Randomized controlled trial on single dose steroid before thyroidectomy for benign disease to improve postoperative nausea, pain, and vocal function

OBJECTIVE: To evaluate the effects of a single preoperative dose of steroid on thyroidectomy outcomes. BACKGROUND: Nausea, pain, and voice alteration frequently occur after thyroidectomy. Because steroids effectively reduce nausea and inflammation, a preoperative administration of steroids could improve these thyroidectomy outcomes. METHODS: Seventy-two patients (men = 20, women = 52) undergoing thyroidectomy for benign disease were included in this randomized, controlled, 2 armed (group D: 8 mg dexamethasone, n = 37; group C: 0.9% NaCl, n = 35), double-blinded study (clinical trial number NCT00619086). Anesthesia, surgical procedures, antiemetics, and analgesic treatments were standardized. Nausea (0-3), pain (visual analog scale), antiemetic and analgesic requirements, and digital voice recording were documented before and 4, 8, 16, 24, 36, and 48 hours after surgery. Patients were followed-up 30 days after hospital discharge. RESULTS: Baseline characteristics were similar among the 2 treatment groups. Nausea was pronounced in the first 16 hours postoperatively (scores were <0.3 and 0.8-1.0 for group D and C, respectively (P = 0.005)), and was significantly lower in group D compared with group C during the observation period (P = 0.001). Pain diminished within 48 hours after surgery (visual analog scale 20 and 35 in group D and C, respectively (P = 0.009)). Antiemetic and analgesic requirements were also significantly diminished. Changes in voice mean frequency were less prominent in the dexamethasone group compared with the placebo group (P = 0.015). No steroid-related complications occurred. CONCLUSION: A preoperative single dose of steroid significantly reduced nausea, vomiting, and pain, and improved postoperative voice function within the first 48 hours (most pronounced within 16 hours) after thyroid resection; this strategy should be routinely applied in thyroidectomies.

Targeting the Blood-brain Barrier with a Non-canonical Iron-mimicry Mechanism

Treatment of central nervous system (CNS) diseases is limited by the blood-brain barrier (BBB), a selective vascular interface restricting passage of most molecules from blood into brain. Specific transport systems have evolved allowing circulating polar molecules to cross the BBB and gain access to the brain parenchyma. However, to date, few ligands exploiting such systems have proven clinically viable in the setting of CNS diseases. We reasoned that combinatorial phage-display screenings in vivo would yield peptides capable of crossing the BBB and allow for the development of ligand-directed targeting strategies of the brain. Here we show the identification of a peptide mediating systemic targeting to the normal brain and to an orthotopic human glioma model. We demonstrate that this peptide functionally mimics iron through an allosteric mechanism and that a non-canonical association of (i) transferrin, (ii) the iron-mimic ligand motif, and (iii) transferrin receptor mediates binding and transport of particles across the BBB. We also show that in orthotopic human glioma xenografts, a combination of transferrin receptor over-expression plus extended vascular permeability and ligand retention result in remarkable brain tumor targeting. Moreover, such tumor targeting attributes enables Herpes simplex virus thymidine kinase-mediated gene therapy of intracranial tumors for molecular genetic imaging and suicide gene delivery with ganciclovir. Finally, we expand our data by analyzing a large panel of primary CNS tumors through comprehensive tissue microarrays. Together, our approach and results provide a translational avenue for the detection and treatment of brain tumors.

The Nature of Scientific Proof in the Age of Simulations. Is numerical mimicry a third way of establishing truth?

Is numerical mimicry a third way of establishing truth? Kevin Heng received his M.S. and Ph.D. in astrophysics from the Joint Institute for Laboratory Astrophysics (JILA) and the University of Colorado at Boulder. He joined the Institute for Advanced Study in Princeton from 2007 to 2010, first as a Member and later as the Frank & Peggy Taplin Member. From 2010 to 2012 he was a Zwicky Prize Fellow at ETH Z¨urich (the Swiss Federal Institute of Technology). In 2013, he joined the Center for Space and Habitability (CSH) at the University of Bern, Switzerland, as a tenure-track assistant professor, where he leads the Exoplanets and Exoclimes Group. He has worked on, and maintains, a broad range of interests in astrophysics: shocks, extrasolar asteroid belts, planet formation, fluid dynamics, brown dwarfs and exoplanets. He coordinates the Exoclimes Simulation Platform (ESP), an open-source set of theoretical tools designed for studying the basic physics and chemistry of exoplanetary atmospheres and climates (www.exoclime.org). He is involved in the CHEOPS (Characterizing Exoplanet Satellite) space telescope, a mission approved by the European Space Agency (ESA) and led by Switzerland. He spends a fair amount of time humbly learning the lessons gleaned from studying the Earth and Solar System planets, as related to him by atmospheric, climate and planetary scientists. He received a Sigma Xi Grant-in-Aid of Research in 2006

Die beiden Systeme der hebräischen Vocal- und Accentzeichen

Michel Friedländer

Desenmascarando la domesticación de las mujeres : Graciela Cabal y el recurso a la “mimicry"

La literatura, además de su especificidad como obra de arte, constituye un modo privilegiado de conocimiento y es una herramienta clave en la construcción de nuestra identidad. Precisamente, aquel que posee el lenguaje tiene la capacidad de ordenar el mundo. Esto se debe a la interdependencia que existe entre mundo y lenguaje: el discurso nos remite a una red relaciones de poder, el entramado patriarcal, que se da en la sociedad, que es construida con palabras y que, justamente por esto, puede cambiarse. Entonces, si la forma de relatar es una manera de ordenar el mundo, lo que quedaría por delante sería romper con el discurso que somete a las mujeres. Luce Irigaray (1985) propone un modo de hacerlo: utilizando la mimicry, mímesis o imitación intencionada, que permite asumir deliberadamente la subordinación de mujeres y llevarla a una afirmación para poder frustrarla. La escritora Graciela Beatriz Cabal hizo suya la propuesta de Irigaray y la plasmó en su obra. Este artículo, entonces, versará sobre la utilización de la mimicry en su obra. Para analizar la utilización de dicho recurso, se examinará el cuento La Señora Planchita (1999). .

Vocal tract settings in speakers suffering from obstructive sleep apnea síndrome

Automatic systems based on speech signal analysis for the early dete ction of obstructive sleep apnea (OSA) have achieved fairly high performance rates in recent years. However, a satisfactory explanation of these results has not been available. This presentation aims at explaining via an examination of the long-term spectra of OSA patients and normal control speakers these systems’ ability to discover OSA speakers on the base of all-purpose cepstral coefficients. An in terpretation of the long- term spectra in terms of the underlying tract settings suggests that the speech of OSA patients is characterized by a pharyngeal narrowing that may be captured by acoustic cues of the spectral contour of windowed speech frames. A novel interpretation of long-term spectra in terms of the first principal component of the temporal sequence of short-term amplitude-spectra is also discussed.

Estimating tremor in Vocal Fold Biomechanics for Neurological Disease characterisation

Neurological Diseases (ND) are affecting larger segments of aging population every year. Treatment is dependent on expensive accurate and frequent monitoring. It is well known that ND leave correlates in speech and phonation. The present work shows a method to detect alterations in vocal fold tension during phonation. These may appear either as hypertension or as cyclical tremor. Estimations of tremor may be produced by auto-regressive modeling of the vocal fold tension series in sustained phonation. The correlates obtained are a set of cyclicality coefficients, the frequency and the root mean square amplitude of the tremor. Statistical distributions of these correlates obtained from a set of male and female subjects are presented. Results from five study cases of female voice are also given.

Monitoring treatment of vocal fold paralysis by biomechanical analysis of voice

A case study of vocal fold paralysis treatment is described with the help of the voice quality analysis application BioMet®Phon. The case corresponds to a description of a 40 - year old female patient who was diagnosed of vocal fold paralysis following a cardio - pulmonar intervention which required intubation for 8 days and posterior tracheotomy for 15 days. The patient presented breathy and asthenic phon ation, and dysphagia. Six main examinations were conducted during a full year period that the treatment lasted consisting in periodic reviews including video - endostroboscopy, voice analysis and breathing function monitoring. The phoniatrician treatment inc luded 20 sessions of vocal rehabilitation, followed by an intracordal infiltration with Radiesse 8 months after the rehabilitation treatment started followed by 6 sessions of rehabilitation more. The videondoscopy and the voicing quality analysis refer a s ubstantial improvement in the vocal function with recovery in all the measures estimated (jitter, shimmer, mucosal wave contents, glottal closure, harmonic contents and biomechanical function analysis). The paper refers the procedure followed and the results obtained by comparing the longitudinal progression of the treatment, illustrating the utility of voice quality analysis tools in speech therapy.

Relevance of the glottal pulse and the vocal tract in gender detection

Gender detection is a very important objective to improve efficiency in tasks as speech or speaker recognition, among others. Traditionally gender detection has been focused on fundamental frequency (f0) and cepstral features derived from voiced segments of speech. The methodology presented here consists in obtaining uncorrelated glottal and vocal tract components which are parameterized as mel-frequency coefficients. K-fold and cross-validation using QDA and GMM classifiers showed that better detection rates are reached when glottal source and vocal tract parameters are used in a gender-balanced database of running speech from 340 speakers.

Vocal fold biomechanical analysis for the singing voice

Teaching the adequate use of the singing voice conveys a lot of knowledge in musical performance as well as in objective estimation techniques involving the use of air, muscles, room and body acoustics, and the tuning of a fine instrument as the human voice. Although subjective evaluation and training is a very delicate task to be carried out only by expert singers, biomedical engineering may help contributing with well - funded methodologies developed for the study of voice pathology. The present study is a preliminary study of exploratory character describing the performance of a student singer in a regular classroom under the point of view of vocal fold biomechanics. Estimate s of biomechanical parameters obtained from singing voice are given and their use i n the classroom is discussed.

Análisis de la modulación de voz ocasionada por el temblor vocal

La realización de este proyecto está basado en el estudio realizado por Jean Schoentgen en el cual el autor caracterizó el micro temblor vocal por medio del índice y la frecuencia de modulación. En este proyecto se utilizará la herramienta Matlab para el cálculo de estos parámetros y al finalizar se analizarán los datos obtenidos. El proyecto se ha dividido en tres grandes partes. En la primera de ellas se ha explicado brevemente los conceptos básicos de la voz y conceptos importantes tales como el temblor fisiológico, el patológico y el Jitter vocal entre otros, también se han detallado conceptos matemáticos utilizados en el desarrollo del código. Esto se realizó con el fin que el lector tenga claros algunos conceptos importantes antes del desarrollo del código y así pueda entender con más facilidad el estudio realizado en este proyecto, en esta parte no se ha realizado una explicación muy extensa de cada concepto, entendiendo que el lector posee unos conocimientos básicos de ingeniería, por otra parte existen innumerables libros que explican de una manera más precisa cada uno de estos conceptos. En la segunda parte se llevó a cabo el desarrollo del código. Como se mencionó anteriormente se ha utilizado la herramienta Matlab que es muy utilizada en la mayoría de las asignaturas de la carrera obteniendo así un buen dominio de esta, además posee unos toolbox muy útiles que facilitan los cálculos matemáticos. En esta parte se ilustra paso a paso cada etapa de elaboración del código y algunas graficas de la señal de voz a medida que pasa por cada etapa del código. En la última parte se obtienen los datos de todos los cálculos de los registros de voz y se analiza cada uno de ellos a la vez que se comparan con los del estudio de Jean Schoentgen y se analizan las posibles diferencias. ABSTRACT. The Project is based on the search made by Jean Schoentgen, whose research the micro tremor vocal can be established by frequency modulation and modulation index. This project has been carried out in Matlab to calculate the aforementioned parameters and finally, the results were contrasted with the results from Jean Shoetngen’s research. This project consists of three parts: The first of all, to be able to understand this project to future readers .It was explained different basic concepts about the voice such as physiologic tremor, pathological tremor and Jitter. Furthermore, mathematical concepts were explained in detail, due to these were used in the software development. Then, it was focused on software development such as the elaboration of code and different voice signals that were processed. This part was made with Matlab, which is mathematical software with high-level language for numerical computation, visualization, collaborate across disciplines including signal and image processing and application development. At finally, the acquired calculations were contrasted with the results from Jean Schoentgen’s research.

Vocal imitation in zebra finches is inversely related to model abundance

A juvenile male zebra finch, Taeniopygia guttata, kept singly with its father develops a fairly complete imitation of the father’s song. The imitation is less complete when other male siblings are present, possibly because as imitation commences, model abundance increases. Here we examine the consequences of allowing more or less access to a song model. Young males heard a brief song playback when they pecked at a key, but different males were allowed to hear different numbers of playbacks per day. Using an automated procedure that scored the similarity between model and pupil songs, we discovered that 40 playbacks of the song motif per day, lasting a total of 30 sec, resulted in a fairly complete imitation. More exposure led to less complete imitation. Vocal imitation often may reflect the interaction of diverse influences. Among these, we should now include the possible inhibitory effect of model overabundance, which may foster individual identity and explain the vocal diversity found in zebra finches and other songbirds.

Musical Listening and Kinesthesis : Is There an Audio-Vocal Tuning System?

Peer reviewed

Structural mimicry of a native protein by a minimized binding domain

The affinity between molecules depends both on the nature and presentation of the contacts. Here, we observe coupling of functional and structural elements when a protein binding domain is evolved to a smaller functional mimic. Previously, a 38-residue form of the 59-residue B-domain of protein A, termed Z38, was selected by phage display. Z38 contains 13 mutations and binds IgG only 10-fold weaker than the native B-domain. We present the solution structure of Z38 and show that it adopts a tertiary structure remarkably similar to that observed for the first two helices of B-domain in the B-domain/Fc complex [Deisenhofer, J. (1981) Biochemistry 20, 2361–2370], although it is significantly less stable. Based on this structure, we have improved on Z38 by designing a 34-residue disulfide-bonded variant (Z34C) that has dramatically enhanced stability and binds IgG with 9-fold higher affinity. The improved stability of Z34C led to NMR spectra with much greater chemical shift dispersion, resulting in a more precisely determined structure. Z34C, like Z38, has a structure virtually identical to the equivalent region from native protein A domains. The well-defined hydrophobic core of Z34C reveals key structural features that have evolved in this small, functional domain. Thus, the stabilized two-helix peptide, about half the size and having one-third of the remaining residues altered, accurately mimics both the structure and function of the native domain.

HIV-1 Tat protein mimicry of chemokines

The HIV-1 Tat protein is a potent chemoattractant for monocytes. We observed that Tat shows conserved amino acids corresponding to critical sequences of the chemokines, a family of molecules known for their potent ability to attract monocytes. Synthetic Tat and a peptide (CysL24–51) encompassing the “chemokine-like” region of Tat induced a rapid and transient Ca2+ influx in monocytes and macrophages, analogous to β-chemokines. Both monocyte migration and Ca2+ mobilization were pertussis toxin sensitive and cholera toxin insensitive. Cross-desensitization studies indicated that Tat shares receptors with MCP-1, MCP-3, and eotaxin. Tat was able to displace binding of β-chemokines from the β-chemokine receptors CCR2 and CCR3, but not CCR1, CCR4, and CCR5. Direct receptor binding experiments with the CysL24–51 peptide confirmed binding to cells transfected with CCR2 and CCR3. HIV-1 Tat appears to mimic β-chemokine features, which may serve to locally recruit chemokine receptor-expressing monocytes/macrophages toward HIV producing cells and facilitate activation and infection.