Psychiatric comorbidity in patients with spasmodic dysphonia: a controlled study

OBJECTIVES: To study the prevalence of psychiatric comorbidity assessed by a structured clinical interview in patients with spasmodic dysphonia (SD) compared with patients suffering from vocal fold paralysis (VFP). METHODS: In 48 patients with SD and 27 patients with VFP, overall psychiatric comorbidity was studied prospectively using the Structured Clinical Interview for DSM-IV Axis I disorders. Physical disability and psychometric variables were assessed with standardised self-rating questionnaires. RESULTS: 41.7% of SD subjects and 19.5% of the control group met DSM-IV clinical criteria for current psychiatric comorbidity (p<0.05). Significant predictors of psychiatric comorbidity in SD were severity of voice impairment and subjective assessment of "satisfaction with health". As a limitation, the severity of voice impairment in patients with SD was nearly twice as high, and their illness had lasted nearly twice as long. CONCLUSIONS: We found a high prevalence of psychiatric comorbidity in patients with SD. The significant correlation between current psychiatric comorbidity and the extent of voice pathology may point to an especially strong interaction between somatic and psychiatric complaints in SD.

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.

Microscopic wire guide-based orotracheal mouse intubation: description, evaluation and comparison with transillumination

Airway access is needed for a number of experimental animal models, and the majority of animal research is based on mouse models. Anatomical conditions in mice are small, and the narrow glottic opening allows intubation only with a subtle technique. We therefore developed a microscopic endotracheal intubation method with a wire guide technique in mice anaesthetized with halothane in oxygen. The mouse is hung perpendicularly with its incisors on a thread fixed on a vertical plate. The tongue is placed with a pair of forceps between the left hand's thumb and forefinger and slightly pulled, while the neck and thorax are positioned using the third and fourth fingers. By doing so, the neck can be slightly stretched, which allows optimal visualization of the larynx and the vocal cords. To ensure a safe intubation, a fine wire guide is placed under vision between the vocal cords and advanced about 5 mm into the trachea. An intravenous 22G x 1 in. plastic or Teflon catheter is guided over this wire. In a series of 41 mice, between 21 and 38 g, the success rate for the first intubation attempt was >95%. Certainty of the judgement procedure was 100% and success rate was higher using the described method when compared with a transillumination method in a further series. The technique is safe, less invasive than tracheostomy and suitable for controlled ventilation and pulmonary substance application.

Heterotic T-folds with a small number of neutral moduli

We discuss non-geometric supersymmetric heterotic string models in D=4, in the framework of the free fermionic construction. We perform a systematic scan of models with four a priori left-right asymmetric Z2 projections and shifts. We analyze some 220 models, identifying 18 inequivalent classes and addressing variants generated by discrete torsions. They do not contain geometrical or trivial neutral moduli, apart from the dilaton. However, we show the existence of flat directions in the form of exactly marginal deformations and identify patterns of symmetry breaking where product gauge groups, realized at level one, are broken to their diagonal at higher level. We also describe an “inverse Gepner map” from Heterotic to Type II models that could be used, in certain non geometric settings, to define “effective” topological invariants.

Functional hoarseness in children: short-term play therapy with family dynamic counseling as therapy of choice

Children with nonorganic voice disorders (NVDs) are treated mainly using direct voice therapy techniques such as the accent method or glottal attack changes and indirect methods such as vocal hygiene and voice education. However, both approaches tackle only the symptoms and not etiological factors in the family dynamics and therefore often enjoy little success. The aim of the "Bernese Brief Dynamic Intervention" (BBDI) for children with NVD was to extend the effectiveness of pediatric voice therapies with a psychosomatic concept combining short-term play therapy with the child and family dynamic counseling of the parents. This study compares the therapeutic changes in three groups where different procedures were used, before intervention and 1 year afterward: counseling of parents (one to two consultations; n = 24), Brief Dynamic Intervention on the lines of the BBDI (three to five play therapy sessions with the child plus two to four sessions with the parents; n = 20), and traditional voice therapy (n = 22). A Voice Questionnaire for Parents developed by us with 59 questions to be answered on a four-point Likert scale was used to measure the change. According to the parents' assessment, a significant improvement in voice quality was achieved in all three methods. Counseling of parents (A) appears to have led parents to give their child more latitude, for example, they stopped nagging the child or demanding that he/she should behave strictly by the rules. After BBDI (B), the mothers were more responsive to their children's wishes and the children were more relaxed and their speech became livelier. At home, they called out to them less often at a distance, which probably improved parent-child dialog. Traditional voice therapy (C) seems to have had a positive effect on the children's social competence. BBDI seems to have the deepest, widest, and therefore probably the most enduring therapeutic effect on children with NVD.

Search for contact interactions and large extra dimensions in dilepton events from pp collisions at sqrts=7 TeV with the ATLAS detector

A search for nonresonant new phenomena, originating from either contact interactions or large extra spatial dimensions, has been carried out using events with two isolated electrons or muons. These events, produced at the LHC in proton-proton collisions at root s = 7 TeV, were recorded by the ATLAS detector. The data sample, collected throughout 2011, corresponds to an integrated luminosity of 4.9 and 5.0 fb(-1) in the e(+)e(-) and mu(+)mu(-) channels, respectively. No significant deviations from the Standard Model expectation are observed. Using a Bayesian approach, 95% confidence level lower limits ranging from 9.0 to 13.9 TeV are placed on the energy scale of llqq contact interactions in the left-left isoscalar model. Lower limits ranging from 2.4 to 3.9 TeV are also set on the string scale in large extra dimension models. After combining these limits with results from a similar search in the diphoton channel, slightly more stringent limits are obtained.

Search for contact interactions and large extra dimensions in the dilepton channel using proton-proton collisions at s√ = 8 TeV with the ATLAS detector

A search is conducted for non-resonant new phenomena in dielectron and dimuon final states, originating from either contact interactions or large extra spatial dimensions. The LHC 2012 proton–proton collision dataset recorded by the ATLAS detector is used, corresponding to 20 fb−1 at √ s = 8 TeV. The dilepton invariant mass spectrum is a discriminating variable in both searches, with the contact interaction search additionally utilizing the dilepton forward-backward asymmetry. No significant deviations from the Standard Model expectation are observed. Lower limits are set on the ℓℓqq contact interaction scale ʌ between 15.4 TeVand 26.3 TeV, at the 95%credibility level. For large extra spatial dimensions, lower limits are set on the string scale MS between 3.2 TeV to 5.0 TeV.

MSSM soft terms from supergravity with gauged R-symmetry in de Sitter vacuum

We work out the phenomenology of a model of supersymmetry breaking in the presence of a tiny (tunable) positive cosmological constant, proposed by the authors in arXiv:1403.1534. It utilizes a single chiral multiplet with a gauged shift symmetry that can be identified with the string dilaton (or an appropriate compactification modulus). The model is coupled to the MSSM, leading to calculable soft supersymmetry breaking masses and a distinct low energy phenomenology that allows to differentiate it from other models of supersymmetry breaking and mediation mechanisms.

Sacred vocation program follow up evaluation at the Baylor healthcare system

Background: The Sacred Vocation Program (SVP) (Amick B, Karff S., 2003) helps workers find meaning, spirituality, and see their job as a sacred vocation. The SVP is based on Participatory Action Research (PAR) (Minkler & Wallerstein, 1997; Parker & Wall, 1998). This study aims to evaluate the SVP implemented at the Baylor Healthcare System, Dallas-Fort Worth. ^ Methods: The study design is a qualitative design. We used data from study participants who have participated in focus groups. During these focus groups specific questions and probes regarding the effectiveness of the SVP have been asked. We analyzed the focus groups and derived themes. ^ Results: Results of this study demonstrate SVP helps graduates feel valued and important. The SVP has improved meaningful work for employees and improved a sense of belonging for participants. The program has also increased participant spirituality. The coping techniques developed during a SVP class helps participants deal with stressful situations. The SVP faces challenges of implementation fidelity, poor communication, program viability in tough economic times and implementation of phase II. Another sustainability challenge for SVP is the perception of the program being a religious one versus a spiritual program. ^ Conclusion: Several aspects of the SVP work. The phase I of SVP is successful in improving meaningful work and a sense of belonging for participants. The coping techniques help participants deal with difficult work situations. The SVP can increase effectiveness through improvements in implementation fidelity, communication and leadership commitment. ^

The effect of acoustic screens on orchestra musicians

La Directiva 2003/10/CE del Parlamento Europeo y del Consejo, del 6 de febrero de 2003, específica con arreglo al apartado 1 del artículo 16 de la Directiva 89/391/CEE las disposiciones mínimas de seguridad y de salud relativas a la exposición de los trabajadores a los riesgos derivados de los agentes físicos (ruido). En la industria musical, y en concreto en los músicos de orquesta, una exposición de más de ocho horas al día a un nivel de presión sonora de 80dB(A) o más es algo muy común. Esta situación puede causar a los trabajadores daños auditivos como la hiperacusia, hipoacusia, tinitus o ruptura de la membrana basilar entre otros. Esto significa que deben tomarse medidas para implementar las regulaciones de la forma más razonable posible para que la interpretación del músico, la dinámica y el concepto musical que se quiere transmitir al público se vea lo menos afectada posible. Para reducir la carga auditiva de los músicos de orquesta frente a fuertes impactos sonoros provenientes de los instrumentos vecinos, se está investigando sobre el uso de unos paneles acústicos que colocados en puntos estratégicos de la orquesta pueden llegar a reducir el impacto sonoro sobre el oído hasta 20dB. Los instrumentos de viento metal y de percusión son los responsables de la mayor emisión de presión sonora. Para proteger el oído de los músicos frente a estos impactos, se colocan los paneles en forma de barrera entre dichos instrumentos y los músicos colocados frente a ellos. De esta forma se protege el oído de los músicos más afectados. Para ver el efecto práctico que producen estos paneles en un conjunto orquestal, se realizan varias grabaciones en los ensayos y conciertos de varias orquestas. Los micrófonos se sitúan a la altura del oído y a una distancia de no más de 10cm de la oreja de varios de los músicos más afectados y de los músicos responsables de la fuerte emisión sonora. De este modo se puede hacer una comparación de los niveles de presión sonora que percibe cada músico y evaluar las diferencias de nivel existentes entre ambos. Así mismo se utilizan configuraciones variables de los paneles para comparar las diferencias de presión sonora que existen entre las distintas posibilidades de colocarlos y decidir así sobre la mejor ubicación y configuración de los mismos. A continuación, una vez obtenidos las muestras de audio y los diferentes archivos de datos medidos con un analizador de audio en distintas posiciones de la orquesta, todo ello se calibra y analiza utilizando un programa desarrollado en Matlab, para evaluar el efecto de los paneles sobre la percepción auditiva de los músicos, haciendo especial hincapié en el análisis de las diferencias de nivel de presión sonora (SPL). Mediante el cálculo de la envolvente de las diferencias de nivel, se evalúa de un modo estadístico el efecto de atenuación de los paneles acústicos en los músicos de orquesta. El método está basado en la probabilidad estadística de varias muestras musicales ya que al tratarse de música tocada en directo, la dinámica y la sincronización entre los músicos varía según el momento en que se toque. Estos factores junto con el hecho de que la partitura de cada músico es diferente dificulta la comparación entre dos señales grabadas en diferentes puntos de la orquesta. Se necesita por lo tanto de varias muestras musicales para evaluar el efecto de atenuación de los paneles en las distintas configuraciones mencionadas anteriormente. El estudio completo del efecto de los paneles como entorno que influye en los músicos de orquesta cuando están sobre el escenario, tiene como objetivo la mejora de sus condiciones de trabajo. Abstract For several years, the European Union has been adopting many laws and regulations to protect and give more security to people who are exposed to some risk in their job. Being exposed to a loud sound pressure level during many hours in the job runs the risk of hearing damage. Particularly in the field of music, the ear is the most important working tool. Not taking care of the ear can cause some damage such as hearing loss, tinnitus, hyperacusis, diplacusis, etc. This could have an impact on the efficiency and satisfaction of the musicians when they are playing, which could also cause stress problems. Orchestra musicians, as many other workers in this sector, are usually exposed to a sound level of 80dB(A) or more during more than eight hours per day. It means that they must satisfy the law and their legal obligations to avoid health problems proceeding from their job. Putting into practice the new regulations is a challenge for orchestras. They must make sure that the repertoire, with its dynamic, balance and feeling, is not affected by the reduction of sound levels imposed by the law. This study tries to investigate the benefits and disadvantages of using shields as a hearing protector during rehearsals and orchestral concerts.

Simulating accepting networks of evolutionary processors with filtered connections by accepting evolutionary P systems

In this work, we propose a variant of P system based on the rewriting of string-objects by means of evolutionary rules. The membrane structure of such a P system seems to be a very natural tool for simulating the filters in accepting networks of evolutionary processors with filtered connections. We discuss an informal construction supporting this simulation. A detailed proof is to be considered in an extended version of this work.

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.

Dust effects on PV array performance: in-field observations with non-uniform patterns

This paper presents the impact of non-homogeneous deposits of dust on the performance of a PV array. The observations have been made in a 2-MW PV park in the southeast region of Spain. The results are that inhomogeneous dust leads to more significant consequences than the mere short-circuit current reduction resulting from transmittance losses. In particular, when the affected PV modules are part of a string together with other cleaned (or less dusty) ones, operation voltage losses arise. These voltage losses can be several times larger than the short-circuit ones, leading to power losses that can be much larger than what measurements suggest when the PV modules are considered separately. Significant hot-spot phenomena can also arise leading to cells exhibiting temperature differences of more than 20 degrees and thus representing a threat to the PV modules' lifetime.

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.