Högt och lågt i skandinaviska dialekter

The typology of Scandinavian dialects is based on prosodic features, namely tone and intonation. We look at three variables that account for the variation between the large dialect groups: 1. The value of the lexical tone in accent 2, 2. Whether there is one or two association points for the tonal contour in compounds, and 3. Whether there is spreading or interpolation between the lexical tone and the prominence tone in compounds. The relevance of these variables is illustrated by comparisons of real pronunciations from several dialects, including Olso (East Norwegian), Göteborg (West Swedish), Stockholm (Central Swedish), Norberg (Dala Swedish), Skåne (South Swedish), and Luleå (North Swedish)

Prosodically controlled derivations in the mental lexicon

Swedish morphemes are classified as prosodically specified or prosodically unspecified, depending on lexical or phonological stress, respectively. Here, we investigate the allomorphy of the suffix -(i)sk, which indicates the distinction between lexical and phonological stress; if attached to a lexically stressed morpheme, it takes a non-syllabic form (-sk), whereas if attached to a phonologically stressed morpheme, an epenthetic vowel is inserted (-isk). Using mismatch negativity (MMN), we explored the neural processing of this allomorphy across lexically stressed and phonologically stressed morphemes. In an oddball paradigm, participants were occasionally presented with congruent and incongruent derivations, created by the suffix -(i)sk, within the repetitive presentation of their monomorphemic stems. The results indicated that the congruent derivation of the lexically stressed stem elicited a larger MMN than the incongruent sequences of the same stem and the derivational suffix, whereas after the phonologically stressed stem a non-significant tendency towards an opposite pattern was observed. We argue that the significant MMN response to the congruent derivation in the lexical stress condition is in line with lexical MMN, indicating a holistic processing of the sequence of lexically stressed stem and derivational suffix. The enhanced MMN response to the incongruent derivation in the phonological stress condition, on the other hand, is suggested to reflect combinatorial processing of the sequence of phonologically stressed stem and derivational suffix. These findings bring a new aspect to the dual-system approach to neural processing of morphologically complex words, namely the specification of word stress.Peer reviewe

Phonological Variations Are Compensated at the Lexical Level : Evidence From Auditory Neural Activity

Dealing with phonological variations is important for speech processing. This article addresses whether phonological variations introduced by assimilatory processes are compensated for at the pre-lexical or lexical level, and whether the nature of variation and the phonological context influence this process. To this end, Swedish nasal regressive place assimilation was investigated using the mismatch negativity (MMN) component. In nasal regressive assimilation, the coronal nasal assimilates to the place of articulation of a following segment, most clearly with a velar or labial place of articulation, as in utan mej "without me" > [MODIFIER LETTER TRIANGULAR COLONtam mejMODIFIER LETTER TRIANGULAR COLON]. In a passive auditory oddball paradigm, 15 Swedish speakers were presented with Swedish phrases with attested and unattested phonological variations and contexts for nasal assimilation. Attested variations - a coronal-to-labial change as in utan "without" > [MODIFIER LETTER TRIANGULAR COLONtam] - were contrasted with unattested variations - a labial-to-coronal change as in utom "except" > *[MODIFIER LETTER TRIANGULAR COLONtLATIN SMALL LETTER OPEN On] - in appropriate and inappropriate contexts created by mej "me" [mejMODIFIER LETTER TRIANGULAR COLON] and dej "you" [dejMODIFIER LETTER TRIANGULAR COLON]. Given that the MMN amplitude depends on the degree of variation between two stimuli, the MMN responses were expected to indicate to what extent the distance between variants was tolerated by the perceptual system. Since the MMN response reflects not only low-level acoustic processing but also higher-level linguistic processes, the results were predicted to indicate whether listeners process assimilation at the pre-lexical and lexical levels. The results indicated no significant interactions across variations, suggesting that variations in phonological forms do not incur any cost in lexical retrieval; hence such variation is compensated for at the lexical level. However, since the MMN response reached significance only for a labial-to-coronal change in a labial context and for a coronal-to-labial change in a coronal context, the compensation might have been influenced by the nature of variation and the phonological context. It is therefore concluded that while assimilation is compensated for at the lexical level, there is also some influence from pre-lexical processing. The present results reveal not only signal-based perception of phonological units, but also higher-level lexical processing, and are thus able to reconcile the bottom-up and top-down models of speech processing.Peer reviewe

Prosodic structure and suprasegmental features:Short-vowel stød in Danish

This paper presents a phonological analysis of a glottalization phenomenon in dialects of Danish known as ‘short-vowel stød’. It is argued that both short-vowel stød and common Danish stød involve the attachment of a laryngeal feature to a prosodic node—specifically the mora. In the case of short-vowel stød that mora lacks segmental content, as it is projected top-down due to local prosodic requirements, not bottom-up by segmental material. I show that this device provides an account of the distribution of short-vowel stød as arising from the interplay of constraints on metrical structure (both lexically stored and computed by the grammar) and the requirement for morae to be featurally licensed. The analysis provides further evidence for the analysis of ‘tonal accents’ and related phenomena in terms of metrical structure rather than lexical tone or laryngeal features, and contributes to our understanding of the relationship between segmental and suprasegmental phonology in Germanic languages

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Att utveckla receptiva färdigheter

Hur man uppfattar, läser och förstår språk kallas reception och står i kontrast till produktion, som handlar om att tala och skriva. Receptionen uppfattas numera som en mycket aktiv process när man lär sig språk och den innehåller flera moment som vi ska uppmärksamma i denna inledande text. Texten syftar till att ge en bakgrund till de följande modultexterna, och till att särskilt lyfta fram några centrala faktorer som har generell betydelse både för receptionen av språk, och för utvecklandet av receptiva färdigheter hos elever i skolåldern. Efter en inledande beskrivning av de olika steg man kan urskilja i receptionen, diskuteras vikten dels av att placera ett första ordförråd i långtidsminnet, dels av att sträva mot automatisering av avkodningsförmågan. Vi återkommer sedan till dessa centrala frågor från ett par olika synvinklar under rubriken fonologisk medvetenhet. På vägen ges en del resultat från forskning och några metodiska tips för ordinlärning och avkodningsträning