Speech in Sri Lankan cleft palate subjects with delayed palatoplasty.

This investigation was undertaken within the context of the Sri Lankan Cleft Up and Palate Project, probably the largest surgical and research programme to date concerned with the late operated cleft lip and/or palate subject (Mars et al., 1990). This study examines the speech results of88 patients who received palatal surgery by a visiting British surgical team. The main cohort, consisting of 67 nonsyndromic cleft lip and/or palate Sinh ala speaking patients over the age of eight years at palate repair, have been studied longitudinally. All these patients have pre-operative, post-operative, and post-therapy speech recordings. In addition, 21 similar patients below the age of eight years at surgery have been partially examined. 51 patients have further speech recordings at 4 or 5 years post-operatively. Investigations of velopharyngeal function were undertaken using lateral skull X-rays of patients phonating "ee', nasopharyngoscopy, and a perceptual assessment. Post-operative intra-oral examinations were also carried out. A unique method of speech analysis has been devised, and is used to describe the speech results. The results have shown that patients who have established their speech with an unrepaired palate usually have severely disordered speech, with the exception of some patients with less severe clefts. Post-operatively, many patients retain these poor speech patterns, even with some speech therapy support. Post-therapy, only one third of the cohort had normal or near-normal speech, none of whom were adults. The value of palatal closure is very limited if regular speech therapy is not available as a follow-up to surgery. Only 20% of the cohort achieved post-operative velopharyngeal closure, suggesting that palatoplasty is an inadequate surgical procedure for the majority of patients, in particular those who present with major clefts and are older than eight years of age at surgery. The important variables affecting outcome are palatal repair, speech therapy intervention, age, cleft type, nature of pre-operative speech, and nature of surgery. Structural factors in particular velopharyngeal function and also possibly fistulae, in the adult group, are further relevant variables. Criteria for selecting patients for surgery within this type of environment are proposed

Gewässerschutz im legislativen Kompetenzgefüge des europäischen Mehrebenensystems

Die vorliegende Arbeit wurde im Wintersemester 2013/2014 vom Rat der Rechtswissenschaftlichen Fakultät der Friedrich-Schiller-Universität Jena als Dissertation angenommen. Die Verfasserin widmet sich der Frage, nach welchen Kriterien eine sinnvolle Kompetenzverteilung vorzunehmen ist. Am Beispiel des Gewässerschutzes wird untersucht, ob die legislative Kompetenzordnung des europäischen Mehrebenensystems den Kriterien der Effektivität, Effizienz und Subsidiarität entspricht. Dazu werden im ersten Teil der Arbeit Begriffe und Konzepte des Gewässerschutzes, des Mehrebenensystems und der Kompetenz dargelegt. Anhand dieser Begriffe und Konzepte werden sodann im zweiten Teil die nationalen und die europäischen Rechtssetzungskompetenzen im Bereich des Gewässerschutzes analysiert und geprüft, ob diese Kompetenzordnung den Erfordernissen des Gewässerschutzes Rechnung trägt. Dabei werden auch die früheren Ausgestaltungen der Kompetenzvorschriften intensiv untersucht

Universal Abelian covers for surface singularities {zn=f(x,y)}

In recent work, W. D. Neumann and J. Wahl construct explicit equations for many interesting normal surface singularities with rational homology sphere links, which they call splice quotients. The construction begins with the topological type of a normal surface singularity, that is, a good resolution graph ¡ that is a tree of rational curves. If ¡ satisfies certain combinatorial conditions, then there exist splice quotients with resolution graph ¡. Let {zn = f(x, y)} define a surface Xf,n with an isolated singularity at the origin in C3. For f irreducible, we completely characterize, in terms of n and the Puiseux pairs of f, those Xf,n for which the resolution graph satisfies the combinatorial conditions defined by Neumann and Wahl. Briefly stated, we find that the conditions are not often satisfied. Furthermore, given a splice quotient (X, 0), it turns out that "equisingular deformations" of (X, 0) are usually not splice quotients, as we demonstrate already for singularities of the form {z2 = xP + yQ} with rational homology sphere link

What is the true evidence for gender-related differences during plant and cut maneuvers? A systematic review

Purpose Female athletes have a significantly higher risk of sustaining an anterior cruciate ligament (ACL) injury than male athletes. Biomechanical and neuromuscular factors have been reported as the main cause. The purpose of this review was to critically review results of the published literature on gender differences regarding biomechanical and neuromuscular movement patterns during plant and cutting maneuvers. Methods MEDLINE (1966 to December 2008), EMBASE (1947 to December 2008) and CINAHL (1981 to December 2008) searches were performed. The seven studies meeting the inclusion criteria were analyzed. Results Biomechanical gender differences were of questionable clinical relevance. Quadriceps dominance was not found in women. Conclusion The question raises whether ACL injuries during plant and cutting maneuvers are purely gender related and whether women do have to move like men in order to reduce injury risk? Caution is warranted in making inferences as studies were heterogeneous in terms of subject and study characteristics and had low statistical power as a result of insufficient number of subjects. It is advised that future research moves beyond the isolated gender comparison and that larger sample sizes will be included. This review may aid in improving experiments to draw valid conclusions, in order to direct future ACL injury prevention programs, which might need to be more individualized

Food web structure and community composition : a comparison across space and time in the North Sea

Ecological communities are constantly changing as a response to environmental and anthropogenic pressures. Yet, how changes in community composition influence the structure of food webs over time and space remains elusive. Using ecological network analysis, we assessed how food web structure changed across six distinct areas of the North Sea over a sixteen-year time-period. We used multivariate analyses to disentangle and compare spatio-temporal dynamics in community composition (i.e. changes in species abundances) and food web structure (i.e. changes in network properties). Specifically, we assessed how changes in community composition were reflected in food web structure. Our results revealed a strong spatial coupling between community composition and food web structure along a south-north gradient. However, the temporal covariation between community composition and food web structure depended on the spatial scale. We observed a temporal mismatch at regional scale, but a strong coupling at local scale. In particular, we found that community composition can be influenced by hydro-climatic events over large areas, with diverse effects manifesting in local food web structure. Our proposed methodological framework quantified and compared spatio-temporal changes in community composition and food web structure, providing key information to support effective management strategies aimed at conserving the structure and functioning of ecological communities in times of environmental change.Peer reviewe