| 1. |
- Alsved, Malin, et al.
(författare)
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Exhaled respiratory particles during singing and talking
- 2020
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Ingår i: Aerosol Science and Technology. - : Informa UK Limited. - 1521-7388 .- 0278-6826. ; 54:11, s. 245-1248
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Tidskriftsartikel (refereegranskat)abstract
- Choir singing has been suspended in many countriesduring the Covid-19 pandemic due to incidental reportsof disease transmission. The mode of transmission has been attributed to exhaled droplets, but with the exception of a study on tuberculosis from1968, there is presently almost no scientific evidence ofincreased particle emissions from singing. A substantial number of studies have,however, investigated aerosols emitted from breathing,talking, coughing and sneezing. It has also been shown that justnormal breathing over time can generate more viablevirus aerosol than coughing, since the latter is a less fre-quent activity.Compared to talking, singing often involves continu-ous voicing, higher sound pressure, higher frequencies,deeper breaths, higher peak airflows and more articu-lated consonants. All these factors are likely to increaseexhaled emissions.The aim of this study was to investigate aerosol anddroplet emissions during singing, as compared to talking and breathing. We also examined the presence of SARS-CoV-2 in the air from breathing, talking and singing,and the efficacy of face masks to reduce emissions. In this study we defined aerosol particles as having a drysize in the range 0.5–10mm. Although debatable from anaerosol physics point of view, a cutoff diameter between5 and 10mm is normally used in medicine for classifica-tion of aerosol versus droplet route of transmission. Droplets are here defined as exhaled particles, frommicron size with no upper size limit, and measured dir-ectly at the mouth before complete evaporation, thuspartly in liquid phase.
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| 2. |
- Johansson, Kerstin, et al.
(författare)
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Perceptual Detection of Subtle Dysphonic Traits in Individuals with Cervical Spinal Cord Injury Using an Audience Response Systems Approach
- 2017
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Ingår i: Journal of Voice. - : MOSBY-ELSEVIER. - 0892-1997 .- 1873-4588. ; 31:1
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. Reduced respiratory function following lower cervical spinal cord injuries (CSCIs) may indirectly result in vocal dysfunction. Although self-reports indicate voice change and limitations following CSCI, earlier efforts using global perceptual ratings to distinguish speakers with CSCI from noninjured speakers have not been very successful. We investigate the use of an audience response system-based approach to distinguish speakers with CSCI from noninjured speakers, and explore whether specific vocal traits can be identified as characteristic for speakers with CSCI. Methods. Fourteen speech-language pathologists participated in a web-based perceptual task, where their overt reactions to vocal dysfunction were registered during the continuous playback of recordings of 36 speakers (18 with CSCI, and 18 matched controls). Dysphonic events were identified through manual perceptual analysis, to allow the exploration of connections between dysphonic events and listener reactions. Results. More dysphonic events, and more listener reactions, were registered for speakers with CSCI than for noninjured speakers. Strain (particularly in phrase-final position) and creak (particularly in nonphrase-final position) distinguish speakers with CSCI from noninjured speakers. Conclusions. For the identification of intermittent and subtle signs of vocal dysfunction, an approach where the temporal distribution of symptoms is registered offers a viable means to distinguish speakers affected by voice dysfunction from non-affected speakers. In speakers with CSCI, clinicians should listen for presence of final strain and nonfinal creak, and pay attention to self-reported voice function and voice problems, to identify individuals in need for clinical assessment and intervention.
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| 3. |
- Švec, J.G., et al.
(författare)
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Tutorial and guidelines on measurement of sound pressure level in voice and speech
- 2018
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Ingår i: Journal of Speech, Language and Hearing Research. - : American Speech-Language-Hearing Association. - 1092-4388 .- 1558-9102. ; 61:3, s. 441-461
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Sound pressure level (SPL) measurement of voice and speech is often considered a trivial matter, but the measured levels are often reported incorrectly or incompletely, making them difficult to compare among various studies. This article aims at explaining the fundamental principles behind these measurements and providing guidelines to improve their accuracy and reproducibility. Method: Basic information is put together from standards, technical, voice and speech literature, and practical experience of the authors and is explained for nontechnical readers. Results: Variation of SPL with distance, sound level meters and their accuracy, frequency and time weightings, and background noise topics are reviewed. Several calibration procedures for SPL measurements are described for stand-mounted and head-mounted microphones. Conclusions: SPL of voice and speech should be reported together with the mouth-to-microphone distance so that the levels can be related to vocal power. Sound level measurement settings (i.e., frequency weighting and time weighting/averaging) should always be specified. Classified sound level meters should be used to assure measurement accuracy. Head-mounted microphones placed at the proximity of the mouth improve signal-to-noise ratio and can be taken advantage of for voice SPL measurements when calibrated. Background noise levels should be reported besides the sound levels of voice and speech.
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| 4. |
- Berg, Malin, 1976, et al.
(författare)
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Replacement of a Tracheal Stenosis with a Tissue-Engineered Human Trachea Using Autologous Stem Cells: A Case Report
- 2014
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Ingår i: Tissue Engineering. Part A. - 1937-3341 .- 1937-335X. ; 20:1-2, s. 389-397
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Tidskriftsartikel (refereegranskat)abstract
- Cell-based therapies, involving tissue engineering represent interesting and potentially important strategies for treatment of patients with various disorders. Here, using a detergent-enzymatic method we prepared an intact 3-dimensional scaffold of an extracellular matrix (ECM) derived from a human cadaver donor trachea, which we repopulated with autologous stem cells and implanted into a 76-year old patient with tracheal stenosis including lower part of the larynx. Although the graft provided the patient with an open airway, a week after surgery, the mucous membrane of the graft was covered by a 1-2mm thick fungal infection, which was treated with local and systemic anti-fungal therapy. The airway lumen was postoperatively controlled by fiberbrandoscopy and found stable and sufficient. However, twenty-three days later the patient died due to cardiac arrest but with a patent, open, stable tracheal transplant and intact anastomoses. Histopathological results of the transplanted tracheal graft at autopsy showed a squamous but not ciliated epithelium, neovascularization, bundles of -sma positive muscle cells, serous glands and nerve fibres with S-100 positive nerve cells in the submucosa and intact chondrocytes in the cartilage. Our findings suggest that although autologous stem cells- engineered tracheal matrices may represent a tool for clinical tracheal replacement. Further preclinical studies are required for generating functional airway grafts and long term effects of such grafts.
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| 5. |
- Ternström, Sten, 1956-, et al.
(författare)
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Voice Maps as a Tool for Understanding and Dealing with Variability in the Voice
- 2022
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Ingår i: Applied Sciences. - : MDPI AG. - 2076-3417. ; 12:22, s. 11353-11353
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Tidskriftsartikel (refereegranskat)abstract
- Individual acoustic and other physical metrics of vocal status have long struggled to prove their worth as clinical evidence. While combinations of metrics or “features” are now being intensely explored using data analytics methods, there is a risk that explainability and insight will suffer. The voice mapping paradigm discards the temporal dimension of vocal productions and uses fundamental frequency (fo) and sound pressure level (SPL) as independent control variables to implement a dense grid of measurement points over a relevant voice range. Such mapping visualizes how most physical voice metrics are greatly affected by fo and SPL, and more so individually than has been generally recognized. It is demonstrated that if fo and SPL are not controlled for during task elicitation, repeated measurements will generate “elicitation noise”, which can easily be large enough to obscure the effect of an intervention. It is observed that, although a given metric’s dependencies on fo and SPL often are complex and/or non-linear, they tend to be systematic and reproducible in any given individual. Once such personal trends are accounted for, ordinary voice metrics can be used to assess vocal status. The momentary value of any given metric needs to be interpreted in the context of the individual’s voice range, and voice mapping makes this possible. Examples are given of how voice mapping can be used to quantify voice variability, to eliminate elicitation noise, to improve the reproducibility and representativeness of already established metrics of the voice, and to assess reliably even subtle effects of interventions. Understanding variability at this level of detail will shed more light on the interdependent mechanisms of voice production, and facilitate progress toward more reliable objective assessments of voices across therapy or training.
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| 6. |
- Verikas, Antanas, et al.
(författare)
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Advances in laryngeal imaging
- 2009
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Ingår i: European Archives of Oto-Rhino-Laryngology. - New York : Springer-Verlag New York. - 0937-4477 .- 1434-4726. ; 266:10, s. 1509-1520
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Tidskriftsartikel (refereegranskat)abstract
- Imaging and image analysis became an important issue in laryngeal diagnostics. Various techniques, such as videostroboscopy, videokymography, digital kymograpgy, or ultrasonography are available and are used in research and clinical practice. This paper reviews recent advances in imaging for laryngeal diagnostics.
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| 7. |
- Saber, Amanj, 1972-, et al.
(författare)
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Staphylococcus aureus in chronic rhinosinusitis: the effect on the epithelial chloride channel (cystic fibrosis transmembrane conductance regulator, CFTR) and the epithelial sodium channel (ENaC) physiology
- 2019
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Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 0001-6489 .- 1651-2251. ; 139:7, s. 652-658
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Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic rhinosinusitis (CRS) is an inflammatory disease of the nose and the paranasal sinuses, often associated with an infection by Staphylococcus aureus (S. aureus). Disturbance in the function of ion channels is regarded as an etiological factor for pathogenesis of CRS.Aims: The study aims to measure the mRNA expression of the ENaC and CFTR ion channels in nasal epithelial cells (NECs) and to investigate the effect of both the budesonide and S. aureus on these ion channels.Materials and method: NECs biopsies obtained from healthy volunteers and patients with CRS. NECs were infected with S. aureus strains and/or budesonide to study the mRNA expression levels of the ENaC and CFTR ion channels.Results: The mRNA expression level of CFTR was increased while that of ENaC was decreased. S. aureus infection and budesonide treatment induced a significant modulation of ENaC and CFTR ion channels expression.Conclusion: The CFTR and ENaC ion channel physiology are of importance in the pathogenesis of CRS. Exposure to S. aureus infection and treatment with budesonide modulated the mRNA expression of CFTR and ENaC ion channels.Significance: Better understanding of the pathophysiology of CRS.
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| 8. |
- Claeson, Anna-Sara, 1974-, et al.
(författare)
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Feasibility and reliability of measures of bioactive lipids in human plasma and nasal mucosa
- 2022
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Ingår i: Journal of chromatography. B. - : Elsevier. - 1570-0232 .- 1873-376X. ; 1206
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Tidskriftsartikel (refereegranskat)abstract
- Analysis of bioactive lipids is increasingly useful in clinical studies, and there is a need for non-invasive and easy-to-use sampling methods that meet the demands of reliability. Samples that can be taken by a non-professional and that can be taken repeatedly so as to provide more detailed information about the inflammatory process are often desired. In this study, the feasibility of non-invasive sampling of nasal mucosa and saliva for the analysis of bioactive lipid mediators (e.g. oxylipins and endocannabinoids) was evaluated in a pilot study (n = 10). In a second study, the reliability (relative and absolute) of sampling of these lipid mediators derived from nasal mucosa and from plasma was assessed by calculation of the intraclass correlation coefficient and Bland–Altman’s limit of agreement. Samples were taken at the same time of day on two occasions from a cohort of individuals with and without building-related intolerance (n = 37). Nasal mucosa proved to be a suitable matrix for the analysis of bioactive lipids and was therefore included in the study on reliability together with the plasma samples. Relative reliability varied among the identified oxylipins and endocannabinoids. Arachidonic acid derivatives showed generally better reliability. Absolute reliability measures also varied indicating that only a subset of the oxylipins and endocannabinoids were suitable as biomarkers in either nasal mucosa or plasma and should therefore be used with caution for that purpose.
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| 9. |
- Fyrberg, Åsa
(författare)
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Acquired brain injury in children and adolescents: Investigating assessment of communicative participation in daily life situations
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aims The overall aim of this thesis was to explore assessments of communicative participation in children and adolescents (hereafter: adolescents) with acquired brain injuries, mainly through evaluations in the Communicative Effectiveness Index (CETI) and in interviews with the participants. The aim was also to capture important changes in communication over time. Five sub-studies were carried out, presented in Papers I-V. Methods Paper I: Pragmatic evaluations were explored in eight participants with severe brain injuries. The data were obtained in clinical surroundings by a speech language pathologist and rehabilitation assistants, using clinically applied pragmatic taxonomy, the Pragmatic Protocol (PP). Paper II: Descriptive and comparative methods were used to assess the communication outcome in an adolescent with ABI. The investigations included linguistic and cognitive test data and adolescent/parent evaluations of communication skills in the CETI, post-injury and at follow-up. Video recordings to explore communication management were analysed through self-evaluation and interview procedures. Paper III: The contribution of CETI in the assessment of ABI was examined through parent evaluations of communication in 30 adolescents, which were compared with linguistic, cognitive and brain injury data. Paper IV: Assessments of daily communication skills delivered by the parents of eight adolescents were compared with self-evaluations by the adolescents themselves. Interview data were analysed in particular by applying activity-based communication analysis, ACA (Allwood, 2013), and the theory of distributed cognition (Hutchins, 1995a). Paper V: Change scores in 30 adolescents between post-injury measurements and follow-up results were estimated. Results Paper I: Seven of eight participants with severe brain injuries were assessed as having a highly reduced capacity to communicate within all the assessed pragmatic parameters that involved speech and language skills. Paper II: Self-evaluation of the video recordings and analyses of communication management in Paper II confirmed impaired communication, related to language comprehension difficulties, high speech rate and the number of speakers involved. Paper III: The CETI data showed that adolescents with more communication difficulties, according to their parents, also obtained significantly lower scores in tests of grammar comprehension and verbal IQ. The trend was similar for word comprehension, naming and perceptual IQ, although this was not supported by significant results. However, complex communicative interactions, such as fast conversations with several speakers involved, were affected in all participants, including those with higher results in linguistic and cognitive tests. As a result, complex communicative situations appeared to be particularly vulnerable to the effects of the brain injuries, regardless of injury severity. The aetiologies of the injuries did not affect the outcome in individual results. However, the majority of adolescents with more communication difficulties according to parent evaluations had left-hemisphere brain lesions. Paper IV: Overall high agreement between the adolescent and parental assessments was found. However, complex communicative situations more frequently received lower scores in the parental ratings. Analyses using the ACA and distributed cognition models and interview data pointed to the usability of a systematic comparison of the shared views on communication after ABI in adolescence, to increase knowledge of the participation perspective in real-life communication. Paper V: The nature and extent of communication abilities after communication strategies applied by the parents at home showed a significant increase in ability in 30 participants (p < .01), but some tasks did not improve as much, even showing a reduction in capacity after the one-year application of communication strategies, according to parental estimations. Conclusions One general conclusion in this thesis is that evaluations of communication abilities in adolescents with ABI benefit from analyses of interaction in everyday situations. The data obtained in the clinical surroundings, in particular, the results from cognitive, linguistic and cerebral lesion site data, appear to have a certain predictive value in terms of the communication outcomes rated in the CETI, thereby strengthening the content validity of the CETI in adolescent participants with ABI. The findings further point to the important role parents play in exploring the adolescents’ communicative participation in real life by sharing their opinions in interviews, based on the CETI results. The participation perspective can be addressed in the self-assessments by the adolescents themselves, as was shown in analyses of video recordings and in the interviews exploring the activitybased communication analysis and distributed cognition perspectives. The mixed-method design applied in this thesis could provide information which could contribute to shaping fruitful individualised rehabilitation programmes in adolescents with ABI.
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| 10. |
- Fransson, Anette E, et al.
(författare)
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Hydrogen Inhalation Protects against Ototoxicity Induced by Intravenous Cisplatin in the Guinea Pig
- 2017
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Ingår i: Frontiers in Cellular Neuroscience. - : Frontiers Media SA. - 1662-5102. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Permanent hearing loss and tinnitus as side-effects from treatment with the anticancer drug cisplatin is a clinical problem. Ototoxicity may be reduced by co-administration of an otoprotective agent, but the results in humans have so far been modest.Aim: The present preclinical in vivo study aimed to explore the protective efficacy of hydrogen (H2) inhalation on ototoxicity induced by intravenous cisplatin.Materials and Methods: Albino guinea pigs were divided into four groups. The Cispt (n = 11) and Cispt+H2 (n = 11) groups were given intravenous cisplatin (8 mg/kg b.w., injection rate 0.2 ml/min). Immediately after, the Cispt+H2 group also received gaseous H2 (2% in air, 60 min). The H2 group (n = 5) received only H2 and the Control group (n = 7) received neither cisplatin nor H2. Ototoxicity was assessed by measuring frequency specific ABR thresholds before and 96 h after treatment, loss of inner (IHCs) and outer (OHCs) hair cells, and by performing densitometry-based immunohistochemistry analysis of cochlear synaptophysin, organic transporter 2 (OCT2), and copper transporter 1 (CTR1) at 12 and 7 mm from the round window. By utilizing metabolomics analysis of perilymph the change of metabolites in the perilymph was assessed.Results: Cisplatin induced electrophysiological threshold shifts, hair cell loss, and reduced synaptophysin immunoreactivity in the synapse area around the IHCs and OHCs. H2 inhalation mitigated all these effects. Cisplatin also reduced the OCT2 intensity in the inner and outer pillar cells and in the stria vascularis as well as the CTR1 intensity in the synapse area around the IHCs, the Deiters' cells, and the stria vascularis. H2 prevented the majority of these effects.Conclusion: H2 inhalation can reduce cisplatin-induced ototoxicity on functional, cellular, and subcellular levels. It is proposed that synaptopathy may serve as a marker for cisplatin ototoxicity. The effect of H2 on the antineoplastic activity of cisplatin needs to be further explored.
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