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BACKGROUND: To the best of our knowledge, studies on the relationship between spectral energy distribution and the degree of perceived twang-like voices are still sparse. Through an auditory-perceptual test we aimed to explore the spectral features that may relate with the auditory-perception of twang-like voices. METHODS: Ten judges who were blind to the test's tasks and stimuli rated the amount of twang perceived on seventy-six audio samples. The stimuli consisted of twenty voices recorded from eight CCM singers who sustained the vowel [a:] in different pitches, with and without a twang-like voice. Also, forty filtered and sixteen synthesized-manipulated stimuli were included. RESULTS AND CONCLUSIONS: Based on the intra-rater reliability scores, four judges were identified as suitable to be included in the analyses. Results showed that the frequency of F1 and F2 correlated strongly with the auditory-perception of twang-like voices (0.90 and 0.74, respectively), whereas F3 showed a moderate negative correlation (-0.52). The frequency difference between F1 and F3 showed a strong negative correlation (-0.82). The mean energy between 1-2 kHz and 2-3 kHz correlated moderately (0.51 and 0.42, respectively). The frequency of F4 and F5, and the energy above 3 kHz showed weak correlations. Since the spectral changes under 2 kHz have been associated with the jaw, lips, and tongue adjustments (i.e. vowel articulation) and a higher vertical laryngeal position might affect the frequency of all formants (including F1 and F2), our results suggest that vowel articulation and the laryngeal height may be relevant when performing twang-like voices.
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The neurocomputational model 'Directions into Velocities of Articulators' (DIVA) was developed to account for various aspects of normal and disordered speech production and acquisition. The neural substrates of DIVA were established through functional magnetic resonance imaging (fMRI), providing physiological validation of the model. This study introduces DIVA_EEG an extension of DIVA that utilizes electroencephalography (EEG) to leverage the high temporal resolution and broad availability of EEG over fMRI. For the development of DIVA_EEG, EEG-like signals were derived from original equations describing the activity of the different DIVA maps. Synthetic EEG associated with the utterance of syllables was generated when both unperturbed and perturbed auditory feedback (first formant perturbations) were simulated. The cortical activation maps derived from synthetic EEG closely resembled those of the original DIVA model. To validate DIVA_EEG, the EEG of individuals with typical voices (N = 30) was acquired during an altered auditory feedback paradigm. The resulting empirical brain activity maps significantly overlapped with those predicted by DIVA_EEG. In conjunction with other recent model extensions, DIVA_EEG lays the foundations for constructing a complete neurocomputational framework to tackle vocal and speech disorders, which can guide model-driven personalized interventions.
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PURPOSE: This exploratory study aims to investigate variations in voice production in the presence of background noise (Lombard effect) in individuals with nonphonotraumatic vocal hyperfunction (NPVH) and individuals with typical voices using acoustic, aerodynamic, and vocal fold vibratory measures of phonatory function. METHOD: Nineteen participants with NPVH and 19 participants with typical voices produced simple vocal tasks in three sequential background conditions: baseline (in quiet), Lombard (in noise), and recovery (5 min after removing the noise). The Lombard condition consisted of speech-shaped noise at 80 dB SPL through audiometric headphones. Acoustic measures from a microphone, glottal aerodynamic parameters estimated from the oral airflow measured with a circumferentially vented pneumotachograph mask, and vocal fold vibratory parameters from high-speed videoendoscopy were analyzed. RESULTS: During the Lombard condition, both groups exhibited a decrease in open quotient and increases in sound pressure level, peak-to-peak glottal airflow, maximum flow declination rate, and subglottal pressure. During the recovery condition, the acoustic and aerodynamic measures of individuals with typical voices returned to those of the baseline condition; however, recovery measures for individuals with NPVH did not return to baseline values. CONCLUSIONS: As expected, individuals with NPVH and participants with typical voices exhibited a Lombard effect in the presence of elevated background noise levels. During the recovery condition, individuals with NPVH did not return to their baseline state, pointing to a persistence of the Lombard effect after noise removal. This behavior could be related to disruptions in laryngeal motor control and may play a role in the etiology of NPVH. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.20415600.
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Prega Vocal , Voz , Acústica , Glote , Humanos , FonaçãoRESUMO
RESUMEN Se expone el caso de una mujer de 19 años a quien se le realizó el diagnóstico de un xantoastrocitoma pleomórfico anaplásico parietooccipital izquierdo, neoplasia poco frecuente que suele presentarse en la población pediátrica y en los adultos jóvenes. Dicho tumor debuta generalmente con crisis convulsivas y sus características histológicas patognomónicas son el pleomorfismo celular, la vacuolización lipídica de su citoplasma y la reactividad a la proteína ácida fibrilar glial (PAFG) y S100. El estudio de nuevos marcadores que puedan brindar otras oportunidades terapéuticas ha permitido encontrar mutaciones en el oncogén BRAF. Este tumor presenta una variante anaplásica más agresiva que se trata con cirugía y quimiorradiación. En nuestro caso, después de varias progresiones a otras intervenciones, se utilizó bevacizumab y carmustine como tratamiento de segunda línea con respuesta completa.
SUMMARY The case of a young woman of 19-years-old is presented; whom the diagnosis was made of a left parietal-occipital xanthoastrocytoma pleomorphic anaplastic; this neoplasia is rare and usually affects the pediatric and young adult population. This generally debuts with seizures and their pathognomonic histologic characteristics are the pleomorphic cells with cytoplasmatic lipid vacuolation and the reactivity of glial fibrillary acidic protein (GFAP) and S100. The study of new markers that may provide other therapeutic opportunities has allowed finding mutations in the BRAF oncogene. This tumor has a more aggressive anaplastic variant that is treated with surgery and chemoradation. In our case after several progressions to other interventions, we used bevacizumab and carmustine as second-line treatment obtaining complete response.
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Radioterapia , Carmustina , Bevacizumab , Glioma , AntineoplásicosRESUMO
BACKGROUND: Non-small cell lung cancer (NSCLC) has a 5-year survival of 5-16%. Epidermal growth factor receptor (EGFR) mutations, in most cases, confer sensitivity to EGFR tyrosine kinase inhibitor (TKI) therapy. Nonetheless, it is still unclear why clinical outcomes vary among patients with identical EGFR mutations. The amplification of the EGFR gene (EGFRamp) may play a significant role. OBJECTIVE: Compare the complete (CR) and partial response (PR) rates, overall survival (OS), and progression-free survival (PFS) in Hispanic patients with lung adenocarcinoma treated with erlotinib with EGFR mutations (L858R or exon 19 deletion [Del19]) with and without concomitant EGFRamp. PATIENTS AND METHODS: Seventy-two EGFR-positive lung adenocarcinoma patients of Hispanic origin, who underwent first-line treatment with erlotinib, were evaluated for EGFRamp by fluorescence in situ hybridization (FISH). The clinical outcomes were analyzed according to EGFR mutations and EGFRamp status. RESULTS: 30.6% of samples showed EGFRamp, more frequently present in patients with Del19 (p = 0.05). Patients with EGFRamp had a longer PFS (in months) [(28.5, 95% CI 22.3-34.6) vs. (11.0, 95% CI 8.2-16.7); p = 0.002] and OS [(37.8, 95% CI 30.9-44.7) vs. (27.1, 95% CI 12.8-41.3); p = 0.009] than those without. EGFRamp significantly influenced the response to erlotinib (p = 0.0001). EGFRamp+/Del19 had a longer OS, 37.8 (95% CI 31.0-44.6), compared to EGFRamp+/L8585R, 27.5 (95% CI 12.4-42.5) (p < 0.001) and longer PFS (p = 0.043). CONCLUSION: Among Hispanic patients, EGFRamp was present in 30% of patients with EGFR mutations. EGFR mutations and EGFRamp are associated with better OS, PFS, CR, and PR to erlotinib and, hence, could aid in the correct selection of patients that benefit from EGFR TKI treatment.
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Adenocarcinoma de Pulmão/tratamento farmacológico , Antineoplásicos/uso terapêutico , Cloridrato de Erlotinib/uso terapêutico , Neoplasias Pulmonares/tratamento farmacológico , Mutação , Adenocarcinoma de Pulmão/enzimologia , Adenocarcinoma de Pulmão/genética , Adenocarcinoma de Pulmão/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Receptores ErbB/antagonistas & inibidores , Receptores ErbB/genética , Feminino , Amplificação de Genes , Humanos , Neoplasias Pulmonares/enzimologia , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Análise de Sobrevida , Adulto JovemRESUMO
Purpose: Our goal was to test prevailing assumptions about the underlying biomechanical and aeroacoustic mechanisms associated with phonotraumatic lesions of the vocal folds using a numerical lumped-element model of voice production. Method: A numerical model with a triangular glottis, posterior glottal opening, and arytenoid posturing is proposed. Normal voice is altered by introducing various prephonatory configurations. Potential compensatory mechanisms (increased subglottal pressure, muscle activation, and supraglottal constriction) are adjusted to restore an acoustic target output through a control loop that mimics a simplified version of auditory feedback. Results: The degree of incomplete glottal closure in both the membranous and posterior portions of the folds consistently leads to a reduction in sound pressure level, fundamental frequency, harmonic richness, and harmonics-to-noise ratio. The compensatory mechanisms lead to significantly increased vocal-fold collision forces, maximum flow-declination rate, and amplitude of unsteady flow, without significantly altering the acoustic output. Conclusion: Modeling provided potentially important insights into the pathophysiology of phonotraumatic vocal hyperfunction by demonstrating that compensatory mechanisms can counteract deterioration in the voice acoustic signal due to incomplete glottal closure, but this also leads to high vocal-fold collision forces (reflected in aerodynamic measures), which significantly increases the risk of developing phonotrauma.
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Simulação por Computador , Glote/patologia , Glote/fisiopatologia , Modelos Biológicos , Distúrbios da Voz/patologia , Distúrbios da Voz/fisiopatologia , Acústica , Algoritmos , Percepção Auditiva , Retroalimentação Sensorial , Humanos , Músculos Laríngeos/fisiopatologia , Masculino , Voz/fisiologiaRESUMO
Objetivo. Conocer el comportamiento de la nefritis lúpica en nuestra población. Determinar la frecuencia de las principales variables clínicas que acompañan esta patología. Búsqueda de tendencias entre el tipo histológico de la nefritis con sus hallazgos clínicos. Métodos. Estudio descriptivo realizado en la Unidad Renal de la Clínica San Pedro Claver de Bogotá (IV Nivel), en el período comprendido entre marzo de 1998 y septiembre de 2003. Se evaluaron 145 pacientes quienes asistieron a la consulta ambulatoria remitidos para valoración de compromiso renal con diagnóstico de LES. Resultados. Se evaluaron 145 casos. Fueron excluidos 7 casos por no cumplir con cuatro de los 11 criterios de la ACR para el diagnóstico de LES. Predominó el género femenino, con 130 casos (94,2 por ciento), sobre el masculino con 8 casos (5,8 por ciento). La edad promedio de diagnóstico de LES fue de 29,6 años. La distribución por grupos etáreos mostró que los pacientes con edades entre 20 y 50 años representan el 85 por ciento. Se encontraron al 45 por ciento de los pacientes hipertensos y con proteinuria el 58 por ciento. En el 68 por ciento de los casos se evideció disminución de la tasa de filtración glomerular. Se realizó biopsia en el 51 por ciento de los pacientes. Según la clasificación de la OMS (1996) se observó del tipo I el 1 por ciento, del tipo II y tipo III 17 por ciento cada una, tipo IV el 48 por ciento y del tipo V el 10 por ciento. No se observó ninguna tendencia entre el tipo de biopsia y el grado de compromiso renal, ni con la progresión a insuficiencia renal crónica terminal. Discusión. Los resultados mostraron una distribución por género, grupo etáreo y biopsia, similar a los informados en la literatura. El número de pacientes hipertensos, con presencia de proteinuria y disminución en la tasa de filtración glomerular fueron mayores comparados con las grandes series internacionales. No se observó relación entre el tipo de biopsia OMS encontrado y los pacientes que progresaron a insuficiencia renal crónica terminal
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Nefrite Lúpica/classificação , Nefrite Lúpica/diagnóstico , Nefrite Lúpica/patologiaRESUMO
The objective of this study was to evaluate the effect of deferment on dry matter accumulation and tillering, in a Tanzania grass pasture, (Panicum maximum Jacq. c.v. Tanzania-1) (Poaceae), maintained at different sward height, under grazing, in the northwest region of Paraná state - Brazil, during the period of December 19th, 1998 to May 13th, 1999. The treatments (sward height) were: 20, 40, 60 and 80,0cm. After deferment, the parameters were evaluated for the period from May 14th to July 22nd, 1999. The experimental design was completely randomized, with two replications. There was an effect of treatments on dry matter accumulation, green lamina dry matter accumulation and tiller mass. It was concluded that deferment of Tanzania grass pastures after the reproductive phase, increased the forage mass and green leaf mass, for grazing during the period of low herbage yield.
O objetivo deste trabalho foi avaliar o efeito do diferimento no acúmulo de matéria seca e perfilhamento, em uma pastagem de capim tanzânia, (Panicum maximum Jacq. cv. Tanzânia-1) (Poaceae), mantida a diferentes alturas sob pastejo, na região Noroeste do Estado do Paraná, durante o período de 19/12/1998 a 13/05/1999. Os tratamentos (alturas de pasto) foram: 20, 40, 60 e 80 cm. Após o diferimento, os parâmetros foram avaliados no período de 14/5/1999 a 22/7/1999. O delineamento experimental utilizado foi o completamente casualizado, com duas repetições. Os resultados mostraram efeito significativo dos tratamentos sobre o acúmulo de matéria seca, acúmulo de matéria seca de lâminas verdes e massa de perfilho. Conclui-se que o diferimento em pastagens de capim Tanzânia, realizado logo após o período reprodutivo da pastagem, permite o aumento da oferta de forragem e dos níveis de matéria seca de lâminas verdes para o pastejo, no período de maior escassez de forragem.
RESUMO
The objective of this study was to evaluate the effect of deferment on dry matter accumulation and tillering, in a Tanzania grass pasture, (Panicum maximum Jacq. c.v. Tanzania-1) (Poaceae), maintained at different sward height, under grazing, in the northwest region of Paraná state - Brazil, during the period of December 19th, 1998 to May 13th, 1999. The treatments (sward height) were: 20, 40, 60 and 80,0cm. After deferment, the parameters were evaluated for the period from May 14th to July 22nd, 1999. The experimental design was completely randomized, with two replications. There was an effect of treatments on dry matter accumulation, green lamina dry matter accumulation and tiller mass. It was concluded that deferment of Tanzania grass pastures after the reproductive phase, increased the forage mass and green leaf mass, for grazing during the period of low herbage yield.
O objetivo deste trabalho foi avaliar o efeito do diferimento no acúmulo de matéria seca e perfilhamento, em uma pastagem de capim tanzânia, (Panicum maximum Jacq. cv. Tanzânia-1) (Poaceae), mantida a diferentes alturas sob pastejo, na região Noroeste do Estado do Paraná, durante o período de 19/12/1998 a 13/05/1999. Os tratamentos (alturas de pasto) foram: 20, 40, 60 e 80 cm. Após o diferimento, os parâmetros foram avaliados no período de 14/5/1999 a 22/7/1999. O delineamento experimental utilizado foi o completamente casualizado, com duas repetições. Os resultados mostraram efeito significativo dos tratamentos sobre o acúmulo de matéria seca, acúmulo de matéria seca de lâminas verdes e massa de perfilho. Conclui-se que o diferimento em pastagens de capim Tanzânia, realizado logo após o período reprodutivo da pastagem, permite o aumento da oferta de forragem e dos níveis de matéria seca de lâminas verdes para o pastejo, no período de maior escassez de forragem.