mouse F9 concentrate. In both cases, inhibitors are primarily IgG1 immunoglobulins representing a Th2-driven humoral immune response. We further demonstrate that anti-mouse F9 antibody formation in the gene-based approach can be reduced by transient immune modulation at the time of vector administration. Moreover, this maneuver resulted in complete absence of anti-mouse F9 and sustained expression of functional mouse F9 in some hemophilia B mice, particularly in those animals treated with the immunosuppressive drug cyclophosphamide. These data have direct relevance for design of clinical trials and strategies aimed at avoiding immune responses against a secreted transgene product.

Prevention of marine biofouling using natural compounds from marine organisms

All surfaces that are submerged in the sea rapidly become covered by a biofilm. This process, called biofouling, has substantial economic consequences. Paints containing tri-butyl-tin (TBT) and copper compounds are used to protect marine structures by reducing biofouling. However, these compounds have damaging effects on the marine environment, as they are not biodegradable. It has been noted that many seaweeds and invertebrates found in the sea are not covered by a mature biofilm. This is due to the release of compounds into the surrounding seawater that deter the settlement of fouling organisms. In addition, seaweeds and invertebrates have bacteria on their surfaces that produce compounds to deter settling organisms. The production of compounds by bacteria and their living hosts work in concert to protect the hosts' surfaces. All of these compounds can be collected so they may be natural alternatives to TBT and copper compounds. However, the benefits associated with the use of bacteria as sources of these compounds means that bacteria are the organisms of choice for obtaining natural products for antifouling coatings.

Prefrontal cortex in humans and apes: a comparative study of area 10

Area 10 is one of the cortical areas of the frontal lobe involved in higher cognitive functions such as the undertaking of initiatives and the planning of future actions. It is known to form the frontal pole of the macaque and human brain, but its presence and organization in the great and lesser apes remain unclear. It is here documented that area 10 also forms the frontal pole of chimpanzee, bonobo, orangutan, and gibbon brains. Imaging techniques and stereological tools are used to characterize this area across species and provide preliminary estimates of its absolute and relative size. Area 10 has similar cytoarchitectonic features in the hominoid brain, but aspects of its organization vary slightly across species, including the relative width of its cortical layers and the space available for connections. The cortex forming the frontal pole of the gorilla appears highly specialized, while area 10 in the gibbon occupies only the orbital sector of the frontal pole. Area 10 in the human brain is larger relative to the rest of the brain than it is in the apes, and its supragranular layers have more space available for connections with other higher-order association areas. This suggests that the neural substrates supporting cognitive functions associated with this part of the cortex enlarged and became specialized during hominid evolution.

Intravenous administration of an E1/E3-deleted adenoviral vector induces tolerance to factor IX in C57BL/6 mice

Inbred immunocompetent C57BL/6 mice have been a favored strain to study transgene expression of human blood coagulation factor IX (hF.IX) from viral vectors because systemic expression of the secreted protein is not limited by antibody responses following intravenous (i.v.) injection of vector. For example, i.v. injection of an adenoviral (Ad) vector results in sustained expression of hF.IX in normal or hemophilic C57BL/6 mice, while anti-hF.IX antibodies rapidly emerge in other strains (Gene Therapy 4: 473; Blood 91: 784). To investigate these observations further, we injected naive C57BL/6 mice and C57BL/6 mice with pre-existing anti-hF.IX with Ad-hF.IX vector via peripheral vein. All mice expressed hF.IX antigen without detectable anti-hF.IX, even when challenged with hF.IX in different immunogenic settings at later time points. Moreover, in mice with pre-existing immunity, anti-hF.IX titers diminished to undetectable levels after i.v. administration of Ad-hF.IX. Lymphocytes from mice that had received Ad-hF.IX i.v. failed to proliferate when stimulated with hF.IX in vitro after the animals had been repeatedly challenged with hF.IX protein formulated in complete Freund's adjuvant. Thus, absence of anti-hF.IX in C57BL/6 mice after i.v. injection of Ad vector is not due to ignorance to the foreign transgene product. Similar experiments in other strains showed that immune tolerance to hF.IX does not correlate with the strain haplotype or expression of IL-10 cytokine. Given the well-documented immunogenicity of the first-generation adenoviral vector, data from C57BL/6 mice may therefore grossly underestimate immunological consequences in certain gene therapy protocols.

The public awareness of aphasia: an international survey

We surveyed 929 shoppers in Exeter (England), Louisiana (USA) and Sydney (Australia) to determine what they knew of aphasia. Between 10% and 18% said they had heard of aphasia but only between 1.5% and 7.6% had even some basic knowledge of aphasia. We found that more females knew something about aphasia than males and that older people were more likely to have heard of it, although those with some knowledge were significantly younger. Informants had heard of aphasia mainly through their work or the media and were mainly professionals like teachers, nurses, therapists, managers and administrators, followed by a retired/student group. We found some differences in awareness levels in the different locations we sampled. Results have implications for targeting awareness raising and campaigning.

An investigation into the quality of life of individuals after laryngectomy

BACKGROUND

Little longitudinal data are available on the general physical, psychological, and social problems experienced as a result of laryngectomy or on the preoperative status of patients in regard to these aspects. In particular, prospective longitudinal data gathered from the same group of subjects over time and examining a variety of such outcomes is rare. This descriptive study addresses these issues.

METHODS

The study investigates the progress of a group of 34 laryngectomees from the preoperative stage up to 6 months after surgery. Medical complications, communication, swallowing, diet, physical, and psychosocial adjustment were measured using both the Short-Form Health Survey (SF-36) and original outcome tools.

RESULTS

A large percentage of subjects demonstrated significant and persistent communication and swallowing problems throughout the period studied. Low preoperative and postoperative scores on the SF-36 demonstrate that this group had a poorer state of general health in many respects than those with serious medical conditions previously documented.

CONCLUSIONS

The results suggest that communication and swallowing difficulties persist for many laryngectomees up to 6 months after surgery and still require further investigation. Poor preoperative and postoperative general health scores indicate that this group may require more long-term social support than is currently being offered to adjust to the laryngectomy.

Carbohydrate and fluid intake affect the saliva flow rate and IgA response to cycling

PURPOSE

The purpose of this study was to examine the effect of regular CHO beverage ingestion and restricted fluid intake on various salivary parameters during prolonged cycle exercise.

METHODS

In a randomized block design, 15 recreationally active men cycled for 2 h at 60% VO2max on three occasions, separated by 1 wk. On the CHO and placebo (PLA) treatments, subjects consumed either a glucose (60 g x L(-1)) or placebo drink before (400 mL), during (150 mL every 15 min), and after (400 mL) the exercise. On the restricted fluid intake (RFI) treatment subjects were given a total of 200 mL of placebo fluid to take as desired every 15-min during the exercise. Timed, unstimulated saliva samples were collected preexercise, at 1, 1.5, and 2 h of exercise and at 1 h postexercise. Blood samples were obtained from a subset of 8 subjects preexercise, postexercise, and at 1 h postexercise.

RESULTS

Postexercise plasma glucose levels were 18% and 20% lower on the PLA and RFI treatments, respectively, compared with the CHO treatment (P < 0.01). Saliva flow rates were significantly higher on the CHO treatment compared with the RFI treatment at 1.5 h and 2 h of exercise (P < 0.01 and P < 0.05, respectively). Salivary IgA (s-IgA) concentration was significantly lower on the CHO treatment compared with the RFI treatment throughout the exercise (P < 0.05). No other differences were seen between treatments for either saliva flow rate or s-IgA concentration. Neither s-IgA secretion rate, alpha-amylase activity, nor alpha-amylase secretion rate were affected by treatment.

CONCLUSIONS

These findings suggest that CHO and fluid intake influence the s-IgA and saliva flow rate response to prolonged submaximal exercise.

Role of feeding in the reproductive 'group effect' in females of the German cockroach Blattella germanica (L.)

We have found that whether a female German cockroach, Blattella germanica (L.), is kept alone or in the presence of another female has a major impact on how fast it reproduces and how much it eats. By the sixth day of adulthood, females paired since adult eclosion had substantially larger oöcytes than did females isolated during the same time, and females paired with intact females, or with ones rendered incapable of feeding, consumed more rat chow in the first six days of adulthood than did isolated females. The stimulatory effect of pairing on reproduction was, however, partially independent of feeding because the oöcytes of solitary and paired females differed in size on day 6 even when they were given, and had consumed, the same amount of food. This result was confirmed with analysis of covariance using the total food intake of a female as the covariate in the analysis. A female's social condition probably influenced the development of its oöcytes by affecting the quantity of juvenile hormone synthesized by its corpora allata. The corpora allata of paired females produced more hormone than did those of isolated ones, even when all females had consumed an equivalent amount of food. Moreover, females treated with a juvenile hormone analog, fenoxycarb, reproduced more quickly than identically reared and fed control females, showing that juvenile hormone could influence reproduction independently of feeding. We conclude that both group rearing and food intake accelerate oöcyte development by diminishing the brain's inhibition on the synthesis of juvenile hormone.

Bean alpha-amylase inhibitor 1 in transgenic peas (Pisum sativum) provides complete protection from pea weevil (Bruchus pisorum) under field conditions

Two alpha-amylase inhibitors, called alphaAI-1 and alphaAI-2, that share 78% amino acid sequence identity and have a differential specificity toward mammalian and insect alpha-amylases are present in different accessions of the common bean (Phaseolus vulgaris). Using greenhouse-grown transgenic peas (Pisum sativum), we have shown previously that expression of alphaAI-1 in pea seeds can provide complete protection against the pea weevil (Bruchus pisorum). Here, we report that alphaAI-1 also protects peas from the weevil under field conditions. The high degree of protection is explained by our finding that alphaAI-1 inhibits pea bruchid alpha-amylase by 80% over a broad pH range (pH 4.5-6.5). alphaAI-2, on the other hand, is a much less effective inhibitor of pea bruchid alpha-amylase, inhibiting the enzyme by only 40%, and only in the pH 4.0-4.5 range. Nevertheless, this inhibitor was still partially effective in protecting field-grown transgenic peas against pea weevils. The primary effect of alphaAI-2 appeared to be a delay in the maturation of the larvae. This contrasts with the effect of alphaAI-1, which results in larval mortality at the first or second instar. These results are discussed in relationship to the use of amylase inhibitors with different specificities to bring about protection of crops from their insect pests or to decrease insect pest populations below the economic injury level.

Preventing falls on an elderly care rehabilitation ward

OBJECTIVE

Comparison of two flooring types--carpet and vinyl--in the bed areas, and two modes of physiotherapy--conventional therapy and additional leg strengthening exercises--in avoiding falls.

DESIGN

Randomized 2 x 2 controlled trial.

SETTING

Elderly care rehabilitation ward in a community hospital.

SUBJECTS

Fifty-four consecutive patients referred for rehabilitation.

OUTCOME MEASURES

The incidence of falls, and the change in strength.

RESULTS

There were 10 falls on carpet, and only a single fall on vinyl floor covering (relative risk 8.3, 95% confidence interval 0.95-73, p = 0.05). There were four falls in those receiving additional exercise, and seven falls in those receiving only conventional physiotherapy (relative risk 0.21, 95% confidence interval 0.04-1.2, p = 0.12). Fifty-nine per cent of patients were able to complete strength measurements on admission and discharge. In these, handgrip strength improved more in those given additional exercise than conventional physiotherapy (2.1 kg versus -0.3 kg, p < 0.05).

CONCLUSION

There is no evidence to support either intervention in preventing falls on a rehabilitation ward, but within this low-powered study, there was a strong trend towards vinyl being superior.

A multinational comparison of aphasia management practices

The effect of restructuring of healthcare on the quality, quantity, and nature of aphasia management is largely unknown. The current study is the first to examine access, diagnostic, treatment, and discharge patterns of patients with aphasia in Australia, Canada, the UK, the US private sector (US-Private), and the US Veterans Health Administration in the Department of Veterans Affairs (US-VA). The authors developed a 37-item survey to be completed by clinicians working with aphasic patients. The survey focused on eight areas: access to care, evaluation procedures, group treatment, number and duration of treatment sessions, limitations of the number of sessions, termination of treatment, follow-up practices, and resumption of treatment. 394 surveys were distributed and 175 were returned completed (44% return rate). Respondents represented a range of ages, work experiences, and work settings. There was considerable consistency among respondents from our five healthcare systems. Results suggest that patients may be routinely denied treatment in direct contradiction to the research literature. Just as we carefully monitor the progress of patients receiving our treatment, we are obliged to monitor the effects of managed care on our patients, fellow clinicians, and our profession.

Scene-based nonuniformity correction with video sequences and registration

We describe a new, to our knowledge, scene-based nonuniformity correction algorithm for array detectors. The algorithm relies on the ability to register a sequence of observed frames in the presence of the fixed-pattern noise caused by pixel-to-pixel nonuniformity. In low-to-moderate levels of nonuniformity, sufficiently accurate registration may be possible with standard scene-based registration techniques. If the registration is accurate, and motion exists between the frames, then groups of independent detectors can be identified that observe the same irradiance (or true scene value). These detector outputs are averaged to generate estimates of the true scene values. With these scene estimates, and the corresponding observed values through a given detector, a curve-fitting procedure is used to estimate the individual detector response parameters. These can then be used to correct for detector nonuniformity. The strength of the algorithm lies in its simplicity and low computational complexity. Experimental results, to illustrate the performance of the algorithm, include the use of visible-range imagery with simulated nonuniformity and infrared imagery with real nonuniformity.

Role of vector in activation of T cell subsets in immune responses against the secreted transgene product factor IX

Defining immune responses against the secreted transgene product in a gene therapy setting is critical for treatment of genetic diseases such as hemophilia B (coagulation factor IX deficiency). We have previously shown that intramuscular administration of an adeno-associated viral (AAV) vector results in stable expression of therapeutic levels of factor IX (F.IX) and may be associated with humoral immune responses against F.IX. This study demonstrates that intramuscular injection of an AAV vector expressing F.IX fails to activate F.IX-specific cytotoxic T lymphocytes (CTLs) in hemostatically normal or in hemophilia B mice, so that there is an absence of cellular immune responses against F.IX. However, transgene-derived F.IX can cause B cell responses characterized by production of T helper cell-dependent antibodies (predominantly IgG1, but also IgG2 subclasses) resulting from activation of CD4+ T helper cells primarily of the Th2 subset. In contrast, administration of an adenoviral vector efficiently activated F.IX-specific CTLs and T helper cells of both Th1 and Th2 subsets, leading to inflammation and destruction of transduced muscle tissue and activation of B cells as well. Therefore, vector sequences fundamentally influence T cell responses against transgene-encoded F.IX. In conclusion, activation of the immune system in AAV-mediated gene transfer is restricted to pathways mediated by F.IX antigen presentation through MHC class II determinants resulting in T and B cell responses that are more comparable to responses in the setting of protein infusion rather than of viral infection/gene transfer.