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Purpose:This article introduces early career clinicians to speech privacy (SP): its definition, a brief history in the context of the Health Insurance Portability and Accountability Act, and applications in health care settings. General considerations for speech-language pathologists (SLPs) are outlined, along with basic principles for considering what might threaten SP. The example of speakers who use an electrolarynx (EL) is used to call attention to some specific issues that clinicians may encounter in trying to maintain SP.Conclusions:This article provided an overview of SP considerations for early career clinicians. In the case of EL users, these include the unique quality of EL speech and the settings in which SLPs may work with these patients. More research is needed to investigate SP concerns for specific clinical populations that seek SLP services and the physical conditions in which clinician–client discussions occur. Recommendations for clinical practice are provided.

There is a long history of racial and ethnic disparities in healthcare and they continue to persist in contemporary society. These disparities have the potential to negatively affect morbidity and mortality in racial and ethnic minorities diagnosed with laryngeal cancer. Diagnosis, medical treatment, and rehabilitation for laryngeal cancer have improved considerably, leading to improvements in overall survival rates and physical, social, and psychological functioning. Yet members of minority and underrepresented groups are at an increased risk for experiencing reduced access to quality care and delays between diagnosis and treatment, and as a result have lower survival rates. Increasing health providers’ awareness of racial and ethnic disparities in laryngeal cancer is necessary to facilitate changes in patient and provider education, clinical practice, and health policies. The purpose of this review is to summarize current literature on disparities in laryngeal cancer diagnosis, treatment, and rehabilitation among Black and Hispanic patients. We present recent data from the Surveillance, Epidemiology, and End Results database to examine trends in laryngeal cancer and patient, provider, and health systems factors that may perpetuate these disparities. In addition, we offer interventions to address racism and other racial and ethnic biases in laryngeal cancer care and describe research and legislative actions that are needed to reduce disparities in this area.

PurposeThe purpose of this study was to identify changes in NCAA Division II female athletes' objective and subjective voice characteristics before, during, and after a regular volleyball season.MethodAcoustic, aerodynamic, and Voice Handicap Index-10 data were collected from five female volleyball athletes at three timepoints: preseason, midseason, and postseason.ResultsIndividual data suggest increases in objective and subjective voice characteristics at midseason, but many values returned to typical limits at postseason. Increases observed in acoustic, aerodynamic, and Voice Handicap Index-10 data for the volleyball team captain remained elevated at midseason and postseason.ConclusionsFemale volleyball players are a group of voice users who are required to communicate in the presence of background noise while engaging in varying levels of physical effort. As a result, they may experience negative changes to objective and/or subjective voice characteristics during a regular season. The present data, concerning changes in female volleyball athletes' voice characteristics, need to be confirmed by studies with a larger number of participants.

BackgroundProgressive ventricular dilatation after intraventricular haemorrhage (IVH) in preterm infants has a very high risk of severe disability and death. Drainage, irrigation and fibrinolytic therapy (DRIFT), in a randomised controlled trial (RCT), reduced severe cognitive impairment at 2 years.ObjectiveTo assess if the cognitive advantage of DRIFT seen at 2 years persisted until school age.ParticipantsThe RCT conducted in four centres recruited 77 preterm infants with IVH and progressive ventricular enlargement over specified measurements. Follow-up was at 10 years of age.InterventionIntraventricular injection of a fibrinolytic followed by continuous lavage, until the drainage was clear, and standard care consisting of control of expansion by lumbar punctures and if expansion persisted via a ventricular access device.Primary outcomeCognitive quotient (CQ), derived from the British Ability Scales and Bayley III Scales, and survival without severe cognitive disability.ResultsOf the 77 children randomised, 12 died, 2 could not be traced, 10 did not respond and 1 declined at 10-year follow-up. 28 in the DRIFT group and 24 in the standard treatment group were assessed by examiners blinded to the intervention. The mean CQ score was 69.3 (SD=30.1) in the DRIFT group and 53.7 (SD=35.7) in the standard treatment group (unadjusted p=0.1; adjusted p=0.01, after adjustment for the prespecified variables sex, birth weight and IVH grade). Survival without severe cognitive disability was 66% in the DRIFT group and 35% in the standard treatment group (unadjusted p=0.019; adjusted p=0.003).ConclusionDRIFT is the first intervention for posthaemorrhagic ventricular dilatation to objectively demonstrate sustained cognitive improvement.Trial registration numberISRCTN80286058.

A proliferation of data sources has led to the notional existence of an implicit Knowledge Graph (KG) that contains vast amounts of biological knowledge contributed by distributed Application Programming Interfaces (APIs). However, challenges arise when integrating data across multiple APIs due to incompatible semantic types, identifier schemes, and data formats. We present ROBOKOP KG (http://robokopkg.renci.org), which is a KG that was initially built to support the open biomedical question-answering application, ROBOKOP (Reasoning Over Biomedical Objects linked in Knowledge-Oriented Pathways) (http://robokop.renci.org). Additionally, we present the ROBOKOP Knowledge Graph Builder (KGB), which constructs the KG and provides an extensible framework to handle graph query over and integration of federated data sources.

Objectives: To evaluate our experience with a significant number of brain malignancy–related vocal fold paralysis patients and their response to vocal cord–related therapies.Background: Vocal fold paralysis is a potentially devastating complication of various types of pediatric diseases and surgeries that can lead to significant vocal and swallowing difficulties. While there is significant data in the literature on outcomes of children treated for vocal fold paralysis following cardiac or thyroid surgery, there is a scarcity of such information on children following the treatment of neurologic malignancy.Methods: Records of 19 patients at a tertiary center who were treated for neurologic malignancies and developed either unilateral or bilateral vocal fold paralysis were reviewed for vocal fold pathology and vocal fold paralysis treatment-related variables, including initial diagnosis, management with observation or speech therapy, duration of therapy, pre- and postintervention swallow studies, and surgical intervention.Results: Bilateral vocal fold paralysis was noted in 26% (5/19) patients. Eighty-four percent (16/19) of patients had stable or improved ability to vocalize and swallow following therapy. There was no statistically significant difference in speech or swallowing improvement after speech therapy alone or speech therapy in combination with injection laryngoplasty (P= .25). No complications were noted with surgical intervention.Conclusions: Patients with vocal fold paralysis secondary to neurologic malignancy can have an improvement in speech and swallowing after a variety of treatments, including speech therapy or early injection laryngoplasty. There was no statistically significant difference in improvement based on the type of intervention utilized. A larger sample size is needed to conclude whether surgical intervention combined with speech therapy leads to more rapid and significant functional improvement than speech therapy alone.

PurposeThe purpose of this article is to provide a review of the neck-type electrolarynx, describe acoustic and perceptual characteristics of electrolaryngeal speech, and highlight the potential impact of electrolaryngeal speech on voice-related quality of life postlaryngectomy, concluding by describing efforts to improve electrolaryngeal speech rehabilitation. Although several alaryngeal communication options exist, the electrolarynx is the most readily available means of producing voice and speech postlaryngectomy. This is due to the small and handheld nature of an electrolaryngeal device, which is commonly placed against the neck during use. Research suggests that approximately half of laryngectomees use an electrolarynx up to 2 years postlaryngectomy.ConclusionGiven the importance of the electrolarynx postlaryngectomy, decisions should be made in conjunction with the laryngectomee. It is important to ask: Why not an electrolarynx?

Well‐managed irrigated pasture production can be optimized without nitrogen (N) fertilizer. The objective was to determine mixture and planting ratios of tall fescue (Schedonorus arundinaceaSchreb.) (TF), meadow brome (Bromus ripariusRehm.) (MB), orchardgrass (Dactylis glomerataL.) (OG), timothy (Phleum pratenseL.) (TIM), and perennial ryegrass (Lolium perenneL.) (PRG) with alfalfa (Medicago sativaL.) (ALF), birdsfoot trefoil (Lotus corniculatusL.) (BFTF), or cicer milkvetch (Astragalus cicerL.) (CMV) that maximize productivity. Planting ratios were 0:100 (grass:legume), 25:75, 50:50, 75:25, and three 100:0 grass monocultures fertilized at 0, 67, and 134 kg N ha−1. Seasonal production of TF–ALF was 12.69 Mg ha−1, equal to TF fertilized at 134 kg N ha−1. ALF mixtures with MB, OG, TIM, and PRG produced 12.57, 10.97, 11.77, and 10.74 Mg ha−1, respectively, and 8 to 40% more than grasses receiving 134 kg N ha−1. Production of BFTF mixtures with TF, MB, and OG were 11.69, 11.45, and 9.95 Mg ha−1, respectively, equal to their respective grass monoculture receiving 134 kg N ha−1. The BFTF–TIM and BFTF–PRG mixtures averaged 12% more forage than grass monocultures receiving 134 kg N ha−1. Production of CMV‐grass was similar to that of grasses receiving 67 kg N ha−1. Seasonal forage distribution was more uniform in ALF– and BFTF–grass mixtures, averaging 30% more at the second and third harvests than fertilized grasses. The TF and MB legume mixtures averaged 7% more production in the 50:50 planting ratios than the other two grass–legume mixtures, while the 50:50 and 25:75 ratios of OG and TIM–legume mixtures averaged 12% more than the 75:25 and the 25:75 PRG–legume planting ratio averaged 9% more than the 50:50 and 75:25. Forage production of grass–legume mixtures can equal or exceed fertilized grass monocultures and with more uniform distribution over the growing season.

New mass-produced, wide-field, small-aperture telescopes have the potential to revolutionize ground-based astronomy by greatly reducing the cost of collecting area. In this paper, we introduce a new class of large telescope based on these advances: an all-sky, arcsecond-resolution, 1000 telescope array which builds a simultaneously high-cadence and deep survey by observing the entire sky all night. As a concrete example, we describe the Argus Array, a 5 m-class telescope with an all-sky field of view and the ability to reach extremely high cadences using low-noise CMOS detectors. Each 55 GPix Argus exposure covers 20% of the entire sky to mg= 19.6 each minute and mg= 21.9 each hour; a high-speed mode will allow sub-second survey cadences for short times. Deep coadds will reach mg= 23.6 every five nights over 47% of the sky; a larger-aperture array telescope, with an étendue close to the Rubin Observatory, could reach mg= 24.3 in five nights. These arrays can build two-color, million-epoch movies of the sky, enabling sensitive and rapid searches for high-speed transients, fast-radio-burst counterparts, gravitational-wave counterparts, exoplanet microlensing events, occultations by distant solar system bodies, and myriad other phenomena. An array of O(1000) telescopes, however, would be one of the most complex astronomical instruments yet built. Standard arrays with hundreds of tracking mounts entail thousands of moving parts and exposed optics, and maintenance costs would rapidly outpace the mass-produced-hardware cost savings compared to a monolithic large telescope. We discuss how to greatly reduce operations costs by placing all optics in thermally controlled, sealed domes with only a few moving parts. Coupled with careful software scope control and use of existing pipelines, we show that the Argus Array could become the deepest and fastest Northern sky survey, with total costs in the $20M range.

The measurement of volatile organic compound (VOC) emissions from building products and materials by manufacturers and testing laboratories, and the use of the test results for labeling programs, continue to expand. One issue that hinders wide acceptance for chamber product testing is the lack of a reference material to validate test chamber performance. To meet this need, the National Institute of Standards and Technology (NIST) and Virginia Tech (VT) have developed a prototype reference material that emits a single VOC similar to the emissions of a diffusion-controlled building product source with a dynamic emissions profile. The prototype material has undergone extensive testing at NIST and a pilot interlaboratory study (ILS) with four laboratories. The next development step is an evaluation of the prototype source in multiple-sized chambers of 14 laboratories in seven countries. Each laboratory was provided duplicate specimens and a test protocol. Study results identified significant issues related to the need to store the source at a subzero Celsius temperature until tested and possible inconsistencies in large chambers. For laboratories using a small chamber and meeting all the test method criteria, the results were very encouraging with relative standard deviations ranging from 5% to 10% across the laboratories.Implications: Currently, the chamber performance of laboratories conducting product VOC emissions testing is assessed through interlaboratory studies (ILS) using a source with an unknown emission rate. As a result, laboratory proficiency can only be based on the mean and standard deviation of emission rates measured by the participating ILS laboratories. A reference material with a known emission rate has the potential to provide an independent assessment of laboratory performance as well as improve the quality of interlaboratory studies. Several international laboratories with different chamber testing systems demonstrated the ability to measure the emission rate of such a reference material within an acceptable measurement uncertainty.

The detection of Mo in n-type Si has been reported in only a few references. An unidentified peak was detected in an n-type epitaxial layer by DLTS with an activation energy and capture cross-section of 0.255 eV and 3.5 x 10[?]16 cm2, respectively. These results were consistent with measurements of n-type silicon implanted with Mo. A p-type epitaxial wafer was exposed to the same epitaxial growth environment resulting in the detection of the Mo-d level, thus confirming the Mo contamination. The change in the enthalpy of the capture of electrons into the unidentified level was 14 meV resulting in the majority carrier capture cross-section being determined to be 1.2 x 10[?]16 cm2 assuming a multi-phonon process. Using the activation energy and enthalpy change of capture cross-section data, the change in Gibbs free energy as a function of temperature was calculated to be Ec-0.269 eV. Poole-Frenkel effect measurements determined the deep level to be an acceptor-like state. The total change in entropy was determined to be 1k, the first reported total entropy change for an acceptor level of a 4d transition metal. The measured enthalpy energy was in reasonable agreement with the reported theoretical calculation of a substitution Mo-a deep level.

The main focus of this paper is to use discrete-event simulation models, to test the robustness of two process control methods against processes with different statistical distributions. The two methods under scrutiny are the Small-Batch & R chart and the Set-Up Process Algorithm (SUPA). These have been developed for ‘setup dominant processes’, were the major source of product variation is detected between batches. Minimizing this type of variation is critical to ensure spare parts produced at a later date will fit in operating assemblies, maintaining a Through-life Engineering Service. This paper shows their suitability to industry.

N-({(5S)-3-[4-(1,1-dioxidothiomorpholin-4-yl)-3,5-difluorophenyl]-2-oxo-1,3-oxazolidin-5-yl}methyl)acetamide (PNU-288034), an oxazolidinone antibiotic, was terminated in phase I clinical development because of insufficient exposure. Analysis of the drug pharmacokinetic and elimination profiles suggested that PNU-288034 undergoes extensive renal secretion in humans. The compound was well absorbed and exhibited approximately linear pharmacokinetics in the oral dose range of 100 to 1000 mg in human. PNU-288034 was metabolically stable in liver microsomes across species, and unchanged drug was cleared in the urine by an apparent active renal secretion process in rat and monkey (two to four times glomerular filtration rate) but not dog. In vitro studies conducted to characterize the transporters involved demonstrated PNU-288034 uptake by human organic anion transporter 3 (OAT3; K(m) = 44 +/- 5 microM) and human multidrug and toxin extrusion protein 1 (hMATE1; K(m) = 340 +/- 55 microM). The compound was also transported by multidrug resistance P-glycoprotein and breast cancer resistance protein. In contrast, human organic cation transporter 2, human OAT1, and hMATE2-K did not transport PNU-288034. Coadministration of PNU-288034 and the OAT3 inhibitor probenecid significantly increased PNU-288034 plasma area under the curve (170%) and reduced both plasma and renal clearance in monkey. Coadministration of PNU-288034 and cimetidine, a MATE1 inhibitor, also reduced plasma clearance in rat to a rate comparable with probenecid coadministration. Collectively, our results demonstrated a strong in vitro-in vivo correlation for active renal secretion coordinated through the vectorial transport process of OAT3 and MATE1, which ultimately resulted in limiting the systemic exposure of PNU-288034.

This paper concerns the electrochemical growth of compound semiconductor thin film superlattice structures using electrochemical atomic layer deposition (ALD). Electrochemical ALD is the electrochemical analogue of atomic layer epitaxy (ALE) and ALD, methods based on nanofilm formation an atomic layer at a time, using surface-limited reactions. Underpotential deposition (UPD) is a type of electrochemical surfaced-limited reaction used in the present studies for the formation of PbSe/PbTe superlattices via electrochemical ALD. PbSe/PbTe thin-film superlattices with modulation wavelengths (periods) of 4.2 and 7.0 nm are reported here. These films were characterized using electron probe microanalysis, X- ray diffraction, atomic force microscopy (AFM), and infrared reflection absorption measurements. The 4.2 nm period superlattice was grown after deposition of 10 PbSe cycles, as a prelayer, resulting in an overall composition of PbSe0.52Te0.48. The 7.0 nm period superlattice was grown after deposition of 100 PbTe cycle prelayer, resulting for an overall composition of PbSe0.44Te0.56. The primary Bragg diffraction peak position, 2, for the 4.2 superlattice was consistent with the average (111) angles for PbSe and PbTe. First-order satellite peaks, as well as a second, were observed, indicating a high-quality superlattice film. For the 7.0 nm superlattice, Bragg peaks for both the (200) and (111) planes of the PbSe/PbTe superlattice were observed, with satellite peaks shifted 1° closer to the (111), consistent with the larger period of the superlattice. AFM suggested conformal superlattice growth on the Au on glass substrate. Band gaps for the 4.2 and 7.0 nm period superlattices were measured as 0.48 and 0.38 eV, respectively.

A method is introduced that permits accurate and robust extraction of the location and time course of synaptic conductance from potentials recorded on either side of, and perhaps at some distance from, the synapse in question. It is shown that such data permits one to fully overcome the problems typically associated with lack of spaceclamp. The method does not presume anything about the nature of the time course and yet is applicable to branched, active cells receiving simultaneous input from a number of synapses.

This double‐blind, four‐way crossover study assessed the effect of valdecoxib on the QTc interval duration in 25 male and 9 female healthy adults. Subjects received placebo or 40 mg, 80 mg, or 120 mg valdecoxib once daily for 5 days. Serial ECGs were obtained for 24 hours before the first treatment (baseline) and on the 5th day of each treatment. The study was statistically powered to detect a difference of ≥ 5.6 ms in the average daily QTc change from baseline and a ≥ 7.8‐ms difference in the average maximal daily change from baseline. No QTc prolongation versus placebo (Fridericia's or Bazett's correction) was observed for any valdecoxib dose. A 22% greater than proportional increase in valdecoxib AUC0–24was observed over the 40‐ to 120‐mg dose range, supporting the conclusiveness of the negative QTc risk assessment even at supratherapeutic doses (up to three times the maximum recommended dose of 40 mg per day) and concentrations. In conclusion, repeated administration of doses up to 120 mg valdecoxib had no effect on cardiac repolarization in healthy volunteers, suggesting that chronic administration of valdecoxib to patients would not increase the risk from cardiac arrhythmia associated with QT prolongation.

ABSTRACTTo evaluate the pharmacokinetic effect of adding delavirdine mesylate to the antiretroviral regimens of human immunodeficiency virus (HIV)-infected patients stabilized on a full dosage of ritonavir (600 mg every 12 h), 12 HIV-1-infected subjects had delavirdine mesylate (400 mg every 8 h) added to their current antiretroviral regimens for 21 days. Ritonavir pharmacokinetics were evaluated before (day 7) and after (day 28) the addition of delavirdine, and delavirdine pharmacokinetics were evaluated on day 28. The mean values (± standard deviations) for the maximum concentration in serum (Cmax) of ritonavir, the area under the concentration-time curve from 0 to 12 h (AUC0-12), and the minimum concentration in serum (Cmin) of ritonavir before the addition of delavirdine were 14.8 ± 6.7 μM, 94 ± 36 μM · h, and 3.6 ± 2.1 μM, respectively. These same parameters were increased to 24.6 ± 13.9 μM, 154 ± 83 μM · h, and 6.52 ± 4.85 μM, respectively, after the addition of delavirdine (Pis <0.05 for all comparisons). Delavirdine pharmacokinetic parameters in the presence of ritonavir included a Cmaxof 23 ± 16 μM, an AUC0-8of 114 ± 75 μM · h, and a Cminof 9.1 ± 7.5 μM. Therefore, delavirdine increases systemic exposure to ritonavir by 50 to 80% when the drugs are coadministered.

Student enrollment in colleges and universities has increased markedly during the last three decades. Between Fall 1970 and Fall 2000, enrollment in all degree-granting institutions rose from 8.5 million to about 15.1 million students. Simultaneously, there has been a proliferation of developmental skills programs in higher education institutions, largely in response to an increasing proportion of underprepared college students. This paper presents some empirical evidence of the effectiveness of three reading skills courses offered at a midwestern, regional, four-year state university. Regression analysis is used to explore possible determinants of students' academic performance in college. The study's findings suggest that underprepared readers' success in college is directly and significantly related to taking and passing a reading skills course.

Surrogate functions have become an important tool in multidisciplinary design optimization to deal with noisy functions, high computational cost, and the practical difficulty of integrating legacy disciplinary computer codes. A combination of mathematical, statistical, and engineering techniques, well known in other contexts, have made polynomial surrogate functions viable for MDO. Despite the obvious limitations imposed by sparse high fidelity data in high dimensions and the locality of low order polynomial approximations, the success of the panoply of techniques based on polynomial response surface approximations for MDO shows that the implementation details are more important than the underlying approximation method (polynomial, spline, DACE, kernel regression, etc.). This paper selectively surveys some of the ancillary techniques—statistics, global search, parallel computing, variable complexity modeling—that augment the construction and use of polynomial surrogates.

The conceptual design of aircraft often entails a large number of nonlinear constraints that result in a nonconvex feasible design space and multiple local optima. The design of the high-speed civil transport (HSCT) is used as an example of a highly complex conceptual design with 26 design variables and 68 constraints. This paper compares three global optimization techniques on the HSCT problem and two test problems containing thousands of local optima and noise: multistart local optimizations using either sequential quadratic programming (SQP) as implemented in the design optimization tools (DOT) program or Snyman's dynamic search method, and a modified form of Jones' DIRECT global optimization algorithm. SQP is a local optimizer, while Snyman's algorithm is capable of moving through shallow local minima. The modified DIRECT algorithm is a global search method based on Lipschitzian optimization that locates small promising regions of design space and then uses a local optimizer to converge to the optimum. DOT and the dynamic search algorithms proved to be superior for finding a single optimum masked by noise of trigonometric form. The modified DIRECT algorithm was found to be better for locating the global optimum of functions with many widely separated true local optima.

We develop the theory and accompanying algorithm for the recovery of a dendritic neuron's cytoplasmic resistivity, membrane capacitance, leakage conductance, and two maximal channel conductances from weighted averages of simultaneous recordings of somatic and dendritic potential following a somatic current stimulus. We test our results on two model systems with distinct, though prescribed, channel kinetics and branching patterns.

The excitable nature of a biological cell is manifested in the many voltage gated ion channels that perforate its membrane. The forms of the associated ionic currents, and in particular the functions that govern their kinetics, permit one to distinguish, electrophysiologically, between various cell types. We show, in the context of FitzHugh–Nagumo and Morris–Lecar models and without recourse to voltage or space clamping, that such currents and kinetics may be stably inferred from a cell’s voltage response to a specified input current.

Abstract: The excitable nature of a biological cell is manifested in the many voltage gated ion channels that perforate its membrane. The forms of the associated ionic currents, and in particular the functions that govern their kinetics, permit one to distinguish, electrophysiologically, between various cell types. We show, in the context of FitzHugh-Nagumo and Morris-Lecar models and without recourse to voltage or space clamping, that such currents and kinetics may be stably inferred from a cell’s voltage response to a specified input current.

Human leukocyte antigen (HLA) class I polymorphism was studied within a population of 70 unrelated Kolla Amerindians from the far northwest of Argentina close to the Bolivian border. The results indicate that the HLA-A, -B, and -C alleles typical of other Amerindian populations also predominate in the Kolla. These alleles belong to the following allele groups: HLA-A∗02, ∗68, ∗31, ∗24, HLA-B∗35, ∗15, ∗51, ∗39, ∗40, ∗48, and Cw∗01, ∗03, ∗04, ∗07, ∗08, and ∗15. For the HLA-A locus, heterogeneity was seen for HLA-A∗02 with A∗0201, ∗0211, and ∗0222; and for A∗68 with ∗68012 and ∗6817, the latter being a novel allele identified in this population. Analysis of HLA-B identified heterogeneity for all Amerindian allele groups except HLA-B∗48, including the identification of the novel B∗5113 allele. For HLA-C heterogeneity was identified within the Cw∗07, ∗04, and ∗08 groups with Cw∗0701/06, ∗0702, ∗04011, ∗0404, ∗0803, and ∗0809 identified. The most frequent “probable” haplotype found in this population was B∗3505-Cw∗04011. This study supports previous studies, which demonstrate increased diversity at HLA-B compared with HLA-A and -C. The polymorphism identified within the Kolla HLA-A, -B, and -C alleles supports the hypothesis that HLA evolution is subject to positive selection for diversity within the peptide binding site.