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While speech and language do not fossilize, they still leave traces that can be extracted and interpreted. Here, we suggest that the shape of the hard structures of the vocal tract may also allow inferences about the speech of long-gone humans. These build on recent experimental and modelling studies, showing that there is extensive variation between individuals in the precise shape of the vocal tract, and that this variation affects speech and language. In particular, we show that detailed anatomical information concerning two components of the vocal tract (the lower jaw and the hard palate) can be extracted and digitized from the osteological remains of three historical populations from The Netherlands, and can be used to conduct three-dimensional biomechanical simulations of vowel production. We could recover the signatures of inter-individual variation between these vowels, in acoustics and articulation. While 'proof-of-concept', this study suggests that older and less well-preserved remains could be used to draw inferences about historic and prehistoric languages. Moreover, it forces us to clarify the meaning and use of the uniformitarian principle in linguistics, and to consider the wider context of language use, including the anatomy, physiology and cognition of the speakers. This article is part of the theme issue 'Reconstructing prehistoric languages'.The aim of this paper is to develop further the idea that symptoms that emerge in speech and language processing following brain damage can make a contribution to discussions of the early evolution of language. These diverse impairments are called aphasia, and this paper proposes that the recovery of a non-fluent aphasia syndrome following stroke could provide insights into the course of the pre-history of human language evolution. The observable symptoms emerge during recovery, crucially enabled by (dis)inhibition in parallel with a range of impairments in action processing (apraxias), including apraxia of speech. They are underpinned by changes in cortical and subcortical status following brain damage. It is proposed that the observed recovery mimics ontogenic and phylogenic processes in human speech and language. The arguments put forward provide insights tending to support the motor-gestural model of speech and language evolution. This article is part of the theme issue 'Reconstructing prehistoric languages'.In speech, the connection between sounds and word meanings is mostly arbitrary. However, among basic concepts of the vocabulary, several words can be shown to exhibit some degree of form-meaning resemblance, a feature labelled vocal iconicity. Vocal iconicity plays a role in first language acquisition and was likely prominent also in pre-historic language. However, an unsolved question is how vocal iconicity survives sound evolution, which is assumed to be inevitable and 'blind' to the meaning of words. We analyse the evolution of sound groups on 1016 basic vocabulary concepts in 107 Eurasian languages, building on automated homologue clustering and sound sequence alignment to infer relative stability of sound groups over time. We correlate this result with the occurrence of sound groups in iconic vocabulary, measured on a cross-linguistic dataset of 344 concepts across single-language samples from 245 families. We find that the sound stability of the Eurasian set correlates with iconic occurrence in the global set. Further, we find that sound stability and iconic occurrence of consonants are connected to acquisition order in the first language, indicating that children acquiring language play a role in maintaining vocal iconicity over time. This article is part of the theme issue 'Reconstructing prehistoric languages'.[Figure see text].[Figure see text].[Figure see text].[Figure see text].[Figure see text].[Figure see text].[Figure see text].

In the assessment of diseases causing skeletal lesions such as multiple myeloma (MM), whole-body low-dose computed tomography (WBLDCT) is a sensitive diagnostic imaging modality, which has the potential to replace the conventional radiographic survey.

To optimize radiation protection and examine radiation exposure, and effective and organ doses of WBLDCT using different modern dual-source CT (DSCT) devices, and to establish local diagnostic reference levels (DRL).

In this retrospective study, 281 WBLDCT scans of 232 patients performed between January 2017 and April 2020 either on a second- (A) or third-generation (B) DSCT device could be included. Radiation exposure indices and organ and effective doses were calculated using a commercially available automated dose-tracking software based on Monte-Carlo simulation techniques.

The radiation exposure indices and effective doses were distributed as follows (median, interquartile range) (A) second-generation DSCT volume-weighted CT dose index (CTDI

) 1.78 where our locally determined values may help as benchmarks.

Most commonly used diffusion-weighted imaging (DWI) models include intravoxel incoherent motion (IVIM), diffusion kurtosis imaging (DKI), stretched exponential model (SEM), and mono-exponential model (MEM). Previous studies of the four models were inconsistent on which model was more effective in distinguishing cervical cancer from normal cervical tissue.

To assess the performance of four DWI models in characterizing cervical cancer and normal cervical tissue.

Forty-seven women with suspected cervical carcinoma underwent DWI using eight b-values before treatment. Imaging parameters, calculated using IVIM, SEM, DKI, and MEM, were compared between cervical cancer and normal cervical tissue. The diagnostic performance of the models was evaluated using independent

-test, Mann-Whitney U test, receiver operating characteristic (ROC) curve analysis, and multivariate logistic regression analysis.

All parameters except pseudo-diffusion coefficient (D*) differed significantly between cervical cancer and normal cervical tissue (

 < 0.001). Through logistic regression analysis, all combined models showed a significant improvement in area under the ROC curve (AUC) compared to individual DWI parameters. The model with combined IVIM parameters had a larger AUC value compared to those of other combined models (

 < 0.05).

All four DWI models are useful for differentiating cervical cancer from normal cervical tissue and IVIM may be the optimal model.

All four DWI models are useful for differentiating cervical cancer from normal cervical tissue and IVIM may be the optimal model.Background Children operated on for a simple congenital heart defect (CHD) are at risk of neurodevelopmental abnormalities. Abnormal cortical development and folding have been observed in fetuses with CHD. We examined whether sulcal folding patterns in adults operated on for simple CHD in childhood differ from those of healthy controls, and whether such differences are associated with neuropsychological outcomes. Methods and Results Patients (mean age, 24.5 years) who underwent childhood surgery for isolated atrial septal defect (ASD; n=33) or ventricular septal defect (VSD; n=30) and healthy controls (n=37) were enrolled. Sulcal pattern similarity to healthy controls was determined using magnetic resonance imaging and looking at features of sulcal folds, their intersulcal relationships, and sulcal graph topology. The sulcal pattern similarity values were tested for associations with comprehensive neuropsychological scores. Patients with both ASD and VSD had decreased sulcal pattern similarity in the left hemisphere compared with controls. The differences were found in the left temporal lobe in the ASD group and in the whole left hemisphere in the VSD group (P=0.033 and P=0.039, respectively). The extent of abnormal left hemispheric sulcal pattern similarity was associated with worse neuropsychological scores (intelligence, executive function, and visuospatial abilities) in the VSD group, and special educational support in the ASD group. Conclusions Adults who underwent surgery for simple CHD in childhood display altered left hemisphere sulcal folding patterns, commensurate with neuropsychological scores for patients with VSD and special educational support for ASD. This may indicate that simple CHD affects early brain development. Registration URL https//www.clinicaltrials.gov; Unique identifier NCT03871881.

Patients experiencing out-of-hospital cardiac arrest who remain comatose after initial resuscitation are at high risk of morbidity and mortality attributable to the ensuing post-cardiac arrest syndrome. see more Systemic inflammation constitutes a major component of post-cardiac arrest syndrome, and IL-6 (interleukin-6) levels are associated with post-cardiac arrest syndrome severity. The IL-6 receptor antagonist tocilizumab could potentially dampen inflammation in post-cardiac arrest syndrome. The objective of the present trial was to determine the efficacy of tocilizumab to reduce systemic inflammation after out-of-hospital cardiac arrest of a presumed cardiac cause and thereby potentially mitigate organ injury.

Eighty comatose patients with out-of-hospital cardiac arrest were randomly assigned 11 in a double-blinded placebo-controlled trial to a single infusion of tocilizumab or placebo in addition to standard of care including targeted temperature management. Blood samples were sequentially drawn during the indial injury was also reduced, documented by reductions in creatine kinase myocardial band and troponin T; tocilizumab versus placebo at 12 hours -36% [-54%; -11%] and -38% [-53%; -19%], respectively, both

<0.01. N-terminal pro B-type natriuretic peptide was similarly reduced by active treatment; tocilizumab versus placebo at 48 hours -65% [-80%; -41%],

<0.001. There were no differences in survival or neurological outcome.

Treatment with tocilizumab resulted in a significant reduction in systemic inflammation and myocardial injury in comatose patients resuscitated from out-of-hospital cardiac arrest. Registration URL https//www.clinicaltrials.gov; Unique identifier NCT03863015.

Treatment with tocilizumab resulted in a significant reduction in systemic inflammation and myocardial injury in comatose patients resuscitated from out-of-hospital cardiac arrest. Registration URL https//www.clinicaltrials.gov; Unique identifier NCT03863015.

Medication cessation and service disengagement often precedes relapse in people with severe mental illnesses but currently specialist mental health services only become involved after a relapse. Early detection of non-adherence is needed to enable intervention to avert relapse. This paper aims to demonstrate how digitally automated non-adherence risk monitoring from Medicare data with active follow-up can work and perform in practice in a real-world mental health service setting.

AI

software is an automated risk monitoring tool to detect non-adherence using Medicare data. It was implemented prospectively in a cohort of 354 registered patients of a community mental health clinic between July 2019 and February 2020. Patients flagged as at risk by the software were reviewed by two clinicians. We describe the risks automatically flagged for non-adherence and the clinical responses. We examine differences in clinical and demographic factors in patients flagged at increased risk of non-adherence.

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