von Langenbeck procedures at 8 months or Wardill at 18 months for primary repair of cleft palate in adult Swedish patients with unilateral complete cleft lip and palate: A study of facial growth

The purpose of this study was to compare facial growth in patients with unilateral complete cleft lip and palate (UCLP) in whom the palate was repaired with the von Langenbeck procedure at 8 months (L-8), or the Wardill procedure at 18 months (W-18). A total of 151 unaffected subjects were used as a reference series. Sixty-one adult patients, 34 in the L-8 group and 27 in the W-18 group, were investigated clinically and with lateral skull radiography and also filled out a questionnaire about their dental condition. Multiple linear regression was used to analyse the effects of the surgical strategy, sex, and the presence of a velopharyngeal flap on several dependent variables indicating sagittal jaw relations, vertical jaw relations, and inclination of incisors. The UCLP group was characterised by a short (n-sp) and retrusive maxilla (s-n-ss) and a retrusive mandible for women (s-n-sm), larger maxillary inclination (NSL/NL), more retroclined lower incisors (IL_I/ML), shorter upper facial heights (n-sp) and normal total face height (n-gn) than the reference group. In the UCLP group there were significant differences between men and women in mandibular prognathism (s-n-sm), maxillary/mandibular relations (ss-n-sm), maxillary inclination (NSL/NL), total anterior facial height (n-gn), and upper anterior facial height (n-sp). Lateral crossbite was found in 20% of the UCLP group. The prevalence was similar in the L-8 and W-18 groups. Almost 80% of the patients in the UCLP group considered that their dental condition was good. The choice of surgical strategy had no significant influence on the variables measured on facial morphology.     

Histamine regulation of pancreatitis and pancreatic cancer: a review of recent findings

The pancreas is a dynamic organ that performs a multitude of functions within the body. Diseases that target the pancreas, like pancreatitis and pancreatic cancer, are devastating and often fatal to the suffering patient. Histamine and histamine receptors (H1-H4HRs) have been found to play a critical role in biliary diseases. Accordingly, the biliary tract and the pancreas share similarities with regards to morphological, phenotypical and functional features and disease progression, studies related the role of H1-H4HRs in pancreatic diseases are important. In this review, we have highlighted the role that histamine, histidine decarboxylase (HDC), histamine receptors and mast cells (the main source of histamine in the body) play during both pancreatitis and pancreatic cancer. The objective of the review is to demonstrate that histamine and histamine signaling may be a potential therapeutic avenue towards treatment strategies for pancreatic diseases.Key Words: Histamine, pancreas, pancreatitis, pancreatic cancer     

Root resorption diagnosed with cone beam computed tomography after 6 months of orthodontic treatment with fixed appliance and the relation to risk factors

Objectives:To investigate root resorption after 6 months of active orthodontic treatment and its relation to possible risk factors.Materials and Methods:Ninety-seven patients (10–18 years) with a Class I malocclusion and crowding treated with fixed appliance and premolar extractions were examined with cone beam computed tomography before and after 6 months of active treatment. The exposure covered all teeth from first molar to first molar in both jaws. The Malmgren index was used to evaluate the degree of root resorption. Irregular root contour (score 1) was seen in most teeth already before active treatment, and therefore resorptions were registered only as score 2 (<2 mm, minor resorption) or higher.Results:Minor root resorption was noted in 10% of the patients and severe root resorption, >2 mm (score 3) was found in four patients. Root resorption was more frequently seen in the upper jaw, especially the incisors. There was no statistically significant correlation of root resorption with any of the selected risk factors.Conclusions:After 6 months of treatment, clinically significant resorption was diagnosed in 4% of the patients, ie, in 96% of the patients the radiographic examination did not reveal any significant information. The selected risk factors did not have any impact on the amount of resorption after 6 months of active treatment.     

Action perception predicts action performance

Everyday action impairments often are observed in demented older adults, and they are common potential barriers to functional independence. We evaluated whether the ability to segment and efficiently encode activities is related to the ability to execute activities. Further, we evaluated whether brain regions important for segmentation also were important for action performance. Cognitively healthy older adults and those with very mild or mild dementia of the Alzheimer's type watched and segmented movies of everyday activities and then completed the Naturalistic Action Test. Structural MRI was used to measure volume in the dorsolateral prefrontal cortex (DLPFC), medial temporal lobes (MTL), posterior cortex, and anterior cingulate cortex (ACC). Dementia status and the ability to segment everyday activities strongly predicted naturalistic action performance, and MTL volume largely accounted for this relationship. In addition, the current results supported the Omission-Commission Model: Different cognitive and neurological mechanisms predicted different types of action error. Segmentation, dementia severity, and MTL volume predicted everyday omission errors, DLPFC volume predicted commission errors, and ACC volume predicted action additions. These findings suggest that event segmentation may be critical for effective action production, and that the segmentation and production of activities may recruit the same event representation system.     

Quantitative ultrasonography of facial muscles

Introduction: There is no standardized method for examination of facial muscles with ultrasound. The purpose of this study was to identify those facial muscles accessible for reliable identification and to provide reference data. Methods: In healthy subjects all facial muscles were screened for visibility, separation from adjacent muscles, and reliability of landmarks. Bilateral scans of reliable muscles were performed in 40 adult volunteers. Results: Six facial muscles were clearly demarcated with ultrasound. These were: frontalis, orbicularis oculi, orbicularis oris, depressor anguli oris, depressor labii inferioris, and mentalis muscles. Cross-sectional area and muscle thickness showed gender differences and were independently related to age for some muscles. A significant left–right side difference was only seen for the orbicularis oculi muscle in women. Conclusions: These data demonstrate the usefulness of ultrasonography to assess facial muscles and provide reference values that can be applied in the clinical setting. Muscle Nerve 47: 878–883, 2013     

Non-word Repetition Impairment in Autism and Specific Language Impairment: Evidence for Distinct Underlying Cognitive Causes

Language-impaired individuals with autism perform poorly on tests such as non-word repetition that are sensitive clinical markers of specific language impairment (SLI). This has fuelled the theory that language impairment in autism represents a co-morbid SLI. However, the underlying cause of these deficits may be different in each disorder. In a novel task, we manipulated non-word stimuli in three ways known to influence the repetition accuracy of children with SLI. Participants with SLI were affected differently by these manipulations to children with autism. Children with autism performed similarly to language-matched typical children in terms of levels and patterns of performance, and types of error made, suggesting that the underlying cognitive cause of non-word repetition deficits is different in each disorder.     

Verbal and non-verbal working memory in aphasia: What three n-back tasks reveal

Background: Researchers have found that many individuals with aphasia (IWA) present with cognitive deficits that may impact their communication, and perhaps underlie their language-processing deficits (e.g., Erickson et al., 1996 Erickson, E., Goldinger and LaPointe, L. 1996. Auditory vigilance in aphasic individuals: Detecting non-linguistic stimuli with full or divided attention. Brain and Cognition, 30: 244–253. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Murray et al., 1997 Murray, L.L., Holland, A.L. and Beeson, P.M. 1997. Accuracy monitoring and task demand evaluation in aphasia. Aphasiology, 11: 401–414. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar]; Wright et al., 2003 Wright, H. H., Newhoff, M., Downey, R. and Austerman, S. 2003. Additional data on working memory in aphasia. Journal of International Neuropsychological Society, 9: 302 [Google Scholar]). However, many investigations of cognitive ability in aphasia have included measures that may be considered “language heavy”; they require overt lexical, semantic, and/or phonological processing to follow the task instructions and/or formulate a response. Few have considered the amount of linguistic processing required to perform the task. Subsequently, it is not clear if poorer performance by IWA on cognitive tasks compared to neurologically intact (NI) participants is due to a deficit in the respective cognitive domain or due to the inability of IWA to perform the task because of their language difficulties.

Aims: The purpose of the current study was to explore the effect of varying linguistic processing demands in the context of a dynamic working memory task—an n-back task for participants with and without aphasia.

Method & Procedures: This study compared differences on three different n-back tasks within and across groups for individuals with aphasia and NI matched peers. Participants completed three different n-back tasks; stimuli for the tasks varied in “linguistic load”. For each n-back task participants completed two levels of difficulty: 1-back and 2-back.

Outcomes & Results: The aphasia group performed significantly worse than the NI participants across the n-back tasks. All participants performed significantly better with the stimuli that carried a higher linguistic load (i.e., the fruit), than with the fribbles (semi-linguistic) and blocks (non-linguistic). All participants performed significantly better on the 1-back than the 2-back working memory task. Unlike the NI participants, IWA performed equally poorly with the fribbles and the blocks in the 2-back task.

Conclusions: Overall, the performance of individuals with aphasia on working memory tasks that varied in their linguistic load was similar to the control group but reduced. However, unlike the NI participants, IWA were less skilled at rapidly utilising linguistic knowledge to increase performance on the fribbles, demonstrating the further decrement in working memory that results from a decreased ability to utilise a linguistic strategy to increase performance on verbal working memory tasks. The results of this study indicate that language ability has a significant influence on performance on working memory tasks and should be considered when discussing cognitive deficits in aphasia.     

Automated analysis of the Cinderella story

Background: AphasiaBank is a collaborative project whose goal is to develop an archival database of the discourse of individuals with aphasia. Along with databases on first language acquisition, classroom discourse, second language acquisition, and other topics, it forms a component of the general TalkBank database. It uses tools from the wider system that are further adapted to the particular goal of studying language use in aphasia.

Aims: The goal of this paper is to illustrate how TalkBank analytic tools can be applied to AphasiaBank data.

Methods &Procedures: Both aphasic (n?=?24) and non-aphasic (n?=?25) participants completed a 1-hour standardised videotaped data elicitation protocol. These sessions were transcribed and tagged automatically for part of speech. One component of the larger protocol was the telling of the Cinderella story. For these narratives we compared lexical diversity across the groups and computed the top 10 nouns and verbs across both groups. We then examined the profiles for two participants in greater detail.

Conclusions: Using these tools we showed that, in a story-retelling task, aphasic speakers had a marked reduction in lexical diversity and a greater use of light verbs. For example, aphasic speakers often substituted “girl” for “stepsister” and “go” for “disappear”. These findings illustrate how it is possible to use TalkBank tools to analyse AphasiaBank data.     

Comparing monitoring and production based approaches to the treatment of phonological assembly difficulties in aphasia

Background: Waldron, Whitworth, and Howard (2011 Waldron, H., Whitworth, A. and Howard, D. 2011. Therapy for phonological assembly difficulties: A case series. Aphasiology, 25(4): 434–455. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) replicated the auditory and monitoring therapy reported in a single case by Franklin, Buerk, and Howard (2002 Franklin, S., Buerk, F. and Howard, D. 2002. Generalised improvement in speech production for a subject with reproduction conduction aphasia. Aphasiology, 16(10/11): 1087–1114. [Taylor & Francis Online] , [Google Scholar]) with four participants with phonological assembly difficulties. No participant responded in the same way as Franklin et al.’s client MB and, notably, all improvements seen were item-specific, in contrast to MB who had shown generalised improvements in naming, repetition, and reading aloud. Waldron et al. attributed this difference to the combination of underlying impairments in their participants, in particular additional lexical deficits; it remains unknown whether Franklin et al.’s results would be replicated in someone with a more pure phonological assembly difficulty. It is also unknown whether a more direct therapy approach, targeting a reduction in the production of phonological errors, rather than improving monitoring, might also be effective with this client group.

Aims: The current study aimed to compare the effectiveness of the auditory and monitoring therapy reported by Franklin et al. (2002 Franklin, S., Buerk, F. and Howard, D. 2002. Generalised improvement in speech production for a subject with reproduction conduction aphasia. Aphasiology, 16(10/11): 1087–1114. [Taylor & Francis Online] , [Google Scholar]) with a production-focused therapy based on the articulatory kinematic treatment of apraxia of speech (AOS), in a single participant with phonological assembly difficulties.

Methods & Procedures: Participant RE received three consecutive therapy phases: Franklin et al.’s auditory therapy, followed by a new production therapy involving a hierarchy of articulatory kinematic cues and the production of minimal contrast pairs, and finally Franklin et al.’s monitoring therapy. As RE's linguistic profile was similar to that of Franklin et al.’s client, it was predicted that he would make similar gains, i.e., generalised improvement in the production of treated and untreated words, following all three therapy types.

Outcomes & Results: RE's naming of treated items improved significantly after both the production therapy and the monitoring therapy, but naming of untreated items did not improve and there were no naming improvements following the auditory therapy.

Conclusions: Two possible reasons why RE did not respond as predicted are discussed. First, that RE may have had additional lexical retrieval difficulties, in which case therapy could have improved the link between semantics and lexical phonology; and second, that RE may have had additional mild AOS, in which case therapy may have resulted in improved motor planning abilities. Neither of these hypotheses could fully account for all of RE's results. Nonetheless, the production therapy was shown to be an effective alternative approach for clients with phonological assembly difficulties, when a direct focus on speech production is needed.