Lakota Intonation and Prosody

This thesis provides a comprehensive account of the intonational phonology of Lakota, an indigenous North American language of the Siouan family. Lakota is predominantly a verb final language, characterized by complex verbal morphology. The phonological description of Lakota intonation and prosody presented here is based on acoustic analysis of speech data collected from native speakers. The framework of analysis adopts the fundamental tenets of the autosegmental-metrical approach to intonation as originally formulated by Pierrehumbert (1980) and later reformulated and extended by Pierrehumbert \u26 Beckman (1988), Ladd (2009), and others. The dissertation is organized into two major interrelated parts, the first dealing with the tonal and the second with the prosodic properties of Lakota. The tonal part provides an analysis of the major pitch events in Lakota utterances. I describe the types of pitch accents, their distribution inside phrases with different lengths and structures, and the alignment of these pitch events with respect to the segmental tier. I also provide an analysis of the types of pitch events that occur at the edges of phrases. The description of the intonational events is based on a corpus of declarative and interrogative utterances drawn from narratives and semi-spontaneous speech that sample different speakers, from two different time periods. The results show that the core tone in a pitch accent event in Lakota consists of a high (H) tonal target which can be followed and/or preceded by a low (L) pitch. The majority of accentual high peaks in Lakota are realized within the boundaries of lexically stressed syllables. The trailing L tone, if present, usually occurs in the space of one or two syllables after the stressed syllable. The analysis of the edge tones reveals that Lakota utterances contain boundary tones and intermediate phrase accents. I explore the types of boundary tones and show that the phrase accent is frequent and robust, although there is variation across speakers and genre in terms of the types of phrase accents that are used. I conclude the tonal analysis by considering two prominent aspects of pitch scaling in Lakota phrases. The first is the phenomenon of downstep and the second is the observation of sudden, and extreme, pitch span compressions. I show that these scaling events apply locally at specific points in an utterance. The prosodic part of the dissertation is primarily an acoustic and impressionistic phonetic analysis that yields evidence in favor of levels of prosodic structure in Lakota. I provide a detailed description of the segmental and suprasegmental cues associated with the perception of boundary strengths between adjacent words in phrases. This phonetic analysis shows that Lakota utterances can be organized into three levels of supra-lexical prosodic structure: the Intonational Phrase, the Intermediate Phrase, and the Prosodic (phonological) Word. I consider the phenomenon of downstep from the tonal analysis in light of the proposed prosodic structure and show that the application of pitch scaling events is constrained by the prosodic organization. In the final part of the analysis I discuss a few ways in which speech rate and morpho-phonological length influence prosodic phrasing. In particular, I examine the phrasing of several post-verbal enclitics based on the outcomes of a small experimental study. The results show that utterances in Lakota can contain complex prosodic domains. Although the thesis arrives at some interesting theoretical conclusions, it leaves open a number of issues for future research

Foot-and-mouth disease virus 2C is a hexameric AAA+ protein with a coordinated ATP hydrolysis mechanism.

Foot-and-mouth disease virus (FMDV), a positive sense, single-stranded RNA virus, causes a highly contagious disease in cloven-hoofed livestock. Like other picornaviruses, FMDV has a conserved 2C protein assigned to the superfamily 3 helicases a group of AAA+ ATPases that has a predicted N-terminal membrane-binding amphipathic helix attached to the main ATPase domain. In infected cells, 2C is involved in the formation of membrane vesicles, where it co-localizes with viral RNA replication complexes, but its precise role in virus replication has not been elucidated. We show here that deletion of the predicted N-terminal amphipathic helix enables overexpression in Escherichia coli of a highly soluble truncated protein, 2C(34–318), that has ATPase and RNA binding activity. ATPase activity was abrogated by point mutations in the Walker A (K116A) and B (D160A) motifs and Motif C (N207A) in the active site. Unliganded 2C(34–318) exhibits concentration-dependent self-association to yield oligomeric forms, the largest of which is tetrameric. Strikingly, in the presence of ATP and RNA, FMDV 2C(34–318) containing the N207A mutation, which binds but does not hydrolyze ATP, was found to oligomerize specifically into hexamers. Visualization of FMDV 2C-ATP-RNA complexes by negative stain electron microscopy revealed hexameric ring structures with 6-fold symmetry that are characteristic of AAA+ ATPases. ATPase assays performed by mixing purified active and inactive 2C(34–318) subunits revealed a coordinated mechanism of ATP hydrolysis. Our results provide new insights into the structure and mechanism of picornavirus 2C proteins that will facilitate new investigations of their roles in infection

California's Medicaid, managed care program : the two-plan model

Throughout the years we have seen a tremendous rise in health care costs primarily due to inflation, population growth, and technological advances. Inflation has caused an increase in the cost of things such as electricity, equipment, labor, and supplies. The population growth in combination with technological advances, which have extended life expectancy, have also contributed to the rise in health care costs. These advancements in medicine have resulted in ethical issues relating to quality of life versus quantity. Health care professionals are forced with this dilemma each and every day. Technology has advanced tremendously throughout the years and has helped to prolong lives for days, weeks, and sometimes months. The rise of health care costs has also led to nearly 37 million Americans with little coverage or no coverage at all. The health care delivery system is shifting from fee-for service to prepaid health plans, also known as managed care, as a possible approach to controlling costs. Its primary purpose is "to reduce health care expenditures while maintaining the quality of care" (Raffel, 75). Prepaid health plans provide "comprehensive health services to a voluntarily enrolled population for a fixed, prepaid, usually capitated fee" (Raffel, 75). Managed care, such as the Health Maintenance Organizations (HMO) and the Preferred Provider Organizations (PPO), have slowly begun to control the United States health care delivery system and with its growing population and policy changes, almost everyone would be required to enroll in a managed care system. The underlying problem of health maintenance organizations is that HMO's have begun to compete with one another for their share of the profit by "curtailing services in order to keep their costs down: making patients wait for appointments, ordering fewer laboratory and x-ray tests, and reducing the amount of nonemergency surgery" (Raffel, 76). Many physicians have begun working together in order to provide quality and quantity care by using cost-containment efforts. Secondly, managed care programs use primary care physicians as gatekeepers who have the sole responsibility of deciding who gets what procedure for what ailment or disease. Many argue that when primary care programs use gatekeepers, they may overlook a problem that would delay a diagnosis which can become very crucial to a patient's condition if they do not receive proper care immediately after initial diagnosis, especially in a life threatening situation. Medicaid has incurred enormous costs to the government, and it is trying to promote and influence states throughout the country to adopt a managed care program as a means of controlling costs. Every state has a different Medicaid program and managed care system that provides care to its beneficiaries, and each state has its own unique way of mandating its program. California is in the process of adopting a managed care program, the local initiative, where all recipients will be required to enroll. On January 22, 1996, The Department of Health and Human Services Secretary Donna E. Shalala approved California's Two-Plan Model and stated: "that it is expected to be fully implemented over the next two years, and once implemented, this will be the largest Medicaid managed care initiative in the nation" (Approval of California's Two-Plan Model for Medicaid Managed Care, 1). The Department of Health (OHS) contracted with two managed care plans for each county - one a commercial health plan called Foundation Health, and second - a local initiative plan called L.A. Care through a bidding process. L.A. Care "is a publicly sponsored health plan cooperatively developed by government, clinics, hospitals, physicians and other providers historically serving the MediCal population" (California Department of Health Services, Sept.97). L.A. Care's contract includes seven plan partners: Blue Cross, Community Health Plan, Kaiser Permanente, Maxicare, Tower Health, United Health Plan, and Care 1st Health Plan. Foundation Health has two subcontracts, one with Molina Medical Centers, and the other with Universal Health Plan. The Two-Plan Model failed in its initial stages of implementation. On March 1, 1997, the Local Initiative was supposed to take effect in Los Angeles County. Some counties in California had already adopted their O\/vTl programs, such as Orange County's Cal-Optima plan. State administrators had been hesitant in adopting a managed care plan for Los Angeles County because implementation of managed care programs in other counties had been proven to be ineffective and inefficient. Because Los Angeles County had the highest number of Medi-Cal beneficiaries, the state was hesitant in adopting a program for fear of failing to meet the needs of the Medi-Cal recipients. After the Local Initiative was implemented, major problems were developed. Applications for choosing a health plan were mailed to recipients and were expected to be returned by a deadline. But applications were delayed because patients received their packages three to four days prior to the deadlines. In some instances patients received two packages with different deadlines. Another major problem that enrollees had in the Los Angeles County was materials were printed in English and Spanish, but the majority of the Medi-Cal population speaks another language. Implementing a managed care program needs complete policy analysis and careful planning. The six steps of the rational model in the textbook of Basic Methods of Policy analysis will be examined and evaluated to determine the successes and failures of the Local Initiative policy.California State University, Northridge. Department of Public Administration.Includes bibliographical references (leaves 46-47

Reconstruction of chronic long head of biceps tendon tears with gracilis allograft: report of two cases

We present two cases of symptomatic chronic long head of the biceps tendon (LHBT) ruptures treated with reconstruction of the tendon with an allograft due to native tendon shortening in one case and complete native tendon loss in the other. A gracilis allograft was Pulver-Taft weaved through the biceps muscle belly to reconstruct the LHBT and provide sufficient working length to perform a subpectoral tenodesis. In cases of chronic, symptomatic LHBT rupture with a shortened or absent tendon, a gracilis allograft can be used to reconstruct the biceps tendon and to perform a subpectoral tenodesis, providing symptom relief and reversing a Popeye muscle

Anterior capsular reconstruction with acellular dermal allograft for subscapularis deficiency: a report of two cases

Anterior glenohumeral instability with an irreparable subscapularis tear is a challenging problem for the orthopedic shoulder surgeon. Current techniques, including tendon transfers, yield inconsistent results with high rates of recurrent instability. Acellular dermal allografting has been used in young patients with massive superior rotator cuff tears with early success, but acellular dermal allografting is comparatively unstudied in anterior deficiency. We present two cases of anterior capsular reconstruction with an acellular dermal allograft in patients ages 66 and 58 years with irreparable subscapularis tendon tears. Follow-up for both patients exceeded 4 years, with forward flexion >140°, external rotation exceeding 60°, a Single Assessment Numeric Evaluation score >90 points, a visual analog scale score of 0 points, and an American Shoulder and Elbow Score of 98 points. In conclusion, acellular dermal allografting can be used to reconstruct the anterior capsule in patients with massive irreparable subscapularis tears, similar to its use in superior capsular reconstruction in patients with massive posterosuperior rotator cuff tears

The Usefulness of Intraoperative Cerebral C-Arm CT Angiogram for Implantation of Intracranial Depth Electrodes in Stereotactic Electroencephalography Procedure

Background: Stereotactic electroencephalography (SEEG) is an invasive diagnostic tool for localizing the epileptic zone in patients with medically refractory focal epilepsy. Despite technical and imaging advances in guiding the electrode placement, vascular injury is still one of its most serious complications. Object: To investigate the usefulness of intraoperative cerebral C-arm CT angiogram (CCTA) in avoiding intracranial hemorrhagic complications during SEEG electrode implantation. Methods: Trajectory data from 12 patients who underwent SEEG electrode implantation were studied in detail. This included an analysis of the implantation of 146 SEEG electrodes, which were guided by intraoperative CCTA, as well as the standard planning based on preoperative contrast-enhanced MRI. In addition, a prospective analysis of SEEG hemorrhagic complications using the studied methodology was performed in a total of 87 patients receiving 1,310 electrodes. Results: There was no complication related to the CCTA itself. Intraoperative CCTA entailed modification of the original trajectory based on the preoperative MRI in 27 of 146 electrode implantations (18.5%). In 10 of them, a severe vascular complication was adverted by intraoperative CCTA. The safety of this new approach was also confirmed by the analysis of postinterventional CT, which revealed a symptomatic hematoma caused by 1 single electrode out of the 1,310 implanted. Conclusions: This study showed that intraoperative CCTA in addition to preoperative MRI is useful in guiding a safer SEEG electrode implantation. The combination of both imaging modalities essentially minimizes the risk of serious hemorrhagic complications

Systemic Inflammatory Effects of Traumatic Brain Injury, Femur Fracture, and Shock: An Experimental Murine Polytrauma Model

Objective. Despite broad research in neurotrauma and shock, little is known on systemic inflammatory effects of the clinically most relevant combined polytrauma. Experimental investigation in an animal model may provide relevant insight for therapeutic strategies. We describe the effects of a combined injury with respect to lymphocyte population and cytokine activation. Methods. 45 male C57BL/6J mice (mean weight 27 g) were anesthetized with ketamine/xylazine. Animals were subjected to a weight drop closed traumatic brain injury (WD-TBI), a femoral fracture and hemorrhagic shock (FX-SH). Animals were subdivided into WD-TBI, FX-SH and combined trauma (CO-TX) groups. Subjects were sacrificed at 96 h. Blood was analysed for cytokines and by flow cytometry for lymphocyte populations. Results. Mortality was 8%, 13% and 47% for FX-SH, WD-TBI and CO-TX groups (P < 0.05). TNFα (11/13/139 for FX-SH/WD-TBI/CO-TX; P < 0.05), CCL2 (78/96/227; P < 0.05) and IL-6 (16/48/281; P = 0.05) showed significant increases in the CO-TX group. Lymphocyte populations results for FX-SH, WD-TBI and CO-TX were: CD-4 (31/21/22; P = n.s.), CD-8 (7/28/34, P < 0.05), CD-4-CD-8 (11/12/18; P = n.s.), CD-56 (36/7/8; P < 0.05). Conclusion. This study shows that a combination of closed TBI and femur-fracture/ shock results in an increase of the humoral inflammation. More attention to combined injury models in inflammation research is indicated

Predictive factors for beneficial application of high-frequency electromagnetics for tumour vaporization and coagulation in neurosurgery

<p>Abstract</p> <p>Objective</p> <p>To identify preoperative and intraoperative factors and conditions that predicts the beneficial application of a high-frequency electromagnetic field (EMF) system for tumor vaporization and coagulation.</p> <p>Methods</p> <p>One hundred three subsequent patients with brain tumors were microsurgically treated using the EMF system in addition to the standard neurosurgical instrumentarium. A multivariate analysis was performed regarding the usefulness (ineffective/useful/very helpful/essential) of the new technology for tumor vaporization and coagulation, with respect to tumor histology and location, tissue consistency and texture, patients' age and sex.</p> <p>Results</p> <p>The EMF system could be used effectively during tumor surgery in 83 cases with an essential contribution to the overall success in 14 cases. In the advanced category of effectiveness (very helpful/essential), there was a significant difference between hard and soft tissue consistency (50 of 66 cases vs. 3 of 37 cases). The coagulation function worked well (very helpful/essential) for surface (73 of 103 cases) and spot (46 of 103 cases) coagulation when vessels with a diameter of less than one millimeter were involved. The light-weight bayonet hand piece and long malleable electrodes made the system especially suited for the resection of deep-seated lesions (34 of 52 cases) compared to superficial tumors (19 of 50 cases).</p> <p>The EMF system was less effective than traditional electrosurgical devices in reducing soft glial tumors. Standard methods where also required for coagulation of larger vessels.</p> <p>Conclusion</p> <p>It is possible to identify factors and conditions that predict a beneficial application of high-frequency electromagnetics for tumor vaporization and coagulation. This allows focusing the use of this technology on selective indications.</p

УСТРАНЕНИЕ ДЕФЕКТОВ ОСНОВАНИЯ ЧЕРЕПА И СРЕДНЕЙ ЗОНЫ ЛИЦА ПОСЛЕ ХИРУРГИЧЕСКОГО ЛЕЧЕНИЯ РАСПРОСТРАНЕННЫХ КРАНИОМАКСИЛЛЯРНЫХ ОПУХОЛЕЙ

Introduction. Performance the radical surgical treatment in patients with widespread cranio-maxillary tumors is followed by appearance of extensive defects.Objective. To explore the possibility of the applying the basic methods of eliminating defects cranio-maxillary localization after surgical treatment of tumors and their impact on quality of life and survival.Material and methods. The results of surgical treatment of 94 patients with the widespread cranio-maxillary tumors, depending on the performed type of the surgery and method of eliminating postoperative defects were analyzed.Results. Efficiency of different methods of reconstruction of defects of the midface and anterior skull base and their impact on quality of life and survival after the surgery were estimated. The use of general oncological methods in combination with the methods of the primary effectively correction of formed defects allows to achieve better results in the treatment of patients with widespread cranio-maxillary tumors. .Введение. Выполнение радикального оперативного пособия у пациентов с распространенными краниомаксиллярными опухолями сопровождается возникновением обширных дефектов.Цель исследования – изучить возможности применения основных методик устранения дефектов краниомаксиллярной локализации после хирургического лечения опухолей, их влияние на качество жизни и выживаемость.Материал и методы. Проанализированы результаты хирургического лечения 94 больных с распространенными краниомаксиллярными опухолями в зависимости от характера выполненного оперативного вмешательства, применяемой методики устранения послеоперационных дефектов.Результаты. Выполнена оценка эффективности использования различных методов в реконструкции дефектов средней зоны лица и основания черепа после хирургического лечения, их влияния на качество жизни и выживаемость. Применение онкологических методик в сочетании с первичным устранением образовавшихся дефектов позволяет добиться более высоких результатов лечения краниомаксиллярных опухолей