The sociolinguistic stratification of a connected speech process - The case of the T to R rule in the Black Country

This paper examines the connected speech process described by Wells (1982b) as the T to R rule in the West Midlands speech variety associated with the Black Country. The T to R rule is well known as a linguistic marker of local varieties of the middle and far north of England. Less well understood is its position in the phonological systems of Midlands varieties. Varieties of the Midlands of England are underresearched in comparison with varieties of the north, and what is known about the application of the T to R rule in this transitional dialect area is correspondingly nebulous. This paper focuses on the Black Country area, and examines the possible outputs in the contexts which give rise to /t/ becoming [?] in local varieties of the north. I examine the written and spoken evidence which suggests that the T to R rule does indeed operate in the Black Country variety. My analysis focuses on possible phonetic outcomes of the T to R rule across time. In my conclusion, I discuss briefly the possibility that, lying on a bundle of isoglosses separating north from south, the variety of the Black Country reflects this in that a T to [?] rule, rather than a T to R rule, is the dominant output of this connected speech process in the Black Country.

New biomarkers and risk stratification in atrial fibrillation:simplicity and practicality matter

Advances in our understanding of pathological mechanisms can inform the identification of various biomarkers for risk stratification, monitoring drug efficacy and toxicity; and enabling careful monitoring of polypharmacy. Biomarkers in the broadest sense refer to 'biological markers' and this can be blood-based (eg. fibrin D-dimer, von Willebrand factor, etc) urine-based (eg. thromboxane), or even related to cardiac or cerebral imaging(1). Most biomarkers offer improvements over clinical risk scores in predicting high risk patients - at least statistically - but usually at the loss of simplicity and practicality for easy application in everyday clinical practice. Given the various biomarkers can be informed by different aspects of pathophysiology (e.g. inflammation, clotting, collagen turnover) they can nevertheless contribute to a better understanding of underlying disease processes(2). Indeed, many age-related diseases share common modifiable underpinning mechanisms e.g. inflammation, oxidative stress and visceral adiposity.

Retinal arteriolar diameter response to flicker light provocation - A useful marker for risk stratification in cardiovascular disease?

Purpose: To to evaluate the benefit of bilinear and linear fitting to characterize the retinal vessel dilation to flicker light stimulation for the purpose of risk stratification in cardiovascular disease. Methods: Forty-five patients (15 with coronary artery disease (CAD), 15 with Diabetes Mellitus (DM) and 15 with CAD and DM) all underwent contact tonometry, digital blood pressure measurement, fundus photography, retinal vessel oximetry, static retinal vessel analysis and continous retinal diameter assessment using the retinal vessel analyser (and flicker light provocation). In addition we measured blood glucose (HbA1c) and keratinin levels in DM patients. Results: With increased severity of cardiovascular disease a more linear reaction profile of retinal arteriolar diameter to flicker light provocation can be observed. Conclusion: Absolute values of vessel dilation provide only limited information on the state of retinal arteriolar dilatory response to flicker light. The approach of bilinear fitting takes into account the immediate response to flicker light provocation as well as the maintained dilatory capacity during prolonged stimulation. Individuals with cardiovascular disease however show a largely linear reaction profile indicating an impairment of the initial rapid dilatory response as usually observed in healty individuals