Evidence for a minimal competence core of consonant sounds in the speech of African American children: A preliminary study

Most studies have stressed those aspects of African American English (AAE) that differ from Standard English (SE) varieties. Therefore word‐ final consonant performance has been investigated most often. In contrast, this intensive study aimed to reveal whether a common core of initial consonants is used by typically developing AAE children at or close to the 3^rd birthday. More than 2000 phonetically transcribed utterances were extracted from the audiovisual archives of natural samples of speech for seven children. All seven children met the productivity criterion for a shared core of 15 sounds in their repertoire of correctly produced word‐initial consonants. The children also met the criterion for using word‐initial consonant clusters or blends that commonly included the stop+sonorant type. The results provided preliminary evidence for a minimal competence core of word‐initial consonants that is consistent with developmental data on typically developing speakers of SE and other languages besides English. Sample sizes of more than 50 spontaneous utterances were required to elicit these core features. Research and clinical implications of these results are discussed.     

Impact of Length of Residence in the United States on Risk of Diabetes and Hypertension in Resettled Refugees

The relationship between resettlement and development of chronic disease has yet to be elucidated in refugees. We aimed to assess the relationship between length of residence in the US and development of diabetes and hypertension utilizing multivariable logistic regression models in a sample of former refugee patients seeking primary care services. Multivariable logistic regression models adjusting for age, gender, and country of origin showed significantly increasing odds of type 2 diabetes (OR 1.12, 95% CI 1.03–1.22, p?<?0.01) and hypertension (OR 1.07, 95% CI 1.00–1.14) with increasing length of stay in the US for resettled refugee adults. A significant proportion of diabetes (26.7%) and hypertension (36.9%) diagnoses were made within one year of arrival, highlighting the critical role of focusing diagnosis and prevention of chronic disease in newly resettled refugees, and continuing this focus throughout follow-up as these patients acculturate to their new homeland.     

The effect on quality of chest compressions and exhaustion of a compression--ventilation ratio of 30:2 versus 15:2 during cardiopulmonary resuscitation--a randomised trial

BACKGROUND: Recent cardio pulmonary resuscitation (CPR) guidelines changed the compression:ventilation ratio in 30:2. OBJECTIVE: To compare the quality of chest compressions and exhaustion using the ratio 30:2 versus 15:2. METHODS: A prospective, randomised crossover design was used. Subjects were recruited from the H.-Hart hospital personnel and the University College Katho for nurses and bio-engineering. Each participant performed 5min of CPR using either the ratio 30:2 or 15:2, then after a 15min rest switched to the other ratio. The data were collected using a questionnaire and an adult resuscitation manikin. The outcomes included exhaustion as measured by a visual analogue scale (VAS) score, depth of chest compressions, rates of chest compressions, total number of chest compressions, number of correct chest compressions and incomplete release. Data were compared using the Wilcoxon Signed Ranks Test. The results are presented as medians and interquartile ranges (IQR). RESULTS: One hundred and thirty subjects completed the study. The exhaustion-score using the VAS was 5.9 (IQR 2.25) for the ratio 30:2 and 4.5 (IQR 2.88) for the ratio 15:2 (P<0.001). The compression depth was 40.5mm (IQR 15.75) for 30:2 and 41mm (IQR 15.5) for 15:2 (P=0.5). The compression rate was 118beats/min (IQR 29) for 30:2 and 115beats/min (IQR 32) for 15:2 (P=0.02). The total number of compressions/5min was 347 (IQR 79) for 30:2 and 244compressions/5min (IQR 72.5) for 15:2 (P<0.001). The number of correct compression/5min was 61.5 (IQR 211.75) for 30:2 and 55.5 (IQR 142.75) for 15:2 (P=0.001). The relative risk (RR) of incomplete release in 30:2 versus 15:2 was 1.087 (95% CI=0.633-1.867). CONCLUSIONS: Although the 30:2 ratio is rated to be more exhausting, the 30:2 technique delivers more chest compressions and the quality of chest compressions remains unchanged.     

Effect of iron deficiency on tissue oxygen delivery in cyanotic congenital heart disease

To test the hypothesis that tissue oxygen delivery would be affected by diminished oxygen stores in cyanotic congenital heart disease, serum ferritin, transferrin saturation, hemoglobin, red cell mean corpuscular volume (MCV), red cell 2,3-diphosphoglycerate (DPG), P50, blood gases, oxygen saturations and systemic oxygen transport were measured in 29 hypoxemic infants and children. For the group, aortic saturation was 81 +/- 9%, PaO2 was 50 +/- 12 mm Hg, hemoglobin 16.2 +/- 2.1 gm/dl and systemic oxygen transport 620 +/- 145 ml/min/m2. P50 was increased above normal values (28.8 +/- 2.3 vs 26.6 +/- 1.1 mm Hg, p less than 0.01), and DPG was 2.35 +/- 0.54 mumol/ml, at the upper limits of normal for this assay. Iron deficiency was present in 8. When patients with P50 greater than or equal to 30 mm Hg and P50 less than 30 mm Hg were compared, iron stores were diminished in the high P50 group: [serum ferritin (19 +/- 8 vs 53 +/- 48 ng/ml, p = 0.0006), transferrin saturation (11 +/- 6 vs 23 +/- 11%, p = 0.003) and MCV (79 +/- 8 vs 86 +/- 4 fl, p = 0.05)]. Hemoglobin, aortic oxygen saturation, PaO2 and systemic oxygen transport were similar in both groups. In children with iron sufficiency, 15 of 21 had MCV greater than 90th percentile for age and sex (p less than 0.001 versus expected distribution). Also, MCV greater than 90th percentile for age and sex had a positive predictive value of 0.88 for iron sufficiency. This study demonstrates that diminished iron stores in cyanotic congenital heart disease are associated with a more right-shifted oxyhemoglobin dissociation curve (increased P50).(ABSTRACT TRUNCATED AT 250 WORDS)     

Who Can I Ask? Who Would I Tell? An Egocentric Network Analysis Among a Sample of Women At-Risk to Explore Anticipated Advice Seeking and Disclosure Around Pre-exposure Prophylaxis (PrEP)

AIDS and Behavior - Pre-Exposure Prophylaxis (PrEP) health campaigns invite women to talk with their provider, partner, and peers about PrEP, though they do not offer specific guidance about who...     

Clinical, laboratory and genetic markers associated with erosions and remission in patients with early inflammatory arthritis: a prospective cohort study

We investigated the relationship between clinical, laboratory and genetic markers and outcome measures in 159 patients with recent onset of inflammatory arthritis (IA). The majority of patients were managed in community-based rheumatology practice. Median duration of arthritis at baseline was 3 months with median follow-up of 4.0 years (range 0–10). Markers of disease activity and 1987 ACR criteria for rheumatoid arthritis (RA) were estimated every 6 months for the first 2 years and annually thereafter. Presence of shared epitopes (SE) was established by PCR-based method. Main outcome variables were attainment of remission and presence of erosions on X-rays of hands and feet at 3 years. Remission was seen in 34.3% of patients and was independently related to age 60 and older (odds ratio (OR) 3.2; 95% confidence interval (CI), 1.2–8.7) and inversely to the presence of rheumatoid factor (RF) (OR 8.3; 95% CI, 3.2–21.3 for persistent arthritis). Patients with two SE were likely to have persistent arthritis (P=0.006), but this was not significant when corrected for RF. Independent predictors for erosions at 3 years were RF (OR 7.5; 95% CI, 1.9–29.5) and area under the curve for number of swollen joints (OR 1.08; 95% CI, 1.02–1.16). SE status was not predictive of erosions at 3 years (OR 1.6; 95% CI, 0.7–3.7). In univariate analysis, patients possessing DERAA motif on DRB1 were less likely to have erosive disease than without this motif at 4 years (OR 0.21; 95% CI, 0.0–0.9, P=0.037) but this finding was partly explained by adjusting for RF (adjusted OR 0.24; 95% CI 0.04–1.37). In this study of recent onset IA, active disease and RF were associated with poor outcome. Whilst SE did not predict erosive disease, patients with DERAA motif may be protected against erosions whilst the presence of two SE alleles suggests persistence of arthritis.     

Value of p63 and podoplanin (D2‐40) immunoreactivity in the distinction between primary cutaneous tumors and adenocarcinomas metastatic to the skin: a clinicopathologic and immunohistochemical study of 79 cases

The distinction of metastatic carcinomas to the skin from poorly differentiated primary cutaneous carcinomas and sometimes primary benign adnexal tumors can pose a significant diagnostic challenge. The purpose of this study was to evaluate the role of p63 and podoplanin (D2‐40) immunoreactivity for separating primary skin tumors vs. cutaneous metastases of carcinomas from internal organs. Thirty seven primary tumors and 42 cutaneous metastatic adenocarcinomas were evaluated. The 37 primary cutaneous tumors included 14 cases of benign adnexal tumors, 9 malignant skin adnexal neoplasms, and 14 primary squamous and basal cell carcinomas. The 42 metastatic adenocarcinomas all corresponded to metastases from patients with a well‐documented history of a primary tumor at another location. We found variable positivity with podoplanin in all primary cutaneous neoplasms including spiradenoma (6/6), hidradenoma (2/4), cylindroma (3/3), desmoplastic trichilemmoma (1/1), poorly differentiated squamous cell carcinoma (4/4), sebaceous carcinoma (1/1), basal cell carcinoma (4/10), trichilemmal carcinoma (2/2), eccrine carcinoma (3/3), microcystic adnexal carcinoma (1/1), adnexal carcinoma NOS (1/1), and porocarcinoma (1/1). In contrast, all metastatic carcinomas were negative (0/42) for podoplanin. In regards to p63, all cases of primary cutaneous tumors were positive for p63 (37/37); in contrast, all cutaneous metastatic carcinomas were negative (0/42). Sensitivity, specificity, and positive and negative predictive values of podoplanin and p63 immunoreactivity to separate primary skin neoplasms from metastatic carcinomas were 78.4, 100.0, 100.0 and 84.0% for podoplanin, respectively, and 100.0, 100.0, 100.0 and 100.0% for p63, respectively. The differences in p63 and podoplanin immunohistochemical expression between primary skin tumors and metastatic carcinomas to the skin were statistically significant (p < 0, 0001). The results of our study suggest that the combined expression of p63 and podoplanin are a useful adjunct for the diagnosis of skin tumors in the clinical setting of a questionable metastasis and may be relatively specific for distinguishing primary skin tumors from metastatic carcinomas to the skin. Plaza JA, Ortega PF, Stockman DL, Suster S. Value of p63 and podoplanin (D2‐40) immunoreactivity in the distinction between primary cutaneous tumors and adenocarcinomas metastatic to the skin: a clinicopathologic and immunohistochemical study of 79 cases.     

Psychological Stressors and Coping Strategies Used by Adolescents Living with and Not Living with Hiv Infection in Nigeria

Little is known about stressful triggers and coping strategies of Nigerian adolescents and whether or not, and how, HIV infection modulates these sources of stress and coping. This study evaluated differences in stressors and coping strategies among Nigerian adolescents based on HIV status. We analysed the data of six hundred 10–19 year old adolescents recruited through a population-based survey from 12 States of Nigeria who self-reported their HIV status. Data on stressors and coping strategies were retrieved by self-report from participants, using a validated structured questionnaire. We compared results between adolescents with and without HIV with respect to identification of specific life events as stressors, and use of specific coping strategies to manage stress. Logistic regression analysis adjusted for age and sex. Adolescents living with HIV (ALHIV) had significantly increased odds of identifying ‘having to visit the hospital regularly’ (AOR: 5.85; 95 % CI: 2.11–16.20; P = 0.001), and ‘having to take drugs regularly’ (AOR: 9.70; 95 % CI: 4.13–22.81; P < 0.001) as stressors; and ‘Seeking social support’ (AOR: 3.14; 95 % CI: 1.99–4.93; p < 0.001) and ‘using mental disengagement’ (OR: 1.64; 95 % CI: 0.49–1.84; p = 0.001) as coping strategies. Adolescents not living with HIV had significantly increased odds of identifying ‘argument with a friend or family member’ as a stressor (AOR: 6.59; 95 % CI: 3.62–11.98; P < 0.001). Life events related to adolescents’ HIV positive status were significant stressors for ALHIV. Providing targeted psychosocial support could help reduce the impact of such HIV status-related stressors on ALHIV.