The Effects of Altered Auditory Feedback (AAF) on Fluency in Adults Who Stutter: A Systematic Review

Background and Objectives: Stuttering affects 70 million people worldwide, which is about 1% of the population. Altered auditory feedback (AAF) is a process by which an individual’s auditory speech signal is electronically changed to temporarily increase the fluency of a person who stutters. For the purpose of this systematic review, AAF includes delayed auditory feedback (DAF) and frequency-altered feedback (FAF). This systematic review examines fluency enhancement in adults who stutter when using AAF devices. Methods: A review of the literature was searched using PubMed, Ovid MEDLINE, PsycINFO, and CINAHL databases with key search terms related to stuttering and AAF. Inclusion criteria included: 1) adults ages ≥ 18 years old who stutter, 2) comparison of altered auditory feedback forms and/or no altered auditory feedback forms in the treatment of stuttering, 3) inclusion of DAF or FAF, 4) outcomes related to aspects of stuttering or people who stutter (e.g., fluency level, speech naturalness, speech rate), and 5) experimental research. Studies were quality assessed and rated by the authors. Results: A total of 16 articles were included in this review. Articles were of ‘moderate’ quality. Conclusions: AAF devices are generally effective in reducing stuttering frequency, with most notable fluency enhancement occurring during oral reading. The degree of fluency enhancement between individuals who stutter is variable and is influenced by factors such as stuttering severity. While research generally supports the use of AAF devices in reducing stuttering frequency, there are inconsistent findings regarding speech naturalness. AAF is likely most effective when used in conjunction with traditional speech therapy. Further research is needed to better understand the relationship between AAF and stuttering, particularly regarding unstructured speaking tasks and speech naturalness.https://scholarworks.uvm.edu/csdms/1004/thumbnail.jp

Consensual Qualitative Research: An Update

The authors reviewed the application of consensual qualitative research (CQR) in 27 studies published since the method’s introduction to the field in 1997 by C. E. Hill, B. J. Thompson, and E. N. Williams (1997). After first describing the core components and the philosophical underpinnings of CQR, the authors examined how it has been applied in terms of the consensus process, biases, research teams, data collection, data analysis, and writing up the results and discussion sections of articles. On the basis of problems that have arisen in each of these areas, the authors made recommendations for modifications of the method. The authors concluded that CQR is a viable qualitative method and suggest several ideas for research on the method itself

Upper limits for PH3 and H2S in Titan's Atmosphere from Cassini CIRS

We have searched for the presence of simple P and S-bearing molecules in Titan's atmosphere, by looking for the characteristic signatures of phosphine and hydrogen sulfide in infrared spectra obtained by Cassini CIRS. As a result we have placed the first upper limits on the stratospheric abundances, which are 1 ppb (PH3) and 330 ppb (H2S), at the 2-sigma significance level.Comment: 12 pages text, 1 table, 2 figure

The association between hemoglobin concentration and neurologic outcome after cardiac arrest.

PURPOSE: The purpose of the study is to determine the association between hemoglobin concentration (Hgb) and neurologic outcome in postarrest patients. METHODS: We conducted a retrospective cohort study using the Penn Alliance for Therapeutic Hypothermia (PATH) cardiac arrest registry. Inclusion criteria were resuscitated cardiac arrest (inhospital or out of hospital) and an Hgb value recorded within 24 hours of return of spontaneous circulation. The primary outcome was favorable neurologic status at hospital discharge. Survival to hospital discharge was a secondary outcome. RESULTS: There were 598 eligible patients from 21 hospitals. Patients with favorable neurologic outcome had significantly higher median Hgb in the first 2 hours (12.7 vs 10.5 g/dL; P \u3c .001) and 6 hours (12.6 vs 10.6 g/dL; P \u3c .001) postarrest. Controlling for age, pulseless rhythm, etiology, location of arrest, receipt of targeted temperature management, hematologic or metastatic malignancy, or preexisting renal insufficiency, there was a significant relationship between Hgb and neurologic outcome within the first 6 hours after arrest (odds ratio, 1.23; 95% confidence interval, 1.09-1.38) and survival to hospital discharge (odds ratio, 1.20; 95% confidence interval, 1.08-1.34). CONCLUSION: Higher Hgb after cardiac arrest is associated with favorable neurologic outcome, particularly within the first 6 hours. It is unclear if this effect is due to impaired oxygen delivery or if Hgb is a marker for more severe illness

Prevention Program Sustainability and Associated Determinants: A Literature Review, Version 1.0

The Department of Homeland Security (DHS) has made millions of dollars available through the Targeted Violence and Terrorism Prevention (TVTP) Grant Program to help communities across the United States develop capabilities to combat terrorism and targeted violence. Given this investment, a key objective is ensuring the long-term impact of these programs, which depends on their sustainment beyond the initial grant. Thus, the purpose of this report is to review the relevant literature on program sustainability and discuss implications for the TVTP Grant Program. We began the review by exploring definitions of sustainability as well as similar social programming concepts, such as adaptation, scalability, and impact. Our review found no consensus definition for prevention program sustainability, suggesting the TVTP Grant Program should develop a bespoke definition guided by strategic program priorities and incorporating other social programming concepts as needed. We then examined the determinants, or factors related positively to long-term programmatic success, of sustainability. All determinants relate to capacity building at two levels: 1. Organizational (Internal). Internal organizational capacity is impacted by (a) internal stakeholder buy-in and engagement, (b) adequacy of personnel resources, particularly in terms of expertise, (c) the presence of ongoing evaluation activities to support adaptations, and (d) support from the funding agency. 2. Community (External). External community capacity is impacted by (a) external stakeholder buy-in and continued engagement beyond the initial award, and (b) the fit between the program offerings and community needs

Extended twin study of alcohol use in Virginia and Australia

Drinking alcohol is a normal behavior in many societies, and prior studies have demonstrated it has both genetic and environmental sources of variation. Using two very large samples of twins and their first-degree relatives (Australia ≈ 20,000 individuals from 8,019 families; Virginia ≈ 23,000 from 6,042 families), we examine whether there are differences: (1) in the genetic and environmental factors that influence four interrelated drinking behaviors (quantity, frequency, age of initiation, and number of drinks in the last week), (2) between the twin-only design and the extended twin design, and (3) the Australian and Virginia samples. We find that while drinking behaviors are interrelated, there are substantial differences in the genetic and environmental architectures across phenotypes. Specifically, drinking quantity, frequency, and number of drinks in the past week have large broad genetic variance components, and smaller but significant environmental variance components, while age of onset is driven exclusively by environmental factors. Further, the twin-only design and the extended twin design come to similar conclusions regarding broad-sense heritability and environmental transmission, but the extended twin models provide a more nuanced perspective. Finally, we find a high level of similarity between the Australian and Virginian samples, especially for the genetic factors. The observed differences, when present, tend to be at the environmental level. Implications for the extended twin model and future directions are discussed

Phenotypic and genotypic characteristics of small colony variants and their role in chronic infection

Small colony variant (SCV) bacteria arise spontaneously within apparently homogeneous microbial populations, largely in response to environmental stresses, such as antimicrobial treatment. They display unique phenotypic characteristics conferred in part by heritable genetic changes. Characteristically slow growing, SCVs comprise a minor proportion of the population from which they arise but persist by virtue of their inherent resilience and host adaptability. Consequently, SCVs are problematic in chronic infection, where antimicrobial treatment is administered during the acute phase of infection but fails to eradicate SCVs, which remain within the host causing recurrent or chronic infection. This review discusses some of the phenotypic and genotypic changes that enable SCVs to successfully proliferate within the host environment as potential pathogens and strategies that could ameliorate the resolution of infection where SCVs are present

Drug Discovery Opportunities and Challenges at G Protein Coupled Receptors for Long Chain Free Fatty Acids

Discovery of G protein coupled receptors for long chain free fatty acids (FFAs), FFA1 (GPR40) and GPR120, has expanded our understanding of these nutrients as signaling molecules. These receptors have emerged as important sensors for FFA levels in the circulation or the gut lumen, based on evidence from in vitro and rodent models, and an increasing number of human studies. Here we consider their promise as therapeutic targets for metabolic disease, including type 2 diabetes and obesity. FFA1 directly mediates acute FFA-induced glucose-stimulated insulin secretion in pancreatic beta-cells, while GPR120 and FFA1 trigger release of incretins from intestinal endocrine cells, and so indirectly enhance insulin secretion and promote satiety. GPR120 signaling in adipocytes and macrophages also results in insulin sensitizing and beneficial anti-inflammatory effects. Drug discovery has focused on agonists to replicate acute benefits of FFA receptor signaling, with promising early results for FFA1 agonists in man. Controversy surrounding chronic effects of FFA1 on beta-cells illustrates that long term benefits of antagonists also need exploring. It has proved challenging to generate highly selective potent ligands for FFA1 or GPR120 subtypes, given that both receptors have hydrophobic orthosteric binding sites, which are not completely defined and have modest ligand affinity. Structure activity relationships are also reliant on functional read outs, in the absence of robust binding assays to provide direct affinity estimates. Nevertheless synthetic ligands have already helped dissect specific contributions of FFA1 and GPR120 signaling from the many possible cellular effects of FFAs. Approaches including use of fluorescent ligand binding assays, and targeting allosteric receptor sites, may improve further pre-clinical ligand development at these receptors, to exploit their unique potential to target multiple facets of diabetes

Cross-country risk quantification of extreme wildfires in Mediterranean Europe.

We estimate the country-level risk of extreme wildfires defined by burned area (BA) for Mediterranean Europe and carry out a cross-country comparison. To this end, we avail of the European Forest Fire Information System (EFFIS) geospatial data from 2006 to 2019 to perform an extreme value analysis. More specifically, we apply a point process characterization of wildfire extremes using maximum likelihood estimation. By modeling covariates, we also evaluate potential trends and correlations with commonly known factors that drive or affect wildfire occurrence, such as the Fire Weather Index as a proxy for meteorological conditions, population density, land cover type, and seasonality. We find that the highest risk of extreme wildfires is in Portugal (PT), followed by Greece (GR), Spain (ES), and Italy (IT) with a 10-year BA return level of 50'338 ha, 33'242 ha, 25'165 ha, and 8'966 ha, respectively. Coupling our results with existing estimates of the monetary impact of large wildfires suggests expected losses of 162-439 million € (PT), 81-219 million € (ES), 41-290 million € (GR), and 18-78 million € (IT) for such 10-year return period events. SUMMARY: We model the risk of extreme wildfires for Italy, Greece, Portugal, and Spain in form of burned area return levels, compare them, and estimate expected losses