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An experiment is reported, the results of which confirm and extend an earlier observation that visual information for the speaker's lip movements profoundly modifies the auditorv perception of natural speech by normally hearing subjects. The effect is most pronounced when there is auditory information for a bilabial utterance combined with visual information for a nonlabial utterance. However, the effect is also obtained with the reverse combination, although to a lesser extent. These findings are considered for their relevance to auditory theories of speech perception.

Most children with Down syndrome are capable of learning to read single words. However, there was no evidence over this two-year period to support the hypothesis that learning to read will help to enhance language and memory development in children with Down syndrome.

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We propose that the source of general disruption in both depressed and anxious patients may be a competition between attempts to direct attentional resources to the task in hand and away from the distractive and intrusive effects of automatic negative thoughts.

Purpose: Age is a poor prognostic factor in melanoma patients. Elderly melanoma patients have a different presentation and clinical course than younger patients. We evaluated the impact of age ≥70 years (yrs) on the diagnosis and natural history of melanoma.Methods: Retrospective review of 610 patients with malignant melanoma entered into a prospective sentinel lymph node (SLN) database, treated from June 1997 to June 2010. Disease characteristics and clinical outcomes were compared between patients ≥70 yrs vs. <70 yrs of age.Results: 237 patients (39%) were ≥70 yrs. Elderly patients had a higher proportion of head and neck melanomas (34% vs. 20%, p<0.001), and greater mean tumor thickness (2.4mm vs. 1.8mm, p<0.001). A greater proportion of T3 or T4 melanoma was seen in the elderly (p<0.001) as well as a greater mean number of mitotic figures: 3.6/mm2 vs. 2.7/mm2 (p=0.005). Despite greater mean thickness, the incidence of SLN metastases was less in the ≥70 yrs group with T3/T4 melanomas (18% vs. 33%, p=0.02). The elderly had a higher rate of local and in-transit recurrences, 14.5% vs. 3.4% at 5 yrs (p<0.001). 5 yr disease-specific mortality and overall mortality were worse for those ≥70 yrs: 16% vs. 8% (p=0.004), and 30% vs. 12% (p<0.001), respectively.Conclusions: Elderly (≥70 yrs) melanoma patients present with thicker melanomas and a higher mitotic rate but have fewer SLN metastases. Melanoma in the elderly is more common on the head and neck. Higher incidence of local/in-transit metastases is seen among the elderly. Five-year disease-specific mortality and overall mortality are both worse for these patients.

Options in the implementation of PBI are discussed that could potentially save costs for the healthcare providers and increase the value of a PBI-based approach.