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Background: Cefazolin is guideline recommended for perioperative prophylaxis in orthopedic surgery. Despite its unique R1 side chain, cefazolin is often avoided in patients with beta-lactam allergy with concern for cross reactivity. Objectives: The primary outcome was the percentage of patients who received cefazolin perioperatively. Secondary outcomes included the percentage of patients with a beta-lactam allergy clarified following the telephone interview and clinical outcomes including acute kidney injury, surgical site infection, Clostridioides difficile infection, and re-admission at 30 and 90 days. Methods: This single-center, quasi-experimental study evaluated a pilot program in which a pharmacist phoned patients > 18 years of age with a scheduled orthopedic surgery and a documented beta-lactam allergy to assess their allergy preoperatively. Recommendations to use cefazolin were based on an algorithm. Patients were divided into pre- and post-intervention cohorts. Results: A total of 832 patients were screened for inclusion with 135 and 66 patients included in the pre- and post-intervention cohorts. No significant difference was identified in the primary outcome. In the post-intervention cohort, 62% had a beta-lactam reaction updated in the electronic medical record. Those with a beta-lactam allergy delabeled or made less severe were numerically more likely to receive cefazolin than those with an unchanged reaction or a reaction made more severe (95.2% vs 68% vs 65%). There were no differences in clinical outcomes between groups. Conclusion: A pharmacist-conducted preoperative beta-lactam allergy interview in adult patients undergoing elective orthopedic surgery improved beta-lactam allergy documentation but, did not result in increased utilization of cefazolin. [ABSTRACT FROM AUTHOR]

The 1-year longitudinal study presented here examined the extent to which the ability to build phonologically specific lexical entries as a result of increasing vocabulary size predicts word reading via its impact on phonological awareness within and across languages in 62 emerging English (L1) and French (L2) Grade 1 children (M = 75.69 months, SD = 3.18) enrolled in an early French immersion program in Canada. Lexical specificity was assessed with a computerized word learning game in which children were taught new English (e.g., 'foal' and 'sole') and French (e.g., "bac" 'bin' and "bague" 'ring') word pairs contrasted by minimal phonological differences. The results revealed that the specificity of English words at the beginning of Grade 1 predicted English word reading at the end of Grade 1 and that this relationship was mediated by English phonological awareness at the beginning of Grade 1. French lexical specificity at the beginning of Grade 1 did not predict French word reading at the end of Grade 1. Notably, English lexical specificity at the beginning of Grade 1 also predicted French word reading at the end of Grade 1 and this relationship was mediated by English phonological awareness at the beginning of Grade 1. It is concluded that exposure to word pairs involving minimal phonological contrasts fosters phonological awareness, which in turn facilitates word reading within the L1 that then transfers to the L2.

According to Einstein's general theory of relativity, a clock runs more slowly if it is close to a large gravitating object. This principle was highlighted in the movie "Interstellar," in which the main character spends several hours on a planet orbiting a massive black hole, and returns to find that his young daughter has become an elderly woman. In the movie, one hour on the planet equates to seven years on Earth. The same effect can be measured on a much smaller scale by changing locations within Earth's gravitational field. Using atomic clocks, we have compared the ticking of time at Colorado College (elevation 1845 m above sea level), at the United States Air Force Academy (elevation 2165 m), and near the summit of Pikes Peak (elevation 4288 m). Our results confirm that clocks do indeed tick more quickly at higher altitudes, in accordance with Einstein's theory. This work was carried out as a collaboration of physics majors and faculty at Colorado College (CC) and the United States Air Force Academy (USAFA). The experimental technique is straightforward and our results can be reproduced by other students and teachers, given access to an atomic clock and reasonably large changes in elevation. Indeed, a similar endeavor has been reported by amateur clock enthusiasts.

A recurring finding of research on the L2 acquisition of coda obstruent voicing is that, in terms of the phonetic parameters that serve to realize the voicing contrast, learners are overwhelmingly more accurate with duration than the voicing of the obstruent itself. The current work expands our understanding of this asymmetry in two ways. First, as previous studies have focused almost exclusively on learners of English, we investigate here whether L2 learners' superior production of duration is also found among learners of other target languages via a study of Mandarin-speaking learners' production of French stop and fricative codas. Results from 18 Mandarin-speaking learners of French, primarily of beginner and intermediate proficiency who completed a sentence reading task, parallel those of previous studies with greater accuracy observed for vowel duration than the laryngeal voicing of the obstruent. Second, we explore potential sources of this asymmetry, in particular, the roles of L1 experience as well as of universal factors, namely, the relative perceptual salience of duration versus voicing, and the articulatory difficulty of voicing obstruents. [ABSTRACT FROM AUTHOR]

This longitudinal study investigated how lexical restructuring can stimulate emerging bilingual children's phonological awareness in their first (L1) and second (L2) languages. Sixty-two English (L1) – French (L2) bilingual children (Mage = 75.7 months, SD = 3.2) were taught new English and French word pairs differing minimally in phonological contrast. The results indicated that increasing lexical specificity in English mediated the relationship between English vocabulary and English phonological awareness both concurrently and longitudinally at the end of Grade 1. A longitudinal relationship was established among French vocabulary, French lexical specificity, and French phonological awareness at the end of Grade 1. Notably, cross-language transfer from English lexical specificity was a better predictor of development in French phonological awareness, especially for words that contained phonological contrasts that occurred in both languages. The results from this study highlight the phonological foundations of early literacy and extend the lexical restructuring hypothesis to emerging bilingual children. [ABSTRACT FROM AUTHOR]

Models such as Eckman's markedness differential hypothesis, Flege's speech learning model, and Brown's feature-based theory of perception seek to explain and predict the relative difficulty second language (L2) learners face when acquiring new or similar sounds. In this paper, we test their predictive adequacy as concerns native English speakers' mastery of French /[image omitted]/ and Spanish /[image omitted]/. Based on an acoustic analysis of the learner data, we demonstrate that these three models do not account for the full range of variability nor for the developmental sequences attested, because they do not consider the degree of difficulty involved in the simultaneous mastery of multiple phonetic parameters across prosodic positions. Consequently, models of L2 phonological acquisition must not only integrate findings from markedness theory and speech perception but also incorporate phonetic constraints on production.

This article seeks to illuminate the degree of position-based variation observed in the acquisition of new segments in a second language and to explain such variability as the consequence of phonetic constraints; this approach contrasts with much previous research that has used typological markedness to the same end. Specifically, it is proposed that learners will have the least difficulty acquiring sounds that involve novel combinations of voicing and manner in positions that favor the phonetic implementation of these sounds. Moreover, on the assumption that not all parameters can be mastered simultaneously, it is predicted that learners will first acquire aspects of a segment's articulation that are perceptually salient and articulatorily easier. The data come from a study of the acquisition of French by 20 intermediate- and advanced-proficiency English-speaking learners of French. Acoustic analysis of the data reveals asymmetries that favor accuracy with manner in onsets versus more targetlike realization of voicing in codas, in which devoicing exists in the input. Beyond demonstrating the role of phonetic principles in determining position-based variation, the findings contribute to our understanding of the acquisition of new consonantal contrasts by providing empirical evidence from a non-Germanic language to bear on this line of inquiry.