'SO STONED' : common sense approach of the dizzy patient

The history taking of a dizzy patient is of utmost importance in order to differentiate the possible etiologies of vertigo. The key factors that allow a first approximation of diagnosis identification are based on the time profile, symptom profile, and trigger profile of the disease. Here, the proposed mnemonic "SO STONED" comprises eight different dimensions that characterize the vertigo-related complaints of the patient and guide the clinician in his or her decision scheme. All the letters "SO STONED" have a specific meaning: Symptoms, Often (Frequency), Since, Trigger, Otology, Neurology, Evolution, and Duration. Since the most common vestibular diseases have different fingerprints when all dimensions are considered, this tool can facilitate the identification of the appropriate vestibular diagnosis

The impact of voice disorders among teachers: vocal complaints, treatment-seeking behavior, knowledge of vocal care, and voice-related absenteeism

OBJECTIVES: Teachers are at increased risk for developing voice disorders. Occupational risk factors have been extensively examined; however, little attention has been paid to the consequences of the vocal complaints. The objective of this study was to investigate the knowledge that teachers have about vocal care, treatment-seeking behavior, and voice-related absenteeism. METHODS: The study group comprised 994 teachers and 290 controls whose jobs did not involve vocal effort. All participants completed a questionnaire inquiring about vocal complaints, treatment-seeking behavior, voice-related absenteeism, and knowledge about vocal care. Comparisons were made between teachers with and without vocal complaints and with the control group. RESULTS: Teachers reported significantly more voice problems than the control population (51.2% vs 27.4%) (chi(2)=50.45, df=1, P<0.001). Female teachers reported significantly higher levels of voice disorders than their male colleagues (38% vs 13.2%, chi(2)=22.34, df=1, P<0.001). Teachers (25.4%) sought medical care and eventually 20.6% had missed at least 1 day of work because of voice problems. Female teachers were significantly more likely to seek medical help (chi(2)=7.24, df=1, P=0.007) and to stay at home (chi(2)=7.10, df=1, P=0.008) in comparison with their male colleagues. Only 13.5% of all teachers received information during their education. CONCLUSIONS: Voice disorders have an impact on teachers' personal and professional life and imply a major financial burden for society. A substantial number of teachers needed medical help and was obligated to stay at home because of voice problems. This study strongly recommends the implementation of vocal education during the training of teacher students to prepare the vocal professional user

Vocal characteristics of middle-aged premenopausal women

Aging influences the laryngeal anatomy and physiology, leading to altered vocal quality. In middle-aged women, the voice is affected by a combination of aging and menopausal transition. However, in many studies about vocal aging, the menopausal transition is not taken into account. The purpose of this study was to measure and describe the effect of aging on the vocal characteristics by comparing young women (between 20 and 28 years) and middle-aged premenopausal women (between 45 and 52 years). To determine the vocal characteristics in both groups, objective (aerodynamic measurements, vocal performance measurements, acoustic analysis, and a determination of the Dysphonia Severity Index) and subjective assessment techniques (perceptual evaluation, videostroboscopic evaluation, and Voice Handicap Index) were used. The middle-aged premenopausal women showed a smaller frequency and intensity range, a lower habitual fundamental frequency, and a higher soft phonation index compared with the young women. The results of this study are important when studying the voices of middle-aged women. Vocal characteristics of middle-aged women differ from young women, and these changes cannot only be because of hormonal changes during the menopause

Physiological Targets of Artificial Gravity: The Sensory-Motor System

This chapter describes the pros and cons of artificial gravity applications in relation to human sensory-motor functioning in space. Spaceflight creates a challenge for sensory-motor functions that depend on gravity, which include postural balance, locomotion, eye-hand coordination, and spatial orientation. The sensory systems, and in particular the vestibular system, must adapt to weightlessness on entering orbit, and again to normal gravity upon return to Earth. During this period of adaptation, which persists beyond the actual gravity-level transition itself the sensory-motor systems are disturbed. Although artificial gravity may prove to be beneficial for the musculoskeletal and cardiovascular systems, it may well have negative side effects for the neurovestibular system, such as spatial disorientation, malcoordination, and nausea

Systemic Inflammation and Reperfusion Injury in Patients With Acute Myocardial Infarction

Despite early recanalization of an occluded infarct artery, tissue reperfusion remains impaired in more than one-third of the acute myocardial infarction (AMI) patients owing to a process of reperfusion injury. The role of systemic inflammation in triggering this phenomenon is unknown. Proinflammatory factors (hs-CRP, TNF-α) and anti-inflammatory mediators (IL-1 receptor antagonist, IL-10) were measured in 65 patients during the acute phase of a myocardial infarction as well as in 11 healthy control subjects. Myocardial reperfusion injury was defined as the presence of persistent ST-segment elevation despite successful coronary intervention (≥ 50% of the initial value) and was observed in 28 patients. Systemic proinflammatory mediators (particularly hs-CRP and leukocytes) were higher in AMI patients compared to control subjects. Within the group of AMI patients, only serum TNF-α differed significantly between patients with versus without reperfusion injury: a median value of 25 versus 13 pg/mL was observed, respectively. Logistic regression analysis identified a high level of TNF-α as the most important independent determinant of reperfusion injury (P = .001), beyond total ischemic time (P = .01) and extent of jeopardized myocardium (P = .08). There was no correlation between the TNF-α level and the total ischemic time (P = .8) or the extent of jeopardized myocardium (P = .6). Systemic inflammation, in particular high levels of TNF-α, is strongly associated with the occurrence of reperfusion injury after successful recanalization. Our findings suggest that TNF-α is involved in the triggering and/or amplification of local inflammatory responses related to ischemia-reperfusion injury

The effect of spaceflight on the otolith-mediated ocular counter-roll

The otoliths of the vestibular system are seen as the primary gravitational sensors and are responsible for a compensatory eye torsion called the ocular counter-roll (OCR). The OCR ensures gaze stabilization and is sensitive to a lateral head roll with respect to gravity and the Gravito-Inertial Acceleration (GIA) vector during e.g., centrifugation. This otolith-mediated reflex will make sure you will still be able to maintain gaze stabilization and postural stability when making sharp turns during locomotion. To measure the effect of prolonged spaceflight on the otoliths, we measured the OCR induced by off-axis centrifugation in a group of 27 cosmonauts before and after their 6-month space mission to the International Space Station (ISS). We observed a significant decrease in OCR early post-flight, with first- time flyers being more strongly affected compared to frequent or experienced flyers. Our results strongly suggest that experienced space crew have acquired the ability to adapt faster after G-transitions and should therefore be sent for more challenging space missions, e.g., Moon or Mars, because they are noticeably less affected by microgravity regarding their vestibular system

Isabelle Modelchecking for insider threats

The Isabelle Insider framework formalises the technique of social explanation for modeling and analysing Insider threats in infrastructures including physical and logical aspects. However, the abstract Isabelle models need some refinement to provide sufficient detail to explore attacks constructively and understand how the attacker proceeds. The introduction of mutable states into the model leads us to use the concepts of Modelchecking within Isabelle. Isabelle can simply accommodate classical CTL type Modelchecking. We integrate CTL Modelchecking into the Isabelle Insider framework. A running example of an IoT attack on privacy motivates the method throughout and illustrates how the enhanced framework fully supports realistic modeling and analysis of IoT Insiders

The effect of spaceflight and microgravity on the human brain

peer reviewedMicrogravity, confinement, isolation, and immobilization are just some of the features astronauts have to cope with during space missions. Consequently, long-duration space travel can have detrimental effects on human physiology. Although research has focused on the cardiovascular and musculoskeletal system in particular, the exact impact of spaceflight on the human central nervous system remains to be determined. Previous studies have reported psychological problems, cephalic fluid shifts, neurovestibular problems, and cognitive alterations, but there is paucity in the knowledge of the underlying neural substrates. Previous space analogue studies and preliminary spaceflight studies have shown an involvement of the cerebellum, cortical sensorimotor, and somatosensory areas and the vestibular pathways. Extending this knowledge is crucial, especially in view of long-duration interplanetary missions (e.g., Mars missions) and space tourism. In addition, the acquired insight could be relevant for vestibular patients, patients with neurodegenerative disorders, as well as the elderly population, coping with multisensory deficit syndromes, immobilization, and inactivity

The OCareCloudS project: toward organizing care through trusted cloud services

The increasing elderly population and the shift from acute to chronic illness makes it difficult to care for people in hospitals and rest homes. Moreover, elderly people, if given a choice, want to stay at home as long as possible. In this article, the methodologies to develop a cloud-based semantic system, offering valuable information and knowledge-based services, are presented. The information and services are related to the different personal living hemispheres of the patient, namely the daily care-related needs, the social needs and the daily life assistance. Ontologies are used to facilitate the integration, analysis, aggregation and efficient use of all the available data in the cloud. By using an interdisciplinary research approach, where user researchers, (ontology) engineers, researchers and domain stakeholders are at the forefront, a platform can be developed of great added value for the patients that want to grow old in their own home and for their caregivers