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1.
Lang Speech ; 67(1): 140-165, 2024 Mar.
Article in English | MEDLINE | ID: mdl-37161280

ABSTRACT

Expanding on psycholinguistic research on linguistic adaptation, the phenomenon whereby speakers change how they comprehend or produce structures as a result of cumulative exposure to less frequent or unfamiliar linguistic structures, this study asked whether speakers can learn semantic and syntactic properties of the American English vernacular negative auxiliary inversion (NAI) structure (e.g., didn't everybody eat, meaning "not everybody ate") during the course of an experiment. Formal theoretical analyses of NAI informed the design of a task in which American English-speaking participants unfamiliar with this structure were exposed to NAI sentences in either semantically ambiguous or unambiguous contexts. Participants rapidly adapted to the interpretive properties of NAI, selecting responses similar to what would be expected of a native speaker after only limited exposure to semantically ambiguous input. On a separate ratings task, participants displayed knowledge of syntactic restrictions on NAI subject type, despite having no previous exposure. We discuss the results in the context of other experimental studies of adaptation and suggest the implementation of top-down strategies via analogy to other familiar structure types as possible explanations for the behaviors observed in this study. The study illustrates the value of integrating insights from formal theoretical research and psycholinguistic methods in research on adaptation and highlights the need for more interdisciplinary and cross-disciplinary work in both experimental and naturalistic contexts to understand this phenomenon.


Subject(s)
Language , Semantics , Humans , Linguistics , Psycholinguistics , Learning
2.
Vet Surg ; 47(8): 1002-1008, 2018 Nov.
Article in English | MEDLINE | ID: mdl-30303548

ABSTRACT

OBJECTIVE: To report outcomes and risk factors for mortality in dogs that underwent surgical management of lung lobe torsion. STUDY DESIGN: Retrospective case series from 5 veterinary teaching hospitals (2005-2017). ANIMALS: Fifty dogs with 52 instances of lung lobe torsion. METHODS: Data collected from medical records included signalment, clinical findings, results of clinicopathologic testing and diagnostic imaging, surgical treatment, lung lobe affected, intraoperative and postoperative complications, histopathologic and microbiologic findings, and outcome. Follow-up was obtained from medical records and telephone contact with primary care veterinarians. RESULTS: Fifty-two instances of lung lobe torsion were identified in 50 dogs, with a median follow-up of 453 days (range, 0-3075). Forty-six (92%) dogs survived to discharge. Dogs with concurrent torsion of the right cranial and middle lung lobes were less likely to survive (2/4) than those with torsion of the left cranial lung lobe (22/22). No other risk factors for mortality prior to hospital discharge were identified. Overall median survival time after hospital discharge was 1369 days. Four dogs had >1 episode of lung lobe torsion. CONCLUSION: The percentage of dogs surviving to discharge after surgical treatment of lung lobe torsion was higher than previously reported. The short- and long-term prognosis was excellent with surgical treatment of lung lobe torsion. CLINICAL SIGNIFICANCE: Surgery should be recommended when lung lobe torsion is suspected because of the high survival to discharge rate and excellent long-term prognosis.


Subject(s)
Dog Diseases/surgery , Lung/pathology , Torsion Abnormality/veterinary , Animals , Dog Diseases/mortality , Dogs , Female , Male , Medical Records , Postoperative Complications/mortality , Postoperative Complications/veterinary , Prognosis , Retrospective Studies , Risk Factors , Torsion Abnormality/surgery , Treatment Outcome , United States
3.
Respir Res ; 7: 142, 2006 Dec 05.
Article in English | MEDLINE | ID: mdl-17147826

ABSTRACT

BACKGROUND: Several studies have reported an association between asthma and gastro-oesophageal reflux, but it is unclear which condition develops first. The role of obesity in mediating this association is also unclear. We explored the associations between respiratory symptoms, lung function, and gastro-oesophageal reflux symptoms in a birth cohort of approximately 1000 individuals. METHODS: Information on respiratory symptoms, asthma, atopy, lung function and airway responsiveness was obtained at multiple assessments from childhood to adulthood in an unselected birth cohort of 1037 individuals followed to age 26. Symptoms of gastro-oesophageal reflux and irritable bowel syndrome were recorded at age 26. RESULTS: Heartburn and acid regurgitation symptoms that were at least "moderately bothersome" at age 26 were significantly associated with asthma (odds ratio = 3.2; 95% confidence interval = 1.6-6.4), wheeze (OR = 3.5; 95% CI = 1.7-7.2), and nocturnal cough (OR = 4.3; 95% CI = 2.1-8.7) independently of body mass index. In women reflux symptoms were also associated with airflow obstruction and a bronchodilator response to salbutamol. Persistent wheezing since childhood, persistence of asthma since teenage years, and airway hyperresponsiveness since age 11 were associated with a significantly increased risk of heartburn and acid regurgitation at age 26. There was no association between irritable bowel syndrome and respiratory symptoms. CONCLUSION: Reflux symptoms are associated with respiratory symptoms in young adults independently of body mass index. The mechanism of these associations remains unclear.


Subject(s)
Asthma/epidemiology , Gastroesophageal Reflux/epidemiology , Population Surveillance , Respiratory Physiological Phenomena , Adolescent , Adult , Asthma/physiopathology , Bronchial Hyperreactivity/epidemiology , Child , Child, Preschool , Cohort Studies , Cough/epidemiology , Cross-Sectional Studies , Female , Gastroesophageal Reflux/physiopathology , Heartburn/epidemiology , Humans , Irritable Bowel Syndrome/epidemiology , Longitudinal Studies , Male , New Zealand/epidemiology , Odds Ratio , Prevalence , Respiratory Function Tests , Respiratory Sounds , Risk Factors , Sex Distribution , Sex Factors
4.
Am J Respir Crit Care Med ; 171(5): 440-5, 2005 Mar 01.
Article in English | MEDLINE | ID: mdl-15557135

ABSTRACT

RATIONALE: Several studies have identified an association between asthma and obesity in women. It remains unclear if this association is due to genuine asthma or to symptoms caused by overweight, at what age the association develops, and whether it is confined to females. OBJECTIVE: To explore the relations between body mass index, asthma, and atopy in a birth cohort of approximately 1,000 individuals. METHODS: Information on asthma and measurements of lung function, airway responsiveness, and atopy were obtained on multiple occasions between ages 9 and 26. Associations between these outcomes and body mass index were analyzed using generalized mixed linear regression models. Further analyses adjusted for potential covariates including breastfeeding, birth order, parental asthma, and personal and family smoking history. MAIN RESULTS: Body mass index was positively associated with asthma, wheeze, asthma treatment, atopy, immunoglobulin E, and inversely with the FEV(1)/FVC ratio in females. There was no significant association with airway responsiveness to methacholine or salbutamol. There was little evidence of an association between body mass index and asthma or atopy in males. Analyses adjusting for potential covariates showed similar findings. Asthma was not associated with a raised body mass index in childhood and childhood asthma did not lead to being overweight as an adult. CONCLUSIONS: A raised body mass index is associated with asthma and atopy in women but not men. Population attributable fraction calculations estimate that 28% (95% confidence interval 7-45) of asthma developing in women after age 9 is due to overweight.


Subject(s)
Asthma/epidemiology , Body Mass Index , Adolescent , Adult , Age Factors , Asthma/physiopathology , Child , Child, Preschool , Cohort Studies , Cross-Sectional Studies , Female , Humans , Male , Multivariate Analysis , New Zealand/epidemiology , Regression Analysis , Respiratory Function Tests , Respiratory Sounds , Sex Factors
5.
Sleep Breath ; 8(2): 61-72, 2004 Jun.
Article in English | MEDLINE | ID: mdl-15211390

ABSTRACT

STUDY OBJECTIVE: To examine levels of sleep-disordered breathing, daytime sleepiness, and impaired performance in 60 motor vehicle crash drivers and 60 controls matched for age, gender, and body mass index. MEASUREMENTS AND RESULTS: All participants underwent polysomnography and daytime function assessments. Cases reported significantly higher levels of driver sleepiness (% sleepiness: mean +/- SD; cases: 26 +/- 17%; controls: 16 +/- 12%; p = 0.003) and demonstrated slower reaction times on a sustained attention task ( p = 0.02). There was a trend for more objective sleepiness in cases (maintenance of wakefulness test: cases: 17 +/- 4 minutes; controls: 18 +/- 3 minutes, p = 0.06) despite no differences in general subjective sleepiness (Epworth score: cases: 8 +/- 4; controls: 8 +/- 4; p = 0.93). There were no significant differences in polysomnography measures between groups (apneas + hypopneas per hour slept: cases: 8 +/- 9; controls: 9 +/- 16; p = 0.89; arousals per hour slept: cases: 18 +/- 8; controls: 21 +/- 12; p = 0.11). CONCLUSION: Crash drivers demonstrated significantly more driver sleepiness, slower reaction times and a trend for greater objective sleepiness compared with well-matched controls. However, the findings in crash drivers were independent of medical causes of sleep fragmentation, with both cases and controls showing moderate levels of unrecognized mild sleep-disordered breathing. Crash prevention strategies should focus on increasing personal awareness of the risks of sleepiness behind the wheel in all individuals.


Subject(s)
Accidents, Traffic/statistics & numerical data , Automobile Driving/statistics & numerical data , Circadian Rhythm , Disorders of Excessive Somnolence/epidemiology , Sleep Apnea Syndromes/epidemiology , Adult , Body Mass Index , Case-Control Studies , Disorders of Excessive Somnolence/diagnosis , Electroencephalography , Fatigue/epidemiology , Female , Health Status , Humans , Male , Middle Aged , Polysomnography , Reaction Time , Severity of Illness Index , Sleep Apnea Syndromes/diagnosis , Surveys and Questionnaires
6.
Respirology ; 9(2): 215-21, 2004 Jun.
Article in English | MEDLINE | ID: mdl-15182272

ABSTRACT

BACKGROUND: Short-acting beta-agonists (SABAs) are associated with reduced lung function and increased bronchial hyper-responsiveness. Earlier studies have failed to show that these changes are clinically important when SABAs are taken regularly in modest doses. However, some patients use SABAs to excess, especially with deteriorating asthma. Our aim was to establish whether adverse effects of SABAs are greater at higher than normal doses and after withdrawing inhaled corticosteroid (ICS) therapy. METHODOLOGY: This was a randomized controlled study. The treatments were salbutamol/ipratropium 100 microg/20 microg/puff or ipratropium 20 microg/puff, each 12 puffs daily. Phase 1 was of 2 weeks duration. During phase 2 ICS were withdrawn until loss of control (LOC) occurred. RESULTS: During phase 1 the mean FEV1 fell by 9.3% with salbutamol (0.26 L; 95% C.I. 0.13, 0.39), but by only 1.6% with ipratropium (0.05 L; 95% C.I. -0.06, 0.16; P = 0.006). During phase 2 FEV1 fell by a further 18.9% with salbutamol (0.54 L; 95% C.I. 0.39, 0.69), but by only 10.5% (0.33 L; 95% C.I. 0.17, 0.49; P = 0.032) with ipratropium. Time to LOC was significantly shorter with salbutamol (8.9 days) compared to ipratropium (16.8 days; P = 0.03). CONCLUSION: Adverse changes in lung function with SABA appear to be greater with higher doses and increasing airway inflammation. This highlights the risks of excessive SABA use in patients who neglect ICS therapy and/or who rely on 'relievers'.


Subject(s)
Adrenergic beta-Agonists/adverse effects , Albuterol/adverse effects , Asthma/drug therapy , Bronchodilator Agents/adverse effects , Ipratropium/adverse effects , Adrenergic beta-Agonists/administration & dosage , Adult , Albuterol/administration & dosage , Area Under Curve , Asthma/prevention & control , Bronchodilator Agents/administration & dosage , Female , Forced Expiratory Volume , Humans , Ipratropium/administration & dosage , Male , Middle Aged
7.
N Engl J Med ; 349(15): 1414-22, 2003 Oct 09.
Article in English | MEDLINE | ID: mdl-14534334

ABSTRACT

BACKGROUND: The outcome of childhood asthma in adults has been described in high-risk cohorts, but few population-based studies have reported the risk factors for persistence and relapse. METHODS: We assessed children born from April 1972 through March 1973 in Dunedin, New Zealand, repeatedly from 9 to 26 years of age with questionnaires, pulmonary-function tests, bronchial-challenge testing, and allergy testing. RESULTS: By the age of 26 years, 51.4 percent of 613 study members with complete respiratory data had reported wheezing at more than one assessment. Eighty-nine study members (14.5 percent) had wheezing that persisted from childhood to 26 years of age, whereas 168 (27.4 percent) had remission, but 76 (12.4 percent) subsequently relapsed by the age of 26. Sensitization to house dust mites predicted the persistence of wheezing (odds ratio, 2.41; P=0.001) and relapse (odds ratio, 2.18; P=0.01), as did airway hyperresponsiveness (odds ratio for persistence, 3.00; P<0.001; odds ratio for relapse, 3.03; P<0.001). Female sex predicted the persistence of wheezing (odds ratio, 1.71; P=0.03), as did smoking at the age of 21 years (odds ratio, 1.84; P=0.01). The earlier the age at onset, the greater the risk of relapse (odds ratio, 0.89 per year of increase in the age at onset; P<0.001). Pulmonary function was consistently lower in those with persistent wheezing than in those without persistent wheezing. CONCLUSIONS: In an unselected birth cohort, more than one in four children had wheezing that persisted from childhood to adulthood or that relapsed after remission. The factors predicting persistence or relapse were sensitization to house dust mites, airway hyperresponsiveness, female sex, smoking, and early age at onset. These findings, together with persistently low lung function, suggest that outcomes in adult asthma may be determined primarily in early childhood.


Subject(s)
Asthma , Adolescent , Adult , Age of Onset , Asthma/classification , Asthma/physiopathology , Bronchial Hyperreactivity/diagnosis , Child , Child, Preschool , Cohort Studies , Disease Progression , Environmental Exposure , Female , Humans , Longitudinal Studies , Male , New Zealand , Pyroglyphidae/immunology , Recurrence , Respiratory Function Tests , Respiratory Sounds/immunology , Respiratory Sounds/physiopathology , Risk Factors , Sex Factors , Smoking/adverse effects , Surveys and Questionnaires
8.
Lancet ; 360(9337): 901-7, 2002 Sep 21.
Article in English | MEDLINE | ID: mdl-12354471

ABSTRACT

BACKGROUND: Breastfeeding is widely advocated to reduce risk of atopy and asthma, but the evidence for such an effect is conflicting. We aimed to assess long-term outcomes of asthma and atopy related to breastfeeding in a New Zealand birth cohort. METHODS: Our cohort consisted of 1037 of 1139 children born in Dunedin, New Zealand, between April, 1972, and March, 1973, and residing in Otago province at age 3 years. Children were assessed every 2-5 years from ages 9 to 26 years with respiratory questionnaires, pulmonary function, bronchial challenge, and allergy skin tests. History of breastfeeding had been independently recorded in early childhood. FINDINGS: 504 (49%) of 1037 eligible children were breastfed (4 weeks or longer) and 533 (51%) were not. More children who were breastfed were atopic at all ages from 13 to 21 years to cats (p=0.0001), house dust mites (p=0.0010), and grass pollen (p<0.0001) than those who were not. More children who were breastfed reported current asthma at each assessment between age 9 (p=0.0008) and 26 years (p=0.0008) than those who were not. Breastfeeding effects were not affected by parental history of hayfever or asthma. Multifactor analysis controlling for socioeconomic status, parental smoking, birth order, and use of sheepskin bedding in infancy, showed odds ratios of 1.94 (95% CI 1.42-2.65, p<0.0001) for any allergen positive at age 13 years, 2.40 (1.36-4.26, p=0.0003) for current asthma at 9 years, and 1.83 (1.35-2.47, p<0.0001) for current asthma at 9-26 years by repeated-measures analysis. INTERPRETATION: Breastfeeding does not protect children against atopy and asthma and may even increase the risk.


Subject(s)
Asthma/etiology , Breast Feeding/adverse effects , Hypersensitivity/etiology , Adult , Allergens , Animals , Asthma/epidemiology , Cats , Child , Dust , Female , Humans , Hypersensitivity/epidemiology , Infant, Newborn , Longitudinal Studies , Male , New Zealand/epidemiology , Respiratory Sounds , Risk
9.
Pediatr Pulmonol ; 34(3): 164-71, 2002 Sep.
Article in English | MEDLINE | ID: mdl-12203844

ABSTRACT

The clinical outcome of asymptomatic airway hyperresponsiveness (AHR) first detected in childhood is sparsely reported, with conflicting results. We used a birth cohort of 1,037 children followed to age 26 years to assess the clinical outcome of asymptomatic AHR to methacholine first documented in study members at age 9 years. Of 547 study members who denied wheezing symptoms ever at age 9 years, 41 (7.5%) showed AHR. Forty showed methacholine responsiveness, with a provocation concentration of methacholine that elicited a 20% drop in forced expired volume in 1 sec (PC(20)) < or = 8 mg/mL, and one had baseline airway obstruction with a bronchodilator response exceeding 10%. Of these 41 study members, 18 (44%), 11 (27%), and 4 (10%) maintained AHR in 1, 2, and 3 later assessments, respectively, while 23 (56%) manifested AHR only at age 9. Compared with asymptomatic study members without AHR, those with asymptomatic AHR at age 9 years were more likely to report asthma and wheeze at any subsequent assessment, were more likely to have high IgE levels and eosinophils at ages 11 and 21, and more often demonstrated positive responses to skin allergen testing at ages 13 and 21 years. Persistent AHR at later assessments increased these likelihoods further.In conclusion, asymptomatic children with AHR are more likely to develop asthma and atopy later in life compared with asymptomatic children without AHR. Persistent AHR, even though initially asymptomatic, was associated with an even greater increased risk of development of asthma. We suggest that rather than considering AHR as a marker of asthma, it should be regarded as a parallel pathological process that may lead to subsequent symptoms and clinical evidence of asthma.


Subject(s)
Asthma/epidemiology , Hypersensitivity/epidemiology , Adolescent , Adult , Asthma/physiopathology , Bronchial Hyperreactivity , Bronchial Provocation Tests , Child , Child, Preschool , Follow-Up Studies , Humans , Hypersensitivity/physiopathology , Spirometry
10.
J Allergy Clin Immunol ; 110(2): 220-7, 2002 Aug.
Article in English | MEDLINE | ID: mdl-12170261

ABSTRACT

BACKGROUND: Predictors of hospital admissions for asthma in children and young adults in a general population are not well defined, because most studies have used selected subpopulations. OBJECTIVE: The purpose of this investigation was to determine risk factors for single and multiple hospital admissions for asthma. METHODS: The members of a population-based, unselected birth cohort of 1037 New Zealanders answered questionnaires and underwent lung function, airway responsiveness, and allergy testing on 7 occasions to the age of 26 years. RESULTS: Among the 766 study members (74% of the cohort) who reported wheezing symptoms ever by the age of 26 years, 136 hospitalizations were reported by 62 individuals (8.3% of those at risk, 6.2% of the total cohort). Only 55 of these 136 admissions involved children less than 9 years of age; admissions continued to occur between the ages of 9 and 18 years (40 admissions) and at >18 years (41 admissions). Those admitted were predominantly male, had earlier ages of onset of symptoms, were more atopic, and had more airway hyperresponsiveness to methacholine than those not admitted. Frequent symptoms and low lung function were evident among the 45 study members with single admissions and even more evident among the 17 study members with multiple (2-10) admissions. CONCLUSIONS: A surprisingly large fraction of this unselected population experienced hospitalization for asthma during the 26-year follow-up, many being admitted in later childhood, adolescence, and early adulthood. Clinical characteristics and markers of severity, including frequent respiratory symptoms, airway hyperresponsiveness, atopy, and low lung function, identify those at high risk for hospitalization for asthma, particularly with respect to multiple admissions.


Subject(s)
Asthma/epidemiology , Hospitalization/statistics & numerical data , Patient Admission/statistics & numerical data , Adolescent , Adult , Asthma/drug therapy , Asthma/immunology , Asthma/physiopathology , Child , Child, Preschool , Female , Humans , Longitudinal Studies , Male , New Zealand/epidemiology , Patient Readmission/statistics & numerical data , Population Surveillance , Respiratory Function Tests , Risk Factors , Surveys and Questionnaires
11.
Am J Respir Crit Care Med ; 165(11): 1480-8, 2002 Jun 01.
Article in English | MEDLINE | ID: mdl-12045120

ABSTRACT

Airway remodeling may lead to irreversible loss of lung function in asthma. The impact of childhood asthma, airway responsiveness, atopy, and smoking on airway remodeling was investigated in a birth cohort studied longitudinally to age 26. A low postbronchodilator ratio of forced exhaled volume in 1 second (FEV1) to vital capacity (VC) at age 18 or 26 was used as a marker of airway remodeling. "Normal" study members with no history of asthma ever, no wheezing in the last year, and no smoking ever were used to determine sex- and age-specific reference values for this ratio. The lower limit of normal was defined as the mean ratio minus 1.96 standard deviation, delimiting the 2.5% of the normal population with the lowest FEV1/VC ratio. A low postbronchodilator FEV1/VC ratio was found in 7.4% and 6.4% of study members at ages 18 and age 26 and 4.6% at both assessments. Lung function was low throughout childhood in those with a consistently low postbronchodilator FEV1/VC ratio at both ages. Those with consistently low postbronchodilator ratios also showed a greater decline in the prebronchodilator FEV1/VC ratio from ages 9 to 26 compared with those with normal postbronchodilator ratios at both ages (males, -12% versus -6%, p < 0.0001; females, -10.5% versus -5.5%, p < 0.01). Asthma, male sex, airway hyperresponsiveness, and low lung function in childhood were each independently associated with a low postbronchodilator FEV1/VC ratio, which in turn was associated with an accelerated decline in lung function and decreased reversibility. These data suggest that airway remodeling in asthma, as manifested by impaired lung function, begins in childhood and continues into adult life.


Subject(s)
Asthma/epidemiology , Asthma/physiopathology , Bronchodilator Agents/therapeutic use , Forced Expiratory Volume/physiology , Vital Capacity/physiology , Adolescent , Adult , Age Distribution , Age of Onset , Asthma/diagnosis , Asthma/drug therapy , Biomarkers , Bronchial Hyperreactivity , Case-Control Studies , Child , Cohort Studies , Female , Humans , Longitudinal Studies , Male , Patch Tests , Predictive Value of Tests , Prevalence , Probability , Reference Values , Respiratory Function Tests , Risk Factors , Sensitivity and Specificity , Severity of Illness Index , Sex Distribution
12.
Respirology ; 7(2): 133-9, 2002 Jun.
Article in English | MEDLINE | ID: mdl-11985736

ABSTRACT

BACKGROUND: Asthma self-management plans (SMP) are widely recommended for use, but there is little information regarding the degree of patient adherence to their instructions. The aim of the present study was to perform a descriptive analysis of patient responses to worsening asthma with regard to using individualized SMP. METHODS: Diary data were obtained from an earlier 2 year study in which patients used regularly revised SMP in combination with daily recordings of peak expiratory flow (PEF) and symptoms to manage intercurrent asthma episodes. Based on PEF and symptom changes, the SMP contained instructions about increasing the dose of inhaled corticosteroid (ICS) or commencing oral prednisone during worsening asthma, depending on severity. Data from 165 patient diaries were analysed. First, documented responses to episodes of worsening asthma were matched against SMP instructions and adherence was determined using a priori criteria. Second, each occasion when the ICS dose was increased or prednisone was commenced was identified and changes in PEF and/or symptoms that may have led to these actions were sought. RESULTS: Adherence for increasing the ICS dose was dependent on asthma severity, ranging from 78% during severe episodes to 31% during mild short-lived events. When oral prednisone was indicated, patients were adherent on 56% of occasions. Symptoms prompted intervention more frequently than changes in PEF. Significant changes in PEF were absent on 41 and 48% of occasions for ICS dose increase and oral prednisone use, respectively. CONCLUSIONS: Adherence to asthma SMP is variable and often poor. It tends to increase in proportion to the severity and duration of an asthma episode. This underscores the importance of SMP in more severe asthma. Symptoms are more important then PEF in prompting patients to alter treatment. This ought to modify our approach in constructing individual asthma SMP.


Subject(s)
Anti-Inflammatory Agents/therapeutic use , Asthma/drug therapy , Glucocorticoids/therapeutic use , Patient Compliance , Prednisone/therapeutic use , Adult , Female , Humans , Male , Middle Aged , Retrospective Studies
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