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Identification of deleted consonants.

VC transitions have often been found to be better cues for the identification of deleted consonants than CV transitions. The lower score for CV transitions could very well be due to an interfering "click sensation" caused by the abrupt begining of these transitions. In the present investigation the abrubt onset was eliminated by replacing the deleted portions of the consonants with noise bursts; this also caused the incomplete syllables to sound more natural. The results show that the identification of deleted initial voiceless plosives is greatly improved by the addition of noise. The original difference between initial and final plosive transitions disappears almost completely.

Humans

Embedding cardiovascular risk assessment into routine BTK inhibitor management in chronic lymphocytic leukemia.

INTRODUCTION: Cardiovascular (CV) toxicities remain a major challenge during Bruton tyrosine kinase inhibitor (BTKi) therapy for chronic lymphocytic leukemia (CLL). Selecting the optimal BTKi based solely on a history of overt CV disease may underestimate underlying cardiovascular vulnerability. AREAS COVERED: We performed a targeted, non-systematic review of PubMed and MEDLINE to examine the association between baseline CV comorbidities and BTKi-related CV toxicities in CLL. Current evidence indicates that preferential use of BTKis with more favorable CV safety profiles, coupled with appropriate cardio-oncology surveillance, reduces the risk of CV adverse events in patients with pre-existing CV disease. In patients without established CV disease, the Systematic Coronary Risk Evaluation 2 (SCORE2) and SCORE2-Older Persons (SCORE2-OP) may help identify clinically meaningful latent CV risk, enabling early optimization of modifiable risk factors in line with the proactive cardiovascular management strategy endorsed by the 2026 European Hematology Association (EHA) CLL guidelines. EXPERT OPINION: A structured, risk-adapted approach integrating standardized CV risk assessment, early management of modifiable risk factors, individualized BTKi selection, and multidisciplinary cardio-oncology collaboration may improve the safety and tolerability of BTKi therapy in CLL. Pending prospective validation, SCORE2 and SCORE2-OP should complement, rather than replace, dedicated cardio-oncology evaluation.

Humans

Plasma proteomics and coronary artery calcium score: synergistic, concordant and contrasting predictions of cardiovascular outcomes in The Multi-Ethnic Study of Atherosclerosis.

BACKGROUND: Coronary artery calcium (CAC) scores inform subclinical atherosclerotic cardiovascular disease (ASCVD) burden, helping guide preventative treatments. However, prediction of cardiovascular (CV) events by CAC is largely limited to ASCVD outcomes. This study investigated whether a previously validated proteomic test for predicting a broad composite of four-year CV events could enhance the prognostic utility of CAC. METHODS: We used a 27-protein CV risk score (Prot-CVR), derived from ~5,000 SomaScan&#x2122; Assay plasma protein measurements, to predict four-year risk of a composite CV and mortality outcome (myocardial infarction, stroke/TIA, heart failure hospitalization, death) in 2,122 participants with &#x2265;1 CV risk factors from the Multi-Ethnic Study of Atherosclerosis (MESA) observational cohort at exam 5 and compared predictions to CAC Agatston scores. Discriminatory performance was assessed using C-Index and 4-year area under the curve (AUC). Cox Proportional Hazard (CoxPH) ratios were calculated for the composite outcome, ASCVD outcome (myocardial infarction, resuscitated cardiac arrest, stroke, coronary heart disease death), and individual events. Changes in Prot-CVR and CAC scores from baseline to MESA exam 5 (+10-years) in CV event versus event-free participants were assessed using 2-tailed paired t-tests. CoxPH regression models of CV event status distributed by Prot-CVR, CAC, and relevant co-variates were evaluated for performance relative to individual models. RESULTS: Individual Prot-CVR and CAC models predicting the composite outcome had comparable 4-year AUCs, but Prot-CVR had a higher C-index (0.68 (0.65-0.70) versus 0.63 (0.60-0.65), p=0.001) and greater hazard ratios for the composite outcome (p<0.001), death (p<0.001), and heart failure (p=0.015). A combined CoxPH model of Prot-CVR + CAC + Age had a higher 4-year AUC (0.72, p<0.05) and C-Index (0.71, p<0.05) than Prot-CVR or CAC alone. Both Prot-CVR and CAC scores detected an increase in risk prior to an approaching CV event in ~10-year sensitivity-to-change analysis. For 49.6% of MESA population with CAC=0 at baseline, Prot-CVR was greater in composite event versus event free participants at 4 years (0.23 versus 0.15, p=0.006) and full follow-up (0.18 versus 0.13, p<0.001). CONCLUSION: Protein testing complements CAC for CV risk assessment although the improvement is modest. Prot-CVR may resolve which patients with CAC=0 are at heightened CV risk.

Journal Article

Cardiovascular Complications Are Increased in Inflammatory Bowel Disease: A Path Toward Achievement of a Personalized Risk Estimation.

Background/Objectives: The global burden of inflammatory bowel diseases (IBDs) continues to rise, with up to 50% of patients experiencing extraintestinal manifestations. Cardiovascular diseases (CVDs) are of particular concern, ranking as the second leading cause of mortality in this population. Despite a comparatively lower prevalence of traditional cardiovascular (CV) risk factors, the persistent inflammatory milieu and immune dysregulation inherent to IBD may contribute to heightened CVD risk. In this study, following a review of the current literature, an ongoing prospective trial designed to clarify CV risk profiles in IBD patients is detailed. Methods: A cohort of patients with IBD is being enrolled for comprehensive baseline evaluation of CV risk factors, lifestyle metrics, and disease characteristics. The incidence of major adverse cardiovascular events (MACEs) will be tracked and contrasted with a gender- and age-matched non-IBD cohort over a 2-year follow-up period. In cases of MACE occurrence, a multi-omics analysis-including genomic, proteomic, transcriptomic, and microbiome profiling-will be performed, along with a parallel evaluation in matched IBD controls without MACE. An artificial intelligence (AI) framework will support the analysis of this complex dataset. Results: To date, over 150 patients with IBD have been enrolled, and detailed phenotypic data and biological samples have been collected. Conclusions: We aim to introduce an IBD-specific correction factor for existing CV risk scores upon study completion. This is particularly relevant for individuals under 40 years of age, who are often inadequately assessed by current risk stratification models.

Crohn&#x2019;s disease

The effects of age upon the visual perception of speech.

A sample of 110 middle-aged and geriatric subjects (40 to 87 years) with normal hearing and vision was drawn from the general population in order to compare visual performance for consonant-vowel (CV) syllables and sentences. Results of this investigation revealed that, above 70, age was a factor affecting visual perception of syllables. Individuals above age 70 received the poorest speechreading scores and were inconsistent in viseme categorization. Results of a comparison of speechreading scores for sentences and syllables revealed a greater number of differences among sentences. Only individuals between 40 and 60 years of age received statistically similar mean scores when presented with common sentences. Finally, using a linear regression model, it was found that sentence speechreading performance could be accurately predicted from the CV syllable score within a range of accuracy of +/- 9.7%.

Adult

Order effect of acoustic segments of VC and CV syllables on stop and vowel identification.

The purpose of this study was to determine the importance of the vocalic transition relative to other acoustic cues in the perception of both CV and VC syllables. Subjects identified stops, /p, t, k, b, d, g/ and vowels, /i, u, 3/ from the aperiodic, aperiodic + vocalic transition, vocalic transition, and vocalic transition + vowel segments edited from VC and CV syllables. The major findings were as follows: (1) no significant difference was found in consonant identification scores between aperiodic, aperiodic + vocalic transition, and vocalic transition segments in CV syllables compared to those in VC syllables; (2) consonant identifications from vocalic transition + vowel segments in VC syllables were significantly greater than those from vocalic transition + vowel segments in CV syllables; (3) no significant difference was found in vowel identification scores between aperiodic + vocalic transition, vocalic transition + vowel, and vocalic transition segments in CV syllables compared to those in VC syllables; and (4) vowel identifications from aperiodic segments were significantly greater in CV syllables than in VC syllables. The results revealed a significant right-to-left perceptual advantage for both vowels and consonants. The findings for consonant identification emphasize the importance of the temporal order relationship between the vocalic transition and steady-state vowels in the perceptual process.

Acoustics

Magnesium administration for vasospasm prevention in acute aneurysmal SAH: a multicenter randomized controlled trial.

Aneurysmal subarachnoid hemorrhage (aSAH) is associated with significant morbidity and mortality, with cerebral vasospasm (CV) and delayed cerebral ischemia (DCI) being the primary contributors to poor outcomes. Magnesium sulfate (MgSO&#x2084;) has demonstrated neuroprotective and vasodilatory properties in preclinical models. This study aimed to evaluate the effect of targeted serum magnesium (Mg) maintenance on CV and exploratory clinical outcomes following aSAH. We conducted a prospective, multicenter, single-blind RCT across four neurocritical care units in Korea between 2019 and 2024. A total of 121 aSAH patients were randomized to receive either IV MgSO&#x2084;or placebo within six hours of admission. Mg was infused to maintain serum concentrations between 2.0 and 3.0 mg/dL for 14 days. The primary outcome was incidence of CV assessed by transcranial doppler. Secondary outcomes included DCI, ICU and hospital length of stay, modified rankin scale (mRS) at 30 days. There was no significant difference in overall CV incidence; however, the Mg group demonstrated significantly lower mean flow velocity and Lindegaard ratio on days 4-9, indicating reduced vasospasm severity. In exploratory multivariable analyses, a median serum Mg concentration&#x2009;>&#x2009;2.5 mg/dL during the first 14 hospital days was independently associated with lower risks of CV and DCI. No significant differences were found in mRS scores, ICU and hospital stay, or serious adverse events between groups. Early targeted Mg administration improved TCD-derived hemodynamic markers during the peak vasospasm window; however, it did not significantly reduce CV incidence, DCI, ICU or hospital stay, or 30-day functional outcome.

Humans

Dichotic listening in adults with sensorineural hearing loss.

Digits and consonant-vowel (CV) nonsense syllables were presented dichotically to 36 normal-hearing subjects and 36 subjects with bilaterally symmetrical sensorineural hearing loss. The normal-hearing subjects performed significantly better in the recall of both digits and CV nonsense syllables, and recall decreased significantly as the degree of hearing loss increased. The expected right ear advantage was observed for the normal-hearing subjects on both tests. As a group, the hearing-loss subjects showed no significant ear preference, and ear preference did not vary significantly with the degree of hearing loss. However, individual hearing-loss subjects showed marked ear asymmetry for the dichotic digits. For both dichotic tests, individual ear preference increased as the degree of hearing loss increased. Significant but low correlations were observed between better ear speech discrimination scores for the hearing-loss subjects and the preferred ear for dichotic CV nonsense syllables.

Adult

Influence of amplification on the discrimination of dichotic consonant-vowel syllables in a population with sensorineural hearing loss.

This study was designed to investigate the premise that the long-term use of monaural amplification influences dichotic listening conditions in a population with sensorineural hearing losses. 30 subjects with moderate, bilateral sensorineural hearing losses and 10 normally-hearing adults were chosen for this study. 20 of the subjects with sensorineural hearing loss had worn amplification successfully for at least 1 year prior to testing. 10 of these subjects had worn amplification only on the right ear while the remaining 10 had worn amplification only on the left ear. All subjects received 60 monaural and dichotic consonant-vowel (CV) nonsense syllables presented at equal loudness levels using the most comfortable level (MCL) as the loudness criteria. While monaural scores revealed nonsignificant differences between ears for all subjects, using percentage of error, dichotic results produced a right-ear advantage for the right-ear-aided, unaided and normally-hearing subjects. A significant left-ear advantage was seen for the left-ear-aided subjects. Results of this study suggest that amplification introduces selective listening effects which alter reported dichotic test scores.

Audiometry, Pure-Tone

Analytic study of the Tadoma method: discrimination ability of untrained observers.

This study reports the ability of two observers with normal-hearing and sight to discriminate pairs of speech elements through the Tadoma method of speechreading. The observers were blindfolded and exposed to masking noise to eliminate visual and auditory cues. They placed their right hand over the speaker's face and neck so that the thumb rested lightly on the lips and the fingers fanned out over the cheek and neck. The discrimination tests were conducted using an ABX procedure. Average discrimination scores for the five types of test materials used in the ABX tests were 87% on W-22 words, 83% on Modified Rhyme Test words, 70% on vowels, 77% on CV and VC nonsense syllables, and 71% on consonant clusters. In all of the ABX tests, the inexperienced observers performed at least as well as the experienced Tadoma user studied by Norton, et al (1977). This finding indicates that the basic tactile sensitivity of inexperienced observers is comparable to that of an experienced deaf-blind Tadoma user.

Cues

Toxicity of Leucaena leucocephala. The effect of iodine and mineral supplements on penned steers fed a sole diet of Leucaena.

Steers fed a sole diet of Leucaena leucocephala cv. Peru (leucaena), rapidly developed a hypothyroid condition. Total serum thyroxine (T4) levels declined from c 120 n mol litre-1 to 13 n mol litre-1 within six weeks of full leucaena feeding. Associated with the hypothyroidism was a declined in feed intake, poor weight gain, hair loss, excessive salivation and the development of lesions on the oesophagus of some animals. Light steers (119 kg) were more severely affected than heavy steers (220 kg) and two light steers died. During the eight week period of full leucaena feeding animals gained only 0.18 kg head-1 day-1 compared with 0.73 kg head-1 day -1 for steers fed cowpea (Vigna sinensis) hay. Supplementation with minerals (Fe, Cu, Zn) significantly increased mean daily intake (85.4 v 68.9 g/kg0.75), daily liveweight gain, (334 v 14 g), and serum T3 resin uptake (42.5 v 39.6%); decreased hair loss and skin lesions but did not alleviate the low serum T4 levels. Iodine supplementation did not affect intake, bodyweight gain, serum T4 levels, serum T3 uptake or toxicity scores compared with unsupplemented leucaena fed steers. When the leucaena fed animals were subsequently fed cowpea hay, appetite improved and the serum T4 levels returned to normal within two weeks. For the heavy steers over this period, weight gain was similar to the controls; however, the light steers continued to gain poorly.

Animals

Prediction of incident heart failure in established atherosclerotic cardiovascular disease: the SMART2-HF model.

BACKGROUND AND AIMS: Patients with established atherosclerotic cardiovascular disease (ASCVD) are at high risk of developing heart failure (HF). However, incident HF is not part of the risk assessment of current guideline-recommended models. The aim of this study was to develop and externally validate the SMART2-HF model for prediction of incident HF in patients with ASCVD. METHODS: SMART2-HF was developed in 7698 individuals with established ASCVD (coronary, cerebrovascular, or peripheral artery disease, or abdominal aortic aneurysm) but without prior HF from the UCC-SMART cohort. Cox proportional hazards models including sex-predictor interactions and with age as the time scale were derived to estimate the 10-year and lifetime risk of incident HF (hospitalization for HF or HF-related death), accounting for competing non-HF mortality. Predictors, limited to routinely available clinical characteristics, were aligned with the SMART2 risk model for recurrent cardiovascular (CV) risk in the same population. External validation was performed in 240 741 patients with ASCVD from six data sources: the Clinical Practice Research Datalink, the HUNT3 study, the SWEDEHEART Registry, the ASCVD-Particles cohort, the Estonian Biobank and the international REACH Registry. RESULTS: During a median follow-up of 11.2 years (interquartile range 6.1-16.4 years), 1031 incident HF events (13%) occurred in the UCC-SMART cohort. In the external validation data sources, a total of 24 885 incident HF events (10%) occurred. The pooled C-statistic was .696 (95% confidence interval .674-.717), with consistent performance in subgroups by sex and type of ASCVD. Predicted risks matched observed incidence in external validation. CONCLUSIONS: The SMART2-HF model enables the prediction of incident HF in patients with ASCVD. Aligned with the guideline-recommended SMART2 model for recurrent CV risk, SMART2-HF can be used as a complementary tool in this population.

Humans