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The present article illustrates that the specific articulatory and aerodynamic requirements for voiced but not voiceless alveolar or dental stops can cause tongue tip retraction and tongue mid lowering and thus retroflexion of front coronals. This retroflexion is shown to have occurred diachronically in the three typologically unrelated languages Dhao (Malayo-Polynesian), Thulung (Sino-Tibetan), and Afar (East-Cushitic). In addition to the diachronic cases, we provide synchronic data for retroflexion from an articulatory study with four speakers of German, a language usually described as having alveolar stops. With these combined data we supply evidence that voiced retroflex stops (as the only retroflex segments in a language) did not necessarily emerge from implosives, as argued by Haudricourt (1950), Greenberg (1970), Bhat (1973), and Ohala (1983). Instead, we propose that the voiced front coronal plosive /d/ is generally articulated in a way that favours retroflexion, that is, with a smaller and more retracted place of articulation and a lower tongue and jaw position than /t/.
This paper shows that several typologically unrelated languages share the tendency to avoid voiced sibilant affricates. This tendency is explained by appealing to the phonetic properties of the sounds, and in particular to their aerodynamic characteristics. On the basis of experimental evidence it is shown that conflicting air pressure requirements for maintaining voicing and frication are responsible for the avoidance of voiced affricates. In particular, the air pressure released from the stop phase of the affricate is too high to maintain voicing, which in consequence leads to a devoicing of the frication part.
Rate effects on aerodynamics of intervocalic stops : evidence from real speech data and model data
(2008)
This paper is a first attempt towards a better understanding of the aerodynamic properties during speech production and their potential control. In recent years, studies on intraoral pressure in speech have been rather rare, and more studies concern the air flow development. However, the intraoral pressure is a crucial factor for analysing the production of various sounds.
In this paper, we focus on the intraoral pressure development during the production of intervocalic stops.
Two experimental methodologies are presented and confronted with each other: real speech data recorded for four German native speakers, and model data, obtained by a mechanical replica which allows reproducing the main physical mechanisms occurring during phonation. The two methods are presented and applied to a study on the influence of speech rate on aerodynamic properties.
This work investigates laryngeal and supralaryngeal correlates of the voicing contrast in alveolar obstruent production in German. It further studies laryngealoral co-ordination observed for such productions. Three different positions of the obstruents are taken into account: the stressed, syllable initial position, the post-stressed intervocalic position, and the post-stressed word final position. For the latter the phonological rule of final devoicing applies in German. The different positions are chosen in order to study the following hypotheses:
1. The presence/absence of glottal opening is not a consistent correlate of the voicing contrast in German.
2. Supralaryngeal correlates are also involved in the contrast.
3. Supralaryngeal correlates can compensate for the lack of distinction in laryngeal adjustment.
Including the word final position is motivated by the question whether neutralization in word final position would be complete or whether some articulatory residue of the contrast can be found.
Two experiments are carried out. The first experiment investigates glottal abduction in co-ordination with tongue-palate contact patterns by means of simultaneous recordings of transillumination, fiberoptic films and Electropalatography (EPG). The second experiment focuses on supralaryngeal correlates of alveolar stops studied by means of Electromagnetic Articulography (EMA) simultaneously with EPG. Three German native speakers participated in both recordings. Results of this study provide evidence that the first hypothesis holds true for alveolar stops when different positions are taken into account. In fricative production it is also confirmed since voiceless and voiced fricatives are most of the time realised with glottal abduction. Additionally, supralaryngeal correlates are involved in the voicing contrast under two perspectives. First, laryngeal and supralaryngeal movements are well synchronised in voiceless obstruent production, particularly in the stressed position. Second, supralaryngeal correlates occur especially in the post-stressed intervocalic position. Results are discussed with respect to the phonetics-phonology interface, to the role of timing and its possible control, to the interarticulatory co-ordination, and to stress as 'localised hyperarticulation'.
This study examines intraoral pressure for English and German stops in bilabial and alveolar place of articulation. Our subjects are two speakers of American English and three speakers of German. VOICING is the main phonological contrast under evaluation in both word initial and word final position. For initial stops, a few of the pressure characteristics showed differences between English and German, but on the whole the results point to similar production strategies at both places of articulation in the two different languages. Analysis of the pressure trajectory differences between VOICING categories in initial position raises questions about articulatory differences. In the initial closing gesture, time from start of gesture to closure is roughly equivalent for both categories, but the pressure change is significantly smaller on average for VOICED stops. Final stops, however, present a more complicated picture. German final stops are neutralized to a presumed VOICELESS phonological state. English final /p/ is broadly similar to German /p/, but English /t/ often shows no pressure increase at all which is at odds with the conventional account of phonation termination via pressure increase and loss of pressure differential. The results raise the question of whether the German final stops should be considered VOICELESS or some intermediate form, at least as compared to English final stops.
Studying kinematic behavior in speech production is an indispensable and fruitful methodology in order to describe for instance phonemic contrasts, allophonic variations, prosodic effects in articulatory movements. More intriguingly, it is also interpreted with respect to its underlying control mechanisms. Several interpretations have been borrowed from motor control studies of arm, eye, and limb movements. They do either explain kinematics with respect to a fine tuned control by the Central Nervous System (CNS) or they take into account a combination of influences arising from motor control strategies at the CNS level and from the complex physical properties of the peripheral speech apparatus. We assume that the latter is more realistic and ecological. The aims of this article are: first, to show, via a literature review related to the so called '1/3 power law' in human arm motor control, that this debate is of first importance in human motor control research in general. Second, to study a number of speech specific examples offering a fruitful framework to address this issue. However, it is also suggested that speech motor control differs from general motor control principles in the sense that it uses specific physical properties such as vocal tract limitations, aerodynamics and biomechanics in order to produce the relevant sounds. Third, experimental and modelling results are described supporting the idea that the three properties are crucial in shaping speech kinematics for selected speech phenomena. Hence, caution should be taken when interpreting kinematic results based on experimental data alone.
The present article illustrates that the specific articulatory and aerodynamic requirements for voiced but not voiceless alveolar or dental stops can cause tongue tip retraction and tongue mid lowering and thus retroflexion of front coronals. This retroflexion is shown to have occurred diachronically in the three typologically unrelated languages Dhao (Malayo-Polynesian), Thulung (Sino-Tibetan), and Afar (East-Cushitic). In addition to the diachronic cases, we provide synchronic data for retroflexion from an articulatory study with four speakers of German, a language usually described as having alveolar stops. With these combined data we supply evidence that voiced retroflex stops (as the only retroflex segments in a language) did not necessarily emerge from implosives, as argued by Haudricourt (1950), Greenberg (1970), Bhat (1973), and Ohala (1983). Instead, we propose that the voiced front coronal plosive /d/ is generally articulated in a way that favours retroflexion, that is, with a smaller and more retracted place of articulation and a lower tongue and jaw position than /t/.
Proper speech production requires auditory speech feedback control. Models of speech production associate this function with the right cerebral hemisphere while the left hemisphere is proposed to host speech motor programs. However, previous studies have investigated only spectral perturbations of the auditory speech feedback. Since auditory perception is known to be lateralized, with right-lateralized analysis of spectral features and left-lateralized processing of temporal features, it is unclear whether the observed right-lateralization of auditory speech feedback processing reflects a preference for speech feedback control or for spectral processing in general. Here we use a behavioral speech adaptation experiment with dichotically presented altered auditory feedback and an analogous fMRI experiment with binaurally presented altered feedback to confirm a right hemisphere preference for spectral feedback control and to reveal a left hemisphere preference for temporal feedback control during speaking. These results indicate that auditory feedback control involves both hemispheres with differential contributions along the spectro-temporal axis.
Articulatory token-to-token variability not only depends on linguistic aspects like the phoneme inventory of a given language but also on speaker specific morphological and motor constraints. As has been noted previously (Perkell (1997), Mooshammer et al. (2004)), speakers with coronally high "domeshaped" palates exhibit more articulatory variability than speakers with coronally low "flat" palates. One explanation for that is based on perception oriented control by the speaker. The influence of articulatory variation on the cross sectional area and consequently on the acoustics should be greater for flat palates than for domeshaped ones. This should force speakers with flat palates to place their tongue very precisely whereas speakers with domeshaped palates might tolerate a greater variability. A second explanation could be a greater amount of lateral linguo-palatal contact for flat palates holding the tongue in position. In this study both hypotheses were tested.
In order to investigate the influence of the palate shape on the variability of the acoustic output a modelling study was carried out. Parallely, an EPG experiment was conducted in order to investigate the relationship between palate shape, articulatory variability and linguo-palatal contact.
Results from the modelling study suggest that the acoustic variability resulting from a certain amount of articulatory variability is higher for flat palates than for domeshaped ones. Results from the EPG experiment with 20 speakers show that (1.) speakers with a flat palate exhibit a very low articulatory variability whereas speakers with a domeshaped palate vary, (2.) there is less articulatory variability if there is lots of linguo-palatal contact and (3.) there is no relationship between the amount of lateral linguo-palatal contact and palate shape. The results suggest that there is a relationship between token-to-token variability and palate shape, however, it is not that the two parameters correlate, but that speakers with a flat palate always have a low variability because of constraints of the variability range of the acoustic output whereas speakers with a domeshaped palate may choose the degree of variability. Since linguo-palatal contact and variability correlate it is assumed that linguo-palatal contact is a means for reducing the articulatory variability.
Mechanisms of contrasting korean velar stops : A catalogue of acoustic and articulatory parameters
(2003)
The Korean stop system exhibits a three-way distinction in velar stops among /g/, /k'/ and /kh/. If the differentiation is regarded as being based on voicing, such a system is rather unusual because even a two-way distinction between a voiced and a voicless unaspirated velar stop gets easily lost in the languages of the world especially in the case of velar stops. One possibility for maintainig this distinction is that supralaryngeal characteristics like articulators' velocity, duration of surrounding vowels or stop closure duration are involved. The aim of the present study is to set up a catalogue of parameters which are involved in the distinction of Korean velar stops in intervocalic position.
Two Korean speakers have been recorded via Electromagnetic Articulography. The word material consisted of VCV-sequences where V is one of the three vowels /a/, /i/ or /u/ and C one of the Korean velars /g/, /k'/ or /kh/. Articulatory and acoustic signals have been analysed It turned out that the distinction is only partly built on laryngeal parameters and that supralaryngeal characteristics differ for the three stops. Another result is that the voicing contrast is not a matter of one parameter, but there is always a set of parameters involved. Furthermore, speakers seem to have a certain freedom in the choice of these parameters.
Background Multimorbidity is a highly frequent condition in older people, but well designed longitudinal studies on the impact of multimorbidity on patients and the health care system have been remarkably scarce in numbers until today. Little is known about the long term impact of multimorbidity on the patients' life expectancy, functional status and quality of life as well as health care utilization over time. As a consequence, there is little help for GPs in adjusting care for these patients, even though studies suggest that adhering to present clinical practice guidelines in the care of patients with multimorbidity may have adverse effects. Methods The study is designed as a multicentre prospective, observational cohort study of 3.050 patients aged 65 to 85 at baseline with at least three different diagnoses out of a list of 29 illnesses and syndromes. The patients will be recruited in approx. 120 to 150 GP surgeries in 8 study centres distributed across Germany. Information about the patients' morbidity will be collected mainly in GP interviews and from chart reviews. Functional status, resources/risk factors, health care utilization and additional morbidity data will be assessed in patient interviews, in which a multitude of well established standardized questionnaires and tests will be performed. Discussion The main aim of the cohort study is to monitor the course of the illness process and to analyse for which reasons medical conditions are stable, deteriorating or only temporarily present. First, clusters of combinations of diseases/disorders (multimorbidity patterns) with a comparable impact (e.g. on quality of life and/or functional status) will be identified. Then the development of these clusters over time will be analysed, especially with regard to prognostic variables and the somatic, psychological and social consequences as well as the utilization of health care resources. The results will allow the development of an instrument for prediction of the deterioration of the illness process and point at possibilities of prevention. The practical consequences of the study results for primary care will be analysed in expert focus groups in order to develop strategies for the inclusion of the aspects of multimorbidity in primary care guidelines.
Background: Multimorbidity is a common phenomenon in primary care. Until now, no clinical guidelines for multimorbidity exist. For the development of these guidelines, it is necessary to know whether or not patients are aware of their diseases and to what extent they agree with their doctor. The objectives of this paper are to analyze the agreement of self-reported and general practitioner-reported chronic conditions among multimorbid patients in primary care, and to discover which patient characteristics are associated with positive agreement.
Methods: The MultiCare Cohort Study is a multicenter, prospective, observational cohort study of 3,189 multimorbid patients, ages 65 to 85. Data was collected in personal interviews with patients and GPs. The prevalence proportions for 32 diagnosis groups, kappa coefficients and proportions of specific agreement were calculated in order to examine the agreement of patient self-reported and general practitioner-reported chronic conditions. Logistic regression models were calculated to analyze which patient characteristics can be associated with positive agreement.
Results: We identified four chronic conditions with good agreement (e.g. diabetes mellitus κ = 0.80;PA = 0,87), seven with moderate agreement (e.g. cerebral ischemia/chronic stroke κ = 0.55;PA = 0.60), seventeen with fair agreement (e.g. cardiac insufficiency κ = 0.24;PA = 0.36) and four with poor agreement (e.g. gynecological problems κ = 0.05;PA = 0.10).Factors associated with positive agreement concerning different chronic diseases were sex, age, education, income, disease count, depression, EQ VAS score and nursing care dependency. For example: Women had higher odds ratios for positive agreement with their GP regarding osteoporosis (OR = 7.16). The odds ratios for positive agreement increase with increasing multimorbidity in almost all of the observed chronic conditions (OR = 1.22-2.41).
Conclusions: For multimorbidity research, the knowledge of diseases with high disagreement levels between the patients' perceived illnesses and their physicians' reports is important. The analysis shows that different patient characteristics have an impact on the agreement. Findings from this study should be included in the development of clinical guidelines for multimorbidity aiming to optimize health care. Further research is needed to identify more reasons for disagreement and their consequences in health care.
Introduction: In this article three research questions are addressed: (1) Is there an association between socioeconomic status (SES) and patient-reported outcomes in a cohort of multimorbid patients? (2) Does the association vary according to SES indicator used (income, education, occupational position)? (3) Can the association between SES and patient-reported outcomes (self-rated health, health-related quality of life and functional status) be (partly) explained by burden of disease?
Methods: Analyses are based on the MultiCare Cohort Study, a German multicentre, prospective, observational cohort study of multimorbid patients from general practice. We analysed baseline data and data from the first follow-up after 15 months (N = 2,729). To assess burden of disease we used the patients’ morbidity data from standardized general practitioner (GP) interviews based on a list of 46 groups of chronic conditions including the GP’s severity rating of each chronic condition ranging from marginal to very severe.
Results: In the cross-sectional analyses SES was significantly associated with the patient-reported outcomes at baseline. Associations with income were more consistent and stronger than with education and occupational position. Associations were partly explained (17% to 44%) by burden of disease. In the longitudinal analyses only income (but not education and occupational position) was significantly related to the patient-reported outcomes at follow-up. Associations between income and the outcomes were reduced by 18% to 27% after adjustment for burden of disease.
Conclusions: Results indicate social inequalities in self-rated health, functional status and health related quality of life among older multimorbid patients. As associations with education and occupational position were inconsistent, these inequalities were mainly due to income. Inequalities were partly explained by burden of disease. However, even among patients with a similar disease burden, those with a low income were worse off in terms of the three patient-reported outcomes under study.
Temporal development of compensation strategies for perturbed palate shape in German /S/-production
(2006)
The palate shape of four speakers was changed by a prosthesis which either lowered the palate or retracted the alveoles. Subjects wore the prosthesis for two weeks and were recorded several times via EMA. Results of articulatory measurements show that speakers use different compensation methods at different stages of the adaptation. They lower the tongue immediately after the insertion of the prosthesis. Other compensation methods as for example lip protrusion are only acquired after longer practising periods. The results are interpreted as supporting the existence of different mappings between motor commands, vocal tract shape and auditory-acoustic target.
Articulatory token-to-token variability not only depends on linguistic aspects like the phoneme inventory of a given language but also on speaker specific morphological and motor constraints. As has been noted previously (Perkell (1997), Mooshammer et al. (2004)) , speakers with coronally high "domeshaped" palates exhibit more articulatory variability than speakers with coronally low "flat" palates. One explanation for that is based on perception oriented control by the speaker. The influence of articulatory variation on the cross sectional area and consequently on the acoustics should be greater for flat palates than for domeshaped ones. This should force speakers with flat palates to place their tongue very precisely whereas speakers with domeshaped palates might tolerate a greater variability. A second explanation could be a greater amount of lateral linguo-palatal contact for flat palates holding the tongue in position. In this study both hypotheses were tested.
The COVID-19 pandemic has caused strains on health systems worldwide disrupting routine hospital services for all non-COVID patients. Within this retrospective study, we analyzed inpatient hospital admissions across 18 German university hospitals during the 2020 lockdown period compared to 2018. Patients admitted to hospital between January 1 and May 31, 2020 and the corresponding periods in 2018 and 2019 were included in this study. Data derived from electronic health records were collected and analyzed using the data integration center infrastructure implemented in the university hospitals that are part of the four consortia funded by the German Medical Informatics Initiative. Admissions were grouped and counted by ICD 10 chapters and specific reasons for treatment at each site. Pooled aggregated data were centrally analyzed with descriptive statistics to compare absolute and relative differences between time periods of different years. The results illustrate how care process adoptions depended on the COVID-19 epidemiological situation and the criticality of the disease. Overall inpatient hospital admissions decreased by 35% in weeks 1 to 4 and by 30.3% in weeks 5 to 8 after the lockdown announcement compared to 2018. Even hospital admissions for critical care conditions such as malignant cancer treatments were reduced. We also noted a high reduction of emergency admissions such as myocardial infarction (38.7%), whereas the reduction in stroke admissions was smaller (19.6%). In contrast, we observed a considerable reduction in admissions for non-critical clinical situations, such as hysterectomies for benign tumors (78.8%) and hip replacements due to arthrosis (82.4%). In summary, our study shows that the university hospital admission rates in Germany were substantially reduced following the national COVID-19 lockdown. These included critical care or emergency conditions in which deferral is expected to impair clinical outcomes. Future studies are needed to delineate how appropriate medical care of critically ill patients can be maintained during a pandemic.