scholarly journals The Long Road to Automation: Neurocognitive Development of Letter–Speech Sound Processing

2009 ◽  
Vol 21 (3) ◽  
pp. 567-580 ◽  
Author(s):  
Dries J. W. Froyen ◽  
Milene L. Bonte ◽  
Nienke van Atteveldt ◽  
Leo Blomert
Keyword(s):  
Reading Instruction ◽  
Speech Sound ◽  
Speech Sounds ◽  
Adult Readers ◽  
Temporal Window ◽  
Sound Processing ◽  
Difference Wave ◽  
The Difference ◽  
Advanced Readers ◽  
One Year

In transparent alphabetic languages, the expected standard for complete acquisition of letter–speech sound associations is within one year of reading instruction. The neural mechanisms underlying the acquisition of letter–speech sound associations have, however, hardly been investigated. The present article describes an ERP study with beginner and advanced readers in which the influence of letters on speech sound processing is investigated by comparing the MMN to speech sounds presented in isolation with the MMN to speech sounds accompanied by letters. Furthermore, SOA between letter and speech sound presentation was manipulated in order to investigate the development of the temporal window of integration for letter–speech sound processing. Beginner readers, despite one year of reading instruction, showed no early letter–speech sound integration, that is, no influence of the letter on the evocation of the MMN to the speech sound. Only later in the difference wave, at 650 msec, was an influence of the letter on speech sound processing revealed. Advanced readers, with 4 years of reading instruction, showed early and automatic letter–speech sound processing as revealed by an enhancement of the MMN amplitude, however, at a different temporal window of integration in comparison with experienced adult readers. The present results indicate a transition from mere association in beginner readers to more automatic, but still not “adult-like,” integration in advanced readers. In contrast to general assumptions, the present study provides evidence for an extended development of letter–speech sound integration.

Easy Screening for Mild Alzheimer's Disease and Mild Cognitive Impairment from Elderly Speech

2018 ◽  
Vol 15 (2) ◽  
pp. 104-110 ◽  
Author(s):  
Shohei Kato ◽  
Akira Homma ◽  
Takuto Sakuma
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Characteristic Curve ◽  
Linear Regression Analysis ◽  
Speech Sound ◽  
The Elderly ◽  
Speech Sounds ◽  
Mel Frequency Cepstral Coefficients

Objective: This study presents a novel approach for early detection of cognitive impairment in the elderly. The approach incorporates the use of speech sound analysis, multivariate statistics, and data-mining techniques. We have developed a speech prosody-based cognitive impairment rating (SPCIR) that can distinguish between cognitively normal controls and elderly people with mild Alzheimer's disease (mAD) or mild cognitive impairment (MCI) using prosodic signals extracted from elderly speech while administering a questionnaire. Two hundred and seventy-three Japanese subjects (73 males and 200 females between the ages of 65 and 96) participated in this study. The authors collected speech sounds from segments of dialogue during a revised Hasegawa's dementia scale (HDS-R) examination and talking about topics related to hometown, childhood, and school. The segments correspond to speech sounds from answers to questions regarding birthdate (T1), the name of the subject's elementary school (T2), time orientation (Q2), and repetition of three-digit numbers backward (Q6). As many prosodic features as possible were extracted from each of the speech sounds, including fundamental frequency, formant, and intensity features and mel-frequency cepstral coefficients. They were refined using principal component analysis and/or feature selection. The authors calculated an SPCIR using multiple linear regression analysis. Conclusion: In addition, this study proposes a binary discrimination model of SPCIR using multivariate logistic regression and model selection with receiver operating characteristic curve analysis and reports on the sensitivity and specificity of SPCIR for diagnosis (control vs. MCI/mAD). The study also reports discriminative performances well, thereby suggesting that the proposed approach might be an effective tool for screening the elderly for mAD and MCI.

scholarly journals Evidence for complementary effects of code- and knowledge-focused reading instruction

2021 ◽  
pp. 026565902110142
Author(s):  
Meghan Vollebregt ◽  
Jana Leggett ◽  
Sherry Raffalovitch ◽  
Colin King ◽  
Deanna Friesen ◽  
...  
Keyword(s):  
Reading Comprehension ◽  
Word Recognition ◽  
Reading Instruction ◽  
Listening Comprehension ◽  
Nonsense Word ◽  
Dialogic Reading ◽  
Written Expression ◽  
Word Decoding ◽  
School Year ◽  
One Year

There is growing recognition of the need to end the debate regarding reading instruction in favor of an approach that provides a solid foundation in phonics and other underlying language skills to become expert readers. We advance this agenda by providing evidence of specific effects of instruction focused primarily on the written code or on developing knowledge. In a grade 1 program evaluation study, an inclusive and comprehensive program with a greater code-based focus called Reading for All (RfA) was compared to a knowledge-focused program involving Dialogic Reading. Phonological awareness, letter word recognition, nonsense word decoding, listening comprehension, reading comprehension, written expression and vocabulary were measured at the beginning and end of the school year, and one year after in one school only. Results revealed improvements in all measures except listening comprehension and vocabulary for the RfA program at the end of the first school year. These gains were maintained for all measures one year later with the exception of an improvement in written expression. The Dialogic Reading group was associated with a specific improvement in vocabulary in schools from lower socioeconomic contexts. Higher scores were observed for RfA than Dialogic Reading groups at the end of the first year on nonsense word decoding, phonological awareness and written expression, with the differences in the latter two remaining significant one year later. The results provide evidence of the need for interventions to support both word recognition and linguistic comprehension to better reading comprehension.

scholarly journals Estimates of Prevalence of Pulmonary Hypertension according to Different International Definitions

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Richa Tyagi ◽  
Surya Kant ◽  
Akshyaya Pradhan ◽  
Anupam Wakhlu ◽  
Darshan Kumar Bajaj ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Troponin T ◽  
Chronic Respiratory Disease ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
The Difference ◽  
Considerable Morbidity ◽  
One Year ◽  
Definition Of ◽  
Dreaded Disease

Background. Pulmonary hypertension is a dreaded disease associated with considerable morbidity and mortality. The pulmonary hypertension developing due to chronic respiratory disease is a unique subset with symptoms often getting masqueraded by the underlying respiratory condition. The importance of early detection of this complication has been realized worldwide, and recently, the definition of pulmonary hypertension was revised to set the cutoff of mean pulmonary artery pressure (mPAP) at 20 mmHg instead of 25 mmHg at rest. In our study, we have tried to estimate the difference this new definition brings to the prevalence of pulmonary hypertension among interstitial lung disease patients at our centre. Methods. This was a cross-sectional study in which all the patients of ILDs (n = 239) attending the outdoor and indoor Department of Respiratory Medicine, King George’s Medical University, India, for the duration of one year were subjected to transthoracic echocardiography along with measurement of serum pro-B-type natriuretic peptide (BNP) and troponin T values. The data were analyzed using the different definitions, and the prevalence was compared. Result. Incidence of pulmonary hypertension among ILD patients at mPAP cutoff ≥ 25 was 28.9%, while that at value ≥20 mmHg, incidence of pulmonary hypertension increased to 46.0%. An increment of 15–20% in incidence of pulmonary hypertension was observed among different types of ILD when cutoff of mPAP was changed. Conclusion. The new definition helps in a significant increase in the detection of pulmonary hypertension, which certainly helps in earlier detection and better management of patients.

scholarly journals The COVID-19 pandemic shifted the Veterans Affairs System toward being a payer and virtual care provider: is it sustainable?

2021 ◽  
Author(s):  
Liam Rose ◽  
Linda Diem Tran ◽  
Steven M Asch ◽  
Anita Vashi
Keyword(s):  
Financial Incentives ◽  
Care Delivery ◽  
Data Extraction ◽  
Medical Personnel ◽  
Extraction Methods ◽  
Virtual Care ◽  
Large Expansion ◽  
Virtual Visits ◽  
The Difference ◽  
One Year

Objective: To examine how VA shifted care delivery methods one year into the pandemic. Study Setting: All encounters paid or provided by VA between January 1, 2019 and February 27, 2021. Study Design: We aggregated all VA paid or provided encounters and classified them into community (non-VA) acute and non-acute visits, VA acute and non-acute visits, and VA virtual visits. We then compared the number of encounters by week over time to pre-pandemic levels. Data Extraction Methods: Aggregation of administrative VA claims and health records. Principal Findings: VA has experienced a dramatic and persistent shift to providing virtual care and purchasing care from non-VA providers. Before the pandemic, a majority (63%) of VA care was provided in-person at a VA facility. One year into the pandemic, in-person care at VA's constituted just 33% of all visits. Most of the difference made up by large expansions of virtual care; total VA provided visits (in person and virtual) declined (4.9 million to 4.2 million) while total visits of all types declined only 3.5%. Community provided visits exceeded prepandemic levels (2.3 million to 2.9 million, +26%). Conclusion: Unlike private health care, VA has resumed in-person care slowly at its own facilities, and more rapidly in purchased care with different financial incentives a likely driver. The very large expansion of virtual care nearly made up the difference. With a widespread physical presence across the U.S., this has important implications for access to care and future allocation of medical personnel, facilities, and resources.

scholarly journals The difference in outcome of patients with open inguinal hernia repair by using delayed absorbable sutures instead of non-absorbable sutures for mesh fixation

2020 ◽  
Vol 8 (1) ◽  
pp. 24
Author(s):  
Ali G. Mohammed Redha ◽  
Adil A. Jaber ◽  
Aqeel M. Nasser
Keyword(s):  
Hernia Repair ◽  
Mesh Fixation ◽  
Good Alternative ◽  
P Value ◽  
Absorbable Sutures ◽  
Significant Difference ◽  
The Difference ◽  
Group 2 ◽  
One Year ◽  
Group 1

Background: Different methods are found for mesh fixation in inguinal hernioplasty both open and laparoscopic. In open technique, sutures have been the method of choice for their reduced costs and surgeons’ habits. Whether absorbable instead of non-absorbable sutures can be used still a matter of debate in view of hernia recurrence and post-operative complications.Methods: This is a prospective done on 158 male patients with uncomplicated unilateral inguinal hernias. Two groups of 69 patients were evaluated after periods up to 1 year after open hernioplasty by using delayed absorbable sutures in one group (group 1) and non-absorbable sutures in the other group (group 2) for fixation of mesh.Results: In spite of a noticeable reduction in complication in the group 1 in term of number and percentage when compared with group 2 mainly chronic pain, there is no significant difference (p value>0.05). However, these results are associated with zero recurrence in both groups during a period of one year follow up.Conclusions: Delayed absorbable sutures are good alternative of non-absorbable sutures in open mesh hernia repair associated with less complications and almost no increase in chance of recurrence.  

scholarly journals Extrém magas B típusú natriureticus prohormon prognosztikai szerepe a szívelégtelenség miatt kezelt betegek kórházi halálozására

2017 ◽  
Vol 158 (20) ◽  
pp. 779-782
Author(s):  
Béla Bózsik ◽  
Erzsébet Nagy ◽  
Miklós Somlói ◽  
János Tomcsányi
Keyword(s):  
Heart Failure ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Natriuretic Peptide ◽  
Natriuretic Peptides ◽  
Prognostic Value ◽  
Response To Therapy ◽  
Cardiology Department ◽  
The Difference ◽  
One Year

Abstract: Introduction: Patients hospitalized for heart failure have a very high in-hospital as well as one-year mortality. Natriuretic peptides play both a diagnostic and a prognostic role in this disease. Changes of natriuretic peptide levels in response to therapy are a well-known prognostic marker. Regarding in-hospital mortality, however, little is known about the prognostic value of extremely high levels of natriuretic peptides measured on admission. Aim: To decide whether extremely high levels of B-type natriuretic peptide have a prognostic value with regard to in-hospital mortality. Method: NT-proBNP levels on admission and in-hospital mortality were extracted retrospectively from the data of patients treated with heart failure in the cardiology department of the Hospital of St. John of God in Budapest. We separately analyzed the data of patients hospitalized for heart failure in 2015 with extremely high initial NT-proBNP levels. The cut-off value in this regard was 10 000 ng/l. We also analyzed the comorbidities of these patients. Results: The median NT-proBNP level of those patients who survived beyond the index hospital stay in the last 10 years was 4842 ng/l, whereas the median NT-proBNP level of those 182 patients who died during their hospital stay was 10 688 ng/l (p<0.001). In the year 2015, we treated 118 patients with an NT-proBNP level above 10 000 ng/l. Thirteen of these patients died, which means that their in-hospital mortality exceeded 10%. In comparison, the in-hospital mortality of all heart failure patients was 5.8%. The difference of median NT-proBNP levels of surviving versus deceased patients in this group with extremely high NT-proBNP levels was no longer significant (17 080 ng/l vs. 19 152 ng/l). Conclusions: Patients with an NT-proBNP level of >10 000 ng/l on admission have a significantly higher in-hospital mortality. The difference of NT-proBNP levels of surviving versus deceased patients in the group with admission NT-proBNP levels >10 000 ng/l is no longer significant. We could not identify any etiological factors that would explain these extremely high NT-proBNP levels or the excess in-hospital mortality. Orv Hetil. 2017; 158(20): 779–782.

scholarly journals Increasing enrolment in a national VA transitions of care programme: a pre–post evaluation of a data dashboard and nudge-based intervention

2021 ◽  
Vol 28 (1) ◽  
pp. e100416
Author(s):  
Brigid Connelly ◽  
Chelsea Leonard ◽  
David Gaskin ◽  
Theodore Warsavage ◽  
Heather Gilmartin
Keyword(s):  
Performance Metrics ◽  
Transitions Of Care ◽  
Audit And Feedback ◽  
Veterans Health ◽  
Health Administration ◽  
Care Programme ◽  
Post Evaluation ◽  
The Difference ◽  
Two Phases ◽  
One Year

BackgroundThe rural transitions nurse programme (TNP) is a care coordination intervention for high-risk veterans. An interactive dashboard was used to provide real-time performance metrics to sites as an audit and feedback tool. One-year post implementation, enrolment goals were not met. Nudge emails were introduced to increase TNP veteran enrolment. This study evaluated whether veteran enrolment increased when feedback occurred through a dashboard plus weekly nudge email versus dashboard alone.Setting/populationThis observational study included veterans who were hospitalised and discharged from four Veterans Health Administration hospitals participating in TNP.MethodsVeteran enrolment counts between the dashboard phase and dashboard plus weekly nudge email phase were compared. Nudge emails included run charts of enrolment data. The difference of means for weekly enrolment between the two phases were calculated. After 3 months of nudge emails, a survey assessing TNP transitions nurse and physician champion perceptions of the nudge emails was distributed.ResultsThe average enrolment for the four TNP sites during the ~20-month dashboard only phase was 4.23 veterans/week. The average during the 3-month dashboard plus nudge email phase was 4.21 veterans/week. The difference in means was −0.03 (p=0.73). Adjusting for time trends had no further effect. Four nurses responded to the survey. Two nurses reported neutral and two reported positive perceptions of the nudge emails.ConclusionDrawing attention to metrics, through nudge emails, maintained, but did not increase TNP veteran discharges compared to dashboard feedback alone.

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