Functional near-infrared spectroscopy for speech protocols: characterization of motion artifacts and guidelines for improving data analysis.

Monitoring speech tasks with functional near-infrared spectroscopy (fNIRS) enables investigation of speech production mechanisms and informs treatment strategies for speech-related disorders such as stuttering. Unfortunately, due to movement of the temporalis muscle, speech production can induce relative movement between probe optodes and skin. These movements generate motion artifacts during speech tasks. In practice, spurious hemodynamic responses in functional activation signals arise from lack of information about the consequences of speech-related motion artifacts, as well as from lack of standardized processing procedures for fNIRS signals during speech tasks. To this end, we characterize the effects of speech production on fNIRS signals, and we introduce a systematic analysis to ameliorate motion artifacts. The study measured 50 healthy subjects performing jaw movement (JM) tasks and found that JM produces two different patterns of motion artifacts in fNIRS. To remove these unwanted contributions, we validate a hybrid motion-correction algorithm based sequentially on spline interpolation and then wavelet filtering. We compared performance of the hybrid algorithm with standard algorithms based on spline interpolation only and wavelet decomposition only. The hybrid algorithm corrected 94% of the artifacts produced by JM, and it did not lead to spurious responses in the data. We also validated the hybrid algorithm during a reading task performed under two different conditions: reading aloud and reading silently. For both conditions, we observed significant cortical activation in brain regions related to reading. Moreover, when comparing the two conditions, good agreement of spatial and temporal activation patterns was found only when data were analyzed using the hybrid approach. Overall, the study demonstrates a standardized processing scheme for fNIRS data during speech protocols. The scheme decreases spurious responses and intersubject variability due to motion artifacts.

Assessing concentration of antibiotics in tissue during oral treatments against piscirickettsiosis.

The use of antimicrobials in aquaculture is increasingly being scrutinized. In Chile, piscirickettsiosis accounts for approximately 90% of the total volume of antibiotics used in marine aquaculture. Treatment failures are frequently reported, but there is limited information on why this occurs. Fish producers have started assessing the level of antibiotics in fish tissues during and immediately after in-feed treatments to determine if they are adequately medicating their fish. In this study, we evaluated the probability of finding antibiotic concentrations in muscle tissue above the minimum inhibitory concentration for 90% of the P. salmonis isolates (MIC90) recently tested in Chile, for two antibiotics commonly used in aquaculture. We found that the proportion of fish with antibiotic concentrations above the MIC90 varied, depending on the product used, species, day of sample collection, and size category of fish within a cage. The proportion of fish above the MIC90 was lower in fish treated with florfenicol than in fish treated with oxytetracycline. Using a mixed-effects logistic model, we modeled the probability of antibiotic concentrations above MIC90 when fish were treated with florfenicol. Our model suggested lower probabilities of having concentrations above MIC90 in Atlantic salmon than in rainbow trout when samples were collected 14 days after the treatment started compared to 7 days, and in the smaller fish within a cage. We discuss these findings and hypothesize about potential issues with treating large populations of fish with in-feed antimicrobials.

Common characteristics of upper and lower airways in rhinitis and asthma: ARIA update, in collaboration with GA(2)LEN.

This update aimed to review the new evidence available to support or refute prior Allergic Rhinitis and its Impact on Asthma (ARIA) statements. A Medline search of publications between 2000 and 2005 was conducted, with articles selected by experts. New evidence supports previous ARIA statements, such as: (i) allergic rhinitis (AR) is a risk factor for asthma; (ii) patients with persistent rhinitis should be evaluated for asthma; (iii) most patients with asthma have rhinitis; (iv) a combined strategy should be used to treat the airways and (v) in low- to middle-income countries, a different strategy may be needed. The increased risk of asthma has also been found among sufferers from non-AR. Recent reports show AR is a global problem. Many studies demonstrated parallel increasing prevalence of asthma and rhinitis, but in regions of highest prevalence, it may be reaching a plateau. Factors associated with a reduced risk of asthma and AR have been identified, confirming previous findings of protection related to exposure to infections. Treatment of rhinitis with intranasal glucocorticosteroids, antihistamines, leukotriene antagonists or immunotherapy may reduce morbidity because of asthma. To take advantage of the paradigm of unified airways, there is a need to rationalize diagnosis and treatment to optimize management.

Mortality in patients with congenital adrenal hyperplasia: a cohort study.

OBJECTIVE: To determine mortality in patients with congenital adrenal hyperplasia (CAH) compared with that in the general population. DESIGN: We identified 333 children with CAH, treated at several pediatric endocrinology departments in the United Kingdom since 1964, and monitored their mortality to mid 1996. Standardized mortality ratios were calculated, comparing mortality in the cohort with that in the general population, adjusted for sex, age, and calendar period. RESULTS: All-cause mortality in the cohort was 3 times that expected. Mortality was significantly increased at ages 1 to 4 years (standardized mortality ratio = 18.3) but not at older ages and was significantly increased in patients of Indian-subcontinent ethnicity (standardized mortality ratio = 20.4), particularly in girls. From case notes and death certificates, it appears that most deaths were caused by adrenal crisis, often after infection. CONCLUSIONS: Although survival of patients with CAH has greatly improved since steroid therapy has been used, this disease can still have fatal consequences. The high mortality rate in Indian ethnic girls may well reflect lack of parental acceptance and understanding of the disease, as well as of the action required when their child becomes acutely ill. Better communication with and education of parents of children with CAH, especially those from immigrant ethnic minorities, is important.

Final height after long-term growth hormone treatment in Turner syndrome. European Study Group.

OBJECTIVES: To study final height after long-term growth hormone (GH) treatment in girls with Turner syndrome (TS). PATIENTS: One hundred fifty three patients with TS, participating in five European trials, were included. They started GH treatment in 1987-1989 at an age of 10 years or older. Mean age at start of treatment ranged between 11.7 and 14.6 years among countries and mean bone age between 9.4 and 11.8 years. Fourteen girls were lost to follow-up, leaving 139 for analysis. Most girls have now attained final height (FH), defined as a linear growth velocity (GV) of 4 mm/yr or less, measured over at least 6 months (group 1, n = 56), or near-FH, defined as a GV of 5 to 9 mm/yr (group 2, n = 22). Sixty-one girls were still growing 10 mm/yr or more. METHODS AND MAIN RESULTS: At the last measurement, mean (SD) height was 150.7 (4.9) cm in group 1 and 148.5 (5.1) cm in group 2. The differences between FH and projected final height based on extrapolation of the initial height-standard deviation score on Turner syndrome reference values, were 2.9 (3.8) and 3.0 (3.3) cm, respectively. The mean gain over the Bayley-Pinneau prediction of FH was 3.3 (3.9) cm in both groups. No significant differences between countries were found. The range of gains over projected height (-4.7 to 12.1 cm) was large, and 25% of gains were 5 cm or more. Gain over initial projection was strongly related to initial growth delay and to growth response during the first 2 years of treatment. A logistic regression model is presented that predicts gain of more than 5 cm with a positive predictive value of 62% and a negative predictive value of 84%. CONCLUSIONS: Long-term GH treatment in girls with TS, starting treatment at a relatively advanced age ( > 10 years) resulted in a modest mean gain in FH of 3 cm, with wide interindividual variation.

Introduction.

PIP: This is a summary of 7 papers given at a South American Indian Conference. The papers varied by the training and interests of the authors, but the unifying characteristics were their attention to the quality of data, the concern with placing the Lowland South American Indian societies in historical time, and the focus on the individual in a social context. The trend for tribal societies to abandon traditional practices of birth limitation is worrisome at a time when the balance between population growth and economic resources has deteriorated. Survival risks are high. The traditional societies range over a region stretching from Guyana to Mato Grosso, and have varying degrees of economic and political autonomy. All have been exposed to Western influences. A four-generation account of Barama River Caribs family in Guyana illustrates how marriage choices that appear anomalous were responses to changing demographic pressures. The problems of the definition of a population were revealed in the paper on the Wanano of the Rio Vaupes in Northwest Amazon; the aim was to examine Boas' ideas about the links between language, race, and culture in a region of culturally mixed marriages. High-quality reproductive history data was collected and examined on the Xavante in Pimentel Barbosa in eastern Mato Grosso. The study of household and settlement composition, marriage, fertility, and mortality data among the Bakairi, located west of Shavante, in Mat Grosso, suggests that population increases were kept small due to fertility-inhibiting cultural practices. The combination of detailed examination of cultural practices and statistical analysis provided insights into the demographic behavior of the Canela in central Maranhao, who have had longstanding contact with the West and maintained traditional practices. The difficulties of collecting birth and death records between 1976-86 among the Nambiquara in western Maso Grosso were expressed, and the anomalies of female mortality explained. Statistical analysis of the Shipibo of the Ucayali River Basin in Peru demonstrated that growth was attributed to the abandonment of traditional practices.^ieng

Notes on Nambiquara demography.

PIP: Total population, fertility, and differential mortality are described for the Nambiquara of western Mato Grosso, Brazil. The Nambiquara are hunters and subsistence farmers of maize and manioc. Communities are scattered clusters of 30 individuals, led by political "brothers." Dravidian kinship and cross-cousin marriages predominate in exogamous marriages. Western contact occurred after 1910 with the arrival of the telegraph line. Missionary contact was during the 1920s, and Claude Levi-Strauss visited in 1938. The rubber industry dominated during the 1940s and 1950s, and a road built in 1960 brought contact with the world economic community. An Indian post was established in 1943, and demographic data was collected through this center. The author recorded births and deaths in 1969-70, and again in 1973, 1977, 1980, and 1986. This data was supplemented by reports from others between 1974-76, 1982, 1985. Data was considered of acceptable quality between 1976 and 1986. There are three districts: Campo, with Western contact for 60-70 years; the Guapore, isolated until the 1960s or 1970s; and the North people, with the most devastating Western contact due to the telegraph lines. Evidence during the study period showed that the Nambiquara tended to follow traditional customs in social life and had few economic ties to the outside world. High estimates at the turn of the century placed the population totals at 20,000, but in 1970 the total population count averaged around 575 to 600, with reasonable estimates for the precontact society at 6000. Although the population is scattered, the language is the same. The death rate has been estimated at 60/1000 between 1969-74 and 53/1000 between 1943-65. The birth rate was 45/1000 in 1975/76. The population was declining at 1% per year. Between 1965 and 1985, the population began increasing. The average yearly birth rate between 1975-85 was estimated at 55.7/1000 for the whole sample, 44.1 for the Campo, 74.8 for the Guapore, and 37.6 for the North. The death rate declined after 1975. Child spacing averaged 30 months, and women had a higher birth rate in Guapore: .313 births per woman aged 13-34 years, 0.367 for Guapore, .314 for Campo, and .209 for the North. Female mortality was found to be higher at the beginning of the project, but not at the end.^ieng

Infection of the respiratory tract with Mammomanogamus (Syngamus) laryngeus: a new case in Largo, Florida, and a summary of previously reported cases.

We present an unusual cause for chronic cough. Infection in a man by the nematode Mammomanogamus laryngeus is described along with a review of other reported human cases. High index of suspicion is urged, especially in world travelers.

Medical consequences of the New Mexico State Penitentiary riot.

On February 2, 1980, a riot broke out among the 1,157 inmates at the New Mexico State Penitentiary and 139 people were injured. Of these, 33 died. Survivors had a variety of problems resulting from blunt or penetrating trauma, acute intoxication with drugs, or smoke inhalation. Fourteen percent of the casualties arrived at local hospitals in serious or critical condition. A study of the injury patterns revealed a significant difference (P less than .001) in the incidence of severe head trauma in those who had died compared to those who survived. Most of the seriously or critically ill survivors suffered from acute poisoning or from penetrating wounds.

Normal growth despite abnormalities of growth hormone secretion in children treated for acute leukemia.

We have studied the relationship between abnormalities of the growth hormone-somatomedin axis and growth in 26 children previously treated for acute lymphatic leukemia. Each child had previously received cranial irradiation, was in complete clinical and hematologic remission, and off all drugs. The mean standing height SDS of the 26 children was significantly less than normal. There was no significant difference between the mean standing height SDS, height velocity SDS, somatomedin activities, and degree of bone age retardation between the 17 children who received the higher dose of cranial irradiation (Group 1) and the nine who had the lower dose of cranial irradiation (Group II). Furthermore, there was no significant reduction in mean height velocity SDS, somatomedin activity, or bone age in either group when compared to normal age-matched controls. The peak GH responses to both insulin hypoglycemia and an arginine test were significantly lowered in Groups I and II when compared to a control group of children. We conclude that only a minority of children, who previously received cranial irradiation for ALL were clinically GH deficient and, therefore, likely to benefit from GH therapy despite the finding that the majority of these children had reduced GH responses to pharmacologic stimuli.