Quantifying changes in ultrasound tongue-shape pre- and post-intervention in speakers with submucous cleft palate: an illustrative case study

Ultrasound Tongue Imaging is increasingly used during assessment and treatment of speech sound disorders. Recent literature has shown that ultrasound is also useful for the quantitative analysis of a wide range of speech errors. So far, the compensatory articulations of speakers with cleft palate have only been analysed qualitatively. This study provides a pilot quantitative ultrasound analysis, drawing on longitudinal intervention data from a child with submucous cleft palate. Two key ultrasound metrics were used: 1. articulatory t-tests were used to compare tongue-shapes for perceptually collapsed phonemes on a radial measurement grid and 2. the Mean Radial Difference was reported to quantify the extent to which the two tongue shapes differ, overall. This articulatory analysis supplemented impressionistic phonetic transcriptions and identified covert contrasts. Articulatory errors identified in this study using ultrasound were in line with errors identified in the speech of children with cleft palate in previous literature. While compensatory error patterns commonly found in speakers with cleft palate have been argued to facilitate functional phonological development, the nature of our findings suggest that the compensatory articulations uncovered are articulatory in nature.

Ethnicity can predict GLRA1 genotypes in hyperekplexia

OBJECTIVES

Hyperekplexia is predominantly caused by mutations in the α-1 subunit of the inhibitory glycine receptor (GLRA1). Three quarters of cases show autosomal-recessive inheritance.

METHODS

We carefully ascertained reports of ethnicity from our hyperekplexia research cohort. These were compared with all published cases of hyperekplexia with an identified genetic cause. Ethnicities were subgrouped as Caucasian, Asian, Arabic, Turkish, Jewish or Afro-American.

RESULTS

We report the ethnicity of 90 cases: 56 cases from our service augmented by 34 cases from the literature. Homozygous deletions of exons 1 to 7 are predominantly seen in people with Turkish backgrounds (n=16/17, p<0.001). In contrast, the dominant point mutation R271 is seen in people of Asian, Caucasian and African-American heritage (n=19) but not in people with Arab or Turkish ethnicities (p<0.001).

CONCLUSIONS

Self-declared ethnicity can predict gene-screening outcomes. Cultural practices influence the inheritance patterns and a Caucasian founder is postulated for R271 mutations.

Secondary organic aerosol formation during evaporation of droplets containing atmospheric aldehydes, amines, and ammonium sulfate

Reactions of carbonyl compounds in cloudwater produce organic aerosol mass through in-cloud oxidation and during postcloud evaporation. In this work, postcloud evaporation was simulated in laboratory experiments on evaporating droplets that contain mixtures of common atmospheric aldehydes with ammonium sulfate (AS), methylamine, or glycine. Aerosol diameters were measured during monodisperse droplet drying experiments and during polydisperse droplet equilibration experiments at 75% relative humidity, and condensed-phase mass was measured in bulk thermogravimetric experiments. The evaporation of water from a droplet was found to trigger aldehyde reactions that increased residual particle volumes by a similar extent in room-temperature experiments, regardless of whether AS, methylamine, or glycine was present. The production of organic aerosol volume was highest from droplets containing glyoxal, followed by similar production from methylglyoxal or hydroxyacetone. Significant organic aerosol production was observed for glycolaldehyde, acetaldehyde, and formaldehyde only at elevated temperatures in thermogravimetric experiments. In many experiments, the amount of aerosol produced was greater than the sum of all solutes plus nonvolatile solvent impurities, indicating the additional presence of trapped water, likely caused by increasing aerosol-phase viscosity due to oligomer formation.

The thermal stability of water ice at the poles of mercury

Recent radar observations of Mercury have revealed the presence of anomalous radar reflectivity and polarization features near its north and south poles. Thermal model calculations show that, despite Mercury's proximity to the sun, the temperatures of flat, low-reflectivity surfaces at Mercury's poles are not expected to exceed 167 kelvin. The locations of the anomalous polar radar features appear to be correlated with the locations of large, high-latitude impact craters. Maximum surface temperatures in the permanently shadowed regions of these craters are expected to be significantly colder, as low as 60 kelvin in the largest craters. These results are consistent with the presence of water ice, because at temperatures lower than 112 kelvin, water ice should be stable to evaporation over time scales of billions of years.

Secondary organic aerosol formation by self-reactions of methylglyoxal and glyoxal in evaporating droplets

Glyoxal and methylglyoxal are scavenged by clouds, where a fraction of these compounds are oxidized during the lifetime of the droplet. As a cloud droplet evaporates, the remaining glyoxal and methylglyoxal must either form low-volatility compounds such as oligomers and remain in the aerosol phase, or transfer back to the gas phase. A series of experiments on evaporating aqueous aerosol droplets indicates that over the atmospherically relevant concentration range for clouds and fog (4-1000 microM), 33 +/- 11% of glyoxal and 19 +/- 13% of methylglyoxal remains in the aerosol phase while the remainder evaporates. Measurements of aerosol density and time-dependent AMS signal changes are consistent with the formation of oligomers by each compound during the drying process. Unlike glyoxal, which forms acetal oligomers, exact mass AMS data indicates that the majority of methylglyoxal oligomers are formed by aldol condensation reactions, likely catalyzed by pyruvic acid, formed from methylglyoxal disproportionation. Our measurements of evaporation fractions can be used to estimate the global aerosol formation potential of glyoxal and methylglyoxal via self-reactions at 1 and 1.6 Tg C yr(-1), respectively. This is a factor of 4 less than the SOA formed by these compounds if their uptake is assumed to be irreversible. However, these estimates are likely lower limits for their total aerosol formation potential because oxidants and amines will also react with glyoxal and methylglyoxal to form additional low-volatility products.

Dialysis adequacy and self-reported health status in a group of CAPD patients

The purpose of the study was to describe in a cross sectional manner the self-reported level of health of a group of continuous ambulatory peritoneal dialysis (CAPD) patients and to establish whether any clinical or laboratory variables correlated with this measure of health. While undergoing routine baseline and 6 monthly measurements of weekly total urea over volume distribution (Kt/V) and weekly creatinine clearance (Ccr)/1.73 m2 body surface area (BSA), 57 patients voluntarily completed the Short Form 36 health status questionnaire (SF36) (a self-report, multidimensional, generic measure of health status). Weekly Kt/V was correlated with weekly Ccr (r = 0-81, p < 0.001). Thirty-one of the 57 patients were recorded as having Ccr < 65 L/week. A comparison with Australian interim normative data demonstrated that this group of CAPD patients reported lower scores on the eight physical and mental health components that are measured by the SF36 than did the general population. Patients who were most impaired in their physical functioning were more likely to be older, overweight, and to have a lower normalized protein catabolic rate (nPCR). Patients who were adequately dialyzed (Ccr > or = 65 L/week/1.73 m2) reported greater vitality than those patients recorded as having Ccr < 65 L/week/1.73 m2.

An electropalatographic analysis of stutterers' speech

Electropalatography (EPG) was used to investigate tongue-palate contacts from three adult stutterers during fluent and dysfluent speech and the results compared with normative data. Recordings were made of 22 read sentences, a reading passage and a conversational sample. The results showed that the lingual/palatal contacts of some phonemes during periods of stutterers' fluent speech consistently differed from that of the non-stutterers. Furthermore, stutterers produced greater intrasubject articulatory variability. Finally, during successive repetitions, the EPG patterns often became less similar to the target (or 'normal') configuration.

Hypercapnic and hypoxic ventilatory responses in parents and siblings of children with congenital central hypoventilation syndrome

Children with congenital central hypoventilation syndrome (CCHS) have abnormal ventilatory responses to metabolic stimuli. As there is a genetically determined component of chemoreceptor sensitivity, parents and siblings of children with CCHS may also have blunted ventilatory responses to hypercapnea and hypoxia. To test this, we studied hypercapnic ventilatory responses and hypoxic ventilatory responses in six mothers, four fathers, and five siblings (6 to 49 yr of age) of seven children with CCHS and compared them with 15 age- and sex-matched control subjects (5 to 47 yr of age). Pulmonary function tests were not different between relatives of children with CCHS and control subjects. To measure hypercapnic ventilatory responses, subjects rebreathed 5% CO2/95% O2 until PACO2 reached 60 to 70 mm Hg. To measure hypoxic ventilatory responses (L/min/% SaO2), subjects rebreathed 14% O2/7% CO2/balance N2 at mixed venous PCO2 until SaO2 fell to 75%. All tests were completed in less than 4 min. Instantaneous minute ventilation, mean inspiratory flow (tidal volume/inspiratory time), and respiratory timing (inspiratory timing/total respiratory cycle timing) were calculated on a breath-by-breath basis. Hypercapnic ventilatory responses were 1.97 +/- 0.32 L/min/mm Hg PACO2 in children with CCHS relatives and 2.23 +/- 0.23 L/min/mm Hg PACO2 in control subjects. Hypoxic ventilatory responses were -1.99 +/- 0.37 L/min/% SaO2 in the relatives and -1.54 +/- 0.25 L/min/% SaO2 in the control subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Prolonged survival after immunotherapy (irradiated cancer autografts) or mammary cancers, assessed by a measure of therapeutic deficiency

Sixteen women, twelve with stage 2 and four with stage 3 mammary cancers, were given autografts of irradiated cancer cells immediately after simple mastectomy and before postoperative radiotherapy, as a pilot trial with entry limited for ethical and operational reasons. Entry was based upon the presence of the poor prognostic features of tumor diameter exceeding 4 cm, fixation to skin or fascia or presence of axillary lymph nodal metastases. Actuarial survival curves for a period of six years show significant (p less than 0.01) prolongation of survival of the small autografted group (63% at six years) compared to that (30% at six years) of 139 ungrafted stage 2 mammary cancer patients treated by mastectomy and postoperative radiotherapy. The concept of deficiency of a treatment based upon person-years lived is introduced and used to analyze the data. The observations and analyses support the theoretical concept that irradiated autografts of cancers may sensitise residual cancer to subsequent conventional radiotherapy and in the process can activate systemic immunological restraints.

Stimulatory immunotherapy in mammary cancer

Stimulation of rejection reactions by attenuated cancer cells is the most widely studied and the safest type of immunotherapy feasible at present. Transfer of serum and non-specific stimulation can increase the growth of cancers and carry risks of hypersensitivity reactions and granulomatous hepatitis. No such dangers accompany sensitization with irradiated cancer cells which augments the effect of subsequent irradiation of residual cancer in animals. Therefore we have examined the effects of autografts of irradiated cancer (AIC) added to conventional first treatment of mammary cancer by mastectomy and radiotherapy at a time when any residual or disseminated cancer could reasonably be expected to he small and more readily controlled by any systemic component of the putatively radiosensitizing immunotherapy.

Two premenopausal and 14 postmenopausal women with prognostically unfavourable mammary cancer (11 with proved axillary lymph nodal metastases, I without such metastases and 4 in whom the nodal status was unknown because dissections were partial) were treated in this way 4–7 years ago. Twelve (75 per cent) patients are still alive. One survivor had many metastases in bones and subcutaneous tissues which appear to have regressed completely following chemotherapy. The other II survivors have no biochemical, clinical, radiological or scintigraphic signs of disseminated cancer.

Three of the patients have died from metastases; one whose axillary nodal status was unknown developed cancer therein 52 months after first treatment, and another died of distant metastases after 50 months. The third had extensive axillary metastases at operation and died 6 months later. Another patient aged 78 years with unknown axillary nodal status died of pneumonia with no known metastases after 15 months.

In vitro measurements of cancer-directed cellular immunity in the II survivors who are well have been compared with two age-matched groups of females. One group had comparable primary mammary cancer treated by mastectomy and postoperative radiotherapy but no AIC. A second age-matched group consisted of non-cancer-bearing females attending hospital for the treatment of simple conditions. These carefully controlled immunoassays of lymphocytotoxicity and leucocyte migration inhibition (performed twice) show that AIC strengthens cancer-directed cellular immunity, indicating a need for definition of the optimum application of AIC so that a controlled clinical trial may be designed to measure any benefit conferred by AIC upon patients bearing mammary cancers.

Evaluation of leucocyte functions six years after tumour autograft in human mammary cancer

Mammary cancer directed and nonspecific immunoassays were made in 3 groups of female patients. One group had primary mammary cancer treated by mastectomy and postoperative radiotherapy plus an autograft of irradiated tumour (AIT) 40-66 months previously. A second age-matched group had mammary cancer comparable to the first group in clinical presentation and treatment except that no AIT was given. The third group consisted of non-cancer-bearing age-matched females.

The migration of leucocytes from autografted patients was significantly inhibited in the presence of allogeneic mammary cancer cells from a standardized panel, compared with leucocytes from either non-autograft patients or non-cancer bearers. Selected data from a lymphocyte cytotoxicity test revealed a significantly greater kill of allogeneic mammary cancer target cells by autograft lymphocytes than by those of other groups. These indications of increased cancer directed cell mediated immunity in respect of sensitivity and toxicity in association with AIT require further elucidation under strictly controlled conditions.

Comparison of coil and Kiil dialysers

To assess the comparative efficiency, safety, and cost of maintenance dialysis, the treatment of 13 patients with a Kiil dialyser (representing 1,477 hospital and 735 home dialyses) was compared with that of 11 patients using a coil dialyser (898 hospital and 396 home dialyses). Kiil and coil dialysers proved equally satisfactory from a medical standpoint and equally acceptable to the patients. The capital costs of home dialysis were considerably reduced without any threat to safety or efficiency. The running costs of coil dialysers approximate to those of Kiil dialysers.