Spontaanin puheen prosodinen jaksottelu

The common focus of the studies brought together in this work is the prosodic segmentation of spontaneous speech. The theoretically most central aspect is the introduction and further development of the IJ-model of intonational chunking. The study consists of a general introduction and five detailed studies that approach prosodic chunking from different perspectives. The data consist of recordings of face-to-face interaction in several spoken varieties of Finnish and Finland Swedish; the methodology is usage-based and qualitative. The term “speech prosody” refers primarily to the melodic and rhythmic characteristics of speech. Both speaking and understanding speech require the ability to segment the flow of speech into suitably sized prosodic chunks. In order to be usage-based, a study of spontaneous speech consequently needs to be based on material that is segmented into prosodic chunks of various sizes. The segmentation is seen to form a hierarchy of chunking. The prosodic models that have so far been developed and employed in Finland have been based on sentences read aloud, which has made it difficult to apply these models in the analysis of spontaneous speech. The prosodic segmentation of spontaneous speech has not previously been studied in detail in Finland. This research focuses mainly on the following three questions: (1) What are the factors that need to be considered when developing a model of prosodic segmentation of speech, so that the model can be employed regardless of the language or dialect under analysis? (2) What are the characteristics of a prosodic chunk, and what are the similarities in the ways chunks of different languages and varieties manifest themselves that will make it possible to analyze different data according to the same criteria? (3) How does the IJ-model of intonational chunking introduced as a solution to question (1) function in practice in the study of different varieties of Finnish and Finland Swedish? The boundaries of the prosodic chunks were manually marked in the material according to context-specific acoustic and auditory criteria. On the basis of the data analyzed, the IJ-model was further elaborated and implemented, thus allowing comparisons between different language varieties. On the basis of the empirical comparisons, a prosodic typology is presented for the dialects of Swedish in Finland. The general contention is that the principles of the IJ-model can readily be used as a methodological tool for prosodic analysis irrespective of language varieties.Tämän tutkimuksen aiheena on spontaanin puheen prosodinen jaksottelu, jota Suomessa ei ole tutkittu lainkaan. Nykyiset suomalaiset prosodiset mallit perustuvat luettuihin lauseisiin. Tutkimus koostuu johdannosta ja viidestä artikkelista, jotka käsittelevät puheen prosodista jaksottelua eri näkökulmista. Aineistona on suomen ja suomenruotsin varieteetteja. Puheen prosodialla tarkoitetaan lähinnä puheen tonaalisia ja rytmisiä ominaisuuksia. Sekä puhuminen että puheen ymmärtäminen edellyttävät puhevirran jaksottelua sopivan kokoisiksi prosodisiksi jaksoiksi. Tämä tutkimus keskittyy lähinnä kolmeen kysymykseen: (1) Mitä seikkoja on otettava huomioon prosodisen jaksottelumallin laadinnassa, jotta spontaanin puheen jaksottelua voi tehdä saman mallin avulla tutkittavasta kielestä tai murteesta riippumatta? (2) Minkälaisessa prosodisessa jaksossa eri kielten ja niiden varieteettien erot toteutuvat siten, että eri tutkimusaineistoa voidaan analysoida samoilla ehdoilla? (3) Miten kohdan (1) perusteella tehty malli toimii käytännössä suomen ja suomenruotsin varieteettien kuvauksessa? Tässä tutkimuksessa esitelty intonaatiojaksomalli (IJ-malli) on tärkeä osa tutkimustuloksista. Malli perustuu erikokoisten jaksojen hierarkiaan. Sen avulla on mahdollista jaksotella suomen ja suomenruotsin murteet ja venäläisten puhuma suomi prosodisiin jaksoihin, joiden avulla eri varieteetteja voidaan vertailla. Tutkimus on kvalitatiivinen ja perustuu aineistosta kuulohavainnon ja akustisen analyysin avulla tehtyihin johtopäätöksiin. Prosodisten jaksojen rajakohdat on merkitty aineistoon manuaalisesti kontekstista riippuvan tapauskohtaisen arvion perusteella. Tutkimuksessa kuvataan yksityiskohtaisesti suomenruotsin murteiden prosodiaa sekä esitetään prosodinen typologia suomenruotsin murteille. Venäläisten ja äidinkieleltään suomalaisten puhuman suomen vertailusta saadut tulokset taas auttavat ymmärtämään vieraalta kuulostavan aksentin syitä sekä lisäävät keinoja ääntämisopetukseen

Static mechanical allodynia in post-surgical neuropathic pain after breast cancer treatments

Objectives: Static mechanical allodynia (SMA), i. e., pain caused by normally non-painful static pressure, is a prevalent manifestation of neuropathic pain (NP). Although SMA may significantly affect the patient's daily life, it is less well studied in the clinical context. We aimed to characterize SMA in women with chronic post-surgical NP (CPSNP) after breast cancer surgery. Our objective was to improve understanding of the clinical picture of this prevalent pain condition. This is a substudy of a previously published larger cohort of patients with intercostobrachial nerve injury after breast cancer surgery (Mustonen et al. Pain. 2019;160:246-56). Methods: We studied SMA in 132 patients with CPSNP after breast cancer surgery. The presence, location, and intensity of SMA were assessed at clinical sensory examination. The patients gave self-reports of pain with the Brief Pain Inventory (BPI). We studied the association of SMA to type of surgery, oncological treatments, BMI, other pains, and psychological factors. General pain sensitivity was assessed by the cold pressor test. Results: SMA was prevalent (84%) in this cohort whereas other forms of allodynia were scarce (6%). Moderate-to-severe SMA was frequently observed even in patients who reported mild pain in BPI. Breast and the side of chest were the most common locations of SMA. SMA was associated with breast surgery type, but not with psychological factors. Severe SMA, but not self-reported pain, was associated with lower cold pain tolerance. Conclusions: SMA is prevalent in post-surgical NP after breast cancer surgery and it may represent a distinct NP phenotype. High intensities of SMA may signal the presence of central sensitization. Implications: SMA should be considered when examining and treating patients with post-surgical NP after breast cancer surgery.Peer reviewe

Douleur Neuropathique 4 (DN4) stratifies possible and definite neuropathic pain after surgical peripheral nerve lesion

Background Douleur Neuropathique 4 (DN4) is a screening questionnaire to help identify neuropathic pain (NP) in clinical practice and research. We tested the accuracy of the DN4 questionnaire in stratifying possible NP (pNP) and definite NP (dNP) in patients operated for breast cancer. Methods We studied 163 patients from a longitudinal cohort of breast cancer operated patients 4-9 years after surgery. pNP or dNP were classified according to the NP grading system. Surgeon-verified intercostobrachial nerve resection was used as a confirmatory test for dNP. A receiver-operating characteristic (ROC) curve analysis was performed and the area under the curve (AUC) was calculated to test the diagnostic accuracy (sensitivity, specificity, positive and negative predictive values) of the DN4. Additionally, we studied clinical factors that associated with a positive screening outcome in the interview part of the DN4 (DN4i). Results DN4i and DN4 showed significant accuracy in stratifying patients with pNP or dNP with cut-off scores 3 and 4 resulting to sensitivity of 66.2% and 79.4% and specificity of 77.8% and 92.6%, respectively. pNP and dNP patients showed differences in sensory descriptors of pain according to DN4i items. Screening positive on DN4i associated with dNP and younger age. Conclusions Full DN4 could stratify pNP and dNP patients in a chronic postsurgical NP patient group operated for breast cancer. Additionally, DN4i showed significant accuracy in stratifying pNP and dNP, but an examination is necessary to obtain proper accuracy. Demographic factors may have an impact on the screening outcome of DN4i. Significance DN4 stratifies possible and definite postsurgical peripheral neuropathic pain. DN4i may also show this, but full DN4 is more accurate. We confirm DN4i as a valid screening tool for NP.Peer reviewe

What makes surgical nerve injury painful? A 4-year to 9-year follow-up of patients with intercostobrachial nerve resection in women treated for breast cancer

Nerve injury during breast cancer surgery can cause neuropathic pain (NP). It is not known why some, but not all, patients develop chronic postsurgical neuropathic pain (CPSNP) after the same nerve injury. In this study, we examined 251 breast cancer survivors with surgeon-verified intercostobrachial nerve resection to identify factors that associate with CPSNP. The patients were recruited from a previous study of 1000 women treated for breast cancer in 2006 to 2010. This enabled us to analyze preoperative factors that associate with future CPSNP. The patients were re-examined in 2014 to 2016 to diagnose CPSNP using the revised NP diagnostic criteria. Preoperative assessments were pain in the area to be operated on, any chronic pain condition, depressive symptoms, anxiety, sleep, and experimental cold pain sensitivity using the cold pressor test (CPT). Follow-up assessments were CPT, psychological factors, sleep, any chronic pain, and basic laboratory tests. One hundred thirty-seven (55%) patients with intercostobrachial nerve resection fulfilled CPSNP diagnostic criteria after 4 to 9 years. Of them, 30 patients (22%) had moderate to severe pain in self-reports and 86 (63%) presented moderate to severe evoked pain at examination. Preoperative pain in the surgical area, other chronic pains, and breast-conserving surgery were associated with future CPSNP. Other chronic pains, increased psychological burden, and insomnia, both before surgery and at the follow-up, were associated with CPSNP. Preoperative CPT did not associate with future CPSNP. Patients with established CPSNP showed increased pain sensitivity in CPT and higher levels of inflammatory markers, suggesting that central sensitization and inflammation may associate with the maintenance of CPSNP.Peer reviewe

Aikuisten maahanmuuttajien suomen ääntämisestä

Tässä raportissa selvitetään, millaisia suomen kielen ääntämisvaikeuksia esiintyy seitsemää eri lähtökieltä edustavilla aikuisilla maahanmuuttajilla. Tiedosta on apua suomen ääntämisopetuksessa. Puhujien äidinkielet ovat arabia, kiina, somali, tagalog, thai, venäjä ja vietnam. Raportissa mukana olevat lähtökielet ovat osa Proof-korpusta, jota varten äänitettiin 72:n pääkaupunkiseudulla asuvan 10:tä eri äidinkieltä puhuvan maahanmuuttajan lukupuhuntaa ja keskusteluja. Vastaavat puhenäytteet kerättiin myös kontrolliryhmältä, johon kuului 23 syntyperäistä suomenkielistä. Tässä alustavassa tutkimuksessa kolme tutkijaa kuunteli ääninäytteitä ja teki havaintoja ensin itsenäisesti, lopuksi yhdessä. Puhujien lähtökielten todettiin monin tavoin heijastuvan suomen ääntämiseen, vaikka yksilöllisiä eroja oli runsaasti. Yleisesti ottaen suomen konsonantit olivat helppoja lukuunottamatta /ŋ/:ää ja /h/:n allofoneja. Harvinaisimmat vokaalit ja diftongit olivat monille vaikeita. Lähtökielestä riippumatta äänteiden kestojen tuottaminen oli monelle vaikeaa, mutta ongelmien luonne vaihteli kielten ja puhujien välillä. Erityisesti /pitkät/ konsonantit lyhenivät. Myös äänteiden fonologisen pituuden ja painotuksen riippumattomuus tuotti ongelmia. Erityisesti painottomien tavujen /pitkät/ vokaalit sekä sananalkuiset painolliset /lyhyet/ vokaalit olivat vaikeita. Poikkeamat eivät aina liity selkeästi yksittäisiin äänteisiin tai tavuihin, vaan ääntämisen kokonaisvaltaisempiin piirteisiin. Esimerkiksi monille aasialaisille puhujille oli tyypillistä kauttaaltaan kireä äänenlaatu.Peer reviewe

Factors helping pregnant multiparas cope with fear of birth : a qualitative study

Peer reviewe

Alkuraskauden infektioseulonta Suomessa

Äitiysneuvolassa etsitään raskaana olevilta kuppa-, HIV- ja hepatiitti B -infektioita. Jos tartunta siirtyy äidiltä sikiölle, voi lapsi saada vaikean taudin tai jopa kuolla. Alkuraskauden infektioseulan tavoitteena on estää taudin tarttuminen sikiöön hoitamalla äiti ja lapsi ajoissa. Raportissa on selvitetty seulottavien infektioiden esiintyvyyttä raskaana olevilla, sekä seulontaan osallistuneilla että osallistumattomilla, Suomessa vuosina 2005 2009. Lisäksi arvioitiin infektioiden seulonnan vaikuttavuutta ja kustannuksia mallittamalla. Seulonnan arvioidaan Suomessa estävän vuosittain noin 28 vastasyntyneen infektiota. Ilman seulontaa tartunnat olisivat arviomme mukaan aiheuttaneet vuosittain yhden lapsen kuoleman, kahden vammautumisen ja neljälle lapselle elinikäisen HIV-lääkityksen tarpeen. Yhden tartunnan estämisen kustannukset olivat keskimäärin 38 000 euroa. Raportti on tarkoitettu sosiaali- ja terveydenhuollon päättäjille ja työntekijöille. Keskeisiä kohderyhmiä ovat äitiys- ja lastenneuvoloiden asiantuntijat ja valtakunnallisten ohjeistusten laatimisesta vastaavat henkilöt. Tuloksia voidaan hyödyntää laadittaessa yhtenäisiä valtakunnallisia ohjeita näiden tautien ehkäisyyn, seulontaan, hoitoon ja seurantaan raskaana olevilla ja heidän lapsillaan

High intratumoral dihydrotestosterone is associated with antiandrogen resistance in VCaP prostate cancer xenografts in castrated mice

Antiandrogen treatment resistance is a major clinical concern in castration-resistant prostate cancer (CRPC) treatment. Using xenografts of VCaP cells we showed that growth of antiandrogen resistant CRPC tumors were characterized by a higher intratumor dihydrotestosterone (DHT) concentration than that of treatment responsive tumors. Furthermore, the slow tumor growth after adrenalectomy was associated with a low intratumor DHT concentration. Reactivation of androgen signaling in enzalutamide-resistant tumors was further shown by the expression of several androgen-dependent genes. The data indicate that intratumor DHT concentration and expression of several androgen-dependent genes in CRPC lesions is an indication of enzalutamide treatment resistance and an indication of the need for further androgen blockade. The presence of an androgen synthesis, independent of CYP17A1 activity, has been shown to exist in prostate cancer cells, and thus, novel androgen synthesis inhibitors are needed for the treatment of enzalutamide-resistant CRPC tumors that do not respond to abiraterone.Peer reviewe

Optimized design and analysis of preclinical intervention studies in vivo

Recent reports have called into question the reproducibility, validity and translatability of the preclinical animal studies due to limitations in their experimental design and statistical analysis. To this end, we implemented a matching-based modelling approach for optimal intervention group allocation, randomization and power calculations, which takes full account of the complex animal characteristics at baseline prior to interventions. In prostate cancer xenograft studies, the method effectively normalized the confounding baseline variability, and resulted in animal allocations which were supported by RNA-seq profiling of the individual tumours. The matching information increased the statistical power to detect true treatment effects at smaller sample sizes in two castration-resistant prostate cancer models, thereby leading to saving of both animal lives and research costs. The novel modelling approach and its open-source and web-based software implementations enable the researchers to conduct adequately-powered and fully-blinded preclinical intervention studies, with the aim to accelerate the discovery of new therapeutic interventions.Peer reviewe