Evaluation of an investigational hearing screening device (HeLe) to demonstrate acoustic brainstem response among normal-hearing adults

Objective@#This pilot human trial demonstrates the ability of the investigational newborn hearing screening device to provide acoustic stimulation to produce evoked potentials, as well as its ability to capture and acquire auditory evoked potentials, especially the auditory brainstem response (ABR) wave V. This pilot study also demonstrates the ease of recognizing and identifying ABR waves in the graphical presentation of the evoked potentials over time. @*Methods@#Fourteen normal-hearing adults or a total of twenty-eight (28) normal-hearing adult ears underwent auditory brainstem response testing using the investigational hearing screening device. A commercially available auditory brainstem response detection device was used to confirm that the acquired ABR waves of the investigational device are normal. The ABR waves displayed by the investigation device were also reviewed by the clinical audiologists to determine their recognizability and identifiability. @*Results@#The pilot trial demonstrates the ability of the investigational newborn hearing screening device in providing acoustic stimulation to produce evoked potentials, and in acquiring and capturing ABR waves, specifically the wave V, among normal-hearing adult ears. The clinical audiologists recognized and identified the ABR wave V among the evoked potentials at 40dB, 60dB, and 80dB acoustic stimulation. About eighty-nine percent (89.2%) of all ears tested had identifiable and recognizable wave V upon acoustic stimulation at 40dB. @*Conclusion@#The investigational hearing screening device: (1) can provide acoustic stimulation to produce evoked potentials, (2) can accurately capture and acquire these evoked potentials, (3) can present these evoked potentials in a voltage per time graphical display which an audiologist and trained HCP can easily read and interpret (diagnostic ABR), and (4) can present wave V auditory brainstem potentials that can be easily identified by an audiologist and trained HCP (screening ABR).

Research on magneto-acoustic-electrical tomography method based on liquid metal contrast agent and M sequence coded excitation / 生物医学工程学杂志

Magneto-acoustic-electric tomography (MAET) boasts high resolution in ultrasound imaging and high contrast in electrical impedance imaging, making it of significant research value in the fields of early tumor diagnosis and bioelectrical monitoring. In this study, a method was proposed that combined high conductivity liquid metal and maximum length sequence (M sequence) coded excitation to improve the signal-to-noise ratio. It was shown that, under rotational scanning, the liquid metal significantly improved the signal-to-noise ratio of the inter-tissue magneto-acoustic-electric signal and enhanced the quality of the reconstructed image. The signal-to-noise ratio of the signal was increased by 5.6, 11.1, 21.7, and 45.7 times under the excitation of 7-, 15-, 31-, and 63-bit M sequence code, respectively. The total usage time of 31-bit M sequence coded excitation imaging was shortened by 75.6% compared with single-pulse excitation when the same signal-to-noise ratio was improved. In conclusion, the imaging method combining liquid metal and M-sequence coding excitation has positive significance for improving MAET image quality.

Analysis of wideband acoustic immittance measurements in patients with unilateral Ménière's disease / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the characteristics of wideband acoustic immittance（WAI） measurements in patients with unilateral Ménière's disease（MD） and evaluate the clinical value of WAI in diagnosis of MD. Methods:WAI was performed in 30 patients with unilateral MD（30 ears for symptomatic and 30 ears for asymptomatic） and in 26 healthy individuals（52 ears）（control group）. The WAI measurements, including the frequency first appearing two peaks in energy absorbance（EA） tympanogram, resonance frequency（RF）, the peak value of absorbance（PVA）, the integral area of absorbance（IAA）, EA curve at peak pressure, were analyzed. Results:①The occurrence of two peaks in EA tympanogram in both the MD symptomatic and asymptomatic ear was observed in 27 ears（84.4%）, and 38 ears（70.4%） in the control group, with no significant difference in the frequency of first appearing in two peaks onset between the groups（all P>0.05）. ②The RF of the MD symptomatic ears was significantly lower than that of the asymptomatic ears（t=-3.544, P=0.001） and that of the control subjects（t=2.084, P=0.041）; there was no difference of RF between the MD asymptomatic ears and the control group（P>0.05）. ③The PVA were significantly lower in both MD symptomatic（t=4.240, P<0.01） and asymptomatic ears（t=4.202, P=0.001） than in controls. ④The IAA in MD symptomatic（t=3.295, P=0.001） and asymptomatic ears（t=3.193, P=0.003） was significantly lower than in the control group. ⑤Comparison of the EA curve at peak pressure of the three groups: the EAs of MD symptomatic ears were lower than those of the control group at the range of 1 059-2 911 Hz（all P<0.05）; the EAs of MD symptomatic ears were lower than those of MD asymptomatic ears within 1 000 Hz and 1 834-2 119 Hz（all P<0.05）; the EAs of MD asymptomatic ears were lower than those of the control group at the range of 515-2 748 Hz（all P<0.05）. Conclusion:Symptomatic ears in unilateral MD patients show alterations in some WAI measurements compared to asymptomatic ears and/or controls, suggesting that middle ear mechanical fuction of the affected side may be modified due to the endolymphatic hydrops. The clinical significance of WAI needs to be further explored in the context of evaluating MD.

Preliminary analysis of the effect of individualized voice therapy on pediatric voice disorders / 临床耳鼻咽喉头颈外科杂志

Objective:To determine the effectiveness of individualized voice therapy in persistent pediatric voice disorders. Methods:Thirty-eight children who were admitted to the Department of Pediatric Otolaryngology Shenzhen Hospital, Southern Medical University due to persistent voice disorder from November 2021 to October 2022 were included. All children were evaluated by dynamic laryngoscopy before voice therapy. Two voice doctors performed GRBAS score and acoustic analysis on the children's voice samples to obtain the relevant parameters including F0, Jitter, Shimmer, and MPT; All children were given personalized voice therapy for 8 weeks. Results:Among 38 children with voice disorders, 75.8%（29 cases） were diagnosed with vocal nodules, 20.6%（8 cases） were vocal polyps, and 3.4%（1 case） were vocal cysts. And in all children. And 51.7%（20 cases） had the sign of supraglottic extrusion under dynamic laryngoscopy. GRBAS scores decreased from 1.93 ± 0.62, 1.82 ± 0.55, 0.98 ± 0.54, 0.65 ± 0.48, 1.05 ± 0.52 to 0.62 ± 0.60, 0.58 ± 0.53, 0.32 ± 0.40, 0.22 ± 0.36, 0.37 ± 0.36. F0, Jitter, Shimmer decreased from（243.11±39.73） Hz, （0.85±0.99）%, （9.96±3.78）% to（225.43±43.20） Hz, （0.33±0.57）%, （7.72±4.32）%, respectively MPT was prolonged from（5.82±2.30） s to（7.87±3.21） s after treatment. All parameters changes had statistical significance. Conclusion:Voice therapy can solve children's voice problems, improve their voice quality and effectively treat children's voice disorders.

Una mirada a la seguridad del ultrasonido en ecotomografía obstétrica / A look at the safety of ultrasound in obstetric echotomography

Resumen Los índices térmico y mecánico son estimadores de riesgo fetal en una ecografía y se deben controlar sus valores minimizando la exposición. Comparamos los valores de los índices térmico y mecánico obtenidos en exámenes ecográficos obstétricos de pacientes gestantes, con el valor recomendado por la comunidad internacional. Se realizó la estimación de estos índices en 421 ecografías obstétricas en 2019. Los valores fueron comparados entre ellos y con el valor recomendado para cada índice y según el modo de visualización (B, Doppler color y Doppler espectral). Del total de la muestra, para el índice térmico en modo Doppler color un 0,24% superó el valor estándar recomendado y en modo Doppler espectral un 2,85%. Para el índice mecánico se sobrepasó el valor recomendado en modo B en un 11,16%, en un 8,08% en modo Doppler color y, por último, en un 0,48% para el modo Doppler espectral. Los índices mecánico y térmico en esta muestra de exámenes ecográficos obstétricos se encuentran en promedio bajo el valor de referencia. Sin embargo, existe un número importante de casos en que se superan las normas, lo que debe ser una voz de alerta para la comunidad médica.

Abstract The thermal and mechanical indices are the best estimators of fetal risk in an ultrasound and their values should be controlled in order to minimize exposure as much as possible. We compared the values of the thermal and mechanical indices obtained in obstetric ultrasound examinations of pregnant patients, with the value recommended by the international community. These indices were estimated in 421 obstetric ultrasounds during 2019. The estimated values were compared with each other and with the recommended value for each index and according to the display mode (B, color Doppler and spectral Doppler). Of the total sample, for the thermal index in color Doppler mode, 0.24% exceeded the recommended standard value and 2.85%. in spectral Doppler mode. For the mechanical index, the recommended value was exceeded in B mode by 11.16%, in 8.08% in color Doppler mode and, finally, by 0.48% for spectral Doppler mode. The mechanical and thermal indices in this sample of obstetric ultrasound examinations are on average below the reference value. However, there is a significant number of cases in which the standards are exceeded, which should be a warning to the medical community.

Phase amplitude coupling analysis of local field potentials in working memory of rats affected by transcranial magneto-acoustic-electrical stimulation / 生物医学工程学杂志

Transcranial magneto-acoustic-electrical stimulation is a new non-invasive neuromodulation technology, in which the induced electric field generated by the coupling effect of ultrasound and static magnetic field are used to regulate the neural rhythm oscillation activity in the corresponding brain region. The purpose of this paper is to investigate the effects of transcranial magneto-acoustic-electrical stimulation on the information transfer and communication in neuronal clusters during memory. In the experiment, twenty healthy adult Wistar rats were randomly divided into a control group (five rats) and stimulation groups (fifteen rats). Transcranial magneto-acoustic-electrical stimulation of 0.05~0.15 T and 2.66~13.33 W/cm 2 was applied to the rats in stimulation groups, and no stimulation was applied to the rats in the control group. The local field potentials signals in the prefrontal cortex of rats during the T-maze working memory tasks were acquired. Then the coupling differences between delta rhythm phase, theta rhythm phase and gamma rhythm amplitude of rats in different parameter stimulation groups and control group were compared. The experimental results showed that the coupling intensity of delta and gamma rhythm in stimulation groups was significantly lower than that in the control group ( P<0.05), while the coupling intensity of theta and gamma rhythm was significantly higher than that in the control group ( P<0.05). With the increase of stimulation parameters, the degree of coupling between delta and gamma rhythm showed a decreasing trend, while the degree of coupling between theta and gamma rhythm tended to increase. The preliminary results of this paper indicated that transcranial magneto-acoustic-electrical stimulation inhibited delta rhythmic neuronal activity and enhanced the oscillation of theta and gamma rhythm in the prefrontal cortex, thus promoted the exchange and transmission of information between neuronal clusters in different spatial scales. This lays the foundation for further exploring the mechanism of transcranial magneto-acoustic-electrical stimulation in regulating brain memory function.

Effects of transcranial magneto-acoustic electrical stimulation on calcium signals in prefrontal nerve clusters / 生物医学工程学杂志

Transcranial magneto-acoustic electrical stimulation (TMAES) is a novel method of brain nerve regulation and research, which uses induction current generated by the coupling of ultrasound and magnetic field to regulate neural electrical activity in different brain regions. As the second special envoy of nerve signal, calcium plays a key role in nerve signal transmission. In order to investigate the effect of TMAES on prefrontal cortex electrical activity, 15 mice were divided into control group, ultrasound stimulation (TUS) group and TMAES group. The TMAES group received 2.6 W/cm 2 and 0.3 T of magnetic induction intensity, the TUS group received only ultrasound stimulation, and the control group received no ultrasound and magnetic field for one week. The calcium ion concentration in the prefrontal cortex of mice was recorded in real time by optical fiber photometric detection technology. The new object recognition experiment was conducted to compare the behavioral differences and the time-frequency distribution of calcium signal in each group. The results showed that the mean value of calcium transient signal in the TMAES group was (4.84 ± 0.11)% within 10 s after the stimulation, which was higher than that in the TUS group (4.40 ± 0.10)% and the control group (4.22 ± 0.08)%, and the waveform of calcium transient signal was slower, suggesting that calcium metabolism was faster. The main energy band of the TMAES group was 0-20 Hz, that of the TUS group was 0-12 Hz and that of the control group was 0-8 Hz. The cognitive index was 0.71 in the TMAES group, 0.63 in the TUS group, and 0.58 in the control group, indicating that both ultrasonic and magneto-acoustic stimulation could improve the cognitive ability of mice, but the effect of the TMAES group was better than that of the TUS group. These results suggest that TMAES can change the calcium homeostasis of prefrontal cortex nerve clusters, regulate the discharge activity of prefrontal nerve clusters, and promote cognitive function. The results of this study provide data support and reference for further exploration of the deep neural mechanism of TMAES.

Acoustic radiation force impulse elastography and liver fibrosis risk scores in severe obesity

ABSTRACT Objective: Identifying significant fibrosis is crucial to evaluate the prognosis and therapeutic interventions in patients with nonalcoholic fatty liver disease (NAFLD). We assessed the performance of acoustic radiation force impulse (ARFI) elastography, APRI, FIB-4, Forns, NFS and BARD scores in determining liver fibrosis in severe obesity. Subjects and methods: A prospective study included 108 patients undergoing bariatric surgery. Liver biopsy specimens were obtained intraoperatively and classified according to the NAFLD Activity Score. Patients were assessed with serological markers and shear wave velocity of the liver was measured with the Siemens S2000 ultrasound system preoperatively. Optimal cut-off values were determined using the area under the receiver operating characteristic curves (AUROC). Results: In the entire cohort prevalence of NAFLD was 80.6%, steatohepatitis 25.9% and significant fibrosis 19.4%. The best tests for predicting significant fibrosis were FIB-4 and Forns scores (both AUROC 0.78), followed by APRI (AUROC 0.74), NFS (AUROC 0.68), BARD (AUROC 0.64) and ARFI (AUROC 0.62). ARFI elastography was successful in 73% of the patients. Higher body mass index (BMI) correlated with invalid ARFI measurements. In patients with BMI < 42 kg/m2, ARFI showed 92.3% sensitivity and 82,6% specificity for the presence of significant fibrosis, with AUROC 0.86 and cut-off 1.32 m/s. Conclusions: FIB-4 and Forns scores were the most accurate for the prediction of significant fibrosis in bariatric patients. Applicability and accuracy of ARFI was limited in individuals with severe obesity. In patients with BMI < 42 kg/m2, ARFI elastography was capable for predicting significant fibrosis with relevant accuracy.

Ultrasonido Doppler de arterias temporales en pacientes con arteritis de células gigantes: estado del arte y revisión sistemática de la literatura / Temporal artery Doppler ultrasound in patients with giant cell arteritis: State of the art and systematic review of the literature

RESUMEN La arteritis de células gigantes es una vasculitis que afecta de manera predominante a vasos de gran calibre y aparece en personas mayores de 50 arios. Su presentación clínica incluye cefalea, alteraciones auditivas o síntomas similares a polimialgia reumática. En su forma más grave puede causar pérdida de visión uni- o bilateral, secundaria a neuropatía óptica isquémica de tipo arterítico. En la actualidad, el estándar de referencia para su diagnóstico es la biopsia de arterias temporales, procedimiento que no es inocuo y que puede tener como complicaciones infección, lesión nerviosa o sangrado, entre otras. Entre las técnicas no invasivas de diagnóstico, el ultrasonido y el Doppler de arterias temporales han tomado un rol cada vez más importante en el diagnóstico de esta entidad, dado que son pruebas benignas, con nulos efectos adversos y, a través de estrategias como las clínicas fast-track apoyadas en este método diagnóstico, se ha logrado reducir las complicaciones isquémicas de la enfermedad.

ABSTRACT Giant cell arteritis is a vasculitis that predominantly affects large calibre vessels, and usually appears in people over 50 years-old. Its clinical presentation includes headache, hearing impairment, or polymyalgia rheumatica-like symptoms. In its most severe form, it can cause uni- or bilateral vision loss secondary to arteritic ischaemic optic neuropathy. Currently, the gold standard for its diagnosis is the temporal artery biopsy, a procedure that is not harmless and may have complications such as infection, nerve injury, bleeding, among others. Among non-invasive diagnostic methods, the ultrasound and temporal artery Doppler have gained a predominant role in the diagnosis of giant cell arteritis, as it is a benign test with no adverse effects. Through strategies such as «fast-track¼ clinics, supported by this diagnostic method, a reduction has been achieved in ischaemic complications of the disease.

Adaptação de próteses auditivas em idosos: prescrição de ganho acústico por meio dos limiares de audibilidade obtidos com tom puro e narrow band / Hearing aid fitting in the elderly: prescription of acoustic gain through frequency thresholds obtained with pure tone and narrow band stimuli

RESUMO Objetivo Verificar o benefício obtido pela prescrição de ganho acústico baseada nos limiares audiométricos obtidos com tons puros (Warble) e com ruído de faixa estreita (NB). Método Amostra de 30 idosos, com idade igual ou superior a 60 anos, perda auditiva neurossensorial de grau moderado a severo simétrica bilateral de configuração descendente com limiares em 4kHz iguais ou inferiores a 70dBNA. Foram dois grupos. GTP (grupo tom puro): 15 idosos tiveram as próteses auditivas adaptadas com emprego dos limiares obtidos com tom puro e grupo GNB (grupo Narrowband): 15 idosos tiveram as próteses auditivas adaptadas por meio dos limiares obtidos com NB. Os procedimentos realizados antes da adaptação de próteses auditivas e após três meses de uso de amplificação foram: Escala COSI, IPRF (Índice Percentual de Reconhecimento de fala), Relação Sinal/Ruído e análise do tempo de uso do AASI. O Questionário Internacional de Aparelho de Amplificação Sonora Individual (QI-AASI) foi aplicado após três meses. Resultados Os idosos do grupo em que as próteses auditivas foram adaptadas com ganho prescrito com base nos limiares auditivos obtidos com o estímulo Narrow Band apresentaram melhor desempenho nos seguintes testes: IPRF à orelha direita, pontuação total do questionário QI-AASI, escala COSI e maior tempo de uso do AASI em comparação ao grupo GTP. Conclusão Observou-se maior benefício com o uso de próteses auditivas, pela pontuação total do questionário QI-AASI, escala COSI e maior tempo de uso do AASI, no grupo cuja prescrição do ganho acústico baseou-se nos limiares audiométricos obtidos com o Narrowband.

ABSTRACT Purpose To verify the benefit obtained by the prescription of acoustic gain based on the auditory thresholds obtained with pure tones modulated in frequency and with Narrow Band Noise. Methods The sample consisted of 30 elderly people, aged 60 years or over with moderate to severe descending sensorineural symmetrical hearing loss with thresholds at 4kHz equal to or less than 70dBHL. There were two groups. GTP (pure tone group): 15 elderly people had their hearing aids fitted through the auditory thresholds obtained with pure tone and the GNB group (narrow band group): 15 elderly people had their hearing aids fitted through the auditory thresholds obtained with NB. The procedures performed before the fitting of hearing aids and after three months of amplification use were: COSI, WRS (Word Recognition Score), Signal/Noise ratio. The International Outcome Inventory for Hearing Aids (IOI-HA) was applied only after three months of hearing aid fitting. Results The elderly people in the group in which the hearing aids were fitted with a prescribed gain based on the hearing thresholds obtained with the Narrow Band stimulus showed better performance in the following tests: WRS on the right ear, total score of the IOI-HA inventory, COSI and longer use of hearing aids compared to the GTP group. Conclusion There was a greater benefit with the use of hearing aids, due to the total score of the IOI-HA inventory, COSI scale and longer daily use time of hearing aids, in the group whose prescription of acoustic gain was based on the auditory thresholds obtained with narrow band.

Investigação da discriminação neural das características acústicas dos sons de fala em normo-ouvintes por meio do Frequency Following Response (FFR) / Investigation of the neural discrimination of acoustic characteristics of speech sounds in normal-hearing individuals through Frequency-following Response (FFR)

RESUMO Objetivo Avaliar como as vias auditivas codificam e diferenciam as sílabas plosivas [ga],[da] e [ba], por meio do potencial evocado auditivo Frequency Following Response (FFR), nas crianças em desenvolvimento típico. Método Vinte crianças (6-12 anos) foram avaliadas por meio do FFR para estímulos [ga],[da] e [ba]. Os estímulos foram compostos por seis formantes, sendo diferenciados na transição F2 e F3 (porção transiente). Os demais formantes foram idênticos nas três sílabas (porção sustentada). Foram analisadas latências de 16 ondas que compõe a porção transiente do estímulo (<70ms) e latências de 21 ondas da porção sustentada (90-160ms) nas respostas neurais obtidas para cada uma das sílabas. Resultados As respostas eletrofisiológicas registradas por meio do FFR demonstraram que as latências da porção transiente da resposta neural foram diferentes nas três silabas evocadas. Além disso, os valores de latência das ondas da porção transiente foram aumentando progressivamente, sendo [ga]<[da]<[ba]. Já na porção sustentada da resposta, não houve diferenças significantes nas latências das ondas que compõe essa porção. Conclusão O FFR mostrou-se uma ferramenta eficiente na investigação da discriminação subcortical de diferenças acústicas dos sons de fala, uma vez que demonstrou diferentes resposta eletrofisiológica para três silabas evocadas. Na porção transiente (consoantes) foram observadas mudanças de latência e na porção sustentada (vogal) não houve diferenças entre as latências para os três estímulos. Esses resultados demonstram a capacidade neural de distinção entre características acústicas dos estímulos [ga],[da],[ba].

ABSTRACT Purpose To evaluate how the auditory pathways encode and discriminate the plosive syllables [ga], [da] and [ba] using the auditory evoked Frequency-following Response (FFR) in children with typical development. Methods Twenty children aged 6-12 years were evaluated using the FFR for the [ga], [da] and [ba] stimuli. The stimuli were composed of six formants and were differentiated in the F2 to F3 transition (transient portion). The other formants were identical in the three syllables (sustained portion). The latencies of the 16 waves of the transient portion (<70ms) and of the 21 waves of the sustained portion (90-160ms) of the stimuli were analyzed in the neural responses obtained for each of the syllables. Results The transient portion latencies were different in the three syllables, indicating a distinction in the acoustic characteristics of these syllables through their neural representations. In addition, the transient portion latencies progressively increased in the following order: [ga] <[da] <[ba], whereas no significant differences were observed in the sustained portion. Conclusion The FFR proved to be an efficient tool to investigate the subcortical acoustic differences in speech sounds, since it demonstrated different electrophysiological responses for the three evoked syllables. Changes in latency were observed in the transient portion (consonants) but not in the sustained portion (vowels) for the three stimuli. These results indicate the neural ability to distinguish between acoustic characteristics of the [ga], [da] and [ba] stimuli.

Amplificador de voz: efeitos na dose e na intensidade vocal de professoras sem disfonia / Voice amplifier: effects on dose and vocal intensity of teachers without dysphonia

RESUMO Objetivo Analisar a interferência do uso do amplificador de voz na dose vocal de professoras não disfônicas. Método Trata-se de um estudo experimental, comparativo intrassujeitos, composto por 20 professoras do ensino fundamental da Rede Municipal de Ensino de Belo Horizonte/MG. Após o consentimento as participantes, foram solicitadas a responder o questionário de Escala de Sintomas Vocais - ESV e posteriormente participaram de dois momentos do estudo, selecionados aleatoriamente. No primeiro momento as participantes utilizaram somente o dosímetro vocal e no segundo momento utilizaram o dosímetro vocal e o amplificador de voz. As medições foram registradas pelo aparelho durante 1h40m, na sala de aula que as professoras lecionavam. O espaço entre as duas medições foi de uma semana, sendo mantidas a mesma sala, mesmo horário e mesma disciplina lecionada, em ambos os momentos. Resultados O parâmetro intensidade foi o único que apresentou diferença com o uso de amplificação de voz. Conclusão O uso da amplificação de voz durante a docência de professoras não disfônicas não interfere nos parâmetros acústicos de frequência fundamental, e nas medidas de dose vocal. A intensidade da voz é menor quando o professor faz uso de amplificação vocal.

ABSTRACT Purpose Analyze the interference of using the voice amplifier in vocal dose of non-dysphonic teachers. Methods This is an experimental study comparing people from the same ambience compound for 20 teachers from municipal elementary school in Belo Horizonte/MG. After consent, the participants were requested to answer the vocal symptom scale questionnaire (ESV) and later participated in two different moments of the study, for which they randomly selected. In the first moment, the participants used only the vocal dosimeter and in the second, they used the vocal dosimeter and the voice amplifier. The measurements were recorded by the device for 1h40m, in the classroom that the teachers taught. The time between the two measurements was one week, with the same room, the same time and the same discipline being taught, at both times. Results The intensity parameter was the only one that showed difference with the use of the voice amplifier. Conclusion Use voice amplification while non-dysphonic teachers are teaching doesn't affect the fundamental frequency and vocal dose measure in the acoustics parameters. The vocal intensity is smaller when teacher uses the vocal amplification.

Cytoarchitecture of the superior olivary complex of three neotropical species of bats (Noctilio leporinus, Phyllostomus hastatus and Carollia perspicillata) with different foraging behavior / Citoarquitetura do complexo olivar superior de três espécies neotropicais de morcegos (Noctilio leporinus, Phyllostomus hastatus e Carollia perspicillata) com diferentes comportamentos de forrageamento

Abstract The understanding of the echolocation by studying different auditory nuclei of echolocating bats can be an important link in elucidating questions arising in relation to their foraging behavior. The superior olivary complex (SOC) is the primary center for processing the binaural cues used in sound localization since echo locating bats rely on acoustic cues to navigate and capture prey while in flight. The present study was taken to test the hypothesis that the SOC of echolocating neotropical bats with different foraging behavior will exhibit morphological variations in relative size, degree of complexity and spatial distribution. The brains were collected from six male adult bats of each species: Noctilio leporinus (fish eating), Phyllostomus hastatus (carnivorous/omnivorous) and Carollia perspicillata (fruit eating). They were double-embedded and transverse serial sections were cut and stained with cresyl fast violet. The SOC measured as 640 ± 70 µm in the N. leporinus bat, 480 ± 50 µm in the P. hastatus and 240 ± 30 µm in the C. perspicillata bat. The principal nuclei of the SOC of in all three bats were the LSO, MSO and MNTB. The MSO and LSO were very well developed in N. leporinus bats. The MSO of N. leporinus bat subdivided into DMSO and VMSO. The main cell type of cells present in MSO and LSO are dark staining multipolar cells in all the bats studied. The well-developed MSO and LSO of N. leporinus bats indicate that these bats are highly sensitive to low frequency sounds and interaural intensity differences, which help these bats to forage over water by using various types of echolocation signals. The average size of SOC in P. hastatus and C. perspicillata bats can be attributed to the fact that these bats use vision and smell along with echolocation to forage the food.

Resumo O entendimento da ecolocalização pelo estudo de diferentes núcleos auditivos de morcegos pode ser um elo importante na elucidação das inúmeras questões que surgem em relação ao seu comportamento de forrageamento. O complexo olivar superior (SOC) é o principal centro de processamento das pistas binaurais usadas na localização do som, já que os morcegos ecolocalizadores contam com sinais acústicos para navegar e capturar as presas durante o vôo. O presente estudo foi realizado para testar a hipótese de que morcegos que usam a ecolocalização para diferentes comportamentos de forrageamento irão variar na estrutura, tamanhos relativos e grau de complexidade e distribuição espacial do grupo SOC. Os cérebros foram coletados de seis machos adultos de morcego de cada espécie: Noctilio leporinus (piscívoro), Phyllostomus hastatus (carnívoros/onívoros) e Carollia perspicillata (frugívoro). Eles foram seccionados em série e transversalmente, cortados e corados com coloração rápida cresil-violeta. tolet. O grupo SOC foi medido como 640 ± 70 µm no morcego N. leporinus, 480 ± 50 µm no P. hastatus e 240 ± 30 µm no morcego C. perspicillata. Os principais núcleos do grupo SOC dos três morcegos foram o LSO e o MSO e o MNTB. O MSO e o LSO foram muito bem desenvolvidos em morcegos N. leporinus. A MSO de N. leporinus foi subdividida em DMSO e VMSO. O principal tipo de células presentes na MSO e LSO são as células multipolares de coloração escura em todos os morcegos. Os MSO bem desenvolvidos e LSO de morcegos N. leporinus indicam que estes morcegos são altamente sensíveis a sons de baixa frequência e diferenças de intensidade interaural, que ajudaram estes morcegos a se alimentarem na superfície da água usando vários tipos de sinais de ecolocalização. O tamanho médio de SOC em morcegos de P. hastatus e C. perspicillata pode ser atribuído ao fato destes morcegos usarem visão e olfato junto com a ecolocalização para forragear.

Simulation research on magnetoacoustic B-scan imaging of magnetic nanoparticles / 生物医学工程学杂志

As drug carriers, magnetic nanoparticles can specifically bind to tumors and have the potential for targeted therapy. It is of great significance to explore non-invasive imaging methods that can detect the distribution of magnetic nanoparticles. Based on the mechanism that magnetic nanoparticles can generate ultrasonic waves through the pulsed magnetic field excitation, the sound pressure wave equation containing the concentration information of magnetic nanoparticles was derived. Using the finite element method and the analytical solution, the consistent transient pulsed magnetic field was obtained. A three-dimensional simulation model was constructed for the coupling calculation of electromagnetic field and sound field. The simulation results verified that the sound pressure waveform at the detection point reflected the position of magnetic nanoparticles in biological tissue. Using the sound pressure data detected by the ultrasonic transducer, the B-scan imaging of the magnetic nanoparticles was achieved. The maximum error of the target area position was 1.56%, and the magnetic nanoparticles regions with different concentrations were distinguished by comparing the amplitude of the boundary signals in the image. Studies in this paper indicate that B-scan imaging can quickly and accurately obtain the dimensional and positional information of the target region and is expected to be used for the detection of magnetic nanoparticles in targeted therapy.

Application of acoustic radiation force impulse elastography combined with serum markers in Child-Pugh grading

OBJECTIVES: Acoustic radiation force impulse (ARFI) elastography, the aspartate aminotransferase-to-alanine aminotransferase ratio (AAR), aspartate aminotransferase-to-platelet ratio index (APRI), and the fibrosis-4 (FIB-4) index are widely used to assess liver fibrosis. However, efficacies of these methods in the evaluation of hepatic functional reserve remain unclear. In this study, we investigated the relationship between ARFI elastography combined with either AAR, APRI, or FIB-4 index and Child-Pugh (CP) class for the evaluation of hepatic functional reserve in patients with chronic hepatitis B (CHB)-related cirrhosis. METHODS: The shear wave velocities of 104 patients with clinically confirmed CHB-related cirrhosis were determined using the ARFI; and clinical serum markers (e.g. ALT, AST, PLT) were used to calculate the AAR, APRI, and FIB-4 index. Cirrhosis patients were scored according to their CP class. The ARFI, AAR, APRI, and FIB-4 index were compared with the CP class. The efficacy of each indicator in diagnosis was analyzed using the receiver operating characteristic (ROC) curve and the ARFI combined with either the AAR, APRI, or FIB-4 index, which is used to predict decompensated cirrhosis. RESULTS: No significant differences were observed in gender and age among CP classes A, B, and C patients (p>0.05). The ARFI values and the AAR, APRI, and FIB-4 index of patients with CP classes A, B, and C were significantly different (p<0.05). With an increasing CP class, the ARFI, AAR, APRI, and FIB-4 values increased. The correlation between the ARFI and the CP class was stronger than that between the AAR, APRI, and FIB-4 index and the CP class. The area under the ROC curve for the diagnosis of decompensated cirrhosis using the ARFI was 0.841, which was higher than that for the AAR, APRI, and FIB-4 index. According to the area under the curve results, no significant differences were found when the ARFI was combined with either the AAR, APRI, or FIB-4 index and when the ARFI alone was used. CONCLUSIONS: The ARFI value has a strong correlation with the CP class. Therefore, ARFI elastography complements CP class in the assessment of the hepatic functional reserve in patients with CHB-related cirrhosis.

Immediate effects of cervical stimulation and diaphragmatic release on vocal production / Efeitos imediatos da estimulação cervical e liberação diafragmática na produção vocal

Abstract Introduction: The voice is heavily influenced by breathing and abdominal muscles. Objective: To verify the immediate effects of cervical stimulation and diaphragmatic release on the respiratory and phonatory function of adult women with no vocal complaints. Method: Relaxation maneuvers and eccentric work of the diaphragm were performed together with articulatory maneuver of the third cervical vertebra. Twenty-four women without vocal complaints, aged between 18 and 35 years were part of the intervention. All volunteers were submitted to an evaluation of respiratory muscle strength, maximum phonation time of the vowel /a/, sound pressure level and acoustic vocal analysis, before and after physiotherapeutic intervention. Statistical analysis consisted of the Student's t-test for independent samples and Spearman's correlation. Significance level was set at 5%. Results: There was a significant increase in the maximum phonation time of the vowel /a/ and in the modal sound pressure level. Regarding the acoustic analysis, there was a reduction in the standard deviation values of the fundamental frequency; in the smoothed pitch disturbance quotient; and in the fundamental frequency and amplitude variations. Conclusion: Cervical stimulation and diaphragmatic release improved vocal quality regarding duration of emission, sound pressure, and stability and noise of the glottic signal.

Resumo Introdução: A voz é muito influenciada pela respiração e pela musculatura abdominal. Objetivo: Verificar os efeitos imediatos da estimulação cervical e liberação diafragmática na função respiratória e fonatória de mulheres adultas sem queixas vocais. Método: Realizaram-se manobras de relaxamento e trabalho excêntrico do diafragma junto a uma manobra articulatória da terceira vertebra cervical. Fizerem parte da intervenção 24 mulheres sem queixas vocais, com idades entre 18 e 35 anos. Todas as voluntárias foram submetidas a uma avaliação de força da musculatura respiratória, do tempo máximo de fonação da vogal /a/, do nível de pressão sonora e análise vocal acústica, pré e pós-intervenção fisioterapêutica. Foram realizados os testes t-student para amostras independentes e correlação de Spearman com nível de significância de 5%. Resultados: Verificou-se aumento significativo no tempo máximo de fonação da vogal de /a/ e do nível de pressão sonora modal. Na análise acústica, houve redução dos valores do desvio-padrão da frequência fundamental; do quociente de perturbação do pitch suavizado; da variação da frequência fundamental e da variação da amplitude. Conclusão: As manobras fisioterapêuticas de estimulação cervical e liberação diafragmática melhoraram a qualidade vocal em relação ao tempo de sustentação da emissão, à pressão sonora, à estabilidade e ao ruído do sinal glótico.

Influence of vocal and aerodynamics aspects on the voice-related quality of life of older adults

Abstract The pursuit for quality of life urged a better understanding of aspects involved in ageing to minimize its consequences. Although many studies investigated older adults' voice, aspects affecting this population voice-related quality of life have not yet been explored. Objective To investigate how aerodynamics and vocal aspects are associated with voice-related quality of life in older adults. Methodology fifty-six older adults aged 60 years or above - 39 women and 17 men - were evaluated. The following procedures were performed: application of the Voice-Related Quality of Life (V-RQOL) protocol; vocal assessment, including auditory-perceptual and acoustic analysis, from which we obtained fundamental frequency (F 0 ), standard deviation of fundamental frequency (SDF 0 ), shimmer, amplitude perturbation quotient (APQ), jitter, pitch period perturbation quotient (PPQ), and harmonics to noise ratio (HNR); aerodynamic assessment using a spirometer; and maximum phonation time (MPT) for /a/, /s/, /z/ and number counting. Results older adults tend to present high V-RQOL scores. Among women, roughness, APQ, and HNR parameters were negatively correlated with V-RQOL, whereas F 0 was positively. We found no correlation between spirometry measurements and V-RQOL. MPT for /a/, /z/, and number counting was positively correlated with V-RQOL solely among men. Conclusion Vocal roughness and acoustic parameters have a negative impact on the quality of life of older women. Respiratory aspects related to the available air support for speaking affected the most the voice-related quality of life of older men.

Anaesthetic agent usage and wastage during caesarean deliveries done with spinal anaesthesia in a labour ward theatre: a concern for the financial implication

Background: Local anaesthesia usage and wastage are common in the operation rooms. The wastage is often not given due considerations. Budgetary allocation for drugs is an identifiable area for cost-cutting and savings. Hence, the need to minimize wastage Objectives: To assess and estimate the amount of local anaesthesia usage and wastage in the labour ward theatre. Also, to analyze the financial implications of the wastages and suggest appropriate steps to reduce the wastages. Methodology: A prospective observational study conducted in the labour ward theatre of a tertiary care hospital. The amount of local anaesthesia administered to the patient during spinal anaesthesia prior to caesarean section was considered the dose used. The wastage was considered as the amount of local anaesthetic agents left unutilized in the syringes, ampules or vials after completion of each caesarean delivery. An estimation of the cost of wasted local anaesthetic agents was made. Result: The local anaesthetic agents being used in significant quantities were hyperbaric bupivacaine, plain lidocaine and lidocaine with adrenaline. The wastage was found more during the use of hyperbaric bupivacaine as the cost of its wastage formed the bulk (N75,000.00/ $210.10) of the estimated total cost of wasted local anaesthetic agents during the study period which was N88, 100.00 ($246.77). Conclusion: There were appropriate uses of the local anaesthesia with respect to the choice and doses for caesarean deliveries but there were wastages often ignored as infinitesimal. In the long run, the wastages become significant and the financial implication scale up the burden of health bills. Effective waste reduction strategies have input in the overall reduction of financial burden associated with health care. Emphasis should be t ailored towards awareness of these wastages among resident doctors and their prudent use of local anaesthesia

Feline vocal communication

Parámetros vocales para definir la severidad de una disfonía / Vocal parameters to determine severity of voice disorders

Introducción: la severidad de una disfonía da cuenta del grado de alteración que tiene una voz en relación con todos los procesos fisiológicos involucrados con la producción del sonido. Es importante determinar el nivel de severidad a fin de establecer un programa con el conjunto de ejercicios que permitan una rehabilitación apropiada. Objetivo: comprender si el comportamiento de los diferentes parámetros aerodinámicos, electroglotográficos, acústicos y de autorreporte vocal permite o no determinar la severidad de una disfonía. Método: se evaluaron 55 sujetos con diferentes tipos de disfonía según pará-metros aerodinámicos, electroglotográficos, acústicos y de autorreporte vocal. La muestra fue dividida en 3 grupos de acuerdo con el grado de gravedad de la patología. Se aplicó un análisis de varianza para comparar el comportamiento de las variables dependientes en relación con los niveles de severidad de la disfonía. Con el fin de determinar las diferencias entre estos niveles, se aplicó la prueba Post hoc (Tukey) a las variables significativas. Resultados: es posible determinar el nivel de severidad de una disfonía a partir de parámetros acústicos como el CPP, HNR y el cociente de pendiente espectral 1/5-5/8Khz. También se puede hacer por medio de cuestionarios de autorreporte vocal como el VOISS, el VHI y el VTDS

Introduction: the severity of dysphonia shows the degree of alteration that a voice has in relation to all the physiological processes involved in the production of sound. It is essential to determine the level of severity to establish a program with the set of exercises required for a proper rehabilitation. Objective: to understand if the behavior of the different aerodynamic, electroglot-tographic, acoustic, and vocal self-report parameters allows, or not, to determine the severity of dysphonia. Method: 55 subjects with different types of dysphonia were evaluated according to aerodynamic, electroglottographic, acoustic, and vocal self-report parameters. The sample was divided into three groups in relation to the severity degree of the patho-logy. An analysis of variance was applied to compare the behavior of dependent variables with the severity levels of dysphonia. The Post hoc test (Tukey) was applied to the significant variables to determine the differences between the severity levels. Results: it is possible to determine the level of severity of dysphonia from acoustic parameters such as CPP, HNR, and the ratio of spectral slope 1 / 5-5 / 8Khz. It is also possible to use voice self-report questionnaires such as the VOISS, the VHI, and the VTDS