Protective Strategies Against Dysphonia in Teachers: Preliminary Results Comparing Voice Amplification and 0.9% NaCl Nebulization

Publication date: Available online 31 May 2017
Source:Journal of Voice
Author(s): Maria Lúcia Vaz Masson, Tânia Maria de Araújo
ObjectiveThis study aimed to compare the effects of two protective strategies, voice amplification (VA) and 0.9% NaCl nebulization (NEB), on teachers' voice in the work setting.MethodsAn interventional evaluator-blind study was conducted, assigning 53 teachers from two public high schools to one of the two protective strategy groups (VA or NEB). Vocal function was assessed in a sound-treated booth before and after a 4-week period. Assessment included the severity of voice impairment (Consensus Auditory-Perceptual Evaluation of Voice [CAPE-V]), acoustic analysis of fundamental frequency (f0), sound pressure level (SPL), jitter, shimmer, glottal-to-noise excitation ratio (GNE), noise (VoxMetria), and the self-rated Screening Index for Voice Disorder (SIVD). Data were statistically analyzed using SPSS Statistics (version 22) with a significance level of P ≤ 0.05. Effect size was calculated using Cohen's d coefficient.ResultsThere were no statistical differences between groups at baseline in terms of age, sex, time of teaching, teaching workload, and voice outcomes, except for SPL. During postintervention between groups, NEB displayed lower SIVD scores (VA = 3; NEB = 0; P = 0.018) and VA had lower acoustic irregularity (VA = 3.19; NEB = 3.69; P = 0.027), with moderate to large effect size. Postintervention within-groups decreased CAPE-V for VA (pretest = 31.97; posttest = 28.24; P = 0.021) and SIVD for NEB (pretest = 3; posttest = 0; P = 0.001). SPL decreased in both groups, NEB decreased in men only, and VA decreased in both men and women. NEB increased f0 for female participants (P ≤ 0.001).ConclusionBoth VA and NEB may help mitigate dysphonia in different pathways, being potential interventions for protecting teachers' voices in the work setting. An ongoing study with a control group will further support these preliminary results.



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Change in gait after high tibial osteotomy: A systematic review and meta-analysis

Publication date: September 2017
Source:Gait & Posture, Volume 57
Author(s): Seung Hoon Lee, O-Sung Lee, Seow Hui Teo, Yong Seuk Lee
We conducted a meta-analysis to analyze how high tibial osteotomy (HTO) changes gait and focused on the following questions: (1) How does HTO change basic gait variables? (2) How does HTO change the gait variables in the knee joint? Twelve articles were included in the final analysis. A total of 383 knees was evaluated. There were 237 open wedge (OW) and 143 closed wedge (CW) HTOs. There were 4 level II studies and 8 level III studies. All studies included gait analysis and compared pre- and postoperative values. One study compared CWHTO and unicompartmental knee arthroplasty (UKA), and another study compared CWHTO and OWHTO. Five studies compared gait variables with those of healthy controls. One study compared operated limb gait variables with those in the non-operated limb. Gait speed, stride length, knee adduction moment, and lateral thrust were major variables assessed in 2 or more studies. Walking speed increased and stride length was increased or similar after HTO compared to the preoperative value in basic gait variables. Knee adduction moment and lateral thrust were decreased after HTO compared to the preoperative knee joint gait variables. Change in co-contraction of the medial side muscle after surgery differed depending on the degree of frontal plane alignment. The relationship between change in knee adduction moment and change in mechanical axis angle was controversial. Based on our systematic review and meta-analysis, walking speed and stride length increased after HTO. Knee adduction moment and lateral thrust decreased after HTO compared to the preoperative values of gait variables in the knee joint.



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Interval setting selection affects ambulatory activity outputs in children with cerebral palsy

Publication date: September 2017
Source:Gait & Posture, Volume 57
Author(s): Wilshaw R. Stevens, Kirsten Tulchin-Francis
IntroductionAccelerometer based devices have been widely used to assess the ambulatory activity of children with and without functional disabilities. Many researchers who utilize the StepWatch Activity Monitor (SAM) collect at a 60second (60sec) interval setting. The purpose of this study was to assess the effect of SAM interval settings on ambulatory activity outputs in children with cerebral palsy (CP) and typically developing youth.MethodsParticipants wore a SAM which recorded the number of strides every 10seconds (10s) for one week. Raw 10s data was downsampled to combine strides into 60sec intervals. Strides were ensembled into walking bouts with the Intensity/Duration calculated as a percentage of Total Ambulatory Time (TAT).ResultsTwenty-eight children with CP (14 boys; avg. 12 yrs. 4 mths.; GMFCS Level I n=4, Level II n=19, Level III n=5) completed testing and 28 age matched typically developing youth (14 boys; avg. 12 yrs. 6 mths.) were included. Using the 10sec interval, ∼80% of walking bouts in both groups were less than or equal to 60s. Data recorded at 60sec intervals had higher daily TAT but fewer walking bouts. In children with CP, daily steps were higher using the 60sec interval. At the Easy intensity, the 60sec interval reported an increased volume of Long duration walking, and it rarely identified any Moderate+ intensity activity.Conclusions60sec interval data overestimated low intensity and long duration ambulatory activity. It is imperative that investigators choose a finer interval setting (10sec) to maximize the detection of gait transitions and rest periods which are critical in describing community ambulation of patients with cerebral palsy.



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Change in gait after high tibial osteotomy: A systematic review and meta-analysis

Publication date: September 2017
Source:Gait & Posture, Volume 57
Author(s): Seung Hoon Lee, O-Sung Lee, Seow Hui Teo, Yong Seuk Lee
We conducted a meta-analysis to analyze how high tibial osteotomy (HTO) changes gait and focused on the following questions: (1) How does HTO change basic gait variables? (2) How does HTO change the gait variables in the knee joint? Twelve articles were included in the final analysis. A total of 383 knees was evaluated. There were 237 open wedge (OW) and 143 closed wedge (CW) HTOs. There were 4 level II studies and 8 level III studies. All studies included gait analysis and compared pre- and postoperative values. One study compared CWHTO and unicompartmental knee arthroplasty (UKA), and another study compared CWHTO and OWHTO. Five studies compared gait variables with those of healthy controls. One study compared operated limb gait variables with those in the non-operated limb. Gait speed, stride length, knee adduction moment, and lateral thrust were major variables assessed in 2 or more studies. Walking speed increased and stride length was increased or similar after HTO compared to the preoperative value in basic gait variables. Knee adduction moment and lateral thrust were decreased after HTO compared to the preoperative knee joint gait variables. Change in co-contraction of the medial side muscle after surgery differed depending on the degree of frontal plane alignment. The relationship between change in knee adduction moment and change in mechanical axis angle was controversial. Based on our systematic review and meta-analysis, walking speed and stride length increased after HTO. Knee adduction moment and lateral thrust decreased after HTO compared to the preoperative values of gait variables in the knee joint.



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Interval setting selection affects ambulatory activity outputs in children with cerebral palsy

Publication date: September 2017
Source:Gait & Posture, Volume 57
Author(s): Wilshaw R. Stevens, Kirsten Tulchin-Francis
IntroductionAccelerometer based devices have been widely used to assess the ambulatory activity of children with and without functional disabilities. Many researchers who utilize the StepWatch Activity Monitor (SAM) collect at a 60second (60sec) interval setting. The purpose of this study was to assess the effect of SAM interval settings on ambulatory activity outputs in children with cerebral palsy (CP) and typically developing youth.MethodsParticipants wore a SAM which recorded the number of strides every 10seconds (10s) for one week. Raw 10s data was downsampled to combine strides into 60sec intervals. Strides were ensembled into walking bouts with the Intensity/Duration calculated as a percentage of Total Ambulatory Time (TAT).ResultsTwenty-eight children with CP (14 boys; avg. 12 yrs. 4 mths.; GMFCS Level I n=4, Level II n=19, Level III n=5) completed testing and 28 age matched typically developing youth (14 boys; avg. 12 yrs. 6 mths.) were included. Using the 10sec interval, ∼80% of walking bouts in both groups were less than or equal to 60s. Data recorded at 60sec intervals had higher daily TAT but fewer walking bouts. In children with CP, daily steps were higher using the 60sec interval. At the Easy intensity, the 60sec interval reported an increased volume of Long duration walking, and it rarely identified any Moderate+ intensity activity.Conclusions60sec interval data overestimated low intensity and long duration ambulatory activity. It is imperative that investigators choose a finer interval setting (10sec) to maximize the detection of gait transitions and rest periods which are critical in describing community ambulation of patients with cerebral palsy.



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Change in gait after high tibial osteotomy: A systematic review and meta-analysis

Publication date: September 2017
Source:Gait & Posture, Volume 57
Author(s): Seung Hoon Lee, O-Sung Lee, Seow Hui Teo, Yong Seuk Lee
We conducted a meta-analysis to analyze how high tibial osteotomy (HTO) changes gait and focused on the following questions: (1) How does HTO change basic gait variables? (2) How does HTO change the gait variables in the knee joint? Twelve articles were included in the final analysis. A total of 383 knees was evaluated. There were 237 open wedge (OW) and 143 closed wedge (CW) HTOs. There were 4 level II studies and 8 level III studies. All studies included gait analysis and compared pre- and postoperative values. One study compared CWHTO and unicompartmental knee arthroplasty (UKA), and another study compared CWHTO and OWHTO. Five studies compared gait variables with those of healthy controls. One study compared operated limb gait variables with those in the non-operated limb. Gait speed, stride length, knee adduction moment, and lateral thrust were major variables assessed in 2 or more studies. Walking speed increased and stride length was increased or similar after HTO compared to the preoperative value in basic gait variables. Knee adduction moment and lateral thrust were decreased after HTO compared to the preoperative knee joint gait variables. Change in co-contraction of the medial side muscle after surgery differed depending on the degree of frontal plane alignment. The relationship between change in knee adduction moment and change in mechanical axis angle was controversial. Based on our systematic review and meta-analysis, walking speed and stride length increased after HTO. Knee adduction moment and lateral thrust decreased after HTO compared to the preoperative values of gait variables in the knee joint.



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Interval setting selection affects ambulatory activity outputs in children with cerebral palsy

Publication date: September 2017
Source:Gait & Posture, Volume 57
Author(s): Wilshaw R. Stevens, Kirsten Tulchin-Francis
IntroductionAccelerometer based devices have been widely used to assess the ambulatory activity of children with and without functional disabilities. Many researchers who utilize the StepWatch Activity Monitor (SAM) collect at a 60second (60sec) interval setting. The purpose of this study was to assess the effect of SAM interval settings on ambulatory activity outputs in children with cerebral palsy (CP) and typically developing youth.MethodsParticipants wore a SAM which recorded the number of strides every 10seconds (10s) for one week. Raw 10s data was downsampled to combine strides into 60sec intervals. Strides were ensembled into walking bouts with the Intensity/Duration calculated as a percentage of Total Ambulatory Time (TAT).ResultsTwenty-eight children with CP (14 boys; avg. 12 yrs. 4 mths.; GMFCS Level I n=4, Level II n=19, Level III n=5) completed testing and 28 age matched typically developing youth (14 boys; avg. 12 yrs. 6 mths.) were included. Using the 10sec interval, ∼80% of walking bouts in both groups were less than or equal to 60s. Data recorded at 60sec intervals had higher daily TAT but fewer walking bouts. In children with CP, daily steps were higher using the 60sec interval. At the Easy intensity, the 60sec interval reported an increased volume of Long duration walking, and it rarely identified any Moderate+ intensity activity.Conclusions60sec interval data overestimated low intensity and long duration ambulatory activity. It is imperative that investigators choose a finer interval setting (10sec) to maximize the detection of gait transitions and rest periods which are critical in describing community ambulation of patients with cerebral palsy.



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Whispering Whales

Imagine traveling thousands of miles with your newborn in search of food. Now imagine doing this in almost complete darkness. This is exactly what humpback whales and their newborns do as a matter of routine. The journey to the food-rich Antarctic or Arctic waters from their tropical breeding grounds can be thousands of miles. The mother and calf swim in deep ocean waters where light is scarce and therefore vision is not very useful. The pair has to depend on sound to keep track of each other. But broadcasting their presence to killer whales can be fatal.  

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Hybrid L24 Study Update: Where Are They Now?

Why Hybrid? Cochlear has led the way with the design, the development, and approval of the first Hybrid Implant System available in the U.S. So first, why Hybrid? What are we, as audiologists, aiming for when we start a treatment plan for an individual with hearing loss? The first goal is audibility since it's a prerequisite for speech understanding. The goal of Hybrid Hearing is to provide audibility in the speech range of 125 to 8000 Hz.

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Hybrid L24 Study Update: Where Are They Now?

Why Hybrid? Cochlear has led the way with the design, the development, and approval of the first Hybrid Implant System available in the U.S. So first, why Hybrid? What are we, as audiologists, aiming for when we start a treatment plan for an individual with hearing loss? The first goal is audibility since it's a prerequisite for speech understanding. The goal of Hybrid Hearing is to provide audibility in the speech range of 125 to 8000 Hz.

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Hybrid L24 Study Update: Where Are They Now?

Why Hybrid? Cochlear has led the way with the design, the development, and approval of the first Hybrid Implant System available in the U.S. So first, why Hybrid? What are we, as audiologists, aiming for when we start a treatment plan for an individual with hearing loss? The first goal is audibility since it's a prerequisite for speech understanding. The goal of Hybrid Hearing is to provide audibility in the speech range of 125 to 8000 Hz.

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Novel splice mutation in LRP4 causes severe type of Cenani-Lenz syndactyly syndrome with oro-facial and skeletal symptoms.

Related Articles

Novel splice mutation in LRP4 causes severe type of Cenani-Lenz syndactyly syndrome with oro-facial and skeletal symptoms.

Eur J Med Genet. 2017 May 27;:

Authors: Afzal M, Zaman Q, Kornak U, Mundlos S, Malik S, Flöttmann R

Abstract
Cenani-Lenz syndactyly syndrome (CLSS; MIM-212780) is a rare autosomal recessive limb malformation characterized by complete osseous fusion of all fingers and toes, disorganization of phalangeal elements and severe shortening of the radius and ulna. It is occasionally associated with renal hypoplasia, oro-facial defects, scoliosis of the thoracic spine, hearing loss, and genital anomalies. Here we describe a consanguineous Pakistani kindred with a severe form of CLSS characterized by complete syndactyly and disorganization of fingers, oligo-syndactyly of toes, shortening of limbs, frontal bossing, and hypoplasia/agenesis of left kidney. The affected individuals were additionally presented with short stature, cleft-lip and hypoplastic shoulder joint with restricted upper limb movement. A novel splice variant in LRP4 (c.316+1G > A) segregated with the phenotype in a five generations family. The mutation is predicted to add 29 non-native amino acids with a premature termination, resulting in approximately 90% length reduction of the wild-type transcript. These findings not only further expand the phenotypic variability of CLSS but also indicate that early truncated and loss-of-function mutations in LRP4 lead to a more severe CLSS phenotype.

PMID: 28559208 [PubMed - as supplied by publisher]

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