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

Environment for the People

Environment for the People, a joint publication of PERI and the Centre for Science and the Environment (CSE) in India, documents innovative strategies used by environmental activists around the world to build natural assets. In diverse landscapes, from Bangladesh's riverine delta to Somalia's arid uplands, ommunities are investing in ecological restoration. In 'extractive reserves' in the Amazon rainforest, the defense of sustainable livelihoods goes hand-in-hand with defense of bio-diversity. In the Peruvian Andes, indigenous communities are fighting to protect their lands and water from the ravages of the mining industry. And in cities around the world, from Los Angeles to New Delhi, communities are mobilizing to defend the right to clean air. These and other inspiring cases profiled in Environment for the People illustrate that humankind does not face an inexorable 'tradeoff' between protecting the natural environment and improving economic well-being. On the contrary, struggles for environmental protection and sustainable livelihoods are bound together

Involute composite design evaluation using global design sensitivity derivatives

An optimization capability for involute structures has been developed. Its key feature is the use of global material geometry variables which are so chosen that all combinations of design variables within a set of lower and upper bounds correspond to manufacturable designs. A further advantage of global variables is that their number does not increase with increasing mesh density. The accuracy of the sensitivity derivatives has been verified both through finite difference tests and through the successful use of the derivatives by an optimizer. The state of the art in composite design today is still marked by point design algorithms linked together using ad hoc methods not directly related to a manufacturing procedure. The global design sensitivity approach presented here for involutes can be applied to filament wound shells and other composite constructions using material form features peculiar to each construction. The present involute optimization technology is being applied to the Space Shuttle SRM nozzle boot ring redesigns by PDA Engineering

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

Work domain analysis and intelligent transport systems: Implications for vehicle design

This article presents a Work Domain Analysis (WDA) of the road transport system in Victoria, Australia. A series of driver information requirements and tasks that could potentially be supported through the use of Intelligent Transport Systems (ITS) are then extracted from the WDA. The potential use of ITS technologies to circumvent these information gaps and provide additional support to drivers is discussed. It is concluded that driver information requirements are currently not entirely satisfied by contemporary vehicle design and also that there are a number of driving tasks that could be further supported through the provision of supplementary systems within vehicles

Augmented paper applications: Initial user tests of a wireless pattern reader

A handheld pattern reader has been developed to read low visibility conductive patterns on paper. The patterns are formed by masking conductive paper with a non-conductive, printed lacquer. The reader was developed as part of an EU-funded project investigating methods of augmenting paper. Data read from the patterns was used to trigger events in the digital domain. Usability tests were undertaken to investigate the performance of the prototype. Results showed that at this stage of development there was significant variation in performance of the prototype from user to user. Further work is being undertaken to determine the causes of this variability

Sound scattering by rough elongated elastic objects. I: Means of scattered field

Author Posting. © Acoustical Society of America, 1992. This article is posted here by permission of Acoustical Society of America for personal use, not for redistribution. The definitive version was published in Journal of the Acoustical Society of America 92 (1992): 1641-1664, doi:10.1121/1.403905.By use of the recently published deformed cylinder formulation [T. K. Stanton, J. Acoust. Soc. Am. 86, 691–705 (1989)], the scattered field due to rough elongated dense elastic objects is derived. The (one-dimensional) roughness is characterized by axial variations of radius. Explicit expressions are derived describing both the mean and mean square of the stochastic scattered field for the rough straight finite length cylinder (broadside incidence) for both ka≪1 and ka≫1 (k is the acoustic wave number and a is the radius) while only the mean is calculated for the prolate spheroid, uniformly bent finite cylinder, and infinitely long cylinder for ka≫1 (again, all broadside incidence). The modal-series-based solution is used in the ka≪1 case as the modal solution simplifies to the sum of two terms (monopole and dipole-like terms). For ka≫1, a more convenient approximate ``ray'' solution is used in place of the modal series solution. The results show that (1) when ka≪1 the roughness-induced variations of the mean and mean-square scattered fields due to the rough straight finite cylinder depend on the roughness, but are independent of frequency—an effect that has no counterpart in the area of scattering by rough planar interfaces. (2) When ka≫1 the mean specular (geometrically reflected) and Rayleigh surface elastic waves of the scattered field of each object are attenuated due to the roughness and their variations are dependent upon the frequency. In addition, the (roughness-induced) attenuation of the Rayleigh wave depends on the number of times the wave has circumnavigated the object. The mean-square values for the straight finite cylinder are attenuated in a similar manner with the additional dependence upon the correlation distance of the surface.This work was supported by the U.S. Office of Naval Research (Grant No. N00014-89-J-1729)

Feelings in Politics: How American Foreign Policy Can Benefit from Interpersonal Communication

Misperception clouds good decision-making in international politics. American foreign policy doesn’t currently allow for ample strategic communication training for the President of the United States to prevent misperception from becoming an issue in international relations. Looking at influential political theorists, it’s easy to discover that they all warn of the detriment that comes with an ineffective communicator in the highest power position in the country. My research provides an overview of different perceptions formed by the United States and China of each other throughout the Presidency of Donald Trump and his counterpart in Beijing, President Xi Jinping. By analyzing the official press releases of each country about the foreign policy moves of the other, I was able to discover the points of weak policy where relations plummeted and where ‘sunshine politics’ prevailed, allowing for further development in the relationship between the two countries’ leaders. When the two leaders were sticking to their agreement of having frequent meetings involving dialogue that both countries held in high precedent, perceptions were positive and relations were amicable. The opposite happened when the dialogue was infrequent and American Message-Influence foreign policy prevailed (Corman, 2008) where there was increased unilateral action towards China without dialogue

Sound scattering by spherical and elongated shelled bodies

Author Posting. © Acoustical Society of America, 1990. This article is posted here by permission of Acoustical Society of America for personal use, not for redistribution. The definitive version was published in Journal of the Acoustical Society of America 88 (1990): 1619-1633, doi:10.1121/1.400321.Describing the scattering of sound by elongated objects with high aspect ratios (ratio of length to diameter) usually involves great numerical difficulties. The recently developed deformed cylinder solution was shown to be increasingly accurate in the limit of very high aspect ratios (≥5:1) while requiring relatively low computation times and was applied to objects of constant composition [T. K. Stanton, ``Sound scattering by cylinders of finite length. III. Deformed cylinders,'' J. Acoust. Soc. Am. 86, 691–705 (1989)]. In this article, the approximate formulation is used to describe scattering by prolate spheroids, straight finite cylinders, and uniformly bent cylinders where the objects are composed of an elastic shell surrounded by fluid and filled with either a fluid or gas. The calculations are compared with those involving spherical shells based on the formulation derived in Goodman and Stern [J. Acoust. Soc. Am. 34, 338–344 (1962)]. The calculations are made over a wide range of frequencies and shell thicknesses (ranging from solid elastic objects to thin-shelled objects). Since the deformed cylinder formulation is most accurate for angles of incidence normal or near normal to the lengthwise axis, the calculations are limited to broadside incidence. The simulations show significant variations in the modal interference structure as the shell thickness and shape are varied. Comparisons are also made between predictions and laboratory data involving straight and bent finite-length cylindrical shells (stainless steel) with 3:1 aspect ratios and 52% shell thicknesses. The study not only shows reasonable agreement between the predictions and data, but also illustrates the dramatic change in scattering cross section due to the bend of the object (12 dB in this case).This work was supported in part by the U.S. Office of Naval Researc