Phonetic and Phono-Lexical Accuracy of Non-Native Tone Production by English-L1 and Mandarin-L1 Speakers

Lexical tones are known to be a challenging aspect of speech to acquire in a second language, but several factors are known to affect tone learning facility, such as L1 tonal status (whether a learner's L1 is tonal or not), tone type (the shape of the tones to be acquired), and individual extralinguistic factors (such as musicianship, pitch aptitude, and working memory). Crucially, most of our knowledge of the effect of these factors is based on evidence from perception. The production side of tone learning and the origins of individual variability in learning facility remain relatively understudied. To this end, this study investigated non-native tone production-both in terms of phonetic accuracy in a pseudoword imitation task and in terms of phono-lexical accuracy in a picture-naming task-by English-L1 and Mandarin-L1 speakers. Results show that L1 tonal status and tone type dynamically affected both imitation and picture-naming accuracy, as there were specific accuracy patterns for the English and Mandarin groups. Production accuracy was further facilitated by individual musical experience, working memory, and pitch aptitude. This study's findings add to the currently limited literature on how both language-specific and individual extralinguistic factors modulate non-native tone processing in the speaking modality.

Influence of caregiver input and language experience on the production of coda laterals by English-Malay bilingual preschoolers in multi-accent Singapore

Linguistic input in multi-lingual/-cultural contexts is highly variable. We examined the production of English and Malay laterals by fourteen early bilingual preschoolers in Singapore who were exposed to several allophones of coda laterals: Malay caregivers use predominantly clear-l in English and Malay, but their English coda laterals can also be l-less (vocalised/deleted) and in formal contexts, velarised. Contrastingly, the English coda laterals of the Chinese majority are typically l-less. Findings show that English coda laterals were overall more likely to be l-less than Malay laterals like their caregivers', but English coda laterals produced by children with close Chinese peer(s) were more likely to be l-less than those without. All children produced English coda clear-l, demonstrating the transmission of an ethnic marker that had emerged from long-term contact. In diverse settings, variation is intrinsic to the acquisition process, and input properties and language experience are important considerations in predicting language outcomes.

Temporal lobe perceptual predictions for speech are instantiated in motor cortex and reconciled by inferior frontal cortex

Humans use predictions to improve speech perception, especially in noisy environments. Here we use 7-T functional MRI (fMRI) to decode brain representations of written phonological predictions and degraded speech signals in healthy humans and people with selective frontal neurodegeneration (non-fluent variant primary progressive aphasia [nfvPPA]). Multivariate analyses of item-specific patterns of neural activation indicate dissimilar representations of verified and violated predictions in left inferior frontal gyrus, suggestive of processing by distinct neural populations. In contrast, precentral gyrus represents a combination of phonological information and weighted prediction error. In the presence of intact temporal cortex, frontal neurodegeneration results in inflexible predictions. This manifests neurally as a failure to suppress incorrect predictions in anterior superior temporal gyrus and reduced stability of phonological representations in precentral gyrus. We propose a tripartite speech perception network in which inferior frontal gyrus supports prediction reconciliation in echoic memory, and precentral gyrus invokes a motor model to instantiate and refine perceptual predictions for speech.

Challenges and recommendations for high quality research using electronic health records

Harnessing Real World Data is vital to improve health care in the 21st Century. Data from Electronic Health Records (EHRs) are a rich source of patient centred data, including information on the patient's clinical condition, laboratory results, diagnoses and treatments. They thus reflect the true state of health systems. However, access and utilisation of EHR data for research presents specific challenges. We assert that using data from EHRs effectively is dependent on synergy between researchers, clinicians and health informaticians, and only this will allow state of the art methods to be used to answer urgent and vital questions for patient care. We propose that there needs to be a paradigm shift in the way this research is conducted - appreciating that the research process is iterative rather than linear. We also make specific recommendations for organisations, based on our experience of developing and using EHR data in trusted research environments.

Semantic Cues Modulate Children’s and Adults’ Processing of Audio-Visual Face Mask Speech

During the COVID-19 pandemic, questions have been raised about the impact of face masks on communication in classroom settings. However, it is unclear to what extent visual obstruction of the speaker’s mouth or changes to the acoustic signal lead to speech processing difficulties, and whether these effects can be mitigated by semantic predictability, i.e., the availability of contextual information. The present study investigated the acoustic and visual effects of face masks on speech intelligibility and processing speed under varying semantic predictability. Twenty-six children (aged 8-12) and twenty-six adults performed an internet-based cued shadowing task, in which they had to repeat aloud the last word of sentences presented in audio-visual format. The results showed that children and adults made more mistakes and responded more slowly when listening to face mask speech compared to speech produced without a face mask. Adults were only significantly affected by face mask speech when both the acoustic and the visual signal were degraded. While acoustic mask effects were similar for children, removal of visual speech cues through the face mask affected children to a lesser degree. However, high semantic predictability reduced audio-visual mask effects, leading to full compensation of the acoustically degraded mask speech in the adult group. Even though children did not fully compensate for face mask speech with high semantic predictability, overall, they still profited from semantic cues in all conditions. Therefore, in classroom settings, strategies that increase contextual information such as building on students’ prior knowledge, using keywords, and providing visual aids, are likely to help overcome any adverse face mask effects.

Variation in quality of maternal input and development of coda stops in English-speaking children in Singapore

This study examines the effects of input quality on early phonological acquisition by investigating whether interadult variation in specific phonetic properties in the input is reflected in the production of their children. We analysed the English coda stop release patterns in the spontaneous speech of fourteen mothers and compared them with the spontaneous production of their preschool children. The analysis revealed a very strong positive input-production relationship; mothers who released coda stops to a lesser degree also had children who tended to not release their stops, and the same was true for mothers who released their stops to a higher degree. The findings suggest that young children are sensitive to acoustic properties that are subphonemic, and these properties are also reflected in their production, showing the importance of considering input quality when investigating child production.

Vocalic Intrusions in Consonant Clusters in Child-Directed vs. Adult-Directed Speech

In this paper, we investigate a prosodic-phonetic feature in child-directed speech within a dynamic, complex, interactive theoretical framework. We focus on vocalic intrusions, commonly occurring in Norwegian word initial consonant clusters. We analysed child-directed speech from nine Norwegian-speaking mothers to their children, aged 2;6, 4, and 6 years, and compared the incidence and duration of vocalic intrusions in initial consonant clusters in these data with those in adult-directed speech and child speech. When viewed overall, vocalic intrusion was found to be similar in incidence in child- and adult-directed speech. However, closer examination revealed differential behaviour in child-directed speech for certain conditions. Firstly, a difference emerged for one particular phonetic context: While vocalic intrusions in /Cr/ clusters are frequent in adult-directed speech, their presence is near-categorical in child-directed speech. Secondly, we found that the duration of vocalic intrusions was longer in child- than in adult-directed speech, but only when directed to 2;6-year-olds. We argue that vocalic intrusions in child-directed speech may have both a bonding as well as a didactic function, and that these may vary according to the age of the child being addressed.

Cross-linguistic variation in word-initial cluster production in adult and child language: evidence from English and Norwegian

Young children simplify word initial consonant clusters by omitting or substituting one (or both) of the elements. Vocalic insertion, coalescence and metathesis are said to be used more seldom (McLeod, van Doorn & Reed, 2001). Data from Norwegian children, however, have shown vocalic insertion to be more frequently used (Simonsen, 1990; Simonsen, Garmann & Kristoffersen, 2019). To investigate the extent to which children use this strategy to differing degrees depending on the ambient language, we analysed word initial cluster production acoustically in nine Norwegian and nine English speaking children aged 2;6-6 years, and eight adults, four from each language. The results showed that Norwegian-speaking children produce significantly more instances of vocalic insertions than English-speaking children do. The same pattern is found in Norwegian- versus English-speaking adults. We argue that this cross-linguistic difference is an example of the influence of prosodic-phonetic biases in language-specific developmental paths in the acquisition of speech.

Cross-linguistic Influences on Sentence Accent Detection in Background Noise

This paper investigates whether sentence accent detection in a non-native language is dependent on (relative) similarity between prosodic cues to accent between the non-native and the native language, and whether cross-linguistic differences in the use of local and more widely distributed (i.e., non-local) cues to sentence accent detection lead to differential effects of the presence of background noise on sentence accent detection in a non-native language. We compared Dutch, Finnish, and French non-native listeners of English, whose cueing and use of prosodic prominence is gradually further removed from English, and compared their results on a phoneme monitoring task in different levels of noise and a quiet condition to those of native listeners. Overall phoneme detection performance was high for the native and the non-native listeners, but deteriorated to the same extent in the presence of background noise. Crucially, relative similarity between the prosodic cues to sentence accent of one's native language compared to that of a non-native language does not determine the ability to perceive and use sentence accent for speech perception in that non-native language. Moreover, proficiency in the non-native language is not a straightforward predictor of sentence accent perception performance, although high proficiency in a non-native language can seemingly overcome certain differences at the prosodic level between the native and non-native language. Instead, performance is determined by the extent to which listeners rely on local cues (English and Dutch) versus cues that are more distributed (Finnish and French), as more distributed cues survive the presence of background noise better.

Determination of Campesterol, Stigmasterol, and Beta-Sitosterol in Saw Palmetto Raw Materials and Dietary Supplements by Gas Chromatography: Collaborative Study

An interlaboratory study was conducted to evaluate a method for the determination of campesterol, stigmasterol, and beta-sitosterol in saw palmetto raw materials and dietary supplements at levels >1.00 mg/100 g based on a 23 g sample. Test samples were saponified at high temperature with ethanolic KOH solution. The unsaponifiable fraction containing phytosterols (campesterol, stigmasterol, and beta-sitosterol) was extracted with toluene. Phytosterols were derivatized to trimethylsilyl ethers and then quantified by gas chromatography with hydrogen flame ionization detection. Twelve blind duplicates, one of which was fortified, were successfully analyzed by 10 collaborators. Recoveries were obtained for the sample that was fortified. The results were 99.8, 111, and 111% for campesterol, stigmasterol, and beta-sitosterol, respectively. For repeatability, the relative standard deviation (RSDr) ranged from 3.93 to 17.3% for campesterol, 3.56 to 22.7% for stigmasterol, and 3.70 to 43.9% for beta-sitosterol. For reproducibility, the RSDR ranged from 7.97 to 22.6%, 0 to 26.7%, and 5.27 to 43.9% for campesterol, stigmasterol, and beta-sitosterol, respectively. Overall, the Study Director approved 5 materials with acceptable HorRat values for campesterol, stigmasterol, and beta-sitosterol ranging from 1.02 to 2.16.

Determination of Methylcellulose and Hydroxypropyl Methylcellulose Food Gums in Food and Food Products: Collaborative Study

A collaborative study was performed to determine the reproducibility of a method for the determination of methylcellulose (MC) and hydroxypropyl methylcellulose (HPMC) in food. These widely used food gums possess unusual solubility characteristics and cannot accurately be determined by existing dietary fiber methods. The new method uses the enzyme-digestion procedure of AOAC Official Method 991.43. Digestate solutions must be refrigerated to fully hydrate MC or HPMC. The chilled solutions are filtered and analyzed by size-exclusion liquid chromatography. Collaborating laboratories received 28 samples containing MC or HPMC in the range of 0100%. The sample set included blind duplicates of 5 food matrixes (bread, milk, fish, potato, and powdered juice drink). Cochran and Grubbs tests were used to eliminate outliers. For food samples containing MC, values for within-laboratory precision, repeatability relative standard deviation (RSDr), ranged from 4.2 to 16%, and values for among-laboratories precision, reproducibility relative standard deviation (RSDR), ranged from 11 to 20%. For HPMC samples, RSDr values ranged from 6.4 to 27%, and RSDR values ranged from 17 to 39%. Recoveries of MC and HPMC from the food matrixes ranged from 78 to 101%. These results show acceptable precision and reproducibility for the determination of MC and HPMC, for which no Official AOAC Methods exist. It is recommended that this method be adopted as AOAC Official First Action.

Determination of β-Carotene in Supplements and Raw Materials by Reversed-Phase High Pressure Liquid Chromatography: Collaborative Study

Twelve laboratories representing 4 countries participated in an interlaboratory study conducted to determine all-trans-β-carotene and total β-carotene in dietary supplements and raw materials. Thirteen samples were sent as blind duplicates to the collaborators. Results obtained from 11 laboratories are reported. For products composed as softgels and tablets that were analyzed for total β-carotene, the reproducibility relative standard deviation (RSDR) ranged from 3.35 to 23.09% and the HorRat values ranged from 1.06 to 3.72. For these products analyzed for trans β-carotene, the reproducibility relative standard deviation (RSDR) ranged from 4.28 to 22.76% and the HorRat values ranged from 0.92 to 3.37. The RSDr and HorRat values in the analysis of a beadlet raw material were substantial and it is believed that the variability within the material itself introduced significant variation in subsampling. The method uses high pressure liquid chromatography (LC) in the reversed-phase mode with visible light absorbance for detection and quantitation. If high levels of α-carotenes are present, a second LC system is used for additional separation and quantitation of the carotene species. It is recommended that the method be adopted as an AOAC Official Method.

Training residents in patient-centred communication and empathy: evaluation from patients, observers and residents

BACKGROUND

Patient-centred communication and empathy are key enablers for patient-centred care. However, several studies suggest a downward trend regarding the empathic communication skills of physicians during medical residency. It is known that communication training can have a positive effect on patient-centred communication, empathy and relational skills. Training residents in patient-centred communication and empathy can be an opportunity to improve the patient-centred care. To evaluate the training a tri-focal perspective will be used.

METHODS

A 3-day training was developed to improve residents' patient-centred communication and empathy skills at an academic medical health centre, in the Netherlands. The training included: (1) the basics of patient-centred communication and empathy (through presentations, scientific literature), (2) practicing with actors, and (3) reflecting on residents' video recorded consultations (by themselves and communication experts). A pilot study with a pre-post design was conducted to evaluate the training from patient and observer perspectives. Semi-structured interviews were used to get insight into residents' perspective. Nine residents from different specialities followed the training and enrolled in the pilot study. During two random days consultations between residents and patients were video recorded. Patients were asked to fill in two questionnaires, indicating their perspective on residents' empathy and communication skills before as well as after the consultation. All video recorded consultations were coded to rate residents' communication skills, empathy, computer use and agenda-setting. Statistical analysis were performed using multilevel analysis.

RESULTS

A total of 137 eligible patients took part in the pilot study. Trained residents showed significant improvement in patient-rated empathy scores. According to observers, residents' computer use improved significantly after the training. The communication skills of trained residents did not improve significantly. Agenda setting by residents showed a downward trend. Almost all residents were satisfied with the training, especially with the video-feedback.

CONCLUSIONS

A brief training significantly increased residents' empathy scores according to patients and significantly decreased residents' computer use according to observers. These findings indicate that the quality of patient-centred care can be improved by integrating patient-centred communication into residency programs, at an academic medical health centre. The ultimate goal is to structurally embed the training in residents' education program.

[Shared decision-making: dilemmas in daily practice]

Shared decision-making is an essential - but often neglected - component of evidence-based medicine. In practice, doctors, nurses and patients encounter dilemmas which are understandable, but not insurmountable. We illustrate this by means of a complex decision concerning therapy in the advanced stage of Parkinson's disease. Evidence of effectiveness differs with each individual therapy, and, in practice, the experiences of neurologists also vary widely. In addition, the various treatment strategies all require a different sort of daily care, and have differing impacts on people's lives. It is time that we worked towards a realistic view of shared decision-making. Shared decision-making cannot be generalised to a 'one size fits all' strategy that we can choose to apply or not to apply at will. It should be a flexible instrument which, depending on the individual and the specific situation, can be put to use to deliver the best tailored care.

Protocol of a randomised delayed-start double-blind placebo-controlled multi-centre trial for Levodopa in EArly Parkinson's disease: the LEAP-study

Background

The aim of this study is to investigate if early treatment with levodopa has a beneficial disease modifying effect on Parkinson’s disease (PD) symptoms and functional health, improves the ability to (maintain) work, and reduces the use of (informal) care, caregiver burden, and costs. Additionally, cost-effectiveness and cost-utility of early levodopa treatment will be assessed.

Methods

To differentiate between the direct symptomatic effects and possible disease modifying effects of levodopa, we use a randomised delayed-start double-blind placebo-controlled multi-centre trial design. Patients with early stage PD whose functional health does not yet necessitate initiation of PD-medication will be randomised to either 40 weeks of treatment with levodopa/carbidopa 100/25 mg TID including 2 weeks of dose escalation or to 40 weeks placebo TID. Subsequently, all patients receive levodopa/carbidopa 100/25 mg TID for 40 weeks. There are 8 assessments: at baseline and at 4, 22, 40, 44, 56, 68, and 80 weeks. The primary outcome measure is the difference in the mean total Unified Parkinson’s Disease Rating Scale scores between the early- and delayed-start groups at 80 weeks. Secondary outcome measures are rate of progression, the AMC Linear Disability Score, side effects, perceived quality of life with the Parkinson’s Disease Questionnaire-39, the European Quality of Life-5 Dimensions (EQ-5D), ability to (maintain) work, the use of (informal) care, caregiver burden, and costs. 446 newly diagnosed PD patients without impaired functional health need to be recruited in order to detect a minimal clinical relevant difference of 4 points on the total UPDRS at 80 weeks.

Discussion

The LEAP-study will provide insights into the possible disease modifying effects of early levodopa.

Trial registration

ISRCTN30518857, EudraCT number 2011-000678-72

Dutch and English toddlers' use of linguistic cues in predicting upcoming turn transitions

Adults achieve successful coordination during conversation by using prosodic and lexicosyntactic cues to predict upcoming changes in speakership. We examined the relative weight of these linguistic cues in the prediction of upcoming turn structure by toddlers learning Dutch (Experiment 1; N = 21) and British English (Experiment 2; N = 20) and adult control participants (Dutch: N = 16; English: N = 20). We tracked participants' anticipatory eye movements as they watched videos of dyadic puppet conversation. We controlled the prosodic and lexicosyntactic cues to turn completion for a subset of the utterances in each conversation to create four types of target utterances (fully incomplete, incomplete syntax, incomplete prosody, and fully complete). All participants (Dutch and English toddlers and adults) used both prosodic and lexicosyntactic cues to anticipate upcoming speaker changes, but weighed lexicosyntactic cues over prosodic ones when the two were pitted against each other. The results suggest that Dutch and English toddlers are already nearly adult-like in their use of prosodic and lexicosyntactic cues in anticipating upcoming turn transitions.

The development of prosodic features and their contribution to rhythm production in simultaneous bilinguals

This study aims to analyse facilitatory and inhibitory effects of bilingualism on the acquisition of prosodic features, and their contribution to speech rhythm. Here, we concentrate on phrase-final lengthening and accentuation, prosodic features suggested to give rise to different rhythmic percepts even when syllable structure is kept constant across languages. In particular, we investigate whether the development of these two features in Spanish-English simultaneous bilinguals correlates with rhythm development. Our results demonstrate that, as is the case for bilingual rhythm development overall the development of prosodic head- and edge-marking suggests that the two languages are rhythmically separable from around the age of 4, with clearly separate rhythms at the age of 6. Additionally, we can confirm that bilinguals also start out with an even-timed bias in the development of final lengthening and accentuation as reflected by fewer durational differentiations between prosodic syllable types. Furthermore, we can observe the same advantages in bilingual prosodic acquisition in the structurally more complex language that were found in rhythm development. These advantages are manifested by the earlier mastery of robust durational differentiations between syllable types to an adult-like extent. Finally, the comparison with monolingual data demonstrates that bilinguals do, in fact, have an advantage in their development in comparison with monolinguals. We hypothesise that this advantage is borne out of more advanced motor control and possibly more stable mental representations as a result of the dual language input, and dual language production experience.

Tonal targets in early child English, Spanish, and Catalan

This study analyses the scaling and alignment of low and high intonational targets in the speech of 27 children - nine English-speaking, nine Catalan-speaking and nine Spanish-speaking - between the ages of two and six years. We compared the intonational patterns of words controlled for number of syllables and stress position in the child speech to the adult target speech provided by their mothers, and to a dataset of adult-directed speech recorded at a later stage for the purpose of measuring pitch height. A corpus of 624 utterances was elicited using a controlled naming task and analysed within the Autosegmental Metrical framework. Measuring the pitch height and pitch timing of nuclear pitch accents, we found that once the effects of syllable duration are accounted for, young children reach tonal targets with remarkable precision. Overall, the results indicate that the phonetic aspects of intonation are acquired from a very early age. Even the youngest children show adult-like alignment of the low target, although mastery of the high target increases with age. Young Spanish-speaking children, however, show a more precise attainment of pitch scaling and alignment of their (high) tonal targets than do Catalan and English children; where the ambient language lies within a general prosodic typology appears to influence the acquisition of tonal targets.

Restructured phonological phrases in French: evidence from clash resolution

In common with English and German and many other languages, French has an accentual configuration that arises in clash contexts, here referred to as clash resolution. Experimental research has shown that clash resolution is bounded by the phonological phrase. Moreover, the optional application of clash resolution has provided evidence for the restructured phonological phrase. However, the conditions on restructuring that have been proposed in the literature have been found to make the wrong predictions in a number of cases. In contradiction to earlier claims, perceptual and acoustic evidence shows that lexical heads can also be restructured with their branching complements. In addition, an analysis of the phonetic evidence shows that clash resolution is characterized by the absence of a final pitch accent, while the simultaneous realization of an initial pitch accent on the stress-shift item is optional. In our conclusions, we will discuss the implications of these findings for a phonological account of clash resolution.

Neurostimulation for Parkinson's disease with early motor complications

BACKGROUND

Subthalamic stimulation reduces motor disability and improves quality of life in patients with advanced Parkinson's disease who have severe levodopa-induced motor complications. We hypothesized that neurostimulation would be beneficial at an earlier stage of Parkinson's disease.

METHODS

In this 2-year trial, we randomly assigned 251 patients with Parkinson's disease and early motor complications (mean age, 52 years; mean duration of disease, 7.5 years) to undergo neurostimulation plus medical therapy or medical therapy alone. The primary end point was quality of life, as assessed with the use of the Parkinson's Disease Questionnaire (PDQ-39) summary index (with scores ranging from 0 to 100 and higher scores indicating worse function). Major secondary outcomes included parkinsonian motor disability, activities of daily living, levodopa-induced motor complications (as assessed with the use of the Unified Parkinson's Disease Rating Scale, parts III, II, and IV, respectively), and time with good mobility and no dyskinesia.

RESULTS

For the primary outcome of quality of life, the mean score for the neurostimulation group improved by 7.8 points, and that for the medical-therapy group worsened by 0.2 points (between-group difference in mean change from baseline to 2 years, 8.0 points; P=0.002). Neurostimulation was superior to medical therapy with respect to motor disability (P<0.001), activities of daily living (P<0.001), levodopa-induced motor complications (P<0.001), and time with good mobility and no dyskinesia (P=0.01). Serious adverse events occurred in 54.8% of the patients in the neurostimulation group and in 44.1% of those in the medical-therapy group. Serious adverse events related to surgical implantation or the neurostimulation device occurred in 17.7% of patients. An expert panel confirmed that medical therapy was consistent with practice guidelines for 96.8% of the patients in the neurostimulation group and for 94.5% of those in the medical-therapy group.

CONCLUSIONS

Subthalamic stimulation was superior to medical therapy in patients with Parkinson's disease and early motor complications. (Funded by the German Ministry of Research and others; EARLYSTIM ClinicalTrials.gov number, NCT00354133.).

Measuring child rhythm

Interval-based rhythm metrics were applied to the speech of English, Catalan and Spanish 2, 4 and 6 year-olds, and compared with the (adult-directed) speech of their mothers. Results reveal that child speech does not fall into a well-defined rhythmic class: for all three languages, it is more 'vocalic' (higher %V) than adult speech and has a tendency towards lower variability (when normalized for speech rate) in vocalic interval duration. Consonantal interval variability, however, is higher in child speech, particularly for younger children. Nevertheless, despite the identification of common, cross-linguistic patterns in child speech, the emergence of language-specific rhythmic indices is also clearly observable, even in the speech of 2 year-olds.

Combining formal and functional approaches to topic structure

Fragmentation between formal and functional approaches to prosodic variation is an ongoing problem in linguistic research. In particular, the frameworks of the Phonetics of Talk-in-Interaction (PTI) and Empirical Phonology (EP) take very different theoretical and methodological approaches to this kind of variation. We argue that it is fruitful to adopt the insights of both PTI's qualitative analysis and EP's quantitative analysis and combine them into a multiple-methods approach. One realm in which it is possible to combine these frameworks is in the analysis of discourse topic structure and the prosodic cues relevant to it. By combining a quantitative and a qualitative approach to discourse topic structure, it is possible to give a better account of the observed variation in prosody, for example in the case of fundamental frequency (F0) peak timing, which can be explained in terms of pitch accent distribution over different topic structure categories. Similarly, local and global patterns in speech rate variation can be better explained and motivated by adopting insights from both PTI and EP in the study of topic structure. Combining PTI and EP can provide better accounts of speech data as well as opening up new avenues of investigation which would not have been possible in either approach alone.

The processing of English regular inflections: Phonological cues to morphological structure

Previous studies suggest that different neural and functional mechanisms are involved in the analysis of irregular (caught) and regular (filled) past tense forms in English. In particular, the comprehension and production of regular forms is argued to require processes of morpho-phonological assembly and disassembly, analysing these forms into a stem plus an inflectional affix (e.g., {fill}+{-ed}), as opposed to irregular forms, which do not have an overt stem+affix structure and must be analysed as full forms [Marslen-Wilson, W. D., & Tyler, L. K. (1997). Dissociating types of mental computation. Nature, 387, 592-594; Marslen-Wilson, W. D., & Tyler, L. K. (1998). Rules, representations, and the English past tense. Trends in Cognitive Science, 2, 428-435]. On this account, any incoming string that shows the critical diagnostic properties of an inflected form - a final coronal consonant (/t/, /d/, /s/, /z/) that agrees in voicing with the preceding segment as in filled, mild, or nilled - will automatically trigger an attempt at segmentation. We report an auditory speeded judgment experiment which explored the contribution of these critical morpho-phonological properties (labelled as the English inflectional rhyme pattern) to the processing of English regular inflections. The results show that any stimulus that can be interpreted as ending in a regular inflection, whether it is a real inflection (filled-fill), a pseudo-inflection (mild-mile) or a phonologically matched nonword (nilled-nill), is responded to more slowly than an unambiguously monomorphemic stimulus pair (e.g., belt-bell). This morpho-phonological effect was independent of phonological effects of voicing and syllabicity. The findings are interpreted as evidence for a basic morpho-phonological parsing process that applies to all items with the criterial phonological properties.

Determinants of disability and quality of life in mild to moderate Parkinson disease

OBJECTIVE

To identify factors that independently contribute to disability and quality of life (QoL) in patients with mild to moderate Parkinson disease (PD).

METHODS

A group of 190 patients with PD recruited from outpatient clinics and the Dutch Parkinson's Disease Association participated in this cross-sectional study. Data on demographic and clinical factors, motor symptoms, cognitive functions, affective symptoms, comorbidity, and social support were collected during neurologic and neuropsychological examinations. Disability was rated using the Schwab and England Activities of Daily Living Scale (SE-ADL), the AMC Linear Disability Score (ALDS), and the Functional Independence Measure (FIM). QoL was assessed with the Parkinson's Disease Quality of Life questionnaire (PDQL) and the Medical Outcome Study Short Form (SF-36). Multiple linear regression analyses were conducted to identify determinants of disability and poor QoL.

RESULTS

Axial impairment (postural instability and gait difficulty) explained the largest proportion of variance in disability. Bradykinesia and comorbidity contributed to disability, but to a lesser extent. Self-reported mood symptoms and axial impairment were the two factors most closely associated with poorer QoL, but comorbidity and bradykinesia additionally contributed to the explanatory power. Semantic fluency and psychomotor skills were the only cognitive variables related to some aspects of functional outcome.

CONCLUSION

Axial impairment is strongly associated with disability in patients with mild to moderate Parkinson disease (PD). Self-report indices of mood status and axial impairment are identified as the main determinants of poor quality of life (QoL). The results of this study may help to identify patients with PD at risk for functional dependence and reduced QoL.

Motor procedural learning in Parkinson's disease

Functional neuroimaging research has repeatedly implicated the striatum in motor procedural learning, but attempts to explore this relation in patients with Parkinson's disease (PD) have yielded inconsistent results. Furthermore, the functional impact of procedural learning impairment is unknown. The present study sought to examine the effects of PD on procedural learning and to determine whether impaired procedural learning affects functional status. The performance of 95 non-demented PD patients on the serial reaction time task (SRTT) was compared with that of 44 demographically matched control subjects. The SRTT is a four-choice reaction time task in which visual stimuli are presented in six blocks of 100 trials either in a repeating sequence of 10 stimuli or randomly. Learning was inferred from the reduction of response times over five successive blocks of repeating sequence trials and from the increase in response times in the sixth random block. In addition, neuropsychological tests of declarative memory, executive and visuospatial functions were administered to all participants. Patients also received quantitative ratings of functional outcome. The two groups did not differ in the learning rate across blocks of repeating sequence trials. However, PD patients were significantly less efficient than controls in acquiring sequence-specific knowledge, although this impairment was relatively small (d = 0.38). Patients with more advanced clinical symptoms tended to show worse performance. Separate analyses of a subgroup of 24 non-medicated patients in the early stages of PD revealed no differences in SRTT performance relative to controls. Neuropsychological testing showed impairments in attention and executive functions, immediate and delayed explicit memory and visuospatial skills in the PD group, but none of the cognitive measures were related to procedural learning. Reduced motor sequence learning in PD patients did not influence their functional status. These findings indicate that procedural learning impairment is not an early feature of PD, but is likely to emerge with progression of the disease, independently of cognitive dysfunction or dopaminergic medication.

Temporal and frontal systems in speech comprehension: an fMRI study of past tense processing

A prominent issue in cognitive neuroscience is whether language function is instantiated in the brain as a single undifferentiated process, or whether regions of relative specialisation can be demonstrated. The contrast between regular and irregular English verb inflection has been pivotal to this debate. Behavioural dissociations related to different lesion sites in brain-damaged patients suggest that processing regular and irregular past tenses involves different neural systems. Using event-related fMRI in a group of unimpaired young adults, we contrast processing of spoken regular and irregular past tense forms in a same-different judgement task, shown in earlier research with patients to engage left hemisphere language systems. An extensive fronto-temporal network, linking anterior cingulate (ACC), left inferior frontal cortex (LIFC) and bilateral superior temporal gyrus (STG), was preferentially activated for regularly inflected forms. Access to meaning from speech is supported by temporal cortex, but additional processing is required for forms that end in regular inflections, which differentially engage LIFC processes that support morpho-phonological segmentation and grammatical analysis.

The importance of socioeconomic and nutritional conditions rather than altitude on the physical growth of prepubertal Andean highland boys

The aim of this work was to study the effect of hypoxic stress on the physical growth of prepubertal Bolivian boys (10-11.5 years of age) of the same socioeconomic and nutritional conditions. The subjects consisted of 143 boys living in La Paz (altitude 3600 m, n = 67) and Santa Cruz de la Sierra (altitude 420 m, n = 76). Among the boys studied at high altitude, 23 were from a high socioeconomic background (HA1) and 44 from a low socioeconomic background (HA2). The group studied at low altitude consisted of 47 boys from a high socioeconomic background (LA1) and 29 from a low socioeconomic background (LA2). A scientific evaluation of the nutritional status of the boys was realized from specific anthropometric characteristics (height, body weight, upper arm muscle circumference, body fat mass and body mass index) and haematological (haematocrit, haemoglobin, serum iron, serum ferritin, red cell protoporphyrin, transferrin saturation) and biochemical (total serum protein, albumin and prealbumin) parameters. At high as at low altitudes, the biometric characteristics of boys from a low socioeconomic background were significantly lower than those of boys from a high socioeconomic background. The physical growth of HA2 and LA2 boys was delayed by approximately 2 years. All the boys had biochemical and haematological parameters within the normal range. Boys from a low socioeconomic background were considered as marginally undernourished and those from a high socioeconomic background as well-nourished. Within the same socioeconomic class there was no nutritional difference between highland and lowland boys. Similarly, and this is the most important feature of this study, there was no difference for the overall biometric characteristics between highland and lowland boys of the same socioeconomic and nutritional status. Therefore, it appears that when socioeconomic and nutritional conditions are taken into account, there is no effect of hypoxic stress on the physical growth of prepubertal Andean highland boys.

Effect of chronic hypoxia and socioeconomic status on VO2max and anaerobic power of Bolivian boys

The aim of this work was to analyze the effects of altitude and socioeconomic and nutritional status on maximal oxygen uptake (VO2max) and anaerobic power (P) in 11-yr-old Bolivian boys. At both high (HA) (3,600 m) and low (LA) (420 m) altitudes, the boys were divided into high (HA1, n = 23, LA1, n = 48) and low (HA2, n = 44, LA2, n = 30) socioeconomic levels. Anthropometric characteristics, VO2max, and P [maximal P (Pmax) during a force-velocity test and mean P (P) during a 30-s Wingate test] were measured. Results showed that 1) anthropometric parameters were not different between HA1 and LA1 and HA2 and LA2 boys, but HA2 and LA2 boys were two years behind HA1 and LA1 boys in development; 2) VO2max was not different in boys from the same altitude, but at HA VO2max was 10% lower than at LA (HA1 = 37.2 +/- 5.6, HA2 = 38.9 +/- 6.4, LA1 = 42.5 +/- 5.8, LA2 = 42.5 +/- 5.3 ml.min-1 x kg-1 body wt); and 3) Pmax and P were higher in well-nourished than in undernourished boys, but there was no difference in Pmax and P between HA1 and LA1 and HA2 and LA2 boys (HA1 = 6.8 +/- 1.0, HA2 = 5.5 +/- 0.8, LA1 = 7.1 +/- 1.0, LA2 = 5.3 +/- 0.9 W/kg for Pmax; HA1 = 5.2 +/- 0.8, HA2 = 4.5 +/- 0.9, LA1 = 5.2 +/- 0.7, LA2 = 4.0 +/- 0.6 W/kg for P).(ABSTRACT TRUNCATED AT 250 WORDS)

Propolis allergy. (I). Origin, properties, usage and literature review

Propolis or bee-glue, a resinous bee-hive product, is the cause of an increasing number of cases of allergic contact dermatitis. Formerly only observed in bee-keepers, propolis allergy today is mainly seen in individuals who use propolis in bio-cosmetics and self treatment of various diseases. Nearly 200 cases are summarized in an overview, including the first description of 'poplar bud' contact dermatitis from 1887. As practically all flavonoid aglycones and most of the other phenolics present in propolis are identical with the bud secretion of poplars, evidence is given that the poplar bud constituents are responsible for propolis hypersensitivity.

Propolis allergy. (II). The sensitizing properties of 1,1-dimethylallyl caffeic acid ester

As shown in the preceding paper, propolis or bee-glue is the cause of an increasing number of allergic reactions in persons using it in external preparations and cosmetics. Propolis and its main contact allergen, 1,1-dimethylallyl caffeic acid ester, designated LB-1, show strong sensitizing properties in patients as well as in guinea pig experiments. 9 patients have been patch tested with this compound, 8 of whom reacted strongly. Chemical separation of different propolis samples and poplar bud extracts reveal that LB-1 is always present. Poplar bud secretion is the bee's major source for propolis and hence the origin of LB-1. A warning is indicated, in agreement with several other authors, that propolis should not be used in topical products because of its strong sensitizing properties.

Longitudinal changes in nutritional habits of teenagers: differences in intake between schooldays and weekend days

Longitudinal changes in nutritional habits were studied in Dutch adolescents from 12 to 17 years of age (131 girls and 102 boys). The dietary differences on schooldays and weekend days are reported. In girls only small changes in nutritional habits were seen as they grew older. In boys there was a gradual increase in food intake with age. Overall, higher nutrient intakes could be seen on weekend days. The energy intake on weekend days was consistently higher for girls and boys in all age-groups. The proportional intakes of fat and sugar were rather high, especially on weekend days. The alcohol consumption increased with age for girls as well as boys, and was for some individuals extremely high (boys) on weekend days. The observed levels of intake compared with the recommendations showed a rather low intake of polyunsaturated fatty acids, polysaccharides and iron.