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[The Munich/San Diego/Iowa City Collaboration (MuSIC). MuSIC Report I: Design , characteristics of the collective and preliminary results].

BACKGROUND: We have previously shown that histologically described microcirculation patterns (MCP) can be visualized with indocyanine green (ICG) angiography. We have designed a prospective study to evaluate the prognostic value of these angiographically imaged MCP in small choroidal melanocytic lesions. In this report we describe the design of the study, characterize the patient collective, and present the first results. PATIENTS AND METHODS: In this prospective nonrandomized observational study, unilateral choroidal melanocytic lesions with 1.5-5.5 mm maximum apical height are observed until growth is determined according to defined criteria. Variables are demographic parameters, subjective symptoms, subretinal fluid, location and dimension of tumor, hemorrhage, color, orange pigment, and MCP determined by ICG angiography: normal, straight, parallel without crosslinking, parallel with crosslinking, arcs without branching, arcs with branching, loop, and network. RESULTS: Seventy patients (22 males, 48 females; age: 33-88 years, median: 64 years) have been included up to now: 19 tumors showed growth so far (time to growth: 51-946 days, median: 127 days). The following parameters were statistically significantly correlated with time to tumor growth: flashes (p = 0.082), orange pigment (p = 0.012), subretinal fluid (p < 0.001), maximum basal tumor diameter (p = 0.001), maximum apical tumor height (p < 0.001), parallel with crosslinking (p < 0.001), arcs with branching (p = 0.006), loop (p < 0.001), and network (p < 0.001). Of these, complex MCP (parallel with crosslinking, arcs with branching, loop and/or network) showed the strongest correlation with time to tumor growth in a Cox regression model. Based on our data, the positive predictive value of imaging complex MCP (for growth within 12 months) is 78% and the negative predictive value is 98%. CONCLUSION: Our patient collective demonstrates comparable prognostic parameters for time to growth as described in the literature. In addition, the ICG angiographic detection of complex MCP is more strongly predictive of the time to growth than other clinically determinable factors. Thus, we recommend this examination for patients with small choroidal melanocytic lesions, if the patient is to be counseled regarding the likely biologic behavior of his tumor.

Adult↗

Rock Music and Music Videos.

Sex, violence, sexual violence, drugs, suicide, satanic worship, and racism are common themes in modern rock lyrics. The authors examine their effect on adolescent development and identity, concluding with a discussion of the roles of parents and health care professionals in addressing the problem.

Journal Article↗

Specially selected music in the cardiac laboratory-an important tool for improvement of the wellbeing of patients.

PURPOSE: To investigate the effect of a specially selected music sound environment on the feeling of wellbeing of adult, lightly sedated patients in a Cardiac Catheter Laboratory undergoing invasive procedures. METHOD: Patients (n=193) were randomly assigned to either a music group, who listened to music during the procedure (n=99) or to a non-music group (n=94). Immediately after the procedure all patients were interviewed by a questionnaire about their opinion of the sound environment in the room and about their feeling of wellbeing. RESULTS: In the music group 91% of the patients defined the sound environment as very pleasant/pleasant - compared to 56% in the non-music group. The number of patients with 'no opinion' on the sound environment was lower in the music group than in the non-music group (8% vs. 42%). In the non-music group only 34% of the patients would have liked to listen to music, if possible, whereas 82% of the patients in the music group were very pleased/pleased with the music. Both groups noticed basic sounds and noises with similar frequencies. In the music group 62% of the patients noticed the music spontaneously. Sixty-eight patients (68%) reported that music was of major positive importance to their feeling of wellbeing. These patients expressed that music made them feel less tense, more relaxed and safe. The results were not related to age, sex or procedure. CONCLUSION: Specially selected music had a positive effect on the wellbeing of patients and their opinion on the sound environment during invasive cardiac procedures. Based on the negative expectations and the positive experience of the patients with regard to music environment, we suggest that specially selected music should be a part of the sound environment in the Cardiac Catheter Laboratory.

Adult↗

Live music is beneficial to preterm infants in the neonatal intensive care unit environment.

BACKGROUND: Music stimulation has been shown to provide significant benefits to preterm infants. We hypothesized that live music therapy was more beneficial than recorded music and might improve physiological and behavioral parameters of stable preterm infants in the neonatal intensive care unit. METHODS: Thirty-one stable infants randomly received live music, recorded music, and no music therapy over 3 consecutive days. A control of the environment noise level was imposed. Each therapy was delivered for 30 minutes. Inclusion criteria were postconceptional age > or = 32 weeks, weight > or = 1,500 g, hearing confirmed by distortion product otoacoustic emissions (DPOAEs), and no active illness or documentation of hyperresponsiveness to the music. Heart rate, respiratory rate, oxygen saturation, and a behavioral assessment were recorded, every 5 minutes, before, during, and after therapy, allowing 30 minutes for each interval. The infant's state was given a numerical score as follows: 1, deep sleep; 2, light sleep; 3, drowsy; 4, quiet awake or alert; 5, actively awake and aroused; 6, highly aroused, upset, or crying; and 7, prolonged respiratory pause > 8 seconds. The volume range of both music therapies was from 55 to 70 dB. Parents and medical personnel completed a brief questionnaire indicating the effect of the three therapies. RESULTS: Live music therapy had no significant effect on physiological and behavioral parameters during the 30-minute therapy; however, at the 30-minute interval after the therapy ended, it significantly reduced heart rate (150 +/- 3.3 beats/min before therapy vs 127 +/- 6.5 beats/min after therapy) and improved the behavioral score (3.1 +/- 0.8 before therapy vs 1.3 +/- 0.6 after therapy, p < 0.001). Recorded music and no music therapies had no significant effect on any of the tested parameters during all intervals. Both medical personnel and parents preferred live music therapy to recorded music and no music therapies; however, parents considered live music therapy significantly more effective than the other therapies. CONCLUSIONS: Compared with recorded music or no music therapy, live music therapy is associated with a reduced heart rate and a deeper sleep at 30 minutes after therapy in stable preterm infants. Both recorded and no music therapies had no significant effect on the tested physiological and behavioral parameters.

Analysis of Variance↗

Music therapy assessment in school settings: a preliminary investigation.

The present investigation was undertaken in response to music therapists working in school settings for information relating to the availability of music therapy assessments and the feasibility of standardizing an assessment instrument for music therapists to use in school settings. Five research questions were identified, and the music therapy literature was surveyed to compile responses to those questions. Three different online data bases (ERIC, PsycINFO, and Article 1st) were used, covering articles published between 1980 and 1997. Individual hand searches were done of the Arts in Psychotherapy, Journal of Music Therapy, Journal of Research in Music Education, Journal of the International Association of Music for the Handicapped, Music Therapy and Music Therapy Perspectives. The questions and responses were as follows: 1. Which music-based assessment tools are being used with children with disabilities? Little commonality in assessment tools being used by music therapists and researchers was discovered. Of the total 41 studies, 20 (49%) reported using a "named" or "titled" assessment tool, and in the remaining 51% of studies, the authors reported using an untitled, and usually experimenter-designed, original assessment tool. 2. Have certain assessments been used in more than one study? Very limited replication of existing assessments was found. Of the 16 "named" assessments, only 3 were found to be used in more than one research study. 3. Are the actual assessments published along with the articles describing their use? Only 3 of the 20 studies using named assessments were published along with the journal article. Of the remaining 21 studies using original, experimenter-designed assessment tools, only 6 (28%) had the assessment instrument published with the article. 4. What is the primary purpose for using the assessment? Six primary purposes emerged from the review of the literature: to compare with data obtained from other assessment measures or from other populations (39%), as a baseline or pretest measure (29%), to determine eligibility for services or the receipt of treatment (12%), to determine the psychometric properties of the assessment (7%), suitability of the instrument for the given population (7%), and the identification of musical preferences (5%). 5. What are the musical or nonmusic elements being assessed? Musical elements were: music perception (37%), musical aptitude (29%), musical preferences (12%), and attention to/enjoyment of music (2%). Nonmusical behaviors/responses were: self-expression (10%), motor responses (10%), behavioral responses (7%), cognitive development (2%), and acts of communication (2%). 6. What subject populations are being assessed? Subject populations were: children with developmental disabilities/mental retardation (44%), children with autism (10%), children with hearing impairments (17%), "psychiatric" clients or emotionally disturbed (22%), individuals described as "handicapped" (5%), individuals with physical disabilities (2%), and a student with a speech impairment (2%). Nondisabled individuals were also included in 12 of the aforementioned studies.

Child↗

Synchronizing with music: intercultural differences.

The way in which listeners perceive music changes throughout childhood, but little is known about the factors responsible for these changes. One factor, explicit music training, has received considerable attention, with studies indicating that musicians demonstrate a more complex hierarchical mental representation for music and superior temporal organizational skills. But does acculturation-the passive exposure to a particular type of music since birth-also influence the acquisition of these skills? We compared the music synchronization performance of Tunisian and French subjects with music from these two contrasting musical cultures. Twelve musical excerpts were selected from the two popular music cultures, matched for perceived tempo, complexity, and familiarity, and subjects were asked to tap in time with the music. Tapping mode (rate and hierarchical level) varied with subjects' familiarity with the musical idiom, as evidenced by an interaction between musical culture and type of music: participants synchronized at higher hierarchical levels (and over a wider range) with music from their own culture than with an unfamiliar type of music. Thus, passive acculturation as well as explicit music tuition influence our perception and cognition of music.

Adult↗

[Possible mechanism of production of the musical second heart sound and its clinical significance].

To investigate the predisposing factors and the clinical significance of the musical aortic component of the second heart sound (musical S2), 18 patients with musical S2 (musical group) among the consecutive 2,000 patients with phonocardiographic examination were noninvasively studied by analyzing underlying diseases, phonocardiographic findings, organic changes of the aortic valve, severity of aortic regurgitation and left ventricular dysfunction. Organic changes of the aortic valve were assessed by two-dimensional echocardiography, and aortic regurgitation was assessed by color Doppler flow imaging. Twenty-two normal subjects (normal group) and 17 patients with essential hypertension (hypertensive group) served as controls. Mean ages were matched among the three groups. 1. Left ventricular dilatation (seven patients) and hypertension (six patients) were the dominant part of underlying disease in the musical group. 2. Musical S2 was classified in the following two types based on the phonocardiographic characteristics; musical vibrations followed immediately after the accentuated S2, and the S2 which was replaced by regular vibratory waves. 3. Frequency of the musical vibrations ranged from 120 to 200 Hz, and its duration ranged from 60 to 120 msec. Amplitude of the musical vibrations decreased by inhalation of amyl nitrite, but increased by infusion of methoxamine. In a case with mild rheumatic valve disease, methoxamine induced marked intensification of the amplitude and prolongation of the duration of the musical vibrations, finally giving a typical cooing murmur. 4. Echo intensity of the aortic valve tended to be higher in the musical group than in the other two groups. 5. Echocardiographically, aortic regurgitation appeared more frequently in the musical group (88%) than in the normal (36%) and hypertensive (41%) groups. Area of the aortic regurgitant signal was significantly larger in the musical group (4.1 +/- 1.4 cm2) than in the normal (1.2 +/- 0.8 cm2) and hypertensive (2.3 +/- 1.2 cm2) groups. 6. Left ventricular end-diastolic dimension was significantly larger in the musical group (5.8 +/- 0.6 cm) than in the normal (4.7 +/- 0.5 cm) and hypertensive (4.8 +/- 0.7 cm) groups. Fractional shortening of the left ventricle was significantly smaller in the musical group (26 +/- 10%) than in the normal (37 +/- 5%) and hypertensive (37 +/- 8%) groups. In a case of the musical group, musical vibrations following the S2, which was large in amplitude at the state of heart failure, decreased markedly after the recovery from heart failure.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗