The Diversity of Tone Languages and the Roles of Pitch Variation in Non-tone Languages: Considerations for Tone Perception Research

All languages employ consonants and vowels as discrete contrastive subcomponents of the basic timing units of words (syllables). These two classes of phonemes are used to differentiate between words, whose meanings can be categorically changed by switching even a single vowel or consonant, as in vs. or . They populate the lowest level of the phonological hierarchy, the segmental tier, and both classes are obligatory across spoken languages. But only some languages also make use of lexical tones, contrastive sub-syllabic fundamental frequency (pitch) variations referred to as tonemes (e.g., Jones, 1944), which for those languages comprise a third class of phonemic elements. Perceptual researchers often assume tones to be suprasegmental (e.g., So and Best, 2010, 2011, 2014; Liu et al., 2018; Poltrock et al., 2018), i.e., to extend across the consonants and vowels of the target syllable. While in a phonetic sense tones extend across the voiced segments of a syllable, however, such observations may not straightforwardly reflect the more abstract phonological properties of tones (e.g., see Wang, 1967; Hyman, 2011a,b). Indeed, several tone phonologists claim that lexical tones function as segments in tone languages (e.g., Lin, 1989; Duanmu, 1990, 1994). For the following paragraphs we adopt that phonological view that lexical tones function in tone languages at the segmental level, along with consonants and vowels. However, we return later to consider their phonological status and its relevance for understanding lexical tone perception by native and non-native listeners

Intergroup Dynamics in Speech Perception: Interaction Among Experience, Attitudes and Expectations

Experience, attitudes, and expectations have been identified as separate influences on speech perception and comprehension across groups. In this study, we investigate the interaction among these three variables. 58 Australia-born participants completed an online survey and a vowel categorization task. The survey examined participants’ experience with Vietnamese-accented English and their attitudes towards Asians. The vowel categorization task examined participants’ recovery of a Vietnamese-accented speaker’s intended vowels. Half of the participants were told to expect a Vietnamese accent whereas the other half were not. Results indicated that the relationship between listener expectations and group attitudes varied according to whether or not participants had experience with the Vietnamese accent. This interaction was most clearly reflected on the ‘book’ vowel. Compared to participants who did not expect a Vietnamese accent, had no experience with the Vietnamese accent, but positive attitudes towards the Vietnamese group, those who expected a Vietnamese accent showed a decrease in accuracy on ‘book’ categorization. A decrease in ‘book’ categorization accuracy was also found for those having experience with the accent but negative attitudes. In contrast, an increase in accuracy was found for those having no experience with the Vietnamese accent and negative attitudes towards the Vietnamese group, and those having experience with the accent and positive attitudes. We concluded that expectations, experience and attitudes interact in their relationship with speech perception

The role of acoustic similarity and non-native categorisation in predicting non-native discrimination : Brazilian Portuguese vowels by English vs. Spanish listeners

This study tests whether Australian English (AusE) and European Spanish (ES) listeners differ in their categorisation and discrimination of Brazilian Portuguese (BP) vowels. In particular, we investigate two theoretically relevant measures of vowel category overlap (acoustic vs. perceptual categorisation) as predictors of non-native discrimination difficulty. We also investigate whether the individual listener’s own native vowel productions predict non-native vowel perception better than group averages. The results showed comparable performance for AusE and ES participants in their perception of the BP vowels. In particular, discrimination patterns were largely dependent on contrast-specific learning scenarios, which were similar across AusE and ES. We also found that acoustic similarity between individuals’ own native productions and the BP stimuli were largely consistent with the participants’ patterns of non-native categorisation. Furthermore, the results indicated that both acoustic and perceptual overlap successfully predict discrimination performance. However, accuracy in discrimination was better explained by perceptual similarity for ES listeners and by acoustic similarity for AusE listeners. Interestingly, we also found that for ES listeners, the group averages explained discrimination accuracy better than predictions based on individual production data, but that the AusE group showed no difference

Revealing perceptual structure through input variation: cross-accent categorization of vowels in five accents of English

This paper characterizes the perceptual structure of vowel systems in five regional accents of English, from Australia (A), New Zealand (Z), London (L), Yorkshire (Y), and Newcastle upon Tyne (N), on the basis of “whole system” vowel categorization experiments. We established patterns of within-accent vowel confusions, and then explored cross-accent perception, assessing how listeners from one accent background categorize vowels from another. Our experimental task required mapping continuous phonetic dimensions to perceptual categories in the absence of phonotactic and lexical cues to vowel identity and socio-indexical information about the talker. Our results show that, without these sources of information, there is uncertainty in vowel categorization, even for native accent vowels, and that this degree of uncertainty increases for unfamiliar accents. The patterns of cross-accent perception largely reflect the accent-specific perceptual structure of the listener, as opposed to adaptations to the stimulus accents. This finding contrasts with the type of active talker adaptation found with tasks offering lexical information about vowel identity and indexical information about the talker

A short-form version of the Australian English Communicative Development Inventory

Published online: 06 Oct 2021.Purpose: The Australian English Communicative Development Inventory (OZI) is a 558-item parent report tool for assessing language development at 12–30 months. Here, we introduce the short form (OZI-SF), a 100-item, picture-supported, online instrument with substantially lower time and literacy demands. Method: In tool development (Study 1), 95 items were drawn from the OZI to match its item distribution by age of acquisition and semantic categories. Five items were added from four other semantic categories, plus 12 gestures and six games/routines. Simulations computed OZI-SF scores from existing long-form OZI norm data, and OZI and projected OZI-SF scores were correlated. In an independent norming sample (Study 2), parents (n¼230) completed the OZI-SF for their children aged 12–30 months. Child scores were analysed by age and sex. Result: OZI-SF and OZI scores correlate highly across age and language development levels. Vocabulary scores (receptive, expressive) correlate with age and the median for girls is higher until 24 months. By 24 months, 50% of the sample combine words “often”. The median time to OZI-SF completion was 12 minutes. Conclusion: Fitted percentiles permit working guidelines for typical (median) performance and lower cut-offs for children who may be behind on age-based expectations and/or at risk for a communication difficulty. The OZI-SF is a short-form of the OZI that has promise for research and clinical/educational use with Australian families.This work was supported by the Australian Research Council Centre of Excellence for the Dynamics of Language (ARC CoEDL, CE140100041)

Evolving the theory and praxis of knowledge translation through social interaction: a social phenomenological study

Background: As an inherently human process fraught with subjectivity, dynamic interaction, and change, social interaction knowledge translation (KT) invites implementation scientists to explore what might be learned from adopting the academic tradition of social constructivism and an interpretive research approach. This paper presents phenomenological investigation of the second cycle of a participatory action KT intervention in the home care sector to answer the question: What is the nature of the process of implementing KT through social interaction? Methods: Social phenomenology was selected to capture how the social processes of the KT intervention were experienced, with the aim of representing these as typical socially-constituted patterns. Participants (n = 203), including service providers, case managers, administrators, and researchers organized into nine geographically-determined multi-disciplinary action groups, purposefully selected and audiotaped three meetings per group to capture their enactment of the KT process at early, middle, and end-of-cycle timeframes. Data, comprised of 36 hours of transcribed audiotapes augmented by researchers\u27 field notes, were analyzed using social phenomenology strategies and authenticated through member checking and peer review. Results: Four patterns of social interaction representing organization, team, and individual interests were identified: overcoming barriers and optimizing facilitators; integrating \u27science push\u27 and \u27demand pull\u27 approaches within the social interaction process; synthesizing the research evidence with tacit professional craft and experiential knowledge; and integrating knowledge creation, transfer, and uptake throughout everyday work. Achieved through relational transformative leadership constituted simultaneously by both structure and agency, in keeping with social phenomenology analysis approaches, these four patterns are represented holistically in a typical construction, specifically, a participatory action KT (PAKT) model. Conclusion: Study findings suggest the relevance of principles and foci from the field of process evaluation related to intervention implementation, further illuminating KT as a structuration process facilitated by evolving transformative leadership in an active and integrated context. The model provides guidance for proactively constructing a \u27fit\u27 between content, context, and facilitation in the translation of evidence informing professional craft knowledge

Implementation of corticosteroids in treating COVID-19 in the ISARIC WHO Clinical Characterisation Protocol UK:prospective observational cohort study

BACKGROUND: Dexamethasone was the first intervention proven to reduce mortality in patients with COVID-19 being treated in hospital. We aimed to evaluate the adoption of corticosteroids in the treatment of COVID-19 in the UK after the RECOVERY trial publication on June 16, 2020, and to identify discrepancies in care. METHODS: We did an audit of clinical implementation of corticosteroids in a prospective, observational, cohort study in 237 UK acute care hospitals between March 16, 2020, and April 14, 2021, restricted to patients aged 18 years or older with proven or high likelihood of COVID-19, who received supplementary oxygen. The primary outcome was administration of dexamethasone, prednisolone, hydrocortisone, or methylprednisolone. This study is registered with ISRCTN, ISRCTN66726260. FINDINGS: Between June 17, 2020, and April 14, 2021, 47 795 (75·2%) of 63 525 of patients on supplementary oxygen received corticosteroids, higher among patients requiring critical care than in those who received ward care (11 185 [86·6%] of 12 909 vs 36 415 [72·4%] of 50 278). Patients 50 years or older were significantly less likely to receive corticosteroids than those younger than 50 years (adjusted odds ratio 0·79 [95% CI 0·70–0·89], p=0·0001, for 70–79 years; 0·52 [0·46–0·58], p80 years), independent of patient demographics and illness severity. 84 (54·2%) of 155 pregnant women received corticosteroids. Rates of corticosteroid administration increased from 27·5% in the week before June 16, 2020, to 75–80% in January, 2021. INTERPRETATION: Implementation of corticosteroids into clinical practice in the UK for patients with COVID-19 has been successful, but not universal. Patients older than 70 years, independent of illness severity, chronic neurological disease, and dementia, were less likely to receive corticosteroids than those who were younger, as were pregnant women. This could reflect appropriate clinical decision making, but the possibility of inequitable access to life-saving care should be considered. FUNDING: UK National Institute for Health Research and UK Medical Research Council

Procalcitonin Is Not a Reliable Biomarker of Bacterial Coinfection in People With Coronavirus Disease 2019 Undergoing Microbiological Investigation at the Time of Hospital Admission

Abstract Admission procalcitonin measurements and microbiology results were available for 1040 hospitalized adults with coronavirus disease 2019 (from 48 902 included in the International Severe Acute Respiratory and Emerging Infections Consortium World Health Organization Clinical Characterisation Protocol UK study). Although procalcitonin was higher in bacterial coinfection, this was neither clinically significant (median [IQR], 0.33 [0.11–1.70] ng/mL vs 0.24 [0.10–0.90] ng/mL) nor diagnostically useful (area under the receiver operating characteristic curve, 0.56 [95% confidence interval, .51–.60]).</jats:p

Characterisation of in-hospital complications associated with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol UK: a prospective, multicentre cohort study

Background: COVID-19 is a multisystem disease and patients who survive might have in-hospital complications. These complications are likely to have important short-term and long-term consequences for patients, health-care utilisation, health-care system preparedness, and society amidst the ongoing COVID-19 pandemic. Our aim was to characterise the extent and effect of COVID-19 complications, particularly in those who survive, using the International Severe Acute Respiratory and Emerging Infections Consortium WHO Clinical Characterisation Protocol UK. Methods: We did a prospective, multicentre cohort study in 302 UK health-care facilities. Adult patients aged 19 years or older, with confirmed or highly suspected SARS-CoV-2 infection leading to COVID-19 were included in the study. The primary outcome of this study was the incidence of in-hospital complications, defined as organ-specific diagnoses occurring alone or in addition to any hallmarks of COVID-19 illness. We used multilevel logistic regression and survival models to explore associations between these outcomes and in-hospital complications, age, and pre-existing comorbidities. Findings: Between Jan 17 and Aug 4, 2020, 80 388 patients were included in the study. Of the patients admitted to hospital for management of COVID-19, 49·7% (36 367 of 73 197) had at least one complication. The mean age of our cohort was 71·1 years (SD 18·7), with 56·0% (41 025 of 73 197) being male and 81·0% (59 289 of 73 197) having at least one comorbidity. Males and those aged older than 60 years were most likely to have a complication (aged ≥60 years: 54·5% [16 579 of 30 416] in males and 48·2% [11 707 of 24 288] in females; aged &lt;60 years: 48·8% [5179 of 10 609] in males and 36·6% [2814 of 7689] in females). Renal (24·3%, 17 752 of 73 197), complex respiratory (18·4%, 13 486 of 73 197), and systemic (16·3%, 11 895 of 73 197) complications were the most frequent. Cardiovascular (12·3%, 8973 of 73 197), neurological (4·3%, 3115 of 73 197), and gastrointestinal or liver (0·8%, 7901 of 73 197) complications were also reported. Interpretation: Complications and worse functional outcomes in patients admitted to hospital with COVID-19 are high, even in young, previously healthy individuals. Acute complications are associated with reduced ability to self-care at discharge, with neurological complications being associated with the worst functional outcomes. COVID-19 complications are likely to cause a substantial strain on health and social care in the coming years. These data will help in the design and provision of services aimed at the post-hospitalisation care of patients with COVID-19. Funding: National Institute for Health Research and the UK Medical Research Council

Non-steroidal anti-inflammatory drug use and outcomes of COVID-19 in the ISARIC Clinical Characterisation Protocol UK cohort: a matched, prospective cohort study.

Background: Early in the pandemic it was suggested that pre-existing use of non-steroidal anti-inflammatory drugs (NSAIDs) could lead to increased disease severity in patients with COVID-19. NSAIDs are an important analgesic, particularly in those with rheumatological disease, and are widely available to the general public without prescription. Evidence from community studies, administrative data, and small studies of hospitalised patients suggest NSAIDs are not associated with poorer COVID-19 outcomes. We aimed to characterise the safety of NSAIDs and identify whether pre-existing NSAID use was associated with increased severity of COVID-19 disease. Methods: This prospective, multicentre cohort study included patients of any age admitted to hospital with a confirmed or highly suspected SARS-CoV-2 infection leading to COVID-19 between Jan 17 and Aug 10, 2020. The primary outcome was in-hospital mortality, and secondary outcomes were disease severity at presentation, admission to critical care, receipt of invasive ventilation, receipt of non-invasive ventilation, use of supplementary oxygen, and acute kidney injury. NSAID use was required to be within the 2 weeks before hospital admission. We used logistic regression to estimate the effects of NSAIDs and adjust for confounding variables. We used propensity score matching to further estimate effects of NSAIDS while accounting for covariate differences in populations. Results: Between Jan 17 and Aug 10, 2020, we enrolled 78 674 patients across 255 health-care facilities in England, Scotland, and Wales. 72 179 patients had death outcomes available for matching; 40 406 (56·2%) of 71 915 were men, 31 509 (43·8%) were women. In this cohort, 4211 (5·8%) patients were recorded as taking systemic NSAIDs before admission to hospital. Following propensity score matching, balanced groups of NSAIDs users and NSAIDs non-users were obtained (4205 patients in each group). At hospital admission, we observed no significant differences in severity between exposure groups. After adjusting for explanatory variables, NSAID use was not associated with worse in-hospital mortality (matched OR 0·95, 95% CI 0·84–1·07; p=0·35), critical care admission (1·01, 0·87–1·17; p=0·89), requirement for invasive ventilation (0·96, 0·80–1·17; p=0·69), requirement for non-invasive ventilation (1·12, 0·96–1·32; p=0·14), requirement for oxygen (1·00, 0·89–1·12; p=0·97), or occurrence of acute kidney injury (1·08, 0·92–1·26; p=0·33). Interpretation: NSAID use is not associated with higher mortality or increased severity of COVID-19. Policy makers should consider reviewing issued advice around NSAID prescribing and COVID-19 severity. Funding: National Institute for Health Research and Medical Research Council