Local thermal equilibrium and ideal gas Stephani universes

The Stephani universes that can be interpreted as an ideal gas evolving in local thermal equilibrium are determined. Five classes of thermodynamic schemes are admissible, which give rise to five classes of regular models and three classes of singular models. No Stephani universes exist representing an exact solution to a classical ideal gas (one for which the internal energy is proportional to the temperature). But some Stephani universes may approximate a classical ideal gas at first order in the temperature: all of them are obtained. Finally, some features about the physical behavior of the models are pointed out.Comment: 20 page

Functional anatomy of the masking level difference, an fMRI study

Introduction: Masking level differences (MLDs) are differences in the hearing threshold for the detection of a signal presented in a noise background, where either the phase of the signal or noise is reversed between ears. We use N0/Nπ to denote noise presented in-phase/out-of-phase between ears and S0/Sπ to denote a 500 Hz sine wave signal as in/out-of-phase. Signal detection level for the noise/signal combinations N0Sπ and NπS0 is typically 10-20 dB better than for N0S0. All combinations have the same spectrum, level, and duration of both the signal and the noise. Methods: Ten participants (5 female), age: 22-43, with N0Sπ-N0S0 MLDs greater than 10 dB, were imaged using a sparse BOLD fMRI sequence, with a 9 second gap (1 second quiet preceding stimuli). Band-pass (400-600 Hz) noise and an enveloped signal (.25 second tone burst, 50% duty-cycle) were used to create the stimuli. Brain maps of statistically significant regions were formed from a second-level analysis using SPM5. Results: The contrast NπS0- N0Sπ had significant regions of activation in the right pulvinar, corpus callosum, and insula bilaterally. The left inferior frontal gyrus had significant activation for contrasts N0Sπ-N0S0 and NπS0-N0S0. The contrast N0S0-N0Sπ revealed a region in the right insula, and the contrast N0S0-NπS0 had a region of significance in the left insula. Conclusion: Our results extend the view that the thalamus acts as a gating mechanism to enable dichotic listening, and suggest that MLD processing is accomplished through thalamic communication with the insula, which communicate across the corpus callosum to either enhance or diminish the binaural signal (depending on the MLD condition). The audibility improvement of the signal with both MLD conditions is likely reflected by activation in the left inferior frontal gyrus, a late stage in the what/where model of auditory processing. © 2012 Wack et al

Effects and feasibility of a multi-disciplinary orientation program for newly registered cancer patients: design of a randomised controlled trial

Background Diagnosis and treatment of cancer can contribute to psychological distress and anxiety amongst patients. Evidence indicates that information giving can be beneficial in reducing patient anxiety, so oncology specific information may have a major impact on this patient group. This study investigates the effects of an orientation program on levels of anxiety and self-efficacy amongst newly registered cancer patients who are about to undergo chemotherapy and/or radiation therapy in the cancer care centre of a large tertiary Australian hospital. Methods The concept of interventions for orienting new cancer patients needs revisiting due to the dynamic health care system. Historically, most orientation programs at this cancer centre were conducted by one nurse. A randomised controlled trial has been designed to test the effectiveness of an orientation program with bundled interventions; a face-to-face program which includes introduction to the hospital facilities, introduction to the multi-disciplinary team and an overview of treatment side effects and self care strategies. The aim is to orientate patients to the cancer centre and to meet the health care team. We hypothesize that patients who receive this orientation will experience lower levels of anxiety and distress, and a higher level of self-efficacy. Discussion An orientation program is a common health care service provided by cancer care centres for new cancer patients. Such programs aim to give information to patients at the beginning of their encounter at a cancer care centre. It is clear in the literature that interventions that aim to improve self-efficacy in patients may demonstrate potential improvement in health outcomes. Yet, evidence on the effects of orientation programs for cancer patients on self-efficacy remains scarce, particularly with respect to the use of multidisciplinary team members. This paper presents the design of a randomised controlled trial that will evaluate the effects and feasibility of a multidisciplinary orientation program for new cancer patients

Changes in Body Weight and Psychotropic Drugs: A Systematic Synthesis of the Literature

<div><h3>Introduction</h3><p>Psychotropic medication use is associated with weight gain. While there are studies and reviews comparing weight gain for psychotropics within some classes, clinicians frequently use drugs from different classes to treat psychiatric disorders.</p> <h3>Objective</h3><p>To undertake a systematic review of all classes of psychotropics to provide an all encompassing evidence-based tool that would allow clinicians to determine the risks of weight gain in making both intra-class and interclass choices of psychotropics.</p> <h3>Methodology and Results</h3><p>We developed a novel hierarchical search strategy that made use of systematic reviews that were already available. When such evidence was not available we went on to evaluate randomly controlled trials, followed by cohort and other clinical trials, narrative reviews, and, where necessary, clinical opinion and anecdotal evidence. The data from the publication with the highest level of evidence based on our hierarchical classification was presented. Recommendations from an expert panel supplemented the evidence used to rank these drugs within their respective classes. Approximately 9500 articles were identified in our literature search of which 666 citations were retrieved. We were able to rank most of the psychotropics based on the available evidence and recommendations from subject matter experts. There were few discrepancies between published evidence and the expert panel in ranking these drugs.</p> <h3>Conclusion</h3><p>Potential for weight gain is an important consideration in choice of any psychotropic. This tool will help clinicians select psychotropics on a case-by-case basis in order to minimize the impact of weight gain when making both intra-class and interclass choices.</p> </div

Severe Asthma Standard-of-Care Background Medication Reduction With Benralizumab: ANDHI in Practice Substudy

Background: The phase IIIb, randomized, parallel-group, placebo-controlled ANDHI double-blind (DB) study extended understanding of the efficacy of benralizumab for patients with severe eosinophilic asthma. Patients from ANDHI DB could join the 56-week ANDHI in Practice (IP) single-arm, open-label extension substudy. Objective: Assess potential for standard-of-care background medication reductions while maintaining asthma control with benralizumab. Methods: Following ANDHI DB completion, eligible adults were enrolled in ANDHI IP. After an 8-week run-in with benralizumab, there were 5 visits to potentially reduce background asthma medications for patients achieving and maintaining protocol-defined asthma control with benralizumab. Main outcome measures for non-oral corticosteroid (OCS)-dependent patients were the proportions with at least 1 background medication reduction (ie, lower inhaled corticosteroid dose, background medication discontinuation) and the number of adapted Global Initiative for Asthma (GINA) step reductions at end of treatment (EOT). Main outcomes for OCS-dependent patients were reductions in daily OCS dosage and proportion achieving OCS dosage of 5 mg or lower at EOT. Results: For non-OCS-dependent patients, 53.3% (n = 208 of 390) achieved at least 1 background medication reduction, increasing to 72.6% (n = 130 of 179) for patients who maintained protocol-defined asthma control at EOT. A total of 41.9% (n = 163 of 389) achieved at least 1 adapted GINA step reduction, increasing to 61.8% (n = 110 of 178) for patients with protocol-defined EOT asthma control. At ANDHI IP baseline, OCS dosages were 5 mg or lower for 40.4% (n = 40 of 99) of OCS-dependent patients. Of OCS-dependent patients, 50.5% (n = 50 of 99) eliminated OCS and 74.7% (n = 74 of 99) achieved dosages of 5 mg or lower at EOT. Conclusions: These findings demonstrate benralizumab's ability to improve asthma control, thereby allowing background medication reduction

DEVELOPMENTAL SPEECH PERCEPTION OF THREE ACOUSTIC CUES ASSOCIATED WITH PLACE OF ARTICULATION

The purpose of this research was to study the relationship between age and perception of acoustic cues in 30 normal-language children between five and ten years of age and in 10 adults. To achieve this purpose, four sets of synthetic speech syllables varying along a seven-step, bilabial-to-alveolar place of articulation continuum were created and arranged into three experimental paradigms: discrimination, labeling and adaptation. The major acoustic variable studied was a change in second and third formant frequency (F2, F3) transition trajectory. The effects of length of the F2, F3 transitions as well as the presence or absence of a white noise burst were also studied. Results showed that children\u27s speech perception abilities are different from adults\u27, even at 10 years of age. The adults were shown to have fine discrimination abilities without the need for extensive training. For the discrimination task, children\u27s sensitivity to fine acoustic cues and their response strategies changed developmentally and were most like that of adults in the 9-10-year-old group. The findings also showed that adaptation is age-dependent as adults were the only group to demonstrate a significant adaptation effect with a very small, nonsignificant, developmental pattern evident for children\u27s responses. Further study with nonspeech stimuli is necessary to clarify whether sensitivity or a phonetic response bias was a more important factor for the children\u27s response patterns in the discrimination and adaptation tasks. The results also indicated that normal labeling performance can occur without very fine discrimination as all subjects performed similarly on the labeling task. This tended to support Stevens\u27 (1972) quantal theory of speech perception. The continuum-type effect of lengthened F2-F3 transitions significantly changed discrimination, labeling and adaptation performance while the burst presence only influenced performance in part of the adaptation task. The signal detection approach and the use of the change/no change format in the discrimination task, as well as the use of the adaptation and labeling tasks, were productive in revealing different types of processing used by the different aged subjects

Relationship between acoustic measures and judgments of intelligibility in Parkinson\u27s disease: A within-speaker approach

This study investigated the acoustic basis of within-speaker, across-utterance variation in sentence intelligibility for 12 speakers with dysarthria secondary to Parkinson\u27s disease (PD). Acoustic measures were also obtained for 12 healthy controls for comparison to speakers with PD. Speakers read sentences using their typical speech style. Acoustic measures of speech rate, articulatory rate, fundamental frequency, sound pressure level and F2 interquartile range (F2 IQR) were obtained. A group of listeners judged sentence intelligibility using a computerized visual-analog scale. Relationships between judgments of intelligibility and acoustic measures were determined for individual speakers with PD. Relationships among acoustic measures were also quantified. Although considerable variability was noted, articulatory rate, fundamental frequency and F2 IQR were most frequently associated with within-speaker variation in sentence intelligibility. Results suggest that diversity among speakers with PD should be considered when interpreting results from group analyses