A trip in voice phytotheraphy: TRPA1 ion channel as a target for bioactive compounds in herbal remedies for voice care

Voice is the sound we produce to communicate meanings and ideas and has a capital importance in human social development. Herbs have been used for voice care since ancient times and many herbal remedies are still in use, both as folk medicine and as sources of botanicals used in commercial products. In Europe Sisymbrium officinale (L.) Scop (the "singers'plant\u201d) is the most popular herbal remedy for voice care, but many other plants are employed in phytopreparations. The mechanisms of action of these botanicals include anti-bacterial, anti-inflammatory, mucolytic, antinociceptive and other general activities; nevertheless, mechanisms that could be specifically referred to voice are often unknown. We collected information on plants used worldwide for voice care; the plants have been organized in a database (Herbs for Voice Database) and classified according to the bioactive compounds, their molecular targets and the pathologies they are recommended for. The data were analyzed with the aim to identify some possible common mechanism of action and the molecular targets involved. The analysis of data shows that an important pathway involves the somatosensory TRPA1 (Transient Receptor Potential Ankyrin type 1) ion channel, a well-known mediator of irritation, inflammatory and neurogenic pain. Agonists of this ion channel have been identified in 27 over 44 plants, corresponding to 61,3% of the plants in the database. Also TRPM8 (Transient Receptor Potential Melastatin type 8), involved in the perception of coolness, was identified among the molecular targets. This finding reinforces the hypothesis that these somatosensory ion channels could be involved in relevant mechanisms of action of these traditional remedies and open new perspectives in the rational study of voice phytopharmacology and therapy. This research was funded by FONDAZIONE CARIPLO (Milano, I), University of Milano (I) and Conservatorio di Musica G. Verdi (Milano, I), grant number 2017-1653

Herbs for voice database : developing a rational approach to the study of herbal remedies used in voice care

Herbs have been used for voice care since ancient times and many herbal remedies are still in use in every geographical areas and cultures, both as traditional medicine and as sources of botanicals used in commercial products. Many of these plants are used as extracts and other phytopreparates, and a full phytochemical analysis is sometimes incomplete or lacking. The mechanisms of action of these botanicals include antibacterial, antiinflammatory, mucolytic, and other general activities; nevertheless, mechanisms that could be specifically referred to voice are often unknown, as well as the corresponding molecular targets and therefore a rational approach in the use of these remedies is hard to be applied by phoniatricians. To address this problem, we collected information on plants used for voice care from several different geographical areas, using both literature data and a pool of contributors from an international network of artistic phoniatrics and vocologists. The plants have been organized in a database (Herbs for Voice Database) and classified according to the natural compounds contained in them, their molecular targets and the pathologies they are recommended for. This first database contains 44 plants, 101 phytocompounds, and 32 recognized molecular targets. The distribution of herbs and phytocompounds according to the botanical families, their known biological activity, traditional uses, and molecular targets were analyzed. In particular, data analysis shows that the somatosensory and pain receptor Transient Receptor Potential Ankyrin 1 ion channel is targeted by a large number of different phytochemicals contained in the herbs for voice, and could therefore be involved in a mechanism of action common to many plants

Union of the European Phoniatricians' position statement on the exit strategy of phoniatric and laryngological services : staying safe and getting back to normal after the peak of coronavirus disease 2019 (issued on 25th May 2020)

Background The following position statement from the Union of the European Phoniatricians, updated on 25th May 2020 (superseding the previous statement issued on 21st April 2020), contains a series of recommendations for phoniatricians and ENT surgeons who provide and/or run voice, swallowing, speech and language, or paediatric audiology services. Objectives This material specifically aims to inform clinical practices in countries where clinics and operating theatres are reopening for elective work. It endeavours to present a current European view in relation to common procedures, many of which fall under the aegis of aerosol generating procedures. Conclusion As evidence continues to build, some of the recommended practices will undoubtedly evolve, but it is hoped that the updated position statement will offer clinicians precepts on safe clinical practice.Peer reviewe

Does the enhancement of chemosensory stimuli improve the enjoyment of food in institutionalized elderly people?

Thirty-six institutionalized elderly people and 45 young adults rated their degree of liking for different foods (first courses and fruit juice) modified in appearance, taste and flavor, as compared with unmodified version of the same foods. Taste and odor sensitivities were also measured in both age cohorts. The aim was to evaluate whether food with enhanced taste and flavor, and modified appearance was preferred by both young and elderly people, and to verify whether sensory performance influenced food preference. The elderly had a lower taste and odor abilities and more varying sensory performances than the young. Age had a significant effect on liking; the elderly scored higher than the young, especially for taste and flavor fortified food. Subdividing the elderly according to their sensory performance showed that performance did not influence liking for fruit juice, whereas it had a small, though nonsignificant, effect on first courses

Sensory acceptability of traditional food preparations by elderly people

People's food choices progressively change with ageing. In particular, elderly people show a decrease in the pleasantness associated with food intake as a result of both physiological and psychological factors. The aims of this work were to investigate the most important aspects related to food for the elderly and to determine whether there is an evolution in food preferences during life course. This study involved 48 (36 females and 12 males) institutionalised elderly people aged between 57 and 98 (mean age 82.5). Subjects were selected for their physiological and cognitive ability to carry out the evaluation. In the first step of this work a focus group was carried out using seven institutionalised elderly people. It was shown that the basic criteria associated with food choice were: simple-cooking, tradition and sensory aspects. In the second step subjects rated the liking of 11 first courses using a nine-point hedonic scale. The 11 first courses were selected to include dishes that could plausibly be evaluated as traditional Italian first courses, simple-cooked/familiar first courses, simple-cooked/unfamiliar first courses and complicated-cooked/unfamiliar first courses, according to the observations drawn from focus group. The first courses preferred by elderly people were found to be those classified as traditional Italian preparations, while the first courses that obtained the lowest liking rating were found to be those classified as simple-cooked/ unfamiliar and complicated-cooked/unfamiliar dishes. Finally subjects answered a questionnaire to investigate whether there was a relationship between the variables obtained from the focus group and food preferences for a particular first course by elderly people

Simultaneous monitoring of vocal doses and breathing patterns in professional singers

Background: When learning and improving singing, the quantitative characterization of artists’ performances based only on vocal parameters does not provide enough information to identify strategies for improvement. Simultaneous monitoring of sound production and breathing patterns in professional singers can allow the exploration of the mechanisms that promote effective singing modalities through association with respiratory efforts. Methods: We developed and tested a novel portable device that simultaneously monitors vocal activity and breathing patterns without interfering with natural singing. The device utilizes a combination of a miniature accelerometer to measure vocal doses from skin vibrations on the neck and two respiratory inductive plethysmography (RIP) bands to estimate the breathing pattern by measuring changes in the thoracoabdominal cross-sectional area. Results: The device was tested on 13 professional baroque-style singers and 14 untrained individuals during the execution of singing tasks. It was accurate compared with reference systems (R2 = 0.99 and R2 = 0.91 for the accelerometer and RIP, respectively) and showed differences between the two groups (p ≤ 0.001). Conclusions: By allowing a quantitative characterization of the effectiveness of singing technique, this novel device can help provide a better understanding of the physiology of singing and may be a tool for support learning and training optimization for professional singers

Assessing Acoustic Parameters in Early Music and Romantic Operatic Singing

Objective: Since the recent early music (EM) revival, a subset of singers have begun to specialize in a style of singing that is perceptually different from the more "mainstream" romantic operatic (RO) singing style. The aim of this study is to characterize EM with respect to RO singing in terms of its vibrato characteristics and the singer's formant cluster. Study design: This study presents a within-subject experimental design. Methods: Ten professional singers (5 F; 5M) versed in both EM and RO repertoire were enrolled in the study. Each singer recorded the first 10 bars of the famous Aria, "Amarilli Mia Bella" (Giulio Caccini, 1602) a cappella, in RO and EM styles, in random order. Three sustained notes were extracted from the acoustical recordings and were analyzed using the free user-friendly software Biovoice to extract five parameters: vibrato rate, vibrato extent, vibrato jitter (Jvib), vibrato shimmer, and quality ratio (QR), an estimation of the singer's formant power. Results: Vibrato in EM singing was characterized by a higher rate, a smaller extent, and less regular cycle-cycle period duration (higher Jvib) compared to RO singing. As in previous studies, RO singing presented a more prominent singer's formant, as indicated by a smaller QR. Conclusions: Acoustical analysis of some vibrato characteristics and the Singer's Formant significantly differentiated EM from RO singing styles. Given the acoustical distinctions between EM and RO styles, future scientific and musicological studies should consider distinguishing between the two styles rather than using a singular term for and description of Western Classical singing

Assessing the extent and timing of chemosensory impairments during COVID-19 pandemic

Chemosensory impairments have been established as a specific indicator of COVID-19. They affect most patients and may persist long past the resolution of respiratory symptoms, representing an unprecedented medical challenge. Since the SARS-CoV-2 pandemic started, we now know much more about smell, taste, and chemesthesis loss associated with COVID-19. However, the temporal dynamics and characteristics of recovery are still unknown. Here, capitalizing on data from the Global Consortium for Chemosensory Research (GCCR) crowdsourced survey, we assessed chemosensory abilities after the resolution of respiratory symptoms in participants diagnosed with COVID-19 during the first wave of the pandemic in Italy. This analysis led to the identification of two patterns of chemosensory recovery, partial and substantial, which were found to be associated with differential age, degrees of chemosensory loss, and regional patterns. Uncovering the self-reported phenomenology of recovery from smell, taste, and chemesthetic disorders is the first, yet essential step, to provide healthcare professionals with the tools to take purposeful and targeted action to address chemosensory disorders and their severe discomfort