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PubMed2005

EMBASE search strategies for identifying methodologically sound diagnostic studies for use by clinicians and researchers.

BACKGROUND: Accurate diagnosis by clinicians is the cornerstone of decision making for recommending clinical interventions. The current best evidence from research concerning diagnostic tests changes unpredictably as science advances. Both clinicians and researchers need dependable access to published evidence concerning diagnostic accuracy. Bibliographic databases such as EMBASE provide the most widely available entrée to this literature. The objective of this study was to develop search strategies that optimize the retrieval of methodologically sound diagnostic studies from EMBASE for use by clinicians. METHODS: An analytic survey was conducted, comparing hand searches of 55 journals with retrievals from EMBASE for 4,843 candidate search terms and 6,574 combinations. All articles were rated using purpose and quality indicators, and clinically relevant diagnostic accuracy articles were categorized as 'pass' or 'fail' according to explicit criteria for scientific merit. Candidate search strategies were run in EMBASE, the retrievals being compared with the hand search data. The proposed search strategies were treated as "diagnostic tests" for sound studies and the manual review of the literature was treated as the "gold standard." The sensitivity, specificity, precision and accuracy of the search strategies were calculated. RESULTS: Of the 433 articles about diagnostic tests, 97 (22.4%) met basic criteria for scientific merit. Combinations of search terms reached peak sensitivities of 100% with specificity at 70.4%. Compared with best single terms, best multiple terms increased sensitivity for sound studies by 8.2% (absolute increase), but decreased specificity (absolute decrease 6%) when sensitivity was maximized. When terms were combined to maximize specificity, the single term "specificity.tw." (specificity of 98.2%) outperformed combinations of terms. CONCLUSION: Empirically derived search strategies combining indexing terms and textwords can achieve high sensitivity and specificity for retrieving sound diagnostic studies from EMBASE. These search filters will enhance the searching efforts of clinicians.

Abstracting and Indexing↗
PubMed2006

Look-alike, sound-alike oncology medications.

Confusing medication names and packaging may cause or contribute to potentially harmful medication errors. The names of several chemotherapy and supportive agents can look or sound like the names of other chemotherapy agents or unrelated medications and can be inadvertently interchanged, or mixed up. Poor handwriting, abbreviations of medication names, unclear verbal medication orders, memory lapses, and the large volume of medications currently in use are risk factors for look-alike, sound-alike medication errors. Risk reduction strategies include being aware of medications that look or sound like other medications, installing pop-up alerts in computer systems, prescribing medications by their generic and trade names, placing eye-catching labels and warning stickers on storage bins, storing medications in nonadjacent areas, and advising patients to be alert for potential mix-ups with look-alike, sound-alike medications.

Abbreviations as Topic↗
PubMed1992

Quantitative computer analysis of the sounds of isolated motor unit action potentials.

To develop quantitative measures of motor unit action potential (MUAP) sounds, we correlated Fourier domain features of isolated, individual MUAPs with classic time domain measurements. There were moderate correlations between amplitude or duration measurements, and absolute low-frequency (39 to 234 Hz) energy and amplitude of the peak frequency, and high correlations between the composite time domain feature of amplitude x duration, and total energy, amplitude of the peak frequency, and absolute low-frequency energy. Polyphasic potentials have multiple peaks in the magnitude component of the Fourier transform. Phase information appears to convey the "crisp" sound of MUAPs close to the recording electrode. The clinical description of "large" or "small" MUAPs by sound is likely based on absolute low-frequency energy, and incorporates both amplitude and duration information. We conclude that features of isolated MUAPs may be analyzed in the Fourier domain, and that they correlate closely with traditionally used measures of known diagnostic significance. The sound of the EMG used by clinical electromyographers is amenable to quantitative analysis.

Action Potentials↗
PubMed1999

Transduction of mechanical energy into sound energy in the cicada cyclochila australasiae

The anatomy of the paired tymbal muscles of Cyclochila australasiae was described. Force-distance relationships of the sound-producing in-out cycle of tymbal movement were measured. The largest forces were measured when the push occurred at the apodeme pit on the tymbal plate at angles similar to the angles of internal pull of the tymbal muscle. Initially, inward movement was opposed by the elasticity of the tymbal, which stored energy. At a mean force of 0. 38 N after a mean inward strain of 368 microm, the tymbal ribs buckled, the mean energy release being 45.1 microJ. The energy release occurred over 2-10 ms in three or four sound-producing steps as successive tymbal ribs buckled inwards. After the ribs had buckled, the force decreased to a mean value of 0.17 N. The force returned to zero during the outward movement, during which the tymbal ribs buckled outwards. The mean energy dissipated in the outward movement was 32.8 microJ. During contraction, the tymbal muscle produced mean values for the peak active force of 0.31 N over 295 microm, which gave mean values for the area of the work loops of 47.0 microJ. The calling song of C. australasiae had a mean pulse rate of 234 Hz (117 Hz for each side of the insect). The peak power to mean power ratio for the songs was 8.51:1 (+9.30 dB). Measurements of the sound field around tethered insects and of the peak power to mean power ratio of the songs gave values for the mean power of the song of 3.15-7 mW; these correspond to an energy per song pulse of 13.5-30 microJ. Previously reported mean values are 3. 15 mW for protest song and 5.1 mW for calling song. The efficiency of transduction of mechanical energy into sound energy is between 18 and 46 %.

Journal Article↗
PubMed2003

Distraction therapy with nature sights and sounds reduces pain during flexible bronchoscopy: a complementary approach to routine analgesia.

STUDY OBJECTIVES: To determine whether distraction therapy with nature sights and sounds during flexible bronchoscopy (FB) reduces pain and anxiety. DESIGN: Randomized controlled trial. SETTING: Teaching hospital in Baltimore, MD. PATIENTS: Consecutive adult patients (n = 80) undergoing FB with conscious sedation. INTERVENTION: Nature scene murals were placed at the bedside, and patients were provided a tape of nature sounds to listen to before, during, and after the procedure. Patients assigned to the control group were not offered either the nature scene or the sounds. MEASUREMENTS AND RESULTS: The primary outcomes were patient ratings of pain control (a 5-point scale ranging from poor to excellent) and anxiety. In a multivariate ordinal logistic regression model, the odds of better pain control were greater in the intervention patients than in the control patients (odds ratio [OR], 4.76; 95% confidence interval [CI], 1.35 to 16.7), after adjustment for age, gender, race, education, health status, and dose of narcotic medication. Older patients and patients with better health status reported significantly less pain. There was no difference in patient-reported anxiety between the two groups (OR, 0.87; 95% CI, 0.39 to 1.96). CONCLUSIONS: Distraction therapy with nature sights and sounds significantly reduces pain in patients undergoing FB. Although the precise mechanism of this beneficial effect requires further investigation, clinicians should consider this nonintrusive strategy in addition to standard analgesic medications in patients undergoing painful, invasive procedures.

Adult↗
PubMed2004

GABA( A) synapses shape neuronal responses to sound intensity in the inferior colliculus.

Neurons in the inferior colliculus (IC) change their firing rates with sound pressure level. Some neurons maintain monotonic increases in firing rate over a wide range of sound intensities, whereas other neurons are monotonic over limited intensity ranges. We examined the conditions necessary for monotonicity in this nucleus in vitro in rat brain slices and in vivo in the unanesthetized rabbit. Our in vitro recordings indicate that concurrent activation of GABA(A) synapses with excitatory inputs facilitates monotonic increases in firing rate with increases in stimulus strength. In the absence of synaptic inhibition, excitatory input to IC neurons causes large depolarizations that result in firing block and nonmonotonicity. In vivo, although GABA(A) synapses decrease the firing rate in all IC neurons, they can have opposing effects on rate-level functions. GABAergic inputs activated by all sound intensities maintain monotonicity by keeping the postsynaptic potential below the level at which depolarization block occurs. When these inputs are blocked, firing block can occur and rate-level functions become nonmonotonic. High-threshold GABAergic inputs, in contrast, cause nonmonotonic responses by decreasing the firing rate at high intensities. Our results suggest that a dynamic regulation of the postsynaptic membrane potential by synaptic inhibition is necessary to allow neurons to respond monotonically to a wide range of sound intensities.

Animals↗
PubMed1992

Effect of glossopexy on speech sound production in Robin sequence.

The management of Robin sequence may include glossopexy, in which the tongue is attached to the lower lip and mandible for anterior lingual positioning to resolve upper airway obstruction. The procedure is performed early in infancy and reversed at the time of palatal repair near 1 year of age. This period is critical to prespeech vocalization. The effect of glossopexy on speech sound production was investigated in 17 children with Robin sequence who had glossopexies. Analysis suggested that glossopexy may temporarily affect the development of prespeech skills and sound production. The onset of babbling and initiation of first words was often delayed in the subjects in comparison with syndrome-matched children who had not undergone glossopexy. Tongue-tip sounds were often produced with the tongue blade, but production was perceptually normal. The early delays were temporary and the only long-term effect of glossopexy was a tendency to produce tongue-tip sounds with the tongue blade.

Airway Obstruction↗
PubMed1975

Acoustical studies on respiratory sounds in asthmatic patients.

Changes in the breathing sounds such as stridor and dry and wet rales in asthmatic patients were studied. The breathing sounds were recorded with the small transistor warp type microphone inserted through the nasal orifice into the trachea, main bronchi and segmental bronchi, and were analyzed with sound analyzer. The results were as follows: The whistling rales were caused by the resonance of the bronchial wall, when the vibrating frequency was coincident with its specific frequency. Snoring rales were explained as the sound caused by the air flow passing promptly through contracted bronchi with little secretion. Resonance of either bronchial wall or highly viscous sputum was considered to be responsible for the sonorous rales. Sibilant rales were audible when bronchi promptly repeated dilation and contraction. Stridor was picked up at the upper part of the air tract, from the main bronchus to the trachea, and noise was the main component on the sonogram, presumably caused by the air turbulence due to the narrowing and deformity of bronchial tube or to the sputum adhering to the inner surface of the air tract.

Adolescent↗
PubMed2005

Persistent organic pollutants in the diet of harbor seals (Phoca vitulina) inhabiting Puget Sound, Washington (USA), and the Strait of Georgia, British Columbia (Canada): a food basket approach.

Harbor seals (Phoca vitulina) inhabiting Puget Sound (WA, USA) recently were found to be seven times more contaminated with polychlorinated biphenyls (PCBs) than those inhabiting the adjacent Strait of Georgia (BC, Canada). We carried out a food basket approach to approximate realistic dietary exposures of both new (e.g., polybrominated diphenyl ethers [PBDEs]) and legacy (e.g., dichlorodiphenyltrichloroethane [DDT]) persistent organic pollutants (POPs) for these harbor seals. Food basket homogenates, each consisting of over 200 individual prey items, were constructed using documented dietary preferences for harbor seals in these basins, and analyzed for organochlorine pesticides, flame retardants, and other persistent contaminants. Concentration rankings for the major contaminant classes in the Puget Sound food basket were sigmaPCBs > sigmaPBDEs > sigmaDDT, and for the Strait of Georgia food basket were sigmaPCBs > sigmaDDT > sigmaPBDEs, highlighting the emergence of PBDEs as a significant concern in the regional environment. Consistent with observations in harbor seals, PCB concentrations in the Puget Sound food basket were seven times higher than in its Strait of Georgia counterpart. Based on our food basket results, the estimated daily intake of sigmaPCB toxic equivalents to dioxin by Puget Sound harbor seals exceeds some wildlife consumption guidelines for PCBs. Our results indicate that both legacy and new POPs present a health risk to these marine mammals.

Animals↗
PubMed1991

Sounding depth measurements: a method for evaluating various surgical techniques.

Fourteen patients undergoing periodontal treatment for moderate to severe adult-type periodontitis were included in the study. Seven patients (a total of 210 sites) were treated with modified Widman flap surgery while the other 7 patients (the same number of sites) were treated with apically-positioned flap surgery. The 2 modalities were compared using sounding depth measurements before and immediately after surgery. The mean sounding depth decreased from 4.89 mm to 3.42 mm in the modified Widman flap group, compared to a drop from 4.77 mm to 2.46 mm in the apically-positioned flap group. Neither of these procedures resulted in the total eradication of all periodontal pockets. The final outcome of modified Widman flap surgery may, at times, result in zero sounding depth (placement of the flap at the crest of the bone); on the other hand, very often the flap was placed far supra-crestally in an intended apically-positioned flap procedure. This lack of consistency between intended and actual flap placement would suggest that studies which try to compare different treatment modalities using a flap approach should include sounding depth measurements immediately post-surgery. This is needed to assure that the intended procedure has actually been carried out.

Alveolar Process↗
PubMed1990

[Relation between articulatory function and prosthesis. I-1. Longitudinal changing aspects in the duration of speech sound, muscular discharge of facial muscle and tongue pressure before pronunciation caused by the experimental palatal plate].

The author noticed the relation between articulatory functions and the prosthesis. For the purpose of clarifying the influence of the insertion of denture on the duration of speech sound and the articulatory functions before pronunciation and on the self-compensation of these organs. The experimental palatal plates were inserted on 13 subjects with natural dentition, assuming that they were inserted with complete denture, and the duration of speech sound, muscular discharge of facial muscle and tongue pressure before pronunciation were evaluated longitudinally with the pre-insertion of palatal plate as basis. As the result of this study, the following conclusions were obtained. The results of this study suggest that speech sound, lips and tongue being important organs as the articulators are placed under strong influence before pronunciation by insertion of the denture, whereas on the self-compensation of the articulators before pronunciation differed according to the point of articulation and the manner of articulation of each speech sound. Therefore, it was necessary to take care on the relation between the shape of palatal plate and the articulatory functions of lips and tongue in the clinical prosthodontics.

Articulation Disorders↗
PubMed1989

Relationship between two nontraditional procedures for assessing speech-sound discrimination.

Test of speech-sound discrimination are used by special educators, reading specialists and speech-language pathologists in assessing children's ability to differentiate between speech sounds occurring in standard English. Such tests are important in determining if speech-sound articulation errors are caused by difficulty in making such differentiations. However, during the past 10 years, these tests have been criticized on the basis of their reliability and validity. The purpose of this study was to examine the use of two alternative methods of assessing speech-sound discrimination with a school-aged population to determine if they elicited responses in a similar manner.

Child↗
PubMed1999

Masking of complex sound--technical notes for realization of constant signal-noise-ratio.

Based on findings regarding unconscious semantic information-processing for meaningful visual stimuli, this paper describes a standardized procedure for the construction of constant signal to noise ratio for the masking of complex sounds. The proposed algorithm is derived from psychoacoustical laws concerning frequency and time-weighting of sound. Spectral characteristics are taken into account by mixing signal and white noise within frequency ranges defined through critical bandwidth ("narrow-band masking"). Furthermore, time-weighting is taken into account using sound-pressure patterns generated through low pass filters which follow the international specification DIN IEC 651 which provides specification for sound-level meters. Hardware and software circuits are described in detail. This proposal overcomes recognized lack of standardized methods in studies addressing unconscious semantic processing of auditory stimuli.

Acoustic Stimulation↗
PubMed2003

The emotional symbolism of two English e-sounds: /i/ as in "cheap" is pleasant and /I/ as in "chip" active.

This article aligns the symbolism of the long (/i/) and short (/I/) e sounds in English with the two dimensions of emotional space-Pleasantness and Activation. On the basis of this alignment, the four quadrants of emotional space are labelled Cheerful (high /i/, high /I/), Cheerless (low /i/, low /I/), Tough (low /i/, high /I/), and Tender (high /i/, low /I/). In four phases, data from over 50 samples (mainly, poetry, song lyrics, and names) were plotted and compared in terms of their use of the two e sounds. Significant and meaningful differences among samples were discovered in all phases. The placement of samples in quadrants was additionally informative. Data samples including many long e sounds (/i/) tended to be more Pleasant and those including many short e sounds (/I/) tended to be more Active.

Emotions↗
PubMed1981

Phosphorus in swine. V. Interrelationships of various feedlot performance, serum minerals, structural soundness and bone parameters in barrows, boars and gilts.

Daily gain, daily feed intake, feed per unit of gain, serum Ca, serum P, serum Mg, structural soundness scores, foot pad scores, metacarpal breaking force and metacarpal ash values from five Ca P trials with barrows, gilts or boars were subjected by sex in each trial to multivariate analysis of variance. Correlation coefficients were obtained from the residual sums of squares and sum of products; thus, coefficients were corrected for treatment effects. Individual values were used for all comparisons except those involving daily feed and feed/gain, for which pen means were used. High positive correlations were observed between daily gain and daily feed; there was no relationship between daily gain and feed/gain, but daily feed was positively correlated with feed/gain. Serum Ca levels were not highly correlated with daily gain, daily feed or feed/gain. Although all coefficients were less than .5, serum P was positively (P less than .01 or less than .05) related to daily gain. Serum Ca and serum Mg concentrations were unrelated to serum P concentrations, but serum Ca was positively correlated with serum Mg. There was no relationship between daily gain and soundness or pad scores. Although there were some inconsistencies, a positive relationship was observed between daily gain and metacarpal dried weight, and between daily gain and breaking strength. There appeared to be little, if any, relationship between daily feed and feed/gain and bone parameters. Ca, P and Mg were not consistently related to metacarpal dried weight, breaking strength or ash. Dried weight was positively correlated to breaking strength in four trials and to ash in two trials. Breaking strength was correlated to ash in only one trial. These results offer no support for the belief that stronger, denser bones produce more structurally sound animals, because soundness and pad scores were not related to bone parameters.

Animals↗
PubMed1983

Restricted energy intake and elevated calcium and phosphorus intake for gilts during growth. III. Characterization of feet and limbs and soundness scores of sows during three parities.

Gilts that had previously been fed ad libitum or 75% ad libitum intake and 100 or 150% National Research Council recommended daily Ca and P from weaning to 100 kg were used in a reproductive study in which a 14% protein diet was fed. Foot and leg measurements, subjective toe scores and structural soundness scores were taken at each of three parities, 21 d postweaning. Sows previously ad libitum-fed generally had larger front toes than limit-fed sows; whereas, hind toes were larger for sows previously fed 150% Ca and P levels than sows fed 100% Ca and P. Sows previously fed the ad libitum-150% Ca and P diet had the largest toes. Front inside toes were larger than hind inside toes, but the reverse was observed for front and hind outside toes, with the magnitude of the difference between the inside and outside toes greater for the hind foot. Toe size increased over parities with the greatest increase from parity 2 to 3. Incidence and severity of toe pad and horn scores were generally unaffected by previously fed energy and Ca and P levels and were not correlated to toe size. Hind feet exhibited a larger number of lesions than front feet and outside toes exhibited a larger number of lesions than inside toes, with the hind outside toe exhibiting the greatest number of lesions. In general, incidence and severity of toe lesions decreased or were unchanged from parity 1 to 3. Structural soundness scores were unaffected by previously fed energy or Ca and P levels, but were quadratically affected by parity, with a small increase (poorer) from parity 1 to 2 and a large improvement from parity 2 to 3. Soundness scores were not related to any of the feet or leg measurements and characteristics. Restricting growth rate and feeding elevated Ca and P levels during growth had no effect on incidence and severity of lesions on the toes and overall structural soundness of sows kept for three parities.

Animals↗
PubMed1983

Restricted energy intake and elevated calcium and phosphorus intake for boars during growth. II. Foot and leg measurements and toe and soundness scores.

Boars were assigned at 5 wk of age in a 2 X 2 factorial arrangement to two energy (ad libitum and 75% of ad libitum) and two Ca and P levels (100 and 150% of the National Research Council daily recommended amounts) to determine the effect of reduced growth rate and elevated Ca and P intake on foot and leg measurements, pad and horn incidence and severity of lesions, and structural soundness. There were 20 boars/treatment; 15 boars from each treatment were necropsied at 10 +/- 2-d intervals from 80 to 220 d of age (45 to 185 d on test), with the remaining five boars in each treatment being necropsied at 220 d of age. Feet and leg measurements were taken and toe pads and horns were scored initially and after 78 and 131 d on when necropsied. Boars remaining after 130 d on test were scored for overall structural soundness. Toe size and circumference and length of limbs increased as boars grew, with larger values for ad libitum-fed compared with limit-fed boars when observed at a constant age. However, when these values were corrected for body weight, the effect of energy was generally removed and, in some cases, reversed. Limit-fed boars appeared to have fewer pad and horn lesions, but the effects were inconsistent. In general, Ca and P levels had little or no effect on toe and limb sizes and pad and horn lesion scores, whether or not the values were expressed on a constant age or corrected body weight basis. A comparison of inside and outside toes on the front and hind feet revealed that outside toes were larger than inside toes, with the magnitude of the difference much larger for the hind foot than for the front foot. The hind inside toes had fewer pad and horn lesions. Structural soundness scores were more desirable in ad libitum-fed compared with limit-fed boars; but, elevated Ca and P levels had no effect. Thus, these data do not support a hypothesis that structural soundness can be improved by reducing the growth rate of developing boars or by feeding an elevated level of Ca and P.

Animals↗
PubMedDate not supplied

Effect of loud sound exposure on the cochlear blood flow.

The effect of loud sound exposure on cochlear blood flow was studied in the guinea pig by the laser Doppler method. Fourteen guinea pigs with normal Preyer reflex were anesthetized and tracheotomy was performed. A tracheotomy tube was connected to a ventilator and the experiment was performed with artificial ventilation. After exposure of the tympanic bulla and complete removal of the mucosa, a probe of a laser Doppler flowmeter was attached to the lateral wall of the basal turn of the cochlea. A specially-designed ear piece connected with a speaker was inserted into the external ear canal and loud sound (10 kHz at 120 dB SPL) was delivered to the ear for 30 min. Thirteen of the 14 exposed guinea pigs showed a prompt decrease in cochlear blood flow at the onset of the sound exposure and 12 of the 13 guinea pigs showed a prompt recovery of the cochlear blood flow after the cessation of the sound exposure.

Acoustic Stimulation↗