The coronal fricative problem

This paper examines a range of predicted versus attested error patterns involving coronal fricatives (e.g. [s, z, θ, ð]) as targets and repairs in the early sound systems of monolingual English-acquiring children. Typological results are reported from a cross-sectional study of 234 children with phonological delays (ages 3 years; 0 months to 7;9). Our analyses revealed different instantiations of a putative developmental conspiracy within and across children. Supplemental longitudinal evidence is also presented that replicates the cross-sectional results, offering further insight into the life-cycle of the conspiracy. Several of the observed typological anomalies are argued to follow from a modified version of Optimality Theory with Candidate Chains (McCarthy, 2007).National Institutes of Health DC00433, RR7031K, DC00076, DC001694 (PI: Gierut

Clinical Characteristics Associated with Bacterial Bloodstream Coinfection in COVID-19

INTRODUCTION: Inappropriate antibiotic use in COVID-19 is often due to treatment of presumed bacterial coinfection. Predictive factors to distinguish COVID-19 from COVID-19 with bacterial coinfection or bloodstream infection are limited. METHODS: We conducted a retrospective cohort study of 595 COVID-19 patients admitted between March 8, 2020, and April 4, 2020, to describe factors associated with a bacterial bloodstream coinfection (BSI). The primary outcome was any characteristic associated with BSI in COVID-19, with secondary outcomes including 30-day mortality and days of antibiotic therapy (DOT) by antibiotic consumption (DOT/1000 patient-days). Variables of interest were compared between true BSI (n = 25) and all other COVID-19 cases (n = 570). A secondary comparison was performed between positive blood cultures with true BSI (n = 25) and contaminants (n = 33) on antibiotic use. RESULTS: Fever (\u3e 38 °C) (as a COVID-19 symptom) was not different between true BSI (n = 25) and all other COVID-19 patients (n = 570) (p = 0.93), although it was different as a reason for emergency department (ED) admission (p = 0.01). Neurological symptoms (ED reason or COVID-19 symptom) were significantly higher in the true BSI group (p \u3c 0.01, p \u3c 0.01) and were independently associated with true BSI (ED reason: OR = 3.27, p \u3c 0.01; COVID-19 symptom: OR = 2.69, p = 0.03) on multivariate logistic regression. High (15-19.9 × 10(9)/L) white blood cell (WBC) count at admission was also higher in the true BSI group (p \u3c 0.01) and was independently associated with true BSI (OR = 2.56, p = 0.06) though was not statistically significant. Thirty-day mortality was higher among true BSI (p \u3c 0.01). Antibiotic consumption (DOT/1000 patient-days) between true BSI and contaminants was not different (p = 0.34). True bloodstream coinfection was 4.2% (25/595) over the 28-day period. CONCLUSION: True BSI in COVID-19 was associated with neurological symptoms and nonsignificant higher WBC, and led to overall higher 30-day mortality and worse patient outcomes

Evaluation of the INCREMENT-CPE, Pitt Bacteremia and qPitt Scores in Patients with Carbapenem-Resistant Enterobacteriaceae Infections Treated with Ceftazidime–Avibactam

Background The aim of this study was to evaluate the predictive performance of the INCREMENT-CPE (ICS), Pitt bacteremia score (PBS) and qPitt for mortality among patients treated with ceftazidime–avibactam for carbapenem-resistant Enterobacteriaceae (CRE) infections. Methods Retrospective, multicenter, cohort study of patients with CRE infections treated with ceftazidime–avibactam between 2015 and 2019. The primary outcome was 30-day all-cause mortality. Predictive performance was determined by assessing discrimination, calibration and precision. Results In total, 109 patients were included. Thirty-day mortality occurred in 18 (16.5%) patients. There were no significant differences in discrimination of the three scores [area under the curve (AUC) ICS 0.7039, 95% CI 0.5848–0.8230, PBS 0.6893, 95% CI 0.5709–0.8076, and qPitt 0.6847, 95% CI 0.5671–0.8023; P > 0.05 all pairwise comparisons]. All scores showed adequate calibration and precision. When dichotomized at the optimal cut-points of 11, 3, and 2 for the ICS, PBS, and qPitt, respectively, all scores had NPV > 90% at the expense of low PPV. Patients in the high-risk groups had a relative risk for mortality of 3.184 (95% CI 1.35–8.930), 3.068 (95% CI 1.094–8.606), and 2.850 (95% CI 1.016–7.994) for the dichotomized ICS, PBS, and qPitt, scores respectively. Treatment-related variables (early active antibiotic therapy, combination antibiotics and renal ceftazidime–avibactam dose adjustment) were not associated with mortality after controlling for the risk scores. Conclusions In patients treated with ceftazidime–avibactam for CRE infections, mortality risk scores demonstrated variable performance. Modifications to scoring systems to more accurately predict outcomes in the era of novel antibiotics are warranted

Methods for Minimizing the Confounding Effects of Word Length in the Analysis of Phonotactic Probability and Neighborhood Density

This is the author's accepted manuscript. The original is available at http://jslhr.pubs.asha.org/article.aspx?articleid=1781521&resultClick=3Recent research suggests that phonotactic probability (the likelihood of occurrence of a sound sequence) and neighborhood density (the number of words phonologically similar to a given word) influence spoken language processing and acquisition across the lifespan in both normal and clinical populations. The majority of research in this area has tended to focus on controlled laboratory studies rather than naturalistic data such as spontaneous speech samples or elicited probes. One difficulty in applying current measures of phonotactic probability and neighborhood density to more naturalistic samples is the significant correlation between these variables and word length. This study examines several alternative transformations of phonotactic probability and neighborhood density as a means of reducing or eliminating this correlation with word length. Computational analyses of the words in a large database and reanalysis of archival data supported the use of z scores for the analysis of phonotactic probability as a continuous variable and the use of median transformation scores for the analysis of phonotactic probability as a dichotomous variable. Neighborhood density results were less clear with the conclusion that analysis of neighborhood density as a continuous variable warrants further investigation to differentiate the utility of z scores in comparison to median transformation scores. Furthermore, balanced dichotomous coding of neighborhood density was difficult to achieve, suggesting that analysis of neighborhood density as a dichotomous variable should be approached with caution. Recommendations for future application and analyses are discussed

Real-world, Multicenter Experience With Meropenem-Vaborbactam for Gram-Negative Bacterial Infections Including Carbapenem-Resistant Enterobacterales and Pseudomonas Aeruginosa

Background: We aimed to describe the clinical characteristics and outcomes of patients treated with meropenem-vaborbactam (MEV) for a variety of gram-negative infections (GNIs), primarily including carbapenem-resistant Enterobacterales (CRE). Methods: This is a real-world, multicenter, retrospective cohort within the United States between 2017 and 2020. Adult patients who received MEV for ≥72 hours were eligible for inclusion. The primary outcome was 30-day mortality. Classification and regression tree analysis (CART) was used to identify the time breakpoint (BP) that delineated the risk of negative clinical outcomes (NCOs) and was examined by multivariable logistic regression analysis (MLR). Results: Overall, 126 patients were evaluated from 13 medical centers in 10 states. The most common infection sources were respiratory tract (38.1%) and intra-abdominal (19.0%) origin, while the most common isolated pathogens were CRE (78.6%). Thirty-day mortality and recurrence occurred in 18.3% and 11.9%, respectively. Adverse events occurred in 4 patients: nephrotoxicity (n = 2), hepatoxicity (n = 1), and rash (n = 1). CART-BP between early and delayed treatment was 48 hours (P = .04). MEV initiation within 48 hours was independently associated with reduced NCO following analysis by MLR (adusted odds ratio, 0.277; 95% CI, 0.081-0.941). Conclusions: Our results support current evidence establishing positive clinical and safety outcomes of MEV in GNIs, including CRE. We suggest that delaying appropriate therapy for CRE significantly increases the risk of NCOs

Designation processes and semantic substitutions used by european portuguese children in a vocabulary test

This research study focus on the designation processes and semantic substitutions of each word on the vocabulary sub-task from the language test for children – ABFW, standardized in Brazil and adapted to European Portuguese, as well as the comparison of the results obtained in the two countries, to analyze the relevance of their extensibility to the Portuguese population. Methods: The test was applied to 150 children from 5 to 6 years old, of typical development. The test consists of 9 conceptual categories. Each category consists of different words, which were always assessed in the same sequential order. Results: The sample of this study showed a lower performance only in clothes, places and food semantic categories. All the other categories have outperformed the standard. The categories of vocabulary with higher percentage in the right designation of the words were colors and shapes, animals and toys and music instruments. The categories with a higher percentage of substitution processes, from the reference results, were: food and locations. The most recurrent substitution processes were the co-hyponym, words that designate semantic attributes, valorization of the visual stimulus, hypernym and parasynonyms Conclusion: Given the homogeneity of the results of this study with the results obtained with other studies in Brazil, this test reveal potentiality as an instrument for vocabulary assessment in Portugal.Objetivo: Este estudo teve por objetivo a análise e quantificação dos processos de designação e substituição semântica apresentados na prova do vocabulário do Teste de Linguagem Infantil ABFW, padronizado no Brasil e adaptado para Português Europeu (PE), assim como a comparação dos resultados obtidos nos dois países, de forma a analisar a pertinência da sua extensibilidade à população portuguesa. Métodos: A prova foi aplicada a 150 crianças de 5 e 6 anos de idade, de desenvolvimento típico, na Região Norte de Portugal. A prova é constituída por nove categorias conceituais e cada categoria formada por diferentes vocábulos, que foram avaliados sempre pela mesma ordem sequencial. Resultados: A amostra mostrou desempenho inferior, em relação à norma, apenas nas categorias semânticas vestuário, locais e alimentos. Todas as outras categorias revelaram desempenho superior. As categorias do vocabulário que apresentaram maior percentagem de respostas corretas foram: animais, formas e cores e brinquedos e instrumentos musicais. As categorias que apresentaram percentagem superior de processos de substituição, em relação à norma, foram alimentos e locais. Os processos de substituição mais utilizados foram: substituição por co-hipônimo, vocábulos que designam atributos semânticos, valorização do estímulo visual, hiperônimos e parassinônimos. Conclusão: Dada a homogeneidade dos resultados deste estudo com os resultados obtidos em outros estudos no Brasil, esta prova revela potencialidades como instrumento de avaliação do vocabulário em Portugal.This work is funded by CIEd – Research Centre on Education, projects UID/CED/1661/2013 and UID/CED/1661/2016, Institute of Education, University of Minho, through national funds of FCT/MCTESPT.info:eu-repo/semantics/publishedVersio

Gender-specific association of body composition with inflammatory and adipose-related markers in healthy elderly Europeans from the NU-AGE study

Objectives: The aim of this work was to examine the cross-sectional relationship between body composition (BC) markers for adipose and lean tissue and bone mass, and a wide range of specific inflammatory and adipose-related markers in healthy elderly Europeans. Methods: A whole-body dual-energy X-ray absorptiometry (DXA) scan was made in 1121 healthy (65–79 years) women and men from five European countries of the “New dietary strategies addressing the specific needs of elderly population for a healthy aging in Europe” project (NCT01754012) cohort to measure markers of adipose and lean tissue and bone mass. Pro-inflammatory (IL-6, IL-6Rα, TNF-α, TNF-R1, TNF-R2, pentraxin 3, CRP, alpha-1-acid glycoprotein, albumin) and anti-inflammatory (IL-10, TGF-β1) molecules as well as adipose-related markers such as leptin, adiponectin, ghrelin, and resistin were measured by magnetic bead-based multiplex-specific immunoassays and biochemical assays. Results: BC characteristics were different in elderly women and men, and more favorable BC markers were associated with a better adipose-related inflammatory profile, with the exception of skeletal muscle mass index. No correlation was found with the body composition markers and circulating levels of some standard pro- and anti-inflammatory markers like IL-6, pentraxin 3, IL-10, TGF-β1, TNF-α, IL-6Rα, glycoprotein 130, TNF-α-R1, and TNF-α-R2. Conclusions: The association between BC and inflammatory and adipose-related biomarkers is crucial in decoding aging and pathophysiological processes, such as sarcopenia. DXA can help in understanding how the measurement of fat and muscle is important, making the way from research to clinical practice. Key Points: • Body composition markers concordantly associated positively or negatively with adipose-related and inflammatory markers, with the exception of skeletal muscle mass index. • No correlation was found with the body composition markers and circulating levels of some standard pro- and anti-inflammatory markers like IL-6, pentraxin 3, IL-10, TGF-β1, TNF-α, IL-6Rα, gp130, TNF-α-R1, and TNF-α-R2. • Skeletal muscle mass index (SMI) shows a good correlation with inflammatory profile in age-related sarcopenia