Single-word spelling therapy: Revealing the potential to strengthen the graphemic representations of untreated items

Introduction Research into spelling difficulties following a stroke has focused on several different approaches, but one of the most successful and widely reported is that of using a therapy programme that allows a person with aphasia to releam a limited vocabulary of spellings. This study aims to investigate the viability of this type of spelling therapy with a subject whose spelling impairments were more profound than the participants involved in previously reported case studies of a similar nature (Beeson 1999, Beeson et al 2000, 2002). The subject involved in the current study, SK, also had concomitant non linguistic impairments that exacerbated his access to therapy. Method A partial replication of Beeson's (1999) Anagram and Copy Treatment and Copy and Recall Treatment was used to recreate a treatment programme that was tailored to the specific difficulties shown by SK and was also more realistic for therapists within the NHS to duplicate. Results SK was able to releam a very small vocabulary of spellings that suggested an item- specific treatment effect. However, closer analysis of the subject's responses to all tested items implied generalisation on a graphemic level to untreated items - for example an improved ability to correctly write the first letters of untreated words and identify the correct position of letters within an anagram. Discussion The strengthening of graphemic representations, even following a relatively short treatment period, provided positive evidence that spelling therapy can be an effective intervention for even the most severely affected patients. These findings also emphasise the importance of looking in-depth at spelling changes pre-and post-therapy in order to ascertain the true level of improvement, since whole word releaming does not have to be the only marker of success, especially with patients who have profound dysgraphia

Translating Ultrasound into Clinical Practice for the Assessment of Swallowing and Laryngeal Function: A Speech and Language Pathology-Led Consensus Study

Ultrasound (US) has an emerging evidence base for the assessment of swallowing and laryngeal function. Accessibility and technological advances support the use of US as a clinical assessment tool; however, there is insufficient evidence to support its translation into clinical practice. This study aimed to establish consensus on the priorities for translation of US into clinical practice for the assessment of swallowing and laryngeal function. Nominal Group Technique (NGT) was used as a formal method of consensus development. Clinicians and academics, all members of an international US working group, were invited to participate in the study. Two NGT meetings were held, where participants silently generated and then shared ideas. Participants anonymously ranked items. Rankings were aggregated before participants re-ranked items in order of priority. Discussions regarding rankings were recorded and transcribed to inform analysis. Member-checking with participants informed the final analysis. Participants (n = 15) were speech and language pathologists, physiotherapists and sonographers representing six countries. Fifteen items were identified and prioritised 1–13 (including two equally ranked items). Reliability, validity and normative data emerged as key areas for research while development of training protocols and engagement with stakeholders were considered vital to progressing US into practice. Analysis revealed common themes that might be addressed together in research, in addition to the ranked priority. A measured approach to the translation of US into clinical practice will enable effective implementation of this tool. Priorities may evolve as clinical and professional contexts shift, but this study provides a framework to advance research and clinical practice in this field

(188)Re radiopharmaceuticals for radiosynovectomy: evaluation and comparison of tin colloid, hydroxyapatite and tin-ferric hydroxide macroaggregates

BACKGROUND: Radiosynovectomy is a therapy used to relieve pain and inflammation from rheumatoid arthritis and related diseases. In this study three (188)Re particulate compounds were characterized according to their physico-chemical properties and their biological behavior in rabbits. The results were compared in order to establish which was the radiopharmaceutical that better fits the requirements of this kind of radiotherapy. METHODS: Three radiopharmaceutical formulations, tin colloid, hydroxyapatite particles (HA) and ferric hydroxide macroaggregates coated with tin colloid (FHMA), were physically characterized (number, volume and surface of the particles). For this purpose laser diffraction methodology was used. To evaluate cavity leakage of activity the following studies in New Zealand rabbits were performed: scintigraphic images for 48 hr after intraarticular injection of each radiopharmaceutical, biodistribution at 48 hr and urine samples collection during the first 24 hr post-radiopharmaceutical administration. RESULTS: Labeling procedures for (188)Re-HA and (188)Re-Sn-FHMA were labour intensive while (188)Re-Sn was easily prepared. Furthermore, (188)Re-Sn colloid offered the greatest surface area in the 2–10 microm range and was obtained with a radiochemical purity over 95%, while percentage of bound activity for (188)Re-HA and (188)Re-Sn-FHMA were 55% and 92% respectively. Stability was verified for the three radiopharmaceuticals for 24 hr. Scintigraphic studies and biodistribution in rabbits after intraarticular administration of the radiopharmaceuticals showed relevant activity only in the knee, this being over 90% of the residual activity in the whole body at 48 hr in every case. Renal elimination of (188)Re-Sn colloid and (188)Re-Sn-FHMA was detected by activity measurements in urine samples, during the first 12 hr post-radiopharmaceutical injection. The percentage of activity retained in the knee was 69.1% for (188)Re-Sn colloid, 55.1% for (188)Re-Sn-FHMA and 33.6% for (188)Re-HA. CONCLUSION: The (188)Re-Sn colloid was easy to prepare, minimum facilities were required, was stable for 24 hr and showed minimal leakage from the joint after intraarticular injection into the rabbit's knee. Furthermore, (188)Re-Sn colloid has greater retention in the knee when it is compared with the other radiopharmaceuticals, so it could provide the best therapeutic effect/absorbed dose ratio for the patient

An exactly solvable phase transition model: generalized statistics and generalized Bose-Einstein condensation

In this paper, we present an exactly solvable phase transition model in which the phase transition is purely statistically derived. The phase transition in this model is a generalized Bose-Einstein condensation. The exact expression of the thermodynamic quantity which can simultaneously describe both gas phase and condensed phase is solved with the help of the homogeneous Riemann-Hilbert problem, so one can judge whether there exists a phase transition and determine the phase transition point mathematically rigorously. A generalized statistics in which the maximum occupation numbers of different quantum states can take on different values is introduced, as a generalization of Bose-Einstein and Fermi-Dirac statistics.Comment: 17 pages, 2 figure

Permutable entire functions satisfying algebraic differential equations

It is shown that if two transcendental entire functions permute, and if one of them satisfies an algebraic differential equation, then so does the other one.Comment: 5 page

Not just dyspnoea: swallowing as a concern for adults with laryngotracheal stenosis undergoing airway reconstruction

Acquired laryngotracheal stenosis (LTS) is a rare condition causing dyspnea and stridor. Patients often require multiple surgical procedures with no guarantee of a definitive outcome. Difficulty swallowing is a recognised problem associated with LTS and the reconstructive surgeries required to manage the condition. The breathlessness patient’s experience impacts on swallowing, and the vulnerable structures of the larynx are implicated during complex surgeries. This leads to dysphagia post-surgery, with some patients experiencing more chronic symptoms depending on the biomechanical impact of the surgery, or a pre-existing dysphagia. Despite this there is limited observational research about the dysphagia associated with LTS, with no exploration of the patient experience. Our aim was to investigate patient experience of living with LTS focussing on dysphagia in order to guide clinical practice. A qualitative study was completed using focus groups and semi-structured interviews with 24 patients who have had reconstructive surgery for LTS. Thematic analysis was used to identify three over-arching themes: The Physical Journey, The Emotional Journey and The Medical Journey. Key sub-themes included the importance of self-management and control, presence of symptoms, benefits of therapy, living with a life-long condition, fear and anxiety, autonomy, medicalisation of normal processes and the dichotomy between staff expertise and complacency. Swallowing was connected to all themes. The results are reviewed with consideration of the wider literature of lived experience particularly in relation to other chronic conditions and those that carry a high symptom burden such as head and neck cancer. Future clinical and research recommendations have been made. Akin to other clinical groups, adults with LTS are keen that management of their swallowing is person-centred and holistic

The size of Wiman-Valiron disks

Wiman-Valiron theory and results of Macintyre about "flat regions" describe the asymptotic behavior of entire functions in certain disks around points of maximum modulus. We estimate the size of these disks for Macintyre's theory from above and below.Comment: 20 page

Injectivity of sections of convex harmonic mappings and convolution theorems

In the article the authors consider the class ${\mathcal H}_0$ of sense-preserving harmonic functions $f=h+\overline{g}$ defined in the unit disk $|z|<1$ and normalized so that $h(0)=0=h'(0)-1$ and $g(0)=0=g'(0)$, where $h$ and $g$ are analytic in the unit disk. In the first part of the article we present two classes $\mathcal{P}_H^0(\alpha)$ and $\mathcal{G}_H^0(\beta)$ of functions from ${\mathcal H}_0$ and show that if $f\in \mathcal{P}_H^0(\alpha)$ and $F\in\mathcal{G}_H^0(\beta)$, then the harmonic convolution is a univalent and close-to-convex harmonic function in the unit disk provided certain conditions for parameters $\alpha$ and $\beta$ are satisfied. In the second part we study the harmonic sections (partial sums) $$s_{n, n}(f)(z)=s_n(h)(z)+\overline{s_n(g)(z)},$$ where $f=h+\overline{g}\in {\mathcal H}_0$, $s_n(h)$ and $s_n(g)$ denote the $n$-th partial sums of $h$ and $g$, respectively. We prove, among others, that if $f=h+\overline{g}\in{\mathcal H}_0$ is a univalent harmonic convex mapping, then $s_{n, n}(f)$ is univalent and close-to-convex in the disk $|z|< 1/4$ for $n\geq 2$, and $s_{n, n}(f)$ is also convex in the disk $|z|< 1/4$ for $n\geq2$ and $n\neq 3$. Moreover, we show that the section $s_{3,3}(f)$ of $f\in {\mathcal C}_H^0$ is not convex in the disk $|z|<1/4$ but is shown to be convex in a smaller disk.Comment: 16 pages, 3 figures; To appear in Czechoslovak Mathematical Journa