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words The involvement of visual association areas or their separation from the primary visual cortices is a common accompaniment that is re ected in an inability to read (alexia) In contrast to Broca s aphasia, the patient with Wernicke s aphasia talks volubly, gestures freely, and appears strangely unaware of his de cit Speech is produced mostly without effort; the phrases and sentences appear to be of normal length and are properly intoned and articulated These attributes, in the context of aphasic disturbances, are referred to, as already mentioned, as uency of speech Despite the uency and normal prosody, the patient s speech is remarkably devoid of meaning The patient with Wernicke s aphasia produces many nonsubstantive words, and the words themselves are often malformed or inappropriate, a disorder referred to as paraphasia A phoneme (the minimal unit of sound recognizable as language) or a syllable may be substituted within a word (eg, The grass is greel ); this is called literal paraphasia The substitution of one word for another ( The grass is blue ) is called verbal paraphasia or semantic substitution and is even more characteristic of Wernicke s aphasia Neologisms ie, syllables or words that are not part of the language may also appear ( The grass is grumps ) Fluent, paraphasic speech may be entirely incomprehensible (gibberish or jargon aphasia) Fluency, however, is not an invariable feature of Wernicke s aphasia In some patients speech may be hesitant, in which case the block tends to occur in the part of the phrase that contains the central communicative (predicative) item, such as a key noun, verb, or descriptive phrase The patient with such a disorder conveys the impression of constantly searching for the correct word and of having dif culty in nding it Although the motor apparatus required for the expression of language is intact, patients with Wernicke s aphasia have great dif culty in functioning as social organisms because they are deprived of the main means of communication They cannot understand fully what is said to them; a few simple commands may still be executed, but there is failure to carry out complex ones They cannot read aloud or silently with comprehension, tell others what they want or think, or write spontaneously Written letters are often combined into meaningless words, but there may be a scattering of correct words In trying to designate an object that is seen or felt, they cannot nd the name, even though they can sometimes repeat it from dictation; nor can they write from dictation the very words that they can copy The copying performance is notably slow and laborious and conforms to the contours of the model, including the examiner s handwriting style All these defects, of course, are present in varying degrees of severity In general, the disturbances in reading, writing, naming, and repetition parallel in severity the impairment in comprehension There are, however, exceptions in which either reading or the understanding of spoken language is disproportionately affected Some aphasiologists thus speak of two Wernicke syndromes In terms of the Broca-Wernicke schema, the motor language areas are no longer under control of the auditory and visual areas The disconnection of the motor speech areas from the auditory and visual ones accounts for the impairment of repetition and the inability to read aloud Reading may remain uent, but with the same paraphasic errors that mar conversational language The occurrence of dyslexia (impaired visual perception of letters and words) with lesions in the temporal lobe is explained by the fact that most individuals learn to read by transforming the printed word into the auditory form before it can gain access to the integrative centers in the posterior perisylvian region Only in the congenitally deaf is.

Time Scatter Chart A subset of the scatter chart is the time scatter chart The X value can be a date or time The basic Chart Designer configuration screen for this chart type, shown next, gives you a hint that it is not meant to be used to show information by products or customers; rather, it is used for tracking and data analysis in a more value-driven approach Notice the formatted Date approach to the X axis

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there thought to be a direct pathway between the visual and central integrative language centers Wernicke s aphasia that is due to stroke usually improves in time, sometimes to the point where the de cits can be detected only by asking the patient to repeat unfamiliar words, to name unusual objects or parts of objects, to spell dif cult words, or to write complex self-generated sentences A more favorable prognosis attends those forms in which some of the elements, eg, reading, are only slightly impaired from the outset As discussed earlier, the term Wernicke s area has been applied to the posterior part of area 22 in the most lateral part of the planum temporale As a rule, in Wernicke s aphasia the lesion lies in the posterior perisylvian region (comprising posterosuperior temporal, opercular supramarginal, angular, and posterior insular gyri) and is usually due to embolic (less often thrombotic) occlusion of the lower (inferior) division of the left middle cerebral artery A hemorrhage con ned to the subcortex of the temporoparietal region or involvement of this area by tumor, abscess, or extension of a small putamenal or thalamic hemorrhage may have similar effects but a better prognosis A lesion that involves structures deep to the posterior temporal cortex will cause an associated homonymous quadrant- or hemianopia Usually, there is no associated weakness of limbs or face and the uently aphasic patient may be misdiagnosed as psychotic, especially if there is jargon aphasia According to Kertesz and Benson, persistence of Wernicke s aphasia is related to a lesion that involves both the supramarginal and angular gyri The posterior perisylvian region appears to encompass a variety of language functions, and seemingly minor changes in the size and locale of the lesion are associated with important variations in the elements of Wernicke s aphasia or lead to conduction aphasia or to pure word-deafness (see below) The interesting theoretical problem is whether all the de cits observed are indicative of a unitary language function that resides in the posterior perisylvian region or, instead, of a series of separate sensorimotor activities whose anatomic pathways happen to be crowded together in a small region of the brain In view of the multiple ways in which language is learned and deteriorates in disease, the latter hypothesis seems more likely Global, or Total, Aphasia This syndrome is due to destruction of a large part of the language zone, embracing both Broca s and Wernicke s areas and much of the territory between them The lesion is usually due to occlusion of the left internal carotid artery or proximal middle cerebral artery, but it may be caused by hemorrhage, tumor, or other lesions, and brie y as a postictal effect All aspects of speech and language are affected At most, the patients can say only a few words, usually some cliche or habitual phrase, and they can imitate single sounds Or they can only emit a syllable, such as ah, or cry, shout, or moan Many are initially mute They may understand a few words and phrases, but because of rapid fatigue and verbal and motor perseveration (the obligate repetitive evocation of a word or motor act just after it has been employed) they characteristically fail to carry out a series of simple commands or to name a series of objects They cannot read or write or repeat what is said to them The patient may participate in common gestures of greeting, show modesty and avoidance reactions, and engage in self-help activities With the passage of time, some degree of comprehension of language may return, and the clinical picture that is then most likely to emerge is closest to that of a severe Broca s aphasia.

Almost invariably, a degree of right hemiplegia, hemianesthesia, and homonymous hemianopia accompanies global aphasia of vascular origin In such patients, language function rarely recovers to a great degree On the other hand, improvement frequently occurs when the main cause is cerebral trauma, compression from edema, postconvulsive paralysis, or a transient metabolic derangement such as hypoglycemia, hyponatremia, etc, which may worsen the aphasia of an old lesion that had involved language areas

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we communicate and develop our ideas that way, we look at these dashboards the same way They are just another way to talk to a topic for hours and hours and then finally get to the point If we can narrow down the conversation and get to the point our skill sets in the area of dashboard development would increase at the same rate So, rather than continuing to talk about these topics (following my own lead), let s get started