Informational masking influences segmental and suprasegmental speech categorization.

Auditory categorization requires listeners to integrate acoustic information from multiple dimensions. Attentional theories suggest that acoustic dimensions that are informative attract attention and therefore receive greater perceptual weight during categorization. However, the acoustic environment is often noisy, with multiple sound sources competing for listeners' attention. Amid these adverse conditions, attentional theories predict that listeners will distribute attention more evenly across multiple dimensions. Here we test this prediction using an informational masking paradigm. In two experiments, listeners completed suprasegmental (focus) and segmental (voicing) speech categorization tasks in quiet or in the presence of competing speech. In both experiments, the target speech consisted of short words or phrases that varied in the extent to which fundamental frequency (F0) and durational information signalled category identity. To isolate effects of informational masking, target and competing speech were presented in opposite ears. Across both experiments, there was substantial individual variability in the relative weighting of the two dimensions. These individual differences were consistent across listening conditions, suggesting that they reflect stable perceptual strategies. Consistent with attentional theories of auditory categorization, listeners who relied on a single primary dimension in quiet shifted towards integrating across multiple dimensions in the presence of competing speech. These findings demonstrate that listeners make greater use of the redundancy present in speech when attentional resources are limited.

The effectiveness of exercise interventions to increase physical activity in Cystic Fibrosis: A systematic review.

Physical activity (PA) and exercise have numerous benefits in Cystic Fibrosis (CF) including improved lung function, exercise capacity and quality of life. Despite these benefits, the effectiveness of interventions to promote PA in this population are still largely unknown. The objective of this review was to synthesise existing research and determine whether exercise interventions are effective in promoting PA in people with CF. Using the PRISMA guidelines, a comprehensive search was conducted. Fifteen studies (463 participants) met the inclusion criteria. Eleven studies demonstrated improvements in PA in both short- and long-term interventions. However, the interventions were variable across the included studies, with a large inconsistency in PA assessment tools used. Aerobic training and activity counselling were the two elements identified in this review which most consistently improved PA. Future research should consider larger sample sizes and the use of accurate instruments to assess and track PA levels longitudinally.

How does muscularity assessed by bedside methods compare to computed tomography muscle area at intensive care unit admission? A pilot prospective cross-sectional study.

BACKGROUND: Low muscularity and malnutrition at intensive care unit (ICU) admission have been associated with negative clinical outcomes. There are limited data available evaluating the validity of bedside techniques to measure muscle mass in critically ill adults. We aimed to compare bedside methods for muscle mass assessment [bioimpedance spectroscopy (BIS), arm anthropometry and subjective physical assessment] against reference technology [computed tomography (CT)] at ICU admission. METHODS: Adults who had CT scanning at the third lumbar area <72 h after ICU admission were prospectively recruited. Bedside methods were performed within 48 h of the CT scan. Pearson's correlation compared CT muscle area with BIS-derived fat-free mass (FFM) (kg) and FFM-Chamney (kg) (adjusted for overhydration), mid-upper arm circumference (cm) and mid-arm muscle circumference (cm). Depleted muscle stores were determined using published thresholds for each method. Cohen's kappa (κ) was used to evaluate the agreement between bedside and CT assessment of muscularity status (normal or low). RESULTS: Fifty participants were enrolled. There were strong correlations between CT muscle area and FFM values and mid-arm muscle circumference (P < 0.001). Using FFM-Chamney, all six (100%) participants with low CT muscle area were detected (κ = 0.723). FFM-BIS, arm anthropometry and subjective physical assessment methods detected 28%-38% of participants with low CT muscle area. CONCLUSIONS: BIS-derived FFM using an adjustment algorithm for overhydration was correlated with CT muscle area and had good agreement with muscularity status assessed by CT image analysis. Arm anthropometry and subjective physical assessment techniques were not able to reliably detect participants with low CT muscle area.

Post-feeding behavior in crayfish (Procambarus clarkii): Description of an invertebrate behavioral satiety sequence.

Previous studies have demonstrated that food consumption induces the behavioral satiety sequence (BSS) in some animals, a characteristic series of activities which include exploration, grooming, and resting. The BSS, while valuable in assessing the effects of drugs on food intake, has not been widely studied in non-mammalian species. Our experiment examined post-feeding behavior in crayfish using continuous recording of five behaviors: feeding, walking, grooming, leg wave, and quiescence. We found that food intake, but not sham feeding, significantly decreased feeding behavior, increased leg wave, and increased quiescence. Walking and grooming were not significantly altered by food intake. These findings indicate that post-feeding behaviors in crayfish share some characteristics with the mammalian BSS. Detailed descriptions of post-ingestive behavior in invertebrates may contribute to the development of drugs targeting feeding behaviors in medically and economically important species.

Response and place learning in crayfish spatial behavior.

Previous studies have demonstrated that animals use both environmental cues and egocentric information when orienting in mazes or nature. These two strategies have been examined separately in some species, yielding information on the specific properties associated with each. We examined spatial learning in crayfish (Orconectes rusticus) using an apparatus that required animals to orient under four different conditions: using egocentric (response) cues alone, response cues with inconsistent external (place) cues present, place cues with inconsistent response cues present, and place cues with consistent response cues present. Results demonstrated that crayfish could successfully learn a maze task using response cues alone and when external visual and tactile cues provided inconsistent information. Animals were markedly less successful at learning the task using place cues while disregarding inconsistent response information. We also found that more animals learned successfully when response and external cues were presented in a redundant format where both cues indicated the correct turn. Finally, we found that some crayfish were able to learn a single reversal when trained using response information alone and when response and external cues were presented in the redundant format. We consider these results in the light of findings from other species, and ideas on learning strategy properties, ecological relevance of strategies, and the possible role of stress coping style in crayfish learning.

Risk of malignant progression in Barrett's esophagus indefinite for dysplasia.

Barrett's esophagus is a well-recognized risk factor for esophageal adenocarcinoma. The natural history of Barrett's esophagus classified as 'indefinite for dysplasia' (IND) is poorly characterized. The aim of this study is to characterize the natural history of IND by determining the rate of neoplastic progression and identifying risk factors for progression. Patients from the University of Pennsylvania Health System pathology database and Barrett's esophagus registry with a diagnosis of IND between 2000 and 2014 were identified. Exclusion criteria included: (1) prior diagnosis of low-grade dysplasia (LGD), high-grade dysplasia (HGD), or esophageal adenocarcinoma (EAC); (2) presence of LGD, HGD, or EAC at the time of diagnosis of IND; and (3) lack of follow-up endoscopy after diagnosis. Patients with neoplastic progression were classified as having either prevalent disease (LGD, HGD, or EAC on surveillance biopsy within 12 months of IND diagnosis) or incident disease (LGD, HGD, or EAC on surveillance biopsy >12 months after IND diagnosis). One hundred six patients were eligible for analysis. Of 87 patients with follow-up endoscopy and biopsies within 1 year of IND diagnosis, 7 (8%) had prevalent disease (2 LGD, 4 HGD, 1 EAC). The prevalence of LGD was 2.3%, HGD was 4.6%, and EAC was 1.1%. Importantly, four of the seven prevalent (2 LGD, 2 HGD) cases were found to have dysplasia within 6 months of IND diagnosis. No demographic or endoscopic characteristics studied were associated with prevalent disease. Of the 106 IND patients, there were 66 patients without prevalent dysplasia with >1-year follow-up. Three (4.5%) progressed (1 to LGD after 12 months, 2 to HGD after 16.5 and 28 months), yielding an incidence rate for any dysplasia of 1.4 cases/100 person-years and HGD/EAC of 0.9/100 person-years. Risk factors for incident disease were smoking (p = 0.02) and Barrett's esophagus segment length (p = 0.03). IND is associated with considerable risk of prevalent dysplasia, especially within the first 6 months after diagnosis. However, the incidence of HGD/EAC is low and similar to previous studies of IND. These data suggest that IND patients should have repeat endoscopy within 6 months with careful surveillance protocols. Longer BE length and smoking history may help predict which patients are more likely to develop dysplasia, and therefore identify patients who may warrant even closer monitoring.

Comparison of Field Measurements to Methane Emissions Models at a New Landfill.

Estimates of methane emissions from landfills rely primarily on models due to both technical and economic limitations. While models are easy to implement, there is uncertainty due to the use of parameters that are difficult to validate. The objective of this research was to compare modeled emissions using several greenhouse gas (GHG) emissions reporting protocols including: (1) Intergovernmental Panel on Climate Change (IPCC); (2) U.S. Environmental Protection Agency Greenhouse Gas Reporting Program (EPA GHGRP); (3) California Air Resources Board (CARB); and (4) Solid Waste Industry for Climate Solutions (SWICS), with measured emissions data collected over three calendar years from a young landfill with no gas collection system. By working with whole landfill measurements of fugitive methane emissions and methane oxidation, the collection efficiency could be set to zero, thus eliminating one source of parameter uncertainty. The models consistently overestimated annual methane emissions by a factor ranging from 4-31. Varying input parameters over reasonable ranges reduced this range to 1.3-8. Waste age at the studied landfill was less than four years and the results suggest the need for measurements at additional landfills to evaluate the accuracy of the tested models to young landfills.

Heart Rate Variability: A Risk Factor for Female Sexual Dysfunction.

Heart rate variability (HRV) is a measure of autonomic nervous system activity, which reflects an individual's ability to adapt to physiological and environmental changes. Low resting HRV has been linked to several mental health conditions, including depression, anxiety, and alcohol dependence (Kemp et al. in Biological Psychiatry 67(11):1067-1074, 2010. doi:10.1016/j.biopsych.2009.12.012; Kemp et al. in PloS One, 7(2):e30777, 2012; Quintana et al. in Drug and Alcohol Dependence, 132(1-2):395-398, 2013. doi:10.1016/j.drugalcdep.2013.02.025). HRV has also been used as a method for indexing the relative balance of sympathetic nervous system (SNS) activity to parasympathetic nervous system activity. This balance--in particular, moderately dominant SNS activity--has been shown to play a significant role in women's genital sexual arousal in the laboratory; however, the role of SNS activity in clinically relevant sexual arousal function is unknown. The present study assessed the feasibility of using HRV as an index of women's self-reported sexual arousal function outside the laboratory. Sexual arousal function, overall sexual function, and resting HRV were assessed in 72 women, aged 18-39. Women with below average HRV were significantly more likely to report sexual arousal dysfunction (p < .001) and overall sexual dysfunction (p < .001) than both women with average HRV and women with above average HRV. In conclusion, low HRV may be a risk factor for female sexual arousal dysfunction and overall sexual dysfunction.

Linguistic changes in expressive writing predict psychological outcomes in women with history of childhood sexual abuse and adult sexual dysfunction.

An expressive writing treatment was recently reported to reduce depressive symptoms and improve sexual function and satisfaction in a sample of female survivors of childhood sexual abuse (Meston, Lorenz, & Stephenson, 2013). We conducted a linguistic analysis of this data to determine whether pre- to posttreatment changes in participants' language use were associated with the improvements in sexuality and depression. Linguistic Inquiry and Word Count (LIWC), a program that counts the use of word categories within a text, was used to evaluate the impact of several word categories, previously associated with changes in mental health (Frattaroli, 2006), and shown to differ between childhood sexual abuse survivors and nonabused women (Lorenz & Meston, 2012), on treatment outcomes. A reduction in the use of the word "I" and an increase in positive emotion words were associated with decreased depression symptoms. A reduction in the use of "I" and negative emotion words were associated with improvement in sexual function and sexual satisfaction. The findings suggest that, because language may serve as an implicit measure of depression and sexual health, monitoring language changes during treatment may provide a reliable indicator of treatment response free of the biases of traditional self-report assessments.

Adherence to the 2011 American Gastroenterological Association medical position statement for the diagnosis and management of Barrett's esophagus.

Considerable variability exists in adherence to practice guidelines for Barrett's esophagus (BE). Rapid advances in management approaches to BE led to a new American Gastroenterological Association (AGA) medical position statement in 2011. Our aim was to assess how well members of the AGA Clinical Practice section adhered to these guidelines. A self-administered survey incorporating questions on diagnostic criteria, cancer risk estimates, screening, surveillance, and therapeutics for BE was distributed electronically to 5850 North American members of the AGA Clinical Practice section. The response rate was 470 of 2040 opened e-mails (23%). Intestinal metaplasia was required for diagnosis of BE by 90%, but the Prague classification was used by only 53% of those aware of it. The annual risk of progression to esophageal adenocarcinoma was reported as 0.1-0.5% by 76%. Screening practices were variable, with 35% screening all patients with chronic gastroesophageal reflux disease and 15% repeating endoscopy in patients with gastroesophageal reflux disease following a negative screening. Surveillance guidelines were followed by 79% for nondysplastic BE and 86% for low-grade dysplasia, with expert pathology confirmation of dysplasia reported by 86%. Proton pump inhibitor dosing was variable, with 18% administering twice-daily doses and 30% titrating dose to symptoms. Ablation therapy was recommended by 6% for nondysplastic BE, 38% for low-grade dysplasia, and 52% for high-grade dysplasia. There is satisfactory adherence to the new AGA guidelines with respect to diagnosis, cancer risk estimates, and surveillance intervals in a select group of respondents. However, adherence continues to be variable in the use of the Prague classification, screening, and dosing of antisecretory therapy. Use of ablation therapy increases with grade of dysplasia. The reason for continued variability in adherence to BE practice guidelines remains unclear, and more evidence-based guidance is required to enhance clinical practice.

Surveillance of diarrhoea in small animal practice through the Small Animal Veterinary Surveillance Network (SAVSNET).

Using the Small Animal Veterinary Surveillance Network (SAVSNET), a national small animal disease-surveillance scheme, information on gastrointestinal disease was collected for a total of 76 days between 10 May 2010 and 8 August 2011 from 16,223 consultations (including data from 9115 individual dogs and 3462 individual cats) from 42 premises belonging to 19 UK veterinary practices. During that period, 7% of dogs and 3% of cats presented with diarrhoea. Adult dogs had a higher proportional morbidity of diarrhoea (PMD) than adult cats (P <0.001). This difference was not observed in animals <1 year old. Younger animals in both species had higher PMDs than adult animals (P < 0.001). Neutering was associated with reduced PMD in young male dogs. In adult dogs, miniature Schnauzers had the highest PMD. Most animals with diarrhoea (51%) presented having been ill for 2-4 days, but a history of vomiting or haemorrhagic diarrhoea was associated with a shorter time to presentation. The most common treatments employed were dietary modification (66% of dogs; 63% of cats) and antibacterials (63% of dogs; 49% of cats). There was variability in PMD between different practices. The SAVNET methodology facilitates rapid collection of cross-sectional data regarding diarrhoea, a recognised sentinel for infectious disease, and characterises data that could benchmark clinical practice and support the development of evidence-based medicine.

Internal medicine in the bush: a clinical audit of a rural and remote outreach programme.

BACKGROUND: Provision of internal medicine services in rural Australia is always problematic. AIM: The aim was to undertake an audit of an outreach service operating in Northern New South Wales since 2006. METHODS: The service is conducted eight times a year, involving a consultant and an advanced trainee who travel by car to the towns of Moree and Mungindi and conduct clinics in a general practice setting, an Aboriginal medical service and a local health district clinic. Since 2008, a cardiology service and a diabetes service have been added on a fly-in fly-out basis. Case records of all patients enrolled in the service between February 2006 and July 2013 were reviewed in determining the demographics, clinical presentations and level of service coverage. The experience of the authors in establishing the service provided insights into the challenges and the success factors involved. RESULTS: Five hundred and eighty-three patients were seen on a total of 1070 occasions relating to a wide variety of clinical presentations. Of these, 31.3% were indigenous compared with 20% in the local statistical area, and both indigenous and non-indigenous patients were seen in all settings. Patients fell into 15 different diagnostic categories with indigenous patients more likely to present for diabetes (P < 0.001) and hepatitis B (P < 0.01), but less likely to present for treatment of hepatitis C (P < 0.01). CONCLUSIONS: In providing an outreach service to a mixed community, flexibility in both setting and personnel are essential. Diabetes and liver disease are highly prevalent in indigenous patients, but the low numbers presenting for hepatitis C requires further study.

Effects of expressive writing on sexual dysfunction, depression, and PTSD in women with a history of childhood sexual abuse: results from a randomized clinical trial.

INTRODUCTION: Women with a history of childhood sexual abuse (CSA) have high rates of depression, posttraumatic stress disorder, and sexual problems in adulthood. AIM: We tested an expressive writing-based intervention for its effects on psychopathology, sexual function, satisfaction, and distress in women who have a history of CSA. METHODS: Seventy women with CSA histories completed five 30-minute sessions of expressive writing, either with a trauma focus or a sexual schema focus. MAIN OUTCOME MEASURES: Validated self-report measures of psychopathology and sexual function were conducted at posttreatment: 2 weeks, 1 month, and 6 months. RESULTS: Women in both writing interventions exhibited improved symptoms of depression and posttraumatic stress disorder (PTSD). Women who were instructed to write about the impact of the abuse on their sexual schema were significantly more likely to recover from sexual dysfunction. CONCLUSIONS: Expressive writing may improve depressive and PTSD symptoms in women with CSA histories. Sexual schema-focused expressive writing in particular appears to improve sexual problems, especially for depressed women with CSA histories. Both treatments are accessible, cost-effective, and acceptable to patients.

Dear enemies and nasty neighbors in crayfish: effects of social status and sex on responses to familiar and unfamiliar conspecifics.

Our experiment examined the ability of crayfish (Procambarus clarkii) to discriminate between familiar and unfamiliar conspecifics of equivalent social status, and investigated whether this species displays dear enemy or nasty neighbor effects. Pairs of size and sex matched crayfish fought to establish social status and the resulting dominant and subordinate crayfish then participated in a choice phase in which they interacted with two conspecifics tethered in an arena. Both choice conspecifics had the same social status and sex, but one was familiar (the focal animal's previous opponent) and the other was novel. We found that subordinate focal animals of both sexes spent significantly more time in proximity to the unfamiliar choice animal, behavior inconsistent with the dear enemy and nasty neighbor hypotheses. In contrast, male and female dominant focals differed significantly: females spent more time close to and fighting with the familiar choice animal while male dominants responded equivalently to the two choice animals. Thus the response of crayfish toward familiar and unfamiliar conspecifics was complex and not explained by a single hypothesis. We suggest that, in addition to familiarity and unfamiliarity, the perceived threat-level of opponents influences the behavior of crayfish toward conspecifics.

Sudden Gains During Patient-Directed Expressive Writing Treatment Predicts Depression Reduction in Women with History of Childhood Sexual Abuse: Results from a Randomized Clinical Trial.

Sudden gains are large reductions in symptoms measured in a single between-session interval and are positively associated with long-term treatment outcomes. To date, sudden gains have mostly been observed in therapist-directed psychotherapies. There are currently mixed findings surrounding the mechanisms underlying sudden gains, with some support for a cognitive mechanism and some support for therapist characteristics such as the therapeutic alliance. In this study of 77 female survivors of childhood sexual abuse, sudden gains in trauma symptoms were found in a randomized clinical trial of a patient-directed expressive writing intervention. Women in the active treatment condition (who wrote about their beliefs related to sexuality or trauma) exhibiting sudden gains in trauma symptoms showed larger improvements in depression than those in the control condition (who merely wrote about their daily needs). The extension of sudden gains from psychotherapy to a client-directed treatment refines our understanding of the mechanisms underlying these gains, and supports the hypothesis that cognitive change is a likely mechanism underlying sudden gains.

Physiological stress responses predict sexual functioning and satisfaction differently in women who have and have not been sexually abused in childhood.

Physiological responses to sexual stimuli may contribute to the increased rate of sexual problems seen in women with childhood sexual abuse (CSA) histories. We compared two physiological stress responses as predictors of sexual function and satisfaction, sympathetic nervous system (SNS) activation and cortisol in women with (CSA, N = 136) and without CSA histories (NSA, N = 102). In CSA survivors, cortisol response to sexual stimuli did not significantly predict sexual functioning; however, in NSA women, cortisol increases were associated with poorer sexual functioning, and decreases with higher functioning. For women with CSA histories, lower SNS activity was associated with poorer sexual functioning. For CSA survivors with low lifetime trauma, lower SNS activity was associated with higher sexual satisfaction; for women with high lifetime trauma, the reverse was true. Decreased SNS activity during sexual stimuli predicted higher sexual functioning in NSA women with low lifetime exposure to traumatic events, but lower sexual functioning in those with high exposure. Differences between women with and without CSA histories in the association between cortisol and SNS response and sexual functioning and satisfaction suggests that CSA causes disruptions in both short and long-term stress responses to sexual stimuli that perpetuate into adulthood.

Musicians have fine-tuned neural distinction of speech syllables.

One of the benefits musicians derive from their training is an increased ability to detect small differences between sounds. Here, we asked whether musicians' experience discriminating sounds on the basis of small acoustic differences confers advantages in the subcortical differentiation of closely related speech sounds (e.g., /ba/ and /ga/), distinguishable only by their harmonic spectra (i.e., their second formant trajectories). Although the second formant is particularly important for distinguishing stop consonants, auditory brainstem neurons do not phase-lock to its frequency range (above 1000 Hz). Instead, brainstem neurons convert this high-frequency content into neural response timing differences. As such, speech tokens with higher formant frequencies elicit earlier brainstem responses than those with lower formant frequencies. By measuring the degree to which subcortical response timing differs to the speech syllables /ba/, /da/, and /ga/ in adult musicians and nonmusicians, we reveal that musicians demonstrate enhanced subcortical discrimination of closely related speech sounds. Furthermore, the extent of subcortical consonant discrimination correlates with speech-in-noise perception. Taken together, these findings show a musician enhancement for the neural processing of speech and reveal a biological mechanism contributing to musicians' enhanced speech perception in noise.