Intraspeaker Comparisons of Acoustic and Articulatory Variability in American English /r/ Productions

The purpose of this report is to test the hypothesis that speakers utilize an acoustic, rather than articulatory, planning space for speech production. It has been well-documented that many speakers of American English use different tongue configurations to produce /r/ in different phonetic contexts. The acoustic planning hypothesis suggests that although the /r/ configuration varies widely in different contexts, the primary acoustic cue for /r/, a dip in the F3 trajectory, will be less variable due to tradeoffs in articulatory variability, or trading relations, that help maintain a relatively constant F3 trajectory across phonetic contexts. Acoustic data and EMMA articulatory data from seven speakers producing /r/ in different phonetic contexts were analyzed. Visual inspection of the EMMA data at the point of F3 minimum revealed that each speaker appeared to use at least two of three trading relation strategies that would be expected to reduce F3 variability. Articulatory covariance measures confirmed that all seven speakers utilized a trading relation between tongue back height and tongue back horizontal position, six speakers utilized a trading relation between tongue tip height and tongue back height, and the speaker who did not use this latter strategy instead utilized a trading relation between tongue tip height and tongue back horizontal position. Estimates of F3 variability with and without the articulatory covariances indicated that F3 would be much higher for all speakers if the articulatory covariances were not utilized. These conclusions were further supported by a comparison of measured F3 variability to F3 variabilities estimated from the pellet data with and without articulatory covariances. In all subjects, the actual F3 variance was significantly lower than the F3 variance estimated without articulatory covariances, further supporting the conclusion that the articulatory trading relations were being used to reduce F3 variability. Together, these results strongly suggest that the neural control mechanisms underlying speech production make elegant use of trading relations between articulators to maintain a relatively invariant acoustic trace for /r/ across phonetic contexts

Intraspeaker Comparisons of Acoustic and Articulatory Variability in American English /r/ Productions

The purpose of this report is to test the hypothesis that speakers utilize an acoustic, rather than articulatory, planning space for speech production. It has been well-documented that many speakers of American English use different tongue configurations to produce /r/ in different phonetic contexts. The acoustic planning hypothesis suggests that although the /r/ configuration varies widely in different contexts, the primary acoustic cue for /r/, a dip in the F3 trajectory, will be less variable due to tradeoffs in articulatory variability, or trading relations, that help maintain a relatively constant F3 trajectory across phonetic contexts. Acoustic data and EMMA articulatory data from seven speakers producing /r/ in different phonetic contexts were analyzed. Visual inspection of the EMMA data at the point of F3 minimum revealed that each speaker appeared to use at least two of three trading relation strategies that would be expected to reduce F3 variability. Articulatory covariance measures confirmed that all seven speakers utilized a trading relation between tongue back height and tongue back horizontal position, six speakers utilized a trading relation between tongue tip height and tongue back height, and the speaker who did not use this latter strategy instead utilized a trading relation between tongue tip height and tongue back horizontal position. Estimates of F3 variability with and without the articulatory covariances indicated that F3 would be much higher for all speakers if the articulatory covariances were not utilized. These conclusions were further supported by a comparison of measured F3 variability to F3 variabilities estimated from the pellet data with and without articulatory covariances. In all subjects, the actual F3 variance was significantly lower than the F3 variance estimated without articulatory covariances, further supporting the conclusion that the articulatory trading relations were being used to reduce F3 variability. Together, these results strongly suggest that the neural control mechanisms underlying speech production make elegant use of trading relations between articulators to maintain a relatively invariant acoustic trace for /r/ across phonetic contexts

Articulatory Tradeoffs Reduce Acoustic Variability During American English /r/ Production

Acoustic and articulatory recordings reveal that speakers utilize systematic articulatory tradeoffs to maintain acoustic stability when producing the phoneme /r/. Distinct articulator configurations used to produce /r/ in various phonetic contexts show systematic tradeoffs between the cross-sectional areas of different vocal tract sections. Analysis of acoustic and articulatory variabilities reveals that these tradeoffs act to reduce acoustic variability, thus allowing large contextual variations in vocal tract shape; these contextual variations in turn apparently reduce the amount of articulatory movement required. These findings contrast with the widely held view that speaking involves a canonical vocal tract shape target for each phoneme.National Institute on Deafness and Other Communication Disorders (1R29-DC02852-02, 5R01-DC01925-04, 1R03-C2576-0l); National Science Foundation (IRI-9310518

Longitudinal follow–up of chronic hemodialysis patients without vitamin supplementation

Longitudinal follow–up of chronic hemodialysis patients without vitamin supplementation. Vitamin supplementation for dialysis patients is still controversial. In our study, we followed longitudinally over a period of a year, 15 patients on chronic hemodialysis who were deprived of vitamin supplementation. Microbiological assays were used to determine the levels of five vitamins of the B group (folate, niacin, B12, B6, and thiamine). Vitamin C was measured chemically. During the observation period when vitamins were not supplemented, a marked drop of many of these vitamins in blood levels were encountered. For vitamins B12 and C, the plasma levels remained within the normal range in all the subjects studied. For the other vitamins, the blood levels were found to be low in a few patients. Our data suggest that vitamin supplementation is probably not needed in most stable hemodialysis patients as it is recommended now, and that perhaps, if supplementation is indicated, less should be given than is presently prescribed. Further research is needed in this area

Private sector antimalarial sales a decade after “test and treat”: A cross-sectional study of drug shop clients in rural Uganda

Background The World Health Organization has promoted “test and treat” guidelines for malaria since 2010, recommending all suspected malaria cases be confirmed with a parasitological test, typically a rapid diagnostic test (RDT), prior to treatment with antimalarial medications. However, many fevers at private drug shops in Uganda continue to be treated presumptively as malaria without diagnostic testing. Methods The purpose of this study was to document private sector malaria case management in rural Uganda through a cross-sectional survey of drug shop clients in Bugoye sub-county. Drug shop vendors (n = 46) recorded information about sales interactions with clients reporting fever or requesting antimalarials and collected capillary blood samples from clients who purchased medications without an RDT. We estimated the proportion of clients who purchased an RDT, adhered to the RDT result, and received antimalarials without having laboratory-confirmed malaria. Results Most drug shops were unlicensed (96%) and sold RDTs (98%). Of 934 clients with suspected malaria who visited study drug shops during the data collection period, only 25% bought an RDT. Since some clients reported previous RDTs from the public sector, 40% of clients were aware of their malaria status at the drug shop. Among those with negative tests, 36% still purchased antimalarials. Sixty-five percent of clients who purchased an antimalarial without an RDT subsequently tested negative. Conclusions Despite national guidelines, drug shop clients who purchase antimalarials from drug shops in Bugoye are often not tested to confirm a malaria diagnosis prior to treatment. Most clients treated presumptively with antimalarials did not have malaria. Interventions are needed to improve malaria case management and rational drug use in the private sector

Speech Communication

Contains reports on three research projects.National Institutes of Health (Grant 2 ROI NS04332)National Institutes of Health (Training Grant 5 T32 NS07040)C. J. LeBel FellowshipsNational Institutes of Health (Grant 5 RO1 NS13028)National Science Foundation (Grant BNS76-80278)National Science Foundation (Grant BNS77-26871

Speech Communication

Contains reports on two research projects.National Institutes of Health (Grant 2 ROl1 NS04332)National Institutes of Health (Training Grant 5 T32 NS07040)C.J. LeBel FellowshipsNational Science Foundation (Grant BNS77-26871

“Testing for malaria does not cure any pain” A qualitative study exploring low use of malaria rapid diagnostic tests at drug shops in rural Uganda

The World Health Organization recommends all suspected malaria cases be confirmed with a parasitological test, typically a rapid diagnostic test (RDT), prior to treatment. Despite recommendations, many fevers presenting at private drug shops are treated presumptively as malaria without diagnostic testing. The purpose of this qualitative study was to describe community perceptions of RDTs and explore ways to improve malaria case management at drug shops in Bugoye, western Uganda. A total of 63 in-depth interviews were conducted between September and December 2021 with 24 drug shop clients, 19 drug shop vendors, 12 community health workers, and 8 health and community officials. Data was analyzed using thematic content analysis and narrative techniques. While drug shop clients valued RDTs, the cost of the test limited their use. Further, mistrust in negative results and fear about treatment options for conditions other than malaria led to nonadherence to negative RDTs. Improvement with antimalarials after a negative RDT, or no RDT at all, was seen as proof an individual had malaria, reinforcing the acceptability of liberal antimalarial use. Drug shop vendors were knowledgeable about malaria case management but financially conflicted between recommending best practices and losing business. While clients viewed drug shop vendors as trusted health professionals, health officials distrusted them as business owners focused on maximizing profits. Study results suggest public-private partnerships that recognize the essential role of drug shops, better incorporate them into the healthcare system, and leverage the high levels of community trust in vendors, could provide greater opportunities for oversight and training to improve private-sector malaria case management. Interventions that address financial barriers to RDT use, emphasize the financial benefits of malaria testing, increase vendor knowledge about illnesses confused with malaria, and improve the quality of vendor-client counseling could increase RDT uptake and improve adherence to RDT results

The role of micro-organisms (Staphylococcus aureus and Candida albicans) in the pathogenesis of breast pain and infection in lactating women: study protocol

Background: The CASTLE (Candida and Staphylococcus Transmission: Longitudinal Evaluation) study will investigate the micro-organisms involved in the development of mastitis and &ldquo;breast thrush&rdquo; among breastfeeding women. To date, the organism(s) associated with the development of breast thrush have not been identified. The CASTLE study will also investigate the impact of physical health problems and breastfeeding problems on maternal psychological health in the early postpartum period.Methods/Design: The CASTLE study is a longitudinal descriptive study designed to investigate the role of Staphylococcus spp (species) and Candida spp in breast pain and infection among lactating women, and to describe the transmission dynamics of S. aureus and Candida spp between mother and infant. The relationship between breastfeeding and postpartum health problems as well as maternal psychological well-being is also being investigated. A prospective cohort of four hundred nulliparous women who are at least thirty six weeks gestation pregnant are being recruited from two hospitals in Melbourne, Australia (November 2009 to June 2011). At recruitment, nasal, nipple (both breasts) and vaginal swabs are taken and participants complete a questionnaire asking about previous known staphylococcal and candidal infections. Following the birth, participants are followed-up six times: in hospital and then at home weekly until four weeks postpartum. Participants complete a questionnaire at each time points to collect information about breastfeeding problems and postpartum health problems. Nasal and nipple swabs and breast milk samples are collected from the mother. Oral and nasal swabs are collected from the baby. A telephone interview is conducted at eight weeks postpartum to collect information about postpartum health problems and breastfeeding problems, such as mastitis and nipple and breast pain.Discussion: This study is the first longitudinal study of the role of both staphylococcal and candidal colonisation in breast infections and will help to resolve the current controversy about which is the primary organism in the condition known as breast thrush. This study will also document transmission dynamics of S. aureus and Candida spp between mother and infant. In addition, CASTLE will investigate the impact of common maternal physical health symptoms and the effect of breastfeeding problems on maternal psychological well-being.<br /

Speech Communication

Contains table of contents for Part IV, table of contents for Section 1, an introduction, reports on seven research projects and a list of publications.C.J. Lebel FellowshipDennis Klatt Memorial FundNational Institutes of Health Grant T32-DC00005National Institutes of Health Grant R01-DC00075National Institutes of Health Grant F32-DC00015National Institutes of Health Grant R01-DC00266National Institutes of Health Grant P01-DC00361National Institutes of Health Grant R01-DC00776National Science Foundation Grant IRI 89-10561National Science Foundation Grant IRI 88-05680National Science Foundation Grant INT 90-2471