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Biran M.,Haifa University | Biran M.,Loewenstein Hospital Rehabilitation Center | Biran M.,Tel Aviv University | Fisher S.,Haifa University | Fisher S.,Speech and Hearing Unit
Aphasiology | Year: 2015

Background: Complementation information is a type of lexical-syntactic information that determines which syntactic environments a verb can be inserted into. It includes information about the verb’s predicate argument structure (PAS), the thematic role of each argument, and the verb’s subcategorisation frames. Complementation information might be impaired in aphasia. Various procedures have been used in treatment studies aimed at improving the production of verbs or sentences (including the verb with its arguments); these have usually yielded an improvement in treated verbs, without generalisation to untreated verbs.Aims: In this study, we evaluated a structured treatment procedure, aimed at improving impaired PAS information, and examined whether it improved the production of verbs with their arguments in sentences. The research questions were these: (a) Will treatment improve the production of verbs with their arguments in sentences? (b) Will improvement generalise to untreated verbs? (c) Will improvement be maintained after the end of the treatment? and (d) Will improvement generalise to connected speech (in a task of telling a story in response to a series of pictures)?Methods & Procedures: Two chronic aphasic patients with impairment in PAS information participated in the study. Their complementation information, and specifically their PAS information, was assessed prior to treatment, immediately after treatment, and in follow-ups 6 weeks and 6 months after treatment. The treatment consisted of instruction and practice on the number of arguments different verbs select, and taught the participants a strategy they could use. The practice was organised hierarchically, with regard to the number of arguments a given verb requires and the amount of cueing given.Outcomes & Results: Following treatment, a significant improvement was found in the participants’ ability to produce sentences with the correct number of arguments. This improvement was generalised to untreated verbs and to connected speech and maintained for (at least) 6 months after treatment. However, neither participant showed improvement in other language skills, or even in other types of complementation information (i.e., subcategorisation frames).Conclusions: The findings suggest that structured treatment focusing on PAS information can improve the use of this specific type of information, manifested in the production of sentences including the verb with its arguments. Theoretically, the findings support the view that complementation information is represented separately from other types of language information, and they suggest that different types of complementation information might be represented separately. © 2014, © 2014 Taylor & Francis.

Treger I.,Loewenstein Hospital Rehabilitation Center | Treger I.,Tel Aviv University | Aidinof L.,Loewenstein Hospital Rehabilitation Center | Lutsky L.,Clalit Health Services | Kalichman L.,Ben - Gurion University of the Negev
Archives of Physical Medicine and Rehabilitation | Year: 2010

Objective To evaluate the association between mean flow velocity (MFV) in the middle cerebral artery (MCA) measured by using transcranial Doppler (TCD) and functional and neurologic impairment change during rehabilitation after acute stroke. Design Cross-sectional observational study. Setting Acute neurologic rehabilitation department. Participants Consecutive patients (N=67; 53 men, 14 women; mean ± SD age, 61.54±8.92y) referred to the rehabilitation center during the first 6 months of 2006 for a first ischemic stroke in the MCA area. Interventions Not applicable. Main Outcome Measures All subjects were evaluated on admission and at discharge by using the National Institutes of Health Stroke Scale (NIHSS) and the FIM. TCD measurements of MFV of the ipsilateral and contralateral MCA were performed on admission (during the first 20 days after stroke) and a few days before discharge. Results Contralateral MFV at admission was associated significantly with all indexes of functional rehabilitation success (FIM score at discharge [β=.169; P=.010], change in FIM score [β=.554; P=.010], relative improvement in FIM score [β=.783; P=.003]). No significant association was found between indexes of NIHSS change and ipsilateral or contralateral MFV. Conclusions Ipsilateral or contralateral MFV measured at admission did not change during the 2-month rehabilitation period. Our data showed a significant association between blood flow velocity in the contralateral MCA and functional rehabilitation parameters of patients after first ischemic stroke in the MCA area. © 2010 American Congress of Rehabilitation Medicine.

Biran M.,Tel Aviv University | Biran M.,Loewenstein Hospital Rehabilitation Center | Friedmann N.,Tel Aviv University
Cortex | Year: 2012

This study explored lexical-syntactic information - syntactic information that is stored in the lexicon - and its relation to syntactic and lexical impairments in aphasia. We focused on two types of lexical-syntactic information: predicate argument structure (PAS) of verbs (the number and types of arguments the verb selects) and grammatical gender of nouns. The participants were 17 Hebrew-speaking individuals with aphasia who had a syntactic deficit (agrammatism) or a lexical retrieval deficit (anomia) located at the semantic lexicon, the phonological output lexicon, or the phonological output buffer. After testing the participants' syntactic and lexical retrieval abilities and establishing the functional loci of their deficits, we assessed their PAS and grammatical gender knowledge. This assessment included sentence completion, sentence production, sentence repetition, and grammaticality judgment tasks. The participants' performance on these tests yielded several important dissociations. Three agrammatic participants had impaired syntax but unimpaired PAS knowledge. Three agrammatic participants had impaired syntax but unimpaired grammatical gender knowledge. This indicates that lexical-syntactic information is represented separately from syntax, and can be spared even when syntax at the sentence level, such as embedding and movement are impaired. All 5 individuals with phonological output buffer impairment and all 3 individuals with phonological output lexicon impairment had preserved lexical-syntactic knowledge. These selective impairments indicate that lexical-syntactic information is represented at a lexical stage prior to the phonological lexicon and the phonological buffer. Three participants with impaired PAS (aPASia) and impaired grammatical gender who showed intact lexical-semantic knowledge indicate that the lexical-syntactic information is represented separately from the semantic lexicon. This led us to conclude that lexical-syntactic information is stored in a separate syntactic lexicon. A double dissociation between PAS and grammatical gender impairments indicated that different types of lexical-syntactic information are represented separately in this syntactic lexicon. © 2011 Elsevier Srl.

Adler A.,Tel Aviv University | Hussein O.,Tel Aviv University | Ben-david D.,Tel Aviv University | Masarwa S.,Tel Aviv University | And 29 more authors.
Journal of Antimicrobial Chemotherapy | Year: 2015

Objectives: To study the molecular characteristics of carbapenemase-producing Enterobacteriaceae (CPE) in post-acute-care hospitals (PACHs) in Israel and to analyse the temporal changes between 2008 and 2013. Methods: CPE isolates were obtained during two cross-sectional, point prevalence national surveys of PACHs in Israel performed in 2008 and 2013. Surveillance cultures were collected by streaking rectal swabs onto selective media. Isolates were identified to species level and tested for blaKPC, blaNDM and blaOXA-48 by PCR and by the Carba NP test. Molecular typing was done by PCR for the pilv-l gene, designed for the ST258 KPC-producing Klebsiella pneumoniae (KPC-KP) clone, BOX-PCR and MLST. Results: The prevalence of CPE carriage in the first survey was 184/1147 (16%); all of the isolates were KPC-KP. The prevalence of CPE carriage in the second survey was 127/1287 (9.9%); of these isolates, 113 (89%) were KPC-KP, 9 (7%) were other KPC-producing species and 5 (4%) were NDM- and OXA-48-producing CPE (n = 1 and 4, respectively). The proportion of the KPC-KP population represented by the ST258 clone increased from 120/184 (65%) in 2008 to 91/113 (80%) in 2013. In 58% (71/122) of the KPC-CPE carriers identified in the 2013 survey, the source of acquisition was determined to be the PACH itself. All four OXA-48 CPE were acquired either directly or indirectly from patients arriving from the Palestinian Authority or Syria. Conclusions: Despite the decreased prevalence of CPE in Israeli PACHs, and the emergence of new types of CPE, the KPC-KP ST258 clone remains the predominant clone represented. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.

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