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.

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.