Neural basis of speech and grammar symptoms in non-fluent variant primary progressive aphasia spectrum.

The non-fluent/agrammatic variant of primary progressive aphasia (nfvPPA) is a neurodegenerative syndrome primarily defined by the presence of apraxia of speech (AoS) and/or expressive agrammatism. In addition, many patients exhibit dysarthria and/or receptive agrammatism. This leads to substantial phenotypic variation within the speech-language domain across individuals and time, in terms of both the specific combination of symptoms as well as their severity. How to resolve such phenotypic heterogeneity in nfvPPA is a matter of debate. 'Splitting' views propose separate clinical entities: 'primary progressive apraxia of speech' when AoS occurs in the absence of expressive agrammatism, 'progressive agrammatic aphasia' (PAA) in the opposite case, and 'AOS + PAA' when mixed motor speech and language symptoms are clearly present. While therapeutic interventions typically vary depending on the predominant symptom (e.g. AoS versus expressive agrammatism), the existence of behavioural, anatomical and pathological overlap across these phenotypes argues against drawing such clear-cut boundaries. In the current study, we contribute to this debate by mapping behaviour to brain in a large, prospective cohort of well characterized patients with nfvPPA (n = 104). We sought to advance scientific understanding of nfvPPA and the neural basis of speech-language by uncovering where in the brain the degree of MRI-based atrophy is associated with inter-patient variability in the presence and severity of AoS, dysarthria, expressive agrammatism or receptive agrammatism. Our cross-sectional examination of brain-behaviour relationships revealed three main observations. First, we found that the neural correlates of AoS and expressive agrammatism in nfvPPA lie side by side in the left posterior inferior frontal lobe, explaining their behavioural dissociation/association in previous reports. Second, we identified a 'left-right' and 'ventral-dorsal' neuroanatomical distinction between AoS versus dysarthria, highlighting (i) that dysarthria, but not AoS, is significantly influenced by tissue loss in right-hemisphere motor-speech regions; and (ii) that, within the left hemisphere, dysarthria and AoS map onto dorsally versus ventrally located motor-speech regions, respectively. Third, we confirmed that, within the large-scale grammar network, left frontal tissue loss is preferentially involved in expressive agrammatism and left temporal tissue loss in receptive agrammatism. Our findings thus contribute to define the function and location of the epicentres within the large-scale neural networks vulnerable to neurodegenerative changes in nfvPPA. We propose that nfvPPA be redefined as an umbrella term subsuming a spectrum of speech and/or language phenotypes that are closely linked by the underlying neuroanatomy and neuropathology.

One side effect: two networks? Lateral and posteromedial stimulation spreads induce dysarthria in subthalamic deep brain stimulation for Parkinson's disease.

BACKGROUND: Stimulation-induced dysarthria (SID) is a troublesome and potentially therapy-limiting side effect of deep brain stimulation of the subthalamic nucleus (STN-DBS) in patients with Parkinson's disease (PD). To date, the origin of SID, and especially whether there is an involvement of cerebellar pathways as well as the pyramidal tract, remains a matter of debate. Therefore, this study aims to shed light on structural networks associated with SID and to derive a data-driven model to predict SID in patients with PD and STN-DBS. METHODS: Randomised, double-blinded monopolar reviews determining SID thresholds were conducted in 25 patients with PD and STN-DBS. A fibre-based mapping approach, implementing the calculation of fibr-wise ORs for SID, was employed to identify the distributional pattern of SID in the STN's vicinity. The ability of the data-driven model to classify stimulation volumes as 'causing SID' or 'not causing SID' was validated by calculating receiver operating characteristics (ROC) in an independent out-of-sample cohort comprising 14 patients with PD and STN-DBS. RESULTS: Local fibre-based stimulation maps showed an involvement of fibres running lateral and posteromedial to the STN in the pathogenesis of SID, independent of the investigated hemisphere. ROC analysis in the independent out-of-sample cohort resulted in a good fit of the data-driven model for both hemispheres (area under the curve (AUC)left=0.88, AUCright=0.88). CONCLUSIONS: This study reveals an involvement of both, cerebello-thalamic fibres, as well as the pyramidal tract, in the pathogenesis of SID in STN-DBS. The results may impact future postoperative programming strategies to avoid SID in patients with PD and STN-DBS TRIAL REGISTRATION NUMBER: DRKS00023221; German Clinical Trials Register (DRKS) Number.

De novo variants predicting haploinsufficiency for DIP2C are associated with expressive speech delay.

The disconnected (disco)-interacting protein 2 (DIP2) gene was first identified in D. melanogaster and contains a DNA methyltransferase-associated protein 1 (DMAP1) binding domain, Acyl-CoA synthetase domain and AMP-binding sites. DIP2 regulates axonal bifurcation of the mushroom body neurons in D. melanogaster and is required for axonal regeneration in the neurons of C. elegans. The DIP2 homologues in vertebrates, Disco-interacting protein 2 homolog A (DIP2A), Disco-interacting protein 2 homolog B (DIP2B), and Disco-interacting protein 2 homolog C (DIP2C), are highly conserved and expressed widely in the central nervous system. Although there is evidence that DIP2C plays a role in cognition, reports of pathogenic variants in these genes are rare and their significance is uncertain. We present 23 individuals with heterozygous DIP2C variants, all manifesting developmental delays that primarily affect expressive language and speech articulation. Eight patients had de novo variants predicting loss-of-function in the DIP2C gene, two patients had de novo missense variants, three had paternally inherited loss of function variants and six had maternally inherited loss-of-function variants, while inheritance was unknown for four variants. Four patients had cardiac defects (hypertrophic cardiomyopathy, atrial septal defects, and bicuspid aortic valve). Minor facial anomalies were inconsistent but included a high anterior hairline with a long forehead, broad nasal tip, and ear anomalies. Brainspan analysis showed elevated DIP2C expression in the human neocortex at 10-24 weeks after conception. With the cases presented herein, we provide phenotypic and genotypic data supporting the association between loss-of-function variants in DIP2C with a neurocognitive phenotype.

Factors influencing speech improvement following maxillary complete-arch implant-supported restorations: A retrospective study.

OBJECTIVE: This study explored factors affecting speech improvement in patients with an edentulous maxilla after the delivery of a complete-arch implant-supported fixed dental prosthesis (IFDP). MATERIALS AND METHODS: Patients who had received IFDP for edentulous maxilla were enrolled, and various potential speech improvement-related factors were considered, including patient demographics, anterior residual bone volume, preoperative facial features, preoperative acoustic parameters, and adaptation time. Acoustic analysis and perceptual ratings were used to assess three fricatives [s], [f], and [ɕ]. Correlation and regression analyses were conducted to assess the association between changes in fricatives and potential factors (α = .05). RESULTS: The study included 50 patients (18 females and 32 males, aged 50.62 ± 15.71 years, range 19-76). Significant correlations were found among the change in the center of gravity (ΔCoG) of [s] and anterior residual bone volume, zygomatic implants number and proportion (p < .05). These correlations were largely mirrored in the perceptual score (ΔPS) changes. After controlling for age, sex, preoperative acoustic parameters, and adaptation time, the ΔCoG and ΔPS of fricatives were mainly correlated with the anterior residual bone volume, preoperative acoustic parameters, and adaptation time. CONCLUSION: Speech improvements post-IFDP delivery are mainly related to preoperative speech characteristics, anterior residual bone volume, and adaptation time. The residual bone volume's impact on consonants varies with specific articulatory gestures. This study provides insights into forecasting speech outcomes following IFDP restoration and provides recommendations and methods for data collection in developing future prediction models.

"Letter to the editor: traumatic atlantoaxial rotatory fixation in adults: a systematic review of published cases".

This critique evaluates a recent study on adult traumatic atlantoaxial rotatory fixation (AARF), focusing on its strengths, weaknesses, and suggestions for future research. The study provides a comprehensive examination of the anatomical and biomechanical complexities of the C1-C2 articulation, shedding light on the rare nature of adult traumatic AARF and common injury mechanisms. It categorizes AARF based on the atlanto-dental interval (ADI) and dislocation severity, aiding clinicians in assessing injury severity and treatment planning. Furthermore, the study explores conservative and surgical management approaches, offering valuable insights into treatment decision-making and outcomes. However, limitations such as its retrospective nature, reliance on reported cases, lack of standardized protocols, and limited sample size may constrain the generalizability of findings. Future research should prioritize prospective, multicenter studies with standardized protocols, collaborative efforts among institutions, and innovative techniques to advance our understanding and management of adult traumatic AARF.

Sagittal slope angle of lateral atlantoaxial articulation is associated with the severity of basilar invagination with atlantoaxial dislocation and predicts reduction degree after surgery.

OBJECTIVE: To investigate (1) lateral atlantoaxial articulation (LAA) morphology in patients with basilar invagination (BI) with atlantoaxial dislocation (AAD) and healthy individuals and its relationship with the severity of dislocation and (2) the effect of the LAA morphology on reduction degree (RD) after surgery. METHODS: In this retrospective propensity score matching case-control study, imaging and baseline data of 62 patients with BI and AAD from 2011 to 2022 were collected. Six hundred thirteen  participants without occipitocervical junctional deformity served as controls. Logistic regression and receiver operating characteristic (ROC) curve were used for analysis. RESULTS: The age, BMI and sex did not differ significantly between the two groups after propensity score matching. Sagittal slope angle (SSA) and coronal slope angle (CSA) was lower and greater, respectively, in the patient group than in the control group. A negative SSA value usually indicates anteverted LAA. Regression analysis revealed a significant negative correlation between SSA and severity of dislocation. However, no relationship was found between CSA and the severity of dislocation. The multivariate logistic regression analysis revealed that minimum-SSA emerged as an independent predictor of satisfactory reduction (RD ≥ 90%). The ROC curve demonstrated an area under the curve of 0.844, with a cut-off value set at -40.2. CONCLUSION: SSA in patients group was significantly smaller and more asymmetric than that in the control group. Dislocation severity was related to SSA but not to CSA. Minimum-SSA can be used as a predictor of horizontal RD after surgery.

Can sequencing of articulation ease explain the in-out effect? A preregistered test.

Words whose consonantal articulation places move from the front of the mouth to the back (e.g. BADAKA; inward) receive more positive evaluations than words whose consonantal articulation places move from the back of the mouth to the front (e.g. KADABA; outward). This in-out effect has a variety of affective, cognitive, and even behavioural consequences, but its underlying mechanisms remain elusive. Most recently, a linguistic explanation has been proposed applying the linguistic easy-first account and the so-called labial-coronal effect from developmental speech research and phonology to the in-out effect: Labials (front) are easier to process than coronals (middle); and people prefer easy followed by harder motor components. Disentangling consonantal articulation direction and articulation place, the present three preregistered experiments (total N = 1012) found in-out effects for coronal-dorsal (back), and labial-dorsal articulation places. Critically, no in-out effect emerged for labial-coronal articulation places. Thus, the in-out effect is unlikely an instantiation of easy first.

What is in a name: Taxonomy of speech sound disorders from a cross-linguistic perspective.

BACKGROUND: In response to the call for papers under the theme "What is in a name" proposed by the Scientific Child Speech Committee of the International Association of Communication Sciences and Disorders (IALP), the current paper discusses taxonomy and its relation to speech sound disorders (SSD) from a cross-linguistic perspective. AIMS: This paper starts with a brief description of specific SSD frameworks and nomenclature. METHODS & PROCEDURES: The authors draw from international theoretical and clinical research which underscore the importance of taxonomy systems in SSD. OUTCOMES & RESULTS: The current papers stresses the importance of the contribution to differential diagnosis and prognosis of children with protracted speech profiles on the bases of taxonomy profiles and systems for SSD. CONCLUSIONS & IMPLICATIONS: The advantages and shortcomings of taxonomy in SSD are also discussed from a cross-linguistic context. The language of focus includes the Greek dialectal variation of Cypriot-Greek. WHAT THIS PAPER ADDS: The paper adds to the importance of taxonomy and SSD subsystems which allow differential diagnosis of SSD and the implementation of appropriate intervention methods. What is already known on this subject The use of various taxonomy systems regarding SSD are widely available for English-speaking populations. Such systems in the cross-linguistic framework remain underexplored. What this paper adds to existing knowledge The paper underscores the need for the development, adaptation and use of taxonomy systems that will add to the existing databases and taxonomy subsystems used in English What are the potential or actual clinical implications of this work? Potential clinical implications include the development and implementation of taxonomy systems in profile SSD productions in children.

Evaluation of the Scapulohumeral Distraction (SHD) technique for anterior shoulder dislocation. A randomized controlled trial.

INTRODUCTION: Shoulder dislocation is a common injury presenting in emergency Department. Numerous methods have been described in the literature for glenohumeral reduction. These methods can be divided into two groups: traction maneuvers and the combination of traction with scapula manipulation techniques. In this article, we introduced a new maneuver for shoulder reduction, namely, the combination of traction with handling the scapula (scapulohumeral distraction, SHD) and compare it to the Hippocratic Method (HT). MATERIALS AND METHODS: The study took place from November 2021 to September 2023. A total of 96 patients with acute anterior shoulder dislocation were enrolled in the study. Eighty-seven patients, who met all inclusion criteria, were randomly assigned to one of the two groups (SHD and HM). We evaluated each method for success rate, time to relocation, complications over a follow-up period of one month, patients' satisfaction and pain level during the procedure. RESULTS: Both methods had comparable success rates (SHD 95.3% vs. HM 93.2%, p=.833) while no complications where observed. However, SHD method required significantly less procedure time (p=.001). Moreover, patients in SHD group reported significantly less pain (p=.012) and greater satisfaction (p=.003) levels. Furthermore, when we assessed relocation time, pain and patient satisfaction as a function of recurrence, there were no statistically significant differences between the 2 techniques. Similarly, the evaluation of relocation time for both techniques as a function of BMI and age did not indicate statistically significant differences. CONCLUSION: Scapulohumeral distraction technique (SHD) represents a safe, anatomically based and simple method for shoulder reduction. It showed a statistically significant decrease in relocation time and pain, with patients mentioned higher satisfaction rates compared to the classical Hippocratic method. Nonetheless, there were no statistically significant differences between the two techniques regarding success rate.

Sound symbolism in manual and vocal responses: phoneme-response interactions associated with grasping as well as vertical and size dimensions of keypresses.

It has been shown that reading the vowel [i] and consonant [t] facilitates precision grip responses, while [ɑ] and [k] are associated with faster power grip responses. A similar effect has been observed when participants perform responses with small or large response keys. The present study investigated whether the vowels and consonants could produce different effects with the grip responses and keypresses when the speech units are read aloud (Experiment 1) or silently (Experiment 2). As a second objective, the study investigated whether the recently observed effect, in which the upper position of a visual stimulus is associated with faster vocalizations of the high vowel and the lower position is associated with the low vowel, can be observed in manual responses linking, for example, the [i] with responses of the upper key and [ɑ] with lower responses. Firstly, the study showed that when the consonants are overtly articulated, the interaction effect can be observed only with the grip responses, while the vowel production was shown to systematically influence small/large keypresses, as well as precision/power grip responses. Secondly, the vowel [i] and consonant [t] were associated with the upper responses, while [ɑ] and [k] were associated with the lower responses, particularly in the overt articulation task. The paper delves into the potential sound-symbolic implications of these phonetic elements, suggesting that their acoustic and articulatory characteristics might implicitly align them with specific response magnitudes, vertical positions, and grip types.

Analyzing the accuracy of a cross-mounting technique utilizing digitized interocclusal records.

PURPOSE: To compare the accuracy of a partially digital cross-mounting workflow of direct scans of interocclusal records to a conventional workflow by analyzing the deviations of sequentially cross-mounted casts. MATERIALS AND METHODS: A set of reference casts, comprising maxillary and mandibular full-arch prepared casts and interim prostheses, was articulated, mounted, and scanned to generate four reference casts for cross-mounting. In the conventional approach, 15 sets of these four casts were printed. Polyvinylsiloxane (PVS) records were made using the reference casts and utilized for sequential cross-mounting. In the partially digital group, the same PVS interocclusal records were scanned and used for digital cross-mounting via design software. The mean deviations of both groups from the reference cast were analyzed using a 3D inspection software program. Statistical tests, including paired t-test and analysis of variance (ANOVA), were conducted to compare the average discrepancies between the two groups and to evaluate discrepancies in the anterior and posterior regions (α = 0.05). RESULTS: The range of discrepancies was similar in both the conventional and partially digital groups. The final set of related casts had a mean deviation of 201.58 ± 136.98 mm in the conventional workflow and 248.69 ± 164.71 mm in the partially digital workflow. No statistically significant difference was found between conventional and partially digital groups (p = 0.091). Error propagation was examined by comparing discrepancies at each step within the cross-mounting process. In the conventional group, no significant difference was found (p = 0.148), but a significant difference was found among groups in the partially digital group at each step of sequential mounting (p < 0.001). A significant difference was observed between anterior and posterior deviations in the partially digital group (p < 0.001), but not in the conventional group (p = 0.143). CONCLUSIONS: The study reveals that there is no statistically significant difference between conventional and partially digital cross-mounting workflows. However, within the partially digital group, a significant difference in deviation emerges across cross-mounting steps, with increased deviation in the anterior region.

Accuracy of virtual articulation in maximal intercuspal position in direct and indirect digital workflows for fixed partial denture fabrication.

PURPOSE: To assess the accuracy of virtual articulation in direct digital workflow (DDW) and indirect digital workflow (IDW) in arches prepared for fixed partial dentures (FPDs). MATERIALS AND METHODS: Five pairs of master models were used in this study representing different clinical scenarios of full dentate (FD), and prepared arches for fixed partial dentures as follows: FD group, short span posterior (SSP group), long span posterior (LSP group), short span anterior (SSA group), and long span anterior (LSA). Fourteen pairs of interarch reference points were added to each set of master models to measure linear interarch distance with a caliper (reference measurements). The direct digital workflow included digital scans and virtual articulation with buccal scan images using an intraoral scanner. The indirect digital workflow included conventional polyvinylsiloxane impressions and bites followed by pouring, mounting, and scanning the stone models in a laboratory scanner. The scanned stone models were virtually articulated with buccal scanning in the laboratory scanner. Digital linear interarch measurements on all virtually-articulated models were compared with reference measurements. The absolute mean differences in linear interarch distances were calculated. The Mann-Whitney test was used for statistical analysis (α = .05). RESULTS: The direct digital workflow produced significantly less linear interarch deviations in the virtually articulated models compared to the indirect digital workflow for all study groups (P < .05). However, the direct digital workflow had significantly less accuracy for virtual articulation in long span posterior, long span anterior, and short span anterior groups compared to the full dentate group.  CONCLUSIONS: Both workflows produced virtually-articulated models with acceptable accuracy. However, the direct digital workflow had significantly better accuracy in all assessed clinical scenarios.

Locking of the metacarpophalangeal joint: A comprehensive review of the literature.

Locked metacarpophalangeal joint is an uncommon phenomenon with many possible etiologies. Diagnosis can be difficult because of the many more common pathologies (trigger finger, sagittal band lesion, etc.) that can lead to a clinical picture that may resemble the locked metacarpophalangeal joint. Once the differential diagnoses have been eliminated, the etiology of this blockage must be determined and the surgical procedure must be oriented. The origin of the problem is often difficult to determine, especially since standard imaging tests are often not very informative. Several clinical forms are possible, with blockages in extension or flexion, but which will have a disabling functional impact on the overall function of the hand. Currently, there is no gold standard for the management of this condition. In this study, we performed a review of the literature in order to better understand the different possible etiologies but also to analyze the different diagnostic and therapeutic management. LEVEL OF EVIDENCE: IV.

Mapping cortical activations underlying covert and overt language production using high-density diffuse optical tomography.

Gold standard neuroimaging modalities such as functional magnetic resonance imaging (fMRI), positron emission tomography (PET), and more recently electrocorticography (ECoG) have provided profound insights regarding the neural mechanisms underlying the processing of language, but they are limited in applications involving naturalistic language production especially in developing brains, during face-to-face dialogues, or as a brain-computer interface. High-density diffuse optical tomography (HD-DOT) provides high-fidelity mapping of human brain function with comparable spatial resolution to that of fMRI but in a silent and open scanning environment similar to real-life social scenarios. Therefore, HD-DOT has potential to be used in naturalistic settings where other neuroimaging modalities are limited. While HD-DOT has been previously validated against fMRI for mapping the neural correlates underlying language comprehension and covert (i.e., "silent") language production, HD-DOT has not yet been established for mapping the cortical responses to overt (i.e., "out loud") language production. In this study, we assessed the brain regions supporting a simple hierarchy of language tasks: silent reading of single words, covert production of verbs, and overt production of verbs in normal hearing right-handed native English speakers (n = 33). First, we found that HD-DOT brain mapping is resilient to movement associated with overt speaking. Second, we observed that HD-DOT is sensitive to key activations and deactivations in brain function underlying the perception and naturalistic production of language. Specifically, statistically significant results were observed that show recruitment of regions in occipital, temporal, motor, and prefrontal cortices across all three tasks after performing stringent cluster-extent based thresholding. Our findings lay the foundation for future HD-DOT studies of imaging naturalistic language comprehension and production during real-life social interactions and for broader applications such as presurgical language assessment and brain-machine interfaces.

Safety profile and technical success rate of computed tomography-guided atlanto-axial lateral articulation injections.

OBJECTIVE: To describe the technique, safety profile, and outcome of computed tomography (CT)-guided atlanto-axial lateral articulation injections performed at our institution. METHODS: Consecutive cases of all CT-guided atlanto-axial injections performed from January 2017 to April 2022 at our institution were searched in the electronic medical records. Patient charts were reviewed for demographics, characterization of pain, potential altered anatomy, pain level before and immediately after the procedure, procedure technique, complications, and follow-up outcomes, if available. RESULTS: Forty-five injections in 40 different patients were included. The average age was 67.4 years, and 28 (70%) of the patients were female. Of the 45 injections, 43 (96%) were technically successful. The average change in pain score (0-10) from immediately before to immediately after the injection was -3.36 (SD = 2.87, range = -8 to +3). Of all injections, 14 (31%) had a postprocedural pain score of zero. In 2 cases (4%), patients reported an increase in pain score immediately after the injection. In 3 cases (7%), transient non-vertebral artery vascular uptake of contrast was documented during the procedure, which could be cleared with needle repositioning. There were no complications. CONCLUSION: CT-guided atlanto-axial lateral articulation injection is a safe procedure with a high technical success rate. It allows for direct visualization of vital structures and provides an alternative option to the traditional fluoroscopic guidance, especially in cases of prior technically unsuccessful fluoroscopically guided injection or altered anatomy.

Evaluation of modified C-palatal plates on speech articulation using acoustic analysis.

INTRODUCTION: The purpose of this study was to assess speech perturbation and adaptation for patients wearing modified C-palatal plates (MCPPs) over time. METHODS: The sample consisted of 40 patients, 20 wearing MCPPs as the experimental group (age: 20.7 ± 5.8 years) and 20 patients wearing a transpalatal arch (TPA) as the control group (age: 21.5 ± 6.4 years). The sounds /t/, /d/, /s/, /n/, /r/, /tʃ/. and /j/ were recorded for each patient at six time points: immediately before (T0) and after (T1) appliance placement; then 1, 2, 3 and 4 weeks after placement (T2-T5). Acoustic analysis of pitch and voice onset time (VOT) was performed by Praat software. Repeated measures analysis of variance (RM-ANOVA) was used to assess changes in the pitch and VOT over time and the difference between the appliances. RESULTS: With the MCPP appliance, /n/, /r/, /tʃ/ and /j/ decreased in VOT starting in the first week while /t/ and /s/ almost returned to pre-treatment levels after 2 weeks. VOT for the /d/ sound did not change between T0 and T3, but it decreased after 3 weeks. There were no significant differences in pitch and VOT between the two groups at any time point. CONCLUSIONS: Wearing an MCPP device caused patients to initially distort the articulation of several sounds, but the distortion dissipated within 1 to 2 weeks. It is recommended that patients and/or their parents be advised during pre-treatment counselling of the possibility of temporary speech changes with MCPP placement.

The influence of consonant wanderings and facial expressions in warmth and competence judgments.

ABSTRACTThe preference for usernames whose oral pronunciation implies inward wandering articulatory movements over those involving outward movements - the in-out effect - has been shown to shape person perception judgments. Across three studies, we further tested the boundary conditions to this effect by combining the manipulation of the articulation direction of mock online usernames with one of the most critical cues for interpersonal judgments - facial expressions. As expected, users displaying smiling faces were rated as warmer and more competent than those displaying angry expressions. Notably, even in the presence of such diagnostic cues for social judgment, the articulatory activity involved in pronouncing a person's name still affected the impressions formed, particularly in the warmth dimension. These results show that the in-out effect did not vanish even when highly diagnostic visual information was available. Overall, the current work further emphasises the role of sensorimotor experience in person perception while providing additional evidence for the in-out effect, its boundary conditions, and potential mechanisms.

Longitudinal data on speech outcomes in internationally adopted children compared with non-adopted children with cleft lip and palate.

BACKGROUND: At the beginning of the 21st century, international adoptions of children with cleft lip and/or palate increased dramatically in Sweden. Many children arrived partially or totally unoperated, despite being at an age when palatoplasty has usually been performed. To date, the speech development of internationally adopted (IA) children has been described up to age 7-8 years, but later development remains unstudied. AIMS: To investigate speech development between ages 5 and 10 years in children born with cleft lip and palate (CLP) adopted from China and to compare them with non-adopted (NA) children with CLP. A secondary aim was to compare the frequencies of secondary palatal surgery and number of visits to a speech and language pathologist (SLP) between the groups. METHODS & PROCEDURES: In a longitudinal study, 23 IA children from China were included and matched with 23 NA children born in Sweden. Experienced SLPs blindly reassessed audio recordings from routine follow-ups at ages 5 and 10 years. Velopharyngeal function (VPF) was assessed with the composite score for velopharyngeal competence (VPC-Sum) for single words and rated on a three-point scale (VPC-Rate) in sentence repetition. Target sounds in words and sentences were phonetically transcribed. Per cent correct consonants (PCC) were calculated at word and sentence levels. For in-depth analyses, articulation errors were divided into cleft speech characteristics (CSCs), developmental speech characteristics (DSCs) and s-errors. Information on secondary palatal surgery and number of visits to an SLP was collected. OUTCOMES & RESULTS: VPF differed significantly between the groups at both ages when assessed with VPC-Sum, but not with VPC-Rate. Regardless of the method for assessing VPF, a similar proportion in both groups had incompetent VPF but fewer IA than NA children had competent VPF at both ages. IA children had lower PCC at both ages at both word and sentence levels. More IA children had CSCs, DSCs and s-errors at age 5 years, and CSCs and s-errors at age 10. The development of PCC was significant in both groups between ages 5 and 10 years. The proportion of children receiving secondary palatal surgery did not differ significantly between the groups, nor did number of SLP visits. CONCLUSIONS & IMPLICATIONS: CSCs were more persistent in IA children than in NA children at age 10 years. Interventions should target both cleft and DSCs, be comprehensive and continue past the pre-school years. WHAT THIS PAPER ADDS: What is already known on this subject At the beginning of the 21st century, IA children with cleft lip and/or palate arrived in Sweden partially or totally unoperated, despite being at an age when palatoplasty has usually been performed. Studies up to age 7-8 years show that adopted children, compared with NA peers, have poorer articulation skills, demonstrate both cleft-related and developmental articulation errors, and are more likely to have velopharyngeal incompetence. Several studies also report that adopted children more often require secondary palatal surgery due to fistulas, dehiscence or velopharyngeal incompetence compared with NA peers. What this paper adds to existing knowledge This longitudinal study provides additional knowledge based on longer follow-ups than previous studies. It shows that the proportion of children assessed to have incompetent VPF was similar among IA and NA children. It was no significant difference between the groups regarding the proportion that received secondary palatal surgery. However, fewer IA children were assessed to have a competent VPF. Developmental articulation errors have ceased in most IA and all NA children at age 10 years, but significantly more adopted children than NA children still have cleft-related articulation errors. What are the potential or actual clinical implications of this work? Speech and language therapy should target both cleft-related and developmental articulation errors. When needed, treatment must be initiated early, comprehensive, and continued past the pre-school years, not least for adopted children.

Variables influencing the device-dependent approaches in digitally analysing jaw movement-a systematic review.

BACKGROUND: To explore the digitisation of jaw movement trajectories through devices and discuss the physiological factors and device-dependent variables with their subsequent effects on the jaw movement analyses. METHODS: Based on predefined eligibility criteria, the search was conducted following PRISMA-P 2015 guidelines on MEDLINE, EBSCO Host, Scopus, PubMed, and Web of Science databases in 2022 by 2 reviewers. Articles then underwent Cochrane GRADE approach and JBI critical appraisal for certainty of evidence and bias evaluation. RESULTS: Thirty articles were included following eligibility screening. Both in vitro experiments (20%) and in vivo (80%) devices ranging from electronic axiography, electromyography, optoelectronic and ultrasonic, oral or extra-oral tracking, photogrammetry, sirognathography, digital pressure sensors, electrognathography, and computerised medical-image tracing were documented. 53.53% of the studies were rated below "moderate" certainty of evidence. Critical appraisal showed 80% case-control investigations failed to address confounding variables while 90% of the included non-randomised experimental studies failed to establish control reference. CONCLUSION: Mandibular and condylar growth, kinematic dysfunction of the neuromuscular system, shortened dental arches, previous orthodontic treatment, variations in habitual head posture, temporomandibular joint disorders, fricative phonetics, and to a limited extent parafunctional habits and unbalanced occlusal contact were identified confounding variables that shaped jaw movement trajectories but were not highly dependent on age, gender, or diet. Realistic variations in device accuracy were found between 50 and 330 µm across the digital systems with very low interrater reliability for motion tracing from photographs. Forensic and in vitro simulation devices could not accurately recreate variations in jaw motion and muscle contractions.

ArtiLock: Smartphone User Identification Based on Physiological and Behavioral Features of Monosyllable Articulation.

Although voice authentication is generally secure, voiceprint-based authentication methods have the drawback of being affected by environmental noise, long passphrases, and large registered samples. Therefore, we present a breakthrough idea for smartphone user authentication by analyzing articulation and integrating the physiology and behavior of the vocal tract, tongue position, and lip movement to expose the uniqueness of individuals while making utterances. The key idea is to leverage the smartphone speaker and microphone to simultaneously transmit and receive speech and ultrasonic signals, construct identity-related features, and determine whether a single utterance is a legitimate user or an attacker. Physiological authentication methods prevent other users from copying or reproducing passwords. Compared to other types of behavioral authentication, the system is more accurately able to recognize the user's identity and adapt accordingly to environmental variations. The proposed system requires a smaller number of samples because single utterances are utilized, resulting in a user-friendly system that resists mimicry attacks with an average accuracy of 99% and an equal error rate of 0.5% under the three different surroundings.