Influence of classroom acoustics on the vocal behavior of teacers

Erroneous vocal behavior of teachers and their changes in the voice production due to poor acoustics in classrooms can be investigated through recently developed voice-monitoring devices. These devices are portable analyzers that use a miniature contact-microphone glued to the jugular notch in order to sense the skin acceleration level due to the vibration of the vocal folds. They estimate the Sound Pressure Level (SPL) at a certain distance from the speaker's mouth provided that a preliminary calibration procedure is performed, the fundamental frequency and the time dose. Two different devices are compared in this work: the former is a commercial device, whose phonation sensor is a small accelerometer; the latter, recently developed by the authors, uses an electret condenser microphone to sense the skin acceleration level. SPL and fundamental frequency are estimated over fixed-length frames and the results that refer to a sample of 25 primary school teachers and a university professor are analyzed. The duration of the voice and pause periods is investigated in order to detect the peaks of occurrence and accumulation in different conditions of reverberation. A method for the detection and analysis of the emphatic speech is also propose

Duration of voicing and silence periods of continuous speech in different acoustic environments

This work deals with the duration of voicing and silence periods of continuous speech in rooms with very different reverberation times (RTs). Measurements were conducted using the Ambulatory Phonation Monitoring (APM) 3200 (Kaypentax) and Voice-Care devices (developed at the Politecnico di Torino, Italy), both of which have a contact microphone placed on the base of the neck to detect skin vibrations during phonation. Six university professors and 22 university students made short laboratory monologs in which they explained something that they knew well to a listener 6m away. Seven students also described a map with the intention of correctly explaining directions to a listener who drew the path on a blank chart. Longer speech samples were made by primary school teachers in classrooms. A tendency to increase the voicing periods as the RT increased was on average observed for the university professors, the school teachers, and the university students who described a map. These students also showed longer silence periods than the students who made short monologues. The recognized trends concerned voice professionals or subjects who were highly motivated to make themselves understood in a perturbed speaking situation. Nonparametric statistical tests, which were applied to detect the differences in distributions of voicing and silence periods, have basically supported the findings

Targeting cyclin-dependent kinases in sarcoma treatment: Current perspectives and future directions

Effective treatment of advanced/metastatic bone and soft tissue sarcomas still represents an unmet medical need. Recent advances in targeted therapies have highlighted the potential of cyclin-dependent kinases (CDK) inhibitors in several cancer types, including sarcomas. CDKs are master regulators of the cell cycle; their dysregulation is listed among the “hallmarks of cancer” and sarcomas are no exception to the rule. In this review, we report both the molecular basis, and the potential therapeutic implications for the use of CDK inhibitors in sarcoma treatment. What is more, we describe and discuss the possibility and biological rationale for combination therapies with conventional treatments, target therapy and immunotherapy, highlighting potential avenues for future research to integrate CDK inhibition in sarcoma treatment

A low-cost portable vocal analyser for long-term monitoring and clinical investigation

A low-cost portable device has been developed at Politecnico di Torino to provide traceable measurements of vocal parameters during long-term monitoring as well as short ambulatory tests. The device, named Voice Care, is based on a contact microphone that is attached to the jugular notch of the subject under monitoring and on a wearable data acquisition unit that stores the raw samples of the signal generated by the vocal folds’ vibration. Post processing algorithms have been assessed to evaluate the vocal effort and the vocal load that voice professionals are subjected to during their daily activity, estimating the parameters sound pressure level, fundamental frequency and phonation time percentage. Other investigations are related to the length of voiced and unvoiced frames, whose distribution are dependent on the acoustic characteristics of the environment where the voice monitoring takes place. Another application of the Voice Care is related to short-term ambulatory tests, which allows the cooperation with physicians to make the device a reliable diagnostic tool. Processing algorithms have been extended to estimate other parameters, such as jitter, shimmer and voice quality indexes, that allow the phonatory status of the subject under monitoring to be evaluated. An experimental campaign has been performed involving thirty teachers in four primary schools who have been monitored for two to four days across one week of teaching. The effectiveness of the proposed device has been shown by the obtained results, which were in good agreement with the subjective impression and the classroom acoustics. Other specific tests have been performed in very different acoustic environments (anechoic, reverberant and semi- reverberant chambers) to highlight the device capability in evaluating the environment effects on the vocal production. Ambulatory tests for the optimization of the Voice Care as a diagnostic tool are planned to be carried out soon

Bevacizumab plus XELOX as first-line treatment of metastatic colorectal cancer: The OBELIX study

AIM: To confirm the efficacy and safety of bevacizumab/XELOX combination for the treatment of locally advanced or metastatic colorectal cancer (CRC) in Italy. METHODS: This multicentric, prospective, open-label study included patients with CRC previously untreated with chemotherapy. Patients were administered bevacizumab in combination with XELOX. The primary efficacy end-point was progression-free survival (PFS). Secondary end-points included time to overall response (TOR), duration of response (DOR), time to treatment failure (TTF) and overall survival (OS). The incidence and type of adverse events AEs and severe AEs were evaluated. Also, the mutational status of BRAF and KRAS was assessed by high resolution melting and direct sequencing, and quality of life (QoL) was measured by the EuroQoL EQ-5D questionnaire at baseline and at the last visit. RESULTS: The intention-to-treat population included 197 patients (mean age: 62.3 ± 9.9 years, 56.4% males). At baseline, 16/34 evaluable subjects (47.1%) harbored a KRAS and/or a BRAF mutation; the mean QoL index was 80.2 ± 14.3. First-line therapy was given for 223.7 ± 175.9 d, and after a mean follow-up of 387.7 ± 238.8 d all patients discontinued from the study mainly for disease progression (PD, 45.4%) and AEs (25.4%). Median PFS was 9.7 mo (95%CI: 8.4-10.5) and the median values for secondary end-points were: TOR = 3.9 mo (95%CI: 2.6-4.7), DOR = 8.5 mo (95%CI: 7.3-10.3), TTF = 6.7 mo (95%CI: 6.0-7.7) and OS = 23.2 mo (95%CI: 20.1-27.2). Patients carrying at least one lesion had a lower overall response rate (66.7% vs 88.9%) and a lower probability of achieving complete or partial response than those without mutations, but the difference in relative risk was not statistically significant (P = 0.2). Mean EQ-5D-3L raw index score significantly decreased to 74.9 ± 19.1 at the last visit (signed-rank test, P = 0.0076), but in general the evaluation on QoL perceived by patients was good. CONCLUSION: The efficacy of bevacizumab in combination with XELOX in terms of PFS in patients with aCRC or mCRC in Italy was confirmed, with acceptable toxicity

Advances in Quercus ilex L. breeding: the CRISPR/Cas9 technology via ribonucleoproteins

The CRISPR/Cas9 ribonucleoprotein (RNP)-mediated technology represents a fascinating tool for modifying gene expression or mutagenesis as this system allows for obtaining transgene-free plants, avoiding exogenous DNA integration. Holm oak (Quercus ilex) has an important social, economic, and ecological role in the Mediterranean climate zones of Western Europe and North Africa and is severely affected by oak decline syndrome. Here we report the first example of the application of the CRISPR/Cas9-RNP technology in holm oak. Firstly, we evaluated the protoplast isolation from both in vitro leaves and proembryogenic masses. Proembryogenic masses represented the best material to get high protoplast yield (11 x 106 protoplasts/ml) and viability. Secondly, the protoplast transfection ability was evaluated through a vector expressing green fluorescence protein as marker gene of transfection, reaching a transfection percentage of 62% after 24 hours. CRISPR/Cas9 RNPs were successfully delivered into protoplasts resulting in 5.6% ± 0.5% editing efficiency at phytoene desaturase (pds) target genomic region. Protoplasts were then cultured in semisolid media and, after 45 days in culture, developed embryogenic calli were observed in a Murashige and Skoog media with half concentration of NH4NO3 and KNO3 supplemented with 0.1 mg/L benzylaminopurine and 0.1 mg/L 2,4-dichlorophenoxyacetic acid

Adherence to recommendations by infectious disease consultants and its influence on outcomes of intravenous antibiotic-treated hospitalized patients

BACKGROUND: Consultation to infectious diseases specialists (ID), although not always performed by treating physicians, is part of hospital's daily practice. This study analyses adherence by treating physicians to written ID recommendations (inserted in clinical records) and its effect on outcome in hospitalized antibiotic-treated patients in a tertiary hospital in Spain. METHODS: A prospective, randomized, one-year study was performed. Patients receiving intravenous antimicrobial therapy prescribed by treating physicians for 3 days were identified and randomised to intervention (insertion of written ID recommendations in clinical records) or non-intervention. Appropriateness of empirical treatments (by treating physicians) was classified as adequate, inadequate or unnecessary. In the intervention group, adherence to recommendations was classified as complete, partial or non-adherence. RESULTS: A total of 1173 patients were included, 602 in the non-intervention and 571 in the intervention group [199 (34.9%) showing complete adherence, 141 (24.7%) partial adherence and 231 (40.5%) non-adherence to recommendations]. In the multivariate analysis for adherence (R2 Cox=0.065, p=0.009), non-adherence was associated with prolonged antibiotic prophylaxis (p=0.004; OR=0.37, 95%CI=0.19-0.72). In the multivariate analysis for clinical failure (R2 Cox=0.126, p<0.001), Charlson index (p<0.001; OR=1.19, 95%CI=1.10-1.28), malnutrition (p=0.006; OR=2.00, 95%CI=1.22-3.26), nosocomial infection (p<0.001; OR=4.12, 95%CI=2.27-7.48) and length of hospitalization (p<0.001; OR=1.01, 95%CI=1.01-1.02) were positively associated with failure, while complete adherence (p=0.001; OR=0.35, 95%CI=0.19-0.64) and adequate initial treatment (p=0.010; OR=0.39, 95%CI=0.19-0.80) were negatively associated. CONCLUSIONS: Adherence to ID recommendations by treating physicians was associated with favorable outcome, in turn associated with shortened length of hospitalization. This may have important health-economic benefits and stimulates further investigation. TRIAL REGISTRATION: Current Controlled Trials ISRCTN83234896. http://www.controlled-trials.com/isrctn/sample_documentation.asp

Durata dei periodi di voce e di pausa nel parlato continuo in diverse condizioni di riverberazione per professionisti e non professionisti della voce

L’utilizzo prolungato della voce in ambienti lavorativi dalle pessime caratteristiche acustiche comporta un uso non corretto dell’apparato fonatorio che determina fatica vocale. L'obiettivo della ricerca è quello di indagare oggettivamente la fatica vocale attraverso differenze nel comportamento vocale in diverse condizioni di riverberazione. L’analisi ha riguardato professionisti e non professionisti della voce e si è focalizzata sulla durata dei periodi di voce e di pausa nel parlato continuo. Sono stati eseguiti monitoraggi di 5 minuti utilizzando il dispositivo Voice Care®, sviluppato al Politecnico di Torino, nei laboratori della London South Bank University su 5 docenti inglesi, e all’INRiM di Torino su 9 studenti italiani. I soggetti parlavano di argomenti conosciuti ad un ascoltatore posto a 6 m di distanza. Per i professionisti della voce la massima occorrenza dei periodi di voce si sposta su periodi più lunghi con l’incremento della riverberazione, con conseguente aumento della fatica vocale, rilevata percettivamente