The purpose of this longitudinal study was to predict /r/ acquisition using acoustic signal processing. 19 children, aged 5-7 with inaccurate /r/, were followed until they turned 8 or acquired /r/, whichever came first. Acoustic and descriptive data from 14 participants were analyzed. The remaining 5 children continued to be followed. The study analyzed differences in spectral energy at the baseline acoustic signals of participants who eventually acquired /r/ compared to that of those who did not acquire /r/. Results indicated significant differences between groups in the baseline signals for vocalic and postvocalic /r/, suggesting that the acquisition of certain allophones may be predictable. Participants’ articulatory changes made during the progression of acquisition were also analyzed spectrally. A retrospective analysis described the pattern in which /r/ allophones were acquired, proposing that vocalic /r/ and the postvocalic variant of consonantal /r/ may be acquired prior to prevocalic /r/, and /r/ followed by low vowels may be acquired before /r/ followed by high vowels, although individual variations exist.

With the recent rise in opioid overdose and death1<br/><br/>, chronic opioid therapy (COT) programs using<br/>Center of Disease Control (CDC) guidelines have been implemented across the United States8<br/>.<br/>Primary care clinicians at Mayo Clinic initiated a COT program in September of 2017, during the<br/>use of Cerner Electronic Health Record (EHR) system. Study metrics included provider<br/>satisfaction and perceptions regarding opioid prescription. Mayo Clinic transitioned its EHR<br/>system from Cerner to Epic in October 2018. This study aims to understand if provider perceptions<br/>about COT changed after the EHR transition and the reasons underlying those perceptions.

Background: Creation and reuse of reliable clinical code sets could accelerate the use of EHR data for research. To support that vision, there is an imperative need for methodologically. driven, transparent and automatic approaches to create error-free clinical code sets. Objectives: Propose and evaluate an automatic, generalizable, and knowledge-based approach that uses as starting point a correct and complete knowledge base of ingredients (e.g., the US Drug Enforcement Administration Controlled Substance repository list includes fentanyl as an opioid) to create medication code sets (e.g., Abstral is an opioid medication with fentanyl as ingredient). Methods: Algorithms were written to convert lists of ingredients into medication code sets, where all the medications are codified in the RxNorm terminology, are active medications and have at least one ingredient from the ingredient list. Generalizability and accuracy of the methods was demonstrated by applying them to the discovery of opioid and anti-depressant medications. Results: Errors (39 (1.73%) and 13 (6.28%)), obsolete drugs (172 (7.61%) and 0 (0%)) and missing medications (1,587 (41.26%) and 1,456 (87.55%)) were found in publicly available opioid and antidepressant medication code sets, respectively. Conclusion: The proposed knowledge-based algorithms to discover correct, complete, and up to date ingredient-based medication code sets proved to be accurate and reusable. The resulting algorithms and code sets have been made publicly available for others to use.