Eliminating grammatical function assignment from hierarchical models of speech production: Evidence from the conceptual accessibility of referents

ABSTRACTThe assignment of grammatical functions has been a key feature of hierarchical (serial) models of speech production since their inception in the 1970s. This article argues that grammatical function assignment is neither sufficient nor necessary in such models. It reports a study of the effects of the conceptual accessibility of referents on the selection of English dative syntactic frames in production and shows that the effects relate to linear precedence rather than grammatical function assignment. A secondary topic addressed in the same study is whether second language speakers of English have difficulty integrating syntactic knowledge where it interfaces with conceptual accessibility in speech production. Findings suggest that advanced proficiency speakers do not and are qualitatively similar to native speakers. The implications of this for the interface hypothesis about second language acquisition are discussed.</jats:p

Impact of an Advanced Practice Pharmacist Type 2 Diabetes Management Program: A Pilot Study

Background: The purpose of this study was to describe the impact of an Advanced Practice Pharmacist (APh) on lowering hemoglobin A1c (HbA1c) in patients with type 2 diabetes within a patient centered medical home (PCMH) and to classify the types of therapeutic decisions made by the APh. Methods: This was a retrospective study using data from electronic health records. The study evaluated a partnership between Chapman University School of Pharmacy and Providence St. Joseph Heritage Healthcare that provided diabetes management by an Advanced Practice Pharmacist in a PCMH under a collaborative practice agreement. Change in the HbA1c was the primary endpoint assessed in this study. The type of therapeutic decisions made by the APh were also evaluated. Descriptive analysis and Wilcoxon signed rank test were used to analyze data. Results: The study included 35 patients with diagnosis of type 2 diabetes mellitus managed by an APh from May 2017 to December 2017. Most of the patients were 60-79 years old (68.5%), 45.7% were female, and 45.7% were of Hispanic/Latino ethnicity. The average HbA1c was 8.8%±1.4% (range=6.0%-12.4%) and 7.5%±1.4% (range=5.5%-12.4%) at the initial and final APh visit, respectively (p\u3c0.0001). Therapeutic decisions made by the APh included drug dose increase (35.5% of visits), drug added (16.4%), drug dose decrease (6.4%), drug switch (5.5%), and drug discontinuation (1.8%). Conclusion: The Advanced Practice Pharmacist’s interventions had a significant positive impact on lowering HbA1c in patients with type 2 diabetes mellitus in a PCMH. The most common therapeutic decisions made by the APh included drug dose increase and adding a new drug

Analysis of Gabapentinoids Abuse-Reports in the Middle East and North Africa Region Utilizing the Food and Drug Administration Adverse Event Reporting System

Objectives: The purpose of this study was to identify abuse-related post-marketing reports associated with gabapentinoids use in the Middle East and North Africa (MENA) region countries. Methods: A retrospective cross-sectional analysis of abuse-related adverse drug event (ADE) reports from the Middle East and North Africa (MENA) region. It was performed using the Food and Drug Administration Adverse Event Reporting System (FAERS) database from January 2008 through June 2020. Abuserelated ADE reports for gabapentin and pregabalin were extracted from the FAERS database. Descriptive statistics were performed, and the proportional reporting ratio (PRR) was calculated to detect disproportional attribution of abuse-related ADEs for gabapentin versus pregabalin. Results: We identified 559 all-cause ADE reports for gabapentinoids, including 205 (36.7%) abuse-related ADE reports reported to FAERS in the period of analysis. FAERS included 139 (67.8%) pregabalin and 66 (32.2%) gabapentin abuse-related ADE reports. Among MENA region countries, Turkey (55, 39.6%) and Saudi Arabia (34, 23.7%) had the highest number of abuse-related ADE reports for pregabalin. The most pregabalin abuse-related ADE reports involved adult male patients. The PRR of pregabalin versus gabapentin abuse-related ADE reports was 1.11, indicating that the number of abuse-related events was higher for pregabalin compared to gabapentin. Conclusion: Over 200 cases of abuserelated gabapentinoids events were reported to FEARS from the MENA region in the study period. Further studies should assess risk factors and potential programs to reduce gabapentinoids abuse

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10&nbsp;years; 78.2% included were male with a median age of 37&nbsp;years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Anti-Tumor Effects of Queen Bee Acid (10-Hydroxy-2-Decenoic Acid) Alone and in Combination with Cyclophosphamide and Its Cellular Mechanisms against Ehrlich Solid Tumor in Mice

Queen bee acid or 10-hydroxy-2-decenoic acid (10-HDA) is one of the main and unique lipid components (fatty acids) in royal jelly. Previous studies have demonstrated that 10-HDA has various pharmacological and biological activities. The present study aims to evaluate the anti-tumor effects of 10-HDA alone and combined with cyclophosphamide (CP), as an alkylating agent which widely used for the treatment of neoplastic cancers, against the Ehrlich solid tumors (EST) in mice. Methods: A total of 72 female Swiss albino mice were divided into eight groups. EST mice were treated with 10-HDA (2.5 and 5 mg/kg) alone and combined with CP (25 mg/kg) orally once a day for 2 weeks. Tumor growth inhibition, body weight, the serum level of alpha-fetoprotein (AFP) and carcinoembryonic antigen tumor (CAE), liver and kidney enzymes, tumor lipid peroxidation (LPO) and nitric oxide (NO), antioxidant enzymes (e.g. glutathione reductase (GR), glutathione peroxidase (GPx), catalase enzyme (CAT)), tumor necrosis factor alpha level (TNF-α), and the apoptosis-regulatory genes expression were assessed in tested mice. Results: the findings exhibited that treatment of EST-suffering mice with 10-HDA at the doses of 2.5 and 5 mg/kg especially in combination with CP significantly (p p Conclusions: According to the results of the present investigations, 10-HDA at the doses of 2.5 and 5 mg/kg especially in combination with CP showed promising antitumor effects against EST in mice and can be recommended as a new or alternative anticancer agent against tumor; nevertheless, further investigations, particularly in clinical setting, are required to confirm these results

Home Drug Delivery Service from the Perspective of Community Pharmacy Staff in Saudi Arabia

Background: In response to COVID-19, many big pharmacy chains in Saudi Arabia have started to provide home drug delivery services. This study aims to understand home drug delivery service from the perspective of community pharmacists in Saudi Arabia. Also, the study investigates the obstacles that may limit the use of home drug delivery service. Methods: A cross-sectional self-reported survey was distributed from February 2021 to May 2021. Descriptive analysis of sociodemographic characteristics was conducted and presented. Frequencies and percentages were calculated for all variables. Results: A total of 965 community pharmacists were surveyed. Most of the pharmacists, (73.5%) were young, aged 23 to 34 years old. The vast majority of the participants, (93.6%), said that the service will improve drug adherence. The lack of required knowledge and skills among pharmacists could be the main obstacle to implement home drug delivery service (34%). A shortage in the number of community pharmacists was the second main obstacle (24%). Conclusion: Home delivery services in the future may largely replace the tradition of going in person to the pharmacy. There are obstacles that may limit the full use of the service like shortage in number of pharmacists and the lack of required training

<i>Moringa oleifera</i> and <i>Azadirachta indica</i> Leaves Enriched Diets Mitigate Chronic Oxyfluorfen Toxicity Induced Immunosuppression through Disruption of Pro/Anti-Inflammatory Gene Pathways, Alteration of Antioxidant Gene Expression, and Histopathological Alteration in <i>Oreochromis niloticus</i>

Our goal in this study was to determine the effect of dietary supplementation with Moringa oleifera (M. oleifera), and Azadirachta indica (A. indica) leaves in mitigating the effects of chronic oxyfluorfen (OXY) toxicity on the health status, expressions of immune and antioxidant genes, and tissue morphological alterations in Oreochromis niloticus. In this study, we used 370 healthy O. niloticus (average weight = 25.35 ± 0.29 g). We used 70 fish to study the 96 h lethal concentration 50 (LC50) of OXY. We assigned another 300 fish into six equal groups with five replicates (50 fish/group, 10 fish/replicate) to determine the chronic OXY toxicity for 60 days. The 96 h LC50 of OXY for O. niloticus was 6.685 mg/L. Exposure to 1/10 96 h LC50 of OXY (0.668 mg/L) had health impacts and pathological changes in the main tissues. In addition, the expressions of oxidant and immune genes were disrupted. Dietary supplementation with both M. oleifera and A. indica efficiently mitigated the toxic effects of OXY in the treated groups. Comparing the palliative efficiency of M. oleifera and A. indica, the results showed that M. oleifera was more potent in alleviating the toxic effects of OXY