Perceived vocal morbidity in a problem asthma clinic

<p>Aims: Asthma treatment has the potential to affect patients' voices. We undertook detailed characterisation of voice morbidity in patients attending a problem asthma clinic, and we determined how patients' perceptions related to objective assessment by an experienced observer.</p> <p>Methods: Forty-three patients took part in the study. Subjects completed the self-administered voice symptom score (VoiSS) questionnaire and underwent digital voice recording. These voice recordings were scored using the grade–roughness–breathiness–asthenicity–strain system (GRBAS). Laryngoscopy was also performed.</p> <p>Results: The median VoiSS was 26 (range three to 83). VoiSS were significantly lower in the 17 patients with normal laryngeal structure and function (range four to 46; median 22), compared with the 26 patients with functional or structural laryngeal abnormality (range three to 83; median 33) (95 per cent confidence intervals for difference 0.0–21.0; p = 0.044). The overall grade score for the GRBAS scale did not differ between these two groups, and only 13 patients had a GRBAS score of one or more, recognised as indicating a voice problem. There were positive correlations between related GRBAS score and voice symptom score subscales. Although voice symptom scores were significantly more abnormal in patients with structural and functional abnormalities, this score performed only moderately well as a predictive tool (sensitivity 54 per cent; specificity 71 per cent). Nevertheless, the voice symptom score performed as well as the more labour-intensive GRBAS score (sensitivity 57 per cent; specificity 60 per cent). Patients' inhaled corticosteroid dose (median dose 1000 µg beclomethasone dipropionate or equivalent) had a statistically significant relationship with their overall grade score for the GRBAS scale (r = 0.56; p < 0.001), but not with their VoiSS. Only one patient had evidence of laryngeal candidiasis, and only two had any evidence of abnormality suggesting steroid-induced myopathy.</p> <p>Conclusions: Vocal morbidity is common in patients with asthma, and should not be immediately attributed to steroid-related candidiasis. The VoiSS merits further, prospective validation as a screening tool for ENT and/or speech and language therapy referral in patients with asthma.</p&gt

The mean field infinite range p=3 spin glass: equilibrium landscape and correlation time scales

We investigate numerically the dynamical behavior of the mean field 3-spin spin glass model: we study equilibrium dynamics, and compute equilibrium time scales as a function of the system size V. We find that for increasing volumes the time scales $\tau$ increase like $\ln \tau \propto V$. We also present an accurate study of the equilibrium static properties of the system.Comment: 6 pages, 9 figure

Weathering microenvironments on feldspar surfaces: implications for understanding fluid-mineral reactions in soils

The mechanisms by which coatings develop on weathered grain surfaces, and their potential impact on rates of fluid-mineral interaction, have been investigated by examining feldspars from a 1.1 ky old soil in the Glen Feshie chronosequence, Scottish highlands. Using the focused ion beam technique, electron-transparent foils for characterization by transmission electron microscopy were cut from selected parts of grain surfaces. Some parts were bare whereas others had accumulations, a few micrometres thick, of weathering products, often mixed with mineral and microbial debris. Feldspar exposed at bare grain surfaces is crystalline throughout and so there is no evidence for the presence of the amorphous 'leached layers' that typically form in acid-dissolution experiments and have been described from some natural weathering contexts. The weathering products comprise sub-μm thick crystallites of an Fe-K aluminosilicate, probably smectite, that have grown within an amorphous and probably organic-rich matrix. There is also evidence for crystallization of clays having been mediated by fungal hyphae. Coatings formed within Glen Feshie soils after ∼1.1 ky are insufficiently continuous or impermeable to slow rates of fluid-feldspar reactions, but provide valuable insights into the complex weathering microenvironments on debris and microbe-covered mineral surfaces

Reliability of perceptions of voice quality: evidence from a problem asthma clinic population

<p>Introduction: Methods of perceptual voice evaluation have yet to achieve satisfactory consistency; complete acceptance of a recognised clinical protocol is still some way off.</p> <p>Materials and methods: Three speech and language therapists rated the voices of 43 patients attending the problem asthma clinic of a teaching hospital, according to the grade-roughness-breathiness-asthenicity-strain (GRBAS) scale and other perceptual categories.</p> <p>Results and analysis: Use of the GRBAS scale achieved only a 64.7 per cent inter-rater reliability and a 69.6 per cent intra-rater reliability for the grade component. One rater achieved a higher degree of consistency. Improved concordance on the GRBAS scale was observed for subjects with laryngeal abnormalities. Raters failed to reach any useful level of agreement in the other categories employed, except for perceived gender.</p> <p>Discussion: These results should sound a note of caution regarding routine adoption of the GRBAS scale for characterising voice quality for clinical purposes. The importance of training and the use of perceptual anchors for reliable perceptual rating need to be further investigated.</p&gt

Seasonal trends in concentrations and fluxes of volatile organic compounds above central London

Concentrations and fluxes of seven volatile organic compounds (VOCs) were measured between August and December 2012 at a roof-top site in central London as part of the ClearfLo project (Clean Air for London). VOC concentrations were quantified using a proton transfer reaction-mass spectrometer and fluxes were calculated using a virtual disjunct eddy covariance technique. The median VOC fluxes, including aromatics, oxygenated compounds and isoprene, ranged from 0.07 to 0.33 mg m−2 h−1 and mixing ratios were 7.27 ppb for methanol (m / z 33) and <1 ppb for the remaining compounds. Strong relationships were observed between most VOC fluxes and concentrations with traffic density, but also with photosynthetically active radiation (PAR) and temperature for the oxygenated compounds and isoprene. An estimated 50–90 % of aromatic fluxes were attributable to traffic activity, which showed little seasonal variation, suggesting boundary layer effects or possibly advected pollution may be the primary causes of increased concentrations of aromatics in winter. PAR and temperature-dependent processes accounted for the majority of isoprene, methanol and acetaldehyde fluxes and concentrations in August and September, when fluxes and concentrations were largest. Modelled biogenic isoprene fluxes using the G95 algorithm agreed well with measured fluxes in August and September, due to urban vegetation. Comparisons of estimated annual benzene emissions from the London and National Atmospheric Emissions Inventory agreed well with measured benzene fluxes. Flux footprint analysis indicated emission sources were localized and that boundary layer dynamics and source strengths were responsible for temporal and spatial VOC flux and concentration variability during the measurement period

More about orbitally excited hadrons from lattice QCD

This is a second paper describing the calculation of spectroscopy for orbitally excited states from lattice simulations of Quantum Chromodynamics. New features include higher statistics for P-wave systems and first results for the spectroscopy of D-wave mesons and baryons, for relatively heavy quark masses. We parameterize the Coulomb gauge wave functions for P-wave and D-wave systems and compare them to those of their corresponding S-wave states.Comment: 21 pages plus 14 figs, 3 include