Validity of the OMNI rating of perceived exertion scale for children and adolescents with cerebral palsy

Aim This study evaluated the validity of the OMNI Walk/Run Rating of Perceived Exertion (OMNI-RPE) scores with heart rate and oxygen consumption (VO2) for children and adolescents with cerebral palsy (CP). Method Children and adolescents with CP, aged 6 to 18 years and Gross Motor Function Classification System (GMFCS) levels I to III completed a physical activity protocol with seven trials ranging in intensity from sedentary to moderate-to-vigorous. VO2 and heart rate were recorded during the physical activity trials using a portable indirect calorimeter and heart rate monitor. Participants reported OMNI-RPE scores for each trial. Concurrent validity was assessed by calculating the average within-subject correlation between OMNI-RPE ratings and the two physiological indices. Results For the correlational analyses, 48 participants (22 males, 26 females; age 12y 6mo, SD 3y 4mo) had valid bivariate data for VO2 and OMNI-RPE, while 40 participants (21 males, 19 females; age 12y 5mo, SD 2y 9mo) had valid bivariate data for heart rate and OMNI-RPE. VO2 (r=0.80; 95% CI 0.66–0.88) and heart rate (r=0.83; 95% CI 0.70–0.91) were moderately to highly correlated to OMNI-RPE scores. No difference was found for the correlation of physiological data and OMNI-RPE scores across the three GMFCS levels. The OMNI-RPE scores increased significantly in a dose-response manner (F6,258=116.1, p<0.001) as exercise intensity increased from sedentary to moderate-to-vigorous. Interpretation OMNI-RPE is a clinically feasible option to monitor exercise intensity in ambulatory children and adolescents with CP.

The Evolution of the Russian Romance Through the Nineteenth and Twentieth centuries

This performance dissertation traced the evolution of the Russian romance from 1800 to the present. The Russian romance is a relatively unknown and greatly neglected genre of classical art songs. It is commonly believed that the Russian romance began with Dargomizhsky and Glinka proceeding directly to Tchaikovsky and Rachmaninoff. Forgotten are the composers before Dargornizhsky and Glinka, the bridge composers, and the post-Tchaikovsky and post-Rachmaninoff composers. This may be, in part, because of the difficulties in obtaining Russian vocal scores. While most of the musical world is acquainted with the magnificent Russian instrumental music, the "true soul" of the Russian people lies in its romances. I presented examples of the two different schools of composition, reflecting their philosophical differences in thinking that came about in the 1860s: (1) Russian National school, (2) Western European school. Each school's influence on generations of Russian composers and their pupils have been represented in the recital programs. Also represented was the effect of the October Revolution on music and the voice of the Russian people, Anna Akhmatova. The amount of music that could be included in this dissertation greatly exceeds the amount of available performance time and represents a selected portion of the repertoire. The first recital included repertoire from the beginning of the romance in the early nineteenth century to the beginning of the twentieth century and the second recital focused on the music of the twentieth century, pre and post, the October Revolution. Finally, given the status of Anna Akhmatova and her contributions, the third recital was devoted entirely to her poetry. The "Russian soul" is one of deep, heartfelt emotions and sorrow. Happiness and joy are also present, but always with a touch of melancholy. The audience did not simply go through a musical journey, but took a journey through the "Russian soul". With the strong response of the audience to these recitals, my belief that this repertoire deserves a prominent place in recital programming was confirmed.

THE LESSER-KNOWN PIANO CHAMBER MUSIC OF CAMILLE SAINT-SAENS: A RECORDING PROJECT

Throughout his long and industrious lifetime, Camille Saint-Saens (1835-1921) devoted himself unconditionally to music both as a composer and a performer. Saint-Saens was a self-described traditionalist and musical purist, yet his works are distinctly expressive and imaginative, and they reflect the composer's own unique musical language which incorporates recognizably modem traits such as chromaticism and frequent modulation. As a performer, Saint-Saens preferred to premiere his own works and often included his chamber music in his concert programs. Regarded primarily as a symphonic composer in the present day, however, his extensive and varied collection of chamber music works is sadly neglected. Six varied small-ensemble works with piano from his chamber music repertoire have been selected for study and recording for this project: Piano Trio No. 1 in F Major, Op. 18 (1864); Sonata for Cello and Piano No. 1 inC Minor, Op. 32 (1872); two pieces for two pianos, Le Rouet d'Omphale (The Spinning Wheel ofOmphale), Op. 31 (1871) and Phaeton, Op. 39 (1874); piano duet Konig Harald Haifagar (King Harald Haarfager), Op. 59 (1880); and a wind quartet, Caprice sur des airs Danois et Russes (Caprice on Danish and Russian Airs) for Flute, Oboe, Clarinet and Piano, Op. 79 (1887). Analyses of the forms and harmonic structures of these compositions will be included in this dissertation paper as well as studies from the viewpoint of Saint-Saens' compositional style, ensemble characteristics, and writing for the piano. The recordings for this project were made in four sessions in LeFrak Concert Hall at Queens College, the City University of New York. On September 24, 2003, Op. 31, Op. 39 and Op. 59 were recorded with Professor Morey Ritt, piano. On March 2, 2004, Op. 18 was recorded with Elena Rojas, violin, and Clare Liu, cello, and on March 15, 2004, Op. 32 was recorded, also with Ms. Liu. The Caprice, Op. 79 was recorded on June 27, 2008 with Laura Conwesser, flute; Randall Wolfgang, oboe; and Steve Hartman, clarinet. The recordings may be found on file in the library at the University of Maryland, College Park.

INNOVATIONS IN FRENCH CHAMBER MUSIC AND MÉLODIE (1886 – 1962) – A COLLABORATIVE PIANIST’S PERSPECTIVE

French chamber music in the last quarter of the nineteenth century displayed significant advances in musical innovations and technical developments. As the Parisian public began to favor instrumental music and mélodie over opera, vocal and chamber music with piano became one of the main genres to express French composers’ creativity and individuality. The composers Franck, Debussy, Fauré, Duparc, Ravel, Chausson and Poulenc were the major contributors to this unusually creative period in French music. French mélodies of this period blend precision with lyricism, and demand the performer’s elegance and wit. They show careful settings of the French language’s rhythmic subtleties and increased expressiveness in and importance of the piano accompaniment. The chamber works of this period demanded superior pianistic and instrumental virtuosity while displaying wide ranges of sonority, multiple tone colors, and rhythmic fluidity. The three recitals which comprise this dissertation project were performed at the University of Maryland Gildenhorn Recital Hall on 27 October 2006, All Nations Mission Church (Dayton, NJ) on 5 December 2009, and the Leah M. Smith Lecture Hall of the University of Maryland on 11 May 2010. The repertoire included Poulenc’s Sonata for Oboe and Piano (1962) with oboist Yeongsu Kim, French mélodies by Fauré, Chausson, Debussy, Ravel and Duparc with soprano Jung-A Lee and baritone Hyun-Oh Shin, Poulenc’s Sextet for Piano, Flute, Oboe, Clarinet, Bassoon and Horn (1932-1939) with flutist Katrina Smith, clarinetist Jihoon Chang, bassoonist Erich Heckscher, hornist Heidi Littman and oboist Yeongsu Kim, Debussy’s Sonata for Cello and Piano (1915) with cellist Ji-Sook Shin, Poulenc’s Sonata for Violin and Piano (1942-1949) with violinist Ji-Hee Lim, Franck’s Sonata for Violin and Piano (1886) with violinist Na-Young Cho, Ravel’s Piano Trio (1915) with cellist Ji-Sook Shin and violinist Yu-Jeong Lee and Ravel’s Sonata for Violin and Piano (1927) with violinist Yu-Jeong Lee. The recitals were recorded on compact discs and are archived within the Digital Repository at the University of Maryland (DRUM).

THE PIANO FANTASY FROM BACH TO DANIELPOUR

The Fantasy, as the term suggests, is a genre that composers have found congenial for exploring innovative and imaginative processes. Works in this genre are numerous in the solo piano literature, and extend even to works for piano and orchestra and to chamber music with piano. I was curious to explore how a specific genre of music maintained similar characteristics but evolved over time. A fantasy is primed to be inventive and I wanted to see how composers from different eras and backgrounds would handle their material in this genre. I have learned that composers worked through formal developments while making innovations within this genre. The heart of my dissertation is presented through the recording project. Because ofthe abundance ofpiano fantasies, many works had to be excluded from this project for time's sake. On two compact discs, I have recorded approximately two hours of solo piano music. I have included some shorter fantasies to magnify significant developments from era to era, country to country, and composer to composer. The first disc has recordings of eighteenth and nineteenth-century fantasies: Chromatic Fantasy and Fugue, BWV 903 by J.S. Bach (1685-1750); Fantasia inC major, H. XVII, 4 by Franz Joseph Haydn (1732-1809); Fantasy inc minor, K. 475 by Wolfgang Amadeus Mozart (1756- 1791); Fantasia inf-sharp minor, Op. 28 by Felix Mendelssohn (1809-1847); and Polonaise-Fantaisie in A-flat major, Op. 61 by Frederic Chopin (1810-1849). On the second disc I have included mid-19th, 20th and 2151-century piano fantasies: Fantasy and Fugue on the Theme B-A-C-H by Franz Liszt (1811-1886); Fantasia Baetica by Manuel de Falla (1876-1946); Three Fantasies by William Bergsma (1921-1994); Fantasy, Aria and Fugue by Frederic Goossen (1927-2011); and Piano Fantasy ("Wenn ich einmal sol! scheiden") by Richard Danielpour (b. 1956). The accompanying document includes program notes for each of the pieces recorded. They were recorded on a Steinway "D" in Dekelboum Concert Hall at the University of Maryland by Antonino D'Urzo ofOpusrite Productions. This document is available in the Digital Repository at the University of Maryland and the CO's are available through the Library System at the University of Maryland.

Genome-wide association study identifies variants associated with progression of liver fibrosis from HCV infection.

Polymorphisms in IL28B were shown to affect clearance of hepatitis C virus (HCV) infection in genome-wide association (GWA) studies. Only a fraction of patients with chronic HCV infection develop liver fibrosis, a process that might also be affected by genetic factors. We performed a 2-stage GWA study of liver fibrosis progression related to HCV infection. We studied well-characterized HCV-infected patients of European descent who underwent liver biopsies before treatment. We defined various liver fibrosis phenotypes on the basis of METAVIR scores, with and without taking the duration of HCV infection into account. Our GWA analyses were conducted on a filtered primary cohort of 1161 patients using 780,650 single nucleotide polymorphisms (SNPs). We genotyped 96 SNPs with P values <5 × 10(-5) from an independent replication cohort of 962 patients. We then assessed the most interesting replicated SNPs using DNA samples collected from 219 patients who participated in separate GWA studies of HCV clearance. In the combined cohort of 2342 HCV-infected patients, the SNPs rs16851720 (in the total sample) and rs4374383 (in patients who received blood transfusions) were associated with fibrosis progression (P(combined) = 8.9 × 10(-9) and 1.1 × 10(-9), respectively). The SNP rs16851720 is located within RNF7, which encodes an antioxidant that protects against apoptosis. The SNP rs4374383, together with another replicated SNP, rs9380516 (P(combined) = 5.4 × 10(-7)), were linked to the functionally related genes MERTK and TULP1, which encode factors involved in phagocytosis of apoptotic cells by macrophages. Our GWA study identified several susceptibility loci for HCV-induced liver fibrosis; these were linked to genes that regulate apoptosis. Apoptotic control might therefore be involved in liver fibrosis.

O ator que canta um conto: a manipulação de parâmetros musicais na voz do ator

This research started with an investigation about the theatrical speaking. Through an empirical methodology that analyzed a practical experience of creating a play and bibliographical research, the actress/researcher investigated ways to manipulate musical parameters as tools in the creation process of the actor s voice. The actress/researcher attempted to connect theory and practice, moved by the desire to find a vocal expression in theater that unfolds as living and transforming movement. This dissertation also contains the report of pedagogical experiences, in which the actress/researcher explored strategies to teach the appropriation of musical parameters in the construction of the vocal work of the actor. Considering that speaking in theater is closer to singing than everyday speech, she concluded that the actor may compose music as a music composer does in the elaborating process of building vocal scores. Therefore, she demonstrated that it is of fundamental importance a musical training in the development of the actor.

Decreased oxidative stress in patients with ulcerative colitis supplemented with fish oil omega-3 fatty acids

OBJECTIVE: the potential pathogenicity of free radicals may have a pivotal role in ulcerative colitis. Fish oil omega-3 fatty acids exert anti-inflammatory effects on patients with ulcerative colitis (UC), but the precise mechanism of the action of fish oil on oxidative stress is still controversial. The aim of the present work was to verify the blood oxidative stress in patients with UC and determine whether the association of sulfasalazine to fish oil omega-3 fatty acids is more effective than isolated use of sulfasalazine to reduce the oxidative stress.METHODS:, Nine patients (seven female and two male; me. an age = 40 +/- 11 y) with mild or moderate active UC were studied in a randomized crossover design. In addition to their usual medication (2 g/d of sulfasalazine), they received fish oil omega-3 fatty acids (4.5 g/d) or placebo for 2-mo treatment periods that were separated by 2 mo, when they only received sulfasalazine. Nine healthy individuals served as control subjects to study the oxidative stress status. Disease activity was assessed by laboratory indicators (C-reactive protein, alpha(1)-acid glycoprotein, alpha(1)-antitrypsin, erythrocyte sedimentation rate, albumin, hemoglobin, and platelet count), sigmoidoscopy, and histology scores. Analysis of oxidative stress was assessed by plasma chemiluminescence and erythrocyte lipid peroxidation, both induced by tert butyl hydroperoxide (t-BuOOH) and by plasma malondialdehyde. Antioxidant status was assayed by total plasma antioxidant capacity (TRAP) and microsomal lipid peroxidation inhibition (LPI). Superoxide dismutase (SOD) and catalase erythrocyte enzymatic activities were also determined.RESULTS: No significant changes were observed in any laboratory indicator or in the sigmoidoscopy or histology scores, with the exception of erythrocyte sedimentation rate, which decreased with both treatments. Oxidative stress was demonstrated by significant decreases in TRAP and LPI levels, increased chemiluminescence induced by t-BuOOH, and higher SOD activity in patients with UC. Treatment with fish oil omega-3 fatty acids reverted the chemiluminescence induced by t-BuOOH and LPI to baseline levels but that did not occur when patients received only sulfasalazine. Levels of plasma malondialdehyde, erythrocyte lipid peroxidation, and catalase were not different from those in the control group.CONCLUSIONS: the results indicated that plasma oxidative stress occurs in patients with UC, and there was a significant decrease when the patients used sulfasalazine plus fish oil omega-3 fatty acids. However, there was no improvement in most laboratory indicators, sigmoidoscopy, and histology scores. The results suggested that omega-3 fatty acids may act as free radical scavengers protecting the patients against the overall effect of oxidative stress. (C)Elsevier B.V. 2003.

Severity of Brazilian sickle cell disease patients: severity scores and feasibility of the Bayesian network model use

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

A critical and descriptive approach to interictal behavior with the Neurobehavior Inventory (NBI)

Purpose: The purpose of this study was to test the psychometric properties of the Neurobehavior Inventory (NBI) in a group of temporal lobe epilepsy (TLE) patients from a tertiary care center, correlating its scores with the presence of psychiatric symptoms. Methods: Clinical and sociodemographic data from ninety-six TLE outpatients were collected, and a neuropsychiatric evaluation was performed with the following instruments: Mini-Mental State Examination (MMSE), structured psychiatric interview (MINI-PLUS), Neurobehavior Inventory (NBI), and Hamilton Depression Rating Scale (HAM-D). Results: Some traits evaluated by the NBI showed adequate internal consistency (mean inter-item correlation between 0.2 and 0.4) and were frequent, such as religiosity (74%) and repetitiveness (60.4%). Principal component analysis showed three factors, named here as emotions (Factor 1), hyposexuality (Factor 2), and unusual ideas (Factor 3). Depressive symptoms on HAM-D showed a strong association with emotions and hyposexuality factors. When patients with left TLE and right TLE were compared, the former exhibited more sadness (p=0.017), and the latter, a greater tendency toward sense of personal destiny (p=0.028). Conclusion: Depression influences NBI scoring, mainly emotionality and hyposexuality traits. Neurobehavior Inventory subscales can be better interpreted with an appropriate evaluation of comorbid mood and anxiety disorders. Compromise in left temporal mesial structures is associated with increased tendency toward sad affect, whereas right temporal pathology is associated with increased beliefs in personal destiny. (C) 2012 Elsevier Inc. All rights reserved.

Comparison of child self-reports and parent proxy-reports on quality of life of children with attention deficit hyperactivity disorder

Abstract Background Attention deficit hyperactivity disorder (ADHD) is a neurobiological condition that affects 3%–7% of the pediatric population and significantly compromises the quality of life (QoL) of these individuals. The aim of the current study was to compare child self-reports and parent proxy reports on the QoL of children with ADHD. Methods Forty-five children with ADHD, combined type, aged 8–12 years without comorbidities, were compared with 43 typically developing children. PedsQL™ 4.0 (Pediatric QoL Inventory™) Generic Core Scales (physical, emotional, social, and school functioning) were completed by families and children self-reporting their health-related QoL. Results Children with ADHD reported themselves significantly lowered their PedsQL™ scores on all dimensions in comparison to typically developing children. Statistically significant differences were observed in social functioning (p = 0.010), school functioning (p <0.001), psychosocial health (p <0.001), and total score (p = 0.002). The physical functioning and emotional functioning dimensions did not differ significantly between groups, with p = 0.841 and p = 0.070, respectively. Parents of children with ADHD also reported lower PedsQL™ scores, with statistically significant differences in all dimensions. The relationship between child self-reports and parent proxy reports indicated that there is greater agreement among children with ADHD, except for the school functioning. Conclusions This suggests that children with the disorder and their parents have a perception of the functional limitations the disorder brings. It is therefore important to undertake studies to verify the QoL in children with ADHD that aim to provide and measure the scope of the well-being of these children.

Cognitive improvement in patients with carotid stenosis is independent of treatment type

Treatment of carotid artery stenosis decreases the long-term risk of stroke and may enhance cerebral blood flow. It is therefore expected to have the potential to prevent cognitive decline or even improve cognition over the long-term. However, intervention itself can cause peri-interventional cerebral infarcts, possibly resulting in a decline of cognitive performance, at least for a short time. We investigated the long-term effects of three treatment methods on cognition and the emotional state one year after intervention. In this prospective observational cohort study, 58 patients with extracranial carotid artery stenosis (≥70%) underwent magnetic resonance imaging and assessment of cognition, mood and motor speed before carotid endarterectomy (n = 20), carotid stenting (n = 10) or best medical treatment (n = 28) (i.e., time-point 1 [TP1]), and at one-year follow-up (TP2). Gain scores, reflecting cognitive change after treatment, were built according to performance as (TP2 -TP1)/TP1. Independent of the treatment type, significant improvement in frontal lobe functions, visual memory and motor speed was found. Performance level, motor speed and mood at TP1 were negatively correlated with gain scores, with greater improvement in patients with low performance before treatment. Active therapy, whether conservative or interventional, produces significant improvement of frontal lobe functions and memory in patients with carotid artery disease, independent of treatment type. This effect was particularly pronounced in patients with low cognitive performance prior to treatment.

A methodologic study of pain assessment in Anglo and Hispanic children with cancer

There is growing clinical evidence that even young children experience pain and accompanying anxiety. Few instruments have been validated to assess pain characteristics in children. The study of related demographic, illness, psychologic and parental factors in children has also been limited. This study examines the reliability and validity of pain assessment tools in an outpatient pediatric cancer population. A total of 78 children from three to fifteen years of age were observed and interviewed about the pain of invasive procedures. The effect of cultural factors and the stress of acculturation were examined by comparing data from two cultural groups, Anglo and Hispanic.^ Spielberger State-Trait Anxiety Scales were administered to children and parents prior to an invasive procedure. The Procedure Behavioral Checklist (PBCL) was used for observation of the child's response during the procedure. The Children's Procedural Interview (CPI) which contains items on the PBCL and visual analogues (scales of faces indicating varying degrees of pain and anxiety) was administered following the procedure.^ Reliability coefficients for Anglos were.78 on the PBCL,.79 on the CPI and.85 on the visual analogue scales. For Hispanics, the reliability for the PBCL was.54, while the CPI had a reliability of.72 and the visual analogue scales,.87. Construct validity was demonstrated by high correlations between the PBCL and CPI scores for both ethnic groups (.66 for Anglos and.64 for Hispanics) and by the significant correlation of State anxiety scores with both PBCL and CPI scores. Age was inversely correlated with PBCL and CPI scores for both ethnic groups. Hispanic parents' anxiety scores were higher than Anglo parents, but were not highly correlated with their child's PBCL, CPI or State-Trait anxiety scores. Caregivers' ratings were correlated with the PBCL scores for Anglos but not for Hispanics.^ The findings of this study indicate that pain responses may be reliably assessed using both observational and self-report methods in children, though differences in Anglo and Hispanic cultures exist. Differences in pain symptomatology and assessment in the two cultural groups warrant further study. ^

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.

Functional outcomes after stabilization with Dynesys in patients with spinal degenerative diseases

Objective: To know the impact of the Dynesys system on the functional outcomes in patients with spinal degenerative diseases. Summary of background data: Dynesys system has been proposed as an alternative to vertebral fusion for several spinal degenerative diseases. The fact that it has been used in people with different diagnosis criteria using different tools to measure clinical outcomes makes very difficult unifying the results available nowadays. Methods: The data base of Medlars Online International Literature (MEDLINE) via PubMed©, EMBASE©, and the Cochrane Library Plus were reviewed in search of all the studies published until November 2012 in which an operation with Dynesys in patients with spinal degenerative diseases and an evaluation of the results by an analysis of functional outcomes had taken place. No limits were used to article type, date of publication or language. Results: A total of 134 articles were found, 26 of which fulfilled the inclusion criteria after being assessed by two reviewers. All of them were case series, except for a multicenter randomized clinical trial (RCT) and a prospective case-control study. The selected articles made a total of 1507 cases. The most frequent diagnosis were lumbar spinal canal stenosis (LSCS), degenerative disc disease (DDD), degenerative spondylolisthesis (DS) and lumbar degenerative scoliosis (LDS). In cases of lumbar spinal canal stenosis Dynesys was associated to surgical decompression. Several tools to measure the functional disability and general health status were found. Oswestry Disability Index (ODI), the ODI Korean version (K-Odi), Prolo, Sf-36, Sf-12, Roland-Morris disability questionnaire (RMDQ), and the pain Visual Analogue Scale (VAS) were the most used. They showed positive results in all cases series reviewed. In most studies the ODI decreased about 25% (e.g. from a score of 85% to 60%). Better results when dynamic fusion was combined with nerve root decompression were found. Functional outcomes and leg pain scores with Dynesys were statistically non-inferior to posterolateral spinal fusion using autogenous bone. When Dynesys and decompression was compared with posterior interbody lumbar fixation (PLIF) and decompression, differences in ODI and VAS were not statistically significant. Conclusions: In patients with spinal degenerative diseases due to degenerative disc disorders, spinal canal stenosis and degenerative spondylolisthesis, surgery with Dynesys and decompression improves functional outcomes, decreases disability, and reduces back and leg pain. More studies are needed to conclude that dynamic stabilization is better than posterolateral and posterior interbody lumbar fusion. Studies comparing Dynesys with decompression against decompression alone should be done in order to isolate the effect of the dynamic stabilization.