Post-mortem culture of Balamuthia mandrillaris from the brain and cerebrospinal fluid of a case of granulomatous amoebic meningoencephalitis, using human brain microvascular endothelial cells.

The first isolation in the UK of Balamuthia mandrillaris amoebae from a fatal case of granulomatous amoebic meningoencephalitis is reported. Using primary cultures of human brain microvascular endothelial cells (HBMECs), amoebae were isolated from the brain and cerebrospinal fluid (CSF). The cultures showed a cytopathic effect at 20-28 days, but morphologically identifiable B. mandrillaris amoebae were seen in cleared plaques in subcultures at 45 days. The identification of the organism was later confirmed using PCR on Chelex-treated extracts. Serum taken while the patient was still alive reacted strongly with slide antigen prepared from cultures of the post-mortem isolate, and also with those from a baboon B. mandrillaris strain at 1:10,000 in indirect immunofluorescence, but with Acanthamoeba castellanii (Neff) at 1:160, supporting B. mandrillaris to be the causative agent. If the presence of amoebae in the post-mortem CSF reflects the condition in life, PCR studies on CSF and on biopsies of cutaneous lesions may also be a valuable tool. The role of HBMECs in understanding the interactions of B. mandrillaris with the blood-brain barrier is discussed

Post-mortem culture of Balamuthia mandrillaris from the brain and cerebrospinal fluid of a case of granulomatous amoebic meningoencephalitis, using human brain microvascular endothelial cells

The first isolation in the UK of Balamuthia mandrillaris amoebae from a fatal case of granulomatous amoebic meningoencephalitis is reported. Using primary cultures of human brain microvascular endothelial cells (HBMECs), amoebae were isolated from the brain and cerebrospinal fluid (CSF). The cultures showed a cytopathic effect at 20–28 days, but morphologically identifiable B. mandrillaris amoebae were seen in cleared plaques in subcultures at 45 days. The identification of the organism was later confirmed using PCR on Chelex-treated extracts. Serum taken while the patient was still alive reacted strongly with slide antigen prepared from cultures of the post-mortem isolate, and also with those from a baboon B. mandrillaris strain at 1 : 10 000 in indirect immunofluorescence, but with Acanthamoeba castellanii (Neff) at 1 : 160, supporting B. mandrillaris to be the causative agent. If the presence of amoebae in the post-mortem CSF reflects the condition in life, PCR studies on CSF and on biopsies of cutaneous lesions may also be a valuable tool. The role of HBMECs in understanding the interactions of B. mandrillaris with the blood–brain barrier is discussed

Characteristics of the Supranormal Speaking Voice: Radio Performers

Characteristics of the Supranormal Speaking Voice: Radio Performers Radio performers use their voices to communicate with their audiences and compete in the radio marketplace. This thesis aimed to investigate what makes a good voice for radio. Perspectives on what makes a good voice for radio are likely to vary between radio employers/educators, listeners and clinicians. Therefore, this thesis explored good voice for radio using methods that considered these stakeholder perspectives. Five studies are presented; one using qualitative method and four using quantitative methods. The first study analysed interviews with radio employers/educators and presented a multi-dimensional model of what makes a good voice for radio, which was used in informing the design of four subsequent, quantitative studies on male radio performers. These four studies investigated features that characterised supranormal (better-than-normal) voice in radio performers, rather than dysphonia. They showed that a) good voice for radio is agreed on by listeners and judgments were predicted by an acoustic model with moderate accuracy; b) judgments of voices that were not “good for radio” were unreliable; c) voices of commercial and public radio broadcasters have different spectral characteristics; and d) radio performers’ voices have a higher speed quotient than controls, measured using high-speed videoendoscopy. These results imply that good voices for radio have different acoustic, perceptual and kinematic characteristics to controls. However, not all radio performers were perceived as “good for radio”; judgments appeared to be affected by other factors e.g., context and listener preference. Radio performers may also differ in voice quality to appeal to their stations’ target audiences. Finally, this thesis provides evidence for use of a stakeholder framework when describing the vocal features and demands of performers. Use of measures that are sensitive to the voice demands of performers is likely to facilitate optimal voice outcomes for these individuals

Effectiveness of the progestin-only pill for migraine treatment in women: A systematic review and meta-analysis

Background Migraine is highly prevalent in women (18%). Peak morbidity affects their most productive years, coinciding with peak fertility. Hormonal contraception is often tailored for migraine prevention. Estrogen-containing contraceptives may be contraindicated in women experiencing migraine with aura due to the risk of vascular events. While improvements in migraine with a progestin-only pill (POP), which inhibits ovulation are documented, the strength and quality of evidence has not been formally evaluated. Objectives To determine the effectiveness of progestin-only contraceptives for migraine treatment by systematic review and meta-analysis. Data sources and selection MEDLINE, EMBASE and Cochrane Libraries were searched (1980 to September 2016) for studies on progestin-only treatments for migraine. Studies in English on >4 non-menopausal women aged 18-50 with migraine diagnosed by formal criteria were included. Data extraction and analysis Data were quality-assessed using the GRADE system. A random effects model was used for pooled analyses. Results Pooled analyses of four studies demonstrated that desogestrel 75 mcg/day, POP significantly but modestly reduced the number of migraine attacks and migraine days. Reduced intensity and duration, reduced analgesic and triptan use were observed, along with improved headache-related quality of life. GRADE analysis indicated evidence was low to very low for each outcome measure. Adverse effects resulted in treatment cessation for <10% of participants. Two studies compared desogestrel POP to a combined oral contraceptive, demonstrating similar migraine outcomes for both treatments. Conclusions The desogestrel POP shows promise in improving migraine in women. Current evidence is observational and based on small samples of women using only one oral progestin-only formulation. Further randomized trials on additional progestin-only contraceptives are required to confirm their role in migraine management

Intra- and Inter-Rater Reliability Results (Intra-Class Correlation Coefficients) for Manual Components of the HSVP.

<p>Intra- and Inter-Rater Reliability Results (Intra-Class Correlation Coefficients) for Manual Components of the HSVP.</p

Descriptive Statistics for f0, OQ and SQ for Male Radio Performers and Their Respective Matched-control Groups.

<p>N.B. Means are reported, followed by standard deviations in parentheses. Although the HSVP provides open and speed quotient results as a percentage, results are presented here as a decimal for ease of comparison with previous literature. As a guide, an open quotient of 1 indicates no vocal fold closure and a speed quotient greater than 1 indicates a longer glottal opening compared to closing duration.</p><p>* =  significant measure, differentiating radio performers from controls.</p

The High-Speed Video Program Graphical User Interface.

<p>The High-Speed Video Program Graphical User Interface.</p

Diagram of Simulated GAW Showing Relevant Markers for <i>f</i>0 ( = 1/T), OQ ( = XZ/T), SQ ( = XY/YZ).

<p>Diagram of Simulated GAW Showing Relevant Markers for <i>f</i>0 ( = 1/T), OQ ( = XZ/T), SQ ( = XY/YZ).</p