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Biomedical subjects

C M Reed

Publications and source records attributed to C M Reed.

At least 37 records · Page 2Linked to original sources
PubMed1992

Spectrum of disease in persons with human immunodeficiency virus infection in the United States.

OBJECTIVE: To describe the spectrum of disease in persons with human immunodeficiency virus (HIV) infection. DESIGN: Retrospective survey of medical records. SETTING: More than 50 clinics, hospitals, and private medical practices in nine US cities. PATIENTS: A total of 626 women and 7008 men 13 years of age or older with HIV infection who received medical care from January 1990 through March 1991 were consecutively enrolled. MAIN OUTCOME MEASURES: Any history of diseases in the 1987 case definition for the acquired immunodeficiency syndrome (AIDS), and during the 12-month period preceding enrollment (baseline period), the occurrence of other major diseases, hospitalizations, and results of CD4+ lymphocyte counts. RESULTS: Thirty-two percent of persons met the 1987 case definition for AIDS. The occurrence of an AIDS-indicator disease during the baseline period ranged from 3% (33/1011) to 46% (1254/2748) among persons with CD4+ lymphocyte counts of 0.50 x 10(9)/L or greater and fewer than 0.20 x 10(9)/L (greater than or equal to 500 and less than 200 CD4+ lymphocytes per microliter), respectively, and, at comparable CD4+ lymphocyte levels, was similar among women compared with men, and among persons who reported intravenous drug use compared with men who reported male-to-male sex. The frequency of one or more other major infectious diseases (eg, other pneumonias, bacterial sepsis, pulmonary tuberculosis) ranged from 6% to 16% among persons with CD4+ lymphocyte counts of 0.50 x 10(9)/L or greater and fewer than 0.20 x 10(9)/L, respectively; these illnesses were also associated with a history of intravenous drug use. Among persons who did not meet the 1987 AIDS case definition, 30% of those with an available CD4+ lymphocyte count had fewer CD4+ cells than 0.20 x 10(9)/L, 8% had one or more major infectious diseases, and 14% had one or more hospital admissions. CONCLUSIONS: For every person with AIDS at these sites, two additional persons with HIV infection were receiving medical care, many of whom had severe immunosuppression and a broad spectrum of serious HIV-related disease.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Analytic study of the Tadoma method: improving performance through the use of supplementary tactual displays.

Although results obtained with the Tadoma method of speechreading have set a new standard for tactual speech communication, they are nevertheless inferior to those obtained in the normal auditory domain. Speech reception through Tadoma is comparable to that of normal-hearing subjects listening to speech under adverse conditions corresponding to a speech-to-noise ratio of roughly 0 dB. The goal of the current study was to demonstrate improvements to speech reception through Tadoma through the use of supplementary tactual information, thus leading to a new standard of performance in the tactual domain. Three supplementary tactual displays were investigated: (a) an articulatory-based display of tongue contact with the hard palate; (b) a multichannel display of the short-term speech spectrum; and (c) tactual reception of Cued Speech. The ability of laboratory-trained subjects to discriminate pairs of speech segments that are highly confused through Tadoma was studied for each of these augmental displays. Generally, discrimination tests were conducted for Tadoma alone, the supplementary display alone, and Tadoma combined with the supplementary tactual display. The results indicated that the tongue-palate contact display was an effective supplement to Tadoma for improving discrimination of consonants, but that neither the tongue-palate contact display nor the short-term spectral display was highly effective in improving vowel discriminability. For both vowel and consonant stimulus pairs, discriminability was nearly perfect for the tactual reception of the manual cues associated with Cued Speech. Further experiments on the identification of speech segments were conducted for Tadoma combined with Cued Speech. The observed data for both discrimination and identification experiments are compared with the predictions of models of integration of information from separate sources.

Blindness↗
PubMed1991

Development and testing of artificial low-frequency speech codes.

In a new approach to the frequency-lowering of speech, artificial codes were developed for 24 consonants (C) and 15 vowels (V) for two values of lowpass cutoff frequency F (300 and 500 Hz). Each individual phoneme was coded by a unique, nonvarying acoustic signal confined to frequencies less than or equal to F. Stimuli were created through variations in spectral content, amplitude, and duration of tonal complexes or bandpass noise. For example, plosive and fricative sounds were constructed by specifying the duration and relative amplitude of bandpass noise with various center frequencies and bandwidths, while vowels were generated through variations in the spectral shape and duration of a ten-tone harmonic complex. The ability of normal-hearing listeners to identify coded Cs and Vs in fixed-context syllables was compared to their performance on single-token sets of natural speech utterances lowpass filtered to equivalent values of F. For a set of 24 consonants in C-/a/ context, asymptotic performance on coded sounds averaged 90 percent correct for F = 500 Hz and 65 percent for F = 300 Hz, compared to 75 percent and 40 percent for lowpass filtered speech. For a set of 15 vowels in /b/-V-/t/ context, asymptotic performance on coded sounds averaged 85 percent correct for F = 500 Hz and 65 percent for F = 300 Hz, compared to 85 percent and 50 percent for lowpass filtered speech. Identification of coded signals for F = 500 Hz was also examined in CV syllables where C was selected at random from the set of 24 Cs and V was selected at random from the set of 15 Vs. Asymptotic performance of roughly 67 percent correct and 71 percent correct was obtained for C and V identification, respectively. These scores are somewhat lower than those obtained in the fixed-context experiments. Finally, results were obtained concerning the effect of token variability on the identification of lowpass filtered speech. These results indicate a systematic decrease in percent-correct score as the number of tokens representing each phoneme in the identification tests increased from one to nine.

Evaluation Studies as Topic↗
PubMed1990

A study of the tactual and visual reception of fingerspelling.

A method of communication in frequent use among members of the deaf-blind community is the tactual reception of fingerspelling. In this method, the hand of the deaf-blind individual is placed on the hand of the sender to monitor the handshapes and movements associated with the letters of the manual alphabet. The purpose of the current study was to examine the ability of experienced deaf-blind subjects to receive fingerspelled materials, including sentences and connected text, through the tactual sense. A parallel study of the reception of fingerspelling through the visual sense was also conducted using sighted deaf subjects. For both visual and tactual reception of fingerspelled sentences, accuracy of reception was examined as a function of rate of presentation. In the tactual study, where rates were limited to those that could be produced naturally by an experienced interpreter, highly accurate reception of conversational sentence materials was observed throughout the range of naturally produced rates (i.e., 2 to 6 letters/s). In the visual study, rates in excess of those that can be produced naturally were achieved through variable-speed playback of videotapes of fingerspelled sentences. The results of this study indicate that performance varies systematically as a function of rate of presentation, with scores of 50% correct on conversational sentences obtained at rates of 12 to 16 letters/s (i.e., rates roughly double to triple normal speed). These results suggest that normal communication rates for the visual reception of fingerspelling are restricted by limitations on the rate of manual production. Although maximal rates of natural manual production of fingerspelling correspond to the presentation of a new handshape on the order of once every 150-20 ms, the data from the sped-up visual study suggest that experienced receivers of visual fingerspelling are able to receive sentences at substantially higher rates of fingerspelling (which are, in fact, comparable to communication rates for spoken English).

Adult↗
PubMed1989

Analytic study of the Tadoma method: effects of hand position on segmental speech perception.

In the Tadoma method of communication, deaf-blind individuals receive speech by placing a hand on the face and neck of the talker and monitoring actions associated with speech production. Previous research has documented the speech perception, speech production, and linguistic abilities of highly experienced users of the Tadoma method. The current study was performed to gain further insight into the cues involved in the perception of speech segments through Tadoma. Small-set segmental identification experiments were conducted in which the subjects' access to various types of articulatory information was systematically varied by imposing limitations on the contact of the hand with the face. Results obtained on 3 deaf-blind, highly experienced users of Tadoma were examined in terms of percent-correct scores, information transfer, and reception of speech features for each of sixteen experimental conditions. The results were generally consistent with expectations based on the speech cues assumed to be available in the various hand positions.

Adult↗
PubMed1988

Epidemiological aspects of a St. Louis encephalitis outbreak in Harris County, Texas, 1986.

An outbreak of St. Louis encephalitis (SLE) resulted in 28 cases of the disease in Harris County, Texas, in 1986. The cases occurred principally in Baytown, in eastern Harris County, but five cases were also recognized in Houston. The risk of illness increased sharply with age, and all five fatal cases were in persons greater than 55 y. Case-control methods were used for the first time to study factors associated with the risk of acquiring SLE. Risk was associated with residences poorly sealed against mosquitoes (non-air-conditioned residences and those with inadequate screens). The number of hours spent outdoors and in outdoor activities, except sitting immediately outside residences, were not associated with risk. Our observations suggest that exposure to vector mosquitoes may have occurred indoors. No host factors were significantly associated with risk of acquiring SLE, but more cases were cigarette smokers and had family histories of hypertension or cerebrovascular disease.

Adult↗
PubMed1988

Preliminary results of speech-reception tests obtained with the synthetic Tadoma system.

In the Tadoma method of speech reception used by some deaf-blind individuals, speech is understood by placing a hand on the face of the talker and feeling certain mechanical actions of the face associated with speech production. The synthetic Tadoma system is a computer-driven artificial face that simulates these mechanical actions. This paper reports some preliminary data on the discrimination of nonsense syllables with the synthetic system. Although further work is required to produce an accurate simulation, the results suggest that such a goal is indeed achievable.

Blindness↗
PubMed1988

The benefit of cesarean section in acute myocardial infarction complicated by premature labor.

A 42-year-old woman with no known risk factors had an acute myocardial infarction at 32 weeks' gestation and went into premature labor. She required invasive hemodynamic monitoring and inotropic support. Congestive heart failure improved dramatically after cesarean section. During the acute infarction, ventricular dysfunction was out of proportion to the ultimate ventricular damage. The concept of the stunned myocardium is used to explain this finding and to justify early cesarean section. Another complication of her infarction, left ventricular thrombosis, has not previously been described in pregnancy.

Adult↗
PubMed1987

Spectral-shape discrimination. I. Results from normal-hearing listeners for stationary broadband noises.

This research is concerned with the ability of normal-hearing listeners to discriminate broadband signals on the basis of spectral shape. The signals were six broadband noises whose spectral shapes were modeled after the spectra of unvoiced fricative and plosive consonants. The difficulty of the discriminations was controlled by the addition of noise filtered to match the long-term speech spectrum. Two-interval discrimination measurements were made in which loudness cues were eliminated by randomizing (roving) the overall stimulus level between presentation intervals. Experimental results, examined as a function of intensity rove width, stimulus duration, and stimulus pair, were related to the predictions of a simple filter-bank model whose fitting parameter provides an estimate of internal noise. Most results, with the notable exception of duration effects, were predicted by the model. Estimates of internal noise in each frequency channel averaged roughly 7 dB for long-duration stimuli and 13 dB for short-duration stimuli. Results and predictions are compared to results of other studies concerned with the discrimination of spectral shape.

Humans↗
PubMed1985

Research on the Tadoma method of speech communication.

In Tadoma, speech is received by placing a hand on the talker's face and monitoring actions associated with speech production. Our initial research has documented the speech perception, speech production, and linguistic abilities of deaf-blind individuals highly trained in Tadoma. This research has demonstrated that good speech reception can be achieved through the tactile sense: Performance is roughly equivalent to that of normals listening in noise or babble with a signal-to-noise ratio in the range 0-6 dB. It appears that the principal cues employed are lip movement, jaw movement, oral airflow, and laryngeal vibration, and that the errors which occur are caused primarily by inadequate information on tongue position. Our current research includes (1) learning of Tadoma by normal subjects with simulated deafness and blindness, (2) augmenting Tadoma with a supplemental tactile display of tongue position, and (3) developing a synthetic Tadoma system in which signals recorded from a talker's face are used to drive an artificial face. This research is expected to increase our understanding of Tadoma and its relation to other tactile communication methods, show that performance obtained through Tadoma does not represent the ultimate limits of the tactile sense, and provide a research tool for studying transformations of Tadoma.

Adult↗
PubMed1985

Discrimination and identification of frequency-lowered speech in listeners with high-frequency hearing impairment.

The effects of frequency lowering on consonant perception were studied in four listeners with high-frequency sensorineural loss. Frequency lowering, accomplished by pitch-invariant nonuniform compression of the short-term spectral envelope, included lowering to bandwidths of 2500 and 1250 Hz. Performance on frequency lowering was compared to that obtained with linear amplification using uniform or high-frequency emphasis. Results of pairwise discrimination tests indicated that performance on lowering to 1250 Hz was inferior to that obtained with linear amplification. After training, performance on consonant identification with lowering to bandwidths of 2500 or 1250 Hz was equivalent or inferior to that obtained with linear amplification, depending on the subject. In most cases, the performance of the impaired subjects on a given lowering condition was inferior to that obtained by normal subjects, except for one impaired subject whose performance on two lowering conditions was similar to normal.

Hearing Loss, Sensorineural↗
PubMed1985

Human cutaneous leishmaniasis acquired in Texas.

Four cases of autochthonous human cutaneous leishmaniasis have been identified in south-central Texas since 1980. The patients presented with chronic ulcerating papules on the face, earlobe, and lateral thigh. In two patients, the infections healed without treatment. In the other two patients, the lesions healed following treatment with intramuscular sodium stibogluconate or topical antimony potassium tartrate. Serologic testing of family members, using four different techniques, indicates that asymptomatic infections may occur. These are the first reported cases of cutaneous leishmaniasis acquired in Texas since 1974. Organisms isolated from patients in 1974 and 1980 belonged to the Leishmania mexicana complex when tested by the isoenzyme technique. Although no animal reservoir or insect vector has been identified, six species of sand flies belonging to the genus Lutzomyia do inhibit this part of Texas. Accumulated evidence strongly suggests that cutaneous leishmaniasis is endemic in south-central Texas.

Antibodies↗
PubMed1983

Discrimination of speech processed by low-pass filtering and pitch-invariant frequency lowering.

Consonant discriminability by normal-hearing listeners was studied for monosyllables processed using frequency lowering with either uniform (linear) or nonuniform (warped) compression of the frequency axis. The bandwidth of the compressed signal was either 2500 or 1250 Hz and five compression characteristics were studied, in addition to low-pass filtering, for each of the two bandwidths. Stimuli were 24 consonant-vowel syllables made up of 24 consonants and three vowels, recorded three times by each of two male and female speakers. A "roving-speaker, roving-vowel, roving-utterance," two-interval, forced-choiced procedure with feedback was employed. As expected, performance for the 2500-Hz bandwidth was superior to that for the 1250-Hz bandwidth. For each bandwidth, compression schemes which accomplished greater lowering of the high frequencies relative to the low frequencies resulted in the highest performance. Overall performance for the best frequency-lowering system studied, however, was roughly comparable to that obtained for low-pass filtering. Patterns of performance over articulatory features were different for frequency lowering and filtering. In general, lowering was superior to filtering for contrasts of fricative sounds but inferior for contrasts of nasals and semivowels.

Female↗
PubMed1983

The epidemiology of heat-related deaths, Texas--1950, 1970-79, and 1980.

A study of the deaths during a 1980 heat wave in Texas revealed death rates that were highest in males, the elderly, Blacks and those engaged in heavy labor, the latter two factors perhaps reflecting socioeconomic status. The data suggest that persistent high temperatures were related to death to a greater degree than the temperature peaks reached. Higher heat death rates in earlier years are believed to be attributable to the limited availability of air conditioning in those years.

Black or African American↗
PubMed1982

Analytic study of the Tadoma method: identification of consonants and vowels by an experienced Tadoma user.

Performance on identifying consonant and vowel stimuli through the Tadoma methods of speechreading was studied for a deaf-blind, experienced user of Tadoma. For a set of 24 consonants in CV syllables, performance averaged 55%. For a set of 15 vowels and diphthongs in CVC syllables, performance averaged 56%. Confusion matrices derived from the identification tests were analyzed for performance on a set of articulatory/phonological features, the results of the feature analysis for consonants indicated that the features voicing, lip rounding frication, and place were well-perceived; for vowels, and features lip rounding, tenseness, and vertical lip separation were well-perceived.

Adult↗
PubMed1982

Analytic study of the Tadoma method: further experiments with inexperienced observers.

Results are presented for two studies of speechreading through the Tadoma method using normal subjects with simulated deafness and blindness. In the first study, subjects received training on the identification of consonant and vowel stimuli through Tadoma. In posttraining tests, an average score of 73% was obtained on a set of 24 consonants presented in CV syllables, and an average score of 82% was obtained on a set of 15 vowels and diphthongs presented in /g/-V-/d/ syllables. An analysis of the confusion matrices derived from the identification tests in terms of of various articulatory/phonological features indicated that the features place, voicing, frication, and round were well-perceived for consonants and round, tense, vertical lip separation, and low, for vowels. In the second study, subjects received training through Tadoma on comprehension of sentences composed of words from a 43-item vocabulary. In tests for which sentence stimuli were repeated until a correct response was obtained, the subjects identified an average of 30% of the words correctly on the first presentation and required an average of roughly four presentations for complete identification of the stimulus.

Humans↗