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There is a strong association between total hip bone mineral density (THBMD) changes after 24 mo of treatment and reduced fracture risk. We examined whether changes in THBMD after 12 and 18 mo of treatment are also associated with fracture risk reduction. We used individual patient data (n = 122 235 participants) from 22 randomized, placebo-controlled, double-blind trials of osteoporosis medications. We calculated the difference in mean percent change in THBMD (active-placebo) at 12, 18, and 24 mo using data available for each trial. We determined the treatment-related fracture reductions for the entire follow-up period, using logistic regression for radiologic vertebral fractures and Cox regression for hip, non-vertebral, all (combination of non-vertebral, clinical vertebral, and radiologic vertebral) fractures and all clinical fractures (combination of non-vertebral and clinical vertebral). We performed meta-regression to estimate the study-level association (r2 and 95% confidence interval) between treatment-related differences in THBMD changes for each BMD measurement interval and fracture risk reduction. The meta-regression revealed that for vertebral fractures, the r2 (95% confidence interval) was 0.59 (0.19, 0.75), 0.69 (0.32, 0.82), and 0.73 (0.33, 0.84) for 12, 18, and 24 mo, respectively. Similar patterns were observed for hip: r2 = 0.27 (0.00, 0.54), 0.39 (0.02, 0.63), and 0.41 (0.02, 0.65); non-vertebral: r2 = 0.27 (0.01, 0.52), 0.49 (0.10, 0.69), and 0.53 (0.11, 0.72); all fractures: r2 = 0.44 (0.10, 0.64), 0.63 (0.24, 0.77), and 0.66 (0.25, 0.80); and all clinical fractures: r2 = 0.46 (0.11, 0.65), 0.64 (0.26, 0.78), and 0.71 (0.32, 0.83), for 12-, 18-, and 24-mo changes in THBMD, respectively. These findings demonstrate that treatment-related THBMD changes at 12, 18, and 24 mo are associated with fracture risk reductions across trials. We conclude that BMD measurement intervals as short as 12 mo could be used to assess fracture efficacy, but the association is stronger with longer BMD measurement intervals.

Some osteoporosis drug trials have suggested that treatment is more effective in those with low BMD measured by DXA. This study used data from a large set of randomized controlled trials (RCTs) to determine whether the anti-fracture efficacy of treatments differs according to baseline BMD. We used individual patient data from 25 RCTs (103 086 subjects) of osteoporosis medications collected as part of the FNIH-ASBMR SABRE project. Participants were stratified into FN BMD T-score subgroups (≤-2.5, > -2.5). We used Cox proportional hazard regression to estimate treatment effect for clinical fracture outcomes and logistic regression for the radiographic vertebral fracture outcome. We also performed analyses based on BMD quintiles. Overall, 42% had a FN BMD T-score ≤ -2.5. Treatment with anti-osteoporosis drugs led to significant reductions in fractures in both T-score ≤ -2.5 and > -2.5 subgroups. Compared to those with FN BMD T-score > -2.5, the risk reduction for each fracture outcome was greater in those with T-score ≤ -2.5, but only the all-fracture outcome reached statistical significance (interaction P = .001). Results were similar when limited to bisphosphonate trials. In the quintile analysis, there was significant anti-fracture efficacy across all quintiles for vertebral fractures and with greater effects on fracture risk reduction for non-vertebral, all, and all clinical fractures in the lower BMD quintiles (all interaction P ≤ .03). In summary, anti-osteoporotic medications reduced the risk of fractures regardless of baseline BMD. Significant fracture risk reduction with treatment for 4 of the 5 fracture endpoints was seen in participants with T-scores above -2.5, though effects tended to be larger and more significant in those with baseline T-scores

There is a common belief that antiosteoporosis medications are less effective in older adults. This study used data from randomized controlled trials (RCTs) to determine whether the anti-fracture efficacy of treatments and their effects on BMD differ in people ≥70 compared to those

Purpose: This study aimed to examine the effects of wearing a face mask on speech acoustics and intelligibility, using an acoustic-phonetic analysis of speech. In addition, the effects of speakers' behavioral modification while wearing a mask were examined. Method: Fourteen female adults were asked to read a set of words and sentences under three conditions: (a) conversational, mask-off; (b) conversational, mask-on; and (c) clear, mask-on. Seventy listeners rated speech intelligibility using two methods: orthographic transcription and visual analog scale (VAS). Acoustic measures for vowels included duration, first (F1) and second (F2) formant frequency, and intensity ratio of F1/F2. For consonants, spectral moment coefficients and consonant--vowel (CV) boundary (intensity ratio between consonant and vowel) were measured. Results: Face masks had a negative impact on speech intelligibility as measured by both intelligibility ratings. However, speech intelligibility was recovered in the clear speech condition for VAS but not for transcription scores. Analysis of orthographic transcription showed that listeners tended to frequently confuse consonants (particularly fricatives, affricates, and stops), rather than vowels in the word-initial position. Acoustic data indicated a significant effect of condition on CV intensity ratio only. Conclusions: Our data demonstrate a negative effect of face masks on speech intelligibility, mainly affecting consonants. However, intelligibility can be enhanced by speaking clearly, likely driven by prosodic alterations.

The onset of COVID-19 altered the way parents make decisions on safe activities for their children. Given the impact of this global pandemic, it is important to consider what decisions parents make when faced with the obstacle of keeping a child safe while letting them pursue extracurricular activities, such as sports. To this end, we examine decision-making of parents regarding whether or not they are comfortable allowing their children to participate in sport activities. For this purpose, we conducted two waves of surveys with youth sport parents in spring 2020 and fall 2020. The findings suggest that Black parents and female parents were more comfortable allowing their children to participate and that, in general, parents became more comfortable with local youth sport participation as the pandemic continued. Keywords: parenting; youth sports; COVID19; concerted cultivation; risk society, The novel coronavirus, COVID-19, caused both global health agencies and individuals to reexamine the risks associated with everyday activities (Wang et al., 2021). In response to risk perceptions, people were [...]

In the realm of socioenvironmental justice, much discourse centers on equal access to green areas and on climate injustice in the United States. Marginalized communities, including Indigenous populations, are being excluded from current narratives surrounding the natural spaces that in many cases are historically tied to under-represented groups. This article aims to explore some of the many dimensions of environmental racism, green inequities, climate injustice, and access. The dimensions include but are not limited to racial gatekeeping, nature deprivation in low-income communities, green gentrification, light pollution, and access to clean water. The recommendations section serves as a guide during decisionmaking processes at the local, state, and federal level, as well as moving forward in offering impacted communities protection from environmental racism and socioenvironmental injustice to impacted communities.

Purpose: This study presents the results of acoustic and kinematic analyses of word-initial semivowels (/[voiced alveolar approximant], l, w/) produced by second-language (L2) speakers of English whose native language is Korean. In addition, the relationship of acoustic and kinematic measures to the ratings of foreign accent was examined by correlation analyses. Method: Eleven L2 speakers and 10 native speakers (first language [L1]) of English read "The Caterpillar" passage. Acoustic and kinematic data were simultaneously recorded using an electromagnetic articulography system. In addition to speaking rate, two acoustic measures (ratio of third-formant [F3] frequency to second-formant [F2] frequency and duration of steady states of F2) and two kinematic measures (lip aperture and duration of lingual maximum hold) were obtained from individual target sounds. To examine the degree of contrast among the three sounds, acoustic and kinematic Euclidean distances were computed on the F2-F3 and "x-y" planes, respectively. Results: Compared with L1 speakers, L2 speakers exhibited a significantly slower speaking rate. For the three semivowels, L2 speakers showed a reduced F3/F2 ratio during constriction, increased lip aperture, and reduced acoustic Euclidean distances among semivowels. Additionally, perceptual ratings of foreign accent were significantly correlated with three measures: duration of steady F2, acoustic Euclidean distance, and kinematic Euclidean distance. Conclusions: The findings provide acoustic and kinematic evidence for challenges that L2 speakers experience in the production of English semivowels, especially /[voiced alveolar approximant]/ and /w/. The robust and consistent finding of reduced contrasts among semivowels and their correlations with perceptual accent ratings suggests using sound contrasts as a potentially effective approach to accent modification paradigms.

Purpose: This study investigated relationships within and between perceptual, acoustic, and kinematic measures in speakers with and without dysarthria due to Parkinson's disease (PD) across different clarity conditions. Additionally, the study assessed the predictive capabilities of selected acoustic and kinematic measures for intelligibility and articulatory precision ratings. Method: Forty participants, comprising 22 with PD and 18 controls, read three phrases aloud using conversational, less clear, and more clear speaking conditions. Acoustic measures and their theoretical kinematic parallel measures (i.e., acoustic and kinematic distance and vowel space area [VSA]; second formant frequency [F2] slope and kinematic speed) were obtained from the diphthong /a/ and selected vowels in the sentences. A total of 368 listeners from crowdsourcing provided ratings for intelligibility and articulatory precision. The research questions were examined using correlations and linear mixed-effects models. Results: Intelligibility and articulatory precision ratings were highly correlated across all speakers. Acoustic and kinematic distance, as well as F2 slope and kinematic speed, showed moderately positive correlations. In contrast, acoustic and kinematic VSA exhibited no correlation. Among all measures, acoustic VSA and kinematic distance were robust predictors of both intelligibility and articulatory precision ratings, but they were stronger predictors of articulatory precision. Conclusions: The findings highlight the importance of measurement selection when examining cross-domain relationships. Additionally, they support the use of behavioral modifications aimed at eliciting larger articulatory gestures to improve intelligibility in individuals with dysarthria due to PD. [ABSTRACT FROM AUTHOR]

Posterior spinal instrumented fusion (PSIF) is a treatment option for adolescent spinal deformity. PSIF leads to loss of spinal segment motion. It is unclear the extent to which spinal stiffness is perceived by adolescent patients after fusion. Focus groups of adolescents between ages 11 and 21 years who underwent PSIF for spinal deformity were performed. Focus groups were evaluated for common themes, and a 36-question survey was designed. Survey responses were analyzed relative to last instrumented vertebra (LIV) and Scoliosis Research Society-22 (SRS-22) scores. Five focus groups were held with 18 patients in total. Three main themes were identified by participants: 56% identified difficulty bending forward, 44% identified difficulty hunching while sitting, and 56% identified difficulty with twisting motions. Patients with more distal LIV reported significant more difficulty with self-care/grooming (P =.014) and chores (P <.001). SRS-22 function/activity scores correlated well with survey categories in self-care/grooming (r =.61; P =.049) and recreation (r =.69; P =.019). Focus groups suggest that spinal stiffness is frequently perceived and leads to alteration in daily tasks in adolescents after spinal fusion. [ABSTRACT FROM AUTHOR]

This article examines the potential benefits and challenges of using artificial intelligence (AI) in labor organizing. It acknowledges that while AI can empower workers and advance the goals of the labor movement, there are concerns about job displacement and the concentration of power in big tech companies. The article emphasizes the need for a balance between AI and human involvement in organizing, highlighting how AI can support base-building, leadership development, and worksite collective bargaining. It also discusses the potential for AI to automate tasks and free up organizers for strategic decision-making and relationship-building. The article suggests that AI can be a game-changer for organizing, but careful consideration must be given to its implementation and potential impacts. It proposes the intervention of the federal government to provide resources and create a level playing field, and emphasizes the importance of collaboration between unions, government agencies, academic institutions, technology experts, and community-based organizations to harness the transformative potential of AI in labor organizing. [Extracted from the article]

Purpose: Despite the general agreement that dysarthria characteristics are largely language-independent, few efforts have attempted a systematic comparison across languages. To examine the role of native languages in the perception of speech characteristics of dysarthria secondary to Parkinson's disease (PD), auditory-perceptual ratings of dysarthria, and confidence level of the judgments were compared between two listener groups: language-matched and language-crossed. Method: A total of 60 listeners (35 native speakers of Korean and 25 native speakers of American English) estimated speech abnormality for 20 speech dimensions using a visual analog scale method for both language-matched and language-crossed speech stimuli. Speech stimuli were passage readings of the respective languages obtained from individuals with and without PD. Results: For speech dimension ratings, eight of 20 speech dimensions revealed significant differences in response to PD speech between the two listener groups, for most of which, language-crossed listeners' estimation was lower (i.e., more impaired) than language-matched listeners. For confidence-level ratings, language-matched listeners were less confident in the ratings of speakers with PD compared to the language-crossed listeners. Conclusions: The data support both language-universal and language-specific aspects in perceiving dysarthria characteristics, such that native language plays a role, especially when rating articulatory- and rhythmic-related characteristics. The findings are discussed with respect to the role of linguistic information, such as phonetic inventories and prosodic structures, in perceiving dysarthria characteristics. [ABSTRACT FROM AUTHOR]

Introduction: Vascular and mitochondrial dysfunction are well-established consequences of multiple central nervous system (CNS) disorders, including neurodegenerative diseases and traumatic injuries. We previously reported that 5-hydroxytryptamine 1F receptor (5-HT1FR) agonism induces mitochondrial biogenesis (MB) in multiple organ systems, including the CNS. Methods: Lasmiditan is a selective 5-HT1FR agonist that is FDA-approved for the treatment of migraines. We have recently shown that lasmiditan treatment induces MB, promotes vascular recovery and improves locomotor function in a mouse model of spinal cord injury (SCI). To investigate the mechanism of this effect, primary cerebral microvascular endothelial cells from C57bl/6 mice (mBMEC) were used. Results: Lasmiditan treatment increased the maximal oxygen consumption rate, mitochondrial proteins and mitochondrial density in mBMEC, indicative of MB induction. Lasmiditan also enhanced endothelial cell migration and tube formation, key components of angiogenesis. Trans-endothelial electrical resistance (TEER) and tight junction protein expression, including claudin-5, were also increased with lasmiditan, suggesting improved barrier function. Finally, lasmiditan treatment decreased phosphorylated VE-Cadherin and induced activation of the Akt-FoxO1 pathway, which decreases FoxO1-mediated inhibition of claudin-5 transcription. Discussion: These data demonstrate that lasmiditan induces MB and enhances endothelial cell function, likely via the VE-Cadherin-Akt-FoxO1-claudin-5 signaling axis. Given the importance of mitochondrial and vascular dysfunction in neuropathologies, 5-HT1FR agonism may have broad therapeutic potential to address multiple facets of disease progression by promoting MB and vascular recovery. [ABSTRACT FROM AUTHOR]

Purpose: This study examined speech changes induced by deep-brain stimulation (DBS) in speakers with Parkinson’s disease (PD) using a set of auditoryperceptual and acoustic measures. Method: Speech recordings from nine speakers with PD and DBS were compared between DBS-On and DBS-Off conditions using auditory-perceptual and acoustic analyses. Auditory-perceptual ratings included voice quality, articulation precision, prosody, speech intelligibility, and listening effort obtained from 44 listeners. Acoustic measures were made for voicing proportion, second formant frequency slope, vowel dispersion, articulation rate, and range of fundamental frequency and intensity. Results: No significant changes were found between DBS-On and DBS-Off for the five perceptual ratings. Four of six acoustic measures revealed significant differences between the two conditions. While articulation rate and acoustic vowel dispersion increased, voicing proportion and intensity range decreased from the DBS-Off to DBS-On condition. However, a visual examination of the data indicated that the statistical significance was mostly driven by a small number of participants, while the majority did not show a consistent pattern of such changes. Conclusions: Our data, in general, indicate no-to-minimal changes in speech production ensued from DBS stimulation. The findings are discussed with a focus on large interspeaker variability in PD in terms of their speech characteristics and the potential effects of DBS on speech. [ABSTRACT FROM AUTHOR]