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OBJECTIVE: Previous research has shown that in a task identifying singers across pitch, inexperienced listeners perform very poorly compared to their experienced counterparts. This poor performance may partially be due to lower motivation and reduced attention on the part of inexperienced listeners. The current experiment is designed to examine the role of motivation in difficult perceptual tasks through use of an established methodology that uses singing voice stimuli. METHODS: This study used an ABX paradigm. Listeners heard two different singers, singing /É/ at the same pitch and had to identify which of the two singers produced a third /É/ at a different pitch. Pitches varied across 1.5 octaves. Inexperienced listeners were randomly assigned to 1 of 3 conditions: (1) no feedback, (2) percent correct feedback, and (3) percentile feedback. Prior to the experiment, listeners rated their motivation using the Situational Intrinsic Motivation Scale (SIMS). Data were collected from 99 inexperienced listeners. RESULTS: There were no significant differences between the three feedback conditions, No Feedback, Percent Correct, and Percentile, for any SIMS subscale. Likewise, there were no significant differences in musical experience between the three feedback conditions. A repeated measures ANOVA designed to test the effect of feedback group on mean percent correct responses revealed no significant main or interaction effects of feedback. However, amotivation was a significant predictor of mean percent correct scores. CONCLUSIONS: Motivation is a complex construct that, while not being a primary factor in the current audio-perceptual task, could still be an important confounding factor in perceptual research. In the case of the current study, the two feedback conditions utilized in this study, Percent Correct and Percentile, may not have provided sufficiently robust external motivation to elicit differences in performance. Perceptual and behavioral researchers should be vigilant. More research is necessary.
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OBJECTIVE: The ability to perceive strain or tension in a voice is critical for both speech-language pathologists and singing teachers. Research on voice quality has focused primarily on the perception of breathiness or roughness. The perception of vocal strain has not been extensively researched and is poorly understood. METHODS/DESIGN: This study employs a group and a within-subject design. Synthetic female sung stimuli were created that varied in source slope and vocal tract transfer function. Two groups of listeners, inexperienced listeners and experienced vocal pedagogues, listened to the stimuli and rated the perceived strain using a visual analog scale Synthetic female stimuli were constructed on the vowel /É/ at 2 pitches, A3 and F5, using glottal source slopes that drop in amplitude at constant rates varying from - 6 dB/octave to - 18 dB/octave. All stimuli were filtered using three vocal tract transfer functions, one derived from a lyric/coloratura soprano, one derived from a mezzo-soprano, and a third that has resonance frequencies mid-way between the two. Listeners heard the stimuli over headphones and rated them on a scale from "no strain" to "very strained" using a visual-analog scale. RESULTS: Spectral source slope was strongly related to the perception of strain in both groups of listeners. Experienced listeners' perception of strain was also related to formant pattern, while inexperienced listeners' perception of strain was also related to pitch. CONCLUSION: This study has shown that spectral source slope can be a powerful cue to the perception of strain. However, inexperienced and experienced listeners also differ from each other in how strain is perceived across speaking and singing pitches. These differences may be based on both experience and the goals of the listener.
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OBJECTIVE/HYPOTHESES: The terms "soprano" and "mezzo-soprano" are frequently used by vocal pedagogues to describe a main category of singing timbre categorization, while the terms "lyric" and "dramatic" are often used to describe sub-categories of "soprano" and "mezzo-soprano". A handful of studies have reported on the perceptual dissimilarity of main voice categories, but few, if any, have focused on within voice category perceptual distinctions such as dramatic and lyric vocal timbre. Using stimuli collected from cisgender female singers of varying voice categories and voice weights across the pitches C4, G4, and F5, this study sought (1) to visualize an experienced listener's perception of vocal timbre dissimilarity within and between voice categories using the statistical technique of multidimensional scaling (MDS), (2) to identify salient acoustic predictors of voice category and voice weight, and (3) to determine any dependencies on pitch for the perception of vocal timbre. METHOD/DESIGN: For the pitches C4, G4, and F5, experienced listeners (N=18) rated the dissimilarity of pairs of sung vowels produced by classically trained singers classified as follows: six mezzo-sopranos (three lighter and three heavier) and six sopranos (three lighter and three heavier). The resulting dissimilarity data were analyzed using MDS. Backward linear regression was used to see if one or more of the following variables predicted MDS dimensions: spectral centroid from 0 to 5 kHz, spectral centroid from 0 to 2 kHz, spectral centroid from 2 to 5 kHz, frequency vibrato rate, and frequency vibrato extent. Listeners also completed a categorization task where they rated each individual stimulus on two dimensions: voice category and voice weight. RESULTS: Visual analysis of the MDS solutions appears to show that both voice category and voice weight emerged as dimensions at pitches C4 and G4. Discriminant analysis, on the other hand, statistically confirmed both these dimensions at G4, but only voice weight at C4. At pitch F5, only voice weight emerged as a dimension, both visually and statistically. Acoustic predictors of MDS dimensions were highly variable across pitches. At the pitch C4, no MDS dimension was predicted by the acoustic variables. At pitch G4, the dimension associated with voice weight was predicted by spectral centroid from 0 to 2 kHz. At pitch F5, the dimension associated with voice weight was predicted by spectral centroid from 2 to 5 kHz and frequency vibrato rate. In the categorization task, voice category and voice weight were highly correlated at the pitches C4, G4, and when all pitches were presented together, but weakly correlated at the pitch F5. CONCLUSION: While voice category and sub-category distinctions are commonly used by singing voice professionals to describe the overall timbre of voices, these distinctions may not be able to consistently predict the perceptual difference between any given pair of vocal stimuli, particularly across pitch. Nonetheless, these dimensions do emerge in some fashion when listeners are presented with paired vocal stimuli. On the other hand, when asked to rate stimuli according to the specific labels of mezzo-soprano/soprano and dramatic/lyric, experienced listeners have a very difficult time disentangling voice category from voice weight when presented with a single-note stimulus or even a 3-note stimulus consisting of the pitches C3, G4, and F5.
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Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the causative agent of coronavirus disease 2019. Few studies have compared replication dynamics and host responses to SARS-CoV-2 in cell lines from different tissues and species. Therefore, we investigated the role of tissue type and antiviral genes during SARS-CoV-2 infection in nonhuman primate (kidney) and human (liver, respiratory epithelial, gastric) cell lines. We report different viral growth kinetics and release among the cell lines despite comparable ACE2 expression. Transcriptomics revealed that absence of STAT1 in nonhuman primate cells appeared to enhance inflammatory responses without effecting infectious viral titer. Deletion of RL-6 in respiratory epithelial cells increased viral replication. Impaired infectious virus release was detected in Huh7 but not Huh7.5 cells, suggesting a role for RIG1. Gastric cells MKN45 exhibited robust antiviral gene expression and supported viral replication. Data here provide insight into molecular pathogenesis of and alternative cell lines for studying SARS-CoV-2 infection.
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Chronic obstructive pulmonary usually is subcategorized into 2 groups: chronic bronchitis and emphysema. The main cause of chronic bronchitis and emphysema is smoking; however, alpha1-antitrypsin also has been seen to cause emphysema in patients who are deficient. As symptoms and lung function decline, treatment modalities, such as lung volume reduction surgery, have been used in individuals with chronic obstructive pulmonary disease and upper lobe predominant emphysema. This article analyzes multiple published series where lung volume reduction surgery has been used in individuals with alpha1-antitrypsin deficiency and their overall outcomes.
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Pneumonectomia/métodos , Doença Pulmonar Obstrutiva Crônica/complicações , Enfisema Pulmonar/complicações , Deficiência de alfa 1-Antitripsina/complicações , Deficiência de alfa 1-Antitripsina/cirurgia , Idoso , Anti-Inflamatórios/uso terapêutico , Broncodilatadores/uso terapêutico , Dispneia/cirurgia , Endoscopia , Feminino , Volume Expiratório Forçado , Humanos , Pulmão , Masculino , Pessoa de Meia-Idade , Oxigênio/uso terapêutico , Pneumonectomia/efeitos adversos , Prognóstico , Doença Pulmonar Obstrutiva Crônica/cirurgia , Enfisema Pulmonar/cirurgia , Risco , Fumar/efeitos adversos , Abandono do Hábito de Fumar , Fatores de Tempo , alfa 1-Antitripsina/metabolismo , Deficiência de alfa 1-Antitripsina/diagnósticoRESUMO
Blastomycosis is a systemic fungal infection which primarily involves the lungs but can disseminate to involve extrapulmonary sites. Current testing that exists includes sputum, urine, serum, and pathological tissue analysis. Radiological testing is often non-specific and highly variable. Here we present five cases of pulmonary blastomycosis with challenging radiographic presentations.
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Many post-lingually deafened cochlear implant (CI) users report that they no longer enjoy listening to music, which could possibly contribute to a perceived reduction in quality of life. One aspect of music perception, vocal timbre perception, may be difficult for CI users because they may not be able to use the same timbral cues available to normal hearing listeners. Vocal tract resonance frequencies have been shown to provide perceptual cues to voice categories such as baritone, tenor, mezzo-soprano, and soprano, while changes in glottal source spectral slope are believed to be related to perception of vocal quality dimensions such as fluty vs. brassy. As a first step toward understanding vocal timbre perception in CI users, we employed an 8-channel noise-band vocoder to test how vocoding can alter the timbral perception of female synthetic sung vowels across pitches. Non-vocoded and vocoded stimuli were synthesized with vibrato using 3 excitation source spectral slopes and 3 vocal tract transfer functions (mezzo-soprano, intermediate, soprano) at the pitches C4, B4, and F5. Six multi-dimensional scaling experiments were conducted: C4 not vocoded, C4 vocoded, B4 not vocoded, B4 vocoded, F5 not vocoded, and F5 vocoded. At the pitch C4, for both non-vocoded and vocoded conditions, dimension 1 grouped stimuli according to voice category and was most strongly predicted by spectral centroid from 0 to 2 kHz. While dimension 2 grouped stimuli according to excitation source spectral slope, it was organized slightly differently and predicted by different acoustic parameters in the non-vocoded and vocoded conditions. For pitches B4 and F5 spectral centroid from 0 to 2 kHz most strongly predicted dimension 1. However, while dimension 1 separated all 3 voice categories in the vocoded condition, dimension 1 only separated the soprano stimuli from the intermediate and mezzo-soprano stimuli in the non-vocoded condition. While it is unclear how these results predict timbre perception in CI listeners, in general, these results suggest that perhaps some aspects of vocal timbre may remain.
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This paper proposes that autonomous vehicles should be designed to reduce light pollution. In support of this specific proposal, a moral assessment of autonomous vehicles more comprehensive than the dilemmatic life-and-death questions of trolley problem-style situations is presented. The paper therefore consists of two interrelated arguments. The first is that autonomous vehicles are currently still a technology in development, and not one that has acquired its definitive shape, meaning the design of both the vehicles and the surrounding infrastructure is open-ended. Design for values is utilized to articulate a path forward, by which engineering ethics should strive to incorporate values into a technology during its development phase. Second, it is argued that nighttime lighting-a critical supporting infrastructure-should be a prima facie consideration for autonomous vehicles during their development phase. It is shown that a reduction in light pollution, and more boldly a better balance of lighting and darkness, can be achieved via the design of future autonomous vehicles. Two case studies are examined (parking lots and highways) through which autonomous vehicles may be designed for "driving in the dark." Nighttime lighting issues are thus inserted into a broader ethics of autonomous vehicles, while simultaneously introducing questions of autonomous vehicles into debates about light pollution.
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Automação/ética , Automóveis/ética , Poluição Ambiental/ética , Desenho de Equipamento/ética , Iluminação/ética , Valores Sociais , HumanosRESUMO
A 66-year-old man with diabetes presented to the hospital with a two-month history of dyspnea, cough, rust-colored sputum, night sweats and 20 pound weight loss. He had begun smoking medical marijuana 3 months earlier. CT of the chest showed multiple bilateral large ground glass opacities with surrounding consolidation. Infectious workup was negative. BAL was non-diagnostic. He was treated with broad spectrum antibiotics without improvement. VATS was performed and cultured lung tissue grew Rhizopus species. He was started on intravenous liposomal amphotericin B and micafungin and then transitioned to oral posaconazole after two weeks. Repeat CT two months later showed stable size of the cavities. One month later he died of massive pulmonary hemorrhage. Here we document what we believe is the first known case of pulmonary mucormycosis associated with medical marijuana use.
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BACKGROUND: Cushing's syndrome due to ectopic ACTH secretion has been associated with many cancers; most commonly small cell carcinoma of the lung and bronchial carcinoid tumors. Usually, patients who confer this diagnosis have poor prognosis. CASE PRESENTATION: A 66-year-old female presented with worsening shortness of breath and weakness over three days. Initial laboratory derangements included severe hypokalemia and metabolic alkalosis. Treatment included high amounts of potassium chloride and acetazolamide. Imaging studies revealed anterior medial right upper lobe lung mass as well as suspicion for many liver metastases. Liver biopsy was sought and was positive for small cell carcinoma. CONCLUSION: We describe a case of severe metabolic alkalosis and hypokalemia in a patient with Cushing's syndrome due to ectopic ACTH secretion from small cell lung cancer. To our knowledge, this is the first case identified which exhibited such significant metabolic derangements in the form of serum and arterial blood bicarbonate. As prognosis is quite poor, we recommend swift diagnosis and management.
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BACKGROUND Leukemias and lymphomas can arise from myeloid or lymphoid stem cells. Combined myeloid leukemia and non-Hodgkin's lymphoma (NHL), either synchronous or metachronous, rarely occur in the same patient. This report is of a 67-year-old man with a synchronous diagnosis of both bone marrow chronic myelomonocytic leukemia (CMML) and nodal marginal zone lymphoma (NMZL), which a peripheral low-grade B-cell NHL. CASE REPORT A 67-year-old Caucasian man, who was a long-term cigarette smoker, presented with a five-year history of leukocytosis and cervical lymphadenopathy. He had no symptoms of night sweats, fever, or weight loss. Review of his medical records showed a progressively increasing leukocytosis with a peak of 58×109/L. Computed tomography (CT) imaging of the chest and abdomen showed lymphadenopathy, including enlarged cervical, axillary, mediastinal, and retroperitoneal lymph nodes. Bone marrow biopsy and histology showed CMML. Lymph node biopsy and histology showed NMZL. The patient was treated for NMZL with weekly intravenous rituximab infusions. Although his CMML was stable, the patient requested an evaluation for treatment with hematopoietic allogeneic stem cell transplantation (ASCT). At the time of this report, the patient remains asymptomatic. CONCLUSIONS The synchronous occurrence of bone marrow CMML and NMZL in a single patient is rare and may be attributed to a genetic mutation common to both. There are no current treatment guidelines for this group of patients, and treatment strategies should be individualized to provide an optimum outcome or symptomatic improvement.
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Antineoplásicos Imunológicos/uso terapêutico , Neoplasias da Medula Óssea/tratamento farmacológico , Leucemia Mielomonocítica Crônica/tratamento farmacológico , Linfoma de Zona Marginal Tipo Células B/tratamento farmacológico , Neoplasias Primárias Múltiplas/tratamento farmacológico , Rituximab/uso terapêutico , Idoso , Biópsia , Medula Óssea/patologia , Neoplasias da Medula Óssea/patologia , Humanos , Leucemia Mielomonocítica Crônica/patologia , Linfadenopatia/patologia , Linfoma de Zona Marginal Tipo Células B/patologia , Masculino , Neoplasias Primárias Múltiplas/patologiaRESUMO
The adverse effects of artificial nighttime lighting, known as light pollution, are emerging as an important environmental issue. To address these effects, current scientific research focuses mainly on identifying what is bad or undesirable about certain types and uses of lighting at night. This paper adopts a value-sensitive approach, focusing instead on what is good about darkness at night. In doing so, it offers a first comprehensive analysis of the environmental value of darkness at night from within applied ethics. A design for values orientation is utilized to conceptualize, define, and categorize the ways in which value is derived from darkness. Nine values are identified and categorized via their type of good, temporal outlook, and spatial characteristics. Furthermore, these nine values are translated into prima facie moral obligations that should be incorporated into future design choices, policy-making, and innovations to nighttime lighting. Thus, the value of darkness is analyzed with the practical goal of informing future decision-making about urban nighttime lighting.
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Escuridão , Exposição Ambiental , Poluição Ambiental/ética , Análise Ética/métodos , Iluminação/ética , Valores Sociais , Tomada de Decisões , Humanos , Luz , Princípios MoraisRESUMO
Several North American trees are hypothesized to have lost their co-evolved seed disperser during the late-Pleistocene extinction and are therefore considered anachronistic. We tested this hypothesis for the American persimmon (Diospyros virginiana) by studying the effects of gut passage of proposed seed dispersers on seedling survival and growth, natural fruiting characteristics, and modern animal consumption patterns. We tested gut passage effects on persimmon seeds using three native living species, the raccoon (Procyon lotor), Virginia opossum (Didelphis virginiana), and coyote (Canis latrans), and two Pleistocene analogs; the Asian elephant (Elephas maximus) and alpaca (Vicugna pacos). Persimmon seeds excreted by raccoons, coyotes, and elephants survived gut transit. Gut passage did not affect sprouting success, but did tend to decrease time to sprout and increase seedling quality. Under field conditions, persimmon fruits were palatable on the parent tree and on the ground for an equal duration, but most fruits were consumed on the ground. Seven vertebrate species fed upon persimmon fruits, with the white-tailed deer (Odocoileus virginianus)-a species not capable of dispersing persimmon seeds-comprising over 90% of detections. Conversely, potential living seed dispersers were rarely detected. Our results suggest the American persimmon evolved to attract a variety of seed dispersers and thus is not anachronistic. However, human-induced changes in mammal communities could be affecting successful seed dispersal. We argue that changes in the relative abundance of mammals during the Anthropocene may be modifying seed dispersal patterns, leading to potential changes in forest community composition.
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Stress fractures, including both fatigue and insufficiency types, are frequently encountered in clinical practice as a source of pain in both athletes and patients with predisposing conditions. Radiography is the imaging modality of choice for baseline diagnosis. MRI has greatly improved our ability to diagnose radiographically occult stress fractures. Tc-99m bone scan and CT may also be useful as diagnostic tools. Although fatigue and insufficiency fractures can be self-limited and go onto healing even without diagnosis, there is usually value in initiating prompt therapeutic measures as incomplete stress fractures have the potential of progressing to completion and requiring more invasive treatment or delay in return to activity. This is particularly important in the setting of stress fractures of the femoral neck. Accuracy in the identification of these injuries is also relevant because the differential diagnosis includes entities that would otherwise be treated significantly different (ie, osteoid osteoma, osteomyelitis, and metastasis). The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Fraturas de Estresse/diagnóstico por imagem , Sacro/lesões , Fraturas Ósseas , Humanos , Imageamento por Ressonância Magnética , Radiologia , Compostos Radiofarmacêuticos , Sacro/diagnóstico por imagem , Sociedades Médicas , Tecnécio , Tomografia Computadorizada por Raios X/métodos , Ultrassonografia , Estados UnidosRESUMO
OBJECTIVE: To evaluate the position of the peroneus longus (PL) tendon relative to the cuboid tuberosity and cuboid tunnel during ankle dorsiflexion and plantarflexion using ultrasound and MRI. MATERIALS AND METHODS: The study population included two groups: 20 feet of 10 asymptomatic volunteers who underwent prospective dynamic ultrasound and 55 ankles found through retrospective review of routine ankle MRI examinations. The location of the PL tendon at the cuboid tuberosity and cuboid tunnel was designated as completely within the tunnel, indeterminate, or subluxed with respect to ankle dorsiflexion and plantarflexion. RESULTS: On dynamic ultrasound, the PL tendon was perched plantar to the cuboid tuberosity in dorsiflexion, and glided to enter the cuboid tunnel distal to the tuberosity in plantarflexion in all 20 feet. On the MRI evaluation, there was a statistically significant difference (p = 0.0006) in the location of the PL tendon between the ankles scanned in dorsiflexion and plantarflexion. CONCLUSION: Based on our findings on ultrasound and MRI, the PL tendon can glide in and out of the cuboid tunnel along the cuboid tuberosity depending on ankle position. Thus, "subluxation" of the tendon as it curves to enter the cuboid tunnel, which to the best of our knowledge has not yet been described, should be recognized as a normal, position-dependent phenomenon and not be reported as pathology.
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Imageamento por Ressonância Magnética/métodos , Ossos do Tarso/diagnóstico por imagem , Tendinopatia/diagnóstico por imagem , Traumatismos dos Tendões/diagnóstico por imagem , Tendões/diagnóstico por imagem , Ultrassonografia/métodos , Adolescente , Adulto , Idoso , Criança , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto JovemRESUMO
This retrospective study evaluated the technical success rate of a novel injection into the long head of the biceps tendon sheath by a rotator interval approach in 26 patients. A 25-gauge, 1.5-in needle was positioned into the rotator interval from a lateral approach, where a therapeutic injection was performed. Postinjection sonograms images were reviewed to assess for fluid within the sheath to calculate the technical success rate. Fluid distention of the biceps tendon sheath was shown in all 26 cases, corresponding to a 100% technical success rate. In addition, postinjection ultrasound imaging of the anterior shoulder provided additional diagnostic findings in 6 of 26 patients (23%).
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Corticosteroides/administração & dosagem , Dor de Ombro/etiologia , Dor de Ombro/prevenção & controle , Tendinopatia/diagnóstico por imagem , Tendinopatia/tratamento farmacológico , Ultrassonografia de Intervenção/métodos , Anti-Inflamatórios/administração & dosagem , Feminino , Humanos , Injeções Intramusculares/métodos , Masculino , Pessoa de Meia-Idade , Medição da Dor/efeitos dos fármacos , Dor de Ombro/diagnóstico , Tendinopatia/complicações , Resultado do TratamentoRESUMO
OBJECTIVE: The purpose of this article is to review the normal anatomy and pathologic conditions of the shoulder on the basis of the appearance on MR and ultrasound images obtained during performance of abduction external rotation and flexion adduction internal rotation positional maneuvers. CONCLUSION: Positional MRI and ultrasound are highly useful in evaluation of the shoulder. Knowledge of the normal appearance of anatomic structures and pathologic changes in nontraditional imaging planes is necessary to avoid pitfalls in interpretation.