Diagnosis of Spasmodic Dysphonia Manifested by Swallowing Difficulty in Videofluoroscopic Swallowing Study

PubMed Central

Yeo, Han Gyeol; Lee, Seong Jae; Hyun, Jung Keun

2015-01-01

Spasmodic dysphonia is defined as a focal laryngeal disorder characterized by dystonic spasms of the vocal cord during speech. We described a case of a 22-year-old male patient who presented complaining of idiopathic difficulty swallowing that suddenly developed 6 months ago. The patient also reported pharyngolaryngeal pain, throat discomfort, dyspnea, and voice change. Because laryngoscopy found no specific problems, an electrodiagnostic study and videofluoroscopic swallowing study (VFSS) were performed to find the cause of dysphagia. The VFSS revealed continuous twitch-like involuntary movement of the laryngeal muscle around the vocal folds. Then, he was diagnosed with spasmodic dysphonia by VFSS, auditory-perceptual voice analysis, and physical examination. So, we report the first case of spasmodic dysphonia accompanied with difficulty swallowing that was confirmed by VFSS. PMID:25932430

Acoustic correlate of vocal effort in spasmodic dysphonia.

PubMed

Eadie, Tanya L; Stepp, Cara E

2013-03-01

This study characterized the relationship between relative fundamental frequency (RFF) and listeners' perceptions of vocal effort and overall spasmodic dysphonia severity in the voices of 19 individuals with adductor spasmodic dysphonia. Twenty inexperienced listeners evaluated the vocal effort and overall severity of voices using visual analog scales. The squared correlation coefficients (R2) between average vocal effort and overall severity and RFF measures were calculated as a function of the number of acoustic instances used for the RFF estimate (from 1 to 9, of a total of 9 voiced-voiceless-voiced instances). Increases in the number of acoustic instances used for the RFF average led to increases in the variance predicted by the RFF at the first cycle of voicing onset (onset RFF) in the perceptual measures; the use of 6 or more instances resulted in a stable estimate. The variance predicted by the onset RFF for vocal effort (R2 range, 0.06 to 0.43) was higher than that for overall severity (R2 range, 0.06 to 0.35). The offset RFF was not related to the perceptual measures, irrespective of the sample size. This study indicates that onset RFF measures are related to perceived vocal effort in patients with adductor spasmodic dysphonia. These results have implications for measuring outcomes in this population.

Speech Intelligibility in Severe Adductor Spasmodic Dysphonia

ERIC Educational Resources Information Center

Bender, Brenda K.; Cannito, Michael P.; Murry, Thomas; Woodson, Gayle E.

2004-01-01

This study compared speech intelligibility in nondisabled speakers and speakers with adductor spasmodic dysphonia (ADSD) before and after botulinum toxin (Botox) injection. Standard speech samples were obtained from 10 speakers diagnosed with severe ADSD prior to and 1 month following Botox injection, as well as from 10 age- and gender-matched…

Disfluency in Spasmodic Dysphonia: A Multivariate Analysis.

ERIC Educational Resources Information Center

Cannito, Michael P.; Burch, Annette Renee; Watts, Christopher; Rappold, Patrick W.; Hood, Stephen B.; Sherrard, Kyla

1997-01-01

This study examined visual analog scaling judgments of disfluency by normal listeners in response to oral reading by 20 adults with spasmodic dysphonia (SD) and nondysphonic controls. Findings suggest that although dysfluency is not a defining feature of SD, it does contribute significantly to the overall clinical impression of severity of the…

Treatment for spasmodic dysphonia: limitations of current approaches

PubMed Central

Ludlow, Christy L.

2009-01-01

Purpose of review Although botulinum toxin injection is the gold standard for treatment of spasmodic dysphonia, surgical approaches aimed at providing long-term symptom control have been advancing over recent years. Recent findings When surgical approaches provide greater long-term benefits to symptom control, they also increase the initial period of side effects of breathiness and swallowing difficulties. However, recent analyses of quality-of-life questionnaires in patients undergoing regular injections of botulinum toxin demonstrate that a large proportion of patients have limited relief for relatively short periods due to early breathiness and loss-of-benefit before reinjection. Summary Most medical and surgical approaches to the treatment of spasmodic dysphonia have been aimed at denervation of the laryngeal muscles to block symptom expression in the voice, and have both adverse effects as well as treatment benefits. Research is needed to identify the central neuropathophysiology responsible for the laryngeal muscle spasms in order target treatment towards the central neurological abnormality responsible for producing symptoms. PMID:19337127

Cortical Silent Period Reveals Differences Between Adductor Spasmodic Dysphonia and Muscle Tension Dysphonia.

PubMed

Samargia, Sharyl; Schmidt, Rebekah; Kimberley, Teresa Jacobson

2016-03-01

The pathophysiology of adductor spasmodic dysphonia (AdSD), like other focal dystonias, is largely unknown. The purposes of this study were to determine (a) cortical excitability differences between AdSD, muscle tension dysphonia (MTD), and healthy controls; (b) distribution of potential differences in cranial or skeletal muscle; and (c) if cortical excitability measures assist in the differential diagnosis of AdSD and MTD. Ten participants with adductor spasmodic dysphonia, 8 with muscle tension dysphonia, and 10 healthy controls received single and paired pulse transcranial magnetic stimulation (TMS) to the primary motor cortex contralateral to tested muscles, first dorsal interosseus (FDI), and masseter. We tested the hypothesis that cortical excitability measures in AdSD would be significantly different from those in MTD and healthy controls. In addition, we hypothesized that there would be a correlation between cortical excitability measures and clinical voice severity in AdSD. Cortical silent period duration in masseter and FDI was significantly shorter in AdSD than MTD and healthy controls. Other measures failed to demonstrate differences. There are differences in cortical excitability between AdSD, MTD, and healthy controls. These differences in the cortical measure of both the FDI and masseter muscles in AdSD suggest widespread dysfunction of the GABAB mechanism may be a pathophysiologic feature of AdSD, similar to other forms of focal dystonia. Further exploration of the use of TMS to assist in the differential diagnosis of AdSD and MTD is warranted. © The Author(s) 2015.

Cortical silent period reveals differences between adductor spasmodic dysphonia and muscle tension dysphonia

PubMed Central

Samargia, Sharyl; Schmidt, Rebekah; Kimberley, Teresa Jacobson

2015-01-01

Background The pathophysiology of adductor spasmodic dysphonia (AdSD), like other focal dystonias, is largely unknown. Objective The purposes of this study were to determine 1) cortical excitability differences between AdSD, muscle tension dysphonia (MTD) and healthy controls 2) distribution of potential differences in cranial or skeletal muscle, and 3) if cortical excitability measures assist in the differential diagnosis of AdSD and MTD. Methods 10 participants with adductor spasmodic dysphonia, 8 with muscle tension dysphonia and 10 healthy controls received single and paired pulse transcranial magnetic stimulation (TMS) to the primary motor cortex contralateral to tested muscles, first dorsal interosseus (FDI) and masseter. We tested the hypothesis that cortical excitability measures in AdSD would be significantly different than in MTD and healthy. In addition, we hypothesized there would be a correlation between cortical excitability measures and clinical voice severity in AdSD. Results Cortical silent period (CSP) duration in masseter and FDI was significantly shorter in AdSD than MTD and healthy controls. Other measures failed to demonstrate differences. Conclusion There are differences in cortical excitability between AdSD, MTD and healthy controls. These differences in the cortical measure of both the FDI and masseter muscles in AdSD suggest widespread dysfunction of the GABAB mechanism may be a pathophysiologic feature of AdSD, similar to other forms of focal dystonia. Further exploration of the use of TMS to assist in the differential diagnosis of AdSD and MTD is warranted. PMID:26089309

Gender differences in onabotulinum toxin A dosing for adductor spasmodic dysphonia.

PubMed

Lerner, Michael Z; Lerner, Benjamin A; Patel, Amit A; Blitzer, Andrew

2017-05-01

The objective of this study was to determine the influence of gender on onabotulinum toxin A dosing for the treatment of adductor spasmodic dysphonia symptoms. Retrospective review. A chart review of the senior author's database of botulinum toxin injections was performed. Patients diagnosed with adductor spasmodic dysphonia who received onabotulinum toxin A (BoNTA) injections to the thyroarytenoid muscle for at least 5 years were included for study. Patients who received alternate formulations of botulinum toxin (Myobloc, Dysport, or Xeomin) and patients with alternate diagnoses, such as abductor spasmodic dysphonia, tremor, and oromandibular dystonia, were excluded. The average BoNTA dose was calculated for each patient and statistical analysis was performed comparing the male and female groups. A total of 201 patients (52 males and 149 females) met inclusion criteria. The average follow-up times for the male and female groups were 10.2 ± 3.6 and 11.1 ± 4 years, respectively. The average BoNTA doses for the male and female groups were 0.6 ± 0.42 U and 1.3 ± 1.1 U, respectively. Statistical analysis was performed using an independent samples two-tailed t test yielding a P value of .0000000002. A large effect size was noted with Cohen's d = 0.85. The data from this retrospective chart review reveal a statistically and clinically significant correlation between female gender and higher average BoNTA dose for symptom control in adductor spasmodic dysphonia. Explanations for this observation are speculative and include a possible inverse relationship between optimal BoNTA dose and vocal fold mass and possibly greater neutralizing antibody formation among female patients. 4. Laryngoscope, 127:1131-1134, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Brainstem pathology in spasmodic dysphonia

PubMed Central

Simonyan, Kristina; Ludlow, Christy L.; Vortmeyer, Alexander O.

2009-01-01

Spasmodic dysphonia (SD) is a primary focal dystonia of unknown pathophysiology, characterized by involuntary spasms in the laryngeal muscles during speech production. We examined two rare cases of postmortem brainstem tissue from SD patients compared to four controls. In SD patients, small clusters of inflammation were found in the reticular formation surrounding solitary tract, spinal trigeminal and ambigual nuclei, inferior olive and pyramids. Mild neuronal degeneration and depigmentation were observed in the substantia nigra and locus coeruleus. No abnormal protein accumulations and no demyelination or axonal degeneration were found. These neuropathological findings may provide insights into the pathophysiology of SD. PMID:19795469

Dystonia-causing mutations as a contribution to the etiology of Spasmodic Dysphonia

PubMed Central

de Gusmão, Claudio M.; Fuchs, Tania; Moses, Andrew; Multhaupt-Buell, Trisha; Song, Phillip C.; Ozelius, Laurie J.; Franco, Ramon A.; Sharma, Nutan

2017-01-01

Objective Spasmodic dysphonia is a focal dystonia of the larynx with heterogeneous manifestations and association with familial risk factors. There is scarce data to allow precise understanding of etiology and pathophysiology. Screening for dystonia-causing genetic mutations has the potential to allow accurate diagnosis, inform about genotype-phenotype correlations and allow a better understanding of mechanisms of disease. Study Design Prospective cohort Setting Tertiary academic medical center Subjects and methods We enrolled patients presenting with spasmodic dysphonia to the voice clinic of our academic medical center. Data collected included demographic data, clinical features, family history and treatments administered. The following disease-causing mutations previously associated with spasmodic dysphonia were screened: TOR1A (DYT1), TUBB4 (DYT4), and THAP1 (DYT6). Results 86 patients were recruited comprising 77% females and 23% males. A definite family history of neurological disorder was present in 15% (13/86). Average age of symptom onset was 42.1y (SD±15.7). Most (99%; 85/86) were treated with botulinum toxin and 12% (11/86) received oral medications. Genetic screening was negative in all patients for the GAG deletion in TOR1A (DYT 1) and in the 5 exons currently associated with disease-causing mutations in TUBB4 (DYT4). Two patients tested positive for novel /rare variants in THAP 1 (DYT 6). Conclusion Genetic screening targeted at currently known disease-causing mutations in TOR1A, THAP1 and TUBB4 appears to have low diagnostic yield in sporadic spasmodic dysphonia. In our cohort only two patients tested positive for novel/rare variants in THAP 1. Clinicians should make use of genetic testing judiciously and in cost-effective ways. PMID:27188707

Dystonia-Causing Mutations as a Contribution to the Etiology of Spasmodic Dysphonia.

PubMed

de Gusmão, Claudio M; Fuchs, Tania; Moses, Andrew; Multhaupt-Buell, Trisha; Song, Phillip C; Ozelius, Laurie J; Franco, Ramon A; Sharma, Nutan

2016-10-01

Spasmodic dysphonia is a focal dystonia of the larynx with heterogeneous manifestations and association with familial risk factors. There are scarce data to allow precise understanding of etiology and pathophysiology. Screening for dystonia-causing genetic mutations has the potential to allow accurate diagnosis, inform about genotype-phenotype correlations, and allow a better understanding of mechanisms of disease. Cross-sectional study. Tertiary academic medical center. We enrolled patients presenting with spasmodic dysphonia to the voice clinic of our academic medical center. Data included demographics, clinical features, family history, and treatments administered. The following genes with disease-causing mutations previously associated with spasmodic dysphonia were screened: TOR1A (DYT1), TUBB4 (DYT4), and THAP1 (DYT6). Eighty-six patients were recruited, comprising 77% females and 23% males. A definite family history of neurologic disorder was present in 15% (13 of 86). Average age (± standard deviation) of symptom onset was 42.1 ± 15.7 years. Most (99%; 85 of 86) were treated with botulinum toxin, and 12% (11 of 86) received oral medications. Genetic screening was negative in all patients for the GAG deletion in TOR1A (DYT1) and in the 5 exons currently associated with disease-causing mutations in TUBB4 (DYT4). Two patients tested positive for novel/rare variants in THAP1 (DYT6). Genetic screening targeted at currently known disease-causing mutations in TOR1A, THAP1, and TUBB4 appears to have low diagnostic yield in sporadic spasmodic dysphonia. In our cohort, only 2 patients tested positive for novel/rare variants in THAP1. Clinicians should make use of genetic testing judiciously and in cost-effective ways. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

The point-touch technique for botulinum toxin injection in adductor spasmodic dysphonia: quality of life assessment.

PubMed

Morzaria, S; Damrose, E J

2011-07-01

Botulinum toxin injection under electromyographic guidance is the 'gold standard' for adductor spasmodic dysphonia treatment. The point-touch technique, an alternative injection method which relies on anatomical landmarks, is cheaper, quicker and more accessible, but has not yet gained widespread acceptance due to concerns about patient satisfaction. To assess swallowing and voice-related quality of life following point-touch botulinum toxin injection in adductor spasmodic dysphonia patients. Stanford University Voice and Swallowing Center. Prospective case series (evidence level four). Consecutive adductor spasmodic dysphonia patients with a stable botulinum toxin dose-response relationship were recruited prospectively. The Eating Assessment Tool and Voice-Related Quality of Life questionnaires were completed pre-treatment and at 10 and 30 per cent completion of the injection cycle, respectively. Thirty-seven patients completed follow up. The mean total botulinum toxin dose was 0.88 units. Pre-treatment Voice-Related Quality of Life questionnaire results reflected the burden of disease. Post-treatment Eating Assessment Tool and Voice-Related Quality of Life questionnaire results were collected at 2.53 and 7.84 weeks, respectively; the former showed an increase in dysphagia, albeit statistically insignificant, while the latter showed significantly improved scores (both domain and total). The point-touch technique is a viable alternative for botulinum toxin injection in the treatment of adductor spasmodic dysphonia.

Interarytenoid muscle botox injection for treatment of adductor spasmodic dysphonia with vocal tremor.

PubMed

Kendall, Katherine A; Leonard, Rebecca J

2011-01-01

Up to one-third of patients presenting with adductor spasmodic dysphonia will have an associated vocal tremor. These patients may not respond fully to treatment using thyroarytenoid (TA) muscle botulinum toxin (Botox) injection. Treatment failures are attributed to the involvement of multiple muscle groups in the tremor. This study evaluates the results of combined interarytenoid (IA) and TA muscle Botox injection in a group of 27 patients with adductor spasmodic dysphonia and vocal tremor and in four patients with severe vocal tremor alone. Patient-satisfaction data were reviewed retrospectively. Pre- and postinjection acoustic data were collected prospectively. Acoustic measures of fundamental frequency and cycle-by-cycle variability in frequency (jitter) and intensity (shimmer) were obtained from 15 patients' sustained vowel productions. Measures were collected after TA muscle injection, alone, and after combined TA and IA (TA+IA) muscle injections. In addition, two experienced voice clinicians blindly assessed tremor severity from recordings made for each patient in the two conditions. Patients were also queried regarding their satisfaction with the results of the injections and whether they desired to continue receiving TA+IA treatment. Significant improvement in all acoustic measures except for % jitter was observed after the TA+IA muscle injections. Listeners identified voice samples after TA+IA muscle injections as demonstrating less tremor in 73% of the paired comparisons. Sixty-seven percent of the patients with spasmodic dysphonia and vocal tremor wished to continue to receive IA muscle injections. Only one patient with severe vocal tremor wished to continue with injections. The addition of an IA muscle Botox injection to the treatment of patients with a combination adductor spasmodic dysphonia and vocal tremor may improve voice outcomes. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Vocal Parameters and Self-Perception in Individuals With Adductor Spasmodic Dysphonia.

PubMed

Rojas, Gleidy Vannesa E; Ricz, Hilton; Tumas, Vitor; Rodrigues, Guilherme R; Toscano, Patrícia; Aguiar-Ricz, Lílian

2017-05-01

The study aimed to compare and correlate perceptual-auditory analysis of vocal parameters and self-perception in individuals with adductor spasmodic dysphonia before and after the application of botulinum toxin. This is a prospective cohort study. Sixteen individuals with a diagnosis of adductor spasmodic dysphonia were submitted to the application of botulinum toxin in the thyroarytenoid muscle, to the recording of a voice signal, and to the Voice Handicap Index (VHI) questionnaire before the application and at two time points after application. Two judges performed a perceptual-auditory analysis of eight vocal parameters with the aid of the Praat software for the visualization of narrow band spectrography, pitch, and intensity contour. Comparison of the vocal parameters before toxin application and on the first return revealed a reduction of oscillation intensity (P = 0.002), voice breaks (P = 0.002), and vocal tremor (P = 0.002). The same parameters increased on the second return. The degree of severity, strained-strangled voice, roughness, breathiness, and asthenia was unchanged. The total score and the emotional domain score of the VHI were reduced on the first return. There was a moderate correlation between the degree of voice severity and the total VHI score before application and on the second return, and a weak correlation on the first return. Perceptual-auditory analysis and self-perception proved to be efficient in the recognition of vocal changes and of the vocal impact on individuals with adductor spasmodic dysphonia under treatment with botulinum toxin, permitting the quantitation of changes along time. Copyright © 2017. Published by Elsevier Inc.

Review of differential diagnosis and management of spasmodic dysphonia.

PubMed

Whurr, Renata; Lorch, Marjorie

2016-06-01

The recent literature on spasmodic dysphonia is reviewed with regard to pathogenesis, differential diagnosis, treatment options, audits, and current methods of management. Advances in technology have enabled clinicians to better understand the connection between brain and laryngeal function and dysfunction. Refinements in imaging and genetic investigation techniques have led to advances in the understanding of the underlying mechanism of this neurolaryngeal disorder. Development of diagnostic assessment tools and measures of quality of life hold the potential to improve treatment and care. Fifty articles published between 2014 and 2015 were selected for this review. The sources were drawn from several clinical specialties: 54% come under the scope of laryngology, 32% from neurology, and 14% from other areas. It remains poorly understood, misdiagnosed, and underdiagnosed. Its identification, diagnosis, treatment selection, and coordination of care require an expert specialist multidisciplinary team. More training is required to help people who have this chronic and psychosocially disabling voice disorder, which impinges on all aspects of their lives. Spasmodic dysphonia is now classified as a 'rare' disease in the United States. This designation will assist in international standards of diagnosis, assessment, treatment, and management.

Abnormal activation of the primary somatosensory cortex in spasmodic dysphonia: an fMRI study.

PubMed

Simonyan, Kristina; Ludlow, Christy L

2010-11-01

Spasmodic dysphonia (SD) is a task-specific focal dystonia of unknown pathophysiology, characterized by involuntary spasms in the laryngeal muscles during speaking. Our aim was to identify symptom-specific functional brain activation abnormalities in adductor spasmodic dysphonia (ADSD) and abductor spasmodic dysphonia (ABSD). Both SD groups showed increased activation extent in the primary sensorimotor cortex, insula, and superior temporal gyrus during symptomatic and asymptomatic tasks and decreased activation extent in the basal ganglia, thalamus, and cerebellum during asymptomatic tasks. Increased activation intensity in SD patients was found only in the primary somatosensory cortex during symptomatic voice production, which showed a tendency for correlation with ADSD symptoms. Both SD groups had lower correlation of activation intensities between the primary motor and sensory cortices and additional correlations between the basal ganglia, thalamus, and cerebellum during symptomatic and asymptomatic tasks. Compared with ADSD patients, ABSD patients had larger activation extent in the primary sensorimotor cortex and ventral thalamus during symptomatic task and in the inferior temporal cortex and cerebellum during symptomatic and asymptomatic voice production. The primary somatosensory cortex shows consistent abnormalities in activation extent, intensity, correlation with other brain regions, and symptom severity in SD patients and, therefore, may be involved in the pathophysiology of SD.

Abnormal Activation of the Primary Somatosensory Cortex in Spasmodic Dysphonia: An fMRI Study

PubMed Central

Ludlow, Christy L.

2010-01-01

Spasmodic dysphonia (SD) is a task-specific focal dystonia of unknown pathophysiology, characterized by involuntary spasms in the laryngeal muscles during speaking. Our aim was to identify symptom-specific functional brain activation abnormalities in adductor spasmodic dysphonia (ADSD) and abductor spasmodic dysphonia (ABSD). Both SD groups showed increased activation extent in the primary sensorimotor cortex, insula, and superior temporal gyrus during symptomatic and asymptomatic tasks and decreased activation extent in the basal ganglia, thalamus, and cerebellum during asymptomatic tasks. Increased activation intensity in SD patients was found only in the primary somatosensory cortex during symptomatic voice production, which showed a tendency for correlation with ADSD symptoms. Both SD groups had lower correlation of activation intensities between the primary motor and sensory cortices and additional correlations between the basal ganglia, thalamus, and cerebellum during symptomatic and asymptomatic tasks. Compared with ADSD patients, ABSD patients had larger activation extent in the primary sensorimotor cortex and ventral thalamus during symptomatic task and in the inferior temporal cortex and cerebellum during symptomatic and asymptomatic voice production. The primary somatosensory cortex shows consistent abnormalities in activation extent, intensity, correlation with other brain regions, and symptom severity in SD patients and, therefore, may be involved in the pathophysiology of SD. PMID:20194686

Automated acoustic analysis of task dependency in adductor spasmodic dysphonia versus muscle tension dysphonia.

PubMed

Roy, Nelson; Mazin, Alqhazo; Awan, Shaheen N

2014-03-01

Distinguishing muscle tension dysphonia (MTD) from adductor spasmodic dysphonia (ADSD) can be difficult. Unlike MTD, ADSD is described as "task-dependent," implying that dysphonia severity varies depending upon the demands of the vocal task, with connected speech thought to be more symptomatic than sustained vowels. This study used an acoustic index of dysphonia severity (i.e., the Cepstral Spectral Index of Dysphonia [CSID]) to: 1) assess the value of "task dependency" to distinguish ADSD from MTD, and to 2) examine associations between the CSID and listener ratings. Case-Control Study. CSID estimates of dysphonia severity for connected speech and sustained vowels of patients with ADSD (n = 36) and MTD (n = 45) were compared. The diagnostic precision of task dependency (as evidenced by differences in CSID-estimated dysphonia severity between connected speech and sustained vowels) was examined. In ADSD, CSID-estimated severity for connected speech (M = 39. 2, SD = 22.0) was significantly worse than for sustained vowels (M = 29.3, SD = 21.9), [P = .020]. Whereas in MTD, no significant difference in CSID-estimated severity was observed between connected speech (M = 55.1, SD = 23.8) and sustained vowels (M = 50.0, SD = 27.4), [P = .177]. CSID evidence of task dependency correctly identified 66.7% of ADSD cases (sensitivity) and 64.4% of MTD cases (specificity). CSID and listener ratings were significantly correlated. Task dependency in ADSD, as revealed by differences in acoustically-derived estimates of dysphonia severity between connected speech and sustained vowel production, is a potentially valuable diagnostic marker. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Acoustic Variations in Adductor Spasmodic Dysphonia as a Function of Speech Task.

ERIC Educational Resources Information Center

Sapienza, Christine M.; Walton, Suzanne; Murry, Thomas

1999-01-01

Acoustic phonatory events were identified in 14 women diagnosed with adductor spasmodic dysphonia (ADSD), a focal laryngeal dystonia that disturbs phonatory function, and compared with those of 14 age-matched women with no vocal dysfunction. Findings indicated ADSD subjects produced more aberrant acoustic events than controls during tasks of…

Adductor spasmodic dysphonia: Relationships between acoustic indices and perceptual judgments

NASA Astrophysics Data System (ADS)

Cannito, Michael P.; Sapienza, Christine M.; Woodson, Gayle; Murry, Thomas

2003-04-01

This study investigated relationships between acoustical indices of spasmodic dysphonia and perceptual scaling judgments of voice attributes made by expert listeners. Audio-recordings of The Rainbow Passage were obtained from thirty one speakers with spasmodic dysphonia before and after a BOTOX injection of the vocal folds. Six temporal acoustic measures were obtained across 15 words excerpted from each reading sample, including both frequency of occurrence and percent time for (1) aperiodic phonation, (2) phonation breaks, and (3) fundamental frequency shifts. Visual analog scaling judgments were also obtained from six voice experts using an interactive computer interface to quantify four voice attributes (i.e., overall quality, roughness, brokenness, breathiness) in a carefully psychoacoustically controlled environment, using the same reading passages as stimuli. Number and percent aperiodicity and phonation breaks correlated significanly with perceived overall voice quality, roughness, and brokenness before and after the BOTOX injection. Breathiness was correlated with aperidocity only prior to injection, while roughness also correlated with frequency shifts following injection. Factor analysis reduced perceived attributes to two principal components: glottal squeezing and breathiness. The acoustic measures demonstrated a strong regression relationship with perceived glottal squeezing, but no regression relationship with breathiness was observed. Implications for an analysis of pathologic voices will be discussed.

Vocal aging and adductor spasmodic dysphonia: Response to botulinum toxin injection

PubMed Central

Cannito, Michael P; Kahane, Joel C; Chorna, Lesya

2008-01-01

Aging of the larynx is characterized by involutional changes which alter its biomechanical and neural properties and create a biological environment that is different from younger counterparts. Illustrative anatomical examples are presented. This natural, non-disease process appears to set conditions which may influence the effectiveness of botulinum toxin injection and our expectations for its success. Adductor spasmodic dysphonia, a type of laryngeal dystonia, is typically treated using botulinum toxin injections of the vocal folds in order to suppress adductory muscle spasms which are disruptive to production of speech and voice. A few studies have suggested diminished response to treatment in older patients with adductor spasmodic dysphonia. This retrospective study provides a reanalysis of existing pre-to-post treatment data as function of age. Perceptual judgments of speech produced by 42 patients with ADSD were made by two panels of professional listeners with expertise in voice or fluency of speech. Results demonstrate a markedly reduced positive response to botulinum toxin treatment in the older patients. Perceptual findings are further elucidated by means of acoustic spectrography. Literature on vocal aging is reviewed to provide a specific set of biological mechanisms that best account for the observed interaction of botulinum toxin treatment with advancing age. PMID:18488884

Vocal aging and adductor spasmodic dysphonia: response to botulinum toxin injection.

PubMed

Cannito, Michael P; Kahane, Joel C; Chorna, Lesya

2008-01-01

Aging of the larynx is characterized by involutional changes which alter its biomechanical and neural properties and create a biological environment that is different from younger counterparts. Illustrative anatomical examples are presented. This natural, non-disease process appears to set conditions which may influence the effectiveness of botulinum toxin injection and our expectations for its success. Adductor spasmodic dysphonia, a type of laryngeal dystonia, is typically treated using botulinum toxin injections of the vocal folds in order to suppress adductory muscle spasms which are disruptive to production of speech and voice. A few studies have suggested diminished response to treatment in older patients with adductor spasmodic dysphonia. This retrospective study provides a reanalysis of existing pre-to-post treatment data as function of age. Perceptual judgments of speech produced by 42 patients with ADSD were made by two panels of professional listeners with expertise in voice or fluency of speech. Results demonstrate a markedly reduced positive response to botulinum toxin treatment in the older patients. Perceptual findings are further elucidated by means of acoustic spectrography. Literature on vocal aging is reviewed to provide a specific set of biological mechanisms that best account for the observed interaction of botulinum toxin treatment with advancing age.

Tridimensional assessment of adductor spasmodic dysphonia pre- and post-treatment with Botulinum toxin.

PubMed

Dejonckere, P H; Neumann, K J; Moerman, M B J; Martens, J P; Giordano, A; Manfredi, C

2012-04-01

Spasmodic dysphonia voices form, in the same way as substitution voices, a particular category of dysphonia that seems not suited for a standardized basic multidimensional assessment protocol, like the one proposed by the European Laryngological Society. Thirty-three exhaustive analyses were performed on voices of 19 patients diagnosed with adductor spasmodic dysphonia (SD), before and after treatment with Botulinum toxin. The speech material consisted of 40 short sentences phonetically selected for constant voicing. Seven perceptual parameters (traditional and dedicated) were blindly rated by a panel of experienced clinicians. Nine acoustic measures (mainly based on voicing evidence and periodicity) were achieved by a special analysis program suited for strongly irregular signals and validated with synthesized deviant voices. Patients also filled in a VHI-questionnaire. Significant improvement is shown by all three approaches. The traditional GRB perceptual parameters appear to be adequate for these patients. Conversely, the special acoustic analysis program is successful in objectivating the improved regularity of vocal fold vibration: the basic jitter remains the most valuable parameter, when reliably quantified. The VHI is well suited for the voice-related quality of life. Nevertheless, when considering pre-therapy and post-therapy changes, the current study illustrates a complete lack of correlation between the perceptual, acoustic, and self-assessment dimensions. Assessment of SD-voices needs to be tridimensional.

Voice Onset Time for the Word-Initial Voiceless Consonant /t/ in Japanese Spasmodic Dysphonia-A Comparison With Normal Controls.

PubMed

Yanagida, Saori; Nishizawa, Noriko; Mizoguchi, Kenji; Hatakeyama, Hiromitsu; Fukuda, Satoshi

2015-07-01

Voice onset time (VOT) for word-initial voiceless consonants in adductor spasmodic dysphonia (ADSD) and abductor spasmodic dysphonia (ABSD) patients were measured to determine (1) which acoustic measures differed from the controls and (2) whether acoustic measures were related to the pause or silence between the test word and the preceding word. Forty-eight patients with ADSD and nine patients with ABSD, as well as 20 matched normal controls read a story in which the word "taiyo" (the sun) was repeated three times, each differentiated by the position of the word in the sentence. The target of measurement was the VOT for the word-initial voiceless consonant /t/. When the target syllable appeared in a sentence following a comma, or at the beginning of a sentence following a period, the ABSD patients' VOTs were significantly longer than those of the ADSD patients and controls. Abnormal prolongation of the VOTs was related to the pause or silence between the test word and the preceding word. VOTs in spasmodic dysphonia (SD) may vary according to the SD subtype or speaking conditions. VOT measurement was suggested to be a useful method for quantifying voice symptoms in SD. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Spasmodic dysphonia: a laryngeal control disorder specific to speech.

PubMed

Ludlow, Christy L

2011-01-19

Spasmodic dysphonia (SD) is a rare neurological disorder that emerges in middle age, is usually sporadic, and affects intrinsic laryngeal muscle control only during speech. Spasmodic bursts in particular laryngeal muscles disrupt voluntary control during vowel sounds in adductor SD and interfere with voice onset after voiceless consonants in abductor SD. Little is known about its origins; it is classified as a focal dystonia secondary to an unknown neurobiological mechanism that produces a chronic abnormality of laryngeal motor neuron regulation during speech. It develops primarily in females and does not interfere with breathing, crying, laughter, and shouting. Recent postmortem studies have implicated the accumulation of clusters in the parenchyma and perivascular regions with inflammatory changes in the brainstem in one to two cases. A few cases with single mutations in THAP1, a gene involved in transcription regulation, suggest that a weak genetic predisposition may contribute to mechanisms causing a nonprogressive abnormality in laryngeal motor neuron control for speech but not for vocal emotional expression. Research is needed to address the basic cellular and proteomic mechanisms that produce this disorder to provide intervention that could target the pathogenesis of the disorder rather than only providing temporary symptom relief.

[Stimuli phrases of adductor spasmodic dysphonia phonatory break in mandarin Chinese].

PubMed

Ge, Pingjiang; Ren, Qingyi; Chen, Zhipeng; Cheng, Qiuhui; Sheng, Xiaoli; Wang, Ling; Chen, Shaohua; Zhang, Siyi

2015-12-01

To investigate the characteristics of adductor spasmodic dysphonia phonatory break in mandarin Chinese and select the stimuli phrases. Thirty-eight patients with adductor spasmodic dysphonia were involved in this study. Standard phrase " fù mŭ xīn" and a speech corpus in mandarin Chinese with 229 syllables covering all vowel and constant of mandarin Chinese were selected. Every patient read the phrases above twice in normal speed and comfortable voice. Two auditory perpetual speech pathologists marked phonatory break syllables respectively. The frequency of phonatory break syllables and their located phrases were calculated, rated and described. The phrases including the most phonatory break syllables were selected as stimuli phrases, the phonatory break frequency of which was also higher than that of standard phrase "fù mŭ xīn". Phonatory break happened in the reading of all patients. The average number of phonatory break syllables was 14 (3-33). Phonatroy break occurred when saying 177 (77.3%) syllables in the speech corpus. The syllables "guŏ, rén, zāng, diàn, chē, gè, guăn, a, bā, ne, de" broke in 23.1%-41.0% patients. These syllables belonged to the phrases "pĭng guŏ, huŏ chē, shì de, nĭ shì gè hăo rén, wŏ mén shì yŏu zŏng shì bă qĭn shì nong dé hĕn zāng, wŏ mén nà biān yŏu wăng qiú yùn dong chăng, cān gŭan, jiŭ bā hé yī gè miàn bāo dìan, tā shì duō me kāng kăi a,wŏ yīng gāi zài xìn lĭ xiĕ yī xiē shén mē ne?". Thirty-seven patients (97.3%) had phonatory break in above mentioned words. Ratios of these words phonatory break also were more than "fù mŭ xīn". Adductor spasmodic dysphonic patients exhibited different degrees of phonatory break in mandarine Chinese. The phrases" shì de, pĭng guŏ, huŏ chē, nĭ shì gè hăo rén, wŏ mén nà biān yŏu wăng qiú yùn dong chăng, cān gŭan, jiŭ bā hé yī gè miàn bāo dìan, tā shì duō me kāng kăi a" were recommended as stimuli

Spasmodic Dysphonia: a Laryngeal Control Disorder Specific to Speech

PubMed Central

Ludlow, Christy L.

2016-01-01

Spasmodic dysphonia (SD) is a rare neurological disorder that emerges in middle age, is usually sporadic, and affects intrinsic laryngeal muscle control only during speech. Spasmodic bursts in particular laryngeal muscles disrupt voluntary control during vowel sounds in adductor SD and interfere with voice onset after voiceless consonants in abductor SD. Little is known about its origins; it is classified as a focal dystonia secondary to an unknown neurobiological mechanism that produces a chronic abnormality of laryngeal motor neuron regulation during speech. It develops primarily in females and does not interfere with breathing, crying, laughter, and shouting. Recent postmortem studies have implicated the accumulation of clusters in the parenchyma and perivascular regions with inflammatory changes in the brainstem in one to two cases. A few cases with single mutations in THAP1, a gene involved in transcription regulation, suggest that a weak genetic predisposition may contribute to mechanisms causing a nonprogressive abnormality in laryngeal motor neuron control for speech but not for vocal emotional expression. Research is needed to address the basic cellular and proteomic mechanisms that produce this disorder to provide intervention that could target the pathogenesis of the disorder rather than only providing temporary symptom relief. PMID:21248101

Unilateral versus bilateral thyroarytenoid Botulinum toxin injections in adductor spasmodic dysphonia: a prospective study

PubMed Central

Upile, Tahwinder; Elmiyeh, Behrad; Jerjes, Waseem; Prasad, Vyas; Kafas, Panagiotis; Abiola, Jesuloba; Youl, Bryan; Epstein, Ruth; Hopper, Colin; Sudhoff, Holger; Rubin, John

2009-01-01

Objectives In this preliminary prospective study, we compared unilateral and bilateral thyroarytenoid muscle injections of Botulinum toxin (Dysport) in 31 patients with adductor spasmodic dysphonia, who had undergone more than 5 consecutive Dysport injections (either unilateral or bilateral) and had completed 5 concomitant self-rated efficacy and complication scores questionnaires related to the previous injections. We also developed a Neurophysiological Scoring (NPS) system which has utility in the treatment administration. Method and materials Data were gathered prospectively on voice improvement (self-rated 6 point scale), length of response and duration of complications (breathiness, cough, dysphagia and total voice loss). Injections were performed under electromyography (EMG) guidance. NPS scale was used to describe the EMG response. Dose and unilateral/bilateral injections were determined by clinical judgment based on previous response. Time intervals between injections were patient driven. Results Low dose unilateral Dysport injection was associated with no significant difference in the patient's outcome in terms of duration of action, voice score (VS) and complication rate when compared to bilateral injections. Unilateral injections were not associated with any post treatment total voice loss unlike the bilateral injections. Conclusion Unilateral low dose Dysport injections are recommended in the treatment of adductor spasmodic dysphonia. PMID:19852852

Perceptual analyses of spasmodic dysphonia before and after treatment.

PubMed

Cannito, Michael P; Woodson, Gayle E; Murry, Thomas; Bender, Brenda

2004-12-01

To evaluate expert listeners' perceptions of voice and fluency in persons with adductor spasmodic dysphonia (ADSD) before and after treatment with botulinum toxin type A (Botox), as a function of initial severity of the disorder (while controlling for patients' age at injection). Simple before-and-after trial with blinded randomized listener judgments. Ambulatory care clinic at a single medical center. Forty-two consecutive patients with ADSD who underwent examination, with a 3- to 6-week follow-up, after initial botulinum toxin type A injection. There were also 42 age- and sex-matched healthy control subjects. Injections of botulinum toxin type A into the thyroarytenoid muscle(s). Computer-implemented visual analog scaling judgments of voice quality and speech fluency made by expert listeners under psychoacoustically controlled conditions. Response to botulinum toxin type A varied markedly as a function of pretreatment severity of ADSD. More severe initial symptoms exhibited greater magnitudes of improvement. Patients with mild dysphonia did not exhibit pretreatment to posttreatment change. Following treatment, voice and fluency remained significantly (P<.05) poorer in ADSD than in healthy speakers. Older patients exhibited less improvement than younger patients when the effect of initial severity was statistically controlled. Voice quality and fluency improved for most patients following treatment, but older patients and those with milder dysphonia exhibited the least optimal responses to the procedure. Patients who were profoundly impaired demonstrated the greatest amount of improvement. Computer-implemented visual analog scaling provided a reliable clinical tool for determining treatment-related changes in those with ADSD.

Differentiating between adductor and abductor spasmodic dysphonia using airflow interruption

PubMed Central

Hoffman, Matthew R.; Jiang, Jack J.; Rieves, Adam L.; McElveen, Kelsey A.B.; Ford, Charles N.

2009-01-01

Objective To measure the laryngeal resistance (RL), subglottal pressure (Ps), and mean flow rate (MFR) of adductor (ADSD) and abductor (ABSD) spasmodic dysphonia patients using the airflow interrupter. Methods The RL of six ABSD and seven ADSD patients was measured using the airflow interrupter, a noninvasive device designed to measure MFR and Ps via mechanical balloon valve interruption. Subjects performed ten trials at each of two intensity levels, with each trial consisting of a sustained /a/ during which phonation was interrupted for 500 ms. Laryngeal resistance was calculated as subglottal pressure divided by airflow. Results Mean RL for the ADSD and ABSD subtypes at 65 dB were 24.78 cmH2O/l/s and 14.51 cmH2O/l/s, respectively (p = 0.04). Mean RL at 70 dB were 40.02 cmH2O/l/s and 15.84 cmH2O/l/s (p = 0.014). Ps for the ADSD and ABSD subtypes at 65 dB were 10.23 cmH2O and 8.32 cmH2O, respectively (p = 0.582). At the 70 dB level, Ps were 12.39 cmH2O and 11.78 cmH2O (p = 0.886). MFR for the ADSD and ABSD subtypes at 65 dB were 435 ml/s and 746 ml/s (p = 0.205). Mean MFR at 70 dB were 518 ml/s and 848 ml/s (p = 0.198). Conclusion Noninvasive measurements of RL may be useful for differentiating between ADSD and ABSD. This simple objective test which produces a quantitative output could be used to evaluate laryngeal function in patients with spasmodic dysphonia. PMID:19554636

Liquid-type Botulinum Toxin Type A in Adductor Spasmodic Dysphonia: A Prospective Pilot Study.

PubMed

Cha, Wonjae; Jang, Jeon Yeob; Wang, Soo-Geun; Kang, Ji-Heon; Jo, Min-Gyu

2017-05-01

Botulinum toxin (BTX) has been widely used to treat adductor spasmodic dysphonia (ADSD). Most commercially available forms of BTX require reconstitution before use, which may increase the risk of contamination and requires careful titration. Recently, a liquid-type BTX type A (BTX-A) has been developed, which should simplify the procedure and enhance its efficacy. Herein, we present a prospective pilot study to investigate the efficacy and safety of liquid-type BTX-A in the treatment of ADSD. Twenty-six consecutive liquid-type BTX-A injections were performed in 12 patients with ADSD. We included as a control group 34 consecutive patients with ADSD who had previously undergone 52 vocal fold injection procedures with freeze-dried-type BTX-A. All patients in both groups had improvement of symptoms related to ADSD and period of normal voice. Most patients experienced breathiness, and the onset time, the peak response time, and the duration of breathiness were similar in both groups. The duration of effect (days) was 96.96 ± 18.91 and 77.38 ± 18.97 in the freeze-dried-type and the liquid-type groups, and the duration of benefit (days) was 80.02 ± 18.24 and 62.69 ± 19.73 in the freeze-dried-type and the liquid-type groups. To compare the efficacy between the freeze-dried-type and the liquid-type BTX-A, the sessions of the unilateral vocal fold injection were included and were categorized as group A (1 ~ 2 units BTX-A) and group B (2 ~ 3 units BTX-A), according to the dose per vocal fold. There was no significant difference of effect time between freeze-dried-type and liquid-type BTX-A groups. No adverse events related to BTX or vocal fold injection were reported. Liquid-type BTX-A is safe and effective for the treatment of spasmodic dysphonia. With the advantages of simple preparation, storage, and reuse and animal protein-free constituents, liquid-type BTX-A may be a good option in the treatment of spasmodic dysphonia. Copyright © 2017 The

Outcomes assessment following treatment of spasmodic dysphonia with botulinum toxin.

PubMed

Courey, M S; Garrett, C G; Billante, C R; Stone, R E; Portell, M D; Smith, T L; Netterville, J L

2000-09-01

Spasmodic dysphonia (SD), a disabling focal dystonia involving the laryngeal musculature, is most commonly treated by the intramuscular injection of botulinum toxin (BTX). Although the treatment is well tolerated and generally produces clinical voice improvement, it has never been statistically shown to alter the patient's perception of voice quality or general health. Declining resources for medical care mandate that treatment outcomes be documented. A prospective analysis of the effects of BTX on the patient's perception of voice and general health was undertaken. The Voice Handicap Index (VHI) and Short Form 36 (SF-36) surveys were administered to patients before treatment and 1 month after. Pretreatment and posttreatment scores were analyzed with a Student's t-test. On the VHI, improvements in the patients' perception of their functional, physical, and emotional voice handicap reached statistical significance (p < or = .0005). On the SF-36, patients had statistically significant improvements in mental health (p < or = .03) and social functioning (p < or = .04). Treatment of SD with BTX significantly lessened the patients' perception of dysphonia. In addition, it improved their social functioning and their perception of their mental health. These outcome measures justify the continued treatment of SD with BTX.

Vocal outcome after endoscopic thyroarytenoid myoneurectomy in patients with adductor spasmodic dysphonia.

PubMed

Gandhi, Sachin; Remacle, Marc; Mishra, Prasun; Desai, Vrushali

2014-12-01

Spasmodic dysphonia (SD) remains one of the most difficult of laryngeal pathologies to treat. With limited role for speech therapy, various surgical modalities have been tried with various success rates. The objective of the study is to report the results of vocal outcome after thyroarytenoid myoneurectomy in patients of adductor spasmodic dysphonia (ASD). 15 patients of ASD were selected. GRBAS, and voice handicap index (VHI) were used for perceptual evaluation of voice. Thyroarytenoid myoneurectomy was performed by vaporizing the muscular layer of the vocal fold with CO2 laser, at an intensity of 6 W with 1.2 mm diameter in scanner mode. Voice analysis was repeated at 12, 24 and 48 months follow-up. Preoperative GRBAS scores and VHI score of all the patients were poor. At 12 months 12/15 (80 %) patients having strain score of 0. There was marked improvement in VHI scores at 6 months. 10/15 (67 %) patients have been followed up for 24 months. 5/10 (50 %) patients have strain (S) value of 0. VHI scoring of 5/10 (50 %) patients was <30. Two of the four patients completed 48 months follow-up had a strain (S) value of 0, one patient has strain value of 1 and one patient had strain value of 2. 2/4 patients had VHI score of <30; one patient had that of 40. Trans-oral CO2 laser thyroarytenoid myoneurectomy shows significant long-term improvement in voice quality in terms of reduced speech brakes, effort and strain in voice.

Factors Associated With Patient-perceived Hoarseness in Spasmodic Dysphonia Patients.

PubMed

Hu, Amanda; Hillel, Al; Meyer, Tanya

2016-11-01

The American Academy of Otolaryngology-Head and Neck Surgery Clinical Practice Guidelines on Hoarseness distinguishes between hoarseness, which is a symptom perceived by the patient, and dysphonia, which is a diagnosis made by the clinician. Our objective was to determine factors that are associated with patient-perceived hoarseness in spasmodic dysphonia (SD) patients. Retrospective study. Adductor SD patients who presented for botulinum toxin injections from September 2011 to June 2012 were recruited. The main outcome variable, Voice Handicap Index-10 (VHI-10), was used to quantify patient-perceived hoarseness. Clinical data, Hospital Anxiety and Depression Scale (HADS), and VHI-10 were collected. Clinician-perceived dysphonia was measured by a speech-language pathologist with Consensus Auditory Perceptual Evaluation of Voice (CAPE-V). Statistical analysis included univariate analyses and multiple linear regression. One hundred thirty-nine SD patients had VHI-10 score of 26.0 ± 7.2 (mean ± standard deviation), disease duration of 10.5 + 7.0 years, CAPE-V overall score of 43.2 ± 21.8, HADS anxiety score of 6.7 ± 3.8, and HADS depression score of 3.6 ± 2.8. In univariate analyses, there were positive correlations (P < 0.05) between VHI-10 and female gender, CAPE-V overall, older age, HADS anxiety, and depression. There was no correlation with professional voice use and disease duration. In multiple linear regression (R 2  = 0.178, P < 0.001), age, HADS anxiety, female gender, and CAPE-V were significant. Older age, higher anxiety levels, female gender, and clinician-perceived dysphonia are associated with higher levels of patient-perceived hoarseness in SD patients. Hoarseness is a very personal symptom. Multiple factors determine its self-perception. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

The Mayo Clinic Arizona Spasmodic Dysphonia Experience: A Demographic Analysis of 718 Patients.

PubMed

Patel, Alpen B; Bansberg, Stephen F; Adler, Charles H; Lott, David G; Crujido, Lisa

2015-11-01

Analyze demographic data collected over a 25-year experience of 718 patients with spasmodic dysphonia (SD) who have been treated with botulinum toxin-A (BoNT-A) and compare our data with previously published studies. Seven hundred eighteen patients with SD were treated with 6621 BoNT-A injections at Mayo Clinic Arizona between 1989 and 2014. All patients were treated by the same physician team. Background demographic data for each patient were recorded. Of 718 patients, 557 patients were female (77.6%). Six hundred sixty of 718 (91.8%) patients had adductor SD (AdSD), and 58 of 718 (8.1%) patients had abductor SD (AbSD). Average age of onset was 51 years. Of 718 patients, 378 (52.6%) had vocal tremor (VT); VT was present in 54.4% of AdSD patients and 32.1% of AbSD patients. Thirty-seven of 718 (5.2%) patients had other dystonias, including cervical dystonia (2.3%), blepharospasm (1.4%), limb dystonia (1.1%), and oromandibular dystonia (0.3%). A positive family history of SD was present in only 6 of 718 patients (0.8%) and of other dystonias in 11 of 718 patients (1.5%). Spasmodic dysphonia is a chronic and potentially disabling focal laryngeal dystonia. The Mayo Clinic Arizona SD experience compares to prior reports and reveals a female preponderance, onset in middle age, infrequent hereditary pattern, high co-occurrence of VT, and low co-occurrence of other dystonias. © The Author(s) 2015.

The Consequences of Spasmodic Dysphonia on Communication-Related Quality of Life: A Qualitative Study of the Insider's Experiences

ERIC Educational Resources Information Center

Baylor, C.R.; Yorkston, K.M.; Eadie, T.L.

2005-01-01

The purpose of this study was to explore the biopsychosocial consequences of spasmodic dysphonia (SD) as experienced by people with SD. Qualitative research methods were used to investigate the insider's perspective of living with SD. Six adults with SD participated in face-to-face phenomenological interviews. The results are summarized in a model…

Communication-related affective, behavioral, and cognitive reactions in speakers with spasmodic dysphonia.

PubMed

Watts, Christopher R; Vanryckeghem, Martine

2017-12-01

To investigate the self-perceived affective, behavioral, and cognitive reactions associated with communication of speakers with spasmodic dysphonia as a function of employment status. Prospective cross-sectional investigation. 148 Participants with spasmodic dysphonia (SD) completed an adapted version of the Behavior Assessment Battery (BAB-Voice), a multidimensional assessment of self-perceived reactions to communication. The BAB-Voice consisted of four subtests: the Speech Situation Checklist for A) Emotional Reaction (SSC-ER) and B) Speech Disruption (SSC-SD), C) the Behavior Checklist (BCL), and D) the Communication Attitude Test for Adults (BigCAT). Participants were assigned to groups based on employment status (working versus retired). Descriptive comparison of the BAB-Voice in speakers with SD to previously published non-dysphonic speaker data revealed substantially higher scores associated with SD across all four subtests. Multivariate Analysis of Variance (MANOVA) revealed no significantly different BAB-Voice subtest scores as a function of SD group status (working vs. retired). BAB-Voice scores revealed that speakers with SD experienced substantial impact of their voice disorder on communication attitude, coping behaviors, and affective reactions in speaking situations as reflected in their high BAB scores. These impacts do not appear to be influenced by work status, as speakers with SD who were employed or retired experienced similar levels of affective and behavioral reactions in various speaking situations and cognitive responses. These findings are consistent with previously published pilot data. The specificity of items assessed by means of the BAB-Voice may inform the clinician of valid patient-centered treatment goals which target the impairment extended beyond the physiological dimension. 2b.

Botulinum Toxin Dosing Trends in Spasmodic Dysphonia Over a 20-year Period.

PubMed

Namin, Arya W; Christopher, Kara M; Eisenbeis, John F

2017-01-01

The study aims to (1) identify the botulinum toxin (BTX) dosing trend in a cohort of patients who received at least 20 injections for the treatment of adductor spasmodic dysphonia (ADSD), (2) describe two distinct BTX dosing trends in treating ADSD (a "classic" dosing trend that initially decreases before stabilizing, and a "fluctuating" dosing trend), and (3) determine if patients with the "classic" dosing trend differed in age or in dosing intervals from those with the "fluctuating" dosing trend. This is a retrospective case series. Of 149 patients who received a total of 2484 BTX injections for the treatment of spasmodic dysphonia in 1993-2013, 49 patients received at least 20 injections. The BTX dose and the interval between doses were recorded. The mean dose of injections 1-20 was determined. The age at initial injection, initial dose, and interval in days between treatments were compared for the "fluctuating" and "classic" groups. The cohort exhibits a significant decrease in dose during the first 10-15 injections. The "fluctuating" group had a significantly shorter interval between injections (mean interval = 97.09 days, SD = 29.41; mean interval = 136.90 days, SD = 43.76, P = 0.002). The mean age at initial dose was not significantly different between the "classic" and "fluctuating" groups. The average BTX dose of patients with ADSD who receive long-term injections significantly decreases during the initial 10-15 injections before stabilizing. Patients who exhibit the "fluctuating" dosing pattern have a significantly shorter interval between injections than those with the "classic" dosing pattern. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Communication‐related affective, behavioral, and cognitive reactions in speakers with spasmodic dysphonia

PubMed Central

Vanryckeghem, Martine

2017-01-01

Objectives To investigate the self‐perceived affective, behavioral, and cognitive reactions associated with communication of speakers with spasmodic dysphonia as a function of employment status. Study Design Prospective cross‐sectional investigation Methods 148 Participants with spasmodic dysphonia (SD) completed an adapted version of the Behavior Assessment Battery (BAB‐Voice), a multidimensional assessment of self‐perceived reactions to communication. The BAB‐Voice consisted of four subtests: the Speech Situation Checklist for A) Emotional Reaction (SSC‐ER) and B) Speech Disruption (SSC‐SD), C) the Behavior Checklist (BCL), and D) the Communication Attitude Test for Adults (BigCAT). Participants were assigned to groups based on employment status (working versus retired). Results Descriptive comparison of the BAB‐Voice in speakers with SD to previously published non‐dysphonic speaker data revealed substantially higher scores associated with SD across all four subtests. Multivariate Analysis of Variance (MANOVA) revealed no significantly different BAB‐Voice subtest scores as a function of SD group status (working vs. retired). Conclusions BAB‐Voice scores revealed that speakers with SD experienced substantial impact of their voice disorder on communication attitude, coping behaviors, and affective reactions in speaking situations as reflected in their high BAB scores. These impacts do not appear to be influenced by work status, as speakers with SD who were employed or retired experienced similar levels of affective and behavioral reactions in various speaking situations and cognitive responses. These findings are consistent with previously published pilot data. The specificity of items assessed by means of the BAB‐Voice may inform the clinician of valid patient‐centered treatment goals which target the impairment extended beyond the physiological dimension. Level of Evidence 2b PMID:29299525

Botulinum Toxin in Secondarily Nonresponsive Patients with Spasmodic Dysphonia.

PubMed

Mor, Niv; Tang, Christopher; Blitzer, Andrew

2016-09-01

Chemodenervation with botulinum toxin (BoNT) has been effective and well tolerated for all types of dystonia for >30 years. We reviewed outcomes of our patients treated with BoNT serotype A (BoNT-A) for spasmodic dysphonia (SD) who became secondarily nonresponsive. We found that 8 of 1400 patients became nonresponsive to BoNT-A (0.57%), which is lower than the secondary nonresponse rate in other dystonias. After a cessation period, 4 of our patients resumed BoNT-A injections, and recurrence of immunoresistance was not seen in any of them. When compared with patients with other dystonias, patients with SD receive extremely low doses of BoNT. Small antigen challenge may explain the lower rate of immunoresistance and long-lasting efficacy after BoNT-A is restarted among secondary nonresponsive patients with SD. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Treatment efficacy of electromyography versus fiberscopy-guided botulinum toxin injection in adductor spasmodic dysphonia patients: a prospective comparative study.

PubMed

Kim, Jae Wook; Park, Jae Hong; Park, Ki Nam; Lee, Seung Won

2014-01-01

This study prospectively evaluates and compares the treatment efficacy of botulinum toxin injection under electromyography guidance (EMG group) and percutaneous botulinum toxin injection under flexible fiberscopic guidance (fiberscopy group). Thirty patients with adductor spasmodic dysphonia (ADSD), who had never received treatment, were randomly allocated into EMG- or fiberscopy-guided botulinum toxin injections between March 2008 and February 2010. We assessed acoustic and aerodynamic voice parameters, and the voice handicap index (VHI) before injection and at 1, 3, and 6 months after injection. The mean total dosage of botulinum toxin was similar for both groups: 1.7 ± 0.5 U for the EMG group and 1.8 ± 0.4 U for the fiberscopy group (P > 0.05). There were no significant differences in outcomes between the two groups in either the duration of effectiveness or complications such as breathy voice and aspiration. Botulinum toxin injection under fiberscopic guidance is a viable alternative to EMG-guided botulinum toxin injection for the treatment of adductor spasmodic dysphonia when EMG equipment is unavailable.

Treatment Efficacy of Electromyography versus Fiberscopy-Guided Botulinum Toxin Injection in Adductor Spasmodic Dysphonia Patients: A Prospective Comparative Study

PubMed Central

Kim, Jae Wook; Park, Jae Hong; Park, Ki Nam; Lee, Seung Won

2014-01-01

Introduction. This study prospectively evaluates and compares the treatment efficacy of botulinum toxin injection under electromyography guidance (EMG group) and percutaneous botulinum toxin injection under flexible fiberscopic guidance (fiberscopy group). Methods. Thirty patients with adductor spasmodic dysphonia (ADSD), who had never received treatment, were randomly allocated into EMG- or fiberscopy-guided botulinum toxin injections between March 2008 and February 2010. We assessed acoustic and aerodynamic voice parameters, and the voice handicap index (VHI) before injection and at 1, 3, and 6 months after injection. Results. The mean total dosage of botulinum toxin was similar for both groups: 1.7 ± 0.5 U for the EMG group and 1.8 ± 0.4 U for the fiberscopy group (P > 0.05). There were no significant differences in outcomes between the two groups in either the duration of effectiveness or complications such as breathy voice and aspiration. Conclusion. Botulinum toxin injection under fiberscopic guidance is a viable alternative to EMG-guided botulinum toxin injection for the treatment of adductor spasmodic dysphonia when EMG equipment is unavailable. PMID:25383369

Long-Term Follow-Up of Patients with Spasmodic Dysphonia and Improved Voice despite Discontinuation of Treatment.

PubMed

Geneid, Ahmed; Lindestad, Per-Åke; Granqvist, Svante; Möller, Riitta; Södersten, Maria

2016-01-01

To evaluate voice function in patients with adductor spasmodic dysphonia (AdSD) who discontinued botulinum toxin (BTX) treatment because they felt that their voice had improved sufficiently. Twenty-eight patients quit treatment in 2004, of whom 20 fulfilled the inclusion criteria for the study, with 3 subsequently excluded because of return of symptoms, leaving 17 patients (11 males, 6 females) included in this follow-up study. A questionnaire concerning current voice function and the Voice Handicap Index were completed. Audio-perceptual voice assessments were done by 3 listeners. The inter- and intrarater reliabilities were r > 0.80. All patients had a subjectively good stable voice, but with differences in their audio-perceptual voice assessment scores. Based on the pre-/posttreatment auditory scores on the overall degree of AdSD, patients were divided into 2 subgroups showing more and less improvement, with 10 and 7 patients, respectively. The subgroup with more improvement had shorter duration from the onset of symptoms until the start of BTX treatment, and included 7 males compared to only 4 males in the subgroup with less improvement. It seems plausible that the symptoms of spasmodic dysphonia may decrease over time. Early intervention and male gender seem to be important factors for long-term reduction of the voice symptoms of AdSD. © 2016 S. Karger AG, Basel.

Acoustic and Perceptual Analyses of Adductor Spasmodic Dysphonia in Mandarin-speaking Chinese.

PubMed

Chen, Zhipeng; Li, Jingyuan; Ren, Qingyi; Ge, Pingjiang

2018-02-12

The objective of this study was to examine the perceptual structure and acoustic characteristics of speech of patients with adductor spasmodic dysphonia (ADSD) in Mandarin. Case-Control Study MATERIALS AND METHODS: For the estimation of dysphonia level, perceptual and acoustic analysis were used for patients with ADSD (N = 20) and the control group (N = 20) that are Mandarin-Chinese speakers. For both subgroups, a sustained vowel and connected speech samples were obtained. The difference of perceptual and acoustic parameters between the two subgroups was assessed and analyzed. For acoustic assessment, the percentage of phonatory breaks (PBs) of connected reading and the percentage of aperiodic segments and frequency shifts (FS) of vowel and reading in patients with ADSD were significantly worse than controls, the mean harmonics-to-noise ratio and the fundamental frequency standard deviation of vowel as well. For perceptual evaluation, the rating of speech and vowel in patients with ADSD are significantly higher than controls. The percentage of aberrant acoustic events (PB, frequency shift, and aperiodic segment) and the fundamental frequency standard deviation and mean harmonics-to-noise ratio were significantly correlated with the perceptual rating in the vowel and reading productions. The perceptual and acoustic parameters of connected vowel and reading in patients with ADSD are worse than those in normal controls, and could validly and reliably estimate dysphonia of ADSD in Mandarin-speaking Chinese. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Long-term Effect of Sodium Oxybate (Xyrem®) in Spasmodic Dysphonia with Vocal Tremor

PubMed Central

Simonyan, Kristina; Frucht, Steven J.

2013-01-01

Background Symptoms of spasmodic dysphonia (SD) are usually managed successfully with botulinum toxin injections. Vocal tremor (VT), which accompanies SD, has a poor response to this treatment. Case Report We report a case of a female with SD and VT who became symptom-free for 10 months after the intake of a single dose of sodium oxybate (Xyrem®). The long-term treatment effect correlated with attenuated brain activity in the key regions of dystonic brain network. Discussion Our case demonstrates that the novel treatment of sodium oxybate may hold promise for SD patients, especially those who have associated VT. PMID:24386608

Abnormal Structure–Function Relationship in Spasmodic Dysphonia

PubMed Central

Ludlow, Christy L.

2012-01-01

Spasmodic dysphonia (SD) is a primary focal dystonia characterized by involuntary spasms in the laryngeal muscles during speech production. Although recent studies have found abnormal brain function and white matter organization in SD, the extent of gray matter alterations, their structure–function relationships, and correlations with symptoms remain unknown. We compared gray matter volume (GMV) and cortical thickness (CT) in 40 SD patients and 40 controls using voxel-based morphometry and cortical distance estimates. These measures were examined for relationships with blood oxygen level–dependent signal change during symptomatic syllable production in 15 of the same patients. SD patients had increased GMV, CT, and brain activation in key structures of the speech control system, including the laryngeal sensorimotor cortex, inferior frontal gyrus (IFG), superior/middle temporal and supramarginal gyri, and in a structure commonly abnormal in other primary dystonias, the cerebellum. Among these regions, GMV, CT and activation of the IFG and cerebellum showed positive relationships with SD severity, while CT of the IFG correlated with SD duration. The left anterior insula was the only region with decreased CT, which also correlated with SD symptom severity. These findings provide evidence for coupling between structural and functional abnormalities at different levels within the speech production system in SD. PMID:21666131

Alterations in CNS Activity Induced by Botulinum Toxin Treatment in Spasmodic Dysphonia: An H[subscript 2][superscript 15]O PET Study

ERIC Educational Resources Information Center

Ali, S. Omar; Thomassen, Michael; Schulz, Geralyn M.; Hosey, Lara A.; Varga, Mary; Ludlow, Christy L.; Braun, Allen R.

2006-01-01

Speech-related changes in regional cerebral blood flow (rCBF) were measured using H[subscript 2][superscript 15]O positron-emission tomography in 9 adults with adductor spasmodic dysphonia (ADSD) before and after botulinum toxin (BTX) injection and 10 age- and gender-matched volunteers without neurological disorders. Scans were acquired at rest…

Behavior Assessment Battery: A Pilot Study of the Affective, Behavioral, and Cognitive Correlates Surrounding Spasmodic Dysphonia.

PubMed

Vanryckeghem, Martine; Hoffman Ruddy, Bari; Lehman, Jeffrey

2016-01-01

This study investigates if adults with adductor spasmodic dysphonia (ADSD) report to experience anxiety and voice problems in particular situations, indicate the presence of negative speech-associated attitude, and/or the use of coping behaviors, by means of the Behavior Assessment Battery (BAB) modified for voice. Thirty-two participants with ADSD and 32 adults without a voice disorder participated in this study. Each person completed four different BAB-Voice subtests. These standardized self-report tests are adaptations of the original BAB for people who stutter and explore an individual's speech-related belief, negative emotional reaction to and speech problems in particular speech situations, and the use of concomitant behaviors. Individuals with spasmodic dysphonia (SD) scored statistically significantly higher compared to typical speakers on all BAB subtests, indicating that individuals with SD report being significantly more anxious and experiencing significantly more voice problems in particular speech circumstances. They also reported a significant amount of negative speech-associated attitude and the use of a significant number of coping behaviors. Internal reliability was good for three of the four BAB subtests. The BAB is capable of reflecting the dimensions that surround the disorder of SD. The self-report measures have the potential to augment the observations made by the clinician and may lead to a more diverse and all-encompassing therapy for the person suffering from SD. Future research with a revised version of the BAB-Voice will continue to explore the validity, reliability, and replicability of the initial data. Published by Elsevier Inc.

Perceptual structure of adductor spasmodic dysphonia and its acoustic correlates.

PubMed

Cannito, Michael P; Doiuchi, Maki; Murry, Thomas; Woodson, Gayle E

2012-11-01

To examine the perceptual structure of voice attributes in adductor spasmodic dysphonia (ADSD) before and after botulinum toxin treatment and identify acoustic correlates of underlying perceptual factors. Reliability of perceptual judgments is considered in detail. Pre- and posttreatment trial with comparison to healthy controls, using single-blind randomized listener judgments of voice qualities, as well as retrospective comparison with acoustic measurements. Oral readings were recorded from 42 ADSD speakers before and after treatment as well as from their age- and sex-matched controls. Experienced judges listened to speech samples and rated attributes of overall voice quality, breathiness, roughness, and brokenness, using computer-implemented visual analog scaling. Data were adjusted for regression to the mean and submitted to principal components factor analysis. Acoustic waveforms, extracted from the reading samples, were analyzed and measurements correlated with perceptual factor scores. Four reliable perceptual variables of ADSD voice were effectively reduced to two underlying factors that corresponded to hyperadduction, most strongly associated with roughness, and hypoadduction, most strongly associated with breathiness. After treatment, the hyperadduction factor improved, whereas the hypoadduction factor worsened. Statistically significant (P<0.01) correlations were observed between perceived roughness and four acoustic measures, whereas breathiness correlated with aperiodicity and cepstral peak prominence (CPPs). This study supported a two-factor model of ADSD, suggesting perceptual characterization by both hyperadduction and hypoadduction before and after treatment. Responses of the factors to treatment were consistent with previous research. Correlations among perceptual and acoustic variables suggested that multiple acoustic features contributed to the overall impression of roughness. Although CPPs appears to be a partial correlate of perceived

Tracing Spasmodic Dysphonia: The Source of Ludwig Traube's Priority.

PubMed

Lorch, Marjorie Perlman; Whurr, Renata

2016-08-01

Since the mid-20th century, one citation is given historical priority as the first description of spasmodic dysphonia (SD): Ludwig Traube's 1871 case of the "spastic form of nervous hoarseness." Our objective is to understand how this case serves as the foundation of understanding laryngeal movement disorders. The original German paper was located and translated. Bibliographical and bibliometric methods are used to determine the citation history of this original source over the past 140 years. Although secondary citations in contemporary publications typically credit Traube for establishing the clinical entity SD, his case does not conform to currently accepted diagnostic features. Citation patterns indicate the source of Traube's priority is publications by Arnold and Luchsinger, mid-20th-century ENT clinicians, particularly their influential 1965 textbook used to train US and UK clinicians on voice disorders for several generations. Sometimes secondary citations in medical literature lead to the inadvertent perpetuation of factual misrepresentation. The clinical picture of Traube's original case does not represent what clinicians would recognize as SD today. The rich 19th-century literature on voice disorders is a valuable resource for present day clinicians. © The Author(s) 2016.

Spasmodic dysphonia follow-up with videolaryngoscopy and voice spectrography during treatment with botulinum toxin.

PubMed

Esposito, Marcello; Dubbioso, R; Apisa, P; Allocca, R; Santoro, L; Cesari, U

2015-09-01

Spasmodic dysphonia (SD) is a focal dystonia of laryngeal muscles seriously impairing quality of voice. Adductor SD (ADSD) is the most common presentation of this disorder that can be identified by specialized phoniatricians and neurologists firstly on a clinical evaluation and then confirmed by videolaryngoscopy (VL). Botulinum toxin (BTX) injection with electromyographic guidance in muscles around vocal cords is the most effective treatment. Voice Handicap Index (VHI) questionnaire is the main tool to assess dysphonia and response to treatment. Objective of this study is to perform VL and voice spectrography (VS) to confirm the efficacy of BTX injections over time. 13 patients with ADSD were studied with VHI, VL and VS before and after 4 consecutive treatment with onobotulinumtoxin-A. For each treatment vocal improvement was proved by a significant reduction of VHI score and increase of maximum time phonation and harmonic-to-noise ratio while VL showed the absence of spasm in most of patients. No change of the response to BTX was found between injections. This study supports the efficacy of the treatment of SD with BTX with objective measurements and suggests that the efficacy of recurring treatments is stable over time.

Psychiatric comorbidity in patients with spasmodic dysphonia: a controlled study

PubMed Central

Gündel, H; Busch, R; Ceballos‐Baumann, A; Seifert, E

2007-01-01

Objectives To study the prevalence of psychiatric comorbidity assessed by a structured clinical interview in patients with spasmodic dysphonia (SD) compared with patients suffering from vocal fold paralysis (VFP). Methods In 48 patients with SD and 27 patients with VFP, overall psychiatric comorbidity was studied prospectively using the Structured Clinical Interview for DSM‐IV Axis I disorders. Physical disability and psychometric variables were assessed with standardised self‐rating questionnaires. Results 41.7% of SD subjects and 19.5% of the control group met DSM‐IV clinical criteria for current psychiatric comorbidity (p<0.05). Significant predictors of psychiatric comorbidity in SD were severity of voice impairment and subjective assessment of “satisfaction with health”. As a limitation, the severity of voice impairment in patients with SD was nearly twice as high, and their illness had lasted nearly twice as long. Conclusions We found a high prevalence of psychiatric comorbidity in patients with SD. The significant correlation between current psychiatric comorbidity and the extent of voice pathology may point to an especially strong interaction between somatic and psychiatric complaints in SD. PMID:17615166

Spasmodic Dysphonia in Multiple Sclerosis Treatment With Botulin Toxin A: A Pilot Study.

PubMed

Di Stadio, Arianna; Bernitsas, Evanthia; Restivo, Domenico Antonio; Alfonsi, Enrico; Marchese-Ragona, Rosario

2018-04-09

This study aims to evaluate the effect of botulin toxin A in patients with multiple sclerosis (MS) affected by spasmodic dysphonia (SD) and to show the safety and effectiveness of this treatment in long-term observation. This is a pilot study on three relapsing-remitting MS patients with SD and their response to botulin toxin A. None of the patients reported dysphagia or other adverse events. Significant improvement was observed in terms of both voice quality and laryngostroboscopy results. The treatment effect was durable for 6-8 months. Botulin toxin A is a safe treatment that can be successfully used to treat SD in patients with MS. Larger studies are necessary to confirm our results. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Consensus-Based Attributes for Identifying Patients With Spasmodic Dysphonia and Other Voice Disorders.

PubMed

Ludlow, Christy L; Domangue, Rickie; Sharma, Dinesh; Jinnah, H A; Perlmutter, Joel S; Berke, Gerald; Sapienza, Christine; Smith, Marshall E; Blumin, Joel H; Kalata, Carrie E; Blindauer, Karen; Johns, Michael; Hapner, Edie; Harmon, Archie; Paniello, Randal; Adler, Charles H; Crujido, Lisa; Lott, David G; Bansberg, Stephen F; Barone, Nicholas; Drulia, Teresa; Stebbins, Glenn

2018-06-21

A roadblock for research on adductor spasmodic dysphonia (ADSD), abductor SD (ABSD), voice tremor (VT), and muscular tension dysphonia (MTD) is the lack of criteria for selecting patients with these disorders. To determine the agreement among experts not using standard guidelines to classify patients with ABSD, ADSD, VT, and MTD, and develop expert consensus attributes for classifying patients for research. From 2011 to 2016, a multicenter observational study examined agreement among blinded experts when classifying patients with ADSD, ABSD, VT or MTD (first study). Subsequently, a 4-stage Delphi method study used reiterative stages of review by an expert panel and 46 community experts to develop consensus on attributes to be used for classifying patients with the 4 disorders (second study). The study used a convenience sample of 178 patients clinically diagnosed with ADSD, ABSD, VT MTD, vocal fold paresis/paralysis, psychogenic voice disorders, or hypophonia secondary to Parkinson disease. Participants were aged 18 years or older, without laryngeal structural disease or surgery for ADSD and underwent speech and nasolaryngoscopy video recordings following a standard protocol. Speech and nasolaryngoscopy video recordings following a standard protocol. Specialists at 4 sites classified 178 patients into 11 categories. Four international experts independently classified 75 patients using the same categories without guidelines after viewing speech and nasolaryngoscopy video recordings. Each member from the 4 sites also classified 50 patients from other sites after viewing video clips of voice/laryngeal tasks. Interrater κ less than 0.40 indicated poor classification agreement among rater pairs and across recruiting sites. Consequently, a Delphi panel of 13 experts identified and ranked speech and laryngeal movement attributes for classifying ADSD, ABSD, VT, and MTD, which were reviewed by 46 community specialists. Based on the median attribute rankings, a final

A comparison of the VHI, VHI-10, and V-RQOL for measuring the effect of botox therapy in adductor spasmodic dysphonia.

PubMed

Morzaria, Sanjay; Damrose, Edward J

2012-05-01

Although disease-specific quality-of-life (QOL) instruments are an invaluable outcome measure in spasmodic dysphonia, there is no consensus on which QOL instrument should be used. To determine the responsiveness of the Voice Handicap Index (VHI), Voice Handicap Index-10 (VHI-10), and Voice-Related Quality of Life (V-RQOL) to the treatment effect of botulinum toxin (Botox) in adductor spasmodic dysphonia (ADSD). Stanford University Voice and Swallowing Center. Prospective case series (level of evidence=4). Consecutive ADSD patients with a stable Botox dose-response relationship were recruited prospectively. VHI, VHI-10, and V-RQOL scores were obtained pretreatment and during the middle third of the posttreatment injection cycle. Thrity-seven patients completed the follow-up. The average total Botox dose was 0.88 units. The average follow-up time after injection was 7.84 weeks. The pretreatment QOL scores reflected the burden of the disease. All the three instruments were highly correlated in subscale and total scores. After treatment, all three instruments showed significant improvement. The VHI, VHI-10, and V-RQOL all reflected the morbidity associated with ADSD and were significantly responsive to the effect of Botox therapy. The choice of instrument should be based on physician preference. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Assessing the effectiveness of botulinum toxin injections for adductor spasmodic dysphonia: clinician and patient perception.

PubMed

Braden, Maia N; Johns, Michael M; Klein, Adam M; Delgaudio, John M; Gilman, Marina; Hapner, Edie R

2010-03-01

To determine the effectiveness of Botox treatment for adductor spasmodic dysphonia (ADSD), the clinician and patient judge changes in voice symptoms and the effect on quality of life. Currently, there is no standard protocol for determining the effectiveness of Botox injections in treating ADSD. Therefore, clinicians use a variety of perceptual scales and patient-based self-assessments to determine patients' impressions of severity and changes after treatments. The purpose of this study was to assess clinician-patient agreement of the effects of Botox on voice quality and quality of life in ADSD. Retrospective chart review of 199 randomly selected patients since 2004. Results indicated a weak correlation between the patient's assessment of voice impairment (EIS) and patient's quality of life impairment (Voice-Related Quality of Life [V-RQOL]) in the mild-moderate dysphonia severity group and the moderate-to-severe dysphonia group. There was a weak correlation between the patient's assessment of voice impairment EIS and the clinician's perceptual judgment of voice impairment (Consensus Auditory Perceptual Evaluation of Voice [CAPE-V]) only in the moderate to severe dysphonia group. There was a weak correlation between the patient's quality of life impairment (V-RQOL) and the clinician's perceptual judgment of voice impairment (CAPE-V) only in the severe to profound dysphonia group. The poor relationship among commonly used outcome measures leads us to question how best to assess the effectiveness of Botox in ADSD. Clinicians are required to document treatment outcomes, making it important to use scales that are valid, reliable, and sensitive to change. Future research directions include examining relationships between measures both before and after Botox injections, examining the specific factors that determine quality of life changes, and further research on specific parameters of the CAPE-V as well as comparing perceptual and quality of life scales with acoustic

Spasmodic dysphonia: onset, course, socioemotional effects, and treatment response.

PubMed

Tanner, Kristine; Roy, Nelson; Merrill, Ray M; Sauder, Cara; Houtz, Daniel R; Smith, Marshall E

2011-07-01

This investigation explored the onset, progression, socioemotional effects, and treatment outcomes of spasmodic dysphonia (SD). A cross-sectional epidemiological approach was used to examine questionnaire responses from 150 individuals with SD. Symptoms of SD (mean age at onset, 46 years) began gradually in 76% of cases and were progressive (ie, failed to plateau) in 34% of cases. Botulinum toxin A (Botox) helped to attenuate voice symptoms in 91% of cases; however, the scores on the Voice-Related Quality of Life questionnaire (V-RQOL) were not associated with this effect. The V-RQOL scores improved with time since symptom onset, independent of age and treatment. The patients with only SD experienced onset, course, and progression of symptoms similar to those of the patients with SD and coexisting vocal tremor. The symptoms of SD begin gradually and worsen over time. New evidence indicates that SD symptoms may continue to progress without plateau in at least a subset of patients. Individuals with SD and coexisting vocal tremor experience symptom trajectories similar to those of patients with SD only. Although Botox may attenuate voice symptoms, these effects do not appear to be strongly related to the V-RQOL scores. These results provide new and valuable insights regarding the onset, course, progression, and treatment of SD.

Morell Mackenzie's Contribution to the Description of Spasmodic Dysphonia.

PubMed

Lorch, Marjorie Perlman; Whurr, Renata

2016-12-01

Since the middle of the 20th century, most discussions of spasmodic dysphonia (SD) reference a paper by Ludwig Traube published in1871 as the first historical citation, crediting him with priority for this clinical syndrome. However, our recent research has determined that the original observation by Traube was published in 1864 and does not in fact describe what is currently recognized as SD. It appears that many clinics throughout Europe and North America were investigating and publishing observations on a range of voice disorders. The wider context of work on laryngeal disorders in the 1860s-1870s is considered. One of Traube's contemporaries, Morell Mackenzie, made significant contributions to the understanding of laryngeal movement disorder and its consequences for the voice. These will be examined to gain a clearer focus on the characterization of this disorder. The clinical descriptions published by Morrell Mackenzie in the 1860s provide details that conform quite closely to our current-day understanding of SD. The citation of Traube's "hysterical" patient links to mid 20th-century views of the functional nature of SD and the utility of psychiatric treatment. The description presented by Mackenzie is consistent with current views of SD as a movement disorder. © The Author(s) 2016.

Laryngeal dystonia gravidarum: sudden onset of adductor spasmodic dysphonia in pregnancy.

PubMed

Ankola, Ashish; Sulica, Lucian; Murry, Thomas

2013-12-01

The purpose of this study was to identify the presence or absence of known factors related to onset of adductor spasmodic dysphonia (ADSD) in a population with sudden onset during or after pregnancy. Retrospective review. A review of 350 patient records identified five patients with sudden onset of ADSD related to pregnancy. An age-matched group with sudden onset of ADSD not related to pregnancy served as controls. All subjects completed a 20-question survey of risk factors relevant to ADSD. The average age of onset in both groups was 31 years. Three had onset of ADSD in the postpartum period, the other two during pregnancy. Significantly increased avocational voice use was found in the pregnant group compared to the control group. There was a significant difference in the two groups regarding cumulative risk factors traditionally associated with ADSD. Sudden onset of ADSD can occur in pregnancy in women with clinical profiles that differ from traditional ADSD patients. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Co-Prevalence of Tremor with Spasmodic Dysphonia: A Case-Control Study

PubMed Central

White, Laura; Klein, Adam; Hapner, Edie; Delgaudio, John; Hanfelt, John; Jinnah, H. A.; Johns, Michael

2011-01-01

OBJECTIVES/HYPOTHESIS The aim of this study was to define the co-prevalence of tremor with spasmodic dysphonia (SD). STUDY DESIGN A single institution prospective, case-control study was performed from May 2010 to July 2010. METHODS Consecutive patients with SD (cases) and other voice disorders (controls) were enrolled prospectively. Each participant underwent a voice evaluation and an evaluation for tremor. RESULTS 146 voice disorder controls and 128 patients with SD were enrolled. 26% of patients with SD had vocal tremor, 21% had non-vocal tremor. Patients with SD were 2.8 times more likely to have co-prevalent tremor than the control group (OR = 2.81; 95% CI, 1.55 to 5.08) and only 35% of patients with SD had been seen by a neurologist for the evaluation of dystonia and tremor. CONCLUSIONS Tremor is highly prevalent in patients with SD. It is important for each patient diagnosed with SD to undergo an evaluation for tremor, this is especially important in patients diagnosed with vocal tremor. Level of evidence 3b. PMID:21792965

Central voice production and pathophysiology of spasmodic dysphonia.

PubMed

Mor, Niv; Simonyan, Kristina; Blitzer, Andrew

2018-01-01

Our ability to speak is complex, and the role of the central nervous system in controlling speech production is often overlooked in the field of otolaryngology. In this brief review, we present an integrated overview of speech production with a focus on the role of central nervous system. The role of central control of voice production is then further discussed in relation to the potential pathophysiology of spasmodic dysphonia (SD). Peer-review articles on central laryngeal control and SD were identified from PUBMED search. Selected articles were augmented with designated relevant publications. Publications that discussed central and peripheral nervous system control of voice production and the central pathophysiology of laryngeal dystonia were chosen. Our ability to speak is regulated by specialized complex mechanisms coordinated by high-level cortical signaling, brainstem reflexes, peripheral nerves, muscles, and mucosal actions. Recent studies suggest that SD results from a primary central disturbance associated with dysfunction at our highest levels of central voice control. The efficacy of botulinum toxin in treating SD may not be limited solely to its local effect on laryngeal muscles and also may modulate the disorder at the level of the central nervous system. Future therapeutic options that target the central nervous system may help modulate the underlying disorder in SD and allow clinicians to better understand the principal pathophysiology. NA.Laryngoscope, 128:177-183, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Chiropractic Care for a Patient with Spasmodic Dysphonia Associated with Cervical Spine Trauma

PubMed Central

Waddell, Roger K.

2005-01-01

Abstract Objective To discuss the diagnosis and response to treatment of spasmodic dysphonia in a 25-year-old female vocalist following an auto accident. Clinical Features The voice disorder and neck pain appeared after the traumatic incident. Examination of the cervical spine revealed moderate pain, muscle spasm and restricted joint motion at C-1 and C-5 on the left side. Cervical range of motion was reduced on left rotation. Bilateral manual muscle testing of the trapezius and sternocleidomastoid muscles, which share innervation with the laryngeal muscles by way of the spinal accessory nerve, were weak on the left side. Pre and post accident voice range profiles (phonetograms) that measure singing voice quality were examined. The pre- and post-accident phonetograms revealed significant reduction in voice intensity and fundamental frequency as measured in decibels and hertz. Intervention and Outcome Low-force chiropractic spinal manipulative therapy to C-1 and C-5 was employed. Following a course of care, the patient's singing voice returned to normal, as well as a resolution of her musculo- skeletal complaints. Conclusion It appears that in certain cases, the singing voice can be adversely affected if neck or head trauma is severe enough. This case proposes that trauma with irritation to the cervical spine nerve roots as they communicate with the spinal accessory, and in turn the laryngeal nerves, may be contributory in some functional voice disorders or muscle tension dysphonia. PMID:19674642

Treatment of spasmodic dysphonia with a neuromodulating electrical implant.

PubMed

Pitman, Michael J

2014-11-01

To investigate the feasibility of an implantable electrical stimulation device to treat spasmodic dysphonia (SD) by neuromodulation of the muscle spindle gamma loop. Prospective case series. Five subjects underwent daily stimulation of the left thyroarytenoid muscle (TA) below the level of α-motor neuron activation (AMNA) for 5 consecutive days. Professional and patient voice evaluations were performed. Transcartilagenous placement of an implantable stimulation device lead was investigated in anesthetized porcine and cadaveric human models. Three of 5 subjects improved in all categories of evaluation. One subject improved in three of four categories. These four subjects described significant carryover of effect after treatment. The fifth subject evidenced improvement until contracting an upper respiratory infection on day 3. Transcartilagenous electrode placement into the porcine TA with muscle stimulation was successful. The electrode lead was passed from the cadaveric larynx to the mastoid tip in the subplatysma layer with an absence of tension. The symptoms of SD improve after electrical stimulation of the TA at levels below AMNA. This is likely through neuromodulation of the muscle spindle gamma loop. Implantation of an electrode into the TA with a postauricular implanted stimulator is feasible with modifications of an already existing device. With further investigation, such a device has the potential to deliver an alternative treatment for SD. 4. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

The role of laryngoscopy in the diagnosis of spasmodic dysphonia.

PubMed

Daraei, Pedram; Villari, Craig R; Rubin, Adam D; Hillel, Alexander T; Hapner, Edie R; Klein, Adam M; Johns, Michael M

2014-03-01

Spasmodic dysphonia (SD) can be difficult to diagnose, and patients often see multiple physicians for many years before diagnosis. Improving the speed of diagnosis for individuals with SD may decrease the time to treatment and improve patient quality of life more quickly. To assess whether the diagnosis of SD can be accurately predicted through auditory cues alone without the assistance of visual cues offered by laryngoscopic examination. Single-masked, case-control study at a specialized referral center that included patients who underwent laryngoscopic examination as part of a multidisciplinary workup for dysphonia. Twenty-two patients were selected in total: 10 with SD, 5 with vocal tremor, and 7 controls without SD or vocal tremor. The laryngoscopic examination was recorded, deidentified, and edited to make 3 media clips for each patient: video alone, audio alone, and combined video and audio. These clips were randomized and presented to 3 fellowship-trained laryngologist raters (A.D.R., A.T.H., and A.M.K.), who established the most probable diagnosis for each clip. Intrarater and interrater reliability were evaluated using repeat clips incorporated in the presentations. We measured diagnostic accuracy for video-only, audio-only, and combined multimedia clips. These measures were established before data collection. Data analysis was accomplished with analysis of variance and Tukey honestly significant differences. Of patients with SD, diagnostic accuracy was 10%, 73%, and 73% for video-only, audio-only, and combined, respectively (P < .001, df = 2). Of patients with vocal tremor, diagnostic accuracy was 93%, 73%, and 100% for video-only, audio-only, and combined, respectively (P = .05, df = 2). Of the controls, diagnostic accuracy was 81%, 19%, and 62% for video-only, audio-only, and combined, respectively (P < .001, df = 2). The diagnosis of SD during examination is based primarily on auditory cues. Viewing combined audio and video

Multidimensional assessment of strongly irregular voices such as in substitution voicing and spasmodic dysphonia: a compilation of own research.

PubMed

Moerman, Mieke; Martens, Jean-Pierre; Dejonckere, Philippe

2015-04-01

This article is a compilation of own research performed during the European COoperation in Science and Technology (COST) action 2103: 'Advance Voice Function Assessment', an initiative of voice and speech processing teams consisting of physicists, engineers, and clinicians. This manuscript concerns analyzing largely irregular voicing types, namely substitution voicing (SV) and adductor spasmodic dysphonia (AdSD). A specific perceptual rating scale (IINFVo) was developed, and the Auditory Model Based Pitch Extractor (AMPEX), a piece of software that automatically analyses running speech and generates pitch values in background noise, was applied. The IINFVo perceptual rating scale has been shown to be useful in evaluating SV. The analysis of strongly irregular voices stimulated a modification of the European Laryngological Society's assessment protocol which was originally designed for the common types of (less severe) dysphonia. Acoustic analysis with AMPEX demonstrates that the most informative features are, for SV, the voicing-related acoustic features and, for AdSD, the perturbation measures. Poor correlations between self-assessment and acoustic and perceptual dimensions in the assessment of highly irregular voices argue for a multidimensional approach.

Diagnostic Delays in Spasmodic Dysphonia: A Call for Clinician Education

PubMed Central

Creighton, Francis X.; Hapner, Edie; Klein, Adam; Rosen, Ami; Jinnah, Hyder A.; Johns, Michael M.

2016-01-01

Summary Purpose Spasmodic dysphonia (SD) is a rare but often debilitating disease. Due to lack of awareness among practitioners and lack of well-defined diagnostic criteria, it can be difficult for patients with SD to receive a diagnosis and subsequent treatment. There is currently no literature documenting the efficacy of the medical community in recognizing and diagnosing this disorder. We aimed to quantify the patients’ experiences with obtaining a diagnosis of SD. Methods One hundred seven consecutive patients with SD completed questionnaires about their experiences with SD. Patients were recruited either during outpatient laryngology visits or during participation in a National Institutes of Health funded study investigating SD. Results It took patients an average of 4.43 years (53.21 months) to be diagnosed with SD after first going to a physician with vocal symptoms. Patients had to see an average of 3.95 physicians to receive a diagnosis of SD. Patients (31.4%) had been prescribed medications other than botulinum toxin to treat their symptoms. Patients (30%) attempted alternative therapies for treatment of SD, such as chiropractor or dietary modification. Conclusions Despite advances in diagnostic modalities in medicine, the diagnosis of SD still remains elusive. Objective criteria for the diagnosis of SD and increased clinician education are warranted to address this diagnostic delay. PMID:25873547

Diagnostic Delays in Spasmodic Dysphonia: A Call for Clinician Education.

PubMed

Creighton, Francis X; Hapner, Edie; Klein, Adam; Rosen, Ami; Jinnah, Hyder A; Johns, Michael M

2015-09-01

Spasmodic dysphonia (SD) is a rare but often debilitating disease. Due to lack of awareness among practitioners and lack of well-defined diagnostic criteria, it can be difficult for patients with SD to receive a diagnosis and subsequent treatment. There is currently no literature documenting the efficacy of the medical community in recognizing and diagnosing this disorder. We aimed to quantify the patients' experiences with obtaining a diagnosis of SD. One hundred seven consecutive patients with SD completed questionnaires about their experiences with SD. Patients were recruited either during outpatient laryngology visits or during participation in a National Institutes of Health funded study investigating SD. It took patients an average of 4.43 years (53.21 months) to be diagnosed with SD after first going to a physician with vocal symptoms. Patients had to see an average of 3.95 physicians to receive a diagnosis of SD. Patients (31.4%) had been prescribed medications other than botulinum toxin to treat their symptoms. Patients (30%) attempted alternative therapies for treatment of SD, such as chiropractor or dietary modification. Despite advances in diagnostic modalities in medicine, the diagnosis of SD still remains elusive. Objective criteria for the diagnosis of SD and increased clinician education are warranted to address this diagnostic delay. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Value of Laryngeal Electromyography in Spasmodic Dysphonia Diagnosis and Therapy.

PubMed

Yang, Qingwen; Xu, Wen; Li, Yun; Cheng, Liyu

2015-07-01

To investigate the role of laryngeal electromyography (LEMG) in the diagnosis and treatment of spasmodic dysphonia (SD). The clinical manifestations, characteristics of motor unit potentials (MUPs), recruitment potentials, and laryngeal nerve evoked potentials (EPs) in LEMG, as well as the changes after botulinum toxin (BTX) treatment, were analyzed in 39 patients with adductor SD. The main clinical manifestations were a strained voice and phonation interruptions; in addition, the patients displayed hyper-adducted vocal folds during phonation. LEMG revealed significantly increased amplitudes of the thyroarytenoid muscle MUPs. The recruitment potentials were in a dense bunch, discharging full interference patterns with significantly increased amplitudes; the mean and maximum amplitude of recruitment potentials were 3090 μV and 5000 μV, respectively. The amplitude of EPs of thyroarytenoid muscle increased significantly; the mean and maximum amplitudes were 10.3 mV and 26.3 mV, respectively. After BTX was injected, the LEMG revealed denervation changes, and the EPs weakened or disappeared in the injected muscle. SD could be diagnosed, and the therapeutic efficacy of SD treatments could be evaluated based on clinical characteristics combined with LEMG characteristics. The increased amplitudes of the recruitment potentials and EPs of the thyroarytenoid muscle were the characteristic indexes. After BTX was injected, denervated potential characteristics appeared in the muscles. © The Author(s) 2015.

Inferring speaker attributes in adductor spasmodic dysphonia: ratings from unfamiliar listeners.

PubMed

Isetti, Derek; Xuereb, Linnea; Eadie, Tanya L

2014-05-01

To determine whether unfamiliar listeners' perceptions of speakers with adductor spasmodic dysphonia (ADSD) differ from control speakers on the parameters of relative age, confidence, tearfulness, and vocal effort and are related to speaker-rated vocal effort or voice-specific quality of life. Twenty speakers with ADSD (including 6 speakers with ADSD plus tremor) and 20 age- and sex-matched controls provided speech recordings, completed a voice-specific quality-of-life instrument (Voice Handicap Index; Jacobson et al., 1997), and rated their own vocal effort. Twenty listeners evaluated speech samples for relative age, confidence, tearfulness, and vocal effort using rating scales. Listeners judged speakers with ADSD as sounding significantly older, less confident, more tearful, and more effortful than control speakers (p < .01). Increased vocal effort was strongly associated with decreased speaker confidence (rs = .88-.89) and sounding more tearful (rs = .83-.85). Self-rated speaker effort was moderately related (rs = .45-.52) to listener impressions. Listeners' perceptions of confidence and tearfulness were also moderately associated with higher Voice Handicap Index scores (rs = .65-.70). Unfamiliar listeners judge speakers with ADSD more negatively than control speakers, with judgments extending beyond typical clinical measures. The results have implications for counseling and understanding the psychosocial effects of ADSD.

Risk and protective factors for spasmodic dysphonia: a case-control investigation.

PubMed

Tanner, Kristine; Roy, Nelson; Merrill, Ray M; Kimber, Kamille; Sauder, Cara; Houtz, Daniel R; Doman, Darrin; Smith, Marshall E

2011-01-01

Spasmodic dysphonia (SD) is a chronic, incurable, and often disabling voice disorder of unknown pathogenesis. The purpose of this study was to identify possible endogenous and exogenous risk and protective factors uniquely associated with SD. Prospective, exploratory, case-control investigation. One hundred fifty patients with SD and 150 medical controls (MCs) were interviewed regarding their personal and family histories, environmental exposures, illnesses, injuries, voice use patterns, and general health using a previously vetted and validated epidemiologic questionnaire. Odds ratios and multiple logistic regression analyses (α<0.15) identified several factors that significantly increased the likelihood of having SD. These factors included (1) a personal history of mumps, blepharospasm, tremor, intense occupational and avocational voice use, and a family history of voice disorders; (2) an immediate family history of meningitis, tremor, tics, cancer, and compulsive behaviors; and (3) an extended family history of tremor and cancer. SD is likely multifactorial in etiology, involving both genetic and environmental factors. Viral infections/exposures, along with intense voice use, may trigger the onset of SD in genetically predisposed individuals. Future studies should examine the interaction among genetic and environmental factors to determine the pathogenesis of SD. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Functional reinnervation of vocal folds after selective laryngeal adductor denervation-reinnervation surgery for spasmodic dysphonia.

PubMed

DeConde, Adam S; Long, Jennifer L; Armin, Bob B; Berke, Gerald S

2012-09-01

Selective laryngeal adductor denervation-reinnervation surgery (SLAD-R) offers a viable surgical alternative for patients with adductor spasmodic dysphonia refractory to botulinum toxin injections. SLAD-R selectively denervates the symptomatic thyroarytenoid muscle by dividing the distal adductor branch of the recurrent laryngeal nerve (RLN), and preventing reinnervation, by the proximal RLN and maintaining vocal fold bulk and tone by reinnervating the distal RLN with the ansa cervicalis. We present a patient who had previously undergone successful SLAD-R but presented 10 years postoperatively with a new regional dystonia involving his strap muscles translocated to his reinnervated larynx by his previous ansa-RLN neurorraphy. The patient's symptomatic vocal fold adduction resolved completely on division of the ansa-RLN neurorraphy confirming successful selective functional reinnervation of vocal fold adductors by the ansa cervicalis. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Differences in botulinum toxin dosing between patients with adductor spasmodic dysphonia and essential voice tremor.

PubMed

Orbelo, Diana M; Duffy, Joseph R; Hughes Borst, Becky J; Ekbom, Dale; Maragos, Nicolas E

2014-01-01

To explore possible dose differences in average botulinum toxin (BTX) given to patients with adductor spasmodic dysphonia (ADSD) compared with patients with essential voice tremor (EVT). A retrospective study compared the average BTX dose injected in equal doses to the thyroarytenoid (TA) muscles of 51 patients with ADSD with 52 patients with EVT. Those with ADSD received significantly higher total doses (6.80 ± 2.79 units) compared with those with EVT (5.02 ± 1.65 units). Dose at time of first injection, age at time of first injection, gender, year of first injection, and average time between injections were included in multivariate analysis but did not interact with total average dose findings. Patients with ADSD may need relatively higher doses of BTX injections to bilateral TA muscles compared with patients with EVT. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Everyday listeners' impressions of speech produced by individuals with adductor spasmodic dysphonia.

PubMed

Nagle, Kathleen F; Eadie, Tanya L; Yorkston, Kathryn M

2015-01-01

Individuals with adductor spasmodic dysphonia (ADSD) have reported that unfamiliar communication partners appear to judge them as sneaky, nervous or not intelligent, apparently based on the quality of their speech; however, there is minimal research into the actual everyday perspective of listening to ADSD speech. The purpose of this study was to investigate the impressions of listeners hearing ADSD speech for the first time using a mixed-methods design. Everyday listeners were interviewed following sessions in which they made ratings of ADSD speech. A semi-structured interview approach was used and data were analyzed using thematic content analysis. Three major themes emerged: (1) everyday listeners make judgments about speakers with ADSD; (2) ADSD speech does not sound normal to everyday listeners; and (3) rating overall severity is difficult for everyday listeners. Participants described ADSD speech similarly to existing literature; however, some listeners inaccurately extrapolated speaker attributes based solely on speech samples. Listeners may draw erroneous conclusions about individuals with ADSD and these biases may affect the communicative success of these individuals. Results have implications for counseling individuals with ADSD, as well as the need for education and awareness about ADSD. Copyright © 2015 Elsevier Inc. All rights reserved.

Effects of type II thyroplasty on adductor spasmodic dysphonia.

PubMed

Sanuki, Tetsuji; Yumoto, Eiji; Minoda, Ryosei; Kodama, Narihiro

2010-04-01

Type II thyroplasty, or laryngeal framework surgery, is based on the hypothesis that the effect of adductor spasmodic dysphonia (AdSD) on the voice is due to excessively tight closure of the glottis, hampering phonation. Most of the previous, partially effective treatments have aimed to relieve this tight closure, including recurrent laryngeal nerve section or avulsion, extirpation of the adductor muscle, and botulinum toxin injection, which is currently the most popular. The aim of this study was to assess the effects of type II thyroplasty on aerodynamic and acoustic findings in patients with AdSD. Case series. University hospital. Ten patients with AdSD underwent type II thyroplasty between August 2006 and December 2008. Aerodynamic and acoustic analyses were performed prior to and six months after surgery. Mean flow rates (MFRs) and voice efficiency were evaluated with a phonation analyzer. Jitter, shimmer, the harmonics-to-noise ratio (HNR), standard deviation of the fundamental frequency (SDF0), and degree of voice breaks (DVB) were measured from each subject's longest sustained phonation sample of the vowel /a/. Voice efficiency improved significantly after surgery. No significant difference was found in the MFRs between before and after surgery. Jitter, shimmer, HNR, SDF0, and DVB improved significantly after surgery. Treatment of AdSD with type II thyroplasty significantly improved aerodynamic and acoustic findings. The results of this study suggest that type II thyroplasty provides relief from voice strangulation in patients with AdSD. Copyright 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.

Disease-specific self-efficacy in spasmodic dysphonia patients.

PubMed

Hu, Amanda; Isetti, Derek; Hillel, Allen D; Waugh, Patricia; Comstock, Bryan; Meyer, Tanya K

2013-03-01

Self-efficacy (SE) is an optimistic self-belief that one can perform a novel task. This concept involves empowerment, self-esteem, and adaptation to a stressful situation. SE is a strong predictor of health behaviors. Our objectives were to study SE in spasmodic dysphonia (SD) and to develop a disease-specific SE-SD scale. Prospective study. Academic hospital. Disease-specific SE-SD items were developed with laryngologists, speech pathologists, and SD patients. These items, General SE Scale, Voice Handicap Index-10 (VHI-10), Consensus Auditory Perceptual Evaluation of Voice (CAPE-V), and Hospital Anxiety and Depression Scale (HADS), were administered to SD patients who presented for botulinum toxin injections. One hundred forty-five SD patients (mean age 59.5 ± 13.6 years) had a general SE score (Cronbach's α = 0.894) of 33.4 ± 5.2 out of 40. This was negatively correlated with HADS-A (r = -0.42, P < 0.001) and HADS-D (r = -0.42, P < .001), but not correlated with VHI-10 (r = -0.098, P = .243) and CAPE-V (r = -0.047, P = .57). Factor analysis selected 8 items from the general SE scale and 5 disease-specific SE-SD items to generate a 13-item disease-specific SE-SD scale (Cronbach's α = 0.907). Disease-specific SE-SD score was 42.1 ± 6.9 out of 52 and was negatively correlated with VHI-10 (r = -0.19, P = .005), HADS-A (r = -0.43, P < .001), and HADS-D (r = -0.57, P < .001), but not correlated with CAPE-V (r = -0.024, P = .60). SD patients established on botulinum toxin injections have high degrees of general and disease-specific SE. Patients with higher SE-SD demonstrate lower vocal handicap and lower levels of anxiety and depression. A 13-item disease-specific SE-SD scale has been developed.

Emotional Considerations in Spasmodic Dysphonia: Psychometric Quantification.

ERIC Educational Resources Information Center

Cannito, Michael P.

1991-01-01

This study examined emotional characteristics of 18 female spasmodic dysphonic subjects in comparison to matched normal controls across psychometric measures of depression, anxiety, and somatic complaints. Statistically significant differences were noted between groups for all measures and over half of the dysphonic subjects exhibited clinically…

Impaired limb proprioception in adults with spasmodic dysphonia

PubMed Central

Konczak, Jürgen; Aman, Joshua E.; Chen, Yu-Wen; Li, Kuan-yi; Watson, Peter J.

2015-01-01

Objectives Focal dystonia of the head, neck are associated with a loss of kinaesthetic acuity at muscles distant from the dystonic sites. That is, while the motor deficits in focal dystonia are confined, the associated somatosensory deficits are generalized. This is the first systematic study to examine, if patients diagnosed with spasmodic dystonia (SD) show somatosensory impairments similar in scope to other forms of focal dystonia. Methods Proprioceptive acuity (ability to discriminate between two stimuli) for forearm position and motion sense was assessed in 14 spasmodic dystonia subjects and 28 age-matched controls using a passive motion apparatus. Psychophysical thresholds, uncertainty area and a proprioceptive acuity index were computed based on the subjects’ verbal responses. Results The main findings are: First, the SD group showed significantly elevated thresholds and uncertainty areas for forearm position sense when compared to the control group. Second, 9 out of 14 dystonia subjects (64%) exhibited an acuity index for position sense above the control group maximum. Three SD subjects had a motion sense acuity index above the control group maximum. Conclusion The results indicate that impaired limb proprioception is a common feature of SD. Like other forms of focal dystonia, spasmodic dystonia does affect the somatosensation of non-dystonic muscle systems. That is, SD is associated with a generalized somatosensory deficit. PMID:25737471

Impaired Limb Proprioception in Adults With Spasmodic Dysphonia.

PubMed

Konczak, Jürgen; Aman, Joshua E; Chen, Yu-Wen; Li, Kuan-yi; Watson, Peter J

2015-11-01

Focal dystonia of the head and neck are associated with a loss of kinesthetic acuity at muscles distant from the dystonic sites. That is, while the motor deficits in focal dystonia are confined, the associated somatosensory deficits are generalized. This is the first systematic study to examine, if patients diagnosed with spasmodic dystonia (SD) show somatosensory impairments similar in scope to other forms of focal dystonia. Proprioceptive acuity (ability to discriminate between two stimuli) for forearm position and motion sense was assessed in 14 spasmodic dystonia subjects and 28 age-matched controls using a passive motion apparatus. Psychophysical thresholds, uncertainty area (UA), and a proprioceptive acuity index (AI) were computed based on the subjects' verbal responses. The main findings are as follows: first, the SD group showed significantly elevated thresholds and UAs for forearm position sense compared with the control group. Second, 9 of 14 dystonia subjects (64%) exhibited an AI for position sense above the control group maximum. Three SD subjects had a motion sense AI above the control group maximum. The results indicate that impaired limb proprioception is a common feature of SD. Like other forms of focal dystonia, spasmodic dystonia does affect the somatosensation of nondystonic muscle systems. That is, SD is associated with a generalized somatosensory deficit. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Botulinum Toxin-A Dosing Trends for Adductor Spasmodic Dysphonia at a Single Institution Over 10 Years.

PubMed

Bradley, Joseph P; Barrow, Emily M; Hapner, Edie R; Klein, Adam M; Johns, Michael M

2017-05-01

This study aimed to identify the changes in dosing of botulinum toxin-A for adductor spasmodic dysphonia (ADSD) over a prolonged period. This is a retrospective chart review. One hundred thirteen subjects treated for ADSD from 2003 to 2013 were identified from a clinical database. Subject age, gender, and total injection dose amount were all recorded for all subjects who had at least 10 injections. Fifty-four subjects met criteria for inclusion. There were no age or gender differences in the starting dose for subjects. Dosing decreased significantly compared with the second dose (5.05 ± 1.623 Units), by the sixth dose (4.26 ± 1.698 Units), and continued through the 10th dose (4.08 ± 2.019 Units) (P < 0.005 for all). Botulinum toxin-A dosing for ADSD decreases consistently over subsequent injections after the initial two dose titrations. Copyright © 2017. Published by Elsevier Inc.

An open-label study of sodium oxybate in Spasmodic dysphonia.

PubMed

Rumbach, Anna F; Blitzer, Andrew; Frucht, Steven J; Simonyan, Kristina

2017-06-01

Spasmodic dysphonia (SD) is a task-specific laryngeal dystonia that affects speech production. Co-occurring voice tremor (VT) often complicates the diagnosis and clinical management of SD. Treatment of SD and VT is largely limited to botulinum toxin injections into laryngeal musculature; other pharmacological options are not sufficiently developed. Open-label study. We conducted an open-label study in 23 SD and 22 SD/VT patients to examine the effects of sodium oxybate (Xyrem), an oral agent with therapeutic effects similar to those of alcohol in these patients. Blinded randomized analysis of voice and speech samples assessed symptom improvement before and after drug administration. Sodium oxybate significantly improved voice symptoms (P = .001) primarily by reducing the number of SD-characteristic voice breaks and severity of VT. Sodium oxybate further showed a trend for improving VT symptoms (P = .03) in a subset of patients who received successful botulinum toxin injections for the management of their SD symptoms. The drug's effects were observed approximately 30 to 40 minutes after its intake and lasted about 3.5 to 4 hours. Our study demonstrated that sodium oxybate reduced voice symptoms in 82.2% of alcohol-responsive SD patients both with and without co-occurring VT. Our findings suggest that the therapeutic mechanism of sodium oxybate in SD and SD/VT may be linked to that of alcohol, and as such, sodium oxybate might be beneficial for alcohol-responsive SD and SD/VT patients. 4 Laryngoscope, 127:1402-1407, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Effect of Botulinum Toxin and Surgery among Spasmodic Dysphonia Patients.

PubMed

van Esch, Babette F; Wegner, Inge; Stegeman, Inge; Grolman, Wilko

2017-02-01

Objective The effect of botulinum toxin among patients with adductor spasmodic dysphonia (AdSD) is temporary. To optimize long-term treatment outcome, other therapy options should be evaluated. Alternative treatment options for AdSD comprise several surgical treatments, such as thyroarytenoid myotomy, thyroplasty, selective laryngeal adductor denervation-reinnervation, laryngeal nerve crush, and recurrent laryngeal nerve resection. Here, we present the first systematic review comparing the effect of botulinum toxin with surgical treatment among patients diagnosed with AdSD. Data Sources MEDLINE (PubMed), EMBASE, and the Cochrane Library. Methods Articles were reviewed by 2 independent authors, and data were compiled in tables for analysis of the objective outcome (voice expert evaluation after voice recording), the subjective outcome (patient self-assessment scores), and voice-related quality of life (Voice Health Index scores). Results No clinical trials comparing both treatment modalities were identified. Single-armed studies evaluated either the effect of botulinum toxin or surgical treatment. Thirteen studies reported outcomes after botulinum toxin treatment (n = 419), and 9 studies reported outcomes after surgical treatment (n = 585 patients). A positive effect of bilateral botulinum toxin injections was found for the objective voice outcome, subjective voice outcome, and quality of life. The duration of the beneficial effect ranged from 15 to 18 weeks. Surgical treatment had an overall positive effect on objective voice improvement, subjective voice improvement, and quality of live. Conclusion No preference for one treatment could be demonstrated. Prospective clinical trials comparing treatment modalities are recommended to delineate the optimal outcomes by direct comparison.

Type II thyroplasty changes cortical activation in patients with spasmodic dysphonia.

PubMed

Tateya, Ichiro; Omori, Koichi; Kojima, Hisayoshi; Naito, Yasushi; Hirano, Shigeru; Yamashita, Masaru; Ito, Juichi

2015-04-01

Spasmodic dysphonia (SD) is a complex neurological communication disorder characterized by a choked, strain-strangled vocal quality with voice stoppages in phonation. Its symptoms are exacerbated by situations where communication failures are anticipated, and reduced when talking with animals or small children. Symptoms are also reduced following selected forms of treatment. It is reasonable to assume that surgical alteration reducing symptoms would also alter brain activity, though demonstration of such a phenomenon has not been documented. The objective of this study is to reveal brain activity of SD patients before and after surgical treatment. We performed lateralization thyroplasties on three adductor SD patients and compared pre- and post-operative positron emission tomography recordings made during vocalization. Pre-operatively, cordal supplementary motor area (SMA), bilateral auditory association areas, and thalamus were activated while reading aloud. Such activity was not observed in normal subjects. Type II thyroplasty was performed according to Isshiki's method and the strained voice was significantly reduced or eliminated in all three patients. Post-operative PET showed normal brain activation pattern with a significant decrease in cordal SMA, bilateral auditory association areas and thalamus, and a significant increase in rostral SMA compared with pre-operative recordings. This is the first report showing that treatment to a peripheral organ, which reverses voice symptoms, also reverses dysfunctional patterns of the central nervous system in patients with SD. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Brain activity related to phonation in young patients with adductor spasmodic dysphonia.

PubMed

Kiyuna, Asanori; Maeda, Hiroyuki; Higa, Asano; Shingaki, Kouta; Uehara, Takayuki; Suzuki, Mikio

2014-06-01

This study investigated the brain activities during phonation of young patients with adductor spasmodic dysphonia (ADSD) of relatively short disease duration (<10 years). Six subjects with ADSD of short duration (mean age: 24. 3 years; mean disease duration: 41 months) and six healthy controls (mean age: 30.8 years) underwent functional magnetic resonance imaging (fMRI) using a sparse sampling method to identify brain activity during vowel phonation (/i:/). Intragroup and intergroup analyses were performed using statistical parametric mapping software. Areas of activation in the ADSD and control groups were similar to those reported previously for vowel phonation. All of the activated areas were observed bilaterally and symmetrically. Intergroup analysis revealed higher brain activities in the SD group in the auditory-related areas (Brodmann's areas [BA] 40, 41), motor speech areas (BA44, 45), bilateral insula (BA13), bilateral cerebellum, and middle frontal gyrus (BA46). Areas with lower activation were in the left primary sensory area (BA1-3) and bilateral subcortical nucleus (putamen and globus pallidus). The auditory cortical responses observed may reflect that young ADSD patients control their voice by use of the motor speech area, insula, inferior parietal cortex, and cerebellum. Neural activity in the primary sensory area and basal ganglia may affect the voice symptoms of young ADSD patients with short disease duration. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Perioperative complications and safety of type II thyroplasty (TPII) for adductor spasmodic dysphonia.

PubMed

Mizoguchi, Kenji; Hatakeyama, Hiromitsu; Yanagida, Saori; Nishizawa, Noriko; Oridate, Nobuhiko; Fukuda, Satoshi; Homma, Akihiro

2017-05-01

Type II thyroplasty (TPII) is one of the surgical options offered in the management of adductor spasmodic dysphonia (AdSD); however, there have been no detailed reports of its safety and associated complications during the perioperative period. Our aim was to assess the complications and safety of TPII. TPII was performed for consecutive 15 patients with AdSD from April 2012 through May 2014. We examined retrospectively the perioperative complications, the degree of surgical invasion, and recovery process from surgery. All patients underwent successful surgery under only local anesthesia. Vocal fold erythema was observed in 14 patients and vocal fold edema in 10 patients; however, all of them showed complete resolution within 1 month. No patient experienced severe complications such as acute airway distress or hemorrhage. Fourteen patients were able to have oral from the 1st postoperative morning, with the remaining patient able to have oral intake from the 2nd postoperative day. In addition, no patient experienced aspiration postoperatively. In conclusion, only minor complications were observed in association with TPII in this study. No dysphagia was observed postoperatively, which is an advantage over other treatments. The results of our study suggest that TPII is a safe surgical treatment for AdSD.

Factors influencing botulinum toxin dose instability in spasmodic dysphonia patients.

PubMed

Rosow, David E; Pechman, Amanda; Saint-Victor, Sandra; Lo, Kaming; Lundy, Donna S; Casiano, Roy R

2015-05-01

Many patients with spasmodic dysphonia (SD) see consistent effects from botulinum toxin (BTX) injections of the same dose, whereas others require dosage changes over time. We sought to determine whether demographics (age and gender) or environmental factors (smoking) affect the long-term stability of BTX dosing in these patients. Retrospective review. Charts of all patients undergoing BTX injection for adductor SD were reviewed. Dosage change, defined as whether there was any difference in total dosage used between two beneficial injections, was used as a measure of dosing stability. Beneficial injections were indicated by a voice rating score of at least three of four and any non-zero duration of improved voice. Logistic regression analysis was performed to determine whether age, gender, smoking status, or duration of treatment correlated with odds of having a dosage change. A total of 211 patients were ultimately included. Age, gender, and smoking status were all found to have no correlative effect on dosing stability. The only factor that was predictive of dose stability was the number of previous beneficial injections, as every additional injection led to decreased odds of a change in dosage for the next injection (odds ratio=0.964; 95% confidence interval=0.947-0.981). Dosage of BTX injections for long-term treatment of SD has a significant propensity to remain stable over time. Factors such as age, gender, and smoking status do not appear to influence the dosage stability. These findings should allow for better patient counseling regarding expectations for their long-term treatment. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Case-control study of risk factors for spasmodic dysphonia: A comparison with other voice disorders.

PubMed

Tanner, Kristine; Roy, Nelson; Merrill, Ray M; Sauder, Cara; Houtz, Daniel R; Smith, Marshall E

2012-05-01

This epidemiology study examined risk factors uniquely associated with spasmodic dysphonia (SD). Case-control. A questionnaire was administered to 150 patients with SD (with and without coexisting vocal tremor) and 136 patients with other structural, neurological, and functional voice disorders (excluding SD and vocal tremor). Questions included personal and family medical histories, environmental exposures, trauma, illnesses, voice use habits, and the Short Form 36. Several factors were uniquely associated with SD (α = .05), including: 1) a personal history of cervical dystonia, sinus and throat illnesses, mumps, rubella, dust exposure, and frequent volunteer voice use, 2) a family history of voice disorders, 3) an immediate family history of vocal tremor and meningitis, and 4) an extended family history of head and neck tremor, ocular disease, and meningitis. Vocal tremor coexisted with SD in 29% of cases. Measles and mumps vaccines were protective for SD. SD is likely multifactorial and associated with several endogenous and exogenous factors. Certain viral exposures, voice use patterns, and familial neurological conditions may contribute to the onset of SD later in life. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

Shortened cortical silent period in adductor spasmodic dysphonia: evidence for widespread cortical excitability.

PubMed

Samargia, Sharyl; Schmidt, Rebekah; Kimberley, Teresa Jacobson

2014-02-07

The purpose of this study was to compare cortical inhibition in the hand region of the primary motor cortex between subjects with focal hand dystonia (FHD), adductor spasmodic dysphonia (AdSD), and healthy controls. Data from 28 subjects were analyzed (FHD n=11, 53.25 ± 8.74 y; AdSD: n=8, 56.38 ± 7.5 y; and healthy controls: n=941.67 ± 10.85 y). All subjects received single pulse TMS to the left motor cortex to measure cortical silent period (CSP) in the right first dorsal interosseus (FDI) muscle. Duration of the CSP was measured and compared across groups. A one-way ANCOVA with age as a covariate revealed a significant group effect (p<0.001). Post hoc analysis revealed significantly longer CSP duration in the healthy group vs. AdSD group (p<0.001) and FHD group (p<0.001). These results suggest impaired intracortical inhibition is a neurophysiologic characteristic of FHD and AdSD. In addition, the shortened CSP in AdSD provides evidence to support a widespread decrease in cortical inhibition in areas of the motor cortex that represent an asymptomatic region of the body. These findings may inform future investigations of differential diagnosis as well as alternative treatments for focal dystonias. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Developing the Communicative Participation Item Bank: Rasch Analysis Results From a Spasmodic Dysphonia Sample

PubMed Central

Baylor, Carolyn R.; Yorkston, Kathryn M.; Eadie, Tanya L.; Miller, Robert M.; Amtmann, Dagmar

2011-01-01

Purpose The purpose of this study was to conduct the initial psychometric analyses of the Communicative Participation Item Bank—a new self-report instrument designed to measure the extent to which communication disorders interfere with communicative participation. This item bank is intended for community-dwelling adults across a range of communication disorders. Method A set of 141 candidate items was administered to 208 adults with spasmodic dysphonia. Participants rated the extent to which their condition interfered with participation in various speaking communication situations. Questionnaires were administered online or in a paper version per participant preference. Participants also completed the Voice Handicap Index (B. H. Jacobson et al., 1997) and a demographic questionnaire. Rasch analyses were conducted using Winsteps software (J. M. Linacre, 1991). Results The results show that items functioned better when the 5-category response format was recoded to a 4-category format. After removing 8 items that did not fit the Rasch model, the remaining 133 items demonstrated strong evidence of sufficient unidimensionality, with the model accounting for 89.3% of variance. Item location values ranged from −2.73 to 2.20 logits. Conclusions Preliminary Rasch analyses of the Communicative Participation Item Bank show strong psychometric properties. Further testing in populations with other communication disorders is needed. PMID:19717652

[A study on vowel duration and word length of adductor spasmodic dysphonia].

PubMed

Chen, Zhipeng; Ge, Pingjiang

2016-03-01

To understand the vowel duration and statement reading of the adductor spasmodic dysphonia (ADSD) patients compared with their normal controls, and provide ideas for clinical diagnosis and treatment. Twenty-nine ADSD patients were included in the research, with 31 normal controls. All subjects filled in form voice handicap index (VHI) by themselves. Maximum phonetic time (MPT) and maximum loudness phonetic time(MLPT) were tested on /a/ sound for all patients. Also, all the patients were required to read aloud a standard mandarin assay named , duration were measured with Praat5. 0 software after sounds were collected. A one-way t-test was performed to compare spasmodic group with control group on VHI, MPT, MLPT and duration for reading standard sentences. Pearson/Spearman correlation was tested. Result: The VHI of the 29 ADSD patients is 89±12, and their normal controls 15±16, indicating that the VHI in ADSD group is significantly higher than in the control group(P<0. 01). The MPT of the ADSD group is(16. 9±9. 8 s), and the control group is (25. 3±10.0)s, indicating that MPT in the ADSD group is significantly shorter than the control group(P<0. 01). The MLPT of the ADSD group is (15.7±7. 6)s, and the control group is (26. 5±11. 4)s, indicating that MLPT in the ADSD group is significantly shorter than the control group (P<0. 01). The duration of standard sentence reading of the ADSD group is (55.0±14. 2)s, and the control group is (37. 8±4. 8)s, indicating that the duration of standard sentence reading in the ADSD group is significantly longer than the control group (P<0. 01). Correlation analysis showed that MPT and MLPT are related within the ADSD group(r=0. 697,P< 0.01), other indexes being tested have no significant correlations. The voice disorder condition of the ADSD patients is significantly worse than normal people. Their pronunciations on continuous vowels are not lasting compared with normal people. In the meantime, their ability to

Clinical experience with patients with spasmodic dysphonia and primary Meige syndrome.

PubMed

Pedrero-Escalas, María Fernanda; García-López, Isabel; Santiago-Pérez, Susana; Vivancos, Francisco; Gavilán, Javier

2018-04-28

Meige syndrome (MS) is part of the group of segmental cranial dystonias, which affect more than two cranial muscle groups. Specifically, blepharospasm is associated with another cranial dystonia (oromandibular, cervical or laryngeal). The aim of this paper was to report our experience in patients with spasmodic dysphonia (SD) associated with primary MS. A retrospective study involving 8 patients between May 2010 and June 2015. Variables recorded were: age, sex, associated dystonia, electromyographic pattern in laryngeal muscles and treatment given. Outcomes after treatment were assessed using GRBAS(i) scale and VHI-30 questionnaire, always provided by the same examiner. Fifty-six patients with MS were treated in the Neurology Department. Eight patients of 56 were diagnosed with SD (prevalence of 14%). All of our patients had adductor SD. The median age was 71years. All the patients were treated with intralaryngeal botulinum toxin under electromyographic control. Clinically relevant improvements were found after treatment on both the GRBAS(i) scale and the VHI-30 questionnaire. In the study of SD, we should always rule out an association with MS. From the point of view of otorhinolaryngology, the joint use of the GRBAS(i) scale and the VHI-30 questionnaire are useful, reliable and efficient methods for assessing progress and response to treatment. Laryngeal infiltration under electromyographic control with botulinum toxin is the therapeutic alternative that provides better results. The management of SD associated with MS does not differ from isolated SD. Copyright © 2018 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Publicado por Elsevier España, S.L.U. All rights reserved.

Cortical sensorimotor alterations classify clinical phenotype and putative genotype of spasmodic dysphonia.

PubMed

Battistella, G; Fuertinger, S; Fleysher, L; Ozelius, L J; Simonyan, K

2016-10-01

Spasmodic dysphonia (SD), or laryngeal dystonia, is a task-specific isolated focal dystonia of unknown causes and pathophysiology. Although functional and structural abnormalities have been described in this disorder, the influence of its different clinical phenotypes and genotypes remains scant, making it difficult to explain SD pathophysiology and to identify potential biomarkers. We used a combination of independent component analysis and linear discriminant analysis of resting-state functional magnetic resonance imaging data to investigate brain organization in different SD phenotypes (abductor versus adductor type) and putative genotypes (familial versus sporadic cases) and to characterize neural markers for genotype/phenotype categorization. We found abnormal functional connectivity within sensorimotor and frontoparietal networks in patients with SD compared with healthy individuals as well as phenotype- and genotype-distinct alterations of these networks, involving primary somatosensory, premotor and parietal cortices. The linear discriminant analysis achieved 71% accuracy classifying SD and healthy individuals using connectivity measures in the left inferior parietal and sensorimotor cortices. When categorizing between different forms of SD, the combination of measures from the left inferior parietal, premotor and right sensorimotor cortices achieved 81% discriminatory power between familial and sporadic SD cases, whereas the combination of measures from the right superior parietal, primary somatosensory and premotor cortices led to 71% accuracy in the classification of adductor and abductor SD forms. Our findings present the first effort to identify and categorize isolated focal dystonia based on its brain functional connectivity profile, which may have a potential impact on the future development of biomarkers for this rare disorder. © 2016 EAN.

Cortical sensorimotor alterations classify clinical phenotype and putative genotype of spasmodic dysphonia

PubMed Central

Battistella, Giovanni; Fuertinger, Stefan; Fleysher, Lazar; Ozelius, Laurie J.; Simonyan, Kristina

2017-01-01

Background Spasmodic dysphonia (SD), or laryngeal dystonia, is a task-specific isolated focal dystonia of unknown causes and pathophysiology. Although functional and structural abnormalities have been described in this disorder, the influence of its different clinical phenotypes and genotypes remains scant, making it difficult to explain SD pathophysiology and to identify potential biomarkers. Methods We used a combination of independent component analysis and linear discriminant analysis of resting-state functional MRI data to investigate brain organization in different SD phenotypes (abductor vs. adductor type) and putative genotypes (familial vs. sporadic cases) and to characterize neural markers for genotype/phenotype categorization. Results We found abnormal functional connectivity within sensorimotor and frontoparietal networks in SD patients compared to healthy individuals as well as phenotype- and genotype-distinct alterations of these networks, involving primary somatosensory, premotor and parietal cortices. The linear discriminant analysis achieved 71% accuracy classifying SD and healthy individuals using connectivity measures in the left inferior parietal and sensorimotor cortex. When categorizing between different forms of SD, the combination of measures from left inferior parietal, premotor and right sensorimotor cortices achieved 81% discriminatory power between familial and sporadic SD cases, whereas the combination of measures from the right superior parietal, primary somatosensory and premotor cortices led to 71% accuracy in the classification of adductor and abductor SD forms. Conclusions Our findings present the first effort to identify and categorize isolated focal dystonia based on its brain functional connectivity profile, which may have a potential impact on the future development of biomarkers for this rare disorder. PMID:27346568

An open-label study of sodium oxybate (Xyrem®) in spasmodic dysphonia

PubMed Central

Rumbach, Anna F.; Blitzer, Andrew; Frucht, Steven J.; Simonyan, Kristina

2016-01-01

Objective Spasmodic dysphonia (SD) is a task-specific laryngeal dystonia that affects speech production. Co-occurring voice tremor (VT) often complicates the diagnosis and clinical management of SD. Treatment of SD and VT is largely limited to botulinum toxin injections into laryngeal musculature; other pharmacological options are not sufficiently developed. Study Design and Methods We conducted an open-label study in 23 SD and 22 SD/VT patients to examine the effects of sodium oxybate (Xyrem®), an oral agent with therapeutic effects similar to those of alcohol in these patients. Blinded randomized analysis of voice and speech samples assessed symptom improvement before and after drug administration. Results Sodium oxybate significantly improved voice symptoms (p = 0.001) primarily by reducing the number of SD-characteristic voice breaks and severity of VT. Sodium oxybate further showed a trend for improving VT symptoms (p = 0.03) in a subset of patients who received successful botulinum toxin injections for the management of their SD symptoms. The drug’s effects were observed approximately 30–40 min after its intake and lasted about 3.5–4 hours. Conclusion Our study demonstrated that sodium oxybate reduced voice symptoms in 82.2% of alcohol-responsive SD patients both with and without co-occurring VT. Our findings suggest that the therapeutic mechanism of sodium oxybate in SD and SD/VT may be linked to that of alcohol and as such sodium oxybate might be beneficial for alcohol-responsive SD and SD/VT patients. PMID:27808415

Coprevalence of Anxiety and Depression With Spasmodic Dysphonia: A Case-Control Study

PubMed Central

White, Laura J.; Hapner, Edie R.; Klein, Adam M.; Delgaudio, John M.; Hanfelt, John J.; Jinnah, H. A.; Johns, Michael M.

2012-01-01

Summary Introduction There is evidence supporting an association between depression and anxiety in patients with chronic disease. Spasmodic dysphonia (SD) is a chronic, incurable, and disabling voice disorder. Reported rates of depression and anxiety in SD range from 7.1% to 72%, with a maximum number of 18 patients. The goal of this study was to define the coprevalence of depression and anxiety with SD. Materials and Methods A single-institution case-control study was performed from May to July 2010. Consecutive patients with SD and benign voice disorders were enrolled prospectively. On enrollment, patients were asked to fill out a questionnaire that reviewed the duration of the voice disorder and personal history of anxiety and depression, including current and lifetime diagnosis. Results One hundred forty-six controls with benign voice disorders and 128 patients with SD were enrolled. Patients with SD were no more likely to be diagnosed with depression or anxiety than those of the control group (odds ratio [OR] = 0.985, 95% confidence interval [CI] = 0.59–1.63; and OR = 1.314; 95% CI 0.75–2.3, respectively). Additionally, duration of disease was a risk factor for depression in both the SD group and the control group, and the association was not significantly different between groups. Conclusion Patients with SD were no more likely to have depression or anxiety than those with other voice disorders. It is important for otolaryngologists to be aware of the increased rates of depression in patients diagnosed with chronic diseases, including voice disorders, and to refer to a psychiatrist when appropriate. PMID:22209056

Minithyrotomy with radiofrequency-induced thermotherapy for the treatment of adductor spasmodic dysphonia.

PubMed

Desai, Shaun C; Park, Andrea M; Chernock, Rebecca D; Paniello, Randal C

2016-10-01

A simple, safe and effective surgical alternative for treating adductor spasmodic dysphonia (ADSD) would appeal to many patients. This study evaluates a new option, using radiofrequency-induced thermotherapy (RFITT) of the thyroarytenoid muscle (TA) via the minithyrotomy approach to reduce the force of adduction. Fifteen dogs were used. In part 1, the optimal RFITT power settings, exposure time, probe location, and number of passes were determined. Part 2 compared laryngeal adductor pressures (LAPs) at baseline; immediately postintervention; and at 1, 3, or 6 months postintervention. Interventions included RFITT via the transcervical minithyrotomy approach (n = 15), transoral RFITT (n = 3), botulinum toxin (Botox) injection (n = 3), or no-intervention controls (n = 3). Postintervention induced phonation and histologic analyses were performed as well. In the minithyrotomy RFITT group, the mean LAP was 30.3% of baseline immediately posttreatment. At 1, 3, and 6 months postoperatively, the mean LAPs were 24.9%, 44.8%, and 43.5%, respectively. Transoral RFITT reduced LAP to 56.6% of baseline immediately posttreatment, but returned to normal in the 1 and 3 month animals. The Botox injections dropped the LAP to 57% of baseline at 1 month, but returned to normal at 3 months. Mucosal waves, based on induced phonation stroboscopy, were present at the terminal date in all animals. Thirteen of 15 transcervical RFITT preparations (87%) showed no injury to the lamina propria, whereas 80% showed evidence of TA muscle atrophy and fibrosis. Minithyrotomy RFITT is a feasible technique that shows encouraging long-term results for the potential treatment of patients with ADSD. N/A. Laryngoscope, 126:2325-2329, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Coprevalence of anxiety and depression with spasmodic dysphonia: a case-control study.

PubMed

White, Laura J; Hapner, Edie R; Klein, Adam M; Delgaudio, John M; Hanfelt, John J; Jinnah, H A; Johns, Michael M

2012-09-01

There is evidence supporting an association between depression and anxiety in patients with chronic disease. Spasmodic dysphonia (SD) is a chronic, incurable, and disabling voice disorder. Reported rates of depression and anxiety in SD range from 7.1% to 72%, with a maximum number of 18 patients. The goal of this study was to define the coprevalence of depression and anxiety with SD. A single-institution case-control study was performed from May to July 2010. Consecutive patients with SD and benign voice disorders were enrolled prospectively. On enrollment, patients were asked to fill out a questionnaire that reviewed the duration of the voice disorder and personal history of anxiety and depression, including current and lifetime diagnosis. One hundred forty-six controls with benign voice disorders and 128 patients with SD were enrolled. Patients with SD were no more likely to be diagnosed with depression or anxiety than those of the control group (odds ratio [OR]=0.985, 95% confidence interval [CI]=0.59-1.63; and OR=1.314; 95% CI=0.75-2.3, respectively). Additionally, duration of disease was a risk factor for depression in both the SD group and the control group, and the association was not significantly different between groups. Patients with SD were no more likely to have depression or anxiety than those with other voice disorders. It is important for otolaryngologists to be aware of the increased rates of depression in patients diagnosed with chronic diseases, including voice disorders, and to refer to a psychiatrist when appropriate. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

The Comparison of Thyroarytenoid Muscle Myectomy and Type II Thyroplasty for Spasmodic Dysphonia.

PubMed

Nomoto, Masaki; Tokashiki, Ryoji; Hiramatsu, Hiroyuki; Konomi, Ujimoto; Motohashi, Rei; Sakurai, Eriko; Toyomura, Fumimasa; Ueda, Yuri; Inoue, Shun; Tsukahara, Kiyoaki; Suzuki, Mamoru

2015-07-01

Surgical treatments for adductor spasmodic dysphonia include bilateral thyroarytenoid muscle myectomy (TAM) and type II thyroplasty (TPII), both of which are commonly performed. The present study aimed to compare the effects of TAM and TPII. Retrospective study. Subjects were 30 and 35 patients who underwent TAM and TPII, between March 2008 and November 2012. Voice quality was evaluated based on "voice handicap index 10 (VHI10)" and auditory impressions before and 6 months after surgery using five parameters: "strangulation," "interruption," "tremor," "grade," and "breathiness." Comparison of the two procedures revealed significant improvements in VHI10, strangulation, interruption, and tremor, and a significant decline in breathiness after surgery. In particular, VHI10 was improved by more than six points in 90% of patients with TAM, and 96% with TPII. No significant difference was observed between the severities of two procedures preoperatively. Comparison of each postoperative score between the two procedures revealed that TAM significantly improved strangulation, interruption, and tremor, and significantly worsened breathiness, with no significant difference in VHI10. Scatter plots (x: preoperative scores; y: postoperative scores) and regression lines of evaluation items demonstrated that TAM is more effective than TPII in severe cases. Compared with TPII, TAM tends to improve strangulation, interruption, and tremor; however, it tends to worsen breathiness postoperatively. Postoperative VHI10 scores did not differ significantly between the two procedures. Given favorable improvement rates, both surgical procedures were considered effective. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Botulinum toxin treatment of false vocal folds in adductor spasmodic dysphonia: Functional outcomes.

PubMed

Simpson, C Blake; Lee, Christopher T; Hatcher, Jeanne L; Michalek, Joel

2016-01-01

Supraglottic injection of botulinum toxin (Botox) has been described as an effective treatment for adductor spasmodic dysphonia (ADSD). Anecdotal evidence suggests that the patients have little to no breathiness after injection, but no formal longitudinal studies have been carried out to date. The purpose of this study was to examine the voice outcomes in patients with ADSD after supraglottic Botox injection. Retrospective case series. Patients with ADSD who were treated with supraglottic Botox injections completed a qualitative self-evaluation of voice function after injection using the percentage of normal function (PNF) scale, a validated, quantitative scale from 0% (no function) to 100% (normal function). Posttreatment voice improvement after injection was determined using a Voice Handicap Index-10 (VHI-10) questionnaire. A total of 198 supraglottic injections were performed between July 2011 and October 2014. Twenty-five questionnaires were completed. Mean postinjection PNF was 95.0% ± 8.4% and was significantly increased from the preinjection mean PNF (62.5%) ± 22.6% (P < 0.001). The mean best VHI-10 for all injections was 7.23. In 19 of 25 patients (76%), there was no reduction in PNF in the early postinjection period. In the remaining six patients (24%), the decline in mean vocal function was 9.2%. Supraglottic Botox injection is an effective treatment for ADSD. Postinjection voice is significantly improved, and the majority of patients do not experience breathy voice/decline in vocal function after injection. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Patient perceptions of factors leading to spasmodic dysphonia: a combined clinical experience of 350 patients.

PubMed

Childs, Lesley; Rickert, Scott; Murry, Thomas; Blitzer, Andrew; Sulica, Lucian

2011-10-01

Spasmodic dysphonia (SD) is an idiopathic voice disorder that is characterized by either a strained, strangled voice quality or a breathy voice with aphonic segments of connected speech. It has been suggested that environmental factors play a role in triggering the onset. Clinical observation suggests that some patients associate onset with specific events or factors while others do not. The purpose of this study was to examine a large database of SD patients to determine if specific triggers are associated with the onset of SD. Retrospective chart review. A total of 350 charts of patients with SD were identified and were categorized as either "sudden onset" or "gradual onset." One hundred sixty-nine recalled their circumstances surrounding onset. Forty-five percent of these patients described the onset as sudden. Patient perceptions of inciting events in the sudden onset group were identified 77% of the time and 2% of the time in the gradual onset group. The most common factors identified were stress (42%), upper respiratory infection (33%), and pregnancy and parturition (10%). Thirty-five percent of SD patients perceive their disorder to have a sudden onset with identified inciting events. This prevalence raises questions regarding possible behavioral and environmental factors surrounding the onset of this disorder. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

Voice disorders in the workplace: productivity in spasmodic dysphonia and the impact of botulinum toxin.

PubMed

Meyer, Tanya K; Hu, Amanda; Hillel, Allen D

2013-11-01

The impact of the disordered voice on standard work productivity measures and employment trends is difficult to quantify; this is in large part due to the heterogeneity of the disease processes. Spasmodic dysphonia (SD), a chronic voice disorder, may be a useful model to study this impact. Self-reported work measures (worked missed, work impairment, overall work productivity, and activity impairment) were studied among patients receiving botulinum toxin (BTX) treatments for SD. It was hypothesized that there would be a substantial difference in work-related measures between the best and worst voicing periods. In addition, job types, employment shifts, and vocal requirements during the course of vocal disability from SD were investigated for each individual, and the impact of SD on these patterns was studied. A total of 145 patients with SD, either adductor or abductor, who were established in routine therapeutic BTX injections agreed to participate in a self-administered questionnaire study. Seventy-two participants were currently working and provided highly detailed information on work-related measures. Their answers characterized the effect of SD on their employment status, productivity at work, activity impairment outside of work, employment retention or change, and whether the individual perceived that BTX therapy affected these measures. Patients were asked to complete the Work Productivity and Activity Impairment (WPAI) instrument to determine these measures for their best and worst voicing weeks over the duration since their previous BTX injection. Voice-specific quality of life instruments (Voice Handicap Index-10) and perceptual assessments (Consensus Auditory Perceptual Evaluation of Voice) were elicited to provide correlations of work measures with patient-perceived voice handicap and clinician-perceived voice quality. Cross-sectional analysis using self-administered questionnaire. A total of 108 patients reported ever working during their diagnosis and

Abnormal motor cortex excitability during linguistic tasks in adductor-type spasmodic dysphonia.

PubMed

Suppa, A; Marsili, L; Giovannelli, F; Di Stasio, F; Rocchi, L; Upadhyay, N; Ruoppolo, G; Cincotta, M; Berardelli, A

2015-08-01

In healthy subjects (HS), transcranial magnetic stimulation (TMS) applied during 'linguistic' tasks discloses excitability changes in the dominant hemisphere primary motor cortex (M1). We investigated 'linguistic' task-related cortical excitability modulation in patients with adductor-type spasmodic dysphonia (ASD), a speech-related focal dystonia. We studied 10 ASD patients and 10 HS. Speech examination included voice cepstral analysis. We investigated the dominant/non-dominant M1 excitability at baseline, during 'linguistic' (reading aloud/silent reading/producing simple phonation) and 'non-linguistic' tasks (looking at non-letter strings/producing oral movements). Motor evoked potentials (MEPs) were recorded from the contralateral hand muscles. We measured the cortical silent period (CSP) length and tested MEPs in HS and patients performing the 'linguistic' tasks with different voice intensities. We also examined MEPs in HS and ASD during hand-related 'action-verb' observation. Patients were studied under and not-under botulinum neurotoxin-type A (BoNT-A). In HS, TMS over the dominant M1 elicited larger MEPs during 'reading aloud' than during the other 'linguistic'/'non-linguistic' tasks. Conversely, in ASD, TMS over the dominant M1 elicited increased-amplitude MEPs during 'reading aloud' and 'syllabic phonation' tasks. CSP length was shorter in ASD than in HS and remained unchanged in both groups performing 'linguistic'/'non-linguistic' tasks. In HS and ASD, 'linguistic' task-related excitability changes were present regardless of the different voice intensities. During hand-related 'action-verb' observation, MEPs decreased in HS, whereas in ASD they increased. In ASD, BoNT-A improved speech, as demonstrated by cepstral analysis and restored the TMS abnormalities. ASD reflects dominant hemisphere excitability changes related to 'linguistic' tasks; BoNT-A returns these excitability changes to normal. © 2015 Federation of European Neuroscience Societies and John

The effect of unilateral thalamic deep brain stimulation on the vocal dysfunction in a patient with spasmodic dysphonia: interrogating cerebellar and pallidal neural circuits.

PubMed

Poologaindran, Anujan; Ivanishvili, Zurab; Morrison, Murray D; Rammage, Linda A; Sandhu, Mini K; Polyhronopoulos, Nancy E; Honey, Christopher R

2018-02-01

Spasmodic dysphonia (SD) is a neurological disorder of the voice where a patient's ability to speak is compromised due to involuntary contractions of the intrinsic laryngeal muscles. Since the 1980s, SD has been treated with botulinum toxin A (BTX) injections into the throat. This therapy is limited by the delayed-onset of benefits, wearing-off effects, and repeated injections required every 3 months. In a patient with essential tremor (ET) and coincident SD, the authors set out to quantify the effects of thalamic deep brain stimulation (DBS) on vocal function while investigating the underlying motor thalamic circuitry. A 79-year-old right-handed woman with ET and coincident adductor SD was referred to our neurosurgical team. While primarily treating her limb tremor, the authors studied the effects of unilateral, thalamic DBS on vocal function using the Unified Spasmodic Dysphonia Rating Scale (USDRS) and voice-related quality of life (VRQOL). Since dystonia is increasingly being considered a multinodal network disorder, an anterior trajectory into the left thalamus was deliberately chosen such that the proximal contacts of the electrode were in the ventral oralis anterior (Voa) nucleus (pallidal outflow) and the distal contacts were in the ventral intermediate (Vim) nucleus (cerebellar outflow). In addition to assessing on/off unilateral thalamic Vim stimulation on voice, the authors experimentally assessed low-voltage unilateral Vim, Voa, or multitarget stimulation in a prospective, randomized, doubled-blinded manner. The evaluators were experienced at rating SD and were familiar with the vocal tremor of ET. A Wilcoxon signed-rank test was used to study the pre- and posttreatment effect of DBS on voice. Unilateral left thalamic Vim stimulation (DBS on) significantly improved SD vocal dysfunction compared with no stimulation (DBS off), as measured by the USDRS (p < 0.01) and VRQOL (p < 0.01). In the experimental interrogation, both low-voltage Vim (p < 0.01) and

Validation of a telephone screening tool for spasmodic dysphonia and vocal fold tremor.

PubMed

Johnson, David M; Hapner, Edie R; Klein, Adam M; Pethan, Madeleine; Johns, Michael M

2014-11-01

The objective of this study was to ascertain whether clinicians can reliably distinguish between spasmodic dysphonia (SD)/vocal tremor and other voice disorders by telephone, despite this modality's limited frequency response. Randomized, single-blinded, and prospective study. Voice-disordered patients with (n = 22) and without (n = 17) SD and/or vocal tremor recorded standardized utterances via landline telephone. A laryngologist and two speech-language pathologists blinded to the diagnoses rated each recording as "yes" or "no" to "SD or tremor present?," and if "yes" categorized into adductor, abductor, tremor only, or adductor with tremor subtypes. Twenty-one recordings were presented twice at random so intrarater reliability could be assessed. All ratings were compared with gold standard diagnosis by a second laryngologist who performed a full examination, including videostroboscopy, on each patient. For the comparison "SD or tremor" yes versus no, sensitivity, specificity, positive predictive value, and negative predictive value are 90%, 95%, 96%, and 89%, respectively. Interrater reliability (Cohen kappa) compared with the gold standard ranged from 0.70 to 0.93 (substantial to almost perfect agreement). Cronbach alpha among three raters was 0.90 for this comparison. Intrarater reliability (number matched/number inspected) was very high, ranging from 0.97 to 1.0. Comparing gold standard and telephone rating of SD/tremor subtypes, kappa ranged from 0.48 to 0.60 (moderate agreement). Cronbach alpha among three raters was 0.88 for this comparison. Intrarater reliability ranged from 0.84 to 0.97. SD and tremor can be reliably distinguished from other voice disorders over the telephone. Copyright © 2014 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Considerations for initial dosing of botulinum toxin in treatment of adductor spasmodic dysphonia.

PubMed

Rosow, David E; Parikh, Punam; Vivero, Richard J; Casiano, Roy R; Lundy, Donna S

2013-06-01

To assess the effect on voice improvement and duration of breathiness based on initial dose of onabotulinum toxin A (BTX-A) in the management of adductor spasmodic dysphonia (SD) and to compare voice outcomes for initial bilaterally injected doses of 1.25 units (group A) vs 2.5 units (group B) of BTX-A. Case series with chart review of patients with adductor SD treated at a tertiary care facility from 1990 to 2011. Academic subspecialty laryngology practice. Demographic data (age and sex), voice rating, duration of voice improvement, and breathiness were evaluated and compared between groups A and B using the Student t test and χ(2) analysis. Of 478 patients identified, 305 (223 in group A, 82 in group B) patients met inclusion criteria. The average age was 56.2 years in group A and 57.4 years in group B (P = .5). The female to male ratio was 2.91 for group A vs 3.56 for group B (P = .61). Good voice outcomes (grade 3 or 4) were reported by 91% of group A patients vs 94% of group B (P = .75). The average duration of voice improvement was 99.7 days for group A and 108.3 days for group B (P = .54). The average duration of breathiness was 10.88 days for group A vs 15.42 days for group B (P = .02). Patients injected with 1.25 units bilaterally had a statistically significant shorter duration of breathiness without a statistically significant difference in clinical effectiveness or voice outcome. It is therefore recommended that a relatively low initial BTX-A dose be used with subsequent titration to achieve improved voice outcomes.

Neural correlates of dystonic tremor: a multimodal study of voice tremor in spasmodic dysphonia.

PubMed

Kirke, Diana N; Battistella, Giovanni; Kumar, Veena; Rubien-Thomas, Estee; Choy, Melissa; Rumbach, Anna; Simonyan, Kristina

2017-02-01

Tremor, affecting a dystonic body part, is a frequent feature of adult-onset dystonia. However, our understanding of dystonic tremor pathophysiology remains ambiguous as its interplay with the main co-occurring disorder, dystonia, is largely unknown. We used a combination of functional MRI, voxel-based morphometry and diffusion-weighted imaging to investigate similar and distinct patterns of brain functional and structural alterations in patients with dystonic tremor of voice (DTv) and isolated spasmodic dysphonia (SD). We found that, compared to controls, SD patients with and without DTv showed similarly increased activation in the sensorimotor cortex, inferior frontal (IFG) and superior temporal gyri, putamen and ventral thalamus, as well as deficient activation in the inferior parietal cortex and middle frontal gyrus (MFG). Common structural alterations were observed in the IFG and putamen, which were further coupled with functional abnormalities in both patient groups. Abnormal activation in left putamen was correlated with SD onset; SD/DTv onset was associated with right putaminal volumetric changes. DTv severity established a significant relationship with abnormal volume of the left IFG. Direct patient group comparisons showed that SD/DTv patients had additional abnormalities in MFG and cerebellar function and white matter integrity in the posterior limb of the internal capsule. Our findings suggest that dystonia and dystonic tremor, at least in the case of SD and SD/DTv, are heterogeneous disorders at different ends of the same pathophysiological spectrum, with each disorder carrying a characteristic neural signature, which may potentially help development of differential markers for these two conditions.

Brain Activity in Patients With Adductor Spasmodic Dysphonia Detected by Functional Magnetic Resonance Imaging.

PubMed

Kiyuna, Asanori; Kise, Norimoto; Hiratsuka, Munehisa; Kondo, Shunsuke; Uehara, Takayuki; Maeda, Hiroyuki; Ganaha, Akira; Suzuki, Mikio

2017-05-01

Spasmodic dysphonia (SD) is considered a focal dystonia. However, the detailed pathophysiology of SD remains unclear, despite the detection of abnormal activity in several brain regions. The aim of this study was to clarify the pathophysiological background of SD. This is a case-control study. Both task-related brain activity measured by functional magnetic resonance imaging by reading the five-digit numbers and resting-state functional connectivity (FC) measured by 150 T2-weighted echo planar images acquired without any task were investigated in 12 patients with adductor SD and in 16 healthy controls. The patients with SD showed significantly higher task-related brain activation in the left middle temporal gyrus, left thalamus, bilateral primary motor area, bilateral premotor area, bilateral cerebellum, bilateral somatosensory area, right insula, and right putamen compared with the controls. Region of interest voxel FC analysis revealed many FC changes within the cerebellum-basal ganglia-thalamus-cortex loop in the patients with SD. Of the significant connectivity changes between the patients with SD and the controls, the FC between the left thalamus and the left caudate nucleus was significantly correlated with clinical parameters in SD. The higher task-related brain activity in the insula and cerebellum was consistent with previous neuroimaging studies, suggesting that these areas are one of the unique characteristics of phonation-induced brain activity in SD. Based on FC analysis and their significant correlations with clinical parameters, the basal ganglia network plays an important role in the pathogenesis of SD. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Long-term Evaluation of Type 2 Thyroplasty with Titanium Bridges for Adductor Spasmodic Dysphonia.

PubMed

Sanuki, Tetsuji; Yumoto, Eiji

2017-07-01

Objectives Standard treatments of adductor spasmodic dysphonia (AdSD) provide temporary relief of symptoms. Type 2 thyroplasty offers a long-term solution; however, long-term voice outcome data are lacking. The objective of this study was to assess the long-term voice outcomes of type 2 thyroplasty with titanium bridges through use of a validated voice questionnaire. Study Design Case series with chart review. Setting University hospital. Subjects and Methods Forty-seven consecutively enrolled patients with AdSD underwent type 2 thyroplasty with titanium bridges between August 2006 and November 2014. Questionnaires were completed during regularly scheduled follow-ups and, in some cases, were sent to patients who missed follow-up appointments. In 2015, questionnaires were mailed to all 47 patients and included a Voice Handicap Index-10 evaluation, as well as questions on postoperative vocal symptoms, surgical site, and status of the implanted titanium bridges. Results Of 47 patients with AdSD, 31 (66%) completed the questionnaires. The average follow-up interval was 41.3 months. No patient reported experiencing an adverse event around the surgical site, and almost all were satisfied with their voices postoperatively. The mean postoperative (>3 years) Voice Handicap Index-10 score improved significantly, from 26.3 to 9.4 (n = 17, P = .0009). Conclusions Type 2 thyroplasty for AdSD significantly improved patient quality of life and voice symptoms and continued to do so long after the surgery. The results of this study suggest that type 2 thyroplasty provides relief from vocal symptoms in patients with AdSD for >3 years.

Neural correlates of dystonic tremor: A multimodal study of voice tremor in spasmodic dysphonia

PubMed Central

Kirke, Diana N.; Battistella, Giovanni; Kumar, Veena; Rubien-Thomas, Estee; Choy, Melissa; Rumbach, Anna; Simonyan, Kristina

2016-01-01

Tremor, affecting a dystonic body part, is a frequent feature of adult-onset dystonia. However, our understanding of dystonic tremor pathophysiology remains ambiguous, as its interplay with the main co-occurring disorder, dystonia, is largely unknown. We used a combination of functional MRI, voxel-based morphometry and diffusion-weighted imaging to investigate similar and distinct patterns of brain functional and structural alterations in patients with dystonic tremor of voice (DTv) and isolated spasmodic dysphonia (SD). We found that, compared to controls, SD patients with and without DTv showed similarly increased activation in the sensorimotor cortex, inferior frontal (IFG) and superior temporal gyri, putamen and ventral thalamus, as well as deficient activation in the inferior parietal cortex and middle frontal gyrus (MFG). Common structural alterations were observed in the IFG and putamen, which were further coupled with functional abnormalities in both patient groups. Abnormal activation in left putamen was correlated with SD onset; SD/DTv onset was associated with right putaminal volumetric changes. DTv severity established a significant relationship with abnormal volume of the left IFG. Direct patient group comparisons showed that SD/DTv patients had additional abnormalities in MFG and cerebellar function and white matter integrity in the posterior limb of the internal capsule. Our findings suggest that dystonia and dystonic tremor, at least in the case of SD and SD/DTv, are heterogeneous disorders at different ends of the same pathophysiological spectrum, with each disorder carrying a characteristic neural signature, which may potentially help development of differential markers for these two conditions. PMID:26843004

Outcome Measurement in the Treatment of Spasmodic Dysphonia: A Systematic Review of the Literature.

PubMed

Rumbach, Anna; Aiken, Patrick; Novakovic, Daniel

2018-04-11

The aim of this review was to systematically identify all available studies reporting outcomes measures to assess treatment outcomes for people with spasmodic dysphonia (SD). Full-text journal articles were identified through searches of PubMed, Embase, CINAHL, and Cochrane databases and hand searching of journals. A total of 4,714 articles were retrieved from searching databases; 1,165 were duplicates. Titles and abstracts of 3,549 were screened, with 171 being selected for full-text review. During full-text review, 101 articles were deemed suitable for inclusion. An additional 24 articles were identified as suitable for inclusion through a hand search of reference lists. Data were extracted from 125 studies. A total of 220 outcome measures were identified. Considered in reference to the World Health Organization International Classification of Functioning, Disability and Health (ICF), the majority of outcomes were measured at a Body Function level (n = 212, 96%). Outcomes that explored communication and participation in everyday life and attitudes toward communication (ie, activity and participation domains) were infrequent (n = 8; 4%). Quality of life, a construct not measured within the ICF, was also captured by four outcome measures. No instruments evaluating communication partners' perspectives or burden/disability were identified. The outcome measures used in SD treatment studies are many and varied. The outcome measures identified predominately measure constructs within the Body Functions component of the ICF. In order to facilitate data synthesis across trials, the development of a core outcome set is recommended. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

Longitudinal variations of laryngeal overpressure and voice-related quality of life in spasmodic dysphonia.

PubMed

Yeung, Jeffrey C; Fung, Kevin; Davis, Eric; Rai, Sunita K; Day, Adam M B; Dzioba, Agnieszka; Bornbaum, Catherine; Doyle, Philip C

2015-03-01

Adductor spasmodic dysphonia (AdSD) is a voice disorder characterized by variable symptom severity and voice disability. Those with the disorder experience a wide spectrum of symptom severity over time, resulting in varied degrees of perceived voice disability. This study investigated the longitudinal variability of AdSD, with a focus on auditory-perceptual judgments of a dimension termed laryngeal overpressure (LO) and patient self-assessments of voice-related quality of life (V-RQOL). Longitudinal, correlational study. Ten adults with AdSD were followed over three time periods. At each, both voice samples and self-ratings of V-RQOL were gathered prior to their scheduled Botox injection. Voice recordings subsequently were perceptually evaluated by eight listeners for LO using a visual analog scale. LO ratings for all-voiced and Rainbow Passage sentence stimuli were found to be highly correlated. However, only the LO ratings obtained from judgments of AV stimuli were found to correlate moderately with self-ratings of voice disability for both the physical functioning and social-emotional subscores, as well as the total V-RQOL score. Based on perceptual judgments, LO appears to provide a reliable means of quantifying the severity of voice abnormalities in AdSD. Variability in self-ratings of the V-RQOL suggest that perceived disability related to AdSD should be actively monitored. Further, auditory-perceptual judgments may provide an accurate index of the potential impact of the disorder on the speaker. Similarly, LO was supported as a simple clinical measure that serves as a reliable index of voice change over time. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

Influence of consonant voicing characteristics on sentence production in abductor versus adductor spasmodic dysphonia.

PubMed

Cannito, Michael P; Chorna, Lesya B; Kahane, Joel C; Dworkin, James P

2014-05-01

This study evaluated the hypotheses that sentence production by speakers with adductor (AD) and abductor (AB) spasmodic dysphonia (SD) may be differentially influenced by consonant voicing and manner features, in comparison with healthy, matched, nondysphonic controls. This was a prospective, single blind study, using a between-groups, repeated measures design for the independent variables of perceived voice quality and sentence duration. Sixteen subjects with ADSD and 10 subjects with ABSD, as well as 26 matched healthy controls produced four short, simple sentences that were systematically loaded with voiced or voiceless consonants of either obstruant or continuant manner categories. Experienced voice clinicians, who were "blind" as to speakers' group affixations, used visual analog scaling to judge the overall voice quality of each sentence. Acoustic sentence durations were also measured. Speakers with ABSD or ADSD demonstrated significantly poorer than normal voice quality on all sentences. Speakers with ABSD exhibited longer than normal duration for voiceless consonant sentences. Speakers with ADSD had poorer voice quality for voiced than for voiceless consonant sentences. Speakers with ABSD had longer durations for voiceless than for voiced consonant sentences. The two subtypes of SD exhibit differential performance on the basis of consonant voicing in short, simple sentences; however, each subgroup manifested voicing-related differences on a different variable (voice quality vs sentence duration). Findings suggest different underlying pathophysiological mechanisms for ABSD and ADSD. Findings also support inclusion of short, simple sentences containing voiced or voiceless consonants as part of the diagnostic protocol for SD, with measurement of sentence duration in addition to judments of voice quality severity. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Onabotulinum toxin A dosage trends over time for adductor spasmodic dysphonia: A 15-year experience.

PubMed

Tang, Christopher G; Novakovic, Daniel; Mor, Niv; Blitzer, Andrew

2016-03-01

Although onabotulinum neurotoxin A (BoNTA) has been used for over three decades for the treatment of adductor spasmodic dysphonia, no study has been performed to look at the trend of BoNTA dosages across time. The goal of this study is to evaluate the dosage trends to determine if the dosage necessary for voice improvement in patients increases over time. Charts were reviewed for patients with 15 years or more of experience. Linear regression analysis was performed to determine correlation coefficients and trends. Fifty-five patients receiving BoNTA injections by the senior author (a.b.) for over 15 years were evaluated. Thirty-nine patients (82% female) met inclusion criteria. Patients received injections over an average of 18.6 years ± 1.36 years, with the longest follow-up of 21.5 years. Of 39 patients, 16 (41%) had a negative correlation coefficient (Pearson's r) suggesting a decrease over time, whereas 23 (59%) had a positive correlation coefficient suggesting an increase over time. The mean correlation coefficient was 0.139 ± 0.534 and P < 0.05 in 19 patients and P > 0.05 in 20 patients. R(2) for all patients were less than 0.75. Onabotulinum neurotoxin A injection dosage trends vary depending on the individual over time. Overall, the dose range appears to be stable in the majority of patients, suggesting that tolerance does not play a significant part in dose variation over time. 4. Laryngoscope, 126:678-681, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Long-term voice handicap index after type II thyroplasty using titanium bridges for adductor spasmodic dysphonia.

PubMed

Sanuki, Tetsuji; Yumoto, Eiji; Kodama, Narihiro; Minoda, Ryosei; Kumai, Yoshihiko

2014-06-01

To determine the long-term functional outcomes of type II thyroplasty using titanium bridges for adductor spasmodic dysphonia (AdSD) by perceptual analysis using the Voice Handicap Index-10 (VHI-10) and by acoustic analysis. Fifteen patients with AdSD underwent type II thyroplasty using titanium brides between August 2006 and February 2011. VHI-10 scores, a patient-based survey that quantifies a patient's perception of his or her vocal handicap, were determined before and at least 2 years after surgery. Concurrent with the VHI-10 evaluation, acoustic parameters were assessed, including jitter, shimmer, harmonic-to-noise ratio (HNR), standard deviation of F0 (SDF0), and degree of voice breaks (DVB). The average follow-up interval was 30.1 months. No patient had strangulation of the voice, and all were satisfied with the voice postoperatively. In the perceptual analysis, the mean VHI-10 score improved significantly, from 26.7 to 4.1 two years after surgery. All patients had significantly improved each score of three different aspects of VHI-10, representing improved functional, physical, and emotional well-being. All acoustic parameters improved significantly 2 years after surgery. The treatment of AdSD with type II thyroplasty significantly improved the voice-related quality of life and acoustic parameters 2 years after surgery. The results of the study suggest that type II thyroplasty using titanium bridges provides long-term relief of vocal symptoms in patients with AdSD. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Voice tuning with new instruments for type II thyroplasty in the treatment of adductor spasmodic dysphonia.

PubMed

Sanuki, Tetsuji; Yumoto, Eiji; Toya, Yutaka; Kumai, Yoshihiko

2016-10-01

Adductor spasmodic dysphonia is a rare voice disorder characterized by strained and strangled voice quality with intermittent phonatory breaks and adductory vocal fold spasms. Type II thyroplasty differs from previous treatments in that this surgery does not involve any surgical intervention into the laryngeal muscle, nerve or vocal folds. Type II thyroplasty intervenes in the thyroid cartilage, which is unrelated to the lesion. This procedure, conducted with the aim of achieving lateralization of the vocal folds, requires utmost surgical caution due to the extreme delicacy of the surgical site, critically sensitive adjustment, and difficult procedures to maintain the incised cartilages at a correct position. During surgery, the correct separation of the incised cartilage edges with voice monitoring is the most important factor determining surgical success and patient satisfaction. We designed new surgical instruments: a thyroid cartilage elevator for undermining the thyroid cartilage, and spacer devices to gauge width while performing voice monitoring. These devices were designed to prevent surgical complications, and to aid in selecting the optimal size of titanium bridges while temporally maintaining a separation during voice monitoring. We designed new surgical instruments, including a thyroid cartilage elevator and spacer devices. Precise surgical procedures and performing voice tuning during surgery with the optimal separation width of the thyroid cartilage are key points for surgical success. We introduce the technique of voice tuning using these surgical tools in order to achieve a better outcome with minimal surgical complications. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Lateral Cricoarytenoid Release: Development of a Novel Surgical Treatment Option for Adductor Spasmodic Dysphonia in a Canine Laryngeal Model.

PubMed

Park, Andrea M; Paniello, Randal C

2016-09-01

To investigate the efficacy of a novel adductor muscle-releasing technique designed to decrease the force of vocal fold adduction, as a potential surgical therapy for patients with adductor spasmodic dysphonia (ADSD). Experimental animal study. A canine laryngeal model was used to assess the acute and sustained efficacy of a lateral cricoarytenoid (LCA) muscle release. A total of 34 canine hemilaryngeal preparations were divided among 7 experimental groups. The LCA muscle was separated from its cricoid cartilage origin via an open, anterior, submucosal approach. The laryngeal adductory pressures (LAP) were assessed pre- and post-muscle release via direct recurrent laryngeal nerve stimulation. Measurements were repeated at 1.5, 3, or 6 months postoperatively. Another study evaluated release of the thyroarytenoid (TA) muscle from its thyroid cartilage origin. Releasing the LCA muscle demonstrated a significant decrease in LAP acutely and was maintained at all 3 time points with the aid of a barrier (P < .05). Without the barrier, the LCA muscle reattached to the cricoid. Acute release of the TA muscle did not significantly decrease the LAP. The proposed LCA release procedure may provide patients with a permanent treatment option for ADSD. However, longer-term studies and human trials are needed. © The Author(s) 2016.

Workplace productivity and voice disorders: a cognitive interviewing study on presenteeism in individuals with spasmodic dysphonia.

PubMed

Isetti, Derek; Meyer, Tanya

2014-11-01

The objective of this study was to obtain initial reactions and suggested modifications to two existing presenteeism scales: the Stanford Presenteeism Scale 6 (SPS-6) and the Work Productivity and Activity Impairment Questionnaire-Specific Health Problem (WPAI-SHP) among a cohort of employed individuals with a focal laryngeal dystonia, spasmodic dysphonia (SD). The study design is a qualitative study. Nine speakers with SD underwent cognitive interviews, during which they were asked to evaluate the relevance of statements and clarity of wording on the SPS-6, the WPAI-SHP, and an additional set of voice-related statements designed by the researchers. Participants were asked to complete the scales, rank order statements in terms of perceived importance, and suggest additional statements of relevance. Although all participants noted that their SD did have an effect on their jobs, there were suggestions for modifying both the WPAI-SHP and the SPS-6. Participants regarded specific voice-related statements that were generated by the researchers to be of greater importance than the majority of the statements on the SPS-6. Minor changes in the wording of the instructions on the WPAI-SHP were recommended. Presenteeism is an important construct to measure in individuals with a chronic voice disorder such as SD. However, existing presenteeism scales might best be administered in conjunction with additional statements that are more voice related so that clinicians can be made aware of specific difficulties encountered in the workplace. Copyright © 2014 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Dysphonia in performers: toward a clinical definition of laryngology of the performing voice.

PubMed

Guss, Joel; Sadoughi, Babak; Benson, Brian; Sulica, Lucian

2014-05-01

To identify causes of dysphonia in performers and compare causes and aspects of treatment of dysphonia in performers and nonperformers. Case-control study. A chart review of all new patients presenting with a chief complaint of dysphonia over a 1-year period was performed. The prevalence of laryngeal disorders was reviewed and differences between performers and nonperformers were analyzed. The odds ratio of the prevalence of each disorder was computed against performer status as a risk factor. Four hundred seventy-six new patients complaining of dysphonia presented over 12 months; 74 were vocal performers. The median duration of symptoms in performers was 90 days. Phonotraumatic lesions were significantly more prevalent in performers (63.5% vs. 28.6%, P < 0.001), particularly bilateral mid-fold swelling (4-fold increase in performers), pseudocysts (3-fold increase), and vocal fold hemorrhage/ectasia. Neurologic disorders (vocal fold paralysis and spasmodic dysphonia), neoplastic pathologies, and age-related phenomena (atrophy/presbyphonia) were significantly more common in nonperformers. Overall and diagnosis-specific rates of surgical intervention were equal between the two groups. Phonotraumatic injury is responsible for the majority of dysphonia in vocal performers, to a significantly greater extent than in nonperformers and requires the implementation of standard therapeutic strategies. Awareness of the specific risks and management needs of the performer is of paramount importance to the practice of laryngology of the performing voice. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Endoscopic laser thyroarytenoid myoneurectomy in patients with adductor spasmodic dysphonia: a pilot study on long-term outcome on voice quality.

PubMed

Tsuji, Domingos Hiroshi; Takahashi, Marystella Tomoe; Imamura, Rui; Hachiya, Adriana; Sennes, Luiz Ubirajara

2012-09-01

Adductor spasmodic dysphonia (ADSD) is a focal laryngeal dystonia, which compromises greatly the quality of life of the patients involved. It is a severe vocal disorder characterized by spasms of laryngeal muscles during speech, producing phonatory breaks, forced, strained and strangled voice. Its symptoms result from involuntary and intermittent contractions of thyroarytenoid muscle during speech, which causes vocal fold to strain, pressing each vocal fold against the other and increasing glottic resistance. Botulinum toxin injection remains the gold-standard treatment. However, as injections should be repeated periodically leading to voice quality instability, a more definitive procedure would be desirable. In this pilot study we report the long-term vocal quality results of endoscopic laser thyroarytenoid myoneurectomy. Prospective study. Surgery was performed in 15 patients (11 females and four males), aged between 29 and 73 years, diagnosed with ADSD. Voice Handicap Index (VHI) was obtained before and after surgery (median 31 months postoperatively). A significant improvement in VHI was observed after surgery, as compared with baseline values (P=0.001). The median and interquartile range for preoperative VHI was 99 and 13, respectively and 24 and 42, for postoperative VHI. Subjective improvement of voice as assessed by the patients showed median improvement of 80%. Because long-term follow-up showed significant improvement of voice quality, this innovative surgical technique seems a satisfactory alternative treatment of ADSD patients who seek a definite improvement of their condition. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Clinical Practice Guideline: Hoarseness (Dysphonia) (Update).

PubMed

Stachler, Robert J; Francis, David O; Schwartz, Seth R; Damask, Cecelia C; Digoy, German P; Krouse, Helene J; McCoy, Scott J; Ouellette, Daniel R; Patel, Rita R; Reavis, Charles Charlie W; Smith, Libby J; Smith, Marshall; Strode, Steven W; Woo, Peak; Nnacheta, Lorraine C

2018-03-01

cause amenable to voice therapy. The guideline update group made recommendations for the following KASs: (1) Clinicians should identify dysphonia in a patient with altered voice quality, pitch, loudness, or vocal effort that impairs communication or reduces quality of life (QOL). (2) Clinicians should assess the patient with dysphonia by history and physical examination for underlying causes of dysphonia and factors that modify management. (3) Clinicians should perform laryngoscopy, or refer to a clinician who can perform laryngoscopy, when dysphonia fails to resolve or improve within 4 weeks or irrespective of duration if a serious underlying cause is suspected. (4) Clinicians should perform diagnostic laryngoscopy, or refer to a clinician who can perform diagnostic laryngoscopy, before prescribing voice therapy and document/communicate the results to the speech-language pathologist (SLP). (5) Clinicians should advocate for surgery as a therapeutic option for patients with dysphonia with conditions amenable to surgical intervention, such as suspected malignancy, symptomatic benign vocal fold lesions that do not respond to conservative management, or glottic insufficiency. (6) Clinicians should offer, or refer to a clinician who can offer, botulinum toxin injections for the treatment of dysphonia caused by spasmodic dysphonia and other types of laryngeal dystonia. (7) Clinicians should inform patients with dysphonia about control/preventive measures. (8) Clinicians should document resolution, improvement or worsened symptoms of dysphonia, or change in QOL of patients with dysphonia after treatment or observation. The guideline update group made a strong recommendation against 1 action: (1) Clinicians should not routinely prescribe antibiotics to treat dysphonia. The guideline update group made recommendations against other actions: (1) Clinicians should not obtain computed tomography (CT) or magnetic resonance imaging (MRI) for patients with a primary voice complaint

Clinical Practice Guideline: Hoarseness (Dysphonia) (Update) Executive Summary.

PubMed

Stachler, Robert J; Francis, David O; Schwartz, Seth R; Damask, Cecelia C; Digoy, German P; Krouse, Helene J; McCoy, Scott J; Ouellette, Daniel R; Patel, Rita R; Reavis, Charles Charlie W; Smith, Libby J; Smith, Marshall; Strode, Steven W; Woo, Peak; Nnacheta, Lorraine C

2018-03-01

cause amenable to voice therapy. The guideline update group made recommendations for the following KASs: (1) Clinicians should identify dysphonia in a patient with altered voice quality, pitch, loudness, or vocal effort that impairs communication or reduces quality of life (QOL). (2) Clinicians should assess the patient with dysphonia by history and physical examination for underlying causes of dysphonia and factors that modify management. (3) Clinicians should perform laryngoscopy, or refer to a clinician who can perform laryngoscopy, when dysphonia fails to resolve or improve within 4 weeks or irrespective of duration if a serious underlying cause is suspected. (4) Clinicians should perform diagnostic laryngoscopy, or refer to a clinician who can perform diagnostic laryngoscopy, before prescribing voice therapy and document/communicate the results to the speech-language pathologist (SLP). (5) Clinicians should advocate for surgery as a therapeutic option for patients with dysphonia with conditions amenable to surgical intervention, such as suspected malignancy, symptomatic benign vocal fold lesions that do not respond to conservative management, or glottic insufficiency. (6) Clinicians should offer, or refer to a clinician who can offer, botulinum toxin injections for the treatment of dysphonia caused by spasmodic dysphonia and other types of laryngeal dystonia. (7) Clinicians should inform patients with dysphonia about control/preventive measures. (8) Clinicians should document resolution, improvement or worsened symptoms of dysphonia, or change in QOL of patients with dysphonia after treatment or observation. The guideline update group made a strong recommendation against 1 action: (1) Clinicians should not routinely prescribe antibiotics to treat dysphonia. The guideline update group made recommendations against other actions: (1) Clinicians should not obtain computed tomography (CT) or magnetic resonance imaging (MRI) for patients with a primary voice complaint

A Measure of the Auditory-perceptual Quality of Strain from Electroglottographic Analysis of Continuous Dysphonic Speech: Application to Adductor Spasmodic Dysphonia.

PubMed

Somanath, Keerthan; Mau, Ted

2016-11-01

(1) To develop an automated algorithm to analyze electroglottographic (EGG) signal in continuous dysphonic speech, and (2) to identify EGG waveform parameters that correlate with the auditory-perceptual quality of strain in the speech of patients with adductor spasmodic dysphonia (ADSD). Software development with application in a prospective controlled study. EGG was recorded from 12 normal speakers and 12 subjects with ADSD reading excerpts from the Rainbow Passage. Data were processed by a new algorithm developed with the specific goal of analyzing continuous dysphonic speech. The contact quotient, pulse width, a new parameter peak skew, and various contact closing slope quotient and contact opening slope quotient measures were extracted. EGG parameters were compared between normal and ADSD speech. Within the ADSD group, intra-subject comparison was also made between perceptually strained syllables and unstrained syllables. The opening slope quotient SO7525 distinguished strained syllables from unstrained syllables in continuous speech within individual subjects with ADSD. The standard deviations, but not the means, of contact quotient, EGGW50, peak skew, and SO7525 were different between normal and ADSD speakers. The strain-stress pattern in continuous speech can be visualized as color gradients based on the variation of EGG parameter values. EGG parameters may provide a within-subject measure of vocal strain and serve as a marker for treatment response. The addition of EGG to multidimensional assessment may lead to improved characterization of the voice disturbance in ADSD. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

A measure of the auditory-perceptual quality of strain from electroglottographic analysis of continuous dysphonic speech: Application to adductor spasmodic dysphonia

PubMed Central

Somanath, Keerthan; Mau, Ted

2016-01-01

Objectives (1) To develop an automated algorithm to analyze electroglottographic (EGG) signal in continuous, dysphonic speech, and (2) to identify EGG waveform parameters that correlate with the auditory-perceptual quality of strain in the speech of patients with adductor spasmodic dysphonia (ADSD). Study Design Software development with application in a prospective controlled study. Methods EGG was recorded from 12 normal speakers and 12 subjects with ADSD reading excerpts from the Rainbow Passage. Data were processed by a new algorithm developed with the specific goal of analyzing continuous dysphonic speech. The contact quotient (CQ), pulse width (EGGW), a new parameter peak skew, and various contact closing slope quotient (SC) and contact opening slope quotient (SO) measures were extracted. EGG parameters were compared between normal and ADSD speech. Within the ADSD group, intra-subject comparison was also made between perceptually strained syllables and unstrained syllables. Results The opening slope quotient SO7525 distinguished strained syllables from unstrained syllables in continuous speech within individual ADSD subjects. The standard deviations, but not the means, of CQ, EGGW50, peak skew, and SO7525 were different between normal and ADSD speakers. The strain-stress pattern in continuous speech can be visualized as color gradients based on the variation of EGG parameter values. Conclusions EGG parameters may provide a within-subject measure of vocal strain and serve as a marker for treatment response. The addition of EGG to multi-dimensional assessment may lead to improved characterization of the voice disturbance in ADSD. PMID:26739857

Persistent dysphonia in two performers affecting the singing and projected speaking voice: a report on a collaborative approach to management.

PubMed

Baker, Janet

2002-01-01

The projected speaking voice and the singing voice are highly sensitive to external and internal influences, and teachers of spoken voice and singing are in a unique position to identify subtle and more serious vocal difficulties in their students. Persistent anomalies may herald early onset of changes in vocal fold structure, neurophysiological control, or emotional stability. Two cases are presented to illustrate the benefits of a collaborative approach to diagnosis and management. The first, a 21-year-old male drama and singing student with an abnormally high speaking voice and falsetto singing voice was found to have a psychogenic dysphonia referred to as "puberphonia" or "mutational falsetto". The second, a 34-year-old female alto with strained phonation and perceived stutter of the vocal folds was diagnosed with "adductor spasmodic dysphonia" or "focal laryngeal dystonia" of neurological origin.

National Spasmodic Torticollis Association

MedlinePlus

... relief from the pain and disability caused by ST What is Spasmodic Torticollis? Spasmodic Torticollis also known ... understand. Remember... You Are Not Alone! Treatment Options ST movements often disappear in sleep and may not ...

Chemodenervation of the Larynx

PubMed Central

Kaye, Rachel; Blitzer, Andrew

2017-01-01

Botulinum neurotoxin (BoNT) has existed for thousands of years; however, it was not medically utilized until investigations into its therapeutic use began in sincerity during the late 1970s and 1980s. This, coupled with the reclassification of spasmodic dysphonia as a focal dystonia, led to the use of chemodenervation for this disorder, which has since become a refined technique. Indeed, due to its safety and efficacy, BoNT has been investigated in multiple neurolaryngology disorders, including spasmodic dysphonia, vocal tremor, and muscle tension dysphonia. BoNT has been shown to be a useful and safe adjunct in the treatment for these disorders and may reduce or eliminate oral pharmacotherapy and/or prevent the need for a surgical intervention. We present the historical background, development, proposed mechanisms of action, uses, and techniques for administering BoNT for laryngeal disorders, with a particular focus on spasmodic dysphonia. PMID:29099066

Spasmodic dysphonia

MedlinePlus

Medicine that treats spasm of the vocal cord muscles may be tried. They appear to work in up to one half of people, at best. Some of these medicines have bothersome side effects. Botulinum toxin (Botox) treatments may ...

Spasmodic Dysphonia

MedlinePlus

... motor control Boston University College of Health & Rehabilitation Sciences: Sargent College ... U.S. Department of Health and Human Services National Institutes of Health USA.gov—Government ...

Vocal therapy of hyperkinetic dysphonia.

PubMed

Mumović, Gordana; Veselinović, Mila; Arbutina, Tanja; Škrbić, Renata

2014-01-01

Hyperkinetic (hyperfunctional) dysphonia is a common pathology. The disorder is often found in vocal professionals faced with high vocal requirements. The objective of this study was to evaluate the effects of vocal therapy on voice condition characterized by hyperkinetic dysphonia with prenodular lesions and soft nodules. The study included 100 adult patients and 27 children aged 4-16 years with prenodular lesions and soft nodules. A subjective acoustic analysis using the GIRBAS scale was performed prior to and after vocal therapy. Twenty adult patients and 10 children underwent objective acoustic analysis including several acoustic parameters. Pathological vocal qualities (hoarse, harsh and breathy voice) were also obtained by computer analysis. The subjective acoustic analysis revealed a significant (p<0.01) reduction in all dysphonia parameters after vocal treatment in adults and children. After treatment, all levels of dysphonia were lowered in 85% (85/100) of adult patients and 29% (29/100) had a normal voice. Before vocal therapy 9 children had severe, 13 had moderate and 8 slight dysphonia. After vocal therapy only 1 child had severe dysphonia, 7 had moderate, 10 had slight levels of dysphonia and 9 were without voice disorder. The objective acoustic analysis in adults revealed a significant improvement (p≤0.025) in all dysphonia parameters except SD FO and jitter %. In children, the acoustic parameters SD FO, jitter % and NNE (normal noise energy) were significantly improved (p=0.003-0.03). Pathological voice qualities were also improved in adults and children (p<0.05). Vocal therapy effectively improves the voice in hyperkinetic dysphonia with prenodular lesions and soft nodules in both adults and children, affectinq diverse acoustic parameters.

Spasmodic torticollis: the dental connection.

PubMed

Sims, Anthony B; Stack, Brendan C; Demerjian, G Gary

2012-07-01

Spasmodic torticollis or cervical dystonia (CD) is the most common form of focal dystonia and is characterized by sustained abnormal muscle contractions in the head and neck area resulting in abnormal positioning or posturing of the head. The dystonic muscle spasms associated with spasmodic torticollis may affect any combination of neck muscles. Three cases are reported of spasmodic torticollis that were treated by a dental appliance with individual varying occlusal heights to open the maxillomandibular vertical dimension. Upon increasing the vertical dimension of occlusion, there was a slowing and/or discontinuance of the symptoms of cervical dystonia. The proposed hypothesis for this reversal is that there may be neuritis of the auriculotemporal branch of the trigeminal nerve, which has direct input into the reticular formation (RF), and it may activate the cells of the pontine region of the RF known for the control and deviation of head posture. There is growing clinical evidence that temporomandibular joint (TMJ) dysfunction may be a factor in this neurological and painful disorder when it coexists.

Theoretical Analyses of the Functional Regions of the Heavy Chain of Botulinum Neurotoxin

DTIC Science & Technology

1994-01-01

SE. Schulz GM. liallctt M. Effects of hb)tulinum toxin injections on speech in adductor spasmodic dysphonia . Neurology 1988,38:1220-1225. 3. Jankovic...hemifacial spasm. Mov Disord 1987:4:237-254. 5. Brin MF. Blitzer A, Fahn S, Gould W. Lovelace RE. Adductor laryngeal dystonia (spastic dysphonia ): treatment

Botulinum toxin injection - larynx

MedlinePlus

Injection laryngoplasty; Botox - larynx: spasmodic dysphonia-BTX; Essential voice tremor (EVT)-btx; Glottic insufficiency; Percutaneous electromyography - guided botulinum toxin treatment; Percutaneous indirect laryngoscopy - guided botulinum toxin treatment; ...

Relationship between fatigue, perfectionism, and functional dysphonia.

PubMed

O'Hara, James; Miller, Tracey; Carding, Paul; Wilson, Janet; Deary, Vincent

2011-06-01

Increased levels of fatigue and perfectionism were noted during evaluation of cognitive behavioral therapy for the treatment of functional dysphonia. The investigators thus aimed to explore levels of general fatigue and perfectionism in patients with functional dysphonia and controls. Case-control study. Teaching hospital, United Kingdom. Patients recruited through speech therapy were asked to recruit a friend as a control, of the same sex and within 5 years of their age. An 11-point fatigue questionnaire, previously validated on a normal population, was analyzed using both Likert (0123) and bimodal (0011) systems, with a score greater than 4 on the bimodal system implying substantial fatigue. A 35-point perfectionism questionnaire was also completed and analyzed for "healthy" and "unhealthy" perfectionist traits. There were 75 cases and 62 controls. The mean fatigue score in patients with functional dysphonia was 17.0 and 14.4 for the controls (Likert, P = .009). Under the bimodal scoring system, the mean fatigue scores in functional dysphonia (5.10) and controls (3.01) were also significantly different (P = .003). The mean perfectionism scores were 98.9 for patients with functional dysphonia and 91.2 for controls (P = 0.043). To the investigators' knowledge, this is the first substantial report that fatigue and perfectionism scores are significantly elevated in functional dysphonia. Functional dysphonia is shown to be analogous to other medically unexplained physical symptoms that are also marked by generic somatopsychic distress and for which multiple factors are implicated in their onset and maintenance. This has implications for both research and treatment.

An apparatus for a complimentary treatment of spasmodic torticollis.

PubMed

Saito, I; Weiss, T

1988-07-01

We have developed an apparatus for treating spasmodic torticollis that can be used at home both during intensive therapy and follow-up. The refractoriness of spasmodic torticollis requires patients to practice biofeedback training partly on a home basis. However, it is usually difficult for spasmodic torticollis patients to provide and handle electromyographic (EMG) biofeedback training instruments. The present apparatus has 2 parts: first, a harness with a light source which is fixed on both shoulders; second, a photoreceptor, operant system for rewarding effect, and a digital recorder. The light is adjusted to strike the photoreceptor on the forehead when headposition is normal. Subjects are asked to keep the operant system--e.g. a radio--activated. They are trained in various postures as sitting, standing and walking. This apparatus provides a chance of home training to augment and maintain the effect during therapeutic sessions and the follow-up period.

Use of Botulinum Neurotoxin for the Treatment of Movement Disorders

MedlinePlus

... spasmodic dysphonia, or ABSD). Does BoNT control motor tics? Tics associated with Tourette syndrome are relatively brief, intermittent movements (also known as motor tics) or sounds (also known as vocal or phonic ...

Parkinson's disease detection based on dysphonia measurements

NASA Astrophysics Data System (ADS)

Lahmiri, Salim

2017-04-01

Assessing dysphonic symptoms is a noninvasive and effective approach to detect Parkinson's disease (PD) in patients. The main purpose of this study is to investigate the effect of different dysphonia measurements on PD detection by support vector machine (SVM). Seven categories of dysphonia measurements are considered. Experimental results from ten-fold cross-validation technique demonstrate that vocal fundamental frequency statistics yield the highest accuracy of 88 % ± 0.04. When all dysphonia measurements are employed, the SVM classifier achieves 94 % ± 0.03 accuracy. A refinement of the original patterns space by removing dysphonia measurements with similar variation across healthy and PD subjects allows achieving 97.03 % ± 0.03 accuracy. The latter performance is larger than what is reported in the literature on the same dataset with ten-fold cross-validation technique. Finally, it was found that measures of ratio of noise to tonal components in the voice are the most suitable dysphonic symptoms to detect PD subjects as they achieve 99.64 % ± 0.01 specificity. This finding is highly promising for understanding PD symptoms.

Predicting Voice Disorder Status From Smoothed Measures of Cepstral Peak Prominence Using Praat and Analysis of Dysphonia in Speech and Voice (ADSV).

PubMed

Sauder, Cara; Bretl, Michelle; Eadie, Tanya

2017-09-01

The purposes of this study were to (1) determine and compare the diagnostic accuracy of a single acoustic measure, smoothed cepstral peak prominence (CPPS), to predict voice disorder status from connected speech samples using two software systems: Analysis of Dysphonia in Speech and Voice (ADSV) and Praat; and (2) to determine the relationship between measures of CPPS generated from these programs. This is a retrospective cross-sectional study. Measures of CPPS were obtained from connected speech recordings of 100 subjects with voice disorders and 70 nondysphonic subjects without vocal complaints using commercially available ADSV and freely downloadable Praat software programs. Logistic regression and receiver operating characteristic (ROC) analyses were used to evaluate and compare the diagnostic accuracy of CPPS measures. Relationships between CPPS measures from the programs were determined. Results showed acceptable overall accuracy rates (75% accuracy, ADSV; 82% accuracy, Praat) and area under the ROC curves (area under the curve [AUC] = 0.81, ADSV; AUC = 0.91, Praat) for predicting voice disorder status, with slight differences in sensitivity and specificity. CPPS measures derived from Praat were uniquely predictive of disorder status above and beyond CPPS measures from ADSV (χ 2 (1) = 40.71, P < 0.001). CPPS measures from both programs were significantly and highly correlated (r = 0.88, P < 0.001). A single acoustic measure of CPPS was highly predictive of voice disorder status using either program. Clinicians may consider using CPPS to complement clinical voice evaluation and screening protocols. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Dysphonia and dysphagia after anterior cervical decompression.

PubMed

Tervonen, Hanna; Niemelä, Mika; Lauri, Eija-Riitta; Back, Leif; Juvas, Anja; Räsänen, Pirjo; Roine, Risto P; Sintonen, Harri; Salmi, Tapani; Vilkman, S Erkki; Aaltonen, Leena-Maija

2007-08-01

In this paper, the authors investigate the effects of anterior cervical decompression (ACD) on swallowing and vocal function. The study comprised 114 patients who underwent ACD. The early group (50 patients) was examined immediately pre- and postoperatively, and the late group (64 patients) was examined at only 3 to 9 months postoperatively. Fifty age- and sex-matched patients from the Department of Otorhinolaryngology-Head and Neck Surgery who had not been intubated in the previous 5 years were used as a control group. All patients in the early and control groups were examined by a laryngologist; patients in the late group were examined by a laryngologist and a neurosurgeon. Videolaryngostroboscopy was performed in all members of the patient and control groups, and the function of the ninth through 12th cranial nerves were clinically evaluated. Data were collected concerning swallowing, voice quality, surgery results, and health-related quality of life. Patients with persistent dysphonia were referred for phoniatric evaluation and laryngeal electromyography (EMG). Those with persistent dysphagia underwent transoral endoscopic evaluation of swallowing function and videofluorography. Sixty percent of patients in the early group reported dysphonia and 69% reported dysphagia at the immediate postoperative visit. Unilateral vocal fold paresis occurred in 12%. The prevalence of both dysphonia and dysphagia decreased in both groups 3 to 9 months postoperatively. All six patients with vocal fold paresis in the early group recovered, and in the late group there were two cases of vocal fold paresis. The results of laryngeal EMG were abnormal in 14 of 16 patients with persistent dysphonia. Neither intraoperative factors nor age or sex had any effect on the occurrence of dysphonia, dysphagia, or vocal fold paresis. Most patients were satisfied with the surgical outcome. Dysphonia, dysphagia, and vocal fold paresis are common but usually transient complications of ACD

A Qualitative Study of Interference with Communicative Participation across Communication Disorders in Adults

ERIC Educational Resources Information Center

Baylor, Carolyn; Burns, Michael; Eadie, Tanya; Britton, Deanna; Yorkston, Kathryn

2011-01-01

Purpose: To explore the similarities and differences in self-reported restrictions in communicative participation across different communication disorders in community-dwelling adults. Method: Interviews were conducted with 44 adults representing 7 different medical conditions: spasmodic dysphonia, multiple sclerosis, stroke, stuttering,…

Quantitative evaluation of phonetograms in the case of functional dysphonia.

PubMed

Airainer, R; Klingholz, F

1993-06-01

According to the laryngeal clinical findings, figures making up a scale were assigned to vocally trained and vocally untrained persons suffering from different types of functional dysphonia. The different types of dysphonia--from the manifested hypofunctional to the extreme hyperfunctional dysphonia--were classified by means of this scale. Besides, the subjects' phonetograms were measured and approximated by three ellipses, what rendered possible the definition of phonetogram parameters. The combining of selected phonetogram parameters to linear combinations served the purpose of a phonetographic evaluation. The linear combinations were to bring phonetographic and clinical evaluations into correspondence as accurately as possible. It was necessary to use different kinds of linear combinations for male and female singers and nonsingers. As a result of the reclassification of 71 and the new classification of 89 patients, it was possible to graduate the types of functional dysphonia by means of computer-aided phonetogram evaluation with a clinically acceptable error rate. This method proved to be an important supplement to the conventional diagnostics of functional dysphonia.

Dysphonia risk screening protocol

PubMed Central

Nemr, Katia; Simões-Zenari, Marcia; da Trindade Duarte, João Marcos; Lobrigate, Karen Elena; Bagatini, Flavia Alves

2016-01-01

OBJECTIVE: To propose and test the applicability of a dysphonia risk screening protocol with score calculation in individuals with and without dysphonia. METHOD: This descriptive cross-sectional study included 365 individuals (41 children, 142 adult women, 91 adult men and 91 seniors) divided into a dysphonic group and a non-dysphonic group. The protocol consisted of 18 questions and a score was calculated using a 10-cm visual analog scale. The measured value on the visual analog scale was added to the overall score, along with other partial scores. Speech samples allowed for analysis/assessment of the overall degree of vocal deviation and initial definition of the respective groups and after six months, the separation of the groups was confirmed using an acoustic analysis. RESULTS: The mean total scores were different between the groups in all samples. Values ranged between 37.0 and 57.85 in the dysphonic group and between 12.95 and 19.28 in the non-dysphonic group, with overall means of 46.09 and 15.55, respectively. High sensitivity and specificity were demonstrated when discriminating between the groups with the following cut-off points: 22.50 (children), 29.25 (adult women), 22.75 (adult men), and 27.10 (seniors). CONCLUSION: The protocol demonstrated high sensitivity and specificity in differentiating groups of individuals with and without dysphonia in different sample groups and is thus an effective instrument for use in voice clinics. PMID:27074171

[Clinical-psychological components in the consideration of functional dysphonia--a review].

PubMed

Kiese-Himmel, C

2015-03-01

The etiopathogenesis of functional dysphonia is complex; it is not sufficient to look solely at vocal behavior aspects. The predisposing basis for functional dysphonia can lie in the constitution of an individual, his/her professional speaking and speech behavior and/or may be personality-based. (Prolonged) psychosocial stress, vocal overstressing, unfavorable speaking habits, infection of the upper respiratory tract, inflammatory processes in the larynx, emotional life events and COSO events are considered as possible triggers. The interaction of predisposed and causal factors is unknown. Stress, overall fatigue, anxiety, depression and/or certain personality traits (which complicate or hamper coping) are considered as perpetuating factors. In any case, overlaps between voice symptoms and reactive psychic as well as social problems have to be kept in mind (e. g. the burden of suffering, depressive processing, speaking anxiety, socially withdrawal). Because the association of multiple psychosocial factors with functional dysphonia is not distinct--such are always existent in organ medically unexplained symptoms--functional dysphonia has to be diagnostically differentiated. For the purpose of the article, a psycho-diagnostic path following the ICD-10 chapter V along general lines is presented. Until now, it is unknown which psychosocial factors discriminate a psychogenic dysphonia from muscle tension dysphonia. © Georg Thieme Verlag KG Stuttgart · New York.

Persistant dysphonia following endotracheal intubation.

PubMed

Hamdan, Abdul-Latif; Sabra, Omar; Rameh, Charbel; El-Khatib, Mohamad

2007-02-01

Voice production is a complex process that involves more than one system, yet most causes of dysphonia are attributed to disturbances in the laryngeal structures and little attention is paid to extralaryngeal factors. Persistent dysphonia after general anesthesia is a challenge to both anesthesiologists and otolaryngologists. The etiology is often multivariable and necessitates a team approach for proper diagnosis. Laryngeal symptoms are subdivided into phonatory disturbances and airway related complaints. When they become persistent for more than 72 hours or are coupled with airway symptoms such as hemoptysis, stridor, dyspnea or aspiration, the anesthesiologist should suspect injury to the vocal folds or cricoarytenoid joints. Here-below, the laryngeal manifestations of endotracheal intubation and the pathophysiology of vocal fold scarring are discussed.

Longitudinal Phonatory Characteristics after Botulinum Toxin Type A Injection.

ERIC Educational Resources Information Center

Fisher, Kimberly V.; And Others

1996-01-01

A study investigated the long-term effects of a Botulinum Toxin Type A injection on the glottal competency of a man with adductor spasmodic dysphonia. Results suggest that change in degree of glottal adduction over time can be observed even when vocal instability is present within each recording session. (CR)

The Effect of Listener Experience and Anchors on Judgments of Dysphonia

ERIC Educational Resources Information Center

Eadie, Tanya L.; Kapsner-Smith, Mara

2011-01-01

Purpose: To determine the effect of auditory anchors on judgments of overall severity (OS) and vocal effort (VE) in dysphonic speech when judgments are made by experienced and inexperienced listeners, and when self-rated by individuals with dysphonia (speaker-listeners). Method: Twenty individuals with dysphonia and 4 normal controls provided…

Is Menstrual Dysphonia Associated With Greater Disability and Lower Quality of Life?

PubMed

Barillari, Maria Rosaria; Volpe, Umberto; Innaro, Nadia; Barillari, Umberto

2016-01-01

The aim of the present study had been to examine the relationships between menstrual dysphonia and measures of psychosocial distress, in a sample of female professional voice users. This is a prospective study of 52 consecutive professional voice users, aged 18-40 years, affected by transient dysphonia related to the menstrual cycle and recruited in the Division of Phoniatrics and Audiology of the Second University of Naples, from April 2011 to September 2014. The following evaluation protocol was used: videoendoscopy, the GIRBAS scale, the Voice Handicap Index, and the determination of sexual hormonal plasma levels both during the menstrual and the luteal phase of the cycle. Furthermore, we measured, in all patients, the levels of perceived disability and quality of life during and after the dysphonia episodes by means of the Manchester Short Assessment of Quality of Life and the Sheehan disability scale. Laryngoscopic evaluation revealed that only minor morphologic changes were present during the first days of the follicular phase, usually returning to normal morphology after the menstrual period was over. However, we found that dysphonia episodes of varying degree were present in most evaluated subjects; women with a moderate degree of dysphonia also had a lower quality of life and greater overall disability, during menses. Despite minimal morphologic signs of laryngeal pathology, menstrual dysphonia might represent a disease which is frequent among female professional voice users, which in turn is associated with a certain degree of disability and lower quality of life during premenstrual and menstrual phases. Copyright © 2016. Published by Elsevier Inc.

[Spasmodic torticollis and vertebral hemangioma].

PubMed

Durán, E; Chacón, J R

Spasmodic torticollis in young patients should give rise to a clinical suspicion that this is secondary to another primary disorder. Therefore a series of diagnostic tests should be carried out before it is labelled as idiopathic. The patient was a thirty year old man who had had difficulty in writing with his right hand since childhood. At the age of 20 years he was diagnosed as having writer's cramp and idiopathic spasmodic torticollis. On general physical examination no abnormalities were found. On neurological examination he had: absence of reflexes of both arms, limited but painless rotation of the neck towards the left and hypertrophy of the left trapezius muscle. Laboratory, neurophysiological and neuroimaging investigations seeking a secondary cause for the torticollis were all normal. There were no Keyser-Fleischer rings. Chest X-ray showed, dorsal scoliosis with convexity to the left. CAT and MR of the spine showed a hemangioma in the body of T1. On arteriography of the supra-aortic and vertebral trunks a hemangioma was found at T1 which received contrast material via a branch of the right thyro-bi-cervico-scapular trunk. Various treatments were tried (diazepam, Botox, Dysport, tetrabenazine, baclofen, etc.) with no improvement. A definite diagnosis of secondary torticollis could not be made since the hemangioma was supplied by a very narrow vascular pedicle, so embolization was contraindicated. Cervical spinal cord alterations may cause focal dystonia due to increased excitability of the spinal motor neurone, due to dysfunction of the disinhibitory descending reciprocal paths.

Psychogenic dysphonia: diversity of clinical and vocal manifestations in a case series.

PubMed

Martins, Regina Helena Garcia; Tavares, Elaine Lara Mendes; Ranalli, Paula Ferreira; Branco, Anete; Pessin, Adriana Bueno Benito

2014-01-01

Psychogenic dysphonia is a functional disorder with variable clinical manifestations. To assess the clinical and vocal characteristics of patients with psychogenic dysphonia in a case series. The study included 28 adult patients with psychogenic dysphonia, evaluated at a University hospital in the last ten years. Assessed variables included gender, age, occupation, vocal symptoms, vocal characteristics, and videolaryngostroboscopic findings. 28 patients (26 women and 2 men) were assessed. Their occupations included: housekeeper (n=17), teacher (n=4), salesclerk (n=4), nurse (n=1), retired (n=1), and psychologist (n=1). Sudden symptom onset was reported by 16 patients and progressive symptom onset was reported by 12; intermittent evolution was reported by 15; symptom duration longer than three months was reported by 21 patients. Videolaryngostroboscopy showed only functional disorders; no patient had structural lesions or changes in vocal fold mobility. Conversion aphonia, skeletal muscle tension, and intermittent voicing were the most frequent vocal emission manifestation forms. In this case series of patients with psychogenic dysphonia, the most frequent form of clinical presentation was conversion aphonia, followed by musculoskeletal tension and intermittent voicing. The clinical and vocal aspects of 28 patients with psychogenic dysphonia, as well as the particularities of each case, are discussed. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Biofeedback in dysphonia - progress and challenges.

PubMed

Amorim, Geová Oliveira de; Balata, Patrícia Maria Mendes; Vieira, Laís Guimarães; Moura, Thaís; Silva, Hilton Justino da

There is evidence that all the complex machinery involved in speech acts along with the auditory system, and their adjustments can be altered. To present the evidence of biofeedback application for treatment of vocal disorders, emphasizing the muscle tension dysphonia. A systematic review was conducted in Scielo, Lilacs, PubMed and Web of Sciences databases, using the combination of descriptors, and admitting as inclusion criteria: articles published in journals with editorial committee, reporting cases or experimental or quasi-experimental research on the use of biofeedback in real time as additional source of treatment monitoring of muscle tension dysphonia or for vocal training. Thirty-three articles were identified in databases, and seven were included in the qualitative synthesis. The beginning of electromyographic biofeedback studies applied to speech therapy were promising and pointed to a new method that enabled good results in muscle tension dysphonia. Nonetheless, the discussion of the results lacked physiological evidence that could serve as their basis. The search for such explanations has become a challenge for speech therapists, and determined two research lines: one dedicated to the improvement of the electromyographic biofeedback methodology for voice disorders, to reduce confounding variables, and the other dedicated to the research of neural processes involved in changing the muscle engram of normal and dysphonic patients. There is evidence that the electromyographic biofeedback promotes changes in the neural networks responsible for speech, and can change behavior for vocal emissions with quality. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

The prevalence of childhood dysphonia: a cross-sectional study.

PubMed

Carding, Paul N; Roulstone, Sue; Northstone, Kate

2006-12-01

There is only very limited information on the prevalence of voice disorders, particularly for the pediatric population. This study examined the prevalence of dysphonia in a large cohort of children (n = 7389) at 8 years of age. Data were collected within a large prospective epidemiological study and included a formal assessment by one of five research speech and language therapists as well as a parental report of their child's voice. Common risk factors that were also analyzed included sex, sibling numbers, asthma, regular conductive hearing loss, and frequent upper respiratory infection. The research clinicians identified a dysphonia prevalence of 6% compared with a parental report of 11%. Both measures suggested a significant risk of dysphonia for children with older siblings. Other measures were not in agreement between clinician and parental reports. The clinician judgments also suggested significant risk factors for sex (male) but not for any common respiratory or otolaryngological conditions that were analyzed. Parental report suggested significant risk factors with respect to asthma and tonsillectomy. These results are discussed in detail.

Dysphonia in adults with developmental stuttering: A descriptive study.

PubMed

Botha, Anél; Ras, Elizbé; Abdoola, Shabnam; Van der Linde, Jeannie

2017-06-26

Persons with stuttering (PWS) often present with other co-occurring conditions. The World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF) proposes that it is important to understand the full burden of a health condition. A few studies have explored voice problems among PWS, and the characteristics of voices of PWS are relatively unknown. The importance of conducting future research has been emphasised. This study aimed to describe the vocal characteristics of PWS. Acoustic and perceptual data were collected during a comprehensive voice assessment. The severity of stuttering was also determined. Correlations between the stuttering severity instrument (SSI) and the acoustic measurements were evaluated to determine the significance. Twenty participants were tested for this study. Only two participants (10%) obtained a positive Dysphonia Severity Index (DSI) score of 1.6 or higher, indicating that no dysphonia was present, while 90% of participants (n = 18) scored lower than 1.6, indicating that those participants presented with dysphonia. Some participants presented with weakness (asthenia) of voice (35%), while 65% presented with a slightly strained voice quality. Moderately positive correlations between breathiness and SSI (r = 0.40, p = 0.08) have been reported. In addition, participants with high SSI scores also scored a poor DSI of below 1.6, as observed by a moderate positive correlation between SSI and DSI (r = 0.41). The majority of PWS presented with dysphonia, evident in the perceptual or acoustic parameters of their voices. These results can be used for further investigation to create awareness and to establish intervention strategies for voice disorders among PWS.

Current and emerging concepts in muscle tension dysphonia: a 30-month review.

PubMed

Altman, Kenneth W; Atkinson, Cory; Lazarus, Cathy

2005-06-01

The modern theory of hoarseness is that there are multifactorial etiologies contributing to the voice problem. The hypothesis of this study is that muscle tension dysphonia is multifactorial with various contributing etiologies. This project is a retrospective chart review of all patients seen in the Voice Speech and Language Service and Swallowing Center at our institution with a diagnosis of muscle tension (functional hypertensive) dysphonia over a 30-month period. A literature search and review is also performed regarding current and emerging concepts of muscle tension dysphonia. One hundred fifty subjects were identified (60% female, 40% male, with a mean age of 42.3 years). Significant factors in patient history believed to contribute to abnormal voice production were gastroesophageal reflux in 49%, high stress levels in 18%, excessive amounts of voice use in 63%, and excessive loudness demands on voice use in 23%. Otolaryngologic evaluation was performed in 82% of patients, in whom lesions, significant vocal fold edema, or paralysis/paresis was identified in 52.3%. Speech pathology assessment revealed poor breath support, inappropriately low pitch, and visible cervical neck tension in the majority of patients. Inappropriate intensity was observed in 23.3% of patients. This set of multiple contributing factors is discussed in the context of current and emerging understanding of muscle tension dysphonia. Results confirm multifactorial etiologies contributing to hoarseness in the patients identified with muscle tension dysphonia. An interdisciplinary approach to treating all contributing factors portends the best prognosis.

Dysphonia and vocal fold telangiectasia in hereditary hemorrhagic telangiectasia.

PubMed

Chang, Joseph; Yung, Katherine C

2014-11-01

This case report is the first documentation of dysphonia and vocal fold telangiectasia as a complication of hereditary hemorrhagic telangiectasia (HHT). Case report of a 40-year-old man with HHT presenting with 2 years of worsening hoarseness. Hoarseness corresponded with a period of anticoagulation. Endoscopy revealed vocal fold scarring, vocal fold telangiectasias, and plica ventricular is suggestive of previous submucosal vocal fold hemorrhage and subsequent counterproductive compensation with ventricular phonation. Hereditary hemorrhagic telangiectasia may present as dysphonia with vocal fold telangiectasias and place patients at risk of vocal fold hemorrhage. © The Author(s) 2014.

PubMed

Schützenberger, Anne; Hammer, Georg Philipp

2018-06-01

Sanuki T et al. Long-term Evaluation of Type 2 Thyroplasty with Titanium Bridges for Adductor Spasmodic Dysphonia. Otolaryngol Head Neck Surg 2017; 157: 80–84 JAPANISCHE ÄRZTE FüR HALS-, NASEN- UND OHRENHEILKUNDE SOWIE KOPF- UND HALSCHIRURGIE BERICHTETEN üBER STIMMLICHE LANGZEITERGEBNISSE NACH DURCHFüHRUNG EINER THYROPLASTIK TYP 2 ZUR BEHANDLUNG DER SPASMODISCHEN DYSPHONIE VOM ADDUKTOR TYP.

Voice deviation, dysphonia risk screening and quality of life in individuals with various laryngeal diagnoses

PubMed Central

Nemr, Katia; Cota, Ariane; Tsuji, Domingos; Simões-Zenari, Marcia

2018-01-01

OBJECTIVES: To characterize the voice quality of individuals with dysphonia and to investigate possible correlations between the degree of voice deviation (D) and scores on the Dysphonia Risk Screening Protocol-General (DRSP), the Voice-Related Quality of Life (V-RQOL) measure and the Voice Handicap Index, short version (VHI-10). METHODS: The sample included 200 individuals with dysphonia. Following laryngoscopy, the participants completed the DRSP, the V-RQOL measure, and the VHI-10; subsequently, voice samples were recorded for auditory-perceptual and acoustic analyses. The correlation between the score for each questionnaire and the overall degree of vocal deviation was analyzed, as was the correlation among the scores for the three questionnaires. RESULTS: Most of the participants (62%) were female, and the mean age of the sample was 49 years. The most common laryngeal diagnosis was organic dysphonia (79.5%). The mean D was 59.54, and the predominance of roughness had a mean of 54.74. All the participants exhibited at least one abnormal acoustic aspect. The mean questionnaire scores were DRSP, 44.7; V-RQOL, 57.1; and VHI-10, 16. An inverse correlation was found between the V-RQOL score and D; however, a positive correlation was found between both the VHI-10 and DRSP scores and D. CONCLUSION: A predominance of adult women, organic dysphonia, moderate voice deviation, high dysphonia risk, and low to moderate quality of life impact characterized our sample. There were correlations between the scores of each of the three questionnaires and the degree of voice deviation. It should be noted that the DRSP monitored the degree of dysphonia severity, which reinforces its applicability for patients with different laryngeal diagnoses. PMID:29538494

Voice deviation, dysphonia risk screening and quality of life in individuals with various laryngeal diagnoses.

PubMed

Nemr, Katia; Cota, Ariane; Tsuji, Domingos; Simões-Zenari, Marcia

2018-03-12

To characterize the voice quality of individuals with dysphonia and to investigate possible correlations between the degree of voice deviation (D) and scores on the Dysphonia Risk Screening Protocol-General (DRSP), the Voice-Related Quality of Life (V-RQOL) measure and the Voice Handicap Index, short version (VHI-10). The sample included 200 individuals with dysphonia. Following laryngoscopy, the participants completed the DRSP, the V-RQOL measure, and the VHI-10; subsequently, voice samples were recorded for auditory-perceptual and acoustic analyses. The correlation between the score for each questionnaire and the overall degree of vocal deviation was analyzed, as was the correlation among the scores for the three questionnaires. Most of the participants (62%) were female, and the mean age of the sample was 49 years. The most common laryngeal diagnosis was organic dysphonia (79.5%). The mean D was 59.54, and the predominance of roughness had a mean of 54.74. All the participants exhibited at least one abnormal acoustic aspect. The mean questionnaire scores were DRSP, 44.7; V-RQOL, 57.1; and VHI-10, 16. An inverse correlation was found between the V-RQOL score and D; however, a positive correlation was found between both the VHI-10 and DRSP scores and D. A predominance of adult women, organic dysphonia, moderate voice deviation, high dysphonia risk, and low to moderate quality of life impact characterized our sample. There were correlations between the scores of each of the three questionnaires and the degree of voice deviation. It should be noted that the DRSP monitored the degree of dysphonia severity, which reinforces its applicability for patients with different laryngeal diagnoses.

The putative involvement of the transabdominal muscles in dysphonia: a preliminary study and thoughts.

PubMed

Rubin, J S; Macdonald, I; Blake, E

2011-03-01

Real-time ultrasound was used as an adjunct to assess patterns of periabdominal musculature in 14 individual with dysphonia and muscle tension dysphonia. Fourteen individuals with muscle tension dysphonia were evaluated with real-time ultrasound as a part of their initial evaluation and management. In 13 of 14 individuals, there was an imbalance found during phonation between the transversus abdominis muscles (TAs) and internal oblique muscles (IOs), whereby the IOs were found to be overactive and the TAs underactive. After physiotherapy, this pattern was reversed. The abdominal muscle pattern of overactivity of the internal oblique and underactivity of the TA during phonation was found to be present in the large majority of patients in this pilot sample who had presented with muscle tension dysphonia. The significance of this is unclear but deserves further review. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Hereditary whispering dysphonia.

PubMed Central

Parker, N

1985-01-01

An Australian family group is described where at least twenty members have inherited torsion dystonia and two siblings with an affected mother have similar clinical manifestations, but have also the biochemical and pathological changes found in Wilson's disease. Whispering dysphonia was the commonest presenting symptom, and a diagnosis of hysteria was invariably made if the family history was not known. This group emphasises the enormously varied ways in which torsion dystonia may be manifested in one family, and raises the possibility of a disturbance in copper transport in diseases of the basal ganglia other than Wilson's disease. Images PMID:3156966

Is insufficient pulmonary air support the cause of dysphonia in chronic obstructive pulmonary disease?

PubMed

Hassan, Megahed M; Hussein, Mona T; Emam, Ahmed Mamdouh; Rashad, Usama M; Rezk, Ibrahim; Awad, Al Hussein

2018-08-01

Optimal pulmonary air support is essential pre-requisite for efficient phonation. The objective is to correlate pulmonary and vocal functions in chronic obstructive pulmonary disease (COPD) to find out whether the reduced pulmonary function per se could induce dysphonia. In this prospective case-control study, sixty subjects with stable COPD underwent evaluation of pulmonary and vocal functions. The pulmonary functions measured include {Forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC ratio, peak expiratory flow (PEF), maximum mid-expiratory flow (MMEF)}. The vocal functions were {jitter, shimmer, noise-to-harmonic ratio, pitch perturbation quotient, amplitude perturbation quotient, maximum phonation time (MPT), sound pressure level, phonatory efficiency, resistance and power. A control group (n=35) underwent the same measurements. These functions were compared between subjects and controls. Also, correlation of the vocal and pulmonary functions was conducted. Thirty five (58.3%) of COPD subjects have dysphonia. The pulmonary functions were lower in all COPD group than in the control group (P<0.001 for all parameters). Also, the FVC, FEV1, PEF and MMEF % of predicted values were significantly lower in subjects with dysphonia (n=35) than those without dysphonia (n=25) with P values 0.0018, <0.001, 0.0011 and 0.0026 respectively. In addition, the MPT in all subjects showed positive correlations to the 5 pulmonary functions (P=0.004 for FEV1/FVC ratio and P<0.001 for the rest). Also, the phonatory efficiency showed significant positive correlations with the pulmonary functions FVC, FEV1, PEF and MMEF (P=0.001, 0.001, 0.002 and 0.001 respectively). Unlike efficiency, the phonatory resistance revealed significant negative correlations with these pulmonary functions in the same order (P=0.001, 0.003, 0.002, 0.001 respectively). Dysphonia is a common comorbidity with COPD which attributed to multifactorial etiologies. The lower

Cepstral analysis of normal and pathological voice in Spanish adults. Smoothed cepstral peak prominence in sustained vowels versus connected speech.

PubMed

Delgado-Hernández, Jonathan; León-Gómez, Nieves M; Izquierdo-Arteaga, Laura M; Llanos-Fumero, Yanira

In recent years, the use of cepstral measures for acoustic evaluation of voice has increased. One of the most investigated parameters is smoothed cepstral peak prominence (CPPs). The objectives of this paper are to establish the usefulness of this acoustic measure in the objective evaluation of alterations of the voice in Spanish and to determine what type of voice sample (sustained vowels or connected speech) is the most sensitive in evaluating the severity of dysphonia. Forty subjects participated in this study 40, 20 controls and 20 with dysphonia. Two voice samples were recorded for each subject (one sustained vowel/a/and four phonetically balanced sentences) and the CPPs was calculated using the Praat programme. Three raters perceptually evaluated the voice sample with the Grade parameter of GRABS scale. Significantly lower values were found in the dysphonic voices, both for/a/(t [38] = 4.85, P<.000) and for phrases (t [38] = 5,75, P<.000). In relation to the type of voice sample most suitable for evaluating the severity of voice alterations, a strong correlation was found with the acoustic-perceptual scale of CPPs calculated from connected speech (r s = -0.73) and moderate correlation with that calculated from the sustained vowel (r s = -0,56). The results of this preliminary study suggest that CPPs is a good measure to detect dysphonia and to objectively assess the severity of alterations in the voice. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Toward the Development of an Objective Index of Dysphonia Severity: A Four-Factor Acoustic Model

ERIC Educational Resources Information Center

Awan, Shaheen N.; Roy, Nelson

2006-01-01

During assessment and management of individuals with voice disorders, clinicians routinely attempt to describe or quantify the severity of a patient's dysphonia. This investigation used acoustic measures derived from sustained vowel samples to predict dysphonia severity (as determined by auditory-perceptual ratings), for a diverse set of voice…

Effectiveness of voice therapy in functional dysphonia: where are we now?

PubMed

Bos-Clark, Marianne; Carding, Paul

2011-06-01

To review the recent literature since the 2009 Cochrane review regarding the effectiveness of voice therapy for patients with functional dysphonia. A range of articles report on the effects of voice therapy treatment for functional dysphonia, with a wide range of interventions described. Only one study is a randomized controlled trial. A number of excellent review articles have extended the knowledge base. In primary research, methodological issues persist: studies are small, and not adequately controlled. Studies show improved standards of outcome measurement and of description of the content of voice therapy. There is a continued need for larger, methodologically sound clinical effectiveness studies. Future studies need to be replicable and generalizable in order to inform and elucidate clinical practice.

Is the perception of dysphonia severity language-dependent? A comparison of French and Italian voice assessments.

PubMed

Ghio, Alain; Cantarella, Giovanna; Weisz, Frédérique; Robert, Danièle; Woisard, Virginie; Fussi, Franco; Giovanni, Antoine; Baracca, Giovanna

2015-04-01

In this cross-language study, six Italian and six French voice experts evaluated perceptually the speech of 27 Italian and 40 French patients with dysphonia to determine if there were differences based on native language. French and Italian voice specialists agreed substantially in their evaluations of the overall grade of dysphonia and moderately concerning roughness and breathiness. No statistically significant effects were found related to the language of the speakers with the exception of breathiness, a finding that was interpreted as being due to different voice pathologies in the patient groups. It was concluded that the perception of the overall grade of dysphonia and breathiness is not language-dependent, whereas the significant difference in the perception of roughness may be related to a perception/adaption process.

Dysphonia Detected by Pattern Recognition of Spectral Composition.

ERIC Educational Resources Information Center

Leinonen, Lea; And Others

1992-01-01

This study analyzed production of a long vowel sound within Finnish words by normal or dysphonic voices, using the Self-Organizing Map, the artificial neural network algorithm of T. Kohonen which produces two-dimensional representations of speech. The method was found to be both sensitive and specific in the detection of dysphonia. (Author/JDD)

Cross-system effects of dysphagia treatment on dysphonia: a case report

PubMed Central

LaGorio, Lisa A; Carnaby-Mann, Giselle D; Crary, Michael A

2008-01-01

Traditionally, treatment of dysphagia and dysphonia has followed a specificity approach whereby treatment plans have focused on each dysfunction individually. Recently however, a therapeutic cross-system effect has been proposed between these two dysfunctions. At least one study has demonstrated swallowing improvement in subjects who completed a dysphonia treatment program. However, we are unaware of any evidence demonstrating the converse effect. In this paper, we present a case-report of a 74 year old male who demonstrated improvement in selected vocal parameters after completion of a dysphagia therapy program. Dysphagia therapy resulted in improved laryngeal function in this subject. Results implicate improved vocal fold tension with increased glottal closure. Further investigation into the potential for this cross-system effect is warranted. PMID:18667069

Prominence oscillations

NASA Astrophysics Data System (ADS)

Arregui, Iñigo; Oliver, Ramón; Ballester, José Luis

2018-04-01

Prominences are intriguing, but poorly understood, magnetic structures of the solar corona. The dynamics of solar prominences has been the subject of a large number of studies, and of particular interest is the study of prominence oscillations. Ground- and space-based observations have confirmed the presence of oscillatory motions in prominences and they have been interpreted in terms of magnetohydrodynamic waves. This interpretation opens the door to perform prominence seismology, whose main aim is to determine physical parameters in magnetic and plasma structures (prominences) that are difficult to measure by direct means. Here, we review the observational information gathered about prominence oscillations as well as the theoretical models developed to interpret small and large amplitude oscillations and their temporal and spatial attenuation. Finally, several prominence seismology applications are presented.

Aerodynamic Profiles of Women with Muscle Tension Dysphonia/Aphonia

ERIC Educational Resources Information Center

Gillespie, Amanda I.; Gartner-Schmidt, Jackie; Rubinstein, Elaine N.; Abbott, Katherine Verdolini

2013-01-01

Purpose: In this study, the authors aimed to (a) determine whether phonatory airflows and estimated subglottal pressures (est-P[subscript sub]) for women with primary muscle tension dysphonia/aphonia (MTD/A) differ from those for healthy speakers; (b) identify different aerodynamic profile patterns within the MTD/A subject group; and (c) determine…

[Computer-assisted phonetography as a diagnostic aid in functional dysphonia].

PubMed

Airainer, R; Klingholz, F

1991-07-01

A total of 160 voice-trained and untrained subjects with functional dysphonia were given a "clinical rating" according to their clinical findings. This was a certain value on a scale that recorded the degree of functional voice disorder ranging from a marked hypofunction to an extreme hyperfunction. The phonetograms of these patients were approximated by ellipses, whereby the definition and quantitative recording of several phonetogram parameters were rendered possible. By means of a linear combination of phonetogram parameters, a "calculated assessment" was obtained for each patient that was expected to tally with the "clinical rating". This paper demonstrates that a graduation of the dysphonic clinical picture with regard to the presence of hypofunctional or hyperfunctional components is possible via computerised phonetogram evaluation. In this case, the "calculated assessments" for both male and female singers and non-singers must be computed using different linear combinations. The method can be introduced as a supplementary diagnostic procedure in the diagnosis of functional dysphonia.

Exploring Genetic and Environmental Effects in Dysphonia: A Twin Study

ERIC Educational Resources Information Center

Simberg, Susanna; Santtila, Pekka; Soveri, Anna; Varjonen, Markus; Sala, Eeva; Sandnabba, N. Kenneth

2009-01-01

Purpose: To explore the existence of genetic effects as well as the interaction between potential genetic effects and a voice-demanding occupation on dysphonia. Method: One thousand seven hundred and twenty-eight Finnish twins (555 male; 1,173 female) born between 1961 and 1989 completed a questionnaire concerning vocal symptoms and occupation.…

A possible association between dysphonia and sleep duration: A cross-sectional study based on the Korean National Health and nutrition examination surveys from 2010 to 2012

PubMed Central

Cho, Jung-Hae; Guilminault, Christian; Joo, Young-Hoon; Jin, Sang-Kyun; Han, Kyung-Do

2017-01-01

Background Sleep is important in terms of good general health and appropriate sleep duration has been linked to quality-of-life. Dysphonia may impair communication and social relationships, and is thus also closely related to quality-of-life. No large-scale, cross-sectional epidemiological study of a sample representative of the population of an entire country has yet assessed the possible existence of a relationship between sleep duration and dysphonia. Methods We investigated a possible association between subjective voice problems and self-reported sleep duration in South Korean subjects using 2010–2012 data from the Korean National Health and Nutrition Examination Survey (KNHANES). Cross-sectional data on 17,806 adults (7,578 males and 10,228 females) over the age of 19 years who completed the KNHANES were analyzed. All participants reported voice problems (if present) and their daily average sleep duration using a self-reporting questionnaire. Sleep duration was classified into five categories as follows: ≤5, 6, 7, 8, and ≥9 h/day. Results The overall prevalence of dysphonia was 6.8%; 5.7% in males and 7.7% in females. The prevalence for dysphonia by sleep duration exhibited a U-shape, with the lowest point being at sleep duration of 7-8h. After adjustment for covariates (age, sex, smoking status, alcohol consumption, regular exercise, low income, high-level education), a sleep duration of ≤5 h (OR = 1.454; 95% CI, 1.153–1.832) and a sleep duration of ≥9 h (OR = 1.365; 95% CI, 1.017–1.832) were significantly associated with dysphonia, compared to a sleep duration of 7 h. In terms of gender, males who slept for ≥9 h were at a 2-fold (OR = 2.028; 95% CI, 1.22–3.35) higher odds for dysphonia (p<0.05) compared to those who slept for 7 h. A sleep duration ≤5 h was associated with a 1.6-fold (OR = 1.574; 95% CI, 1.203–2.247) higher odds of dysphonia ≥3 weeks in duration (long-term dysphonia). Conclusions This is the first study to show that

Articulatory Changes Following Treatment of Muscle Tension Dysphonia: Preliminary Acoustic Evidence

ERIC Educational Resources Information Center

Dromey, Christopher; Nissen, Shawn L.; Roy, Nelson; Merrill, Ray M.

2008-01-01

Purpose: Primary muscle tension dysphonia (MTD), a voice disturbance that occurs in the absence of structural or neurological pathology, may respond to manual circumlaryngeal techniques, which ostensibly alter the posture of the larynx and/or the configuration of the vocal folds without directly targeting supralaryngeal articulatory structures.…

An Overview of Laryngeal Muscle Single Fiber Electromyography.

PubMed

Bertorini, Tulio E; Sharaf, Aboubakar G

2015-08-01

Needle electromyography is an important tool in the diagnosis of neuromuscular diseases and has also been applied successfully in the evaluation of the vocal cord paralysis. Laryngeal electromyography, initially described by Weddell, is used to determine the cause of vocal cord paralysis and to differentiate organic from nonorganic causes of speech disorders. This test allows the diagnosis of lower motor neuron and nerve paralysis as well as myopathies. Laryngeal electromyography also helps to determine the prognosis of paralysis caused by traumatic injury of the laryngeal nerves and is used for guidance during botulinum toxin injection in spasmodic dysphonias. Single fiber electromyography is used to diagnose abnormalities of neuromuscular transmission and is applied in the study the architecture of the motor unit in muscles. This article reviews the techniques of laryngeal muscles single fiber electromyography, provides limited informative data, and discusses its potential value in the evaluation of patients with dysphonia.

Auditory-Perceptual and Acoustic Methods in Measuring Dysphonia Severity of Korean Speech.

PubMed

Maryn, Youri; Kim, Hyung-Tae; Kim, Jaeock

2016-09-01

The purpose of this study was to explore the criterion-related concurrent validity of two standardized auditory-perceptual rating protocols and the Acoustic Voice Quality Index (AVQI) for measuring dysphonia severity in Korean speech. Sixty native Korean subjects with various voice disorders were asked to sustain the vowel [a:] and to read aloud the Korean text "Walk." A 3-second midvowel portion of the sustained vowel and two sentences (with 25 syllables) were edited, concatenated, and analyzed according to methods described elsewhere. From 56 participants, both continuous speech and sustained vowel recordings had sufficiently high signal-to-noise ratios (35.5 dB and 37 dB on average, respectively) and were therefore subjected to further dysphonia severity analysis with (1) "G" or Grade from the GRBAS protocol, (2) "OS" or Overall Severity from the Consensus Auditory-Perceptual Evaluation of Voice protocol, and (3) AVQI. First, high correlations were found between G and OS (rS = 0.955 for sustained vowels; rS = 0.965 for continuous speech). Second, the AVQI showed a strong correlation with G (rS = 0.911) as well as OS (rP = 0.924). These findings are in agreement with similar studies dealing with continuous speech in other languages. The present study highlights the criterion-related concurrent validity of these methods in Korean speech. Furthermore, it supports the cross-linguistic robustness of the AVQI as a valid and objective marker of overall dysphonia severity. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

[Description of dysphonia cases assisted in a mutua in 2013].

PubMed

Rodríguez Bayarri, M Jesús; Oliveres Verges, Joan; Linares Salas, Carlos; Martínez Llorente, Enrique; Puget Bosch, Dulce

2015-01-01

To describe a case series of patients with dysphonia evaluated in a national Spanish mutua. Computerized medical records of 2013 were reviewed and 129 patients with diagnoses compatible with dysphonia were identified. Eighty-six (67%) of the 129 cases were recognized as occupational diseases, three cases were considered as occupational injuries (two with a diagnosis of Reinke's edema) and the remaining 40 cases were considered to not be work-related. Most of the cases (90%) occurred in women between the ages of 30 and 49 years. Ninety-three percent of the cases diagnosed as occupational diseases underwent speech therapy and, of these, 72% were cured. The majority of the cases (61%) occurred in teachers. Average duration of sickness absence, among those patients who took it, was 113.5 days. All cases reported as occupational disease met the criteria set by the Spanish legislation (RD 1299/2006). Non-occupational diseases were referred to the national health service. Customized speech therapy was effective for most of the patients. The average duration of sick leave in our series was high. Copyright belongs to the Societat Catalana de Salut Laboral.

3D WHOLE-PROMINENCE FINE STRUCTURE MODELING. II. PROMINENCE EVOLUTION

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gunár, Stanislav; Mackay, Duncan H.

2015-10-20

We use the new three-dimensional (3D) whole-prominence fine structure model to study the evolution of prominences and their fine structures in response to changes in the underlying photospheric magnetic flux distribution. The applied model combines a detailed 3D prominence magnetic field configuration with a realistic description of the prominence plasma distributed along multiple fine structures. In addition, we utilize an approximate Hα visualization technique to study the evolution of the visible cool prominence plasma both in emission (prominence) and absorption (filament). We show that the initial magnetic field configuration of the modeled prominence is significantly disturbed by the changing positionmore » of a single polarity of a magnetic bipole as the bipole is advected toward the main body of the filament. This leads to the creation of a barb, which becomes the dominant feature visible in the synthetic Hα images of both the prominence and filament views. The evolution of the bipole also creates conditions that lead to the disappearance and reappearance of large portions of the main body. We also show that an arch-like region containing a dark void (a bubble) can be naturally produced in the synthetic prominence Hα images. While not visible in terms of the magnetic field lines, it is due to a lack of Hα emission from low-pressure, low-density plasma located in shallow magnetic dips lying along the lines of sight intersecting the dark void. In addition, a quasi-vertical small-scale feature consisting of short and deep dips, piled one above the other, is produced.« less

Functional Dysphonia during Mental Imagery: Testing the Trait Theory of Voice Disorders

ERIC Educational Resources Information Center

van Mersbergen, Miriam; Patrick, Christopher; Glaze, Leslie

2008-01-01

Purpose: Previous research has proposed that persons with functional dysphonia (FD) present with temperamental traits that predispose them to their voice disorder. We investigated this theory in a controlled experiment and compared them with social anxiety (SA) and healthy control (HC) groups. Method: Twelve participants with FD, 19 participants…

Validation of the Cepstral Spectral Index of Dysphonia (CSID) as a Screening Tool for Voice Disorders: Development of Clinical Cutoff Scores.

PubMed

Awan, Shaheen N; Roy, Nelson; Zhang, Dong; Cohen, Seth M

2016-03-01

The purposes of this study were to (1) evaluate the performance of the Cepstral Spectral Index of Dysphonia (CSID--a multivariate estimate of dysphonia severity) as a potential screening tool for voice disorder identification and (2) identify potential clinical cutoff scores to classify voice-disordered cases versus controls. Subjects were 332 men and women (116 men, 216 women) comprised of subjects who presented to a physician with a voice-related complaint and a group of non-voice-related control subjects. Voice-disordered cases versus controls were initially defined via three reference standards: (1) auditory-perceptual judgment (dysphonia +/-); (2) Voice Handicap Index (VHI) score (VHI +/-); and (3) laryngoscopic description (laryngoscopic +/-). Speech samples were analyzed using the Analysis of Dysphonia in Speech and Voice program. Cepstral and spectral measures were combined into a CSID multivariate formula which estimated dysphonia severity for Rainbow Passage samples (i.e., the CSIDR). The ability of the CSIDR to accurately classify cases versus controls in relation to each reference standard was evaluated via a combination of logistic regression and receiver operating characteristic (ROC) analyses. The ability of the CSIDR to discriminate between cases and controls was represented by the "area under the ROC curve" (AUC). ROC classification of dysphonia-positive cases versus controls resulted in a strong AUC = 0.85. A CSIDR cutoff of ≈24 achieved the best balance between sensitivity and specificity, whereas a more liberal cutoff score of ≈19 resulted in higher sensitivity while maintaining respectable specificity which may be preferred for screening purposes. Weaker but adequate AUCs = 0.75 and 0.73 were observed for the classification of VHI-positive and laryngoscopic-positive cases versus controls, respectively. Logistic regression analyses indicated that subject age may be a significant covariate in the discrimination of dysphonia-positive and VHI

Pathogenic variants in TUBB4A are not found in primary dystonia

PubMed Central

Vemula, Satya R.; Xiao, Jianfeng; Bastian, Robert W.; Momčilović, Dragana; Blitzer, Andrew

2014-01-01

Objective: To determine the contribution of TUBB4A, recently associated with DYT4 dystonia in a pedigree with “whispering dysphonia” from Norfolk, United Kingdom, to the etiopathogenesis of primary dystonia. Methods: High-resolution melting and Sanger sequencing were used to inspect the entire coding region of TUBB4A in 575 subjects with primary laryngeal, segmental, or generalized dystonia. Results: No pathogenic variants, including the exon 1 variant (c.4C>G) identified in the DYT4 whispering dysphonia kindred, were found in this study. Conclusion: The c.4C>G DYT4 mutation appears to be private, and clinical testing for TUBB4A mutations is not justified in spasmodic dysphonia or other forms of primary dystonia. Moreover, given its allelic association with leukoencephalopathy hypomyelination with atrophy of basal ganglia and cerebellum and protean clinical manifestations (chorea, ataxia, dysarthria, intellectual disability, dysmorphic facial features, and psychiatric disorders), DYT4 should not be categorized as a primary dystonia. PMID:24598712

Application of the acoustic voice quality index for objective measurement of dysphonia severity.

PubMed

Núñez-Batalla, Faustino; Díaz-Fresno, Estefanía; Álvarez-Fernández, Andrea; Muñoz Cordero, Gabriela; Llorente Pendás, José Luis

Over the past several decades, many acoustic parameters have been studied as sensitive to and to measure dysphonia. However, current acoustic measures might not be sensitive measures of perceived voice quality. A meta-analysis which evaluated the relationship between perceived overall voice quality and several acoustic-phonetic correlates, identified measures that do not rely on the extraction of the fundamental period, such the measures derived from the cepstrum, and that can be used in sustained vowel as well as continuous speech samples. A specific and recently developed method to quantify the severity of overall dysphonia is the acoustic voice quality index (AVQI) that is a multivariate construct that combines multiple acoustic markers to yield a single number that correlates reasonably with overall vocal quality. This research is based on one pool of voice recordings collected in two sets of subjects: 60 vocally normal and 58 voice disordered participants. A sustained vowel and a sample of connected speech were recorded and analyzed to obtain the six parameters included in the AVQI using the program Praat. Statistical analysis was completed using SPSS for Windows, version 12.0. Correlation between perception of overall voice quality and AVQI: A significant difference exists (t(95) = 9.5; p<.000) between normal and dysphonic voices. The findings of this study demonstrate the clinical feasibility of the AVQI as a measure of dysphonia severity. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Articulatory changes in muscle tension dysphonia: evidence of vowel space expansion following manual circumlaryngeal therapy.

PubMed

Roy, Nelson; Nissen, Shawn L; Dromey, Christopher; Sapir, Shimon

2009-01-01

In a preliminary study, we documented significant changes in formant transitions associated with successful manual circumlaryngeal treatment (MCT) of muscle tension dysphonia (MTD), suggesting improvement in speech articulation. The present study explores further the effects of MTD on vowel articulation by means of additional vowel acoustic measures. Pre- and post-treatment audio recordings of 111 women with MTD were analyzed acoustically using two measures: vowel space area (VSA) and vowel articulation index (VAI), constructed using the first (F1) and second (F2) formants of 4 point vowels/ a, i, ae, u/, extracted from eight words within a standard reading passage. Pairwise t-tests revealed significant increases in both VSA and VAI, confirming that successful treatment of MTD is associated with vowel space expansion. Although MTD is considered a voice disorder, its treatment with MCT appears to positively affect vocal tract dynamics. While the precise mechanism underlying vowel space expansion remains unknown, improvements may be related to lowering of the larynx, expanding oropharyngeal space, and improving articulatory movements. The reader will be able to: (1) describe possible articulatory changes associated with successful treatment of muscle tension dysphonia; (2) describe two acoustic methods to assess vowel centralization and decentralization, and; (3) understand the basis for viewing muscle tension dysphonia as a disorder not solely confined to the larynx.

Coronal and Prominence Plasmas

NASA Technical Reports Server (NTRS)

Poland, Arthur I. (Editor)

1986-01-01

Various aspects of solar prominences and the solar corona are discussed. The formation of prominences, prominence diagnostics and structure, prominence dissappearance, large scale coronal structure, coronal diagnostics, small scale coronal structure, and non-equilibrium/coronal heating are among the topics covered.

Do Standard Instrumental Acoustic, Perceptual, and Subjective Voice Outcomes Indicate Therapy Success in Patients With Functional Dysphonia?

PubMed

Reetz, Stephanie; Bohlender, Joerg E; Brockmann-Bauser, Meike

2018-01-29

The validity and sensitivity to change of instrumental acoustic measurements in patients with functional dysphonia have been controversially discussed. This work examines combined voice therapy effects on standard acoustic measurements, and if these agree with perceptual and subjective voice outcomes. Retrospective study. Thirty-nine patients (26 women, 13 men) aged 20-70 years (mean: 46.3, standard deviation 12.8) with functional dysphonia were investigated before and after combined voice therapy. Instrumental parameters included mean and range of speaking fundamental frequency (f o ) and intensity (SPL (dBA)); maximum SPL and mean f o of calling voice; minimum, maximum, range of singing voice f o and SPL, jitter (%), and the Dysphonia Severity Index. Voice Handicap Index-9 international was used for subjective and Grading-Roughness-Breathiness-Asthenia-Strain scale for perceptual assessment. Differences were investigated by Wilcoxon signed ranks test and coherences by Spearman rank correlation coefficient. After treatment, the speaking voice f o range (7-8.13 semitones) and SPL range (12.9-14.85 dB(A)) were significantly larger (P < 0.05). Both parameters were highly correlated (P < 0.001). Subjective symptoms were significantly reduced from a mean Voice Handicap Index-9 international of 15.6-8.6, and all perceptual Grading-Roughness-Breathiness-Asthenia-Strain scale parameters were significantly improved (G: 1.05-0.51) after therapy (P < 0.05). These findings were not associated with any acoustic parameter (P > 0.05). Significantly improved subjective and perceptual findings verify positive combined voice therapy effects in patients with functional dysphonia. The larger f o and SPL speaking voice range after treatment indicate an altered voice technique. These instrumental measures may be clinical indicators of therapy success and transfer effects. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Early Motor Unit Disease Masquerading as Psychogenic Breathy Dysphonia: A Clinical Case Presentation

ERIC Educational Resources Information Center

Aronson, Arnold E.

1971-01-01

Presented is a study of a 20-year-old girl with mild, breathy dysphonia, previously diagnosed as psychogenic. In actuality, her voice change was a sign of early myasthenia gravis. It is pointed out that voice changes can be a first and only sign of early neurologic disease. (Author/KW)

Handle-shaped Prominence

NASA Image and Video Library

2001-02-17

NASA Extreme Ultraviolet Imaging Telescope aboard ESA’s SOHO spacecraft took this image of a huge, handle-shaped prominence in 1999. Prominences are huge clouds of relatively cool dense plasma suspended in the Sun hot, thin corona.

Hedgerow Prominence

NASA Image and Video Library

2017-05-30

A solar prominence at the sun's edge put on quite a display of plasma being pushed and pulled by unstable magnetic fields (May 22-24, 2017). We call them hedgerow prominences because they look somewhat like a hedge of bushes. This is one of the better examples of this type of solar phenomenon than any we have seen in quite some time. Movies are available at https://photojournal.jpl.nasa.gov/catalog/PIA21650

Small Twisting Prominence

NASA Image and Video Library

2018-01-12

A small prominence rose up above the sun, appeared to twist around for several hours, and then began to send some streams of plasma back into the sun (Jan. 3-4, 2018). The action, observed in a wavelength of extreme ultraviolet light, lasted just about one day. Prominences like this one are quite common. In fact, there were several over the past few days. For a sense of scale, the prominence reached up more than several times the size of Earth. Movies are available at https://photojournal.jpl.nasa.gov/catalog/PIA22198

Articulatory Changes in Muscle Tension Dysphonia: Evidence of Vowel Space Expansion Following Manual Circumlaryngeal Therapy

ERIC Educational Resources Information Center

Roy, Nelson; Nissen, Shawn L.; Dromey, Christopher; Sapir, Shimon

2009-01-01

In a preliminary study, we documented significant changes in formant transitions associated with successful manual circumlaryngeal treatment (MCT) of muscle tension dysphonia (MTD), suggesting improvement in speech articulation. The present study explores further the effects of MTD on vowel articulation by means of additional vowel acoustic…

[Clinical study of post-stroke upper limb spasmodic hemiplegia treated with jingou diaoyu needling technique and Bobath therapy].

PubMed

Sun, Runjie; Tian, Liang; Fang, Xiaoli; Du, Xiaozheng; Zhu, Bowen; Song, Zhongyang; Xu, Xuan; Qin, Xiaoguang

2017-04-12

To compare the difference in the clinical efficacy on post-stroke upper limb spasmodic hemiplegia between the combined therapy of jingou diaoyu needling technique and Bobath technology and simple Bobath technology. Sixty patients were randomized into an observation group and a control group, 30 cases in each one. The usual medication of neurological internal medicine was used in the two groups. In the control group, Bobath facilitation technology was applied to the rehabilitation training. In the observation group, on the basis of the treatment as the control group, jingou diaoyu needling technique was used to stimulate Zhongfu (LU 1), Tianfu (LU 3), Chize (LU 5), Quchi (LI 11), Jianshi (PC 5) and Daling (PC 7). The treatment was given once a day; 5 treatments made one session and totally 4-week treatment was required in the two groups. The modified Ashworth scale, the modified Fugle-Meyer assessment (FMA) and the Barthel index (BI) were adopted to evaluate the muscular tension, the upper limb motor function and the activities of daily living (ADL) before and after treatment in the two groups. The clinical efficacy was compared between the two groups. Compared with those before treatment, the modified Ashworth scale, Fugl-Meyer score and BI score were all improved after treatment in the two groups (all P <0.01). The results in the observation group were better than those in the control group (all P <0.01). The total clinical effective rate was 93.3% (28/30) in the observation group and was 80.0% (24/30) in the control group. The efficacy in the observation group was better than that in the control group ( P <0.05). The jingou diaoyu needling technique combined with Bobath therapy achieve the superior efficacy on post-stroke upper limb spasmodic hemiplegia as compared with the simple application Bobath therapy. This combined treatment effectively relieve spasmodic state and improve the upper limb motor function and the activities of daily living.

Curling Prominence

NASA Image and Video Library

2017-12-18

A small prominence observed in profile arched up and sent streams of plasma curling back into the sun over a 30-hour period (Dec. 13-14, 2017). We are observing charged particles streaming along magnetic field lines made visible in extreme ultraviolet light. Prominences are cooler strands of plasma tethered above the sun's surface by magnetic forces. They are quite unstable and frequently fall apart within hours or days. Movies are available at https://photojournal.jpl.nasa.gov/catalog/PIA22196

Effect of Laryngopharyngeal Neuromuscular Electrical Stimulation on Dysphonia Accompanied by Dysphagia in Post-stroke and Traumatic Brain Injury Patients: A Pilot Study

PubMed Central

2016-01-01

Objective To investigate the effect of laryngopharyngeal neuromuscular electrical stimulation (NMES) on dysphonia in patients with dysphagia caused by stroke or traumatic brain injury (TBI). Methods Eighteen patients participated in this study. The subjects were divided into NMES (n=12) and conventional swallowing training only (CST, n=6) groups. The NMES group received NMES combined with CST for 2 weeks, followed by CST without NMES for the next 2 weeks. The CST group received only CST for 4 weeks. All of the patients were evaluated before and at 2 and 4 weeks into the study. The outcome measurements included perceptual, acoustic and aerodynamic analyses. The correlation between dysphonia and swallowing function was also investigated. Results There were significant differences in the GRBAS (grade, roughness, breathiness, asthenia and strain scale) total score and sound pressure level (SPL) between the two groups over time. The NMES relative to the CST group showed significant improvements in total GRBAS score and SPL at 2 weeks, though no inter-group differences were evident at 4 weeks. The improvement of the total GRBAS scores at 2 weeks was positively correlated with the improved pharyngeal phase scores on the functional dysphagia scale at 2 weeks. Conclusion The results demonstrate that laryngopharyngeal NMES in post-stroke or TBI patients with dysphonia can have promising effects on phonation. Therefore, laryngopharyngeal NMES may be considered as an additional treatment option for dysphonia accompanied by dysphagia after stroke or TBI. PMID:27606266

Effect of Laryngopharyngeal Neuromuscular Electrical Stimulation on Dysphonia Accompanied by Dysphagia in Post-stroke and Traumatic Brain Injury Patients: A Pilot Study.

PubMed

Ko, Kyung Rok; Park, Hee Jung; Hyun, Jung Keun; Seo, In-Hyo; Kim, Tae Uk

2016-08-01

To investigate the effect of laryngopharyngeal neuromuscular electrical stimulation (NMES) on dysphonia in patients with dysphagia caused by stroke or traumatic brain injury (TBI). Eighteen patients participated in this study. The subjects were divided into NMES (n=12) and conventional swallowing training only (CST, n=6) groups. The NMES group received NMES combined with CST for 2 weeks, followed by CST without NMES for the next 2 weeks. The CST group received only CST for 4 weeks. All of the patients were evaluated before and at 2 and 4 weeks into the study. The outcome measurements included perceptual, acoustic and aerodynamic analyses. The correlation between dysphonia and swallowing function was also investigated. There were significant differences in the GRBAS (grade, roughness, breathiness, asthenia and strain scale) total score and sound pressure level (SPL) between the two groups over time. The NMES relative to the CST group showed significant improvements in total GRBAS score and SPL at 2 weeks, though no inter-group differences were evident at 4 weeks. The improvement of the total GRBAS scores at 2 weeks was positively correlated with the improved pharyngeal phase scores on the functional dysphagia scale at 2 weeks. The results demonstrate that laryngopharyngeal NMES in post-stroke or TBI patients with dysphonia can have promising effects on phonation. Therefore, laryngopharyngeal NMES may be considered as an additional treatment option for dysphonia accompanied by dysphagia after stroke or TBI.

Intensified Voice Therapy: A New Model for the Rehabilitation of Patients Suffering from Functional Dysphonias

ERIC Educational Resources Information Center

Fischer, Michael J.; Gutenbrunner, Christoph; Ptok, Martin

2009-01-01

The objective of this study was to evaluate a new intervention for chronic dysphonias, consisting of a 2-week outpatient treatment period using intensified voice therapy combined with elements of physical medicine, including physiotherapy (orthotherapy, detonisation and training of the trunk muscles, respiratory therapy and others), manual therapy…

Churning Prominence

NASA Image and Video Library

2017-01-30

On Jan. 23-24, 2017, NASA Solar Dynamics Observatory watched as a solar prominence rose up along the edge of the sun and twisted and churned for about two days before falling apart. The dynamic action was generated by competing magnetic forces. The images were taken in a wavelength extreme ultraviolet light that observes activity close to the solar surface, perfect for capturing prominences, which are notoriously unstable clouds of plasma suspended above the sun. Movies are available at http://photojournal.jpl.nasa.gov/catalog/PIA11237

Reversing Prominence

NASA Image and Video Library

2018-01-18

A prominence rose up above the sun, sent an arch of plasma to link up magnetically with an active region over a one-day period (Jan, 9-10, 2017). Then the flow of plasma seemed to largely change direction and head back where it came from. Finally, amidst the confused patterns of movement, it dissipated and fell away. Prominences are cooler clouds of charged particles tenuously tethered to the sun by magnetic forces. Images were taken in a wavelength of extreme ultraviolet light. Movies are available at https://photojournal.jpl.nasa.gov/catalog/PIA22199

Bendable Prominence

NASA Image and Video Library

2016-10-04

A prominence observed along the right edge of the sun rose up and then most of it bent back down to the surface (Oct. 4, 2016). Prominences are clouds of plasma, usually elongated, that are suspended above the sun by magnetic forces. They are notably unstable. A review of SOHO's coronagraph videos shows that some of the particles did break away into space. The video clip, which covers eight hours of activity, was taken in a wavelength of extreme UV light. Movies are available at http://photojournal.jpl.nasa.gov/catalog/PIA21106

Effects of Voice Therapy on Laryngeal Motor Units During Phonation in Chronic Superior Laryngeal Nerve Paresis Dysphonia.

PubMed

Kaneko, Mami; Hitomi, Takefumi; Takekawa, Takashi; Tsuji, Takuya; Kishimoto, Yo; Hirano, Shigeru

2017-09-26

Injury to the superior laryngeal nerve can result in dysphonia, and in particular, loss of vocal range. It can be an especially difficult problem to address with either voice therapy or surgical intervention. Some clinicians and scientists suggest that combining vocal exercises with adjunctive neuromuscular electrical stimulation may enhance the positive effects of voice therapy for superior laryngeal nerve paresis (SLNP). However, the effects of voice therapy without neuromuscular electrical stimulation are unknown. The purpose of this retrospective study was to demonstrate the clinical effectiveness of voice therapy for rehabilitating chronic SLNP dysphonia in two subjects, using interspike interval (ISI) variability of laryngeal motor units by laryngeal electromyography (LEMG). Both patients underwent LEMG and were diagnosed with having 70% recruitment of the cricothyroid muscle, and 70% recruitment of the cricothyroid and thyroarytenoid muscles, respectively. Both patients received voice therapy for 3 months. Grade, roughness, breathiness, asthenia, and strain (GRBAS) scale, stroboscopic examination, aerodynamic assessment, acoustic analysis, and Voice Handicap Index-10 were performed before and after voice therapy. Mean ISI variability during steady phonation was also assessed. After voice therapy, both patients showed improvement in vocal assessments by acoustic, aerodynamic, GRBAS, and Voice Handicap Index-10 analysis. LEMG indicated shortened ISIs in both cases. This study suggests that voice therapy for chronic SLNP dysphonia can be useful for improving SLNP and voice quality. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Apparent Solar Tornado-Like Prominences

NASA Astrophysics Data System (ADS)

Panasenco, Olga; Martin, Sara F.; Velli, Marco

2014-02-01

Recent high-resolution observations from the Solar Dynamics Observatory (SDO) have reawakened interest in the old and fascinating phenomenon of solar tornado-like prominences. This class of prominences was first introduced by Pettit ( Astrophys. J. 76, 9, 1932), who studied them over many years. Observations of tornado prominences similar to the ones seen by SDO had already been documented by Secchi ( Le Soleil, 1877). High-resolution and high-cadence multiwavelength data obtained by SDO reveal that the tornado-like appearance of these prominences is mainly an illusion due to projection effects. We discuss two different cases where prominences on the limb might appear to have a tornado-like behavior. One case of apparent vortical motions in prominence spines and barbs arises from the (mostly) 2D counterstreaming plasma motion along the prominence spine and barbs together with oscillations along individual threads. The other case of apparent rotational motion is observed in a prominence cavity and results from the 3D plasma motion along the writhed magnetic fields inside and along the prominence cavity as seen projected on the limb. Thus, the "tornado" impression results either from counterstreaming and oscillations or from the projection on the plane of the sky of plasma motion along magnetic-field lines, rather than from a true vortical motion around an (apparent) vertical or horizontal axis. We discuss the link between tornado-like prominences, filament barbs, and photospheric vortices at their base.

Re-interpreting Prominences Classified as Tornadoes

NASA Astrophysics Data System (ADS)

Martin, Sara F.; Venkataramanasastry, Aparna

2015-04-01

Some papers in the recent literature identify tornado prominences with barbs of quiescent prominences while papers in the much older historic literature include a second category of tornado prominence that does not correspond to a barb of a quiescent prominence. The latter are described as prominence mass rotating around a nearly vertical axis prior to its eruption and the rotation was verified by spectral measurements. From H alpha Doppler-shifted mass motions recorded at Helio Research or the Dutch Open Telescope, we illustrate how the apparent tornado-like motions, identified with barbs, are illusions in our mind’s eye resulting from poorly resolved counterstreaming threads of mass in the barbs of quiescent prominences. In contrast, we confirm the second category of rotational motion in prominences shortly before and during eruption. In addition, we identify this second category as part of the late phase of a phenomenon called the roll effect in erupting prominences. In these cases, the eruption begins with the sideways rolling of the top of a prominence. As the eruption proceeds the rolling motion propagates down one leg or both legs of the prominence depending on whether the eruption is asymmetric or symmetric respectively. As an asymmetric eruption continues, the longer lasting leg becomes nearly vertical and its rotational motion also continues. If only this phase of the eruption was observed, as in some historic cases, it was called a tornado prominence. However, when we now observe entire eruptions in time-lapse sequences, the similarity to terrestrial tornadoes is lost. We conclude that neither prominence barbs, that give the illusion of rotation, nor the cases of true rotational motion, in the legs of erupting prominences, are usefully described as tornado prominences when the complete prominence structure or complete erupting event is observed.

Transcutaneous Electrical Nerve Stimulation (TENS) and Laryngeal Manual Therapy (LMT): Immediate Effects in Women With Dysphonia.

PubMed

Conde, Mariana de Cásisa Macedo; Siqueira, Larissa Thaís Donalonso; Vendramini, José Eduardo; Brasolotto, Alcione Ghedini; Guirro, Rinaldo Roberto de Jesus; Silverio, Kelly Cristina Alves

2018-05-01

This study aimed to verify the immediate effect of low-frequency transcutaneous electrical nerve stimulation (TENS) and laryngeal manual therapy (LMT) in musculoskeletal pain, voice quality, and self-reported signs in women with dysphonia. Thirty women with behavioral dysphonia were randomly divided into the TENS group and the LMT group. All participants fulfilled the pain survey and had their voices recorded to posterior perceptual and acoustic analysis before and after intervention. The TENS group received a unique low-frequency TENS session (20 minutes). The LMT group received LMT (20 minutes) with soft and superficial massage in the sternocleidomastoid muscle, suprahyoid muscles, and larynx. Afterward, the volunteers reported their voice, larynx, breathing, and articulatory signs. Pre and post data were compared by parametric and nonparametric tests. After TENS, a decrease in pain intensity in the posterior or anterior region of the neck, shoulders, upper or lower back, and masseter was observed. After LMT, a decrease in pain intensity in the neck anterior region, shoulders, lower back, and temporal region was observed. Also, after TENS, there was an improvement in vowel /a/ instability; after LMT, there was a general improvement in voice quality, decrease in tension, and decrease in breathiness in speech. Positive voice and laryngeal signs were reported after TENS, and positive laryngeal signs and articulation were reported after LMT. TENS and LMT may be used in voice treatment of women with behavioral dysphonia, and both may be considered important therapy resources that reduce musculoskeletal pain and cause positive laryngeal signs. Both TENS and LMT are able to partially improve voice quality, but TENS presented better results. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Streaming Prominence

NASA Image and Video Library

2017-07-05

A prominence at the edge of the sun provided us with a splendid view of solar plasma as it churned and streamed over less than one day (June 25-26, 2017). The charged particles of plasma were being manipulated by strong magnetic forces. When viewed in this wavelength of extreme ultraviolet light, we can trace the movements of the particles. Such occurrences are fairly common but much easier to see when they are near the sun's edge. For a sense of scale, the arch of prominence in the still image has risen up several times the size of Earth. Movies are available at https://photojournal.jpl.nasa.gov/catalog/PIA21768

A psychosocial intervention for the management of functional dysphonia: complex intervention development and pilot randomised trial.

PubMed

Deary, Vincent; McColl, Elaine; Carding, Paul; Miller, Tracy; Wilson, Janet

2018-01-01

Medically unexplained loss or alteration of voice-functional dysphonia-is the commonest presentation to speech and language therapists (SLTs). Besides the impact on personal and work life, functional dysphonia is also associated with increased levels of anxiety and depression and poor general health. Voice therapy delivered by SLTs improves voice but not these associated symptoms. The aims of this research were the systematic development of a complex intervention to improve the treatment of functional dysphonia, and the trialling of this intervention for feasibility and acceptability to SLTs and patients in a randomised pilot study. A theoretical model of medically unexplained symptoms (MUS) was elaborated through literature review and synthesis. This was initially applied as an assessment format in a series of patient interviews. Data from this stage and a small consecutive cohort study were used to design and refine a brief cognitive behavioural therapy (CBT) training intervention for a SLT. This was then implemented in an external pilot patient randomised trial where one SLT delivered standard voice therapy or voice therapy plus CBT to 74 patients. The primary outcomes were of the acceptability of the intervention to patients and the SLT, and the feasibility of changing the SLT's clinical practice through a brief training. This was measured through monitoring treatment flow and through structured analysis of the content of intervention for treatment fidelity and inter-treatment contamination. As measured by treatment flow, the intervention was as acceptable as standard voice therapy to patients. Analysis of treatment content showed that the SLT was able to conduct a complex CBT formulation and deliver novel treatment strategies for fatigue, sleep, anxiety and depression in the majority of patients. On pre-post measures of voice and quality of life, patients in both treatment arms improved. These interventions were acceptable to patients. Emotional

Solar Prominence Fine Structure and Dynamics

NASA Astrophysics Data System (ADS)

Berger, Thomas

2014-01-01

We review recent observational and theoretical results on the fine structure and dynamics of solar prominences, beginning with an overview of prominence classifications, the proposal of possible new ``funnel prominence'' classification, and a discussion of the recent ``solar tornado'' findings. We then focus on quiescent prominences to review formation, down-flow dynamics, and the ``prominence bubble'' phenomena. We show new observations of the prominence bubble Rayleigh-Taylor instability triggered by a Kelvin-Helmholtz shear flow instability occurring along the bubble boundary. Finally we review recent studies on plasma composition of bubbles, emphasizing that differential emission measure (DEM) analysis offers a more quantitative analysis than photometric comparisons. In conclusion, we discuss the relation of prominences to coronal magnetic flux ropes, proposing that prominences can be understood as partially ionized condensations of plasma forming the return flow of a general magneto-thermal convection in the corona.

An analytical model of prominence dynamics

NASA Astrophysics Data System (ADS)

Routh, Swati; Saha, Snehanshu; Bhat, Atul; Sundar, M. N.

2018-01-01

Solar prominences are magnetic structures incarcerating cool and dense gas in an otherwise hot solar corona. Prominences can be categorized as quiescent and active. Their origin and the presence of cool gas (∼104 K) within the hot (∼106K) solar corona remains poorly understood. The structure and dynamics of solar prominences was investigated in a large number of observational and theoretical (both analytical and numerical) studies. In this paper, an analytic model of quiescent solar prominence is developed and used to demonstrate that the prominence velocity increases exponentially, which means that some gas falls downward towards the solar surface, and that Alfvén waves are naturally present in the solar prominences. These theoretical predictions are consistent with the current observational data of solar quiescent prominences.

Prominence Mass Supply and the Cavity

NASA Technical Reports Server (NTRS)

Schmit, Donald J.; Gibson, S.; Luna, M.; Karpen, J.; Innes, D.

2013-01-01

A prevalent but untested paradigm is often used to describe the prominence-cavity system; the cavity is under-dense because it it evacuated by supplying mass to the condensed prominence. The thermal non-equilibrium (TNE) model of prominence formation offers a theoretical framework to predict the thermodynamic evolutin of the prominence and the surrounding corona. We examine the evidence for a prominence-cavity connection by comparing the TNE model and diagnostics of dynamic extreme ultraviolet (EUV) emission surrounding the prominence, specifically prominence horns. Horns are correlated extensions of prminence plasma and coronal plasma which appear to connect the prominence and cavity. The TNE model predicts that large-scale brightenings will occur in the Solar Dynamics Observatory Atmospheric Imaging Assembly 171 A badpass near he prominence that are associated with the cooling phase of condensation formation. In our simulations, variations in the magnitude of footpoint heating lead to variations in the duration, spatial scale, and temporal offset between emission enhancements in the other EUV bandpasses. While these predictions match well a subset of the horn observations, the range of variations in the observed structures is not captured by the model. We discuss the implications of one-dimensional loop simulations for the three-dimensional time-averaged equilibrium in the prominence and the cavity. Evidence suggests that horns are likely caused by condensing prominence plasma, but the larger question of whether this process produces a density-depleted cavity requires a more tightly constrained model of heating and better knowledge of the associated magnetic structure.

Dynamic Mapping of Prominence Activity

NASA Astrophysics Data System (ADS)

Thompson, Barbara J.; Gilbert, Holly R.; Kirk, Michael S.; Mays, M. Leila.; Ofman, Leon; Uritsky, Vadim; Wyper, Peter; Hovis-Afflerbach, Beryl

2016-10-01

We present the results of a prominence mapping effort designed to extract the dynamics of erupting prominences. The material from partially erupting prominences can fall back to the sun, tracing out the topology of the mid- and post-eruptive corona. One question involving the range of observed behavior is the role of magnetic field topology and evolution in determining the motion of the erupting prominence material. A variable-g ballistic approximation is applied to study the motion of the material, using the deviations from constant angular momentum as a means of quantifying the local Lorentz (and other) forces on each piece of material. Variations in dynamic behavior can be traced back to changes in the local magnetic field and the formation of instabilities such as Rayleigh-Taylor. We discuss the use of the prominence trajectories as a means of diagnosing eruptive topologies.

Greenhouse effect in quiescent prominences

NASA Astrophysics Data System (ADS)

Ryutova, M.; Berger, T. E.; Title, A. M.

2010-12-01

Quiescent prominences, by definition, are huge ``clouds'' of cool, dense plasma overlying rarefied hot corona and supported by a complex magnetic field anchored in the photosphere along the magnetic polarity inversion line. One of the most prominent features in their dynamics is formation, growth and collapse of bubble/cavities filled by coronal plasma and emerging, often repeatedly, under a prominence body. As such, prominence/corona interface itself is subject of fundamental plasma instabilities, which include development of a regular series of plumes and spikes typical to the Rayleigh-Taylor instability, the Kelvin-Helmholtz instability, often followed by a sudden collimated mass upflow, which, in nonlinear stage having an explosive character may be responsible for CMEs. These were only recently studied in detail with high cadence, high resolution data obtained from the Hinode satellite. Even more surprises are brought by the SDO/AIA instrument showing the Sun's atmosphere in 12 visible and EUV wavelengths. AIA multi-wavelength images in a temperature range from 105 ~K to 2 × 106 ~K combined with the Hinode/SOT data show that plasma inside the prominence cavity, being as expected, at coronal temperatures, in fact exceeds the temperature of the ambient corona. We suggest that an energetically open highly dynamic processes releasing energy at the prominence/cavity interface accompanied by the ``radiative exchange'', may cause additional increase of temperature and/or density inside cavity. Given pervasive character of prominences, future studies will allow us to perform quantitative and statistical analysis, and reveal relations between the size of cavity, its temperature, and magnetic properties.

QUIESCENT PROMINENCES IN THE ERA OF ALMA: SIMULATED OBSERVATIONS USING THE 3D WHOLE-PROMINENCE FINE STRUCTURE MODEL

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gunár, Stanislav; Heinzel, Petr; Mackay, Duncan H.

2016-12-20

We use the detailed 3D whole-prominence fine structure model to produce the first simulated high-resolution ALMA observations of a modeled quiescent solar prominence. The maps of synthetic brightness temperature and optical thickness shown in the present paper are produced using a visualization method for synthesis of the submillimeter/millimeter radio continua. We have obtained the simulated observations of both the prominence at the limb and the filament on the disk at wavelengths covering a broad range that encompasses the full potential of ALMA. We demonstrate here extent to which the small-scale and large-scale prominence and filament structures will be visible inmore » the ALMA observations spanning both the optically thin and thick regimes. We analyze the relationship between the brightness and kinetic temperature of the prominence plasma. We also illustrate the opportunities ALMA will provide for studying the thermal structure of the prominence plasma from the cores of the cool prominence fine structure to the prominence–corona transition region. In addition, we show that detailed 3D modeling of entire prominences with their numerous fine structures will be important for the correct interpretation of future ALMA observations of prominences.« less

New perspectives on solar prominences

NASA Astrophysics Data System (ADS)

Schmieder, B.; Aulanier, G.

2012-06-01

Recent observations of prominences obtained with high spatial and temporal resolution instruments, on board satellites (Hinode, SDO) as well as on the ground (SST) have provided very intriguing movies and open a new area for understanding the nature of prominences. The main topics are still debate: formation, dynamics, and characteristics of the plasma in the core and in the transition zone between the prominence and corona. We will review briefly the recent advances made in these topics, observationally as well as theoretically.

Mass and energy flow in prominences

NASA Technical Reports Server (NTRS)

Poland, Arthur I.

1990-01-01

Mass and energy flow in quiescent prominences is considered based on the hypothesis that active region prominences have a different structure and thus different mass and energy flow characteristics. Several important physical parameters have been plotted using the computational model, representing the evolutionary process after the prominence formation. The temperature, velocity, conductive flux, and enthalpy flux are plotted against distance from the highest point in the loop to the coolest part of the prominence. It is shown that the maximum velocity is only about 5 km/s. The model calculations indicate that the transition region of prominences is dominated by complex processes. It is necessary to take into account mass flow at temperatures below 200,000 K, and both mass flow and optical depth effects in hydrogen at temperatures below 30,000 K. Both of these effects lead to a less steep temperature gradient through the prominence corona interface than can be obtained from the conduction alone.

Prominence Falls Apart

NASA Image and Video Library

2017-12-15

A small prominence slowly rose further up above the sun, then fell apart and back into the sun over about seven hours (Dec. 6, 2017). Prominences, notoriously unstable, are cooler clouds of particles tethered not far above the sun by magnetic forces. When it stretched out, its distance above the sun was several times the size of Earth. Images were taken in a wavelength of extreme ultraviolet light. These images are colorized since we cannot "see" ultraviolet light. In this case, a yellow tone was used instead of the normal red tint we use for this 304 Angstrom wavelength. Movies are available at https://photojournal.jpl.nasa.gov/catalog/PIA22195

Topological Analyses of Symmetric Eruptive Prominences

NASA Astrophysics Data System (ADS)

Panasenco, O.; Martin, S. F.

Erupting prominences (filaments) that we have analyzed from Hα Doppler data at Helio Research and from SOHO/EIT 304 Å, show strong coherency between their chirality, the direction of the vertical and lateral motions of the top of the prominences, and the directions of twisting of their legs. These coherent properties in erupting prominences occur in two patterns of opposite helicity; they constitute a form of dynamic chirality called the ``roll effect." Viewed from the positive network side as they erupt, many symmetrically-erupting dextral prominences develop rolling motion toward the observer along with right-hand helicity in the left leg and left-hand helicity in the right leg. Many symmetricaly-erupting sinistral prominences, also viewed from the positive network field side, have the opposite pattern: rolling motion at the top away from the observer, left-hand helical twist in the left leg, and right-hand twist in the right leg. We have analysed the motions seen in the famous movie of the ``Grand Daddy" erupting prominence and found that it has all the motions that define the roll effect. From our analyses of this and other symmetric erupting prominences, we show that the roll effect is an alternative to the popular hypothetical configuration of an eruptive prominence as a twisted flux rope or flux tube. Instead we find that a simple flat ribbon can be bent such that it reproduces nearly all of the observed forms. The flat ribbon is the most logical beginning topology because observed prominence spines already have this topology prior to eruption and an initial long magnetic ribbon with parallel, non-twisted threads, as a basic form, can be bent into many more and different geometrical forms than a flux rope.

Back-and-Forth Methodology for Objective Voice Quality Assessment: From/to Expert Knowledge to/from Automatic Classification of Dysphonia

NASA Astrophysics Data System (ADS)

Fredouille, Corinne; Pouchoulin, Gilles; Ghio, Alain; Revis, Joana; Bonastre, Jean-François; Giovanni, Antoine

2009-12-01

This paper addresses voice disorder assessment. It proposes an original back-and-forth methodology involving an automatic classification system as well as knowledge of the human experts (machine learning experts, phoneticians, and pathologists). The goal of this methodology is to bring a better understanding of acoustic phenomena related to dysphonia. The automatic system was validated on a dysphonic corpus (80 female voices), rated according to the GRBAS perceptual scale by an expert jury. Firstly, focused on the frequency domain, the classification system showed the interest of 0-3000 Hz frequency band for the classification task based on the GRBAS scale. Later, an automatic phonemic analysis underlined the significance of consonants and more surprisingly of unvoiced consonants for the same classification task. Submitted to the human experts, these observations led to a manual analysis of unvoiced plosives, which highlighted a lengthening of VOT according to the dysphonia severity validated by a preliminary statistical analysis.

MAGNETIC TOPOLOGY OF BUBBLES IN QUIESCENT PROMINENCES

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dudik, J.; Aulanier, G.; Schmieder, B.

We study a polar-crown prominence with a bubble and its plume observed in several coronal filters by the SDO/AIA and in H{alpha} by the MSDP spectrograph in Bialkow (Poland) to address the following questions: what is the brightness of prominence bubbles in EUV with respect to the corona outside of the prominence and the prominence coronal cavity? What is the geometry and topology of the magnetic field in the bubble? What is the nature of the vertical threads seen within prominences? We find that the brightness of the bubble and plume is lower than the brightness of the corona outsidemore » of the prominence, and is similar to that of the coronal cavity. We constructed linear force-free models of prominences with bubbles, where the flux rope is perturbed by inclusion of parasitic bipoles. The arcade field lines of the bipole create the bubble, which is thus devoid of magnetic dips. Shearing the bipole or adding a second one can lead to cusp-shaped prominences with bubbles similar to the observed ones. The bubbles have complex magnetic topology, with a pair of coronal magnetic null points linked by a separator outlining the boundary between the bubble and the prominence body. We conjecture that plume formation involves magnetic reconnection at the separator. Depending on the viewing angle, the prominence can appear either anvil-shaped with predominantly horizontal structures, or cusp-shaped with predominantly vertical structuring. The latter is an artifact of the alignment of magnetic dips with respect to the prominence axis and the line of sight.« less

[Spasmodic hemiplegia after stroke treated with scalp acupuncture, music therapy and rehabilitation: a randomized controlled trial].

PubMed

Jia, Chengjie; Zhang, Hongru; Ni, Guangxia; Zhang, Yinan; Su, Bin; Xu, Xinlei

2017-12-12

To evaluate the differences in the clinical therapeutic effects on spasmodic hemiplegia after stroke among the alliance therapy of scalp acupuncture, music therapy combined with rehabilitation, the simple rehabilitation therapy and the combination of music therapy and rehabilitation. A total of 76 patients of post-stroke spasmodic hemiplegia were randomized into a rehabilitation group (25 cases), a combination group with music therapy and rehabilitation (25 cases) and an alliance therapy group with scalp acupuncture, music therapy and rehabilitation (26 cases). In the rehabilitation group, the routine rehabilitation therapy was applied, including the removal of various incentives that cause spasm, the correction of body position and the physical therapy. In the combination group, the music therapy was added on the basis of the treatment as the rehabilitation group. The music physician used the rhythmic auditory stimulation, the patterned sensory enhancement and the therapeutic instrumental music playing to set up the task in the treatment. In the alliance therapy group, scalp acupuncture was added on the basis of the treatment as the combination group. The anterior oblique line of vertex-tempora (MS 6) and the posterior oblique line of vertex-tempora (MS 7) on the contralateral side were selected and stimulated with penetrating needling technique. The needles were retained. During the needling retaining, the needles were rotated once every 10 min, for 2 min each time. The treatment was given one session a day, totally for 5 sessions a week, continuously for 4 weeks. The Fugl-Meyer assessment (FMA), Barthel index (BI) and the modified Ashworth scale (MAS) of the affected elbow and the passive knee movement at static condition were observed in the patients before and after treatment. The results of FMA, BI and MAS were not different before treatment in the patients among the three groups (all P >0.05), indicating the comparability among groups. After treatment, FMA

Ion-Neutral Coupling in Solar Prominence

NASA Technical Reports Server (NTRS)

Gilbert, H.; DeVore, C. R.; Karpen, J.; Kucera, T.; Antiochos, S.; Kawashima, R.

2011-01-01

Coupling between ions and neutrals in magnetized plasmas is fundamentally important to many aspects of heliophysics, including our ionosphere, the solar chromosphere, the solar wind interaction with planetary atmospheres, and the interface between the heliosphere and the interstellar medium. Ion-neutral coupling also plays a major role in the physics of solar prominences. By combining theory, modeling, and observations we are working toward a better understanding of the structure and dynamics of partially ionized prominence plasma. Two key questions are addressed in the present work: 1) what physical mechanism(s) sets the cross-field scale of prominence threads? 2) Are ion-neutral interactions responsible for the vertical flows and structure in prominences? We present initial results from a study investigating what role ion-neutral interactions play in prominence dynamics and structure. This research was supported by NASA.

Ion-Neutral Coupling in Solar Prominences

NASA Technical Reports Server (NTRS)

Gilbert, Holly

2011-01-01

Interactions between ions and neutrals in a partially ionized plasma are important throughout heliophysics, including near the solar surface in prominences. Understanding how ion-neutral coupling affects formation, support, structure, and dynamics of prominences will advance our physical understanding of magnetized systems involving a transition from a weakly ionized dense gas to a fully ionized tenuous plasma. We address the fundamental physics of prominence support, which is normally described in terms of a magnetic force on the prominence plasma that balances the solar gravitational force, and the implications for observations. Because the prominence plasma is only partially ionized, it is necessary to consider the support of the both the ionized and neutral components. Support of the neutrals is accomplished through a frictional interaction between the neutral and ionized components of the plasma, and its efficacy depends strongly on the degree of ionization of the plasma. More specifically, the frictional force is proportional to the relative flow of neutral and ion species, and for a sufficiently weakly ionized plasma, this flow must be relatively large to produce a frictional force that balances gravity. A large relative flow, of course, implies significant draining of neutral particles from the prominence. We evaluate the importance of this draining effect for a hydrogen-helium plasma, and consider the observational evidence for cross-field diffusion of neutral prominence material.

Some crucial corona and prominence observations

NASA Technical Reports Server (NTRS)

Tandberg-Hanssen, E. A.

1986-01-01

A number of theories and hypotheses are currently being developed to explain the often complex behavior of corona and prominence plasmas. In order to test the theories and hypotheses certain crucial observations are necessary. Some of these observations are examined and a few conclusions are drawn. Corona mass balance, corona and prominence classifications, prominence formation and stability, and coronal mass ejection are dicussed.

Saddled Prominent

Treesearch

Peter A. Rush; Douglas C. Allen

1987-01-01

The saddled prominent, Heterocampa guttivitta (Walker), defoliates hardwoods in the Northeastern United States and Southeastern Canada. Outbreaks of this native insect have occurred in the United States and Canada at intervals of approximately 10 years since they were first recorded in the early 1900's. Populations, characterized by their instability, build...

Objective Dysphonia Quantification in Vocal Fold Paralysis: Comparing Nonlinear with Classical Measures

PubMed Central

Little, Max A.; Costello, Declan A. E.; Harries, Meredydd L.

2010-01-01

Summary Clinical acoustic voice-recording analysis is usually performed using classical perturbation measures, including jitter, shimmer, and noise-to-harmonic ratios (NHRs). However, restrictive mathematical limitations of these measures prevent analysis for severely dysphonic voices. Previous studies of alternative nonlinear random measures addressed wide varieties of vocal pathologies. Here, we analyze a single vocal pathology cohort, testing the performance of these alternative measures alongside classical measures. We present voice analysis pre- and postoperatively in 17 patients with unilateral vocal fold paralysis (UVFP). The patients underwent standard medialization thyroplasty surgery, and the voices were analyzed using jitter, shimmer, NHR, nonlinear recurrence period density entropy (RPDE), detrended fluctuation analysis (DFA), and correlation dimension. In addition, we similarly analyzed 11 healthy controls. Systematizing the preanalysis editing of the recordings, we found that the novel measures were more stable and, hence, reliable than the classical measures on healthy controls. RPDE and jitter are sensitive to improvements pre- to postoperation. Shimmer, NHR, and DFA showed no significant change (P > 0.05). All measures detect statistically significant and clinically important differences between controls and patients, both treated and untreated (P < 0.001, area under curve [AUC] > 0.7). Pre- to postoperation grade, roughness, breathiness, asthenia, and strain (GRBAS) ratings show statistically significant and clinically important improvement in overall dysphonia grade (G) (AUC = 0.946, P < 0.001). Recalculating AUCs from other study data, we compare these results in terms of clinical importance. We conclude that, when preanalysis editing is systematized, nonlinear random measures may be useful for monitoring UVFP-treatment effectiveness, and there may be applications to other forms of dysphonia. PMID:19900790

Imaging Prominence Eruptions out to 1 AU

NASA Astrophysics Data System (ADS)

Wood, Brian E.; Howard, Russell A.; Linton, Mark G.

2016-01-01

Views of two bright prominence eruptions trackable all the way to 1 AU are here presented, using the heliospheric imagers on the Solar TErrestrial RElations Observatory (STEREO) spacecraft. The two events first erupted from the Sun on 2011 June 7 and 2012 August 31, respectively. Only these two examples of clear prominence eruptions observable this far from the Sun could be found in the STEREO image database, emphasizing the rarity of prominence eruptions this persistently bright. For the 2011 June event, a time-dependent 3D reconstruction of the prominence structure is made using point-by-point triangulation. This is not possible for the August event due to a poor viewing geometry. Unlike the coronal mass ejection (CME) that accompanies it, the 2011 June prominence exhibits little deceleration from the Sun to 1 AU, as a consequence moving upwards within the CME. This demonstrates that prominences are not necessarily tied to the CME's magnetic structure far from the Sun. A mathematical framework is developed for describing the degree of self-similarity for the prominence's expansion away from the Sun. This analysis suggests only modest deviations from self-similar expansion, but close to the Sun the prominence expands radially somewhat more rapidly than self-similarity would predict.

Prominences: The Key to Understanding Solar Activity

NASA Technical Reports Server (NTRS)

Karpen, Judy T.

2011-01-01

Prominences are spectacular manifestations of both quiescent and eruptive solar activity. The largest examples can be seen with the naked eye during eclipses, making prominences among the first solar features to be described and catalogued. Steady improvements in temporal and spatial resolution from both ground- and space-based instruments have led us to recognize how complex and dynamic these majestic structures really are. Their distinguishing characteristics - cool knots and threads suspended in the hot corona, alignment along inversion lines in the photospheric magnetic field within highly sheared filament channels, and a tendency to disappear through eruption - offer vital clues as to their origin and dynamic evolution. Interpreting these clues has proven to be contentious, however, leading to fundamentally different models that address the basic questions: What is the magnetic structure supporting prominences, and how does so much cool, dense plasma appear in the corona? Despite centuries of increasingly detailed observations, the magnetic and plasma structures in prominences are poorly known. Routine measurements of the vector magnetic field in and around prominences have become possible only recently, while long-term monitoring of the underlying filament-channel formation process also remains scarce. The process responsible for prominence mass is equally difficult to establish, although we have long known that the chromosphere is the only plausible source. As I will discuss, however, the motions and locations of prominence material can be used to trace the coronal field, thus defining the magnetic origins of solar eruptions. A combination of observations, theory, and numerical modeling must be used to determine whether any of the competing theories accurately represents the physics of prominences. I will discuss the criteria for a successful prominence model, compare the leading models, and present in detail one promising, comprehensive scenario for

Solar Prominence Eruption

NASA Technical Reports Server (NTRS)

Moore, Ronald L.

1998-01-01

The prominence that erupts in a prominence eruption is a magnetic structure in the chromosphere and corona. It is visible in chromospheric images by virtue of chromospheric-temperature plasma suspended in the magnetic field, and belongs to that large class of magnetic structures appropriately called filaments because of their characteristic sinewy sigmoidal form. Hence, the term "filament eruption" is used interchangeably with the term "prominence eruption". The magnetic field holding a filament is prone to undergo explosive changes in configuration. In these upheavals, because the filament material is compelled by its high conductivity to ride with the magnetic field that threads it, this material is a visible tracer of the field motion. The part of the magnetic explosion displayed by the entrained filament material is the phenomenon known as a filament eruption, the topic of this article. This article begins with a description of basic observed characteristics of filament eruptions, with attention to the magnetic fields, flares, and coronal mass ejections in which erupting filaments are embedded. The present understanding of these characteristics in terms of the form and action of the magnetic field is then laid out by means of a rudimentary three-dimensional model of the field. The article ends with basic questions that this picture leaves unresolved and with remarks on the observations needed to probe these questions.

IMAGING PROMINENCE ERUPTIONS OUT TO 1 AU

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wood, Brian E.; Howard, Russell A.; Linton, Mark G., E-mail: brian.wood@nrl.navy.mil

2016-01-10

Views of two bright prominence eruptions trackable all the way to 1 AU are here presented, using the heliospheric imagers on the Solar TErrestrial RElations Observatory (STEREO) spacecraft. The two events first erupted from the Sun on 2011 June 7 and 2012 August 31, respectively. Only these two examples of clear prominence eruptions observable this far from the Sun could be found in the STEREO image database, emphasizing the rarity of prominence eruptions this persistently bright. For the 2011 June event, a time-dependent 3D reconstruction of the prominence structure is made using point-by-point triangulation. This is not possible for the August event due to amore » poor viewing geometry. Unlike the coronal mass ejection (CME) that accompanies it, the 2011 June prominence exhibits little deceleration from the Sun to 1 AU, as a consequence moving upwards within the CME. This demonstrates that prominences are not necessarily tied to the CME's magnetic structure far from the Sun. A mathematical framework is developed for describing the degree of self-similarity for the prominence's expansion away from the Sun. This analysis suggests only modest deviations from self-similar expansion, but close to the Sun the prominence expands radially somewhat more rapidly than self-similarity would predict.« less

Nonlinear MHD Waves in a Prominence Foot

NASA Astrophysics Data System (ADS)

Ofman, L.; Knizhnik, K.; Kucera, T.; Schmieder, B.

2015-11-01

We study nonlinear waves in a prominence foot using a 2.5D MHD model motivated by recent high-resolution observations with Hinode/Solar Optical Telescope in Ca ii emission of a prominence on 2012 October 10 showing highly dynamic small-scale motions in the prominence material. Observations of Hα intensities and of Doppler shifts show similar propagating fluctuations. However, the optically thick nature of the emission lines inhibits a unique quantitative interpretation in terms of density. Nevertheless, we find evidence of nonlinear wave activity in the prominence foot by examining the relative magnitude of the fluctuation intensity (δI/I ˜ δn/n). The waves are evident as significant density fluctuations that vary with height and apparently travel upward from the chromosphere into the prominence material with quasi-periodic fluctuations with a typical period in the range of 5-11 minutes and wavelengths <2000 km. Recent Doppler shift observations show the transverse displacement of the propagating waves. The magnetic field was measured with the THEMIS instrument and was found to be 5-14 G. For the typical prominence density the corresponding fast magnetosonic speed is ˜20 km s-1, in qualitative agreement with the propagation speed of the detected waves. The 2.5D MHD numerical model is constrained with the typical parameters of the prominence waves seen in observations. Our numerical results reproduce the nonlinear fast magnetosonic waves and provide strong support for the presence of these waves in the prominence foot. We also explore gravitational MHD oscillations of the heavy prominence foot material supported by dipped magnetic field structure.

Two Categories of Apparent Tornado-like Prominences

NASA Astrophysics Data System (ADS)

Martin, Sara F.; Venkataramanasastry, Aparna

2014-06-01

Two categories of solar prominences have been described in the literature as having a pattern of mass motions and/or a shape similar to terrestrial tornados. We first identify the two categories associated with prominences in the historic literature and then show that counterparts do exist for both in recent literature but one has not been called a tornado prominence. One category described as being similar to tornados is associated with the barbs of quiescent filaments but barbs appear to have rotational motion only under special conditions. H alpha Doppler observations from Helio Research confirm that this category is an illusion in our mind’s eye resulting from counterstreaming in the large barbs of quiescent filaments. The second category is a special case of rotational motion occurring during the early stages of some erupting prominences, in recent years called the roll effect in erupting prominences. In these cases, the eruption begins with the sideways rolling of the top of a prominence. As the eruption proceeds the rolling motion propagates down one leg or both legs of an erupting prominence depending on whether the eruption is asymmetric or symmetric respectively. As an asymmetric eruption proceeds, the longer lasting leg becomes nearly vertical and has true rotational motion. If only this phase of the eruption was observed, as in the historic cases, it was called a tornado prominence and spectra recorded in these cases provide proof of the rotational motion. When one observes an entire eruption which exhibits the rolling motion, as accomplished at Helio Research, the similarity to a tornado is lost because the event as a whole has quite a different nature and the analogy to a terrestrial tornado not longer appears suitable or helpful in understanding the observed and deduced physical processes. Our conclusion is that there are no solar prominences with motions that are usefully described as tornado or tornado-like events aside from the fun of observing

INTERNAL DYNAMICS OF A TWIN-LAYER SOLAR PROMINENCE

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xia, C.; Keppens, R.

Modern observations revealed rich dynamics within solar prominences. The globally stable quiescent prominences, characterized by the presence of thin vertical threads and falling knobs, are frequently invaded by small rising dark plumes. These dynamic phenomena are related to magnetic Rayleigh–Taylor instability, since prominence matter, 100 times denser than surrounding coronal plasma, is lifted against gravity by weak magnetic field. To get a deeper understanding of the physics behind these phenomena, we use three-dimensional magnetohydrodynamic simulations to investigate the nonlinear magnetoconvective motions in a twin-layer prominence in a macroscopic model from chromospheric layers up to 30 Mm height. The properties ofmore » simulated falling “fingers” and uprising bubbles are consistent with those in observed vertical threads and rising plumes in quiescent prominences. Both sheets of the twin-layer prominence show a strongly coherent evolution due to their magnetic connectivity, and demonstrate collective kink deformation. Our model suggests that the vertical threads of the prominence as seen in an edge-on view, and the apparent horizontal threads of the filament when seen top-down are different appearances of the same structures. Synthetic images of the modeled twin-layer prominence reflect the strong degree of mixing established over the entire prominence structure, in agreement with the observations.« less

3D WHOLE-PROMINENCE FINE STRUCTURE MODELING

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gunár, Stanislav; Mackay, Duncan H.

2015-04-20

We present the first 3D whole-prominence fine structure model. The model combines a 3D magnetic field configuration of an entire prominence obtained from nonlinear force-free field simulations, with a detailed description of the prominence plasma. The plasma is located in magnetic dips in hydrostatic equilibrium and is distributed along multiple fine structures within the 3D magnetic model. Through the use of a novel radiative transfer visualization technique for the Hα line such plasma-loaded magnetic field model produces synthetic images of the modeled prominence comparable with high-resolution observations. This allows us for the first time to use a single technique tomore » consistently study, in both emission on the limb and absorption against the solar disk, the fine structures of prominences/filaments produced by a magnetic field model.« less

A Computerized Tomography Study of Vocal Tract Setting in Hyperfunctional Dysphonia and in Belting.

PubMed

Saldias, Marcelo; Guzman, Marco; Miranda, Gonzalo; Laukkanen, Anne-Maria

2018-04-03

Vocal tract setting in hyperfunctional patients is characterized by a high larynx and narrowing of the epilaryngeal and pharyngeal region. Similar observations have been made for various singing styles, eg, belting. The voice quality in belting has been described to be loud, speech like, and high pitched. It is also often described as sounding "pressed" or "tense". The above mentioned has led to the hypothesis that belting may be strenuous to the vocal folds. However, singers and teachers of belting do not regard belting as particularly strenuous. This study investigates possible similarities and differences between hyperfunctional voice production and belting. This study concerns vocal tract setting. Four male patients with hyperfunctional dysphonia and one male contemporary commercial music singer were registered with computerized tomography while phonating on [a:] in their habitual speaking pitch. Additionally, the singer used the pitch G4 in belting. The scannings were studied in sagittal and transversal dimensions by measuring lengths, widths, and areas. Various similarities were found between belting and hyperfunction: high vertical larynx position, small hypopharyngeal width, and epilaryngeal outlet. On the other hand, belting differed from dysphonia (in addition to higher pitch) by a wider lip and jaw opening, and larger volumes of the oral cavity. Belting takes advantage of "megaphone shape" of the vocal tract. Future studies should focus on modeling and simulation to address sound energy transfer. Also, they should consider aerodynamic variables and vocal fold vibration to evaluate the "price of decibels" in these phonation types. Copyright © 2018. Published by Elsevier Inc.

Large Prominence Eruption [video

NASA Image and Video Library

2014-10-07

The STEREO (Behind) spacecraft captured this large prominence and corona mass ejection as they erupted into space (Sept. 26, 2014). By combining images from three instruments, scientists can see the eruption itself (in extreme UV light) as well as follow its progression over the period of about 13 hours with its two coronagraphs. Credit: NASA/Goddard/STEREO The STEREO (Behind) spacecraft captured this large prominence and corona mass ejection as they erupted into space (Sept. 26, 2014). By combining images from three instruments, scientists can see the eruption itself (in extreme UV light) as well as follow its progression over the period of about 13 hours with its two coronagraphs.

The Mass of a Solar Quiescent Prominence

NASA Technical Reports Server (NTRS)

Low, B. C.; Fong, B.; Fan, Y.

2003-01-01

This paper follows up on our recent paper on the role of prominence mass in the storage of magnetic energy for driving a coronal mass ejection (CME). The previous paper erroneously rejected a set of sheet- prominence solutions, the recovery of which allows for a simple theoretical estimate of the mass of a quiescent prominence. For coronal fields of 5-10 G, these hydromagnetic solutions suggest that a prominence mass of (1-26) x 10(exp 6) g is needed to hold detached magnetic fields of intensity comparable to the coronal fields in an unbounded atmosphere such that the global magnetic field is energetically able to spontaneously open up and still have enough energy to account for the kinetic and gravitational potential energies carried away in a CME. This simple result is discussed in relation to observed prominence magnetic field intensities, densities, and masses, pointing to the relevance of such observations to the question of magnetic energy storage in the solar corona.

Magnetically Controlled Spasmodic Accretion during Star Formation. II. Results

NASA Astrophysics Data System (ADS)

Tassis, Konstantinos; Mouschovias, Telemachos Ch.

2005-01-01

The problem of the late accretion phase of the evolution of an axisymmetric, isothermal magnetic disk surrounding a forming star has been formulated in a companion paper. The ``central sink approximation'' is used to circumvent the problem of describing the evolution inside the opaque central region for densities greater than 1011 cm-3 and radii smaller than a few AU. Only the electrons are assumed to be attached to the magnetic field lines, and the effects of both negatively and positively charged grains are accounted for. After a mass of 0.1 Msolar accumulates in the central cell (forming star), a series of magnetically driven outflows and associated outward-propagating shocks form in a quasi-periodic fashion. As a result, mass accretion onto the protostar occurs in magnetically controlled bursts. We refer to this process as spasmodic accretion. The shocks propagate outward with supermagnetosonic speeds. The period of dissipation and revival of the outflow decreases in time, as the mass accumulated in the central sink increases. We evaluate the contribution of ambipolar diffusion to the resolution of the magnetic flux problem of star formation during the accretion phase, and we find it to be very significant albeit not sufficient to resolve the entire problem yet. Ohmic dissipation is completely negligible in the disk during this phase of the evolution. The protostellar disk is found to be stable against interchange-like instabilities, despite the fact that the mass-to-flux ratio has temporary local maxima.

Automated image based prominent nucleoli detection

PubMed Central

Yap, Choon K.; Kalaw, Emarene M.; Singh, Malay; Chong, Kian T.; Giron, Danilo M.; Huang, Chao-Hui; Cheng, Li; Law, Yan N.; Lee, Hwee Kuan

2015-01-01

Introduction: Nucleolar changes in cancer cells are one of the cytologic features important to the tumor pathologist in cancer assessments of tissue biopsies. However, inter-observer variability and the manual approach to this work hamper the accuracy of the assessment by pathologists. In this paper, we propose a computational method for prominent nucleoli pattern detection. Materials and Methods: Thirty-five hematoxylin and eosin stained images were acquired from prostate cancer, breast cancer, renal clear cell cancer and renal papillary cell cancer tissues. Prostate cancer images were used for the development of a computer-based automated prominent nucleoli pattern detector built on a cascade farm. An ensemble of approximately 1000 cascades was constructed by permuting different combinations of classifiers such as support vector machines, eXclusive component analysis, boosting, and logistic regression. The output of cascades was then combined using the RankBoost algorithm. The output of our prominent nucleoli pattern detector is a ranked set of detected image patches of patterns of prominent nucleoli. Results: The mean number of detected prominent nucleoli patterns in the top 100 ranked detected objects was 58 in the prostate cancer dataset, 68 in the breast cancer dataset, 86 in the renal clear cell cancer dataset, and 76 in the renal papillary cell cancer dataset. The proposed cascade farm performs twice as good as the use of a single cascade proposed in the seminal paper by Viola and Jones. For comparison, a naive algorithm that randomly chooses a pixel as a nucleoli pattern would detect five correct patterns in the first 100 ranked objects. Conclusions: Detection of sparse nucleoli patterns in a large background of highly variable tissue patterns is a difficult challenge our method has overcome. This study developed an accurate prominent nucleoli pattern detector with the potential to be used in the clinical settings. PMID:26167383

Automated image based prominent nucleoli detection.

PubMed

Yap, Choon K; Kalaw, Emarene M; Singh, Malay; Chong, Kian T; Giron, Danilo M; Huang, Chao-Hui; Cheng, Li; Law, Yan N; Lee, Hwee Kuan

2015-01-01

Nucleolar changes in cancer cells are one of the cytologic features important to the tumor pathologist in cancer assessments of tissue biopsies. However, inter-observer variability and the manual approach to this work hamper the accuracy of the assessment by pathologists. In this paper, we propose a computational method for prominent nucleoli pattern detection. Thirty-five hematoxylin and eosin stained images were acquired from prostate cancer, breast cancer, renal clear cell cancer and renal papillary cell cancer tissues. Prostate cancer images were used for the development of a computer-based automated prominent nucleoli pattern detector built on a cascade farm. An ensemble of approximately 1000 cascades was constructed by permuting different combinations of classifiers such as support vector machines, eXclusive component analysis, boosting, and logistic regression. The output of cascades was then combined using the RankBoost algorithm. The output of our prominent nucleoli pattern detector is a ranked set of detected image patches of patterns of prominent nucleoli. The mean number of detected prominent nucleoli patterns in the top 100 ranked detected objects was 58 in the prostate cancer dataset, 68 in the breast cancer dataset, 86 in the renal clear cell cancer dataset, and 76 in the renal papillary cell cancer dataset. The proposed cascade farm performs twice as good as the use of a single cascade proposed in the seminal paper by Viola and Jones. For comparison, a naive algorithm that randomly chooses a pixel as a nucleoli pattern would detect five correct patterns in the first 100 ranked objects. Detection of sparse nucleoli patterns in a large background of highly variable tissue patterns is a difficult challenge our method has overcome. This study developed an accurate prominent nucleoli pattern detector with the potential to be used in the clinical settings.

Parametric survey of longitudinal prominence oscillation simulations

NASA Astrophysics Data System (ADS)

Zhang, Q. M.; Chen, P. F.; Xia, C.; Keppens, R.; Ji, H. S.

2013-06-01

Context. Longitudinal filament oscillations recently attracted increasing attention, while the restoring force and the damping mechanisms are still elusive. Aims: We intend to investigate the underlying physics for coherent longitudinal oscillations of the entire filament body, including their triggering mechanism, dominant restoring force, and damping mechanisms. Methods: With the MPI-AMRVAC code, we carried out radiative hydrodynamic numerical simulations of the longitudinal prominence oscillations. We modeled two types of perturbations of the prominence, impulsive heating at one leg of the loop and an impulsive momentum deposition, which cause the prominence to oscillate. We studied the resulting oscillations for a large parameter scan, including the chromospheric heating duration, initial velocity of the prominence, and field line geometry. Results: We found that both microflare-sized impulsive heating at one leg of the loop and a suddenly imposed velocity perturbation can propel the prominence to oscillate along the magnetic dip. Our extensive parameter survey resulted in a scaling law that shows that the period of the oscillation, which weakly depends on the length and height of the prominence and on the amplitude of the perturbations, scales with √R/g⊙, where R represents the curvature radius of the dip, and g⊙ is the gravitational acceleration of the Sun. This is consistent with the linear theory of a pendulum, which implies that the field-aligned component of gravity is the main restoring force for the prominence longitudinal oscillations, as confirmed by the force analysis. However, the gas pressure gradient becomes significant for short prominences. The oscillation damps with time in the presence of non-adiabatic processes. Radiative cooling is the dominant factor leading to damping. A scaling law for the damping timescale is derived, i.e., τ~ l1.63 D0.66w-1.21v0-0.30, showing strong dependence on the prominence length l, the geometry of the

SIMULATING THE IN SITU CONDENSATION PROCESS OF SOLAR PROMINENCES

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xia, C.; Keppens, R.; Antolin, P.

2014-09-10

Prominences in the solar corona are a hundredfold cooler and denser than their surroundings, with a total mass of 10{sup 13} up to 10{sup 15} g. Here, we report on the first comprehensive simulations of three-dimensional, thermally and gravitationally stratified magnetic flux ropes where in situ condensation to a prominence occurs due to radiative losses. After a gradual thermodynamic adjustment, we witness a phase where runaway cooling occurs while counter-streaming shearing flows drain off mass along helical field lines. After this drainage, a prominence-like condensation resides in concave upward field regions, and this prominence retains its overall characteristics for moremore » than two hours. While condensing, the prominence establishes a prominence-corona transition region where magnetic field-aligned thermal conduction is operative during the runaway cooling. The prominence structure represents a force-balanced state in a helical flux rope. The simulated condensation demonstrates a right-bearing barb, as a remnant of the drainage. Synthetic images at extreme ultraviolet wavelengths follow the onset of the condensation, and confirm the appearance of horns and a three-part structure for the stable prominence state, as often seen in erupting prominences. This naturally explains recent Solar Dynamics Observatory views with the Atmospheric Imaging Assembly on prominences in coronal cavities demonstrating horns.« less

Exploring the properties of Solar Prominence Tornados

NASA Astrophysics Data System (ADS)

Ahmad, E.; Panesar, N. K.; Sterling, A. C.; Moore, R. L.

2015-12-01

Solar prominences consist of relatively cool and dense plasma embedded in the hotter solar corona above the solar limb. They form along magnetic polarity inversion lines, and are magnetically supported against gravity at heights of up to ~100 Mm above the chromosphere. Often, parts of prominences visually resemble Earth-based tornados, with inverted-cone-shaped structures and internal motions suggestive of rotation. These "prominence tornados" clearly possess complex magnetic structure, but it is still not certain whether they actually rotate around a ''rotation'' axis, or instead just appear to do so because of composite internal material motions such as counter-streaming flows or lateral (i.e. transverse to the field) oscillations. Here we study the structure and dynamics of five randomly selected prominences, using extreme ultraviolet (EUV) 171 Å images obtained with high spatial and temporal resolution by the Atmospheric Imaging Assembly (AIA) onboard the Solar Dynamics Observatory (SDO) spacecraft. All of the prominences resided in non-active-region locations, and displayed what appeared to be tornado-like rotational motions. Our set includes examples oriented both broadside and end-on to our line-of-sight. We created time-distance plots of horizontal slices at several different heights of each prominence, to study the horizontal plasma motions. We observed patterns of oscillations at various heights in each prominence, and we measured parameters of these oscillations. We find the oscillation time periods to range over ~50 - 90 min, with average amplitudes of ~6,000 km, and with average velocities of ~7 kms-1. We found similar values for prominences viewed either broadside or end-on; this observed isotropy of the lateral oscillatory motion suggests that the apparent oscillations result from actual rotational plasma motions and/or lateral oscillations of the magnetic field, rather than to counter-streaming flows. This research was supported by the National

Nonlinear dynamic mechanism of vocal tremor from voice analysis and model simulations

NASA Astrophysics Data System (ADS)

Zhang, Yu; Jiang, Jack J.

2008-09-01

Nonlinear dynamic analysis and model simulations are used to study the nonlinear dynamic characteristics of vocal folds with vocal tremor, which can typically be characterized by low-frequency modulation and aperiodicity. Tremor voices from patients with disorders such as paresis, Parkinson's disease, hyperfunction, and adductor spasmodic dysphonia show low-dimensional characteristics, differing from random noise. Correlation dimension analysis statistically distinguishes tremor voices from normal voices. Furthermore, a nonlinear tremor model is proposed to study the vibrations of the vocal folds with vocal tremor. Fractal dimensions and positive Lyapunov exponents demonstrate the evidence of chaos in the tremor model, where amplitude and frequency play important roles in governing vocal fold dynamics. Nonlinear dynamic voice analysis and vocal fold modeling may provide a useful set of tools for understanding the dynamic mechanism of vocal tremor in patients with laryngeal diseases.

A distinctive type of ascending prominence - 'Fountain'

NASA Technical Reports Server (NTRS)

Tandberg-Hanssen, E.; Hansen, R. T.; Riddle, A. C.

1975-01-01

Cinematographic observations of solar prominences made at Mauna Loa, Hawaii, during the past few years suggest that there is a well-defined subclass of ascending prominences characterized by closed-system transference of chromospheric material along an arch or loop (up one leg and down the other). While this occurs, the entire prominence envelope steadily rises upward and expands through the corona. These prominences are denoted as 'fountains'. Several examples are described. Fountains appear to be well contained by coronal magnetic fields. Their total kinetic energy is of the order of 10 to the 30th power erg, but dissipation is typically quite slow (over time periods of 100 min or so), so that the correlative disturbances (radio bursts, coronal transients, chromospheric brightenings) are generally not spectacular or nonexistent.

EUV observations of quiescent prominences from Skylab

NASA Technical Reports Server (NTRS)

Moe, O. K.; Cook, J. W.; Mango, S. A.

1979-01-01

Measurements of line intensities and line widths for three quiescent prominences observed with Naval Research Laboratory slit spectrograph on ATM/Skylab are reported. The wavelengths of the observed lines cover the range 1175 A to 1960 A. The measured intensities have been calibrated to within approximately a factor 2 and are average intensities over a 2 arcsec by 60 arcsec slit. Nonthermal velocities from the measured line widths are derived. The nonthermal velocity is found to increase with temperature in the prominence transition zone. Electron densities and pressures are derived from density sensitive line ratios. Electron pressures for two of the prominences are found to lie in the range 0.04-0.08 dyn/sq cm, while values for the third and most intense and active of the three prominences are in the range 0.07-0.22 dyn/sq cm.

Prominent Rocks - 3-D

NASA Image and Video Library

1997-07-13

Many prominent rocks near the Sagan Memorial Station are featured in this image from NASA Mars Pathfinder. Shark, Half-Dome, and Pumpkin are at center 3D glasses are necessary to identify surface detail.

Muscle tension dysphonia in Vietnamese female teachers.

PubMed

Nguyen, Duong Duy; Kenny, Dianna T; Tran, Ninh Duy; Livesey, Jonathan R

2009-03-01

There has been no published research on muscle tension dysphonia (MTD) in speakers who use a tonal language. Using a sample of 47 Northern Vietnamese female primary school teachers with MTD, we aimed to discover whether professional voice users of tonal languages presented with the same symptoms of MTD as speakers of nontonal languages and whether they presented with additional symptoms as a result of speaking a tonal language. The vocal characteristics were assessed by use of a questionnaire and expert perceptual evaluation. Laryngeal features were assessed by photolaryngoscopy. The results showed that MTD was associated with a larger number of vocal symptoms than previously reported. However, the participants did not have the same vocal symptoms reported in English speakers, for example, hard glottal attack, pitch breaks, unusual speech rate, and glottal fry. Factor analysis of the vocal symptoms revealed three factors: "vocal fatigue/hyperfunction," "physical discomfort," and "voice quality," all of which demonstrated high reliability. The major laryngeal characteristic was a glottal gap. The glottal shapes observed included: 44.7% had an incomplete closure, 29.8% a posterior gap, 12.8% an hourglass-shaped gap, 8.5% a spindle-shaped gap, and 4.3% had complete glottal closure. The findings implied a potential contribution of linguistic-specific factors and teaching-related factors to the presentation of this voice disorder in this group of teachers.

[Laryngeal papillomatosis: A rare cause of dysphonia in the child. Case series].

PubMed

Cuestas, Giselle; Rodríguez, Verónica; Doormann, Flavia; Bellia Munzón, Patricio; Bellia Munzón, Gastón

2018-06-01

Juvenile laryngeal papillomatosis is an uncommon disease caused by human papilloma virus, mainly types 6 and 11. It is the most common benign laryngeal tumor in children. This condition should be suspected in any children with persistent and progressive dysphonia with or without stridor and respiratory distress. Flexible laryngoscopy under local anesthesia allows to visualize the typical wart-like lesions. The diagnosis is confirmed by pathological anatomy. Existing treatment is palliative and consists mainly of the surgical excision of the papillomas to maintain the airway without obstruction and to improve the quality of the voice, but it has a high rate of relapse. We present 20 patients with juvenile laryngeal papillomatosis. We describe the clinical manifestations, the diagnostic methods and the treatment of this pathology. Sociedad Argentina de Pediatría.

A Study of quiescent prominences using SDO and STEREO data

NASA Astrophysics Data System (ADS)

Panesar, Navdeep Kaur

2014-05-01

In this dissertation, we have studied the structure, dynamics and evolution of two quiescent prominences. Quiescent prominences are large structures and mainly associated with the quiet Sun region. For the analysis, we have used the high spatial and temporal cadence data from the Solar Dynamic Observatory (SDO), and the Solar Terrestrial Relations Observatory (STEREO). We combined the observations from two different directions and studied the prominence in 3D. In the study of polar crown prominence, we mainly investigated the prominence flows on limb and found its association with on-disk brightenings. The merging of diffused active region flux in the already formed chain of prominence caused the several brightenings in the filament channel and also injected the plasma upward with an average velocity of 15 km/s. In another study, we investigated the triggering mechanism of a quiescent tornado-like prominence. Flares from the neighboring active region triggered the tornado-like motions of the top of the prominence. Active region field contracts after the flare which results in the expansion of prominence cavity. The prominence helical magnetic field expands and plasma moves along the field lines which appear as a tornado-like activity. In addition, the thermal structure of the tornado-like prominence and neighbouring active region was investigated by analysing emission in six of the seven EUV channels from the SDO. These observational investigations led to our understanding of structure and dynamics of quiescent prominences, which could be useful for theoretical prominence models.

PROMINENCE FORMATION ASSOCIATED WITH AN EMERGING HELICAL FLUX ROPE

DOE Office of Scientific and Technical Information (OSTI.GOV)

Okamoto, Takenori J.; Tsuneta, Saku; Katsukawa, Yukio

2009-05-20

The formation and evolution process and magnetic configuration of solar prominences remain unclear. In order to study the formation process of prominences, we examine continuous observations of a prominence in NOAA AR 10953 with the Solar Optical Telescope on the Hinode satellite. As reported in our previous Letter, we find a signature suggesting that a helical flux rope emerges from below the photosphere under a pre-existing prominence. Here we investigate more detailed properties and photospheric indications of the emerging helical flux rope, and discuss their relationship to the formation of the prominence. Our main conclusions are: (1) a dark regionmore » with absence of strong vertical magnetic fields broadens and then narrows in Ca II H-line filtergrams. This phenomenon is consistent with the emergence of the helical flux rope as photospheric counterparts. The size of the flux rope is roughly 30,000 km long and 10,000 km wide. The width is larger than that of the prominence. (2) No shear motion or converging flows are detected, but we find diverging flows such as mesogranules along the polarity inversion line. The presence of mesogranules may be related to the emergence of the helical flux rope. (3) The emerging helical flux rope reconnects with magnetic fields of the pre-existing prominence to stabilize the prominence for the next several days. We thus conjecture that prominence coronal magnetic fields emerge in the form of helical flux ropes that contribute to the formation and maintenance of the prominence.« less

Magnetic field and radiative transfer modelling of a quiescent prominence

NASA Astrophysics Data System (ADS)

Gunár, S.; Schwartz, P.; Dudík, J.; Schmieder, B.; Heinzel, P.; Jurčák, J.

2014-07-01

Aims: The aim of this work is to analyse the multi-instrument observations of the June 22, 2010 prominence to study its structure in detail, including the prominence-corona transition region and the dark bubble located below the prominence body. Methods: We combined results of the 3D magnetic field modelling with 2D prominence fine structure radiative transfer models to fully exploit the available observations. Results: The 3D linear force-free field model with the unsheared bipole reproduces the morphology of the analysed prominence reasonably well, thus providing useful information about its magnetic field configuration and the location of the magnetic dips. The 2D models of the prominence fine structures provide a good representation of the local plasma configuration in the region dominated by the quasi-vertical threads. However, the low observed Lyman-α central intensities and the morphology of the analysed prominence suggest that its upper central part is not directly illuminated from the solar surface. Conclusions: This multi-disciplinary prominence study allows us to argue that a large part of the prominence-corona transition region plasma can be located inside the magnetic dips in small-scale features that surround the cool prominence material located in the dip centre. We also argue that the dark prominence bubbles can be formed because of perturbations of the prominence magnetic field by parasitic bipoles, causing them to be devoid of the magnetic dips. Magnetic dips, however, form thin layers that surround these bubbles, which might explain the occurrence of the cool prominence material in the lines of sight intersecting the prominence bubbles. Movie and Appendix A are available in electronic form at http://www.aanda.org

The treatment of muscle tension dysphonia: a comparison of two treatment techniques by means of an objective multiparameter approach.

PubMed

Van Lierde, Kristiane M; De Bodt, Marc; Dhaeseleer, Evelien; Wuyts, Floris; Claeys, Sofie

2010-05-01

The purpose of the present study is to measure the effectiveness of two treatment techniques--vocalization with abdominal breath support and manual circumlaryngeal therapy (MCT)--in patients with muscle tension dysphonia (MTD). The vocal quality before and after the two treatment techniques was measured by means of the dysphonia severity index (DSI), which is designed to establish an objective and quantitative correlate of the perceived vocal quality. The DSI is based on the weighted combination of the following set of voice measurements: maximum phonation time (MPT), highest frequency, lowest intensity, and jitter. The repeated-measures analysis of variance (ANOVA) revealed a significant difference between the objective overall vocal quality before and after MCT. No significant differences were measured between the objective overall vocal quality before and after vocalization with abdominal breath support. This study showed evidence that MCT is an effective treatment technique for patients with elevated laryngeal position, increased laryngeal muscle tension, and MTD. The precise way in which MCT has an effect on vocal quality has not been addressed in this experiment, but merits study. Further research into this topic could focus on electromyography (EMG) recordings in relation to vocal improvements with larger sample of subjects. (c) 2010 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Parker Lecture - Prominences: the key to understanding solar activity

NASA Astrophysics Data System (ADS)

Karpen, Judith T.

2011-05-01

Prominences are spectacular manifestations of both quiescent and eruptive solar activity. The largest examples can be seen with the naked eye during eclipses, making prominences among the first solar features to be described and catalogued. Steady improvements in temporal and spatial resolution from both ground- and space-based instruments have led us to recognize how complex and dynamic these majestic structures really are. Their distinguishing characteristics - cool knots and threads suspended in the hot corona, alignment along inversion lines in the photospheric magnetic field within highly sheared filament channels, and a tendency to disappear through eruption - offer vital clues as to their origin and dynamic evolution. Interpreting these clues has proven to be contentious, however, leading to fundamentally different models that address the basic questions: What is the magnetic structure supporting prominences, and how does so much cool, dense plasma appear in the corona? Despite centuries of increasingly detailed observations, the magnetic and plasma structures in prominences are poorly known. Routine measurements of the vector magnetic field in and around prominences have become possible only recently, while long-term monitoring of the underlying filament-channel formation process remains scarce. The process responsible for prominence mass is equally difficult to establish, although we have long known that the chromosphere is the only plausible source. As I will discuss, however, the motions and locations of prominence material can be used to trace the coronal field, thus defining the magnetic origins of solar eruptions. A combination of observations, theory, and numerical modeling must be used to determine whether any of the competing theories accurately represents the physics of prominences. I will discuss the criteria for a successful prominence model, compare the leading models, and present in detail one promising, comprehensive scenario for prominence

Static current-sheet models of quiescent prominences

NASA Technical Reports Server (NTRS)

Wu, F.; Low, B. C.

1986-01-01

A particular class of theoretical models idealize the prominence to be a discrete flat electric-current sheet suspended vertically in a potential magnetic field. The weight of the prominence is supported by the Lorentz force in the current sheet. These models can be extended to have curved electric-current sheets and to vary three-dimensionally. The equation for force balance is 1 over 4 pi (del times B) times Bdel p- p9 z=zero. Using Cartesian coordinates we take, for simplicity, a uniform gravity with constant acceleration g in the direction -z. If we are interested not in the detailed internal structure of the prominence, but in the global magnetic configuration around the prominence, we may take prominence plasma to be cold. Consideration is given to how such equilibrium states can be constructed. To simplify the mathematical problem, suppose there is no electric current in the atmosphere except for the discrete currents in the cold prominence sheet. Let us take the plane z =0 to be the base of the atmosphere and restrict our attention to the domain z greater than 0. The task we have is to solve for a magnetic field which is everywhere potential except on some free surface S, subject to suit able to boundary conditions. The surface S is determined by requiring that it possesses a discrete electric current density such that the Lorentz force on it is everywhere vertically upward to balance the weight of the material m(S). Since the magnetic field is potential in the external atmosphere, the latter is decoupled from the magnetic field and its plane parallel hydrostatic pressure and density can be prescribed.

Static current-sheet models of quiescent prominences

NASA Astrophysics Data System (ADS)

Wu, F.; Low, B. C.

1986-12-01

A particular class of theoretical models idealize the prominence to be a discrete flat electric-current sheet suspended vertically in a potential magnetic field. The weight of the prominence is supported by the Lorentz force in the current sheet. These models can be extended to have curved electric-current sheets and to vary three-dimensionally. The equation for force balance is 1 over 4 pi (del times B) times Bdel p- p9 z=zero. Using Cartesian coordinates we take, for simplicity, a uniform gravity with constant acceleration g in the direction -z. If we are interested not in the detailed internal structure of the prominence, but in the global magnetic configuration around the prominence, we may take prominence plasma to be cold. Consideration is given to how such equilibrium states can be constructed. To simplify the mathematical problem, suppose there is no electric current in the atmosphere except for the discrete currents in the cold prominence sheet. Let us take the plane z =0 to be the base of the atmosphere and restrict our attention to the domain z greater than 0. The task we have is to solve for a magnetic field which is everywhere potential except on some free surface S, subject to suit able to boundary conditions. The surface S is determined by requiring that it possesses a discrete electric current density such that the Lorentz force on it is everywhere vertically upward to balance the weight of the material m(S). Since the magnetic field is potential in the external atmosphere, the latter is decoupled from the magnetic field and its plane parallel hydrostatic pressure and density can be prescribed.

Nonlinear dynamic-based analysis of severe dysphonia in patients with vocal fold scar and sulcus vocalis

PubMed Central

Choi, Seong Hee; Zhang, Yu; Jiang, Jack J.; Bless, Diane M.; Welham, Nathan V.

2011-01-01

Objective The primary goal of this study was to evaluate a nonlinear dynamic approach to the acoustic analysis of dysphonia associated with vocal fold scar and sulcus vocalis. Study Design Case-control study. Methods Acoustic voice samples from scar/sulcus patients and age/sex-matched controls were analyzed using correlation dimension (D2) and phase plots, time-domain based perturbation indices (jitter, shimmer, signal-to-noise ratio [SNR]), and an auditory-perceptual rating scheme. Signal typing was performed to identify samples with bifurcations and aperiodicity. Results Type 2 and 3 acoustic signals were highly represented in the scar/sulcus patient group. When data were analyzed irrespective of signal type, all perceptual and acoustic indices successfully distinguished scar/sulcus patients from controls. Removal of type 2 and 3 signals eliminated the previously identified differences between experimental groups for all acoustic indices except D2. The strongest perceptual-acoustic correlation in our dataset was observed for SNR; the weakest correlation was observed for D2. Conclusions These findings suggest that D2 is inferior to time-domain based perturbation measures for the analysis of dysphonia associated with scar/sulcus; however, time-domain based algorithms are inherently susceptible to inflation under highly aperiodic (i.e., type 2 and 3) signal conditions. Auditory-perceptual analysis, unhindered by signal aperiodicity, is therefore a robust strategy for distinguishing scar/sulcus patient voices from normal voices. Future acoustic analysis research in this area should consider alternative (e.g., frequency- and quefrency-domain based) measures alongside additional nonlinear approaches. PMID:22516315

A Prominence Puzzle Explained?

NASA Astrophysics Data System (ADS)

Yeates, A. R.; Mackay, D. H.; van Ballegooijen, A. A.

2009-02-01

Long-standing observations reveal a global organisation of the magnetic field direction in solar prominences (aka filaments), large clouds of cool dense plasma suspended in the Sun's hot corona. However, theorists have thus far been unable to explain the origin of this hemispheric pattern. In particular, simple shearing by large-scale surface motions would appear to lead to the wrong magnetic field direction. To explain the observations, we have developed a new model of the global magnetic field evolution in the solar corona over six months. For the first time our model can follow the build-up of magnetic helicity and shear on a global scale, driven by flux emergence and surface motions. The model is successful in predicting the correct magnetic field direction in the vast majority of prominences tested, and has enabled us to determine the key physical mechanisms behind the mysterious hemispheric pattern.

The Effect of Parkinson Disease Tremor Phenotype on Cepstral Peak Prominence and Transglottal Airflow in Vowels and Speech.

PubMed

Burk, Brittany R; Watts, Christopher R

2018-02-19

The physiological manifestations of Parkinson disease are heterogeneous, as evidenced by disease subtypes. Dysphonia has been well documented as an early and progressively significant impairment associated with the disease. The purpose of this study was to investigate how acoustic and aerodynamic measures of vocal function were affected by Parkinson tremor subtype (phenotype) in an effort to better understand the heterogeneity of voice impairment severity in Parkinson disease. This is a prospective case-control study. Thirty-two speakers with Parkinson disease assigned to tremor and nontremor phenotypes and 10 healthy controls were recruited. Sustained vowels and connected speech were recorded from each speaker. Acoustic measures of cepstral peak prominence (CPP) and aerodynamic measures of transglottal airflow (TAF) were calculated from the recorded acoustic and aerodynamic waveforms. Speakers with a nontremor dominant phenotype exhibited significantly (P < 0.05) lower CPP and higher TAF in vowels compared with the tremor dominant phenotype and control speakers, who were not different from each other. No significant group differences were observed for CPP or TAF in connected speech. When producing vowels, participants with nontremor dominant phenotype exhibited reduced phonation periodicity and elevated TAF compared with tremor dominant and control participants. This finding is consistent with differential limb-motor and cognitive impairments between tremor and nontremor phenotypes reported in the extant literature. Results suggest that sustained vowel production may be sensitive to phonatory control as a function of Parkinson tremor phenotype in mild to moderate stages of the disease. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Neutral Atom Diffusion in a Partially Ionized Prominence Plasma

NASA Technical Reports Server (NTRS)

Gilbert, Holly

2010-01-01

The support of solar prominences is normally described in terms of a magnetic force on the prominence plasma that balances the solar gravitational force. Because the prominence plasma is only partially ionized. it is necessary to consider in addition the support of the neutral component of the prominence plasma. This support is accomplished through a frictional interaction between the neutral and ionized components of the plasma, and its efficacy depends strongly on the degree of ionization of the plasma. More specifically, the frictional force is proportional to the relative flow of neutral and ion species, and for a sufficiently weakly ionized plasma, this flow must be relatively large to produce a frictional force that balances gravity. A large relative flow, of course, implies significant draining of neutral particles from the prominence. We evaluate the importance of this draining effect for a hydrogen-helium plasma, and consider the observational evidence for cross-field diffusion of neutral prominence material,

THE THERMAL INSTABILITY OF SOLAR PROMINENCE THREADS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Soler, R.; Goossens, M.; Ballester, J. L., E-mail: roberto.soler@wis.kuleuven.be

The fine structure of solar prominences and filaments appears as thin and long threads in high-resolution images. In H{alpha} observations of filaments, some threads can be observed for only 5-20 minutes before they seem to fade and eventually disappear, suggesting that these threads may have very short lifetimes. The presence of an instability might be the cause of this quick disappearance. Here, we study the thermal instability of prominence threads as an explanation of their sudden disappearance from H{alpha} observations. We model a prominence thread as a magnetic tube with prominence conditions embedded in a coronal environment. We assume amore » variation of the physical properties in the transverse direction so that the temperature and density continuously change from internal to external values in an inhomogeneous transitional layer representing the particular prominence-corona transition region (PCTR) of the thread. We use the nonadiabatic and resistive magnetohydrodynamic equations, which include terms due to thermal conduction parallel and perpendicular to the magnetic field, radiative losses, heating, and magnetic diffusion. We combine both analytical and numerical methods to study linear perturbations from the equilibrium state, focusing on unstable thermal solutions. We find that thermal modes are unstable in the PCTR for temperatures higher than 80,000 K, approximately. These modes are related to temperature disturbances that can lead to changes in the equilibrium due to rapid plasma heating or cooling. For typical prominence parameters, the instability timescale is of the order of a few minutes and is independent of the form of the temperature profile within the PCTR of the thread. This result indicates that thermal instability may play an important role for the short lifetimes of threads in the observations.« less

Prominent Constraints Faced by Government Managers.

DTIC Science & Technology

1983-06-01

A A t-32 412 PROMINENT CONSTRAINTS FACED BY GOVERNMENT MANAGERS (U) JUN 83NAVAL POSTGRADUATE SCHOOL MONTEREY CA R I NIEDERMULLER7N.LASSI FIED F/G ,5...STANDARS-963A- ’ I It I Uf NAVAL POSTGRADUATE SCHOOL Monterey, California co IA THESIS PROMINENT CONSTRAINTS FACED BY GOVERNMENT MANAGERS by Robert T...Government Managers June 1983 S. PERFORMING ORO. REPORT NUMsER 7. AUTNOR(s) .COtAC R03 GRANT NUNSER(W.) Robert T. Niedermuller I. PERPORMIXG OROANIZATIIOM

TORNADO-LIKE EVOLUTION OF A KINK-UNSTABLE SOLAR PROMINENCE

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Wensi; Liu, Rui; Wang, Yuming, E-mail: rliu@ustc.edu.cn

We report on the tornado-like evolution of a quiescent prominence on 2014 November 1. The eastern section of the prominence first rose slowly, transforming into an arch-shaped structure as high as ∼150 Mm above the limb; the arch then writhed moderately in a left-handed sense, while the original dark prominence material emitted in the Fe ix 171 Å passband, and a braided structure appeared at the eastern edge of the warped arch. The unraveling of the braided structure was associated with a transient brightening in the EUV and apparently contributed to the formation of a curtain-like structure (CLS). The CLSmore » consisted of myriad thread-like loops rotating counterclockwise about the vertical if viewed from above. Heated prominence material was observed to slide along these loops and land outside the filament channel. The tornado eventually disintegrated and the remaining material flew along a left-handed helical path constituting approximately a full turn, as corroborated through stereoscopic reconstruction, into the cavity of the stable, western section of the prominence. We suggest that the tornado-like evolution of the prominence was governed by the helical kink instability, and that the CLS formed through magnetic reconnections between the prominence field and the overlying coronal field.« less

Tornado-Like Evolution of A Kink-Unstable Solar Prominence

NASA Astrophysics Data System (ADS)

Wang, W.; Liu, R.; Wang, Y.

2016-12-01

We report on the tornado-like evolution of a quiescent prominence on 2014 November 1. The evolution started with a slow rise of the eastern section of the prominence into an arch-shaped structure as high as 150 Mm above the limb, and then the arch experienced a moderate, left-handed writhing. Following the writhing, the originally dark prominence material became in emission in the Fe IX 171 °A passband, and a braiding structure appeared at the eastern edge of the writhing prominence body, whose unraveling process was associated with a transient brightening in EUV and apparently contributed to the formation of a curtain-like structure (CLS), which consisted of myriads of thread-like loops rotating counterclockwise about the vertical if viewed from above. Material sliding along these loops landed outside of the prominence channel. The tornado was eventually disintegrated and the remaining material flew along a lefthanded helical path of approximately a full turn, as confirmed through stereoscopic reconstruction, into the cavity of the stable, western section of the prominence. We suggest that the tornado-like evolution of the prominence was regulated by the helical kink instability, and that the CLS forms through magnetic reconnections between the flux-rope flux and the overlying flux.

Tornado-like Evolution of a Kink-unstable Solar Prominence

NASA Astrophysics Data System (ADS)

Wang, Wensi; Liu, Rui; Wang, Yuming

2017-01-01

We report on the tornado-like evolution of a quiescent prominence on 2014 November 1. The eastern section of the prominence first rose slowly, transforming into an arch-shaped structure as high as ˜150 Mm above the limb; the arch then writhed moderately in a left-handed sense, while the original dark prominence material emitted in the Fe ix 171 Å passband, and a braided structure appeared at the eastern edge of the warped arch. The unraveling of the braided structure was associated with a transient brightening in the EUV and apparently contributed to the formation of a curtain-like structure (CLS). The CLS consisted of myriad thread-like loops rotating counterclockwise about the vertical if viewed from above. Heated prominence material was observed to slide along these loops and land outside the filament channel. The tornado eventually disintegrated and the remaining material flew along a left-handed helical path constituting approximately a full turn, as corroborated through stereoscopic reconstruction, into the cavity of the stable, western section of the prominence. We suggest that the tornado-like evolution of the prominence was governed by the helical kink instability, and that the CLS formed through magnetic reconnections between the prominence field and the overlying coronal field.

The executive prominent/memory prominent spectrum in Alzheimer's disease is highly heritable.

PubMed

Mez, Jesse; Mukherjee, Shubhabrata; Thornton, Timothy; Fardo, David W; Trittschuh, Emily; Sutti, Sheila; Sherva, Richard; Kauwe, John S; Naj, Adam C; Beecham, Gary W; Gross, Alden; Saykin, Andrew J; Green, Robert C; Crane, Paul K

2016-05-01

Late-onset Alzheimer's disease (LOAD) can present heterogeneously, with several subtypes recognized, including dysexecutive AD. One way to identify people with dysexecutive AD is to consider the difference between memory and executive functioning, which we refer to as the executive prominent/memory prominent spectrum. We aimed to determine if this spectrum was heritable. We used neuropsychological and genetic data from people with mild LOAD (Clinical Dementia Rating 0.5 or 1.0) from the National Alzheimer's Coordinating Center and the Alzheimer's Disease Neuroimaging Initiative. We cocalibrated the neuropsychological data to obtain executive functioning and memory scores and used their difference as a continuous phenotype to calculate its heritability overall and by chromosome. Narrow-sense heritability of the difference between memory and executive functioning scores was 0.68 (standard error 0.12). Single nucleotide polymorphisms on chromosomes 1, 2, 4, 11, 12, and 18 explained the largest fraction of phenotypic variance, with signals from each chromosome accounting for 5%-7%. The chromosomal pattern of heritability differed substantially from that of LOAD itself. Copyright © 2016 Elsevier Inc. All rights reserved.

Developing the Communicative Participation Item Bank: Rasch Analysis Results from a Spasmodic Dysphonia Sample

ERIC Educational Resources Information Center

Baylor, Carolyn R.; Yorkston, Kathryn M.; Eadie, Tanya L.; Miller, Robert M.; Amtmann, Dagmar

2009-01-01

Purpose: The purpose of this study was to conduct the initial psychometric analyses of the Communicative Participation Item Bank--a new self-report instrument designed to measure the extent to which communication disorders interfere with communicative participation. This item bank is intended for community-dwelling adults across a range of…

A prominence eruption driven by flux feeding from chromospheric fibrils

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, Quanhao; Liu, Rui; Wang, Yuming

2014-07-10

We present multi-wavelength observations of a prominence eruption originating from a quadrupolar field configuration, in which the prominence was embedded in a side arcade. Within the two-day period prior to its eruption on 2012 October 22, the prominence was perturbed three times by chromospheric fibrils underneath, which rose upward, became brightened, and merged into the prominence, resulting in horizontal flows along the prominence axis, suggesting that the fluxes carried by the fibrils were incorporated into the magnetic field of the prominence. These perturbations caused the prominence to oscillate and to rise faster than before. The absence of intense heating withinmore » the first two hours after the onset of the prominence eruption, which followed an exponential increase in height, indicates that ideal instability played a crucial role. The eruption involved interactions with the other side arcade, leading up to a twin coronal mass ejection, which was accompanied by transient surface brightenings in the central arcade, followed by transient dimmings and brightenings in the two side arcades. We suggest that flux feeding from chromospheric fibrils might be an important mechanism to trigger coronal eruptions.« less

MAGNETIC FIELD IN ATYPICAL PROMINENCE STRUCTURES: BUBBLE, TORNADO, AND ERUPTION

DOE Office of Scientific and Technical Information (OSTI.GOV)

Levens, P. J.; Labrosse, N.; Schmieder, B.

Spectropolarimetric observations of prominences have been obtained with the THEMIS telescope during four years of coordinated campaigns. Our aim is now to understand the conditions of the cool plasma and magnetism in “atypical” prominences, namely when the measured inclination of the magnetic field departs, to some extent, from the predominantly horizontal field found in “typical” prominences. What is the role of the magnetic field in these prominence types? Are plasma dynamics more important in these cases than the magnetic support? We focus our study on three types of “atypical” prominences (tornadoes, bubbles, and jet-like prominence eruptions) that have all beenmore » observed by THEMIS in the He i D{sub 3} line, from which the Stokes parameters can be derived. The magnetic field strength, inclination, and azimuth in each pixel are obtained by using the inversion method of principal component analysis on a model of single scattering in the presence of the Hanle effect. The magnetic field in tornadoes is found to be more or less horizontal, whereas for the eruptive prominence it is mostly vertical. We estimate a tendency toward higher values of magnetic field strength inside the bubbles than outside in the surrounding prominence. In all of the models in our database, only one magnetic field orientation is considered for each pixel. While sufficient for most of the main prominence body, this assumption appears to be oversimplified in atypical prominence structures. We should consider these observations as the result of superposition of multiple magnetic fields, possibly even with a turbulent field component.« less

Prominence formation and ejection in cool stars

NASA Astrophysics Data System (ADS)

Villarreal D'Angelo, Carolina; Jardine, Moira; See, Victor

2018-03-01

The observational signatures of prominences have been detected in single and binary G and K type stars for many years now, but recently this has been extended to the M dwarf regime. Prominences carry away both mass and angular momentum when they are ejected and the impact of this mass on any orbiting planets may be important for the evolution of exoplanetary atmospheres. By means of the classification used in the massive star community, that involves knowledge of two parameters (the co-rotation and Alfvén radii, rK and rA), we have determined which cool stars could support prominences. From a model of mechanical support, we have determined that the prominence mass mp/M⋆ = (EM/EG)(r⋆/rK)2F where E_MB_\\star ^2r_\\star ^3 and E_G = GM_\\star ^2/r_\\star are magnetic and gravitational energies and F is a geometric factor. Our calculated masses and ejection frequencies (typically 1016 - 1017 g and 0.4 d, respectively) are consistent with observations and are sufficient to ensure that an exoplanet orbiting in the habitable zone of an M dwarf could suffer frequent impacts.

Magnetic Field-Vector Measurements in Quiescent Prominences via the Hanle Effect: Analysis of Prominences Observed at Pic-Du-Midi and at Sacramento Peak

NASA Technical Reports Server (NTRS)

Bommier, V.; Leroy, J. L.; Sahal-Brechot, S.

1985-01-01

The Hanle effect method for magnetic field vector diagnostics has now provided results on the magnetic field strength and direction in quiescent prominences, from linear polarization measurements in the He I E sub 3 line, performed at the Pic-du-Midi and at Sacramento Peak. However, there is an inescapable ambiguity in the field vector determination: each polarization measurement provides two field vector solutions symmetrical with respect to the line-of-sight. A statistical analysis capable of solving this ambiguity was applied to the large sample of prominences observed at the Pic-du-Midi (Leroy, et al., 1984); the same method of analysis applied to the prominences observed at Sacramento Peak (Athay, et al., 1983) provides results in agreement on the most probable magnetic structure of prominences; these results are detailed. The statistical results were confirmed on favorable individual cases: for 15 prominences observed at Pic-du-Midi, the two-field vectors are pointing on the same side of the prominence, and the alpha angles are large enough with respect to the measurements and interpretation inaccuracies, so that the field polarity is derived without any ambiguity.

Relationships between CSID and vocal fold vibratory function

NASA Astrophysics Data System (ADS)

Cooke, Melissa L.

High correlations have been reported between the acoustic-based Cepstral/Spectral Index of Dysphonia (CSID) and perceptual judgments of dysphonia. This study explores whether CSID provides additional insight and explains more of the variance in HSV-based properties of vocal fold vibratory function than has been reported for other acoustic measures. Using the Analysis of Dysphonia in Speech and Voice (ADSV) program, CSID and its component variables were correlated with HSV-based measures of glottal cycle aperiodicity and glottal area for 20 subjects who underwent phonomicrosurgery. Results indicate CSID is only marginally correlated with glottal cycle aperiodicity in pre- and post-surgical conditions and does not correlate as highly as the cepstral peak prominence alone. Additionally, results reveal higher correlations when examining within-subject change from pre-surgical to post-surgical assessments rather than correlating measures across subjects. Future directions are discussed that aim at improving our understanding of the relationships between acoustic parameters and underlying phonatory function.

Formation and plasma circulation of solar prominences and coronal rains

NASA Astrophysics Data System (ADS)

Xia, C.

2016-12-01

Solar prominences are long-lived cool and dense plasma curtains in the hot and rarefied corona. The physical mechanism responsible for their formation and especially for their internal plasma circulation has been uncertain for decades. The observed ubiquitous down flows in quiescent prominences are difficult to interpret as plasma with high conductivity seems to move across horizontal magnetic field lines. Here we present three-dimensional (3D) numerical simulations of prominence formation and evolution in an elongated magnetic flux rope as a result of in-situ plasma condensations fueled by continuous plasma evaporation from the solar chromosphere. The prominence is born and maintained in a fragmented, highly dynamic state with continuous reappearance of multiple blobs and thread structures that move mainly downward dragging along mass-loaded field lines. The prominence plasma circulation is characterized by the dynamic balance between the drainage of prominence plasma back to the chromosphere and the formation of prominence plasma via continuous condensation. Plasma evaporates from the chromosphere, condenses into the prominence in the corona, and drains back to the chromosphere, establishing a stable chromosphere-corona plasma cycle. Another form of cool and dense plasma in the corona is coronal rain, which forms in-situ and drain down arched pathways along loops near active regions. We present 3D simulations of coronal rain in a bipolar arcade and compare it with observational results.

Aerodynamic profiles of women with muscle tension dysphonia/aphonia.

PubMed

Gillespie, Amanda I; Gartner-Schmidt, Jackie; Rubinstein, Elaine N; Abbott, Katherine Verdolini

2013-04-01

In this study, the authors aimed to (a) determine whether phonatory airflows and estimated subglottal pressures (est-Psub) for women with primary muscle tension dysphonia/aphonia (MTD/A) differ from those for healthy speakers; (b) identify different aerodynamic profile patterns within the MTD/A subject group; and (c) determine whether results suggest new understanding of pathogenesis in MTD/A. Retrospective review of aerodynamic data collected from 90 women at the time of primary MTD/A diagnosis. Aerodynamic profiles were significantly different for women with MTD/A as compared with healthy speakers. Five distinct profiles were identified: (a) normal flow, normal est-Psub; (b) high flow, high est-Psub; (c) low flow, normal est-Psub; (d) normal flow, high est-Psub; and (e) high flow, normal est-Psub. This study is the first to identify distinct subgroups of aerodynamic profiles in women with MTD/A and to quantitatively identify a clinical phenomenon sometimes described in association with it-"breath holding"-that is shown by low airflow with normal est-Psub. Results were consistent with clinical claims that diverse respiratory and laryngeal functions may underlie phonatory patterns associated with MTD/A. One potential mechanism, based in psychobiological theory, is introduced to explain some of the variability in aerodynamic profiles of women with MTD/A.

The executive prominent/memory prominent spectrum in Alzheimer’s disease is highly heritable

PubMed Central

Mez, Jesse; Mukherjee, Shubhabrata; Thornton, Timothy; Fardo, David W.; Trittschuh, Emily; Sutti, Sheila; Sherva, Richard; Kauwe, John S.; Naj, Adam C.; Beecham, Gary W.; Gross, Alden; Saykin, Andrew J.; Green, Robert C.; Crane, Paul K.

2016-01-01

Late-onset Alzheimer’s disease (LOAD) can present heterogeneously, with several subtypes recognized, including dysexecutive AD. One way to identify people with dysexecutive AD is to consider the difference between memory and executive functioning, which we refer to as the executive prominent/memory prominent spectrum. We aimed to determine if this spectrum was heritable. We used neuropsychological and genetic data from people with mild LOAD (Clinical Dementia Rating 0.5 or 1.0) from the National Alzheimer’s Coordinating Center and the Alzheimer’s Disease Neuroimaging Initiative. We cocalibrated the neuropsychological data to obtain executive functioning and memory scores and used their difference as a continuous phenotype to calculate its heritability overall and by chromosome. Narrow-sense heritability of the difference between memory and executive functioning scores was 0.68 (standard error 0.12). Single nucleotide polymorphisms on chromosomes 1, 2, 4, 11, 12, and 18 explained the largest fraction of phenotypic variance, with signals from each chromosome accounting for 5%–7%. The chromosomal pattern of heritability differed substantially from that of LOAD itself. PMID:27103524

Voice care knowledge among clinicians and people with healthy voices or dysphonia.

PubMed

Fletcher, Helen M; Drinnan, Michael J; Carding, Paul N

2007-01-01

An important clinical component in the prevention and treatment of voice disorders is voice care and hygiene. Research in voice care knowledge has mainly focussed on specific groups of professional voice users with limited reporting on the tool and evidence base used. In this study, a questionnaire to measure voice care knowledge was developed based on "best evidence." The questionnaire was validated by measuring specialist voice clinicians' agreement. Preliminary data are then presented using the voice care knowledge questionnaire with 17 subjects with nonorganic dysphonia and 17 with healthy voices. There was high (89%) agreement among the clinicians. There was a highly significant difference between the dysphonic and the healthy group scores (P = 0.00005). Furthermore, the dysphonic subjects (63% agreement) presented with less voice care knowledge than the subjects with healthy voices (72% agreement). The questionnaire provides a useful and valid tool to investigate voice care knowledge. The findings have implications for clinical intervention, voice therapy, and health prevention.

Prominence condensation and magnetic levitation in a coronal loop

NASA Technical Reports Server (NTRS)

Van Hoven, G.; Mok, Y.; Drake, J. F.

1992-01-01

The results of a model dynamic simulation of the formation and support of a narrow prominence at the apex of a coronal magnetic loop or arcade are described. The condensation process proceeds via an initial radiative cooling and pressure drop, and a secondary siphon flow from the dense chromospheric ends. The antibuoyancy effect as the prominence forms causes a bending of the confining magnetic field, which propagates toward the semirigid ends of the magnetic loop. Thus, a wide magnetic 'hammock' or well (of the normal-polarity Kippenhahn-Schlueter-type) is formed, which supports the prominence at or near the field apex. The simplicity of this 1.5-dimensional model, with its accompanying diagnostics, elucidates the various contributions to the nonlinear dynamics of prominence condensation and levitation.

Large Prominence Eruption (October 3, 2014)

NASA Image and Video Library

2017-12-08

The STEREO (Behind) spacecraft captured this large prominence and corona mass ejection as they erupted into space (Sept. 26, 2014). By combining images from three instruments, scientists can see the eruption itself (in extreme UV light) as well as follow its progression over the period of about 13 hours with its two coronagraphs. Credit: NASA/Goddard/STEREO The STEREO (Behind) spacecraft captured this large prominence and corona mass ejection as they erupted into space (Sept. 26, 2014). By combining images from three instruments, scientists can see the eruption itself (in extreme UV light) as well as follow its progression over the period of about 13 hours with its two coronagraphs.

Laryngeal manual therapy palpatory evaluation scale: A preliminary study to examine its usefulness in diagnosis of occupational dysphonia.

PubMed

Woźnicka, Ewelina; Niebudek-Bogusz, Ewa; Morawska, Joanna; Wiktorowicz, Justyna; Śliwińska-Kowalska, Mariola

2017-03-24

The aim of this study has been to assess the larynx and soft tissue around the vocal tract in a group of people with healthy voice, and in a group of patients with occupational dysphonia using the new laryngeal manual therapy palpatory evaluation scale (LMTPE). The examinations were performed in a study (dysphonic) group of professional voice users who had developed voice disorders (N = 51) and in the control group of normophonic subjects (N = 50). All the participants underwent perceptual voice assessment and examination by means of the LMTPE scale. Additionally, phoniatric examination including VHI (Voice Handicap Index) questionnaire, GRBAS (the Grade of hoarseness, Roughness, Breathiness, Asthenic, Strained) perceptual evaluation, maximum phonation time (MPT) measurement and videostroboscopy was performed in the study group. The comparison of the LMTPE total score showed that the results of the study group were significantly poorer than those of controls (p < 0.001). In the study group, correlations were found between the LMTPE results and the VHI scores (p < 0.05), perceptual evaluation by the GRBAS (p < 0.05) and the objective parameter MPT (p < 0.05). The study has proven that the LMTPE scale is characterized by the high score of Cronbach's α ratio estimating the reliability of the test. The results have confirmed that the LMTPE scale seems to be a valuable tool, useful in diagnostics of occupational dysphonia, particularly of hyperfunction origin. Med Pr 2017;68(2):179-188. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Adherence to Voice Therapy Recommendations Is Associated With Preserved Employment Fitness Among Teachers With Work-Related Dysphonia.

PubMed

Rinsky-Halivni, Lilah; Klebanov, Miriam; Lerman, Yehuda; Paltiel, Ora

2017-05-01

Referral to voice therapy and recommendations for voice rest and microphone use are common interventions in occupational medicine aimed at preserving the working capability of teachers with occupation-related voice problems. Research on the impact of such interventions in terms of employment is lacking. This study examined changes in fitness (ie, ability) to work of dysphonic teachers referred to an occupational clinic and evaluated employment outcomes following voice therapy, voice rest, and microphone use. A historical prospective study was carried out. Of 365 classroom teachers who were first referred to a regional occupational medicine clinic due to dysphonia between January 2007 and December 2012, 156 were sampled and 153 were followed-up for an average of 5 years (range 2-8). Data were collected from medical records and from interviews conducted in 2014 aimed at assessing employment status. Logistic regression models were used to assess associations between interventions and employment outcomes. Survival analyses were performed to evaluate the association between participating in voice therapy and length of retained employment fitness. Thirty-four (22.2%) teachers suffered declines in working capabilities due to dysphonia. Voice therapy was demonstrated as being a protective factor against such declines (odds ratio = 0.05 [0.01-0.27]). Adherence to recommendation of voice therapy was <50%. Most of the decline in working fitness among nonadherent teachers occurred within 20 months after referral. Unlike voice therapy, voice rest and microphone use were not associated with retention of working capabilities. Voice therapy, especially when instituted early, is a strong predictor for retaining fitness for employment among dysphonic teachers. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Solar Magnetized Tornadoes: Rotational Motion in a Tornado-like Prominence

NASA Astrophysics Data System (ADS)

Su, Yang; Gömöry, Peter; Veronig, Astrid; Temmer, Manuela; Wang, Tongjiang; Vanninathan, Kamalam; Gan, Weiqun; Li, YouPing

2014-04-01

Su et al. proposed a new explanation for filament formation and eruption, where filament barbs are rotating magnetic structures driven by underlying vortices on the surface. Such structures have been noticed as tornado-like prominences when they appear above the limb. They may play a key role as the source of plasma and twist in filaments. However, no observations have successfully distinguished rotational motion of the magnetic structures in tornado-like prominences from other motions such as oscillation and counter-streaming plasma flows. Here we report evidence of rotational motions in a tornado-like prominence. The spectroscopic observations in two coronal lines were obtained from a specifically designed Hinode/EIS observing program. The data revealed the existence of both cold and million-degree-hot plasma in the prominence leg, supporting the so-called prominence-corona transition region. The opposite velocities at the two sides of the prominence and their persistent time evolution, together with the periodic motions evident in SDO/AIA dark structures, indicate a rotational motion of both cold and hot plasma with a speed of ~5 km s-1.

Tracking Prominence Eruptions to 1 AU with STEREO Heliospheric Imaging

NASA Astrophysics Data System (ADS)

Wood, B. E.; Howard, R.; Linton, M.

2015-12-01

It is rare for prominence eruptions to be observable far from the Sun in the inner heliosphere, either in imaging or with in situ plasma instruments. Nevertheless, we here discuss two examples of particularly bright eruptions that are continuously trackable all the way to 1 AU by imagers on the Solar TErrestrial RElations Observatory (STEREO) spacecraft. The two events are from 2011 June 7 and 2012 August 31. Only these two examples of clear prominence eruptions observable this far from the Sun could be found in the STEREO 2007-2014 image database, consistent with the rarity of unambiguous cold prominence material being observed in situ at 1 AU. Full 3-D reconstructions are made of the coronal mass ejections (CMEs) that accompany the prominence eruptions. For the 2011 June event, a time-dependent 3-D reconstruction of the prominence structure is made using point-by-point triangulation, which unfortunately is not possible for the August event due to a poor viewing geometry. However, for the 2012 August event, shock normals computed from plasma measurements at STEREO-B and Wind using the shock jump conditions agree well with expectations from the image-based CME reconstruction. Unlike its accompanying CME, the 2011 June prominence exhibits little deceleration from the Sun to 1 AU, as a consequence moving upwards within the CME. Detailed analysis of the prominence's expansion reveals that deviation from self-similar expansion is never large, but close to the Sun the prominence expands somewhat more rapidly than self-similarity, with this effect decreasing with time.

Reflections: The Value of Patient Support Groups.

PubMed

Hu, Amanda

2017-04-01

A patient support group is defined as "a group of people with common experiences and concerns who provide emotional and moral support for one another." Support groups fulfill many functions: educating patients/family, sharing the illness experience, providing strength to its members, raising public awareness, and fundraising. Some research has shown an improvement in quality of life of patients with head and neck cancer who have participated in support groups. A wide variety of support groups are available for otolaryngology patients, ranging from head and neck oncology to tinnitus and spasmodic dysphonia. Some support groups are face-to-face, while others use social media and the Internet. Surprisingly, engagement in patient support groups is low-about 10%. Some barriers to accessing support groups are awareness, time constraints, and confrontation of negative aspects of the disease. As otolaryngologists, we can help our patients access support groups so that they can benefit from these resources.

Reconnection–Condensation Model for Solar Prominence Formation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kaneko, Takafumi; Yokoyama, Takaaki, E-mail: kaneko@isee.nagoya-u.ac.jp

We propose a reconnection–condensation model in which topological change in a coronal magnetic field via reconnection triggers radiative condensation, thereby resulting in prominence formation. Previous observational studies have suggested that reconnection at a polarity inversion line of a coronal arcade field creates a flux rope that can sustain a prominence; however, they did not explain the origin of cool dense plasmas of prominences. Using three-dimensional magnetohydrodynamic simulations, including anisotropic nonlinear thermal conduction and optically thin radiative cooling, we demonstrate that reconnection can lead not only to flux rope formation but also to radiative condensation under a certain condition. In ourmore » model, this condition is described by the Field length, which is defined as the scale length for thermal balance between radiative cooling and thermal conduction. This critical condition depends weakly on the artificial background heating. The extreme ultraviolet emissions synthesized with our simulation results have good agreement with observational signatures reported in previous studies.« less

Magnetic Field and Plasma Diagnostics from Coordinated Prominence Observations

NASA Astrophysics Data System (ADS)

Schmieder, B.; Levens, P.; Dalmasse, K.; Mein, N.; Mein, P.; Lopez-Ariste, A.; Labrosse, N.; Heinzel, P.

2016-04-01

We study the magnetic field in prominences from a statistical point of view, by using THEMIS in the MTR mode, performing spectropolarimetry of the He I D3 line. Combining these measurements with spectroscopic data from IRIS, Hinode/EIS as well as ground-based telescopes, such as the Meudon Solar Tower, we infer the temperature, density, and flow velocities of the plasma. There are a number of open questions that we aim to answer: - What is the general direction of the magnetic field in prominences? Is the model using a single orientation of magnetic field always valid for atypical prominences? %- Does this depend on the location of the filament on the disk (visible in Hα, in He II 304 Å) over an inversion line between weak or strong network ? - Are prominences in a weak environment field dominated by gas pressure? - Measuring the Doppler shifts in Mg II lines (with IRIS) and in Hα can tell us if there are substantial velocities to maintain vertical rotating structures, as has been suggested for tornado-like prominences. We present here some results obtained with different ground-based and space-based instruments in this framework.

Twisting/Swirling Motions during a Prominence Eruption as Seen from SDO/AIA

NASA Astrophysics Data System (ADS)

Pant, V.; Datta, A.; Banerjee, D.; Chandrashekhar, K.; Ray, S.

2018-06-01

A quiescent prominence was observed at the northwest limb of the Sun using different channels of the Atmospheric Imaging Assembly on board the Solar Dynamics Observatory. We report and analyze twisting/swirling motions during and after the prominence eruption. We segregate the observed rotational motions into small and large scales. Small-scale rotational motions manifest in the barbs of the prominence, while the large-scale rotation manifests as the roll motion during the prominence eruption. We noticed that both footpoints of the prominence rotate in the counterclockwise direction. We propose that a similar sense of rotation in both footpoints leads to a prominence eruption. The prominence erupted asymmetrically near the southern footpoint, which may be due to an uneven mass distribution and location of the cavity near the southern footpoint. Furthermore, we study the swirling motion of the plasma along different circular paths in the cavity of the prominence after the prominence eruption. The rotational velocities of the plasma moving along different circular paths are estimated to be ∼9–40 km s‑1. These swirling motions can be explained in terms of twisted magnetic field lines in the prominence cavity. Finally we observe the twist built up in the prominence, being carried away by the coronal mass ejection, as seen in the Large Angle Spectrometric Coronagraph on board the Solar and Heliospheric Observatory.

The Effect of Background Noise on Intelligibility of Dysphonic Speech

ERIC Educational Resources Information Center

Ishikawa, Keiko; Boyce, Suzanne; Kelchner, Lisa; Powell, Maria Golla; Schieve, Heidi; de Alarcon, Alessandro; Khosla, Sid

2017-01-01

Purpose: The aim of this study is to determine the effect of background noise on the intelligibility of dysphonic speech and to examine the relationship between intelligibility in noise and an acoustic measure of dysphonia--cepstral peak prominence (CPP). Method: A study of speech perception was conducted using speech samples from 6 adult speakers…

SOLAR MAGNETIZED TORNADOES: ROTATIONAL MOTION IN A TORNADO-LIKE PROMINENCE

DOE Office of Scientific and Technical Information (OSTI.GOV)

Su, Yang; Veronig, Astrid; Temmer, Manuela

Su et al. proposed a new explanation for filament formation and eruption, where filament barbs are rotating magnetic structures driven by underlying vortices on the surface. Such structures have been noticed as tornado-like prominences when they appear above the limb. They may play a key role as the source of plasma and twist in filaments. However, no observations have successfully distinguished rotational motion of the magnetic structures in tornado-like prominences from other motions such as oscillation and counter-streaming plasma flows. Here we report evidence of rotational motions in a tornado-like prominence. The spectroscopic observations in two coronal lines were obtainedmore » from a specifically designed Hinode/EIS observing program. The data revealed the existence of both cold and million-degree-hot plasma in the prominence leg, supporting the so-called prominence-corona transition region. The opposite velocities at the two sides of the prominence and their persistent time evolution, together with the periodic motions evident in SDO/AIA dark structures, indicate a rotational motion of both cold and hot plasma with a speed of ∼5 km s{sup –1}.« less

Quiescent Prominence Structure and Dynamics: a new View From the Hinode/SOT

NASA Astrophysics Data System (ADS)

Berger, T.; Okamoto, J.; Slater, G.; Magara, T.; Tarbell, T.; Tsuneta, S.; Hurlburt, N.

2008-05-01

To date the Hinode/Solar Optical Telescope (SOT) has produced over a dozen sub-arcsecond, multi-hour movies of quiescent solar prominences in both the Ca II 396.8~nm H-line and the H-alpha 656.3~nm line. These datasets have revealed new details of the structure and dynamics of quiescent prominences including a new form of mass transport in the form of buoyant plume upflows from the chromosphere. We review the SOT prominence datasets to show that quiescent prominences appear in two major morphological categories: "vertically" and "horizontally" structured. The vertically structured prominences all show ubiquitous downflows in 400--700~km wide "streams" with velocities of approximately 10~km~s-1. Most of the vertically structured prominences also show episodic upflows in the form of dark turbulent plumes with typical velocities of 20~km~s-1. Large-scale oscillations are frequently seen in vertical prominences with periods on the order of 10 min and upward propagation speeds of approximately 10~km~s-1. In addition, "bubble" events in which large voids 10--30~Mm across inflate and then burst are seen in some of the vertical prominences. In contrast, the horizontally structured quiescent prominences exhibit only limited flows along the horizontal filaments. We speculate on the origin of the distinction between the vertically and horizontally structured prominences, taking into account viewing angle and the underlying photospheric magnetic flux density. We also discuss the nature of the mysterious dark plumes and bubble expansions and their implications for prominence mass balance in light of recent models of prominence magnetic structure that find vertical flows along some field lines.

Tracking prominent points in image sequences

NASA Astrophysics Data System (ADS)

Hahn, Michael

1994-03-01

Measuring image motion and inferring scene geometry and camera motion are main aspects of image sequence analysis. The determination of image motion and the structure-from-motion problem are tasks that can be addressed independently or in cooperative processes. In this paper we focus on tracking prominent points. High stability, reliability, and accuracy are criteria for the extraction of prominent points. This implies that tracking should work quite well with those features; unfortunately, the reality looks quite different. In the experimental investigations we processed a long sequence of 128 images. This mono sequence is taken in an outdoor environment at the experimental field of Mercedes Benz in Rastatt. Different tracking schemes are explored and the results with respect to stability and quality are reported.

On Common Ground: Prominent Women Talk about Work & Family.

ERIC Educational Resources Information Center

Zuckerman, Diana, Ed.

This publication presents interviews with 11 prominent women, representing different backgrounds, philosophies, and life experiences, in which they speak about their own experiences with work and family issues. The introduction, "On Common Ground: Prominent Women Talk about Work & Family" (Diana Zuckerman), provides an overview. The 11 interviews…

Dissipative instability in a partially ionised prominence plasma slab

NASA Astrophysics Data System (ADS)

Ballai, I.; Pintér, B.; Oliver, R.; Alexandrou, M.

2017-07-01

Aims: We aim to investigate the nature of dissipative instability appearing in a prominence planar thread filled with partially ionised plasma in the incompressible limit. The importance of partial ionisation is investigated in terms of the ionisation factor and the wavelength of sausage and kink waves propagating in the slab. Methods: In order to highlight the role of partial ionisation, we have constructed models describing various situations we can meet in solar prominence fine structure. Matching the solutions for the transversal component of the velocity and total pressure at the interfaces between the prominence slab and surrounding plasmas, we derived a dispersion relation whose imaginary part describes the evolution of the instability. Results were obtained in the limit of weak dissipation. We have investigated the appearance of instabilities in prominence dark plumes using single and two-fluid approximations. Results: Using simple analytical methods, we show that dissipative instabilities appear for flow speeds that are less than the Kelvin-Helmholtz instability threshold. The onset of instability is determined by the equilibrium flow strength, the ionisation factor of the plasma, the wavelength of waves and the ion-neutral collisional rate. For a given wavelength and for ionisation degrees closer to a neutral gas, the propagating waves become unstable for a narrow band of flow speeds, meaning that neutrals have a stabilising effect. Our results show that the partially ionised plasma describing prominence dark plumes becomes unstable only in a two-fluid (charged particles-neutrals) model, that is for periods that are smaller than the ion-neutral collision time. Conclusions: The present study improves our understanding of the complexity of dynamical processes and stability of solar prominences and the role partial ionisation in destabilising the plasma. We showed the necessity of two-fluid approximation when discussing the nature of instabilities: waves in

SPECTRO-POLARIMETRIC IMAGING REVEALS HELICAL MAGNETIC FIELDS IN SOLAR PROMINENCE FEET

DOE Office of Scientific and Technical Information (OSTI.GOV)

González, M. J. Martínez; Sainz, R. Manso; Ramos, A. Asensio

2015-03-20

Solar prominences are clouds of cool plasma levitating above the solar surface and insulated from the million-degree corona by magnetic fields. They form in regions of complex magnetic topology, characterized by non-potential fields, which can evolve abruptly, disintegrating the prominence and ejecting magnetized material into the heliosphere. However, their physics is not yet fully understood because mapping such complex magnetic configurations and their evolution is extremely challenging, and must often be guessed by proxy from photometric observations. Using state-of-the-art spectro-polarimetric data, we reconstruct the structure of the magnetic field in a prominence. We find that prominence feet harbor helical magneticmore » fields connecting the prominence to the solar surface below.« less

Physics of Solar Prominences: I-Spectral Diagnostics and Non-LTE Modelling

NASA Technical Reports Server (NTRS)

Labrosse, N.; Heinzel, P.; Vial, J.-C,; Kucera, T.; Parenti, S.; Gunar, S.; Schmieder, B.; Kilper, G.

2010-01-01

This review paper outlines background information and covers recent advances made via the analysis of spectra and images of prominence plasma and the increased sophistication of non-LTE (i.e. when there is a departure from Local Thermodynamic Equilibrium) radiative transfer models. We first describe the spectral inversion techniques that have been used to infer the plasma parameters important for the general properties of the prominence plasma in both its cool core and the hotter prominence-corona transition region. We also review studies devoted to the observation of bulk motions of the prominence plasma and to the determination of prominence mass. However, a simple inversion of spectroscopic data usually fails when the lines become optically thick at certain wavelengths. Therefore, complex

Homologous prominence non-radial eruptions: A case study

NASA Astrophysics Data System (ADS)

Duchlev, P.; Koleva, K.; Madjarska, M. S.; Dechev, M.

2016-10-01

The present study provides important details on homologous eruptions of a solar prominence that occurred in active region NOAA 10904 on 2006 August 22. We report on the pre-eruptive phase of the homologous feature as well as the kinematics and the morphology of a forth from a series of prominence eruptions that is critical in defining the nature of the previous consecutive eruptions. The evolution of the overlying coronal field during homologous eruptions is discussed and a new observational criterion for homologous eruptions is provided. We find a distinctive sequence of three activation periods each of them containing pre-eruptive precursors such as a brightening and enlarging of the prominence body followed by small surge-like ejections from its southern end observed in the radio 17 GHz. We analyse a fourth eruption that clearly indicates a full reformation of the prominence after the third eruption. The fourth eruption although occurring 11 h later has an identical morphology, the same angle of propagation with respect to the radial direction, as well as similar kinematic evolution as the previous three eruptions. We find an important feature of the homologous eruptive prominence sequence that is the maximum height increase of each consecutive eruption. The present analysis establishes that all four eruptions observed in Hα are of confined type with the third eruption undergoing a thermal disappearance during its eruptive phase. We suggest that the observation of the same direction of the magnetic flux rope (MFR) ejections can be consider as an additional observational criterion for MFR homology. This observational indication for homologous eruptions is important, especially in the case of events of typical or poorly distinguishable morphology of eruptive solar phenomena.

Solar Prominence Modelling and Plasma Diagnostics at ALMA Wavelengths

NASA Astrophysics Data System (ADS)

Rodger, Andrew; Labrosse, Nicolas

2017-09-01

Our aim is to test potential solar prominence plasma diagnostics as obtained with the new solar capability of the Atacama Large Millimeter/submillimeter Array (ALMA). We investigate the thermal and plasma diagnostic potential of ALMA for solar prominences through the computation of brightness temperatures at ALMA wavelengths. The brightness temperature, for a chosen line of sight, is calculated using the densities of electrons, hydrogen, and helium obtained from a radiative transfer code under non-local thermodynamic equilibrium (non-LTE) conditions, as well as the input internal parameters of the prominence model in consideration. Two distinct sets of prominence models were used: isothermal-isobaric fine-structure threads, and large-scale structures with radially increasing temperature distributions representing the prominence-to-corona transition region. We compute brightness temperatures over the range of wavelengths in which ALMA is capable of observing (0.32 - 9.6 mm), however, we particularly focus on the bands available to solar observers in ALMA cycles 4 and 5, namely 2.6 - 3.6 mm (Band 3) and 1.1 - 1.4 mm (Band 6). We show how the computed brightness temperatures and optical thicknesses in our models vary with the plasma parameters (temperature and pressure) and the wavelength of observation. We then study how ALMA observables such as the ratio of brightness temperatures at two frequencies can be used to estimate the optical thickness and the emission measure for isothermal and non-isothermal prominences. From this study we conclude that for both sets of models, ALMA presents a strong thermal diagnostic capability, provided that the interpretation of observations is supported by the use of non-LTE simulation results.

Closed anterior scoring for prominent-ear correction revisited.

PubMed

Thomas, S S; Fatah, F

2001-10-01

The closed-anterior-scoring technique has been used over the past 3 years to correct 56 prominent ears in 32 patients at the West Midlands Regional Plastic Surgery Unit at Wordsley Hospital. A review was carried out to assess the result of this surgical procedure. We briefly discuss the historical development of other surgical techniques for prominent-ear correction, and describe in detail the operative technique for this procedure, which includes closed scoring and suturing of the cartilage. We used this technique to treat 24 patients with bilateral prominent ears and eight patients with unilateral prominent ears. The series comprised 20 females and 12 males, 26 children and six adults. The age range was from 4 to 24 years old. There were two complications (an upper-pole recurrence and protrusion of a buried prolene suture). Patients were followed up for between 6 months and 3 years (mean: 1.5 years). This procedure is quick and technically easy to learn, with no anterior scars or posterior cartilage overlap. Minimal dissection is involved, leading to a low rate of complications. The learning curve is rapid; this paper represents the experience of a specialist trainee (SST) after he was taught the technique by the senior author. Copyright 2001 The British Association of Plastic Surgeons.

Diagnosing the Prominence-Cavity Connection in the Solar Corona

NASA Astrophysics Data System (ADS)

Schmit, D. J.

The energetic equilibrium of the corona is described by a balance of heating, thermal conduction, and radiative cooling. Prominences can be described by the thermal instability of coronal energy balance which leads to the formation of cool condensations. Observationally, the prominence is surrounded by a density depleted elliptical structure known as a cavity. In this dissertation, we use extreme ultraviolet remote sensing observations of the prominence-cavity system to diagnose the static and dynamic properties of these structures. The observations are compared with numerical models for the time-dependent coronal condensation process and the time-independent corona-prominence magnetic field. To diagnose the density of the cavity, we construct a three-dimensional structural model of the corona. This structural model allows us to synthesize extreme ultraviolet emission in the corona in a way that incorporates the projection effects which arise from the optically thin plasma. This forward model technique is used to constrain a radial density profile simultaneously in the cavity and the streamer. We use a χ2 minimization to find the density model which best matches a density sensitive line ratio (observed with Hinode/Extreme ultraviolet Imaging Spectrometer) and the white light scattered intensity (observed with Mauna Loa Solar Observatory MK4 coronagraph). We use extreme ultraviolet spectra and spectral images to diagnose the dynamics of the prominence and the surrounding corona. Based on the doppler shift of extreme ultraviolet coronal emission lines, we find that there are large regions of flowing plasma which appear to occur within cavities. These line of sight flows have speeds of 10 km/s-1 and projected spatial scales of 100 Mm. Using the Solar Dynamics Observatory Atmospheric Imaging Assembly (SDO/AIA) dataset, we observe dynamic emission from the prominence-cavity system. The SDO/AIA dataset observes multiple spectral bandpasses with different temperature

21 CFR 101.15 - Food; prominence of required statements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 2 2014-04-01 2014-04-01 false Food; prominence of required statements. 101.15 Section 101.15 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION FOOD LABELING General Provisions § 101.15 Food; prominence of required...

21 CFR 101.15 - Food; prominence of required statements.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 2 2012-04-01 2012-04-01 false Food; prominence of required statements. 101.15 Section 101.15 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION FOOD LABELING General Provisions § 101.15 Food; prominence of required...

21 CFR 101.15 - Food; prominence of required statements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Food; prominence of required statements. 101.15 Section 101.15 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION FOOD LABELING General Provisions § 101.15 Food; prominence of required...

21 CFR 101.15 - Food; prominence of required statements.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 2 2013-04-01 2013-04-01 false Food; prominence of required statements. 101.15 Section 101.15 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION FOOD LABELING General Provisions § 101.15 Food; prominence of required...

21 CFR 101.15 - Food; prominence of required statements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 2 2011-04-01 2011-04-01 false Food; prominence of required statements. 101.15 Section 101.15 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION FOOD LABELING General Provisions § 101.15 Food; prominence of required...

ON THE MAGNETISM AND DYNAMICS OF PROMINENCE LEGS HOSTING TORNADOES

DOE Office of Scientific and Technical Information (OSTI.GOV)

Martínez González, M. J.; Ramos, A. Asensio; Arregui, I.

2016-07-10

Solar tornadoes are dark vertical filamentary structures observed in the extreme ultraviolet associated with prominence legs and filament barbs. Their true nature and relationship to prominences requires an understanding of their magnetic structure and dynamic properties. Recently, a controversy has arisen: is the magnetic field organized forming vertical, helical structures or is it dominantly horizontal? And concerning their dynamics, are tornadoes really rotating or is it just a visual illusion? Here we analyze four consecutive spectro-polarimetric scans of a prominence hosting tornadoes on its legs, which helps us shed some light on their magnetic and dynamical properties. We show thatmore » the magnetic field is very smooth in all the prominence, which is probably an intrinsic property of the coronal field. The prominence legs have vertical helical fields that show slow temporal variation that is probably related to the motion of the fibrils. Concerning the dynamics, we argue that (1) if rotation exists, it is intermittent, lasting no more than one hour, and (2) the observed velocity pattern is also consistent with an oscillatory velocity pattern (waves).« less

On the Magnetism and Dynamics of Prominence Legs Hosting Tornadoes

NASA Astrophysics Data System (ADS)

Martínez González, M. J.; Asensio Ramos, A.; Arregui, I.; Collados, M.; Beck, C.; de la Cruz Rodríguez, J.

2016-07-01

Solar tornadoes are dark vertical filamentary structures observed in the extreme ultraviolet associated with prominence legs and filament barbs. Their true nature and relationship to prominences requires an understanding of their magnetic structure and dynamic properties. Recently, a controversy has arisen: is the magnetic field organized forming vertical, helical structures or is it dominantly horizontal? And concerning their dynamics, are tornadoes really rotating or is it just a visual illusion? Here we analyze four consecutive spectro-polarimetric scans of a prominence hosting tornadoes on its legs, which helps us shed some light on their magnetic and dynamical properties. We show that the magnetic field is very smooth in all the prominence, which is probably an intrinsic property of the coronal field. The prominence legs have vertical helical fields that show slow temporal variation that is probably related to the motion of the fibrils. Concerning the dynamics, we argue that (1) if rotation exists, it is intermittent, lasting no more than one hour, and (2) the observed velocity pattern is also consistent with an oscillatory velocity pattern (waves).

Validity of computed tomography in predicting scaphoid screw prominence: a cadaveric study.

PubMed

Griffis, Clare E; Olsen, Cara; Nesti, Leon; Gould, C Frank; Frew, Michael; McKay, Patricia

2017-04-01

Studies of hardware protrusion into joint spaces following fracture fixation have been performed to address whether or not there is discrepancy between the actual and radiographic appearance of screw prominence. The purpose of our study was to prove that, with respect to the scaphoid, prominence as visualized on CT scan is real and not a result of metal artifact. Forty-two cadaveric wrists were separated into four allotted groups with 21 control specimens and 21 study specimens. All specimens were radiographically screened to exclude those with inherent carpal abnormalities. Acutrak® headless compression screws were placed into all specimens using an open dorsal approach. Cartilage was removed from screw insertion site at the convex surface of the scaphoid proximal pole. Control specimens had 0 mm screw head prominence. The studied specimens had 1, 2, and 3 mm head prominence measured with a digital caliper. Computed tomography, with direct sagittal acquisition and metal suppression technique, was then performed on all specimens following screw placement. Two staff radiologists blinded to the study groups interpreted the images. Results revealed that only one of 21 control specimens was interpreted as prominent. Comparatively, in the studied groups, 90% were accurately interpreted as prominent. CT provides an accurate assessment of scaphoid screw head prominence. When a screw appears prominent on CT scan, it is likely to be truly prominent without contribution from metallic artifact.

Aesthetic Refinements in Patients with Prominent Eyes.

PubMed

Richter, Dirk F; Schwaiger, Nina; Wiedner, Maria

2015-12-01

The treatment of prominent eyes is still a challenging task. As well as the surgery, proper preoperative diagnosis differentiating between patients with and without Graves ophthalmopathy plays an important role. In functionally asymptomatic patients with Graves disease suffering from the aesthetic impairment of prominent eyes, the transpalpebral decompression by intraorbital fat removal technique has been proved to be reliable, effective, safe, and easily performed by a trained and experienced oculoplastic surgeon. This technique provides long-lasting results, leading to improvement not only in visual function but also in personal well-being and in the patient's social life, with a high benefit-to-risk ratio. The most powerful tool to treat the lower lid deformity and malar bags in patients without Graves disease is the subperiosteal midface lift. It shortens the lid-cheek junction and blends the retaining periorbital ligaments. Furthermore, it adds volume to the lower lid and gives a stable support. By the nature of the procedure, it also turns a negative into a positive vector. In experienced hands, Olivari's orbital decompression and Hester's midface lift are ideal options for the treatment of prominent eyes. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Brandburg Prominance, Namibia, Africa

NASA Technical Reports Server (NTRS)

1993-01-01

The Brandburg Prominance, Namibia (21.0S, 14.5E) is a round basaltic plug and is the highest feature (over 8,000 ft) in the country. Wind streaks on the surface of the coastal desert, aligned northeast to southwest, are the result of frequent sand storms. Coastal stratus clouds provide most of the life supporting moisture as fog droplets in this arid land where annual rainfall may be less than a quarter of an inch for decades at a time.

Transverse oscillations and stability of prominences in a magnetic field dip

NASA Astrophysics Data System (ADS)

Kolotkov, D. Y.; Nisticò, G.; Nakariakov, V. M.

2016-05-01

Aims: We developed an analytical model of the global transverse oscillations and mechanical stability of a quiescent prominence in the magnetised environment with a magnetic field dip that accounts for the mirror current effect. Methods: The model is based on the interaction of line currents through the Lorentz force. Within this concept the prominence is treated as a straight current-carrying wire, and the magnetic dip is provided by two photospheric current sources. Results: Properties of both vertical and horizontal oscillations are determined by the value of the prominence current, its density and height above the photosphere, and the parameters of the magnetic dip. The prominence can be stable in both horizontal and vertical directions simultaneously when the prominence current dominates in the system and its height is less than the half-distance between the photospheric sources.

BRIGHT PROMINENCE ERUPTION (DECEMBER 14, 2012)

NASA Image and Video Library

2012-12-17

The Sun blows a robust prominence out into space (Dec. 10, 2102). The outer image, from the STEREO-A's COR1 coronagraph, has been changed from green to red to complement the green Sun image, taken in extreme UV light. The movie covers six hours of activity. Kind of Christmassy looking, isn't it? Some of the prominence falls back towards the sun, although the disturbance as a whole continues out into the solar system. Credit: NASA/GSFC/STEREO NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram

Prominent Feature Analysis: What It Means for the Classroom

ERIC Educational Resources Information Center

Swain, Sherry Seale; Graves, Richard L.; Morse, David T.

2010-01-01

The purpose of a prominent feature analysis is to describe the stylistic flexibility that a young writer, or a group of young writers, exhibits on a given day, with a given prompt. In prominent feature analysis, there are no guidebooks, no rubrics--just student papers and the expertise of teachers. Teachers come to the papers individually and yet…

Quiescent Prominences in the Era of ALMA. II. Kinetic Temperature Diagnostics

NASA Astrophysics Data System (ADS)

Gunár, Stanislav; Heinzel, Petr; Anzer, Ulrich; Mackay, Duncan H.

2018-01-01

We provide the theoretical background for diagnostics of the thermal properties of solar prominences observed by the Atacama Large Millimeter/submillimeter Array (ALMA). To do this, we employ the 3D Whole-Prominence Fine Structure (WPFS) model that produces synthetic ALMA-like observations of a complex simulated prominence. We use synthetic observations derived at two different submillimeter/millimeter (SMM) wavelengths—one at a wavelength at which the simulated prominence is completely optically thin and another at a wavelength at which a significant portion of the simulated prominence is optically thick—as if these were the actual ALMA observations. This allows us to develop a technique for an analysis of the prominence plasma thermal properties from such a pair of simultaneous high-resolution ALMA observations. The 3D WPFS model also provides detailed information about the distribution of the kinetic temperature and the optical thickness along any line of sight. We can thus assess whether the measure of the kinetic temperature derived from observations accurately represents the actual kinetic temperature properties of the observed plasma. We demonstrate here that in a given pixel the optical thickness at the wavelength at which the prominence plasma is optically thick needs to be above unity or even larger to achieve a sufficient accuracy of the derived information about the kinetic temperature of the analyzed plasma. Information about the optical thickness cannot be directly discerned from observations at the SMM wavelengths alone. However, we show that a criterion that can identify those pixels in which the derived kinetic temperature values correspond well to the actual thermal properties in which the observed prominence can be established.

Speech–Language Pathology Evaluation and Management of Hyperkinetic Disorders Affecting Speech and Swallowing Function

PubMed Central

Barkmeier-Kraemer, Julie M.; Clark, Heather M.

2017-01-01

Background Hyperkinetic dysarthria is characterized by abnormal involuntary movements affecting respiratory, phonatory, and articulatory structures impacting speech and deglutition. Speech–language pathologists (SLPs) play an important role in the evaluation and management of dysarthria and dysphagia. This review describes the standard clinical evaluation and treatment approaches by SLPs for addressing impaired speech and deglutition in specific hyperkinetic dysarthria populations. Methods A literature review was conducted using the data sources of PubMed, Cochrane Library, and Google Scholar. Search terms included 1) hyperkinetic dysarthria, essential voice tremor, voice tremor, vocal tremor, spasmodic dysphonia, spastic dysphonia, oromandibular dystonia, Meige syndrome, orofacial, cervical dystonia, dystonia, dyskinesia, chorea, Huntington’s Disease, myoclonus; and evaluation/treatment terms: 2) Speech–Language Pathology, Speech Pathology, Evaluation, Assessment, Dysphagia, Swallowing, Treatment, Management, and diagnosis. Results The standard SLP clinical speech and swallowing evaluation of chorea/Huntington’s disease, myoclonus, focal and segmental dystonia, and essential vocal tremor typically includes 1) case history; 2) examination of the tone, symmetry, and sensorimotor function of the speech structures during non-speech, speech and swallowing relevant activities (i.e., cranial nerve assessment); 3) evaluation of speech characteristics; and 4) patient self-report of the impact of their disorder on activities of daily living. SLP management of individuals with hyperkinetic dysarthria includes behavioral and compensatory strategies for addressing compromised speech and intelligibility. Swallowing disorders are managed based on individual symptoms and the underlying pathophysiology determined during evaluation. Discussion SLPs play an important role in contributing to the differential diagnosis and management of impaired speech and deglutition

The role of prominence in Spanish sentence comprehension: An ERP study.

PubMed

Gattei, Carolina A; Tabullo, Ángel; París, Luis; Wainselboim, Alejandro J

2015-11-01

Prominence is the hierarchical relation among arguments that allows us to understand 'Who did what to whom' in a sentence. The present study aimed to provide evidence about the role of prominence information for the incremental interpretation of arguments in Spanish. We investigated the time course of neural correlates associated to the comprehension of sentences that require a reversal of argument prominence hierarchization. We also studied how the amount of available prominence information may affect the incremental build-up of verbal expectations. Results of the ERP data revealed that at the disambiguating verb region, object-initial sentences (only one argument available) elicited a centro-parietal negativity with a peak at 400 ms post-onset. Subject-initial sentences (two arguments available) yielded a broadly distributed positivity at around 650 ms. This dissociation suggests that argument interpretation may depend on their morphosyntactic features, and also on the amount of prominence information available before the verb is encountered. Copyright © 2015 Elsevier Inc. All rights reserved.

Clinical significance of prominent retraction clefts in invasive urothelial carcinoma.

PubMed

Shah, Tanmay S; Kaag, Matthew; Raman, Jay D; Chan, Wilson; Tran, Truc; Kunchala, Sudhir; Shuman, Lauren; DeGraff, David J; Chen, Guoli; Warrick, Joshua I

2017-03-01

Micropapillary morphology in invasive urothelial carcinoma is an established predictor of aggressive disease. It is unknown, however, if prominent retraction is associated with more aggressive disease in the absence of classic micropapillary morphology. We reviewed a retrospective series of 309 radical cystectomy specimens with clinical follow-up data and documented the presence or absence of invasive urothelial carcinoma with prominent retraction clefts, defined as invasive carcinoma with retraction involving the majority of invasive tumor nests in at least one 100× field but without classic micropapillary morphology. Invasive carcinomas with plasmacytoid, sarcomatoid, nested, and small cell morphology were excluded, as were cases without lymph node sampling. In invasive conventional urothelial carcinoma, the presence of prominent retraction clefts was associated lymph node metastasis (odds ratio 4.7, P = .0015, Fisher exact test) but not pathologic tumor stage or several other oncologic parameters (all Ps > .10). Similarly, invasive urothelial carcinoma with micropapillary morphology had lymph node metastasis more frequently than conventional urothelial carcinoma without prominent retraction clefts (P < .001, Fisher exact test), but there was no difference in pathologic tumor stage or oncologic parameters (all Ps > .10). There was no statistically significant difference in rates of lymph node metastasis between invasive urothelial carcinoma with micropapillary morphology and conventional urothelial carcinoma with prominent retraction clefts (P = .54, Fisher exact test). The findings suggest that prominent retraction in invasive urothelial carcinoma may be associated with more aggressive disease, even in the absence of classic micropapillary morphology. Copyright © 2016 Elsevier Inc. All rights reserved.

Structure and Dynamics of Quiescent Prominence Eruptions

NASA Astrophysics Data System (ADS)

Su, Y.; Lu, M.; van Ballegooijen, A.

2012-05-01

We present a survey on the fine structure and dynamics of quiescent prominence eruptions observed both on the disk and at the limb. We have identified 45 quiescent prominence eruptions by looking at the SDO (Solar Dynamics Observatory)/AIA (Atmospheric Imaging Assembly) daily movies from April to June in 2011. Among these events, there are 24 symmetric eruptions (coherent loop-like eruptions) and 21 asymmetric eruptions (one footpoint lifts off) as shown by AIA and STEREO/EUVI observations. Vertical filament threads are identified in 10 out of the 45 events, while horizontal threads are observed in almost all eruptions. We find 23 events with twisting/untwisting motions. For 14 selected limb events, we carry out a detailed study of the eruption dynamics using AIA observations at 304 Å. We find that the initial heights of these erupting prominences are located around 50-110 Mm above the limb. The eruptions start from a speed of less than 5 km/s, then increase to several tens km/s in the AIA field of view. The maximum speed of these events is 50 km/s. The acceleration plots show a positive acceleration in the range of 0 to 20 m/s2. No significant difference is identified in the dynamics of the symmetric and asymmetric eruptions.

The ecology of prominences. [classification, morphology and significance to solar physics

NASA Technical Reports Server (NTRS)

Zirin, H.

1979-01-01

The paper discusses the roles of prominences in the solar scheme. Attention is given to classifications and the ways in which prominences exist: hydrostatic support, ballistic support, and magnetic support. In the case of ballistic support, surges are differentiated from sprays which involve the ejection of material that is already above the solar surface. Discussion also covers filimets and fibrils and the conditions for their appearance. It is proposed that most flares originate in prominence instabilities. In addition supergranulation is covered, noting the network is not seen on the boundary of unipolar regions. It is concluded that prominences play a critical role in flares and field reconnection, and the evolution of solar magnetic fields.

Dynamic formation and magnetic support of loop or arcade prominences

NASA Technical Reports Server (NTRS)

Vanhoven, Gerard; Mok, Y.; Drake, J. F.

1992-01-01

The results of model dynamic simulations of the formation and support of a narrow prominence at the apex of a coronal magnetic loop or arcade are described. The condensation process proceeds via an initial radiative cooling and pressure drop, and a secondary siphon flow from the dense chromospheric ends. The antibuoyancy effect as the prominence forms causes a bending of a confining magnetic field, which propagates toward the semirigid ends of the magnetic loop. Thus, a wide magnetic 'hammock' or well (of a normal polarity Kippenhahn-Schlueter type) is formed, which supports the prominence at or near the field apex.

Piecewise mass flows within a solar prominence observed by the New Vacuum Solar Telescope

NASA Astrophysics Data System (ADS)

Li, Hongbo; Liu, Yu; Tam, Kuan Vai; Zhao, Mingyu; Zhang, Xuefei

2018-06-01

The material of solar prominences is often observed in a state of flowing. These mass flows (MF) are important and useful for us to understand the internal structure and dynamics of prominences. In this paper, we present a high resolution Hα observation of MFs within a quiescent solar prominence. From the observation, we find that the plasma primarily has a circular motion and a downward motion separately in the middle section and legs of the prominence, which creates a piecewise mass flow along the observed prominence. Moreover, the observation also shows a clear displacement of MF's velocity peaks in the middle section of the prominence. All of these provide us with a detailed record of MFs within a solar prominence and show a new approach to detecting the physical properties of prominence.

Mass flows in a prominence spine as observed in EUV

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kucera, T. A.; Gilbert, H. R.; Karpen, J. T.

2014-07-20

We analyze a quiescent prominence observed by the Solar Dynamics Observatory's Atmospheric Imaging Assembly (AIA) with a focus on mass and energy flux in the spine, measured using Lyman continuum absorption. This is the first time this type of analysis has been applied with an emphasis on individual features and fluxes in a quiescent prominence. The prominence, observed on 2010 September 28, is detectable in most AIA wavebands in absorption and/or emission. Flows along the spine exhibit horizontal bands 5''-10'' wide and kinetic energy fluxes on the order of a few times 10{sup 5} erg s{sup –1}cm{sup –2}, consistent withmore » quiet sun coronal heating estimates. For a discrete moving feature we estimate a mass of a few times 10{sup 11} g. We discuss the implications of our derived properties for a model of prominence dynamics, the thermal non-equilibrium model.« less

SPATIAL DAMPING OF PROPAGATING KINK WAVES IN PROMINENCE THREADS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Soler, R.; Oliver, R.; Ballester, J. L., E-mail: roberto.soler@wis.kuleuven.be

Transverse oscillations and propagating waves are frequently observed in threads of solar prominences/filaments and have been interpreted as kink magnetohydrodynamic (MHD) modes. We investigate the spatial damping of propagating kink MHD waves in transversely nonuniform and partially ionized prominence threads. Resonant absorption and ion-neutral collisions (Cowling's diffusion) are the damping mechanisms taken into account. The dispersion relation of resonant kink waves in a partially ionized magnetic flux tube is numerically solved by considering prominence conditions. Analytical expressions of the wavelength and damping length as functions of the kink mode frequency are obtained in the thin tube and thin boundary approximations.more » For typically reported periods of thread oscillations, resonant absorption is an efficient mechanism for the kink mode spatial damping, while ion-neutral collisions have a minor role. Cowling's diffusion dominates both the propagation and damping for periods much shorter than those observed. Resonant absorption may explain the observed spatial damping of kink waves in prominence threads. The transverse inhomogeneity length scale of the threads can be estimated by comparing the observed wavelengths and damping lengths with the theoretically predicted values. However, the ignorance of the form of the density profile in the transversely nonuniform layer introduces inaccuracies in the determination of the inhomogeneity length scale.« less

Prominence Bubbles and Plumes: Thermo-magnetic Buoyancy in Coronal Cavity Systems

NASA Astrophysics Data System (ADS)

Berger, Thomas; Hurlburt, N.

2009-05-01

The Hinode/Solar Optical Telescope continues to produce high spatial and temporal resolution images of solar prominences in both the Ca II 396.8 nm H-line and the H-alpha 656.3 nm line. Time series of these images show that many quiescent prominences produce large scale (50 Mm) dark "bubbles" that "inflate" into, and sometimes burst through, the prominence material. In addition, small-scale (2--5 Mm) dark plumes are seen rising into many quiescent prominences. We show typical examples of both phenomena and argue that they originate from the same mechanism: concentrated and heated magnetic flux that rises due to thermal and magnetic buoyancy to equilibrium heights in the prominence/coronal-cavity system. More generally, these bubbles and upflows offer a source of both magnetic flux and mass to the overlying coronal cavity, supporting B.C. Low's theory of CME initiation via steadily increasing magnetic buoyancy breaking through the overlying helmut streamer tension forces. Quiescent prominences are thus seen as the lowermost parts of the larger coronal cavity system, revealing through thermal effects both the cooled downflowing "drainage" from the cavity and the heated upflowing magnetic "plasmoids" supplying the cavity. We compare SOT movies to new 3D compressible MHD simulations that reproduce the dark turbulent plume dynamics to establish the magnetic and thermal character of these buoyancy-driven flows into the corona.

Dysphonia, Perceived Control, and Psychosocial Distress: A Qualitative Study.

PubMed

Misono, Stephanie; Haut, Caroline; Meredith, Liza; Frazier, Patricia A; Stockness, Ali; Michael, Deirdre D; Butcher, Lisa; Harwood, Eileen M

2018-05-11

The purpose of this qualitative study was to examine relationships between psychological factors, particularly perceived control, and voice symptoms in adults seeking treatment for a voice problem. Semistructured interviews of adult patients with a clinical diagnosis of muscle tension dysphonia were conducted and transcribed. Follow-up interviews were conducted as needed for further information or clarification. A multidisciplinary team analyzed interview content using inductive techniques. Common themes and subthemes were identified. A conceptual model was developed describing the association between voice symptoms, psychological factors, precipitants of ongoing voice symptoms, and perceived control. Thematic saturation was reached after 23 interviews. No participants reported a direct psychological cause for their voice problem, although half described significant life events preceding voice problem onset (eg, miscarriage and other health events, interpersonal conflicts, and family members' illnesses, injuries, and deaths). Participants described psychological influences on voice symptoms that led to rapid exacerbation of their voice symptoms. Participants described the helpfulness of speech therapy and sometimes also challenges of applying techniques in daily life. They also discussed personal coping strategies that included behavioral (eg, avoiding triggers and seeking social support) and psychological (eg, mind-body awareness and emotion regulation) components. Voice-related perceived control was associated with adaptive emotional and behavioral responses, which appeared to facilitate symptom improvement. In this qualitative pilot study, participant narratives suggested that psychological factors and emotions influence voice symptoms, facilitating development of a preliminary conceptual model of how adaptive and maladaptive responses develop and how they influence vocal function. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights

Weighted current sheets supported in normal and inverse configurations - A model for prominence observations

NASA Technical Reports Server (NTRS)

Demoulin, P.; Forbes, T. G.

1992-01-01

A technique which incorporates both photospheric and prominence magnetic field observations is used to analyze the magnetic support of solar prominences in two dimensions. The prominence is modeled by a mass-loaded current sheet which is supported against gravity by magnetic fields from a bipolar source in the photosphere and a massless line current in the corona. It is found that prominence support can be achieved in three different kinds of configurations: an arcade topology with a normal polarity; a helical topology with a normal polarity; and a helical topology with an inverse polarity. In all cases the important parameter is the variation of the horizontal component of the prominence field with height. Adding a line current external to the prominence eliminates the nonsupport problem which plagues virtually all previous prominence models with inverse polarity.

Partial analysis of the flare-prominence of 30 April 1974

NASA Technical Reports Server (NTRS)

Wu, S. T.; Dryer, M.; Mcintosh, P. S.; Reichmann, E.

1975-01-01

A portion of an east limb flare-prominence observed in H-alpha light is analyzed. Following rapid achievement of a maximum mass-ejection velocity of about 375 km/s, the ascending prominence reached a height of at least 200,000 km. A one-dimensional time-dependent hydrodynamic theory is used to compute the total mass and energy ejected during this part of the event. Theoretical aspects of the coronal response are discussed. It is concluded that a moderate temperature and density pulse (factors of ten and two, respectively) for a duration of only 3 min is sufficient for an acceptable simulation of the H-alpha observations and the likely coronal response to the ascending prominence and flare-related ejections.

21 CFR 501.15 - Animal food; prominence of required statements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Animal food; prominence of required statements. 501.15 Section 501.15 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS ANIMAL FOOD LABELING General Provisions § 501.15 Animal food; prominence of required...

21 CFR 201.15 - Drugs; prominence of required label statements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Drugs; prominence of required label statements. 201.15 Section 201.15 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL LABELING General Labeling Provisions § 201.15 Drugs; prominence of required label statements. (a) A word, statement,...

Tether-Cutting Energetics of a Solar Quiet Region Prominence Eruption

NASA Technical Reports Server (NTRS)

Sterling, Alphonse C.; Moore, Ronald L.

2003-01-01

We study the morphology and energetics of a slowly-evolving quiet region solar prominence eruption occurring on 1999 February 8-9 in the solar north polar crown region, using soft X-ray data from the soft X-ray telescope (SXT) on Yohkoh and Fe xv EUV 284 A data from the EUV Imaging Telescope (EIT) on SOHO. After rising at approx. 1 km/s for about six hours, the prominence accelerates to a velocity of approx. 10 km/s, leaving behind EUV and soft X-ray loop arcades of a weak flare in its source region. Intensity dimmings occur in the eruption region cospatially in EUV and soft X-rays, indicating that the dimmings result from a depletion of material. Over the first two hours of the prominence s rapid rise, flare-like brightenings occur beneath the rising prominence which may correspond to "tether cutting" magnetic reconnection. These brightenings have heating requirements of up to approx. 10(exp 28)-10(exp 29) ergs, and this is comparable to the mechanical energy required for the rising prominence over the same time period. If the ratio of mechanical energy to heating energy remains constant through the early phase of the eruption, then we infer that coronal signatures for the tether cutting may not be apparent at or shortly after the start of the fast phase in this or similar low-energy eruptions, since the plasma-heating energy levels would not exceed that of the background corona.

Proposal of a Classification System for the Assessment and Treatment of Prominent Ear Deformity.

PubMed

Lee, Youngdae; Kim, Young Seok; Lee, Won Jai; Rha, Dong Kyun; Kim, Jiye

2018-06-01

Prominent ear is the most common external ear deformity. To comprehensively treat prominent ear deformity, adequate comprehension of its pathophysiology is crucial. In this article, we analyze cases of prominent ear and suggest a simple classification system and treatment algorithm according to pathophysiology. We retrospectively reviewed a total of 205 Northeast Asian patients' clinical data who underwent an operation for prominent ear deformity. Follow-up assessments were conducted 3, 6, and 12 months after surgery. Prominent ear deformities were classified by diagnostic checkpoints. Class I (simple prominent ear) includes prominent ear that developed with the absence of the antihelix without conchal hypertrophy. Class II (mixed-type prominent ear) is defined as having not only a flat antihelix, but also conchal excess. Class III (conchal-type prominent ear) has an enlarged conchal bowl with a well-developed antihelix. Among the three types of prominent ear, class I was most frequent (162 patients, 81.6%). Class II was observed in 28 patients (13.6%) and class III in 10 patients (4.8%). We used the scaphomastoid suture method for correction of antihelical effacement, the anterior approach conchal resection for correction of conchal hypertrophy, and Bauer's squid incision for lobule prominence. The complication rate was 9.2% including early hematoma, hypersensitivity, and suture extrusion. Unfavorable results occurred in 4% including partial recurrence, overcorrection, and undercorrection. To reduce unfavorable results and avoid recurrence, we propose the use of a classification and treatment algorithm in preoperative evaluation of prominent ear. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Comparing Spatial Distributions of Solar Prominence Mass Derived from Coronal Absorption

NASA Technical Reports Server (NTRS)

Gilbert, Holly; Kilper, Gary; Alexander, David; Kucera, Therese

2010-01-01

In the present work we extend the use of this mass-inference technique to a sample of prominences observed in at least two coronal lines. This approach, in theory, allows a direct calculation of prominence mass and helium abundance and how these properties vary spatially and temporally. Our motivation is two-fold: to obtain a He(exp 0)/H(exp 0) abundance ratio, and to determine how the relative spatial distribution of the two species varies in prominences. The first of these relies on the theoretical expectation that the amount of absorption at each EUV wavelength is well-characterized. However, in this work we show that due to a saturation of the continuum absorption in the 625 A and 368 A lines (which have much higher opacity compared to 195 A-) the uncertainties in obtaining the relative abundances are too high to give meaningful estimates. This is an important finding because of its impact on future studies in this area. The comparison of the spatial distribution of helium and hydrogen presented here augments previous observational work indicating that cross-field diffusion of neutrals is an important mechanism for mass loss. Significantly different loss timescales for neutral He and H (helium drains much more rapidly than hydrogen) can impact prominence structure, and both the present and past studies suggest this mechanism is playing a role in structure and possibly dynamics. Section 2 of this paper contains a description of the observations and Section 3 summarizes the method used to infer mass along with the criteria imposed in choosing prominences appropriate for this study. Section 3 also contains a discussion of the problems due to limitations of the available data and the implications for determining relative abundances. We present our results in Section 4, including plots of radial-like scans of prominence mass in different lines to show the spatial distribution of the different species. The last section contains a discussion summarizing the importance

STRUCTURE OF PROMINENCE LEGS: PLASMA AND MAGNETIC FIELD

DOE Office of Scientific and Technical Information (OSTI.GOV)

Levens, P. J.; Labrosse, N.; Schmieder, B.

We investigate the properties of a “solar tornado” observed on 2014 July 15, and aim to link the behavior of the plasma to the internal magnetic field structure of the associated prominence. We made multi-wavelength observations with high spatial resolution and high cadence using SDO/AIA, the Interface Region Imaging Spectrograph (IRIS) spectrograph, and the Hinode/Solar Optical Telescope (SOT) instrument. Along with spectropolarimetry provided by the Télescope Héliographique pour l’Etude du Magnétisme et des Instabilités Solaires telescope we have coverage of both optically thick emission lines and magnetic field information. AIA reveals that the two legs of the prominence are stronglymore » absorbing structures which look like they are rotating, or oscillating in the plane of the sky. The two prominence legs, which are both very bright in Ca ii (SOT), are not visible in the IRIS Mg ii slit-jaw images. This is explained by the large optical thickness of the structures in Mg ii, which leads to reversed profiles, and hence to lower integrated intensities at these locations than in the surroundings. Using lines formed at temperatures lower than 1 MK, we measure relatively low Doppler shifts on the order of ±10 km s{sup −1} in the tornado-like structure. Between the two legs we see loops in Mg ii, with material flowing from one leg to the other, as well as counterstreaming. It is difficult to interpret our data as showing two rotating, vertical structures that are unrelated to the loops. This kind of “tornado” scenario does not fit with our observations. The magnetic field in the two legs of the prominence is found to be preferentially horizontal.« less

Structure of Prominence Legs: Plasma and Magnetic Field

NASA Astrophysics Data System (ADS)

Levens, P. J.; Schmieder, B.; Labrosse, N.; López Ariste, A.

2016-02-01

We investigate the properties of a “solar tornado” observed on 2014 July 15, and aim to link the behavior of the plasma to the internal magnetic field structure of the associated prominence. We made multi-wavelength observations with high spatial resolution and high cadence using SDO/AIA, the Interface Region Imaging Spectrograph (IRIS) spectrograph, and the Hinode/Solar Optical Telescope (SOT) instrument. Along with spectropolarimetry provided by the Télescope Héliographique pour l’Etude du Magnétisme et des Instabilités Solaires telescope we have coverage of both optically thick emission lines and magnetic field information. AIA reveals that the two legs of the prominence are strongly absorbing structures which look like they are rotating, or oscillating in the plane of the sky. The two prominence legs, which are both very bright in Ca II (SOT), are not visible in the IRIS Mg II slit-jaw images. This is explained by the large optical thickness of the structures in Mg II, which leads to reversed profiles, and hence to lower integrated intensities at these locations than in the surroundings. Using lines formed at temperatures lower than 1 MK, we measure relatively low Doppler shifts on the order of ±10 km s-1 in the tornado-like structure. Between the two legs we see loops in Mg II, with material flowing from one leg to the other, as well as counterstreaming. It is difficult to interpret our data as showing two rotating, vertical structures that are unrelated to the loops. This kind of “tornado” scenario does not fit with our observations. The magnetic field in the two legs of the prominence is found to be preferentially horizontal.

3D Reconstruction of a Rotating Erupting Prominence

NASA Technical Reports Server (NTRS)

Thompson, W. T.; Kliem, B.; Torok, T.

2011-01-01

A bright prominence associated with a coronal mass ejection (CME) was seen erupting from the Sun on 9 April 2008. This prominence was tracked by both the Solar Terrestrial Relations Observatory (STEREO) EUVI and COR1 telescopes, and was seen to rotate about the line of sight as it erupted; therefore, the event has been nicknamed the "Cartwheel CME." The threads of the prominence in the core of the CME quite clearly indicate the structure of a weakly to moderately twisted flux rope throughout the field of view, up to heliocentric heights of 4 solar radii. Although the STEREO separation was 48 deg, it was possible to match some sharp features in the later part of the eruption as seen in the 304 Angstrom line in EUVI and in the H alpha-sensitive bandpass of COR1 by both STEREO Ahead and Behind. These features could then be traced out in three dimensional space, and reprojected into a view in which the eruption is directed towards the observer. The reconstructed view shows that the alignment of the prominence to the vertical axis rotates as it rises up to a leading-edge height of approximately equals 2.5 solar radii, and then remains approximately constant. The alignment at 2.5 solar radii differs by about 115 deg. from the original filament orientation inferred from H alpha and EUV data, and the height profile of the rotation, obtained here for the first time, shows that two thirds of the total rotation is reached within approximately equals 0.5 solar radii above the photosphere. These features are well reproduced by numerical simulations of an unstable moderately twisted flux rope embedded in external flux with a relatively strong shear field component.

Tether-Cutting Energetics of a Solar Quiet Region Prominence Eruption

NASA Technical Reports Server (NTRS)

Sterling, Alphonse C.; Moore, Ronald L.

2003-01-01

We study the morphology and energetics of a slowly evolving quiet-region solar prominence eruption occurring on 1999 February 8-9 in the solar north polar crown region, using soft X-ray data from the soft X-ray telescope (SXT) on Yohkoh and Fexv EUV 284 Angstrom data from the EUV Imaging Telescope (EIT) on the Solar and Heliospheric Observatory (SOHO). After rising at approximately equal to l kilometer per second for about six hours, the prominence accelerates to a velocity of approximately equal to 10 kilometers per second, leaving behind EUV and soft X-ray loop arcades of a weak flare in its source region. Intensity dimmings occur in the eruption region cospatially in EUV and soft X-rays, indicating that the dimmings result from a depletion of material. Over the first two hours of the prominences rapid rise, flare-like brightenings occur beneath the rising prominence that might correspond to tether-cutting magnetic reconnection. These brightenings have heating requirements of up to approximately 10(exp 28)-10(exp 29) ergs, and this is comparable to the mechanical energy required for the rising prominence over the same time period. If the ratio of mechanical energy to heating energy remains constant through the early phase of the eruption, then we infer that coronal signatures for the tether cutting may not be apparent at or shortly after the start of the fast phase in this or similar low-energy eruptions, since the plasma-heating energy levels would not exceed that of the background corona.

Alfven-wave dissipation: A support mechanism for quiescent prominences

NASA Technical Reports Server (NTRS)

Jensen, Eberhart

1986-01-01

High resolution filtergrams or spectrograms of the main body of quiescent prominences often show a very vivid dynamical picture that cannot be reconciled with static models. Even if large differences exist between individual prominences in this respect, at least parts of the prominence are usually found to be in a 'choppy', turbulent state. Evidence for systematic flows are found in local regions in the prominence and also in the transition zone in the surroundings. These two regions are probably decoupled magnetically. Alfven waves are generally believed to be responsible for the heating in the upper chromosphere and corona (Hollweg 1986). Since evidence for the presence of Alfven-waves has also been found in the solar wind field, it is highly probable that such waves are generated in the convection zone of the sun and propagated outwards in the solar atmosphere wherever a proper magnetic field is present to carry the waves. The most basic magnetic formations in the solar atmosphere are simple loops. They occur all over the solar surface and cover a large range of magnetic field strengths. Loops with the strongest magnetic fields are found in active regions. It is to be expected that the Alfven-wave flux which is channelled into the loops from below, could show considerable variation both with heliocentric latitude, with time and locally between neighbouring loops. What happens when a magnetic loop is exposed to the appropriate Alfven-wave flux required to heat the upper solar atmosphere is examined.

Non-LTE hydrogen-line formation in moving prominences

NASA Technical Reports Server (NTRS)

Heinzel, P.; Rompolt, B.

1986-01-01

The behavior of hydrogen-line brightness variations, depending on the prominence-velocity changes were investigated. By solving the NON-Local thermodynamic equilibrium (LTE) problem for hydrogen researchers determine quantitatively the effect of Doppler brightening and/or Doppler dimming (DBE, DDE) in the lines of Lyman and Balmer series. It is demonstrated that in low-density prominence plasmas, DBE in H alpha and H beta lines can reach a factor of three for velocities around 160 km/sec, while the L alpha line exhibits typical DDE. L beta brightness variations follow from a combined DBE in the H alpha and DDE in L alpha and L beta itself, providing that all relevant multilevel interlocking processes are taken into account.

ARE TORNADO-LIKE MAGNETIC STRUCTURES ABLE TO SUPPORT SOLAR PROMINENCE PLASMA?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Luna, M.; Moreno-Insertis, F.; Priest, E.

Recent high-resolution and high-cadence observations have surprisingly suggested that prominence barbs exhibit apparent rotating motions suggestive of a tornado-like structure. Additional evidence has been provided by Doppler measurements. The observations reveal opposite velocities for both hot and cool plasma on the two sides of a prominence barb. This motion is persistent for several hours and has been interpreted in terms of rotational motion of prominence feet. Several authors suggest that such barb motions are rotating helical structures around a vertical axis similar to tornadoes on Earth. One of the difficulties of such a proposal is how to support cool prominencemore » plasma in almost-vertical structures against gravity. In this work we model analytically a tornado-like structure and try to determine possible mechanisms to support the prominence plasma. We have found that the Lorentz force can indeed support the barb plasma provided the magnetic structure is sufficiently twisted and/or significant poloidal flows are present.« less

OBSERVATIONS AND MAGNETIC FIELD MODELING OF A SOLAR POLAR CROWN PROMINENCE

DOE Office of Scientific and Technical Information (OSTI.GOV)

Su Yingna; Van Ballegooijen, Adriaan, E-mail: ynsu@head.cfa.harvard.edu

2012-10-01

We present observations and magnetic field modeling of the large polar crown prominence that erupted on 2010 December 6. Combination of Solar Dynamics Observatory (SDO)/Atmospheric Imaging Assembly (AIA) and STEREO{sub B}ehind/EUVI allows us to see the fine structures of this prominence both at the limb and on the disk. We focus on the structures and dynamics of this prominence before the eruption. This prominence contains two parts: an active region part containing mainly horizontal threads and a quiet-Sun part containing mainly vertical threads. On the northern side of the prominence channel, both AIA and EUVI observe bright features which appearmore » to be the lower legs of loops that go above then join in the filament. Filament materials are observed to frequently eject horizontally from the active region part to the quiet-Sun part. This ejection results in the formation of a dense-column structure (concentration of dark vertical threads) near the border between the active region and the quiet Sun. Using the flux rope insertion method, we create nonlinear force-free field models based on SDO/Helioseismic and Magnetic Imager line-of-sight magnetograms. A key feature of these models is that the flux rope has connections with the surroundings photosphere, so its axial flux varies along the filament path. The height and location of the dips of field lines in our models roughly replicate those of the observed prominence. Comparison between model and observations suggests that the bright features on the northern side of the channel are the lower legs of the field lines that turn into the flux rope. We suggest that plasma may be injected into the prominence along these field lines. Although the models fit the observations quiet well, there are also some interesting differences. For example, the models do not reproduce the observed vertical threads and cannot explain the formation of the dense-column structure.« less

The clinical spectrum of laryngeal dystonia includes dystonic cough: observations of a large series.

PubMed

Payne, Susannah; Tisch, Stephen; Cole, Ian; Brake, Helen; Rough, Judy; Darveniza, Paul

2014-05-01

Laryngeal dystonia is a movement disorder of the muscles within the larynx, which most commonly manifests as spasmodic dysphonia (SD). Rarer reported manifestations include dystonic respiratory stridor and dyscoordinate breathing. Laryngeal dystonia has been treated successfully with botulinum neurotoxin (BTX) injections since 1984. We reviewed prospectively collected data in a consecutive series of 193 patients with laryngeal dystonia who were seen at St. Vincent's Hospital between 1991 and 2011. Patient data were analyzed in Excel, R, and Prism. Laryngeal dystonia manifested as SD (92.7%), stridor (11.9%), dystonic cough (6.2%), dyscoordinate breathing (4.1%), paroxysmal hiccups (1.6%), and paroxysmal sneezing (1.6%). There were more women (68.4%) than men (31.6%), and the average age at onset was 47 years. A positive family history of dystonia was present in 16.1% of patients. A higher incidence of extra-laryngeal dystonia (ie, torticollis and blepharospasm) and concurrent manifestations of laryngeal dystonia were present in patients with dystonic cough, dyscoordinate breathing, paroxysmal sneezing, and hiccups than in other patients (P = 0.003 and P < 0.0001, respectively). The average starting dose of BTX decreased from 2.3 to 0.5 units between 1991 and 2011. The median treatment rating was excellent across all subgroups. Patients with adductor SD, stridor, extra-laryngeal dystonia and male patients had relatively better treatment outcomes. Technical failures were rare (1.1%). Dysphonia secondary to vocal cord paresis followed 38.7% of treatments. Laryngeal dystonia manifests predominantly as SD, but other manifestations include stridor, dyscoordinate breathing, paroxysmal cough, hiccups, and sneezing. BTX injections are very effective across all subgroups. Severe adverse events are rare. © 2014 International Parkinson and Movement Disorder Society.

Structure and Dynamics of Quiescent Prominence Eruptions

NASA Astrophysics Data System (ADS)

Lu, Muzhou; Su, Y.; Adriaan van Ballegooijen, A.

2012-05-01

We present a survey on the fine structure and dynamics of quiescent prominence eruptions observed both on the disk and at the limb. We have identified 45 quiescent prominence eruptions by looking at the SDO (Solar Dynamics Observatory)/AIA (Atmospheric Imaging Assembly) daily movies from April to June in 2011. Among these events, there are 24 symmetric eruptions (coherent loop-like eruptions) and 21 asymmetric eruptions (one footpoint lifts off) as shown by AIA and STEREO/EUVI observations. Vertical filament threads are identified in 10 out of the 45 events, while horizontal threads are observed in almost all eruptions. We find 23 events with twisting/untwisting motions. For 14 selected limb events, we carry out a detailed study of the eruption dynamics using AIA observations at 304 Å. We find that the initial heights of these erupting prominences are located around 50-110 Mm above the limb. The eruptions start from a speed of less than 5 km/s, then increase to several tens km/s in the AIA field of view. The maximum speed of these events is 50 km/s. The acceleration plots show a positive acceleration in the range of 0 to 20 m/s^2. No significant difference is identified in the dynamics of the symmetric and asymmetric eruptions. Acknowledgments. This project is supported by the NASA contract SP02H1701R from LMSAL to Smithsonian Astrophysical Observatory (SAO). M. Lu is supported under the NSF-REU solar physics program at SAO, grant number ATM-0851866.

The influence of lower lip position on the perceived attractiveness of chin prominence.

PubMed

Modarai, Faranak; Donaldson, Jane Catalina; Naini, Farhad B

2013-09-01

To evaluate the influence of the lower lip prominence for varying degrees of chin prominence in the sagittal plane and to establish whether lower lip prominence affects the perceived desire for surgery. To assess differences in preference between orthodontists and laypeople as well as the effect of age, gender, and ethnicity of observers on perceptions of attractiveness and desire for surgery. A silhouette of an idealized profile image was created. The image was manipulated to create six images demonstrating different degrees of retrogenia and progenia altered in 4-mm increments from -12 mm to +12 mm and six images demonstrating chin and lower lip prominence in 4-mm increments from -12 mm to +12 mm. One hundred laypeople and 30 orthodontists ranked the images from the most to the least attractive. A duplicate of one of the images was used in order to assess intraexaminer reliability. The amount and direction of sagittal chin position and the prominence of the lower lip were found to have a significant effect on image rank. Chin protrusion was less attractive than retrusion and surgery was desired more often for these images. The overall direction of opinion was the same for laypeople and orthodontists. The chin prominence observed in a progenic patient is deemed less attractive than the combined chin and lower lip prominence observed in a patient with mandibular prognathism. In profiles with a more prominent chin a more protrusive lower lip position was preferred. When the chin was retrusive, a normal lower lip position was preferred to a retrusive lip.

An observation of prominence condensation out of a coronal void

NASA Astrophysics Data System (ADS)

Wagner, W. J.; Newkirk, G., Jr.; Schmidt, H. U.

1983-02-01

Photographic averaging of cine-camera data-frames from the 7 March 1970 eclipse provided a record of the inner white light corona with unusually high resolution for low-contrast features. The authors report that a coronal void, similar to high corona structures associated with prominence formation (MacQueen et al., 1983), extended low into the corona. During eclipse totality, a coronal rain prominence condensed from the base of the void.

Solar activity and erupting prominences [HD Video

NASA Image and Video Library

2017-12-08

Solar activity and erupting prominences. EIT 304A (Jan. 8-10, 2000) Credit: NASA/GSFC/SOHO/ESA To learn more go to the SOHO website: sohowww.nascom.nasa.gov/home.html To learn more about NASA's Sun Earth Day go here: sunearthday.nasa.gov/2010/index.php

Using Prominence Mass Inferences in Different Coronal Lines to Obtain the He/H Abundance

NASA Technical Reports Server (NTRS)

Gilbert, Holly; Kilper, Gary; Alexander, David; Kucera, Therese

2008-01-01

In a previous study we developed a new technique for deriving prominence mass by observing how much coronal radiation in the Fe XI1 (lambda 195) spectral line is absorbed by prominence material. In the present work we apply this method, which allows us to consider the effects of both foreground and background radiation in our calculations, to a sample of prominences absorbing in a coronal line that ionizes both H and He (h < 504 Angstroms), and a line that ionizes only H (504 Angstroms < lambda < 911 Angstroms). This approach, first suggested by Kucera et al. (1998), permits the determination of the abundance ratio [He I]/[H I] of neutral helium and hydrogen in the prominence. This ratio should depend on how the prominence is formed, on its current thermodynamic state, and on its dynamical evolution. Thus, it may provide useful insights into the formation and evolution of prominences.

Using Prominence Mass Inferences in Different Coronal Lines to Obtain the He/H Abundance

NASA Technical Reports Server (NTRS)

Gilbert, Holly; Kilper, Gary; Alexander, David; Kucera, Therese

2009-01-01

In a previous study we developed a new technique for deriving prominence mass by observing how much coronal radiation in the Fe XII (lambda195) spectral Line is absorbed by prominence material. In the present work we apply this method. which allows us to consider the effects of both foreground and background radiation in our calculations, to a sample of prominences absorbing in a coronal line that ionizes both H and He (lambda < 504 Angstroms), and a line that ionizes only H (504 Angstroms < lambda < 911 Angstroms). This approach, first suggested by Mucera et al. (1998). permits the determination of the abundance ratio [He I]/[H I] of neutral helium and hydrogen in the prominence. This ratio should depend on how the prominence is formed, on its current thermodynamic state, and on its dynamical evolution. Thus, it may provide useful insights into the formation and evolution of prominences.

21 CFR 801.15 - Medical devices; prominence of required label statements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Medical devices; prominence of required label statements. 801.15 Section 801.15 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES LABELING General Labeling Provisions § 801.15 Medical devices; prominence of required label statements. (a...

EVIDENCE FOR ROTATIONAL MOTIONS IN THE FEET OF A QUIESCENT SOLAR PROMINENCE

DOE Office of Scientific and Technical Information (OSTI.GOV)

Orozco Suarez, D.; Asensio Ramos, A.; Trujillo Bueno, J., E-mail: dorozco@iac.es

2012-12-20

We present observational evidence of apparent plasma rotational motions in the feet of a solar prominence. Our study is based on spectroscopic observations taken in the He I 1083.0 nm multiplet with the Tenerife Infrared Polarimeter attached to the German Vacuum Tower Telescope. We recorded a time sequence of spectra with 34 s cadence placing the slit of the spectrograph almost parallel to the solar limb and crossing two feet of an intermediate size, quiescent hedgerow prominence. The data show opposite Doppler shifts, {+-}6 km s{sup -1}, at the edges of the prominence feet. We argue that these shifts maymore » be interpreted as prominence plasma rotating counterclockwise around the vertical axis to the solar surface as viewed from above. The evolution of the prominence seen in EUV images taken with the Solar Dynamics Observatory provided us with clues to interpret the results as swirling motions. Moreover, time-distance images taken far from the central wavelength show plasma structures moving parallel to the solar limb with velocities of about 10-15 km s{sup -1}. Finally, the shapes of the observed intensity profiles suggest the presence of, at least, two components at some locations at the edges of the prominence feet. One of them is typically Doppler shifted (up to {approx}20 km s{sup -1}) with respect to the other, thus suggesting the existence of supersonic counter-streaming flows along the line of sight.« less

Using SDO/AIA to Understand the Thermal Evolution of Solar Prominence Formation

NASA Astrophysics Data System (ADS)

Viall, Nicholeen; M.; Kucera, Therese T.; Karpen, Judith

2016-10-01

In this study, we investigate prominence formation using time series analysis of Solar Dynamics Observatory's Atmospheric Imaging Assembly (SDO/AIA) data. We investigate the thermal properties of forming prominences by analyzing observed light curves using the same technique that we have already successfully applied to active regions to diagnose heating and cooling cycles. This technique tracks the thermal evolution using emission formed at different temperatures, made possible by AIA's different wavebands and high time resolution. We also compute the predicted light curves in the same SDO/AIA channels of a hydrodynamic model of thermal nonequilibrium formation of prominence material, an evaporation-condensation model. In these models of prominence formation, heating at the foot-points of sheared coronal flux-tubes results in evaporation of material of a few MK into the corona followed by catastrophic cooling of the hot material to form cool ( 10,000 K) prominence material. We demonstrate that the SDO/AIA light curves for flux tubes undergoing thermal nonequilibrium vary at different locations along the flux tube, especially in the region where the condensate forms, and we compare the predicted light curves with those observed. Supported by NASA's Living with a Star program.

Topic Prominence in Chinese EFL Learners' Interlanguage

ERIC Educational Resources Information Center

Li, Shaopeng; Yang, Lianrui

2014-01-01

The present study aims to investigate the general characteristics of topicprominent typological interlanguage development of Chinese learners of English in terms of acquiring subject-prominent English structures from a discourse perspective. Topic structures mainly appear in Chinese discourse in the form of topic chains (Wang, 2002; 2004). The…

Interpretation of the prominence differential emissions measure for 3 geometries

NASA Technical Reports Server (NTRS)

Schmahl, E. J.; Orrall, F. Q.

1986-01-01

Researchers have used prominence extreme ultraviolet line intensities observed from Skylab to derive the differential emission measure Q(T) in the prominence-corona (PC) interface from 3 x 10,000 to 3 times 1 million K, including the effects of Lyman Continuum absorption. Using lines both shortward and longward of the Lyman limit, researchers have estimated the importance of absorption as function of temperature. The magnitude of the absorption, as well as its rate of increase as a function of temperature, place limits on the thread scales and the character of the interfilar medium. Researchers have calculated models based on three assumed geometries: (1) threads with hot sheaths and cool cores; (2) isothermal threads; and (3) threads with longitudinal temperature gradients along the magnetic field. Comparison of the absorption computed from these models with the observed absorption in prominences shows that none of the geometries is totally satisfactory.

COMPARING SPATIAL DISTRIBUTIONS OF SOLAR PROMINENCE MASS DERIVED FROM CORONAL ABSORPTION

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gilbert, Holly; Kilper, Gary; Kucera, Therese

2011-01-20

In a previous study, Gilbert et al. derived the column density and total mass of solar prominences using a new technique, which measures how much coronal radiation in the Fe XII (195 A) spectral band is absorbed by prominence material, while considering the effects of both foreground and background radiation. In the present work, we apply this method to a sample of prominence observations in three different wavelength regimes: one in which only H{sup 0} is ionized (504 A < {lambda} < 911 A), a second where both H{sup 0} and He{sup 0} are ionized (228 A < {lambda} prominences. Additionally, an enhancement of the technique allowed the calculation of the two-dimensional (2D) spatial distribution of the column density from the continuum absorption in each extreme-ultraviolet observation. We find the total prominence mass is consistently lower in the 625 A observations compared to lines in the other wavelength regimes. There is a significant difference in total mass between the 625 A and 195 A lines, indicating the much higher opacity at 625 A is causing a saturation of the continuum absorption and thus, a potentially large underestimation of mass.« less

On the Support of Solar Prominence Material by the Dips of a Coronal Flux Tube

NASA Astrophysics Data System (ADS)

Hillier, Andrew; van Ballegooijen, Adriaan

2013-04-01

The dense prominence material is believed to be supported against gravity through the magnetic tension of dipped coronal magnetic field. For quiescent prominences, which exhibit many gravity-driven flows, hydrodynamic forces are likely to play an important role in the determination of both the large- and small-scale magnetic field distributions. In this study, we present the first steps toward creating a three-dimensional magneto-hydrostatic prominence model where the prominence is formed in the dips of a coronal flux tube. Here 2.5D equilibria are created by adding mass to an initially force-free magnetic field, then performing a secondary magnetohydrodynamic relaxation. Two inverse polarity magnetic field configurations are studied in detail, a simple o-point configuration with a ratio of the horizontal field (Bx ) to the axial field (By ) of 1:2 and a more complex model that also has an x-point with a ratio of 1:11. The models show that support against gravity is either by total pressure or tension, with only tension support resembling observed quiescent prominences. The o-point of the coronal flux tube was pulled down by the prominence material, leading to compression of the magnetic field at the base of the prominence. Therefore, tension support comes from the small curvature of the compressed magnetic field at the bottom and the larger curvature of the stretched magnetic field at the top of the prominence. It was found that this method does not guarantee convergence to a prominence-like equilibrium in the case where an x-point exists below the prominence flux tube. The results imply that a plasma β of ~0.1 is necessary to support prominences through magnetic tension.

Clinico-Epidemiological Comparison of Delusion-Prominent and Hallucination-Prominent Clinical Subgroups of Paranoid Schizophrenia.

PubMed

Kreinin, Anatoly; Krishtul, Vladimir; Kirsh, Zvi; Menuchin, Michael

2015-01-01

Though hallucinations and delusions are prominent basic impairments in schizophrenia, reports of the relationship between hallucinatory and delusional symptoms among schizophrenia patients are scant. To examine the epidemiological and clinical differences between mainly hallucinatory and mainly delusional subgroups of paranoid schizophrenia patients. One hundred schizophrenia patients, paranoid type, were recruited. In a cross-sectional study, participants were divided into Mainly Hallucinatory (H) and Mainly Delusional (D) subgroups. Demographic variables were compared and clinical characteristics were evaluated using the Scale for the Assessment of Positive Symptoms, the Scale for the Assessment of Negative Symptoms, and the Clinical Global Impression Scale. The Quality-of-Life Enjoyment and Satisfaction Questionnaire-18 was used to assess quality of life. Clinically, the H group was more heterogeneous as expressed by the broader range of scores that described the clinical picture of patients in that subgroup (in 43 of 78 variables, 55.13%) and similar ranges of scores (31 of 78 variables, 39.74%) for patients in the D group. Duration of hospitalization was significantly longer in group H than in group D (p=0.047). There was no statistically significant difference between the H and D subgroups in demographic characteristics. There are distinct epidemiological and clinical differences between the H and D subgroups, with more severe positive and negative symptoms and greater functional impairment in the H group. Paranoid schizophrenia patients with prominent hallucinations have poorer prognosis and need intensive therapeutic rehabilitation beginning with onset-of-illness. Further genetic studies and comparisons of fMRI and/or PET findings are warranted to investigate additional distinctive characteristics of these subgroups.

PATTERNS OF FLOWS IN AN INTERMEDIATE PROMINENCE OBSERVED BY HINODE

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ahn, Kwangsu; Chae, Jongchul; Cao Wenda

2010-09-20

The investigation of plasma flows in filaments/prominences gives us clues to understanding their magnetic structures. We studied the patterns of flows in an intermediate prominence observed by Hinode/SOT. By examining a time series of H{alpha} images and Ca II H images, we have found horizontal flows in the spine and vertical flows in the barb. Both of these flows have a characteristic speed of 10-20 km s{sup -1}. The horizontal flows displayed counterstreaming. Our detailed investigation revealed that most of the moving fragments in fact reversed direction at the end point of the spine near a footpoint close to themore » associated active region. These returning flows may be one possible explanation of the well-known counterstreaming flows in prominences. In contrast, we have found vertical flows-downward and upward-in the barb. Most of the horizontal flows in the spine seem to switch into vertical flows when they approach the barb, and vice versa. We propose that the net force resulting from a small deviation from magnetohydrostatic equilibrium, where magnetic fields are predominantly horizontal, may drive these patterns of flow. In the prominence studied here, the supposed magnetohydrostatic configuration is characterized by magnetic field lines sagging with angles of 13{sup 0} and 39{sup 0} in the spine and the barb, respectively.« less

Predicting Node Degree Centrality with the Node Prominence Profile

PubMed Central

Yang, Yang; Dong, Yuxiao; Chawla, Nitesh V.

2014-01-01

Centrality of a node measures its relative importance within a network. There are a number of applications of centrality, including inferring the influence or success of an individual in a social network, and the resulting social network dynamics. While we can compute the centrality of any node in a given network snapshot, a number of applications are also interested in knowing the potential importance of an individual in the future. However, current centrality is not necessarily an effective predictor of future centrality. While there are different measures of centrality, we focus on degree centrality in this paper. We develop a method that reconciles preferential attachment and triadic closure to capture a node's prominence profile. We show that the proposed node prominence profile method is an effective predictor of degree centrality. Notably, our analysis reveals that individuals in the early stage of evolution display a distinctive and robust signature in degree centrality trend, adequately predicted by their prominence profile. We evaluate our work across four real-world social networks. Our findings have important implications for the applications that require prediction of a node's future degree centrality, as well as the study of social network dynamics. PMID:25429797

Tense or Aspect?: Effects of L1 Tense/Aspect Prominence in L2 Acquisition

ERIC Educational Resources Information Center

Martinovic-Zic, Aida

2009-01-01

This study introduces a typological model of the "conceptual language-specific approach" to the L2 research on the acquisition of tense-aspect. The model is based on the typological notion of prominence, classifying languages into tense-prominent and aspect-prominent (Bhat 1999) and the L1 research proposal that language-specific…

Quiescent Prominence Dynamics Observed with the Hinode Solar Optical Telescope. I. Turbulent Upflow Plumes

NASA Astrophysics Data System (ADS)

Berger, Thomas E.; Slater, Gregory; Hurlburt, Neal; Shine, Richard; Tarbell, Theodore; Title, Alan; Lites, Bruce W.; Okamoto, Takenori J.; Ichimoto, Kiyoshi; Katsukawa, Yukio; Magara, Tetsuya; Suematsu, Yoshinori; Shimizu, Toshifumi

2010-06-01

Hinode/Solar Optical Telescope (SOT) observations reveal two new dynamic modes in quiescent solar prominences: large-scale (20-50 Mm) "arches" or "bubbles" that "inflate" from below into prominences, and smaller-scale (2-6 Mm) dark turbulent upflows. These novel dynamics are related in that they are always dark in visible-light spectral bands, they rise through the bright prominence emission with approximately constant speeds, and the small-scale upflows are sometimes observed to emanate from the top of the larger bubbles. Here we present detailed kinematic measurements of the small-scale turbulent upflows seen in several prominences in the SOT database. The dark upflows typically initiate vertically from 5 to 10 Mm wide dark cavities between the bottom of the prominence and the top of the chromospheric spicule layer. Small perturbations on the order of 1 Mm or less in size grow on the upper boundaries of cavities to generate plumes up to 4-6 Mm across at their largest widths. All plumes develop highly turbulent profiles, including occasional Kelvin-Helmholtz vortex "roll-up" of the leading edge. The flows typically rise 10-15 Mm before decelerating to equilibrium. We measure the flowfield characteristics with a manual tracing method and with the Nonlinear Affine Velocity Estimator (NAVE) "optical flow" code to derive velocity, acceleration, lifetime, and height data for several representative plumes. Maximum initial speeds are in the range of 20-30 km s-1, which is supersonic for a ~10,000 K plasma. The plumes decelerate in the final few Mm of their trajectories resulting in mean ascent speeds of 13-17 km s-1. Typical lifetimes range from 300 to 1000 s (~5-15 minutes). The area growth rate of the plumes (observed as two-dimensional objects in the plane of the sky) is initially linear and ranges from 20,000 to 30,000 km2 s-1 reaching maximum projected areas from 2 to 15 Mm2. Maximum contrast of the dark flows relative to the bright prominence plasma in SOT images

QUIESCENT PROMINENCE DYNAMICS OBSERVED WITH THE HINODE SOLAR OPTICAL TELESCOPE. I. TURBULENT UPFLOW PLUMES

DOE Office of Scientific and Technical Information (OSTI.GOV)

Berger, Thomas E.; Slater, Gregory; Hurlburt, Neal

2010-06-20

Hinode/Solar Optical Telescope (SOT) observations reveal two new dynamic modes in quiescent solar prominences: large-scale (20-50 Mm) 'arches' or 'bubbles' that 'inflate' from below into prominences, and smaller-scale (2-6 Mm) dark turbulent upflows. These novel dynamics are related in that they are always dark in visible-light spectral bands, they rise through the bright prominence emission with approximately constant speeds, and the small-scale upflows are sometimes observed to emanate from the top of the larger bubbles. Here we present detailed kinematic measurements of the small-scale turbulent upflows seen in several prominences in the SOT database. The dark upflows typically initiate verticallymore » from 5 to 10 Mm wide dark cavities between the bottom of the prominence and the top of the chromospheric spicule layer. Small perturbations on the order of 1 Mm or less in size grow on the upper boundaries of cavities to generate plumes up to 4-6 Mm across at their largest widths. All plumes develop highly turbulent profiles, including occasional Kelvin-Helmholtz vortex 'roll-up' of the leading edge. The flows typically rise 10-15 Mm before decelerating to equilibrium. We measure the flowfield characteristics with a manual tracing method and with the Nonlinear Affine Velocity Estimator (NAVE) 'optical flow' code to derive velocity, acceleration, lifetime, and height data for several representative plumes. Maximum initial speeds are in the range of 20-30 km s{sup -1}, which is supersonic for a {approx}10,000 K plasma. The plumes decelerate in the final few Mm of their trajectories resulting in mean ascent speeds of 13-17 km s{sup -1}. Typical lifetimes range from 300 to 1000 s ({approx}5-15 minutes). The area growth rate of the plumes (observed as two-dimensional objects in the plane of the sky) is initially linear and ranges from 20,000 to 30,000 km{sup 2} s{sup -1} reaching maximum projected areas from 2 to 15 Mm{sup 2}. Maximum contrast of the dark flows

Sarcoidosis with prominent necrosis on histopathology.

PubMed

Rosenstein, Rachel; Orme, Charisse; Kim, Randie H; Meehan, Shane A; Femia, Alisa

2016-12-15

Sarcoidosis is a multiorgan inflammatory diseasewith variable clinical presentations and the commonhistopathologic finding of noncaseating granulomas.The etiology of the disease is not known, butevidence suggests both environmental and geneticcontributions to the pathogenesis. Depending onthe severity of cutaneous disease and extent ofextracutaneous involvement, therapies range fromtopical and intralesional glucocorticoids to systemicimmunomodulatory and immunosuppressiveagents. We present the case of a patient withcutaneous sarcoidosis with prominent necrosis onhistopathologic examination in the setting of severepulmonary sarcoidosis.

Propagating Waves Transverse to the Magnetic Field in a Solar Prominence

NASA Astrophysics Data System (ADS)

Schmieder, B.; Kucera, T. A.; Knizhnik, K.; Luna, M.; Lopez-Ariste, A.; Toot, D.

2013-11-01

We report an unusual set of observations of waves in a large prominence pillar that consist of pulses propagating perpendicular to the prominence magnetic field. We observe a huge quiescent prominence with the Solar Dynamics Observatory Atmospheric Imaging Assembly in EUV on 2012 October 10 and only a part of it, the pillar, which is a foot or barb of the prominence, with the Hinode Solar Optical Telescope (SOT; in Ca II and Hα lines), Sac Peak (in Hα, Hβ, and Na-D lines), and THEMIS ("Télescope Héliographique pour l' Etude du Magnétisme et des Instabilités Solaires") with the MTR (MulTi-Raies) spectropolarimeter (in He D3 line). The THEMIS/MTR data indicates that the magnetic field in the pillar is essentially horizontal and the observations in the optical domain show a large number of horizontally aligned features on a much smaller scale than the pillar as a whole. The data are consistent with a model of cool prominence plasma trapped in the dips of horizontal field lines. The SOT and Sac Peak data over the four hour observing period show vertical oscillations appearing as wave pulses. These pulses, which include a Doppler signature, move vertically, perpendicular to the field direction, along thin quasi-vertical columns in the much broader pillar. The pulses have a velocity of propagation of about 10 km s-1, a period of about 300 s, and a wavelength around 2000 km. We interpret these waves in terms of fast magnetosonic waves and discuss possible wave drivers.

A comparison of trained and untrained vocalists on the Dysphonia Severity Index.

PubMed

Awan, Shaheen N; Ensslen, Anysia J

2010-11-01

The purposes of this study were (1) to compare trained and untrained singers on the Dysphonia Severity Index (DSI) and its component measures, and (2) to contribute to normative DSI data for trained singers. This study included 36 untrained participants (15 males and 21 females) and 30 participants (15 males and 15 females) with singing experience between the ages of 18 and 30 years. Measures of maximum phonation time (MPT), highest phonational frequency, lowest intensity, and jitter were obtained for each subject and incorporated into the previously published multivariate DSI formula. Results indicated that vocally trained subjects have significantly higher DSI scores than untrained subjects (mean DSI: 6.48 vs 4.00, respectively), with significant differences observed between trained and untrained groups for three of the four components of the DSI (F(0) high; I low; jitter). The findings of this study are consistent with previous reports that indicate significant increases in the DSI with vocal training, and with various studies that have observed increased vocal capability in trained singers versus their untrained counterparts. The results of this study indicate that alternative normative expectations for the DSI may need to be taken into account when using the DSI with patients who have participated in directed vocal training, such as choral participation and voice/singing lessons. Copyright © 2010 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

A Closer View of Prominent Rocks - 3-D

NASA Image and Video Library

1997-07-13

Many prominent rocks near the Sagan Memorial Station are featured in this image, from NASA Mars Pathfinder. Shark, Half-Dome, and Pumpkin, Flat Top and Frog are at center 3D glasses are necessary to identify surface detail.

EUV lines observed with EIS/Hinode in a solar prominence

NASA Astrophysics Data System (ADS)

Labrosse, N.; Schmieder, B.; Heinzel, P.; Watanabe, T.

2011-07-01

Context. During a multi-wavelength observation campaign with Hinode and ground-based instruments, a solar prominence was observed for three consecutive days as it crossed the western limb of the Sun in April 2007. Aims: We report on observations obtained on 26 April 2007 using EIS (Extreme ultraviolet Imaging Spectrometer) on Hinode. They are analysed to provide a qualitative diagnostic of the plasma in different parts of the prominence. Methods: After correcting for instrumental effects, the rasters at different wavelengths are presented. Several regions within the same prominence are identified for further analysis. Selected profiles for lines with formation temperatures between log (T) = 4.7 and log (T) = 6.3, as well as their integrated intensities, are given. The profiles of coronal, transition region, and He ii lines are discussed. We pay special attention to the He ii line, which is blended with coronal lines. Results: Some quantitative results are obtained by analysing the line profiles. They confirm that depression in EUV lines can be interpreted in terms of two mechanisms: absorption of coronal radiation by the hydrogen and neutral helium resonance continua, and emissivity blocking. We present estimates of the He ii line integrated intensity in different parts of the prominence according to different scenarios for the relative contribution of absorption and emissivity blocking to the coronal lines blended with the He ii line. We estimate the contribution of the He ii 256.32 Å line to the He ii raster image to vary between ~44% and 70% of the raster's total intensity in the prominence according to the different models used to take into account the blending coronal lines. The inferred integrated intensities of the He ii 256 Å line are consistent with the theoretical intensities obtained with previous 1D non-LTE radiative transfer calculations, yielding a preliminary estimate of the central temperature of 8700 K, a central pressure of 0.33 dyn cm-2, and a

Phonetic Realization and Perception of Prominence among Lexical Tones in Mandarin Chinese

ERIC Educational Resources Information Center

Bao, Mingzhen

2008-01-01

Linguistic prominence is defined as words or syllables perceived auditorily as standing out from their environment. It is explored through changes in pitch, duration and loudness. In this study, phonetic realization and perception of prominence among lexical tones in Mandarin Chinese was investigated in two experiments. Experiment 1 explored…

Reconstruction of a helical prominence in 3D from IRIS spectra and images

NASA Astrophysics Data System (ADS)

Schmieder, B.; Zapiór, M.; López Ariste, A.; Levens, P.; Labrosse, N.; Gravet, R.

2017-10-01

Context. Movies of prominences obtained by space instruments e.g. the Solar Optical Telescope (SOT) aboard the Hinode satellite and the Interface Region Imaging Spectrograph (IRIS) with high temporal and spatial resolution revealed the tremendous dynamical nature of prominences. Knots of plasma belonging to prominences appear to travel along both vertical and horizontal thread-like loops, with highly dynamical nature. Aims: The aim of the paper is to reconstruct the 3D shape of a helical prominence observed over two and a half hours by IRIS. Methods: From the IRIS Mg II k spectra we compute Doppler shifts of the plasma inside the prominence and from the slit-jaw images (SJI) we derive the transverse field in the plane of the sky. Finally we obtain the velocity vector field of the knots in 3D. Results.We reconstruct the real trajectories of nine knots travelling along ellipses. Conclusions: The spiral-like structure of the prominence observed in the plane of the sky is mainly due to the projection effect of long arches of threads (up to 8 × 104 km). Knots run along more or less horizontal threads with velocities reaching 65 km s-1. The dominant driving force is the gas pressure. Movies associated to Figs. 1, 9, 10, and 13 are available at http://www.aanda.org

Observation of the Kelvin–Helmholtz Instability in a Solar Prominence

NASA Astrophysics Data System (ADS)

Yang, Heesu; Xu, Zhi; Lim, Eun-Kyung; Kim, Sujin; Cho, Kyung-Suk; Kim, Yeon-Han; Chae, Jongchul; Cho, Kyuhyoun; Ji, Kaifan

2018-04-01

Many solar prominences end their lives in eruptions or abrupt disappearances that are associated with dynamical or thermal instabilities. Such instabilities are important because they may be responsible for energy transport and conversion. We present a clear observation of a streaming kink-mode Kelvin–Helmholtz Instability (KHI) taking place in a solar prominence using the Hα Lyot filter installed at the New Vacuum Solar Telescope, Fuxian-lake Solar Observatory in Yunnan, China. On one side of the prominence, a series of plasma blobs floated up from the chromosphere and streamed parallel to the limb. The plasma stream was accelerated to about 20–60 km s‑1 and then undulated. We found that 2″- and 5″-size vortices formed, floated along the stream, and then broke up. After the 5″-size vortex, a plasma ejection out of the stream was detected in the Solar Dynamics Observatory/Atmospheric Imaging Assembly images. Just before the formation of the 5″-size vortex, the stream displayed an oscillatory transverse motion with a period of 255 s with the amplitude growing at the rate of 0.001 s‑1. We attribute this oscillation of the stream and the subsequent formation of the vortex to the KHI triggered by velocity shear between the stream, guided by the magnetic field and the surrounding media. The plasma ejection suggests the transport of prominence material into the upper layer by the KHI in its nonlinear stage.

Joint SDO and IRIS Observations of a Novel, Hybrid Prominence-Coronal Rain Complex

NASA Astrophysics Data System (ADS)

Liu, Wei; Antolin, Patrick; Sun, Xudong; Gao, Lijia; Vial, Jean-Claude; Gibson, Sarah; Okamoto, Takenori; Berger, Thomas; Uitenbroek, Han; De Pontieu, Bart

2016-10-01

Solar prominences and coronal rain are intimately related phenomena, both involving cool material at chromospheric temperatures within the hot corona and both playing important roles as part of the return flow of the chromosphere-corona mass cycle. At the same time, they exhibit distinct morphologies and dynamics not yet well understood. Quiescent prominences consist of numerous long-lasting, filamentary downflow threads, while coronal rain is more transient and falls comparably faster along well-defined curved paths. We report here a novel, hybrid prominence-coronal rain complex in an arcade-fan geometry observed by SDO/AIA and IRIS, which provides new insights to the underlying physics of such contrasting behaviors. We found that the supra-arcade fan region hosts a prominence sheet consisting of meandering threads with broad line widths. As the prominence material descends to the arcade, it turns into coronal rain sliding down coronal loops with line widths 2-3 times narrower. This contrast suggests that distinct local plasma and magnetic conditions determine the fate of the cool material, a scenario supported by our magnetic field extrapolations from SDO/HMI. Specifically, the supra-arcade fan (similar to those in solar flares; e.g., McKenzie 2013) is likely situated in a current sheet, where the magnetic field is weak and the plasma-beta could be close to unity, thus favoring turbulent flows like those prominence threads. In contrast, the underlying arcade has a stronger magnetic field and most likely a low-beta environment, such that the material is guided along magnetic field lines to appear as coronal rain. We will discuss the physical implications of these observations beyond prominence and coronal rain.

Prominence plasma and magnetic field structure - A coordinated observation with IRIS, Hinode and THEMIS

NASA Astrophysics Data System (ADS)

Schmieder, Brigitte; Labrosse, Nicolas; Levens, Peter; Lopez Ariste, Arturo

2016-07-01

During an international campaign in 2014, utilising both space-based (IRIS and Hinode) and ground-based (THEMIS) instruments, we focused on observing prominences. We compare IRIS observations with those of Hinode (EIS and SOT) in order to build a more complete picture of the prominence structure for a quiescent prominence observed on 15 July 2014, identified to have tornado-like structure. THEMIS provides valuable information on the orientation and strength of the internal magnetic field. Here we find there is almost ubiquitously horizontal field with respect to the local limb, with possibly a turbulent component. The Mg II lines form the majority of our IRIS analysis, with a mixture of reversed and non-reversed profiles present in the prominence spectra. Comparing the differences between the Mg II data from IRIS and the Ca II images from Hinode/SOT provides an intriguing insight into the prominence legs in these channels. We present plasma diagnostics from IRIS, with line of sight velocities of around 10 km/s in either direction along the magnetic loops of material in the front of the prominence, and line widths comparable to those found for prominences by previous authors (e.g. Schmieder et al. 2014). We also take a look into the lines formed at higher, coronal plasma temperatures, as seen by Hinode/EIS, to compare plasma structures at a full range of temperatures.

The prominent antihelix and helix--the myth of the 'overcorrected' ear in otoplasty.

PubMed

Shokrollahi, Kayvan; Manning, Steven; Sadri, Amir; Molajo, Adeyinka; Lineaweaver, William

2015-06-01

Classic teaching of ear anatomy in the context of otoplasty states that if the antihelical fold is more prominent than the helical fold after surgery then the ear is "overcorrected." We set out to explore the role of the antihelix in normal ear anatomy, its relevance to aesthetic perceptions of the ear, and a snapshot of its incidence in nonoperated ears. To readily identify junior staff in our department, their color photographs, names, and contact details are posted on every ward. Using digital methods, we cropped the left ear out of the source images, making them unidentifiable. Clinical and nonclinical staff in our unit were asked to choose their favorite and their least favorite ears based on their aesthetic appeal. Responses were tabulated and the 2 most popular ears were compared. The preferred ear did not conform to the traditional dogma because it had a prominent antihelix and was statistically significant when compared to other choices. We also noted that a prominent antihelix is common among the general population and among colleagues within the department, and hence "normal." Also interesting was that the helix of the ear chosen as the most aesthetic was also the ear where the helix was almost touching the side of the head. We found that when judging the aesthetic nature of the "virgin" ear, antihelical fold prominence did not appear to be a negative attribute. Indeed, we noted that a prominent antihelix was a common attribute, and we conclude that this was a normal variant without undue negative aesthetic stigma. A surgically corrected ear should not necessarily be regarded as a poor outcome simply on the basis of antihelical prominence. Furthermore, we postulate that patients who have a prominent antihelix might be part of a spectrum of individuals who might have had the subtype of prominent ears featuring a deep conchal bowl. Finally, although not tested directly, it appears that we do not have an idea of our own ear shape, as none of the

Dynamics of quiescent prominences; Proceedings of the 117th Colloquium of IAU, Hvar, Yugoslavia, Sept. 25-29, 1989

NASA Technical Reports Server (NTRS)

Ruzdjak, Vladimir (Editor); Tandberg-Hanssen, Einar (Editor)

1990-01-01

Topics discussed include formation of a filament around a magnetic region, evolution of fine structures in a filament, the spatial distribution of prominence threads, high resolution analysis of quiescent prominences at NSO/Sacramento Peak Observatory, small-scale Doppler velocities in a quiescent prominence, Doppler velocity oscillations in quiescent prominences, oscillatory relaxation of an eruptive prominence, and matter flow velocities in an active region emission loop observed in H-alpha. Attention is also given to an automated procedure for measurement of prominence transverse velocities, the nonlinear evolution of magnetized filaments, thermal equilibrium of coronal loops and prominence formation, thermal instability in planar coronal strucutres, radiative transfer in cylindrical prominence threads, numerical simulation of a catastrophe model for prominence eruptions, and the law of evolution and destruction of solar prominences.

Prominence and tornado dynamics observed with IRIS and THEMIS

NASA Astrophysics Data System (ADS)

Schmieder, Brigitte; Levens, Peter; Labrosse, Nicolas; Mein, Pierre; Lopez Ariste, Arturo; Zapior, Maciek

2017-08-01

Several prominences were observed during campaigns in September 2013 and July 2014 with the IRIS spectrometer and the vector magnetograph THEMIS (Tenerife). SDO/AIA and IRIS provided images and spectra of prominences and tornadoes corresponding to different physical conditions of the transition region between the cool plasma and the corona. The vector magnetic field was derived from THEMIS observations by using the He D3 depolarisation due to the magnetic field. The inversion code (PCA) takes into account the Hanle and Zeeman effects and allows us to compute the strength and the inclination of the magnetic field which is shown to be mostly horizontal in prominences as well as in tornadoes. Movies from SDO/AIA in 304 A and Hinode/SOT in Ca II show the highly dynamic nature of the fine structures. From spectra in Mg II and Si IV lines provided by IRIS and H-alpha observed by the Multi-channel Subtractive Double Pass (MSDP) spectrograph in the Meudon Solar Tower we derived the Doppler shifts of the fine structures and reconstructed the 3D structure of tornadoes. We conclude that the apparent rotation of AIA tornadoes is due to large-scale quasi-periodic oscillations of the plasma along more or less horizontal magnetic structures.

PROPAGATING WAVES TRANSVERSE TO THE MAGNETIC FIELD IN A SOLAR PROMINENCE

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schmieder, B.; Kucera, T. A.; Knizhnik, K.

2013-11-10

We report an unusual set of observations of waves in a large prominence pillar that consist of pulses propagating perpendicular to the prominence magnetic field. We observe a huge quiescent prominence with the Solar Dynamics Observatory Atmospheric Imaging Assembly in EUV on 2012 October 10 and only a part of it, the pillar, which is a foot or barb of the prominence, with the Hinode Solar Optical Telescope (SOT; in Ca II and Hα lines), Sac Peak (in Hα, Hβ, and Na-D lines), and THEMIS ({sup T}élescope Héliographique pour l' Etude du Magnétisme et des Instabilités Solaires{sup )} with themore » MTR (MulTi-Raies) spectropolarimeter (in He D{sub 3} line). The THEMIS/MTR data indicates that the magnetic field in the pillar is essentially horizontal and the observations in the optical domain show a large number of horizontally aligned features on a much smaller scale than the pillar as a whole. The data are consistent with a model of cool prominence plasma trapped in the dips of horizontal field lines. The SOT and Sac Peak data over the four hour observing period show vertical oscillations appearing as wave pulses. These pulses, which include a Doppler signature, move vertically, perpendicular to the field direction, along thin quasi-vertical columns in the much broader pillar. The pulses have a velocity of propagation of about 10 km s{sup –1}, a period of about 300 s, and a wavelength around 2000 km. We interpret these waves in terms of fast magnetosonic waves and discuss possible wave drivers.« less

Indications of stellar prominence oscillations on fast rotating stars: the cases of HK Aqr and PZ Tel

NASA Astrophysics Data System (ADS)

Leitzinger, M.; Odert, P.; Zaqarashvili, T. V.; Greimel, R.; Hanslmeier, A.; Lammer, H.

2016-11-01

We present the analysis of six nights of spectroscopic monitoring of two young and fast rotating late-type stars, namely the dMe star HK Aqr and the dG/dK star PZ Tel. On both stars, we detect absorption features reminiscent of signatures of corotating cool clouds or prominences visible in Hα. Several prominences on HK Aqr show periodic variability in the prominence tracks which follow a sinusoidal motion (indication of prominence oscillations). On PZ Tel, we could not find any periodic variability in the prominence tracks. By fitting sinusoidal functions to the prominence tracks, we derive amplitudes and periods which are similar to those of large-amplitude oscillations seen in solar prominences. In one specific event, we also derive a periodic variation of the prominence track in the Hβ spectral line which shows an anti-phase variation with the one derived for the Hα spectral line. Using these parameters and estimated mass density of a prominence on HK Aqr, we derive a minimum magnetic field strength of ˜2 G. The relatively low strength of the magnetic field is explained by the large height of this stellar prominence (≥ 0.67 stellar radii above the surface).

DYNAMICS OF A PROMINENCE-HORN STRUCTURE DURING ITS EVAPORATION IN THE SOLAR CORONA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Bing; Chen, Yao; Fu, Jie

The physical connections among and formation mechanisms of various components of the prominence-horn cavity system remain elusive. Here we present observations of such a system, focusing on a section of the prominence that rises and separates gradually from the main body. This forms a configuration sufficiently simple to yield clues regarding the above issues. It is characterized by embedding horns, oscillations, and a gradual disappearance of the separated material. The prominence-horn structure exhibits a large-amplitude longitudinal oscillation with a period of ∼150 minutes and an amplitude of ∼30 Mm along the trajectory defined by the concave horn structure. The hornsmore » also experience a simultaneous transverse oscillation with a much smaller amplitude (∼3 Mm) and a shorter period (∼10–15 minutes), likely representative of a global mode of the large-scale magnetic structure. The gradual disappearance of the structure indicates that the horn, an observational manifestation of the field-aligned transition region separating the cool and dense prominence from the hot and tenuous corona, is formed due to the heating and diluting process of the central prominence mass; most previous studies suggested that it is the opposite process, i.e., the cooling and condensation of coronal plasmas, that formed the horn. This study also demonstrates how the prominence transports magnetic flux to the upper corona, a process essential for the gradual build-up of pre-eruption magnetic energy.« less

Social Prominence and the Heterogeneity of Rejected Status in Late Elementary School

ERIC Educational Resources Information Center

Farmer, Thomas W.; Hall, Cristin M.; Leung, Man-Chi; Estell, David B.; Brooks, Debra

2011-01-01

The heterogeneity of peer rejection was examined as a function of social prominence in fifth grade classrooms. From an overall sample of 3,891 (1,931 girls) students, 721 youth (424 boys) were identified with rejected status. Social prominence was determined from the aggregation of peer nominations for "leader", "athletic", "cool", and "popular".…

Are Giant Tornadoes the Legs of Solar Prominences?

NASA Astrophysics Data System (ADS)

Wedemeyer, Sven; Scullion, Eamon; Rouppe van der Voort, Luc; Bosnjak, Antonija; Antolin, Patrick

2013-09-01

Observations in the 171 Å channel of the Atmospheric Imaging Assembly of the space-borne Solar Dynamics Observatory show tornado-like features in the atmosphere of the Sun. These giant tornadoes appear as dark, elongated, and apparently rotating structures in front of a brighter background. This phenomenon is thought to be produced by rotating magnetic field structures that extend throughout the atmosphere. We characterize giant tornadoes through a statistical analysis of properties such as spatial distribution, lifetimes, and sizes. A total number of 201 giant tornadoes are detected in a period of 25 days, suggesting that, on average, about 30 events are present across the whole Sun at a time close to solar maximum. Most tornadoes appear in groups and seem to form the legs of prominences, thus serving as plasma sources/sinks. Additional Hα observations with the Swedish 1 m Solar Telescope imply that giant tornadoes rotate as a structure, although they clearly exhibit a thread-like structure. We observe tornado groups that grow prior to the eruption of the connected prominence. The rotation of the tornadoes may progressively twist the magnetic structure of the prominence until it becomes unstable and erupts. Finally, we investigate the potential relation of giant tornadoes to other phenomena, which may also be produced by rotating magnetic field structures. A comparison to cyclones, magnetic tornadoes, and spicules implies that such events are more abundant and short-lived the smaller they are. This comparison might help to construct a power law for the effective atmospheric heating contribution as a function of spatial scale.

Morphology Of A Hot Prominence Cavity Observed with Hinode/XRT and SDO/AIA

NASA Technical Reports Server (NTRS)

Weber, Mark A.; Reeves, K. K.; Gibson, S. E.; Kucera, T. A.

2012-01-01

Prominence cavities appear as circularly shaped voids in coronal emission over polarity inversion lines where a prominence channel is straddling the solar limb. The presence of chromospheric material suspended at coronal altitudes is a common but not necessary feature within these cavities. These voids are observed to change shape as a prominence feature rotates around the limb. We use a morphological model projected in cross-sections to fit the cavity emission in Hinode/XRT passbands, and then apply temperature diagnostics to XRT and SDO/AIA data to investigate the thermal structure. We find significant evidence that the prominence cavity is hotter than the corona immediately outside the cavity boundary. This investigation follows upon "Thermal Properties of A Solar Coronal Cavity Observed with the X-ray Telescope on Hinode" by Reeves et al., 2012, ApJ, in press.

Inhomogeneity and velocity fields effects on scattering polarization in solar prominences

NASA Astrophysics Data System (ADS)

Milić, I.; Faurobert, M.

2015-10-01

One of the methods for diagnosing vector magnetic fields in solar prominences is the so called "inversion" of observed polarized spectral lines. This inversion usually assumes a fairly simple generative model and in this contribution we aim to study the possible systematic errors that are introduced by this assumption. On two-dimensional toy model of a prominence, we first demonstrate importance of multidimensional radiative transfer and horizontal inhomogeneities. These are able to induce a significant level of polarization in Stokes U, without the need for the magnetic field. We then compute emergent Stokes spectrum from a prominence which is pervaded by the vector magnetic field and use a simple, one-dimensional model to interpret these synthetic observations. We find that inferred values for the magnetic field vector generally differ from the original ones. Most importantly, the magnetic field might seem more inclined than it really is.

Liking goes with liking: An intuitive congruence between preference and prominence.

PubMed

Morvinski, Coby; Amir, On

2018-03-26

In a series of 8 experiments, we demonstrate the existence of a "labeling effect" wherein people intuitively relate preferred choices to prominently labeled cues (such as heads as opposed to tails in a coin toss) and vice versa. Importantly, the observed congruence is asymmetric-it does not manifest for nonprominent cues and nonpreferred choices. This is because the congruence is driven by a process of evaluative matching: prominent cues are liked, but nonprominent cues are neutral or at most slightly negative in contrast. When we test prominent, yet truly negatively labeled cues, we indeed find a matching with less liked products. We discuss the theoretical contributions to the study of preferences and decision making, as well as demonstrate the practical implications to researchers and practitioners by using this process to assess intuitive preferences and reduce the compromise effect. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Autosomal-dominant GTPCH1-deficient DRD: clinical characteristics and long-term outcome of 34 patients.

PubMed

Trender-Gerhard, I; Sweeney, M G; Schwingenschuh, P; Mir, P; Edwards, M J; Gerhard, A; Polke, J M; Hanna, M G; Davis, M B; Wood, N W; Bhatia, K P

2009-08-01

An autosomal dominantly inherited defect in the GCH1 gene that encodes guanosine triphosphate cyclohydrolase 1 (GTPCH1) is the most common cause of dopa-responsive dystonia (DRD). A classic phenotype of young-onset lower-limb dystonia, diurnal fluctuations and excellent response to levodopa has been well recognised in association with GCH1 mutations, and rare atypical presentations have been reported. However, a number of clinical issues remain unresolved including phenotypic variability, long-term response to levodopa and associated non-motor symptoms, and there are limited data on long-term follow-up of genetically proven cases. A detailed clinical evaluation of 34 patients (19 women, 15 men), with confirmed mutations in the GCH1 gene, is presented. The classic phenotype was most frequent (n = 23), with female predominance (F:M = 16:7), and early onset (mean 4.5 years) with involvement of legs. However, a surprisingly large number of patients developed craniocervical dystonia, with spasmodic dysphonia being the predominant symptom in two subjects. A subset of patients, mainly men, presented with either a young-onset (mean 6.8 years) mild DRD variant not requiring treatment (n = 4), or with an adult-onset (mean 37 years) Parkinson disease-like phenotype (n = 4). Two siblings were severely affected with early hypotonia and delay in motor development, associated with compound heterozygous GCH1 gene mutations. The study also describes a number of supplementary features including restless-legs-like symptoms, influence of female sex hormones, predominance of tremor or parkinsonism in adult-onset cases, initial reverse reaction to levodopa, recurrent episodes of depressive disorder and specific levodopa-resistant symptoms (writer's cramp, dysphonia, truncal dystonia). Levodopa was used effectively and safely in 20 pregnancies, and did not cause any fetal abnormalities.

The prominence-corona interface and its relationship to the chromosphere-corona transition

NASA Technical Reports Server (NTRS)

Rabin, Douglas

1986-01-01

The classical model of the chromosphere-corona transition does not account for the observed behavior of the differential emission measure for T approx. less than 100,000 K. Several models have been proposed to resolve this discrepancy in physically different ways. Because the observed differential emission measure at the prominence-corona interface is on average nearly the same as in the chromosphere-corona transition, prominences offer a fresh testing ground for models tailored to the chromosphere-corona transition. The researcher considered three such models and concluded that none extends in a natural way to the environment of prominences. The researcher advanced a simple idea involving thermal conduction both along and across the magnetic field from the corona into cool threads.

Quiescent and Eruptive Prominences at Solar Minimum: A Statistical Study via an Automated Tracking System

NASA Astrophysics Data System (ADS)

Loboda, I. P.; Bogachev, S. A.

2015-07-01

We employ an automated detection algorithm to perform a global study of solar prominence characteristics. We process four months of TESIS observations in the He II 304Å line taken close to the solar minimum of 2008-2009 and mainly focus on quiescent and quiescent-eruptive prominences. We detect a total of 389 individual features ranging from 25×25 to 150×500 Mm2 in size and obtain distributions of many of their spatial characteristics, such as latitudinal position, height, size, and shape. To study their dynamics, we classify prominences as either stable or eruptive and calculate their average centroid velocities, which are found to rarely exceed 3 km/s. In addition, we give rough estimates of mass and gravitational energy for every detected prominence and use these values to estimate the total mass and gravitational energy of all simultaneously existing prominences (1012 - 1014 kg and 1029 - 1031 erg). Finally, we investigate the form of the gravitational energy spectrum of prominences and derive it to be a power-law of index -1.1 ± 0.2.

Heating of an Erupting Prominence Associated with a Solar Coronal Mass Ejection on 2012 January 27

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, Jin-Yi; Moon, Yong-Jae; Kim, Kap-Sung

2017-07-20

We investigate the heating of an erupting prominence and loops associated with a coronal mass ejection and X-class flare. The prominence is seen as absorption in EUV at the beginning of its eruption. Later, the prominence changes to emission, which indicates heating of the erupting plasma. We find the densities of the erupting prominence using the absorption properties of hydrogen and helium in different passbands. We estimate the temperatures and densities of the erupting prominence and loops seen as emission features using the differential emission measure method, which uses both EUV and X-ray observations from the Atmospheric Imaging Assembly onmore » board the Solar Dynamics Observatory and the X-ray Telescope on board Hinode . We consider synthetic spectra using both photospheric and coronal abundances in these calculations. We verify the methods for the estimation of temperatures and densities for the erupting plasmas. Then, we estimate the thermal, kinetic, radiative loss, thermal conduction, and heating energies of the erupting prominence and loops. We find that the heating of the erupting prominence and loop occurs strongly at early times in the eruption. This event shows a writhing motion of the erupting prominence, which may indicate a hot flux rope heated by thermal energy release during magnetic reconnection.« less

Observations of apparent superslow wave propagation in solar prominences

NASA Astrophysics Data System (ADS)

Raes, J. O.; Van Doorsselaere, T.; Baes, M.; Wright, A. N.

2017-06-01

Context. Phase mixing of standing continuum Alfvén waves and/or continuum slow waves in atmospheric magnetic structures such as coronal arcades can create the apparent effect of a wave propagating across the magnetic field. Aims: We observe a prominence with SDO/AIA on 2015 March 15 and find the presence of oscillatory motion. We aim to demonstrate that interpreting this motion as a magneto hydrodynamic (MHD) wave is faulty. We also connect the decrease of the apparent velocity over time with the phase mixing process, which depends on the curvature of the magnetic field lines. Methods: By measuring the displacement of the prominence at different heights to calculate the apparent velocity, we show that the propagation slows down over time, in accordance with the theoretical work of Kaneko et al. We also show that this propagation speed drops below what is to be expected for even slow MHD waves for those circumstances. We use a modified Kippenhahn-Schlüter prominence model to calculate the curvature of the magnetic field and fit our observations accordingly. Results: Measuring three of the apparent waves, we get apparent velocities of 14, 8, and 4 km s-1. Fitting a simple model for the magnetic field configuration, we obtain that the filament is located 103 Mm below the magnetic centre. We also obtain that the scale of the magnetic field strength in the vertical direction plays no role in the concept of apparent superslow waves and that the moment of excitation of the waves happened roughly one oscillation period before the end of the eruption that excited the oscillation. Conclusions: Some of the observed phase velocities are lower than expected for slow modes for the circumstances, showing that they rather fit with the concept of apparent superslow propagation. A fit with our magnetic field model allows for inferring the magnetic geometry of the prominence. The movie attached to Fig. 1 is available at http://www.aanda.org

Simultaneous Transverse and Longitudinal Oscillations in a Quiescent Prominence Triggered by a Coronal Jet

NASA Astrophysics Data System (ADS)

Zhang, Q. M.; Li, D.; Ning, Z. J.

2017-12-01

In this paper, we report our multiwavelength observations of the simultaneous transverse and longitudinal oscillations in a quiescent prominence. The prominence was observed by the Global Oscillation Network Group and by the Atmospheric Imaging Assembly on board the Solar Dynamics Observatory on 2015 June 29. A GOES C2.4 flare took place in NOAA active region 12373, which was associated with a pair of short ribbons and a remote ribbon. During the impulsive phase of the flare, a coronal jet spurted out of the primary flare site and propagated in the northwest direction at an apparent speed of ∼224 km s‑1. Part of the jet stopped near the remote ribbon. The remaining part continued moving forward before stopping to the east of the prominence. Once the jet encountered the prominence, it pushed the prominence to oscillate periodically. The transverse oscillation of the eastern part (EP) of prominence can be divided into two phases. In phase I, the initial amplitude, velocity, period, and damping timescale are ∼4.5 Mm, ∼20 km s‑1, ∼25 minutes, and ∼7.5 hr, respectively. The oscillation lasted for two cycles. In phase II, the initial amplitude increases to ∼11.3 Mm, while the initial velocity halves to ∼10 km s‑1. The period increases by a factor of ∼3.5. With a damping timescale of ∼4.4 hr, the oscillation lasted for about three cycles. The western part of prominence also experienced transverse oscillation. The initial amplitude is only ∼2 Mm and the velocity is less than 10 km s‑1. The period (∼27 minutes) is slightly longer than that of the EP in phase I. The oscillation lasted for about four cycles with the shortest damping timescale (∼1.7 hr). To the east of prominence, a handful of horizontal threads experienced longitudinal oscillation. The initial amplitude, velocity, period, and damping timescale are ∼52 Mm, ∼50 km s‑1, ∼99 minutes, and 2.5 hr, respectively. To our knowledge, this is the first report of simultaneous

ARE GIANT TORNADOES THE LEGS OF SOLAR PROMINENCES?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wedemeyer, Sven; Scullion, Eamon; Rouppe van der Voort, Luc

Observations in the 171 A channel of the Atmospheric Imaging Assembly of the space-borne Solar Dynamics Observatory show tornado-like features in the atmosphere of the Sun. These giant tornadoes appear as dark, elongated, and apparently rotating structures in front of a brighter background. This phenomenon is thought to be produced by rotating magnetic field structures that extend throughout the atmosphere. We characterize giant tornadoes through a statistical analysis of properties such as spatial distribution, lifetimes, and sizes. A total number of 201 giant tornadoes are detected in a period of 25 days, suggesting that, on average, about 30 events aremore » present across the whole Sun at a time close to solar maximum. Most tornadoes appear in groups and seem to form the legs of prominences, thus serving as plasma sources/sinks. Additional H{alpha} observations with the Swedish 1 m Solar Telescope imply that giant tornadoes rotate as a structure, although they clearly exhibit a thread-like structure. We observe tornado groups that grow prior to the eruption of the connected prominence. The rotation of the tornadoes may progressively twist the magnetic structure of the prominence until it becomes unstable and erupts. Finally, we investigate the potential relation of giant tornadoes to other phenomena, which may also be produced by rotating magnetic field structures. A comparison to cyclones, magnetic tornadoes, and spicules implies that such events are more abundant and short-lived the smaller they are. This comparison might help to construct a power law for the effective atmospheric heating contribution as a function of spatial scale.« less

Formation and Evolution of a Multi-Threaded Prominence

NASA Technical Reports Server (NTRS)

Luna, M.; Karpen, J. T.; DeVore, C. R.

2012-01-01

We investigate the process of formation and subsequent evolution of prominence plasma in a filament channel and its overlying arcade. We construct a three-dimensional time-dependent model of a filament-channel prominence suitable to be compared with observations. We combine this magnetic field structure with one-dimensional independent simulations of many flux tubes. The magnetic structure is a three-dimensional sheared double arcade, and the thermal non-equilibrium process governs the plasma evolution. We have found that the condensations in the corona can be divided into two populations: threads and blobs. Threads are massive condensations that linger in the field line dips. Blobs are ubiquitous small condensations that are produced throughout the filament and overlying arcade magnetic structure, and rapidly fall to the chromosphere. The total prominence mass is in agreement with observations. The threads are the principal contributors to the total mass, whereas the blob contribution is small. The motion of the threads is basically horizontal, while blobs move in all directions along the field. The peak velocities for both populations are comparable, but there is a weak tendency for the velocity to increase with the inclination, and the blobs with motion near vertical have the largest values of the velocity. We have generated synthetic images of the whole structure in an H proxy and in two EUV channels of the AIA instrument aboard SDO. These images show the plasma at cool, warm and hot temperatures. The theoretical differential emission measure of our system agrees very well with observations in the temperature range log T = 4.6-5.7. We conclude that the sheared-arcade magnetic structure and plasma dynamics fit well the abundant observational evidence.

Improvement of Vocal Pathologies Diagnosis Using High-Speed Videolaryngoscopy

PubMed Central

Tsuji, Domingos Hiroshi; Hachiya, Adriana; Dajer, Maria Eugenia; Ishikawa, Camila Cristina; Takahashi, Marystella Tomoe; Montagnoli, Arlindo Neto

2014-01-01

Introduction The study of the dynamic properties of vocal fold vibration is important for understanding the vocal production mechanism and the impact of organic and functional changes. The advent of high-speed videolaryngoscopy (HSV) has provided the possibility of seeing the real cycle of vocal fold vibration in detail through high sampling rate of successive frames and adequate spatial resolution. Objective To describe the technique, advantages, and limitations of using HSV and digital videokymography in the diagnosis of vocal pathologies. Methods We used HSV and digital videokymography to evaluate one normophonic individual and four patients with vocal fold pathologies (nodules, unilateral paralysis of the left vocal fold, intracordal cyst, and adductor spasmodic dysphonia). The vocal fold vibration parameters (glottic closure, vibrational symmetry, periodicity, mucosal wave, amplitude, and glottal cycle phases) were assessed. Results Differences in the vocal vibration parameters were observed and correlated with the pathophysiology. Conclusion HSV is the latest diagnostic tool in visual examination of vocal behavior and has considerable potential to refine our knowledge regarding the vocal fold vibration and voice production, as well as regarding the impact of pathologic conditions have on the mechanism of phonation. PMID:25992109

A qualitative study of interference with communicative participation across communication disorders in adults.

PubMed

Baylor, Carolyn; Burns, Michael; Eadie, Tanya; Britton, Deanna; Yorkston, Kathryn

2011-11-01

To explore the similarities and differences in self-reported restrictions in communicative participation across different communication disorders in community-dwelling adults. Interviews were conducted with 44 adults representing 7 different medical conditions: spasmodic dysphonia, multiple sclerosis, stroke, stuttering, Parkinson's disease, amyotrophic lateral sclerosis, and laryngectomy. This article represents a secondary analysis of qualitative data collected in cognitive interviews during development of the Communicative Participation Item Bank. The data were analyzed to identify themes in participants' experiences related to communicative participation. Participants described many situations in which they experienced interference in communicative participation. Two themes emerged from the data. The first theme was Interference is both "functional" and "emotional," in which participants defined interference as limitations in accomplishing tasks and emotional consequences. The second theme was "It depends"-sources of interference, in which participants described many variables that contribute to interference in participation. Participants had limited control of some variables such as symptoms and environmental contexts, but personal decisions and priorities also influenced participation. Despite different impairments and activity limitations, participants described similar communicative participation restrictions. These similarities may have theoretical and clinical implications in terms of how we assess, treat, and study the participation restrictions associated with communication disorders.

The Causal Ordering of Prominence and Salience in Identity Theory: An Empirical Examination

PubMed Central

Brenner, Philip S.; Serpe, Richard T.; Stryker, Sheldon

2016-01-01

Identity theory invokes two distinct but related concepts, identity salience and prominence, to explain how the organization of identities that make up the self impacts the probability that a given identity is situationally enacted. However, much extant research has failed to clearly distinguish between salience and prominence, and their empirical relationship has not been adequately investigated, impeding a solid understanding of the significance and role of each in a general theory of the self. This study examines their causal ordering using three waves of panel data from 48 universities focusing on respondents’ identities as science students. Analyses strongly support a causal ordering from prominence to salience. We provide theoretical and empirical grounds to justify this ordering while acknowledging potential variation in its strength across identities. Finally, we offer recommendations about the use of prominence and salience when measures of one or both are available or when analyses use cross-sectional data. PMID:27284212

HELICAL MOTIONS OF FINE-STRUCTURE PROMINENCE THREADS OBSERVED BY HINODE AND IRIS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Okamoto, Takenori J.; Liu, Wei; Tsuneta, Saku, E-mail: joten.okamoto@nao.ac.jp

Fine-structure dynamics in solar prominences holds critical clues to understanding their physical nature of significant space-weather implications. We report evidence of rotational motions of horizontal helical threads in two active-region prominences observed by the Hinode and/or Interface Region Imaging Spectrograph satellites at high resolution. In the first event, we found transverse motions of brightening threads at speeds up to 55 km s{sup -1} seen in the plane of the sky. Such motions appeared as sinusoidal space–time trajectories with a typical period of ∼390 s, which is consistent with plane-of-sky projections of rotational motions. Phase delays at different locations suggest themore » propagation of twists along the threads at phase speeds of 90–270 km s{sup -1}. At least 15 episodes of such motions occurred in two days, none associated with an eruption. For these episodes, the plane-of-sky speed is linearly correlated with the vertical travel distance, suggestive of a constant angular speed. In the second event, we found Doppler velocities of 30–40 km s{sup -1} in opposite directions in the top and bottom portions of the prominence, comparable to the plane-of-sky speed. The moving threads have about twice broader line widths than stationary threads. These observations, when taken together, provide strong evidence for rotations of helical prominence threads, which were likely driven by unwinding twists triggered by magnetic reconnection between twisted prominence magnetic fields and ambient coronal fields.« less

ERRATUM: Propagating Waves Transverse to the Magnetic Field in a Solar Prominence

NASA Technical Reports Server (NTRS)

Schmieder, B.; Kucera, T. A.; Knizhnik, K.; Luna, M.; Lopez-Ariste, A.; Toot, D.

2014-01-01

We report an unusual set of observations of waves in a large prominence pillar that consist of pulses propagating perpendicular to the prominence magnetic field. We observe a huge quiescent prominence with the Solar Dynamics Observatory Atmospheric Imaging Assembly in EUV on 2012 October 10 and only a part of it, the pillar, which is a foot or barb of the prominence, with the Hinode Solar Optical Telescope (SOT; in Ca II and Halpha lines), Sac Peak (in Ha, Hß, and Na-D lines), and THEMIS ("Télescope Héliographique pour l' Etude du Magnétisme et des Instabilités Solaires") with the MTR (MulTi-Raies) spectropolarimeter (in He D3 line). The THEMIS/MTR data indicates that the magnetic field in the pillar is essentially horizontal and the observations in the optical domain show a large number of horizontally aligned features on a much smaller scale than the pillar as a whole. The data are consistent with a model of cool prominence plasma trapped in the dips of horizontal field lines. The SOT and Sac Peak data over the four hour observing period show vertical oscillations appearing as wave pulses. These pulses, which include a Doppler signature, move vertically, perpendicular to the field direction, along thin quasi-vertical columns in the much broader pillar. The pulses have a velocity of propagation of about 10 km/s, a period of about 300 s, and a wavelength around 2000 km. We interpret these waves in terms of fast magnetosonic waves and discuss possible wave drivers.

The Fate of Cool Material in the Hot Corona: Solar Prominences and Coronal Rain

NASA Astrophysics Data System (ADS)

Liu, Wei; Antolin, Patrick; Sun, Xudong; Vial, Jean-Claude; Berger, Thomas

2017-08-01

As an important chain of the chromosphere-corona mass cycle, some of the million-degree hot coronal mass undergoes a radiative cooling instability and condenses into material at chromospheric or transition-region temperatures in two distinct forms - prominences and coronal rain (some of which eventually falls back to the chromosphere). A quiescent prominence usually consists of numerous long-lasting, filamentary downflow threads, while coronal rain consists of transient mass blobs falling at comparably higher speeds along well-defined paths. It remains puzzling why such material of similar temperatures exhibit contrasting morphologies and behaviors. We report recent SDO/AIA and IRIS observations that suggest different magnetic environments being responsible for such distinctions. Specifically, in a hybrid prominence-coronal rain complex structure, we found that the prominence material is formed and resides near magnetic null points that favor the radiative cooling process and provide possibly a high plasma-beta environment suitable for the existence of meandering prominence threads. As the cool material descends, it turns into coronal rain tied onto low-lying coronal loops in a likely low-beta environment. Such structures resemble to certain extent the so-called coronal spiders or cloud prominences, but the observations reported here provide critical new insights. We will discuss the broad physical implications of these observations for fundamental questions, such as coronal heating and beyond (e.g., in astrophysical and/or laboratory plasma environments).

Conditions for the formation of prominences as inferred from optical observations

NASA Technical Reports Server (NTRS)

Martin, Sara F.

1990-01-01

It is suggested that three conditions, if dynamically maintained for a sufficient period of time, will result in the formation of a solar prominence. These conditions are the presence of a coronal arcade that connects the magnetic fields on opposite sides of a prominence; the existence of a long-term (hours to days) converging flow of small patches of opposite-polarity magnetic flux toward a common-polarity inversion zone; and the cancellation of encountered patches of magnetic flux of opposite polarity at a photospheric polarity inversion boundary.

Formation, levitation, and stability of prominences in the magnetized solar atmosphere

NASA Technical Reports Server (NTRS)

Drake, J. F.; Mok, Y.; Van Hoven, G.

1993-01-01

The dynamic formation of prominences in the initial magnetothermal equilibrium and their stability to sideward displacements are investigated focusing on the structure of the 2D solar atmosphere in the presence of coronal arcades or loops. A model based on 2D magnetohydrodynamic equations takes into account gravity, compressible flows, heating, radiation, anisotropic thermal conduction, and coupling to a deep chromosphere. It is found that prominences in simple arcades characterized by magnetic field with significant curvature at the apex are unstable to a lateral displacement.

TIME EVOLUTION OF PLASMA PARAMETERS DURING THE RISE OF A SOLAR PROMINENCE INSTABILITY

DOE Office of Scientific and Technical Information (OSTI.GOV)

Orozco Suárez, D.; Asensio Ramos, A.; Trujillo Bueno, J.

We present high-spatial resolution spectropolarimetric observations of a quiescent hedgerow prominence taken in the He I 1083.0 nm triplet. The observation consisted of a time series in sit-and-stare mode of ∼36 minutes duration. The spectrograph's slit crossed the prominence body and we recorded the time evolution of individual vertical threads. Eventually, we observed the development of a dark Rayleigh-Taylor plume that propagated upward with a velocity, projected onto the plane of the sky, of 17 km s{sup –1}. Interestingly, the plume apex collided with the prominence threads pushing them aside. We inferred Doppler shifts, Doppler widths, and magnetic field strength variations bymore » interpreting the He I Stokes profiles with the HAZEL code. The Doppler shifts show that clusters of threads move coherently while individual threads have oscillatory patterns. Regarding the plume we found strong redshifts (∼9-12 km s{sup –1}) and large Doppler widths (∼10 km s{sup –1}) at the plume apex when it passed through the prominence body and before it disintegrated. We associate the redshifts with perspective effects while the Doppler widths are more likely due to an increase in the local temperature. No local variations of the magnetic field strength associated with the passage of the plume were found; this leads us to conclude that the plumes are no more magnetized than the surroundings. Finally, we found that some of the threads' oscillations are locally damped, what allowed us to apply prominence seismology techniques to infer additional prominence physical parameters.« less

Further Validation of the Coach Identity Prominence Scale

ERIC Educational Resources Information Center

Pope, J. Paige; Hall, Craig R.

2014-01-01

This study was designed to examine select psychometric properties of the Coach Identity Prominence Scale (CIPS), including the reliability, factorial validity, convergent validity, discriminant validity, and predictive validity. Coaches (N = 338) who averaged 37 (SD = 12.27) years of age, had a mean of 13 (SD = 9.90) years of coaching experience,…

Schizophrenia with prominent catatonic features: A selective review.

PubMed

Ungvari, Gabor S; Gerevich, Jozsef; Takács, Rozália; Gazdag, Gábor

2017-08-14

A widely accepted consensus holds that a variety of motor symptoms subsumed under the term 'catatonia' have been an integral part of the symptomatology of schizophrenia since 1896, when Kraepelin proposed the concept of dementia praecox (schizophrenia). Until recently, psychiatric classifications included catatonic schizophrenia mainly through tradition, without compelling evidence of its validity as a schizophrenia subtype. This selective review briefly summarizes the history, psychopathology, demographic and epidemiological data, and treatment options for schizophrenia with prominent catatonic features. Although most catatonic signs and symptoms are easy to observe and measure, the lack of conceptual clarity of catatonia and consensus about the threshold and criteria for its diagnosis have hampered our understanding of how catatonia contributes to the pathophysiology of schizophrenic psychoses. Diverse study samples and methodologies have further hindered research on schizophrenia with prominent catatonic features. A focus on the motor aspects of broadly defined schizophrenia using modern methods of detecting and quantifying catatonic signs and symptoms coupled with sophisticated neuroimaging techniques offers a new approach to research in this long-overlooked field. Copyright © 2017. Published by Elsevier B.V.

Audibility threshold spectrum for prominent discrete tone analysis

NASA Astrophysics Data System (ADS)

Kimizuka, Ikuo

2005-09-01

To evaluate the annoyance of tonal components in noise emissions, ANSI S1.13 (for general purposes) and/or ISO 7779/ECMA-74 (dedicatedfor IT equipment) state two similar metrics: tone-to-noise ratio (TNR) and prominence ratio(PR). By these or either of these two parameters, noise of question with a sharp spectral peak is analyzed by high resolution FFF and classified as prominent when it exceeds some criterion curve. According to present procedures, however this designation is dependent on only the spectral shape. To resolve this problem, the author proposes a threshold spectrum of human ear audibility. The spectrum is based on the reference threshold of hearing which is defined in ISO 389-7 and/or ISO 226. With this spectrum, one can objectively define whether the noise peak of question is audible or not, by simple comparison of the peak amplitude of noise emission and the corresponding value of threshold. Applying the threshold, one can avoid overkilling or unnecessary action for noise. Such a peak with absolutely low amplitude is not audible.

SYNTHETIC HYDROGEN SPECTRA OF OSCILLATING PROMINENCE SLABS IMMERSED IN THE SOLAR CORONA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zapiór, M.; Heinzel, P.; Oliver, R.

We study the behavior of H α and H β spectral lines and their spectral indicators in an oscillating solar prominence slab surrounded by the solar corona, using an MHD model combined with a 1D radiative transfer code taken in the line of sight perpendicular to the slab. We calculate the time variation of the Doppler shift, half-width, and maximum intensity of the H α and H β spectral lines for different modes of oscillation. We find a non-sinusoidal time dependence of some spectral parameters with time. Because H α and H β spectral indicators have different behavior for differentmore » modes, caused by differing optical depths of formation and different plasma parameter variations in time and along the slab, they may be used for prominence seismology, especially to derive the internal velocity field in prominences.« less

Parents' Evaluations of Their Children's Dysphonia: The Mamas and the Papas.

PubMed

Amir, Ofer; Wolf, Michael; Mick, Liron; Levi, Omer; Primov-Fever, Adi

2015-07-01

This study aimed to evaluate the validity and reliability of a Hebrew translation of the Pediatric Voice Handicap Index (pVHI). It also examined differences between mothers and fathers in evaluating their child's dysphonia. Observational design. The pVHI was first translated and adapted to Hebrew. The translated version was, then, administered to a group of 141 parents of children aged younger than 14 years. Fifty-eight parents had a dysphonic child, and 83 had a nondysphonic child. Based on the parents' responses to the pVHI, statistical analyses were performed, evaluating validity and reliability, as well as group differences. Following, a subset of the participants, in which only cases where the responses of both parents were available, was examined for evaluating differences between the responses of mothers (n = 46) and fathers (n = 46). Statistical analyses revealed high reliability of the Hebrew version of the pVHI (Cronbach alpha = .97). Parents of the dysphonic children rated their children significantly higher than parents of the nondysphonic group (P < 0.001). Mothers of the dysphonic children rated their children significantly higher than the fathers, on all subscales of the questionnaire (≥0.001 P < 0.047). In contrast, no significant differences were found between mothers and fathers of the nondysphonic children (P > 0.05). The Hebrew version of the pVHI is a reliable tool for quantifying parents' perception of their child's voice handicap. Mothers of dysphonic children evaluate their children's voice handicap more severely than fathers, whereas both parents of nondysphonic children perform this evaluation similarly. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Comparison of Pitch Strength With Perceptual and Other Acoustic Metric Outcome Measures Following Medialization Laryngoplasty.

PubMed

Rubin, Adam D; Jackson-Menaldi, Cristina; Kopf, Lisa M; Marks, Katherine; Skeffington, Jean; Skowronski, Mark D; Shrivastav, Rahul; Hunter, Eric J

2018-05-14

The diagnoses of voice disorders, as well as treatment outcomes, are often tracked using visual (eg, stroboscopic images), auditory (eg, perceptual ratings), objective (eg, from acoustic or aerodynamic signals), and patient report (eg, Voice Handicap Index and Voice-Related Quality of Life) measures. However, many of these measures are known to have low to moderate sensitivity and specificity for detecting changes in vocal characteristics, including vocal quality. The objective of this study was to compare changes in estimated pitch strength (PS) with other conventionally used acoustic measures based on the cepstral peak prominence (smoothed cepstral peak prominence, cepstral spectral index of dysphonia, and acoustic voice quality index), and clinical judgments of voice quality (GRBAS [grade, roughness, breathiness, asthenia, strain] scale) following laryngeal framework surgery. This study involved post hoc analysis of recordings from 22 patients pretreatment and post treatment (thyroplasty and behavioral therapy). Sustained vowels and connected speech were analyzed using objective measures (PS, smoothed cepstral peak prominence, cepstral spectral index of dysphonia, and acoustic voice quality index), and these results were compared with mean auditory-perceptual ratings by expert clinicians using the GRBAS scale. All four acoustic measures changed significantly in the direction that usually indicates improved voice quality following treatment (P < 0.005). Grade and breathiness correlated the strongest with the acoustic measures (|r| ~0.7) with strain being the least correlated. Acoustic analysis on running speech highly correlates with judged ratings. PS is a robust, easily obtained acoustic measure of voice quality that could be useful in the clinical environment to follow treatment of voice disorders. Copyright © 2018. Published by Elsevier Inc.

Onset of solar flares as predicted by two-dimensional MHD-models of quiescent prominences

NASA Technical Reports Server (NTRS)

Galindotrejo, J.

1985-01-01

The close connection between the sudden disapperance (disparition brusque) of the quiescent prominences and the two-ribbon flares are well known. During this dynamic phase the prominence ascends rapidly (typically with a velocity about 100 Km/sec) and disappears. In another later stage is observed material falling back into the chromosphere. The impact of this downfalling matter on the chromosphere produces the H brightening, which shows the symmetric double pattern. The occurence of the disparition brusque is thought to be a consequence of a plasma instability of magnetohydrostatic (MHD) structures. By means of the MHD-energy principle, the stability properties of four prominence models are analyzed. It is shown that all considered models undergo instabilities for parameters outside of the observed range at quiescent prominences. The possibility that such instabilities in the flare parameter range may indicate just the onset of a flare is considered.

Combined Functional Voice Therapy in Singers With Muscle Tension Dysphonia in Singing.

PubMed

Sielska-Badurek, Ewelina; Osuch-Wójcikiewicz, Ewa; Sobol, Maria; Kazanecka, Ewa; Rzepakowska, Anna; Niemczyk, Kazimierz

2017-07-01

The purpose of this study was to evaluate vocal tract function and the voice quality in singers with muscle tension dysphonia (MTD) after undergoing combined functional voice therapy of the singing voice. This is a prospective, randomized study. Forty singers (29 females and 11 males, mean age: 24.6 ± 8.8 years) with MTD were enrolled in the study. The study group consisted of 20 singers who underwent combined functional voice therapy (10-15 individual sessions, 30-40 minutes each). Singers who did not opt for vocal rehabilitation consisted of the control group. Effects of rehabilitation were assessed with videolaryngostroboscopy, palpation of the vocal tract structures, flexible fiberoptic evaluation of the pharynx and the larynx, perceptual speaking and singing voice assessment, acoustic analysis, maximal phonation time, and the Voice Handicap Index. After combined functional voice therapy in the study group, great improvement was noticed in palpation of the vocal tract structures (P < 0.001), perceptual voice assessment (P < 0.001), phonetograms (P = 0.002), and singing range obtained from acoustic analysis of glissando (P < 0.001). In the control group, no statistically significant differences were found between the first and the second assessments. Combined functional voice therapy proved to be an efficacious treatment method in singers with MTD in singing. Development of palpation and perceptual singing voice examination protocols enables one to compare results before and after rehabilitation in clinics. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Three-dimensional MHD Simulations of Solar Prominence Oscillations in a Magnetic Flux Rope

NASA Astrophysics Data System (ADS)

Zhou, Yu-Hao; Xia, C.; Keppens, R.; Fang, C.; Chen, P. F.

2018-04-01

Solar prominences are subject to all kinds of perturbations during their lifetime, and frequently demonstrate oscillations. The study of prominence oscillations provides an alternative way to investigate their internal magnetic and thermal structures because the characteristics of the oscillations depend on their interplay with the solar corona. Prominence oscillations can be classified into longitudinal and transverse types. We perform three-dimensional ideal magnetohydrodynamic simulations of prominence oscillations along a magnetic flux rope, with the aim of comparing the oscillation periods with those predicted by various simplified models and examining the restoring force. We find that the longitudinal oscillation has a period of about 49 minutes, which is in accordance with the pendulum model where the field-aligned component of gravity serves as the restoring force. In contrast, the horizontal transverse oscillation has a period of about 10 minutes and the vertical transverse oscillation has a period of about 14 minutes, and both of them can be nicely fitted with a two-dimensional slab model. We also find that the magnetic tension force dominates most of the time in transverse oscillations, except for the first minute when magnetic pressure overwhelms it.

Management of prominent ears: personal approach.

PubMed

Pérez-Macias, José Manuel

2008-03-01

Various methods for correcting prominent ears have been reported. Although anterior cartilage antihelix abrasion combined with posterior retention sutures is a conventional procedure, it does not include anterior conchal cartilage abrasion and thus allows easier reduction of the condromastoid angle. A simple and effective technique is described that involves using a rasp to score the whole anterior surface of the auricular cartilage, including the concha, in combination with Mustarde-type conchal-antihelical and conchal-mastoid retention sutures. This method was applied to 342 patients (675 ears) over 23 years, who were followed up for periods varying from 18 to 24 months. Good results were obtained for all patients with minimal complications.

Developing animals flout prominent assumptions of ecological physiology.

PubMed

Burggren, Warren W

2005-08-01

Every field of biology has its assumptions, but when they grow to be dogma, they can become constraining. This essay presents data-based challenges to several prominent assumptions of developmental physiologists. The ubiquity of allometry is such an assumption, yet animal development is characterized by rate changes that are counter to allometric predictions. Physiological complexity is assumed to increase with development, but examples are provided showing that complexity can be greatest at intermediate developmental stages. It is assumed that organs have functional equivalency in embryos and adults, yet embryonic structures can have quite different functions than inferred from adults. Another assumption challenged is the duality of neural control (typically sympathetic and parasympathetic), since one of these two regulatory mechanisms typically considerably precedes in development the appearance of the other. A final assumption challenged is the notion that divergent phylogeny creates divergent physiologies in embryos just as in adults, when in fact early in development disparate vertebrate taxa show great quantitative as well as qualitative similarity. Collectively, the inappropriateness of these prominent assumptions based on adult studies suggests that investigation of embryos, larvae and fetuses be conducted with appreciation for their potentially unique physiologies.

Word-level prominence in Persian: An Experimental Study.

PubMed

Sadeghi, Vahid

2017-12-01

Previous literature on the phonetics of stress in Persian has reported that fundamental frequency is the only reliable acoustic correlate of stress, and that stressed and unstressed syllables are not differentiated from each other in the absence of accentuation. In this study, the effects of lexical stress on duration, overall intensity and spectral tilt were examined in Persian both in the accented and unaccented conditions. Results showed that syllable duration is consistently affected by stress in Persian in both the accented and unaccented conditions across all vowel types. Unlike duration, the results for overall intensity and spectral tilt were significant only in the accented condition, suggesting that measures of intensity are not a correlate of stress in Persian but they are mainly caused by the presence of a pitch movement. The findings are phonologically interpreted as suggesting that word-level prominence in Persian is typologically similar to 'stress accent' languages, in which multiple phonetic cues are used to signal the prominence contrast in the accented condition, and stressed and unstressed syllables are different from each other even when the word is not pitch-accented.

Correlation between financial relationships with commercial interests and research prominence at an oncology meeting.

PubMed

Moy, Beverly; Bradbury, Angela R; Helft, Paul R; Egleston, Brian L; Sheikh-Salah, Moktar; Peppercorn, Jeffrey

2013-07-20

Little is known about the effects of financial relationships between biomedical researchers and industry (financial conflicts of interest [FCOIs]) on research prominence. We examined the prevalence of FCOIs in oncology and associations between FCOIs and research prominence among abstracts presented at American Society of Clinical Oncology (ASCO) annual meetings. We analyzed 20,718 abstracts presented at ASCO meetings in 2006 and 2008 to 2011. Measures included the following: financial relationships, peer review score (PRS), and meeting placement prominence (descending order of prominence: plenary session, clinical science symposium, oral presentation, poster discussion, general posters, and publish only). Of 20,718 abstracts, 36% reported at least one author with an FCOI. The proportion of abstracts with any FCOI increased from 33% in 2006 to 38% in 2011 (P < .001). Abstracts with FCOIs had significantly higher meeting prominence compared with publish only and general poster abstracts. The odds ratios compared with general posters were 7.3 for plenary session, 2.2 for clinical science symposium, 1.9 for oral presentation, and 1.7 for poster discussion (P < .001). Abstracts with FCOIs had significantly better PRSs compared with those without FCOIs. For all abstracts, PRS was 2.76 (95% CI, 2.75 to 2.77) with FCOIs compared with 3.01 (95% CI, 3.001 to 3.02) without FCOIs (P < .001). Omitting publish-only abstracts, PRS was 2.62 (95% CI, 2.61 to 2.63) with FCOIs compared with 2.73 without FCOIs (95% CI, 2.71 to 2.73). Abstracts with FCOIs had more prominent meeting placement and better PRSs. FCOIs were reported more frequently by year, suggesting an increasing influence of industry on cancer research, greater disclosure, or both.

Tic Tac TOE: Effects of Predictability and Importance on Acoustic Prominence in Language Production

ERIC Educational Resources Information Center

Watson, Duane G.; Arnold, Jennifer E.; Tanenhaus, Michael K.

2008-01-01

Importance and predictability each have been argued to contribute to acoustic prominence. To investigate whether these factors are independent or two aspects of the same phenomenon, naive participants played a verbal variant of Tic Tac Toe. Both importance and predictability contributed independently to the acoustic prominence of a word, but in…

An eruptive prominence and associated cm-mm emission outside the solar limb

NASA Technical Reports Server (NTRS)

Zodi, A. M.; Correia, E.; Costa, J. E. R.; Kaufmann, P.; Martin, S. F.

1988-01-01

Radio maps at 22 and 44 GHz are presented which show the emission before and after the eruption of a quiescent prominence located at the west limb. The observed radiation followng the eruption is not consistent with thermal bremsstrahlung mechanism. It can be interpreted as due to gyrosynchrotron emission of nonthermal electrons. The observations appear to be similar to the microwave radiation observed in post-flare loops. This radiation is due to nonthermal electrons trapped in the closed magnetic structures formed after the prominence eruption.

A-B Distinction in a Sample of Prominent Psychotherapists

ERIC Educational Resources Information Center

Geller, Jesse D.; Berzins, Juris I.

1976-01-01

A sample of prominent psychotherapists were asked to fill out the A-B therapist "type" scale and comment on their possible differential effectiveness in treating schizoid/schizophrenic versus neurotic patients. The data suggest that B therapists desire and seek more complex and exciting sensory-cognitive inputs during therapy hours than A…

Exploring the prominence-corona connection and its expansion into the outer corona using total solar eclipse observations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Habbal, Shadia Rifai; Morgan, Huw; Druckmüller, Miloslav, E-mail: shadia@ifa.hawaii.edu

Prominences constitute the most complex magnetic structures in the solar corona. The ubiquitous presence of their seemingly confined dense and cool plasma in an otherwise million-degree environment remains a puzzle. Using a decade of white light total solar eclipse observations, we show how these images reveal an intricate relationship between prominences and coronal structures both in their immediate vicinity, known as coronal cavities, and in the extended corona out to several solar radii. Observations of suspended prominences and twisted helical structures spanning several solar radii are central to these findings. The different manifestations of the prominence-corona interface that emerge frommore » this study underscore the fundamental role played by prominences in defining and controlling the complex expansion and dynamic behavior of the solar magnetic field in the neighborhood of magnetic polarity reversal regions. This study suggests that the unraveling of prominences and the outward expansion of the helical twisted field lines linked to them could be the solar origin of twisted magnetic flux ropes detected in interplanetary space, and of the mechanism by which the Sun sheds its magnetic helicity. This work also underscores the likely role of the prominence-corona interface as a source of the slow solar wind.« less

Visibility of Prominences Using the He i D3 Line Filter on the PROBA-3/ASPIICS Coronagraph

NASA Astrophysics Data System (ADS)

Jejčič, S.; Heinzel, P.; Labrosse, N.; Zhukov, A. N.; Bemporad, A.; Fineschi, S.; Gunár, S.

2018-02-01

We determine the optimal width and shape of the narrow-band filter centered on the He i D3 line for prominence and coronal mass ejection (CME) observations with the ASPIICS ( Association of Spacecraft for Polarimetric and Imaging Investigation of the Corona of the Sun) coronagraph onboard the PROBA-3 ( Project for On-board Autonomy) satellite, to be launched in 2020. We analyze He i D3 line intensities for three representative non-local thermal equilibrium prominence models at temperatures 8, 30, and 100 kK computed with a radiative transfer code and the prominence visible-light (VL) emission due to Thomson scattering on the prominence electrons. We compute various useful relations at prominence line-of-sight velocities of 0, 100, and 300 km s-1 for 20 Å wide flat filter and three Gaussian filters with a full-width at half-maximum (FWHM) equal to 5, 10, and 20 Å to show the relative brightness contribution of the He i D3 line and the prominence VL to the visibility in a given narrow-band filter. We also discuss possible signal contamination by Na i D1 and D2 lines, which otherwise may be useful to detect comets. Our results mainly show that i) an optimal narrow-band filter should be flat or somewhere between flat and Gaussian with an FWHM of 20 Å in order to detect fast-moving prominence structures, ii) the maximum emission in the He i D3 line is at 30 kK and the minimal at 100 kK, and iii) the ratio of emission in the He i D3 line to the VL emission can provide a useful diagnostic for the temperature of prominence structures. This ratio is up to 10 for hot prominence structures, up to 100 for cool structures, and up to 1000 for warm structures.

Polarimetric measurements in prominences and "tornadoe" observed by THEMIS

NASA Astrophysics Data System (ADS)

Schmieder, Brigitte; López Ariste, Arturo; Levens, Peter; Labrosse, Nicolas; Dalmasse, Kévin

2015-10-01

Since 2013, coordinated campaigns with the THEMIS spectropolarimeter in Tenerife and other instruments (space based: Hinode/SOT, IRIS or ground based: Sac Peak, Meudon) are organized to observe prominences. THEMIS records spectropolarimetry at the He I D3 and we use the PCA inversion technique to derive their field strength, inclination and azimuth.

A harmonic linear dynamical system for prominent ECG feature extraction.

PubMed

Thi, Ngoc Anh Nguyen; Yang, Hyung-Jeong; Kim, SunHee; Do, Luu Ngoc

2014-01-01

Unsupervised mining of electrocardiography (ECG) time series is a crucial task in biomedical applications. To have efficiency of the clustering results, the prominent features extracted from preprocessing analysis on multiple ECG time series need to be investigated. In this paper, a Harmonic Linear Dynamical System is applied to discover vital prominent features via mining the evolving hidden dynamics and correlations in ECG time series. The discovery of the comprehensible and interpretable features of the proposed feature extraction methodology effectively represents the accuracy and the reliability of clustering results. Particularly, the empirical evaluation results of the proposed method demonstrate the improved performance of clustering compared to the previous main stream feature extraction approaches for ECG time series clustering tasks. Furthermore, the experimental results on real-world datasets show scalability with linear computation time to the duration of the time series.

Sexual Well-Being in Patients with Blepharospasm, Spasmodic Torticollis, and Hemifacial Spasm: A Pilot Study

PubMed Central

Perozzo, Paola; Salatino, Adriana; Cerrato, Paolo; Ricci, Raffaella

2016-01-01

Mood, anxiety, and other psychological symptoms are common in dystonic patients suffering from blepharospasm (BSP) and spasmodic torticollis (ST). Since sexual well-being is an important aspect of mental health, here, we investigated whether these patients may also experience a worsening of their sexual life. In particular, quality of sexual life was evaluated in patients suffering from BSP (N = 30), ST (N = 30), and in a control group of patient with Hemifacial spasm (HFS; N = 30), undergoing botulinum toxin type A therapy. A group of 30 age-matched healthy volunteers constituted an additional control group. Patients were evaluated just before the periodic injection of botulinum toxin. Sexual functioning was assessed using the Sexual Functioning Inventory, a reduced form of the Golombok Rust Inventory, previously employed in patients with Parkinson’s disease. Depression (Beck Depression Inventory) and anxiety (STAI-X1/X2) were also assessed. Results revealed that sexual functioning was significantly affected in patients with BSP, ST, and HFS with respect to healthy controls. Dystonic patients manifested more sexual dysfunction than patients with HFS. Overall, females had a poorer quality of sexual life than males and, among females, women with BSP were the most dysfunctional. Psychological symptoms were present in patients with dystonia, but not in patients with HFS. As discussed in the paper, several factors might be taken into account to explain worse quality of sexual life in patients with dystonia compared to patients with hemifacial spasm. Among them an important role might be played by the central origin of dystonia pathophysiology (i.e., altered activity of cortico-striato-thalamic-cortical circuits). Future investigations are necessary to further explore these preliminary findings, considering that this is the first time that sexual well-being is evaluated in patients with BSP, ST, and HFS, and comparable data are not available. PMID:27761118

Energy release from a stream of infalling prominence debris on 2011 September 7-8

NASA Astrophysics Data System (ADS)

Inglis, A. R.; Gilbert, H. R.; Ofman, L.

2017-12-01

In recent years high-resolution and high-cadence EUV imaging has revealed a new phenomenon, impacting prominence debris, where prominence material from failed or partial eruptions can impact the lower atmosphere and release energy. We present a clear example of this phenomenon occurring on 2011 September 7-8. The initial eruption of prominence material was associated with an X1.8-class flare from AR11283, occurring at 22:30 UT on 2011 September 7, resulting in a semi-continuous stream of this material returning to the solar surface between 00:20 - 00:40 UT on 2011 September 8. A substantial area remote from the original active region experienced brightening in multiple EUV channels observed by SDO/AIA. Using the differential emission measure, we estimated the energetic properties of this event. We found that the radiated energy of the impacted plasma was of order 10^27 ergs, while the upper limit on the thermal energy peaked at 10^28 ergs. Based on these estimates we were able to determine the mass content of the debris to be in the range 2x10^14 < m < 2x10^15 g. Given typical promimence masses, the likely debris mass is towards the lower end of this range. This clear example of a prominence debris event shows that significant energy release takes place during these events, and that such impacts may be used as a novel diagnostic tool for investigating prominence material properties.

Vaginal orgasm is more prevalent among women with a prominent tubercle of the upper lip.

PubMed

Brody, Stuart; Costa, Rui Miguel

2011-10-01

Recent studies have uncovered multiple markers of vaginal orgasm history (unblocked pelvic movement during walking, less use of immature psychological defense mechanisms, greater urethrovaginal space). Other markers (perhaps of prenatal origin) even without obvious mechanistic roles in vaginal orgasm might exist, and a clinical observation led to the novel hypothesis that a prominent tubercle of the upper lip is such a marker. To examine the hypothesis that a prominent tubercle of the upper lip is associated specifically with greater likelihood of experiencing vaginal orgasm (orgasm elicited by penile-vaginal intercourse [PVI] without concurrent masturbation). Women (N = 258, predominantly Scottish) completed an online survey reporting their frequencies of various sexual activities and corresponding orgasms, age, and the prominence of the tubercle of their upper lip. Social desirability response bias was also assessed. Multivariate associations of lip tubercle prominence with vaginal orgasm (ever and past month consistency) and with orgasm by other means. RESULTS.: A prominent and sharply raised lip tubercle was associated with greater odds (odds ratio = 12.3) of ever having a vaginal orgasm, and also with greater past month vaginal orgasm consistency (an effect driven by the women who never had a vaginal orgasm), than less prominent lip tubercle categories. Lip tubercle was not associated with social desirability responding, or with orgasm triggered by masturbation during PVI, solitary or partner clitoral or vaginal masturbation, vibrator, or cunnilingus. The results are discussed in light of the unique nature of vaginal orgasm and the possibility of prenatal developmental influences. © 2011 International Society for Sexual Medicine.

The Na i and Sr ii Resonance Lines in Solar Prominences

NASA Astrophysics Data System (ADS)

Stellmacher, G.; Wiehr, E.

2017-07-01

We estimate the electron density, ne, and its spatial variation in quiescent prominences from the observed emission ratio of the resonance lines Na i 5890 Å (D2) and Sr ii 4078 Å. For a bright prominence (τ_{α}≈25) we obtain a mean ne≈2×10^{10} cm^{-3}; for a faint one (τ _{α }≈4) ne≈4×10^{10} cm^{-3} on two consecutive days with moderate internal fluctuation and no systematic variation with height above the solar limb. The thermal and non-thermal contributions to the line broadening, T_{kin} and V_{nth}, required to deduce ne from the emission ratio Na i/Sr ii cannot be unambiguously determined from observed widths of lines from atoms of different mass. The reduced widths, ΔλD/λ0, of Sr ii 4078 Å show an excess over those from Na D2 and Hδ 4101 Å, assuming the same T_{kin} and V_{nth}. We attribute this excess broadening to higher non-thermal broadening induced by interaction of ions with the prominence magnetic field. This is suggested by the finding of higher macro-shifts of Sr ii 4078 Å as compared to those from Na D2.

Perceptions of Social Responsibility of Prominent Animal Welfare Groups.

PubMed

Widmar, Nicole J Olynk; Morgan, Carissa J; Croney, Candace C

2018-01-01

Nonhuman animal welfare is an increasingly important component of consumer expectations of corporate social responsibility (CSR). The extent to which prominent animal welfare or protection organizations may influence people's perceptions of food industry CSR may be related to an organization's perceived social responsibility. Data from an online survey of 300 U.S. residents were used to explore relationships between demographics/lifestyle choices and perceptions of prominent animal welfare organizations (using best-worst scaling methodology). Overall, the American Society for the Prevention of Cruelty to Animals was perceived to be the most socially responsible organization analyzed, followed by the Humane Society of the United States and the American Humane Association (AHA). Results suggest that the perceived social responsibility of animal protection organizations in this study was not strongly linked to personally (financially) supporting them, with 2 exceptions: the perceptions of People for the Ethical Treatment of Animals and AHA. Improved understanding of the perception of animal welfare or protection organizations can inform decision making by organizations interested in furthering animal welfare causes.

Three-dimensional prominence-hosting magnetic configurations: Creating a helical magnetic flux rope

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xia, C.; Keppens, R.; Guo, Y.

2014-01-10

The magnetic configuration hosting prominences and their surrounding coronal structure is a key research topic in solar physics. Recent theoretical and observational studies strongly suggest that a helical magnetic flux rope is an essential ingredient to fulfill most of the theoretical and observational requirements for hosting prominences. To understand flux rope formation details and obtain magnetic configurations suitable for future prominence formation studies, we here report on three-dimensional isothermal magnetohydrodynamic simulations including finite gas pressure and gravity. Starting from a magnetohydrostatic corona with a linear force-free bipolar magnetic field, we follow its evolution when introducing vortex flows around the mainmore » polarities and converging flows toward the polarity inversion line near the bottom of the corona. The converging flows bring the feet of different loops together at the polarity inversion line, where magnetic reconnection and flux cancellation happen. Inflow and outflow signatures of the magnetic reconnection process are identified, and thereby the newly formed helical loops wind around preexisting ones so that a complete flux rope grows and ascends. When a macroscopic flux rope is formed, we switch off the driving flows and find that the system relaxes to a stable state containing a helical magnetic flux rope embedded in an overlying arcade structure. A major part of the formed flux rope is threaded by dipped field lines that can stably support prominence matter, while the total mass of the flux rope is in the order of 4-5× 10{sup 14} g.« less

Disruption of a coronal streamer by an eruptive prominence and coronal mass ejection

NASA Technical Reports Server (NTRS)

Illing, R. M. E.; Hundhausen, A. J.

1986-01-01

The coronal mass ejection of August 18, 1980 is analyzed using images from the coronagraph on the Solar Maximum Mission (SMM) satellite. The event occurred at the site of a large coronal helmet streamer and evolved into the three-part structure of a bright frontal shell, followed by a relatively dark space surrounding a bright filamentary core as seen in many mass ejections of the SMM epoch. The bright core can be identified as material from a prominence whose eruption was observed from the ground. The mass of the frontal shell is equal to that of the coronal helmet streamer, indicating that the shell is the coronal material previously in the helmet streamer, displaced and set into motion by the erupting prominence and surrounding cavity. The mass ejected in the bright core (or prominences) is estimated to be 50 percent larger than the 'coronal' material in the front loop.

Facial profile parameters and their relative influence on bilabial prominence and the perceptions of facial profile attractiveness: A novel approach

PubMed Central

Denize, Erin Stewart; McDonald, Fraser; Sherriff, Martyn

2014-01-01

Objective To evaluate the relative importance of bilabial prominence in relation to other facial profile parameters in a normal population. Methods Profile stimulus images of 38 individuals (28 female and 10 male; ages 19-25 years) were shown to an unrelated group of first-year students (n = 42; ages 18-24 years). The images were individually viewed on a 17-inch monitor. The observers received standardized instructions before viewing. A six-question questionnaire was completed using a Likert-type scale. The responses were analyzed by ordered logistic regression to identify associations between profile characteristics and observer preferences. The Bayesian Information Criterion was used to select variables that explained observer preferences most accurately. Results Nasal, bilabial, and chin prominences; the nasofrontal angle; and lip curls had the greatest effect on overall profile attractiveness perceptions. The lip-chin-throat angle and upper lip curl had the greatest effect on forehead prominence perceptions. The bilabial prominence, nasolabial angle (particularly the lower component), and mentolabial angle had the greatest effect on nasal prominence perceptions. The bilabial prominence, nasolabial angle, chin prominence, and submental length had the greatest effect on lip prominence perceptions. The bilabial prominence, nasolabial angle, mentolabial angle, and submental length had the greatest effect on chin prominence perceptions. Conclusions More prominent lips, within normal limits, may be considered more attractive in the profile view. Profile parameters have a greater influence on their neighboring aesthetic units but indirectly influence related profile parameters, endorsing the importance of achieving an aesthetic balance between relative prominences of all aesthetic units of the facial profile. PMID:25133133

Comparing UV/EUV line parameters and magnetic field in a quiescent prominence with tornadoes

NASA Astrophysics Data System (ADS)

Levens, P. J.; Labrosse, N.; Schmieder, B.; López Ariste, A.; Fletcher, L.

2017-10-01

Context. Understanding the relationship between plasma and the magnetic field is important for describing and explaining the observed dynamics of solar prominences. Aims: We determine if a close relationship can be found between plasma and magnetic field parameters, measured at high resolution in a well-observed prominence. Methods: A prominence observed on 15 July 2014 by the Interface Region Imaging Spectrograph (IRIS), Hinode, the Solar Dynamics Observatory (SDO), and the Télescope Héliographique pour l'Étude du Magnétisme et des Instabilités Solaires (THEMIS) is selected. We perform a robust co-alignment of data sets using a 2D cross-correlation technique. Magnetic field parameters are derived from spectropolarimetric measurements of the He I D3 line from THEMIS. Line ratios and line-of-sight velocities from the Mg II h and k lines observed by IRIS are compared with magnetic field strength, inclination, and azimuth. Electron densities are calculated using Fe xii line ratios from the Hinode Extreme-ultraviolet Imaging Spectrometer, which are compared to THEMIS and IRIS data. Results: We find Mg II k/h ratios of around 1.4 everywhere, similar to values found previously in prominences. Also, the magnetic field is strongest ( 30 G) and predominantly horizontal in the tornado-like legs of the prominence. The k3 Doppler shift is found to be between ±10 km s-1 everywhere. Electron densities at a temperature of 1.5 × 106 K are found to be around 109 cm-3. No significant correlations are found between the magnetic field parameters and any of the other plasma parameters inferred from spectroscopy, which may be explained by the large differences in the temperatures of the lines used in this study. Conclusions: This is the first time that a detailed statistical study of plasma and magnetic field parameters has been performed at high spatial resolution in a prominence. Our results provide important constraints on future models of the plasma and magnetic field in

Effect of geographical and ethnic variation on Dysphonia Severity Index: a study of Indian population.

PubMed

Jayakumar, T; Savithri, S R

2012-01-01

Dysphonia Severity Index (DSI) is a widely used multiparametric approach to objectively quantify the voice quality. Few research groups have investigated the test-retest, interobserver variability, and influence of age and gender. They have also verified the application of DSI in various voice rehabilitation conditions. However, all these studies have been conducted on European population. There is a possibility of variation in the basic parameters of DSI across geographical and ethnic groups. Hence, the present study evaluated DSI in Indian population. One hundred twenty voluntary participants (60 males, 60 females) who had G(0) on the Grade, Roughness, Breathiness, Aesthenia, Strain (GRBAS) scale participated in the study (age range of 18-25 years, M=21.8, standard deviation=2.7). Maximum phonation time (MPT), frequency intensity, and jitter measurements were made using CSL 4500 (Kay Elemetrics, Pine Brook, NJ). Results showed noticeable difference between Indian and European population on MPT, Highest frequency (F(0)-High), and DSI values. Significant gender difference was also observed on MPT and F(0)-High. Test-retest reliability showed >95% for all the parameters. The MPT decrement lead to a reduction in the overall DSI value in both the genders. These results of the study caution voice professionals to reinvestigate and establish their own norms for their geographical and ethnic groups. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Spectrophotometric determination of some anti-tussive and anti-spasmodic drugs through ion-pair complex formation with thiocyanate and cobalt(II) or molybdenum(V)

NASA Astrophysics Data System (ADS)

El-Shiekh, Ragaa; Zahran, Faten; El-Fetouh Gouda, Ayman Abou

2007-04-01

Two rapid, simple and sensitive extractive specrophotometric methods has been developed for the determination of anti-tussive drugs, e.g., dextromethorphan hydrobromide (DEX) and pipazethate hydrochloride (PiCl) and anti-spasmodic drugs, e.g., drotaverine hydrochloride (DvCl) and trimebutine maleate (TM) in bulk and in their pharmaceutical formulations. The proposed methods depend upon the reaction of cobalt(II)-thiocyanate (method A) and molybdenum(V)-thiocyanate ions (method B) with the cited drugs to form stable ion-pair complexes which extractable with an n-butnol-dichloromethane solvent mixture (3.5:6.5) and methylene chloride for methods A and B, respectively. The blue and orange red color complexes are determined either colorimetrically at λmax 625 nm (using method A) and 467 or 470 nm for (DEX and PiCl) or (DvCl and TM), respectively (using method B). The concentration range is 20-400 and 2.5-50 μg mL -1 for methods A and B, respectively. The proposed method was successfully applied for the determination of the studied drugs in pure and in pharmaceutical formulations applying the standard additions technique and the results obtained in good agreement well with those obtained by the official method.

A Prominence Account of Syllable Reduction in Early Speech Development: The Child's Prosodic Phonology of "Tiger" and "Giraffe."

ERIC Educational Resources Information Center

Snow, David

1998-01-01

This paper tested a theory of syllable prominence with 11 children (ages 11 to 26 months). The theory proposes that syllable prominence is a product of two orthogonal suprasegmental systems: stress/accent peaks and phrase boundaries. Use of the developed prominence scale found it parsimoniously accounted for observed biases in syllable omissions…

A qualitative study of interference with communicative participation across communication disorders in adults

PubMed Central

Baylor, Carolyn; Burns, Michael; Eadie, Tanya; Britton, Deanna; Yorkston, Kathryn

2012-01-01

Purpose To explore the similarities and differences in self-reported restrictions in communicative participation across different communication disorders in community-dwelling adults. Methods Interviews were conducted with 44 adults representing seven different medical conditions: spasmodic dysphonia, multiple sclerosis, stroke, stuttering, Parkinson’s disease, amyotrophic lateral sclerosis, and laryngectomy. This paper represents a secondary analysis of qualitative data collected in cognitive interviews during development of the Communicative Participation Item Bank. The data were analyzed to identify themes in participants’ experiences related to communicative participation. Results Participants described many situations in which they experienced interference in communicative participation. Two themes emerged from the data. The first theme was Interference is both “functional” and “emotional” in which participants defined interference as limitations in accomplishing tasks and emotional consequences. The second theme was “It depends” - Sources of interference in which participants described many variables that contribute to interference in participation. Participants had limited control of some variables such as symptoms and environmental contexts, but personal decisions and priorities also influenced participation. Conclusions Despite different impairments and activity limitations, participants described similar communicative participation restrictions. These similarities may have theoretical and clinical implications in terms of how we assess, treat and study the participation restrictions associated with communication disorders. PMID:21813820

Head turning as a prominent motor symptom in status epilepticus.

PubMed

Bauer, Gerhard; Broessner, Gregor; Unterberger, Iris; Walser, Gerald; Pfausler, Bettina; Trinka, Eugen

2008-06-01

Head and eye turning is frequently observed during seizures. Versions with tonic and/or clonic symptoms can be differentiated from smooth head deviations. Head turning as a prominent symptom of status epilepticus has not previously been reported. We present eight case reports, (7 women/1 man, mean age 41 years, median 41.5, range 10 to 74), of status epilepticus (SE), with head turning as a prominent motor symptom. Six were accompanied by continuous frontal, occipital and temporal ictal epileptiform discharges. Furthermore, two patients had absence status with rhythmic and clonic head versions. While the localizing significance of head turnings in SE is low, in our cases, the direction was away from the discharging hemisphere in all cases of focal SE regardless of whether the turning was classified as version (three cases) or deviation (three cases). In this small series of SE, the classical observation of a patient looking away from the discharging hemisphere is still valid.

16 CFR 1500.121 - Labeling requirements; prominence, placement, and conspicuousness.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., layout, or color with other printed matter on the label. This regulation contains the Commission's..., which bear(s) the labeling designed to be most prominently displayed, shown, presented, or examined... designed to be displayed for sale or, on display panels other than the principal display panel, in lines...

16 CFR 1500.121 - Labeling requirements; prominence, placement, and conspicuousness.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., layout, or color with other printed matter on the label. This regulation contains the Commission's..., which bear(s) the labeling designed to be most prominently displayed, shown, presented, or examined... designed to be displayed for sale or, on display panels other than the principal display panel, in lines...

16 CFR 1500.121 - Labeling requirements; prominence, placement, and conspicuousness.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., layout, or color with other printed matter on the label. This regulation contains the Commission's..., which bear(s) the labeling designed to be most prominently displayed, shown, presented, or examined... designed to be displayed for sale or, on display panels other than the principal display panel, in lines...

16 CFR 1500.121 - Labeling requirements; prominence, placement, and conspicuousness.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., layout, or color with other printed matter on the label. This regulation contains the Commission's..., which bear(s) the labeling designed to be most prominently displayed, shown, presented, or examined... designed to be displayed for sale or, on display panels other than the principal display panel, in lines...

Measurement of prominent eta-decay branching fractions.

PubMed

Lopez, A; Mehrabyan, S; Mendez, H; Ramirez, J; Ge, J Y; Miller, D H; Sanghi, B; Shipsey, I P J; Xin, B; Adams, G S; Anderson, M; Cummings, J P; Danko, I; Hu, D; Moziak, B; Napolitano, J; He, Q; Insler, J; Muramatsu, H; Park, C S; Thorndike, E H; Yang, F; Artuso, M; Blusk, S; Khalil, S; Li, J; Menaa, N; Mountain, R; Nisar, S; Randrianarivony, K; Sia, R; Skwarnicki, T; Stone, S; Wang, J C; Bonvicini, G; Cinabro, D; Dubrovin, M; Lincoln, A; Asner, D M; Edwards, K W; Naik, P; Briere, R A; Ferguson, T; Tatishvili, G; Vogel, H; Watkins, M E; Rosner, J L; Adam, N E; Alexander, J P; Cassel, D G; Duboscq, J E; Ehrlich, R; Fields, L; Galik, R S; Gibbons, L; Gray, R; Gray, S W; Hartill, D L; Heltsley, B K; Hertz, D; Jones, C D; Kandaswamy, J; Kreinick, D L; Kuznetsov, V E; Mahlke-Krüger, H; Mohapatra, D; Onyisi, P U E; Patterson, J R; Peterson, D; Riley, D; Ryd, A; Sadoff, A J; Shi, X; Stroiney, S; Sun, W M; Wilksen, T; Athar, S B; Patel, R; Yelton, J; Rubin, P; Eisenstein, B I; Karliner, I; Lowrey, N; Selen, M; White, E J; Wiss, J; Mitchell, R E; Shepherd, M R; Besson, D; Pedlar, T K; Cronin-Hennessy, D; Gao, K Y; Hietala, J; Kubota, Y; Klein, T; Lang, B W; Poling, R; Scott, A W; Zweber, P; Dobbs, S; Metreveli, Z; Seth, K K; Tomaradze, A; Ernst, J; Ecklund, K M; Severini, H; Love, W; Savinov, V

2007-09-21

The decay psi(2S) --> etaJ/psi is used to measure, for the first time, all prominent eta-meson branching fractions with the same experiment in the same dataset, thereby providing a consistent treatment of systematics across branching fractions. We present results for eta decays to gamma gamma, pi(+)pi(-)pi(0), 3pi(0), pi(+)pi(-)gamma and e(+)e(-)gamma, accounting for 99.9% of all eta decays. The precision of several of the branching fractions and their ratios is improved. Two channels, pi(+)pi(-)gamma and e(+)e(-)gamma, show results that differ at the level of three standard deviations from those previously determined.

Measurement of Prominent η-Decay Branching Fractions

NASA Astrophysics Data System (ADS)

Lopez, A.; Mehrabyan, S.; Mendez, H.; Ramirez, J.; Ge, J. Y.; Miller, D. H.; Sanghi, B.; Shipsey, I. P. J.; Xin, B.; Adams, G. S.; Anderson, M.; Cummings, J. P.; Danko, I.; Hu, D.; Moziak, B.; Napolitano, J.; He, Q.; Insler, J.; Muramatsu, H.; Park, C. S.; Thorndike, E. H.; Yang, F.; Artuso, M.; Blusk, S.; Khalil, S.; Li, J.; Menaa, N.; Mountain, R.; Nisar, S.; Randrianarivony, K.; Sia, R.; Skwarnicki, T.; Stone, S.; Wang, J. C.; Bonvicini, G.; Cinabro, D.; Dubrovin, M.; Lincoln, A.; Asner, D. M.; Edwards, K. W.; Naik, P.; Briere, R. A.; Ferguson, T.; Tatishvili, G.; Vogel, H.; Watkins, M. E.; Rosner, J. L.; Adam, N. E.; Alexander, J. P.; Cassel, D. G.; Duboscq, J. E.; Ehrlich, R.; Fields, L.; Galik, R. S.; Gibbons, L.; Gray, R.; Gray, S. W.; Hartill, D. L.; Heltsley, B. K.; Hertz, D.; Jones, C. D.; Kandaswamy, J.; Kreinick, D. L.; Kuznetsov, V. E.; Mahlke-Krüger, H.; Mohapatra, D.; Onyisi, P. U. E.; Patterson, J. R.; Peterson, D.; Riley, D.; Ryd, A.; Sadoff, A. J.; Shi, X.; Stroiney, S.; Sun, W. M.; Wilksen, T.; Athar, S. B.; Patel, R.; Yelton, J.; Rubin, P.; Eisenstein, B. I.; Karliner, I.; Lowrey, N.; Selen, M.; White, E. J.; Wiss, J.; Mitchell, R. E.; Shepherd, M. R.; Besson, D.; Pedlar, T. K.; Cronin-Hennessy, D.; Gao, K. Y.; Hietala, J.; Kubota, Y.; Klein, T.; Lang, B. W.; Poling, R.; Scott, A. W.; Zweber, P.; Dobbs, S.; Metreveli, Z.; Seth, K. K.; Tomaradze, A.; Ernst, J.; Ecklund, K. M.; Severini, H.; Love, W.; Savinov, V.

2007-09-01

The decay ψ(2S)→ηJ/ψ is used to measure, for the first time, all prominent η-meson branching fractions with the same experiment in the same dataset, thereby providing a consistent treatment of systematics across branching fractions. We present results for η decays to γγ, π+π-π0, 3π0, π+π-γ and e+e-γ, accounting for 99.9% of all η decays. The precision of several of the branching fractions and their ratios is improved. Two channels, π+π-γ and e+e-γ, show results that differ at the level of three standard deviations from those previously determined.

Correcting prominent ears with the island technique.

PubMed

DeMoura, L F

1977-01-01

A surgical procedure is described which corrects the ansiform ear by repositioning and reconstructing the anthelix and the anterior crus with the formation of the triangular fossa. This corrects the scaphoconchal angle and improves the cephaloauricular angle, overcoming the problem of prominent ears. Correction in early childhood is recommended in order to avoid personality problems that may result from the deformity, particularly in boys. The technique employed yields important advantages: (1) prolonged use of the helmet-type of surgical dressing is unnecessary; (2) scars are less conspicuous; (3) the outcome is attractive and normal; (4) bleeding and inflammatory complications are avoided; and (5) recurrence of the malformation is unlikely.

The role of prominence in determining the scope of boundary-related lengthening in Greek.

PubMed

Katsika, Argyro

2016-03-01

This study aims at examining and accounting for the scope of the temporal effect of phrase boundaries. Previous research has indicated that there is an interaction between boundary-related lengthening and prominence such that the former extends towards the nearby prominent syllable. However, it is unclear whether this interaction is due to lexical stress and/or phrasal prominence (marked by pitch accent) and how far towards the prominent syllable the effect extends. Here, we use an electromagnetic articulography (EMA) study of Greek to examine the scope of boundary-related lengthening as a function of lexical stress and pitch accent separately. Boundaries are elicited by the means of a variety of syntactic constructions.. The results show an effect of lexical stress. Phrase-final lengthening affects the articulatory gestures of the phrase-final syllable that are immediately adjacent to the boundary in words with final stress, but is initiated earlier within phrase-final words with non-final stress. Similarly, the articulatory configurations during inter-phrasal pauses reach their point of achievement later in words with final stress than in words with non-final stress. These effects of stress hold regardless of whether the phrase-final word is accented or de-accented. Phrase-initial lengthening, on the other hand, is consistently detected on the phrase-initial constriction, independently of where the stress is within the preceding, phrase-final, word. These results indicate that the lexical aspect of prominence plays a role in determining the scope of boundary-related lengthening in Greek. Based on these results, a gestural account of prosodic boundaries in Greek is proposed in which lexical and phrasal prosody interact in a systematic and coordinated fashion. The cross-linguistic dimensions of this account and its implications for prosodic structure are discussed.

Impact of muscle tension dysphonia on tonal pitch target implementation in vietnamese female teachers.

PubMed

Nguyen, Duong Duy; Kenny, Dianna T

2009-11-01

Muscle tension dysphonia (MTD) is a voice disorder with deteriorated vocal quality, particularly pitch problems. Because pitch is mainly controlled by the laryngeal muscles, and because MTD is characterized by increased laryngeal muscle tension, we hypothesized that it may result in problems in pitch target implementation in tonal languages. We examined tonal samples of 42 Vietnamese female primary school teachers diagnosed with MTD and compared them with 30 vocally healthy female teachers who spoke the same dialect. Tonal data were analyzed using Computerized Speech Lab (CSL-4300B) for Windows. From tonal sampling bases, fundamental frequency (F0) was measured at target points specified by contour examination. Parameters representing pitch movement including time, size, and speed of movement were measured for the falling tone and rising tone. We found that F0 at target points in MTD group was lowered in most tones, especially tones with extensive F0 variation. In MTD group, target F0 of the broken tone in isolation was 37.5 Hz lower (P<0.01) and target F0 of rising tone in isolation was 46 Hz lower (P<0.01) than in control group. In MTD group, speed of pitch fall of the falling tone in isolation was faster than control group by 2.2 semitones/second (st/s) (P<0.05) and speed of pitch rise in the rising tone in isolation was slower than control group by 7.2 st/s (P<0.01). These results demonstrate that MTD is associated with problems in tonal pitch variation.

Observations of loops and prominences

NASA Technical Reports Server (NTRS)

Strong, Keith T.

1994-01-01

We review recent observations by the Yohkoh-SXT (Soft X-ray Telescope) in collaboration with other spacecraft and ground-based observatories of coronal loops and prominences. These new results point to problems that SoHO will be able to address. With a unique combination of rapid-cadence digital imaging (greater than or equal to 32 s full-disk and greater than or equal to 2 s partial-frame images), high spatial resolution (greater than or equal to 2.5 arcsec pixels), high sensitivity (EM less than or equal to 10(exp 42) cm(exp -3)), a low-scatter mirror, and large dynamic range, SXT can observe a vast range of targets on the Sun. Over the first 21 months of Yohkoh operations SXT has taken over one million images of the corona and so is building up an invaluable long-term database on the large-scale corona and loop geometry. The most striking thing about the SXT images is the range of loop sizes and shapes. The active regions are a bright tangle of magnetic field lines, surrounded by a network of large-scale quiet-Sun loops stretching over distances in excess of 105 km. The cross-section of most loops seems to be constant. Loops displaying significant Gamma's are the exception, not the rule, implying the presence of widespread currents in the corona. All magnetic structures show changes. Time scales range from seconds to months. The question of how these structures are formed, become filled with hot plasma, and are maintained is still open. While we see the propagation of brightenings along the length of active-region loops and in X-ray jets with velocities of several hundred km/s, much higher velocities are seen in the quiet Sun. In XBP flares, for example, velocities of over 1000 km/s are common. Active-region loops seem to be in constant motion, moving slowly outward, carrying plasma with them. During flares, loops often produce localized brightenings at the base and later at the apex of the loop. Quiescent filaments and prominences have been observed regularly

[Observation of the dysphonia severity index in evaluating curative effect of vocal cord polyp surgery].

PubMed

Zhou, Zhou; Ge, Pingjiang; Liu, Qian; Liu, Ming; Zhang, Wei

2015-08-01

To investigate the applicability of the eysphonia severity index (DSI) in evaluating effects of surgery between before and after groups of vocal polyp patients. Analyses of measurement data pre and pro-surgery of 70 vocal polyp patients and 35 no voice disorders volunteers (control group). The voice quality was measured subjectively with the voice handicap index (VHI), the GRBAS and fiber electronic laryngoscopy. Measures of maximum phonation time (MPT), shimmer and jitter were obtained for each subject by using DiVAS 2.30 (XION, Germany). The DiVAS 2.30 had spotanenously calculate the scores of DSI. Using SPSS 17.0 to find the differences of DSI scores among the three groups by one-way ANOVA variance analysis. And finding out of the correlation with DSI scores and VHI scores, GRBAS, MPT, jitter and shimmer. DSI improved significantly after surgery in the vocal polyps group (mean difference DSI -2.92 and 1.87, respectively) and also in the control group (mean difference DSI -2.92 and 2.30, respectively). However, no significant difference between the control group and the after surgery group. By using Pearson correlation analysis, this study observed a strong correlation between the DSI scores and the VHI scores, the values of GRBAS, shimmer (P < 0.01). DSI is an effective and high accuracy multi-parameter system for evaluation of vocal cord polyp patients as an independent assessment of dysphonia. DSI also can be used in evaluation of the effects of the vocal polyps surgery.

Propagating Waves Transverse to the Magnetic Field in a Solar Prominence

NASA Astrophysics Data System (ADS)

Kucera, Therese A.; Knizhnik, K.; Lopez Ariste, A.; Luna Bennasar, M.; Schmieder, B.; Toot, D.

2013-07-01

We have observed a quiescent prominence with the Hinode Solar Optical Telescope (SOT, in Ca II and H-alpha lines), Sacramento Peak Observatory (in H-alpha, H-beta and Sodium-D lines), and THEMIS/MTR (Télescope Héliographique pour l'Étude du Magnétisme et des Instabilités Solaires/MulTi Raies, providing vector magnetograms), and SDO/AIA (Solar Dynamics Observatory Atmospheric Imaging Assembly, in EUV) over a 4 hour period on 2012 October 10. The small fields of view of SOT, Sac Peak and THEMIS are centered on a large pillar-like prominence footpoint extending towards the surface. This feature appears in the larger field of view of the 304 Å band, as a large, quasi-vertical column with material flowing horizontally on each side. The THEMIS/MTR data indicate that the magnetic field in the pillar is essentially horizontal and the observations in the optical wavelengths show a large number of horizontally aligned features on a much smaller scale than the pillar as a whole. The data are consistent with a model of cool prominence plasma trapped in the dips of horizontal field lines. The SOT and Sac Peak data show what appear to be moving wave pulses. These pulses, which include a Doppler signature, move vertically, perpendicular to the field direction, along quasi-vertical columns. The pulses have a velocity of propagation of about 10 km/s, a period about 260 sec, and a wavelength around 2000 km. We interpret these waves in terms of fast magneto-sonic waves and discuss possible wave drivers.

The Apparent Critical Decay Index at the Onset of Solar Prominence Eruptions

NASA Astrophysics Data System (ADS)

Zuccarello, F. P.; Aulanier, G.; Gilchrist, S. A.

2016-04-01

A magnetic flux rope (MFR) embedded in a line-tied external magnetic field that decreases with height as {z}-n is unstable to perturbations if the decay index of the field n is larger than a critical value. The onset of this instability, called torus instability, is one of the main mechanisms that can initiate coronal mass ejections. Since flux ropes often possess magnetic dips that can support prominence plasma, this is also a valuable mechanism to trigger prominence eruptions. Magnetohydrodynamic (MHD) simulations of the formation and/or emergence of MFRs suggest a critical value for the onset of the instability in the range [1.4-2]. However, detailed observations of prominences suggest a value in the range [0.9-1.1]. In this Letter, by using a set of MHD simulations, we show why the large discrepancy between models and observations is only apparent. Our simulations indeed show that the critical decay index at the onset of the eruption is n=1.4+/- 0.1 when computed at the apex of the flux rope axis, while it is n=1.1+/- 0.1 when it is computed at the altitude of the topmost part of the distribution of magnetic dips. The discrepancy only arises because weakly twisted curved flux ropes do not have dips up to the altitude of their axis.

Dynamics of a Solar Prominence Tornado Observed by SDO/AIA on 2012 November 7-8

NASA Astrophysics Data System (ADS)

Mghebrishvili, Irakli; Zaqarashvili, Teimuraz V.; Kukhianidze, Vasil; Ramishvili, Giorgi; Shergelashvili, Bidzina; Veronig, Astrid; Poedts, Stefaan

2015-09-01

We study the detailed dynamics of a solar prominence tornado using time series of 171, 304, 193, and 211 Å spectral lines obtained by the Solar Dynamics Observatory/Atmospheric Imaging Assembly during 2012 November 7-8. The tornado first appeared at 08:00 UT, November 07, near the surface, gradually rose upwards with the mean speed of ˜1.5 km s-1 and persisted over 30 hr. Time-distance plots show two patterns of quasi-periodic transverse displacements of the tornado axis with periods of 40 and 50 minutes at different phases of the tornado evolution. The first pattern occurred during the rising phase and can be explained by the upward motion of the twisted tornado. The second pattern occurred during the later stage of evolution when the tornado already stopped rising and could be caused either by MHD kink waves in the tornado or by the rotation of two tornado threads around a common axis. The later hypothesis is supported by the fact that the tornado sometimes showed a double structure during the quasi-periodic phase. 211 and 193 Å spectral lines show a coronal cavity above the prominence/tornado, which started expansion at ˜13:00 UT and continuously rose above the solar limb. The tornado finally became unstable and erupted together with the corresponding prominence as coronal mass ejection (CME) at 15:00 UT, November 08. The final stage of the evolution of the cavity and the tornado-related prominence resembles the magnetic breakout model. On the other hand, the kink instability may destabilize the twisted tornado, and consequently prominence tornadoes can be used as precursors for CMEs.

NUMERICAL STUDY ON IN SITU PROMINENCE FORMATION BY RADIATIVE CONDENSATION IN THE SOLAR CORONA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kaneko, T.; Yokoyama, T., E-mail: kaneko@eps.s.u-tokyo.ac.jp

2015-06-10

We propose an in situ formation model for inverse-polarity solar prominences and demonstrate it using self-consistent 2.5 dimensional MHD simulations, including thermal conduction along magnetic fields and optically thin radiative cooling. The model enables us to form cool dense plasma clouds inside a flux rope by radiative condensation, which is regarded as an inverse-polarity prominence. Radiative condensation is triggered by changes in the magnetic topology, i.e., formation of the flux rope from the sheared arcade field, and by thermal imbalance due to the dense plasma trapped inside the flux rope. The flux rope is created by imposing converging and shearingmore » motion on the arcade field. Either when the footpoint motion is in the anti-shearing direction or when heating is proportional to local density, the thermal state inside the flux rope becomes cooling-dominant, leading to radiative condensation. By controlling the temperature of condensation, we investigate the relationship between the temperature and density of prominences and derive a scaling formula for this relationship. This formula suggests that the proposed model reproduces the observed density of prominences, which is 10–100 times larger than the coronal density. Moreover, the time evolution of the extreme ultraviolet emission synthesized by combining our simulation results with the response function of the Solar Dynamics Observatory Atmospheric Imaging Assembly filters agrees with the observed temporal and spatial intensity shift among multi-wavelength extreme ultraviolet emission during in situ condensation.« less

From Wilhelm von Humboldt to Hitler-are prominent people more prone to have Parkinson's disease?

PubMed

Horowski; Horowski; Calne; Calne

2000-10-01

We describe Parkinsonism in prominent people, where Wilhelm von Humboldt and Adolf Hitler provide just two spectacular, opposing examples. In both of them, there is little if any evidence that the disease did influence their life ambitions, methods of achieving them or cognitive function in general. Thus, Hitler's Parkinsonism should remain a 'footnote' to history, and historians should acknowledge that in his last years, his trembling, his curbed posture, his slow walking, mask-like face and low voice did not indicate remorse, fear or depression as a consequence of his crimes, but were mere expressions of his disease which, until the end, had no impact on his intellectual skills and methods. The apparently higher incidence of Parkinsonism in prominent people may be just due to their higher visibility, or a consequence of disease-related personality traits (e.g. ambition, perfectionism, rigidity) which may contribute to becoming, e.g., a prominent authoritarian person. Perhaps even some early behaviour pattern (such as repressed emotions or acting in public-which could even increase the risk of some infection) contributes to a greater vulnerability for developing Parkinsonism. Further studying other prominent cases might lead us to better understanding of risk factors and the expression of early Parkinsonism.

Three-Dimensional Morphology of a Coronal Prominence Cavity

NASA Technical Reports Server (NTRS)

Gibson, S. E.; Kucera, T. A.; Rastawicki, D.; Dove, J.; deToma, G.; Hao, J.; Hill, S.; Hudson, H. S.; Marque, C.; McIntosh, P. S.;

A different type of 'glue ear': report of an unusual case of prominent ears.

PubMed

Purcell, Elizabeth M; O'Neill, Ann C; Regan, Padraic J

2003-09-01

Prominent ears is a condition that can cause extreme psychological distress in young people. This cosmetic deformity can be corrected by otoplasty, an outpatient surgical procedure that is associated with a high rate of patient satisfaction. We report the unusual case of a teenage boy who had repeatedly applied cyanoacrylate adhesive ("superglue") to his postauricular skin in an attempt to pin back his prominent ears. This case of "glue ear" was ultimately resolved by successful otoplasty, although the residual effects of the glue resulted in delayed healing of the surgical wound.

Open questions on prominences from coordinated observations by IRIS, Hinode, SDO/AIA, THEMIS, and the Meudon/MSDP

NASA Astrophysics Data System (ADS)

Schmieder, B.; Tian, H.; Kucera, T.; López Ariste, A.; Mein, N.; Mein, P.; Dalmasse, K.; Golub, L.

2014-09-01

Context. A large prominence was observed by multiple instruments on the ground and in space during an international campaign on September 24, 2013, for three hours (12:12 UT -15:12 UT). Instruments used in the campaign included the newly launched (June 2013) Interface Region Imaging Spectrograph (IRIS), THEMIS (Tenerife), the Hinode Solar Optical Telescope (SOT), the Solar Dynamic Observatory's Atmospheric Imaging Assembly (SDO/AIA), and the Multichannel Subtractive Double Pass spectrograph (MSDP) in the Meudon Solar Tower. The movies obtained in 304 Å with the EUV imager SDO/AIA, and in Ca II line by SOT show the dynamic nature of the prominence. Aims: The aim of this work is to study the dynamics of the prominence fine structures in multiple wavelengths to understand their formation. Methods: The spectrographs IRIS and MSDP provided line profiles with a high cadence in Mg II h (2803.5 Å) and k (2796.4 Å) lines along four slit positions (IRIS), and in Hα in a 2D field of view (MSDP). The spectropolarimetry of THEMIS (Tenerife) allowed us to derive the magnetic field of the prominence using the He D3 line depolarization (Hanle effect combined with the Zeeman effect). Results: The magnetic field is found to be globally horizontal with a relatively weak field strength (8-15 Gauss). On the other hand, the Ca II movie reveals turbulent-like motion that is not organized in specific parts of the prominence. We tested the addition of a turbulent magnetic component. This model is compatible with the polarimetric observations at those places where the plasma turbulence peaks. On the other hand, the Mg II line profiles show multiple peaks well separated in wavelength. This is interpreted by the existence of small threads along the line of sight with a large dispersion of discrete values of Doppler shifts, from 5 km s-1 (a quasi-steady component) to 60-80 km s-1. Each peak corresponds to a Gaussian profile, and not to a reversed profile as was expected by the present non

16 CFR § 1500.121 - Labeling requirements; prominence, placement, and conspicuousness.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., layout, or color with other printed matter on the label. This regulation contains the Commission's..., which bear(s) the labeling designed to be most prominently displayed, shown, presented, or examined... designed to be displayed for sale or, on display panels other than the principal display panel, in lines...

Primary mucoepidermoid carcinoma of the lung with prominent clear cells

PubMed Central

Fink, David D.; Lomas, Angela M.; Roden, Anja C.; Shah, Prashant C.

2017-01-01

Mucoepidermoid carcinoma of the lung is a rare malignancy of salivary gland-type origin. We report a case of a 21-year-old man with a right mainstem bronchus mass composed predominantly of clear cells. This case represents a rare primary pulmonary low-grade mucoepidermoid carcinoma positive for MAML2 rearrangement by fluorescence in situ hybridization with a prominent clear cell component. PMID:28670072

The Role of Prominence in Pronoun Resolution: Active versus Passive Representations

ERIC Educational Resources Information Center

Foraker, Stephani; McElree, Brian

2007-01-01

A prominent antecedent facilitates anaphor resolution. Speed-accuracy tradeoff modeling in Experiments 1 and 3 indicated that clefting did not affect the speed of accessing an antecedent representation, which is inconsistent with claims that discourse-focused information is actively maintained in focal attention [e.g., Gundel, J. K. (1999). "On…

Treatment of Prominent Ears with an Implantable Clip System: A Pilot Study

PubMed Central

Kang, Norbert V.; Kerstein, Ryan L.

2016-01-01

Background The earFold™ implantable clip system is a new treatment for prominent ears using an implant made from nickel-titanium alloy, forged into a predetermined shape. The implant is fixed to the cartilage then released, causing the cartilage to fold back. Objectives The study aimed to test the safety and behaviour of the implant in vivo. Methods This was a Phase 1, prospective, nonrandomised study. Thirty-nine patients were recruited, from 7 to 57 years of age (22 adults and 17 children). Thirty-seven patients were followed up for a minimum of 18 months. A total of 131 implants was used to treat 75 ears. All treatments were performed under local anaesthetic. Results Eighteen patients asked for their implants to be left in place permanently. Twenty-one patients agreed to have their implants removed at 6, 12, or 18 months after insertion. Complications affected 8 patients and included extrusion, infection, hypertrophic scarring, and Spock-ear formation. No new complications have arisen in any of the patients since the conclusion of the study, up to a maximum of 47 months. Patients were overwhelmingly satisfied with the outcome of treatment. Conclusions earFold can be used as a permanent implant to correct prominence of the human ear. It is best suited for treating prominent ears with a poorly formed or absent antihelical fold. The procedure is quick and predictable with a complication rate comparable to suture-based otoplasty techniques. PMID:26673575

Liking Goes with Liking: An Intuitive Congruence between Preference and Prominence

ERIC Educational Resources Information Center

Morvinski, Coby; Amir, On

2018-01-01

In a series of 8 experiments, we demonstrate the existence of a "labeling effect" wherein people intuitively relate preferred choices to prominently labeled cues (such as heads as opposed to tails in a coin toss) and vice versa. Importantly, the observed congruence is asymmetric--it does not manifest for nonprominent cues and…

Magnetic field vector and electron density diagnostics from linear polarization measurements in 14 solar prominences

NASA Technical Reports Server (NTRS)

Bommier, V.

1986-01-01

The Hanle effect is the modification of the linear polarization parameters of a spectral line due to the effect of the magnetic field. It has been successfully applied to the magnetic field vector diagnostic in solar prominences. The magnetic field vector is determined by comparing the measured polarization to the polarization computed, taking into account all the polarizing and depolarizing processes in line formation and the depolarizing effect of the magnetic field. The method was applied to simultaneous polarization measurements in the Helium D3 line and in the hydrogen beta line in 14 prominences. Four polarization parameters are measured, which lead to the determination of the three coordinates of the magnetic field vector and the electron density, owing to the sensitivity of the hydrogen beta line to the non-negligible effect of depolarizing collisions with electrons and protons of the medium. A mean value of 1.3 x 10 to the 10th power cu. cm. is derived in 14 prominences.

Self-presentation in Online Professional Networks: Men's Higher and Women's Lower Facial Prominence in Self-created Profile Images.

PubMed

Sczesny, Sabine; Kaufmann, Michèle C

2017-01-01

Men are presented with higher facial prominence than women in the media, a phenomenon that is called face-ism . In naturalistic settings, face-ism effects could be driven by gender biases of photographers and/or by gender differences in self-presentation. The present research is the first to investigate whether women and men themselves create this different facial prominence. In a controlled laboratory study, 61 participants prepared a picture of themselves from a half-body photograph, allegedly to be uploaded to their profile for an online professional network. As expected, men cropped their photos with higher facial prominence than women did. However, women and men did not differ in the self-presentational motivations, goals, strategies, and personality variables under investigation, so that the observed face-ism effect could not be explained with these variables. Generally, the higher participants' physical appearance self-esteem, the higher was their self-created facial prominence.

Spheromaks, solar prominences, and Alfvén instability of current sheets

NASA Astrophysics Data System (ADS)

Bellan, P. M.; Yee, J.; Hansen, J. F.

2001-06-01

Three related efforts underway at Caltech are discussed: experimental studies of spheromak formation, experimental simulation of solar prominences, and Alfvén wave instability of current sheets. Spheromak formation has been studied by using a coaxial magnetized plasma gun to inject helicity-bearing plasma into a very large vacuum chamber. The spheromak is formed without a flux conserver and internal λ profiles have been measured. Spheromak-based technology has been used to make laboratory plasmas having the topology and dynamics of solar prominences. The physics of these structures is closely related to spheromaks (low β, force-free, relaxed state equilibrium) but the boundary conditions and symmetry are different. Like spheromaks, the equilibrium involves a balance between hoop forces, pinch forces, and magnetic tension. It is shown theoretically that if a current sheet becomes sufficiently thin (of the order of the ion skin depth or smaller), it becomes kinetically unstable with respect to the emission of Alfvén waves and it is proposed that this wave emission is an important aspect of the dynamics of collisionless reconnection.

Effective scoring of scapha prevents helix irregularity in prominent ear correction - a biomechanical study.

PubMed

Nagasao, Tomohisa; Miyamoto, Junpei; Shimizu, Yusuke; Kasai, Shogo; Kishi, Kazuo; Kaneko, Tsuyoshi

2014-09-01

As the antihelix is created in the operation for prominent ear, the helix often presents irregularities. This biomechanical study aims to elucidate effective techniques to prevent these irregularities. Finite element models were produced simulating 10 prominent ears. The scaphas of the 10 models were thinned to simulate scoring or abrasion of the cartilage. The thinning was conducted in four fashions. In the first group, no thinning was conducted (Non-Scoring Models); in the second group, the upper half of the scapha was thinned (Upper-Scoring Models); in the third group, the lower half of the scapha was thinned (Lower-Scoring Models); in the fourth group, the whole scapha was thinned (Whole-Scoring Models). Mattress sutures were applied to create the antihelix to simulate Mustarde's in-suture technique. Thereafter, transformation of the helix's contour was evaluated. Irregularity developed on the upper region of the helix with Non-Scoring and Lower-Scoring Models; the degree of the upper-region's irregularity was reduced with Upper-Scoring Models and Whole-Scoring Models. Although the edge of the helix moved in the posterior-medial direction with other type models, it moved in the anterior direction with Whole-Scoring Models. Irregularity of the upper region of the helix can be prevented by performing scoring or abrasion of the upper part of the scapha. The prominence of the helix and width of the auricle are adjustable by varying the areas of the scapha receiving scoring or abrasion. These findings are useful in improving operative outcomes in the treatment of prominent ears. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

THE ROLE OF THE INNER CORONAL NULL POINT IN THE FORMATION AND EVOLUTION OF SOLAR QUIESCENT PROMINENCES

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, Y. Z., E-mail: yzzhangmail@sohu.com

2015-02-10

Using a 2.5-dimensional MHD simulation, we investigate the role played by the inner coronal null point in the formation and evolution of solar quiescent prominences. The flux rope is characterized by its magnetic fluxes, the toroidal magnetic flux Φ {sub p} and the poloidal flux Φ{sub ψ}. It is found that for a given Φ {sub p}, the catastrophe does not occur in the flux rope system until Φ{sub ψ} increases to a critical point. Moreover, the magnetic flux of the null point is the maximum value of the magnetic flux in the quadrupole background magnetic field, and represented bymore » ψ {sub N}. The results show that the bigger ψ {sub N} usually corresponds to the smaller catastrophic point, the lower magnetic energy of the flux rope system, and the lesser magnetic energy inside the flux rope. Our results confirm that catastrophic disruption of the prominence occurs more easily when there is a bigger ψ {sub N}. However, ψ {sub N} has little influence on the maximum speed of the coronal mass ejections (CMEs) with an erupted prominence. Thus we argue that a topological configuration with the inner coronal null point is a necessary structure for the formation and evolution of solar quiescent prominences. In conclusion, it is easier for the prominences to form and to erupt as a core part of the CMEs in the magnetic structure with a greater ψ {sub N}.« less

An update on auricular reconstruction: three major auricular malformations of microtia, prominent ear and cryptotia.

PubMed

Park, Chul; Yoo, Yeon-Sik; Hong, Sung-Taek

2010-12-01

Microtia, prominent ear, and cryptotia are the most common types of auricular malformations. This review provides updated information on these types of reconstructions, in addition to recalling previously accepted surgical methods. Autogenous costal cartilage is still considered as an ideal material for framework fabrication in microtia reconstruction. Many surgeons have adopted the Nagata approach, the Brent approach, or variations of the two, in their work. With these employed techniques, auricles reconstructed by experienced surgeons have proven to be aesthetically promising. However, with regards to the harvesting of the costal cartilage, the underdevelopment of the chest wall donor site, alopecia of the scalp, and scarring of the postauricular-mastoid region are still considered problematic aspects of these approaches. Some articles have described attempts to solve these problems, whereas some experiments in cartilage production using tissue engineering techniques have shown promise in their initial stages of development.It is generally accepted that prominent ears should be corrected through a combination of sculpting and suture techniques, according to the individual shape and the quality of the ear prominence.Most of the cryptotia malformations show not only embedded upper auricles, but also associated adhesions of the upper auricular cartilage. Their correction should therefore resolve both deformities. A number of articles highlighting clinical experiences with auricular reconstructions for microtia, prominent ear, and cryptotia have been included in this review. We believe that the information synthesized here will become a basis for further development of auricular reconstruction techniques.

Treatment of Prominent Ears with an Implantable Clip System: A Pilot Study.

PubMed

Kang, Norbert V; Kerstein, Ryan L

2016-03-01

The earFold™ implantable clip system is a new treatment for prominent ears using an implant made from nickel-titanium alloy, forged into a predetermined shape. The implant is fixed to the cartilage then released, causing the cartilage to fold back. The study aimed to test the safety and behaviour of the implant in vivo. This was a Phase 1, prospective, nonrandomised study. Thirty-nine patients were recruited, from 7 to 57 years of age (22 adults and 17 children). Thirty-seven patients were followed up for a minimum of 18 months. A total of 131 implants was used to treat 75 ears. All treatments were performed under local anaesthetic. Eighteen patients asked for their implants to be left in place permanently. Twenty-one patients agreed to have their implants removed at 6, 12, or 18 months after insertion. Complications affected 8 patients and included extrusion, infection, hypertrophic scarring, and Spock-ear formation. No new complications have arisen in any of the patients since the conclusion of the study, up to a maximum of 47 months. Patients were overwhelmingly satisfied with the outcome of treatment. earFold can be used as a permanent implant to correct prominence of the human ear. It is best suited for treating prominent ears with a poorly formed or absent antihelical fold. The procedure is quick and predictable with a complication rate comparable to suture-based otoplasty techniques. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

Imaging of Prominent Carbon Stars: From CRIRES and NACO to MATISSE

NASA Astrophysics Data System (ADS)

Hron, Josef

2018-04-01

We present an update to the spectro-astrometry carried out with CRIRES for some prominent carbon stars in the L- and M-bands. For TX Psc additional NACO imaging is compared with the CRIRES results. We also discuss the prospects and plans for MATISSE, the second generation VLTI instrument to operate in L, M and N.

Self-presentation in Online Professional Networks: Men's Higher and Women's Lower Facial Prominence in Self-created Profile Images

PubMed Central

Sczesny, Sabine; Kaufmann, Michèle C.

2018-01-01

Men are presented with higher facial prominence than women in the media, a phenomenon that is called face-ism. In naturalistic settings, face-ism effects could be driven by gender biases of photographers and/or by gender differences in self-presentation. The present research is the first to investigate whether women and men themselves create this different facial prominence. In a controlled laboratory study, 61 participants prepared a picture of themselves from a half-body photograph, allegedly to be uploaded to their profile for an online professional network. As expected, men cropped their photos with higher facial prominence than women did. However, women and men did not differ in the self-presentational motivations, goals, strategies, and personality variables under investigation, so that the observed face-ism effect could not be explained with these variables. Generally, the higher participants' physical appearance self-esteem, the higher was their self-created facial prominence. PMID:29387029

Proteomic Changes in Rat Thyroarytenoid Muscle Induced by Botulinum Neurotoxin Injection

PubMed Central

Welham, Nathan V.; Marriott, Gerard; Tateya, Ichiro; Bless, Diane M.

2009-01-01

Botulinum neurotoxin (BoNT) injection into the thyroarytenoid (TA) muscle is a commonly performed medical intervention for adductor spasmodic dysphonia. The mechanism of action of BoNT at the neuromuscular junction is well understood, however, aside from reports focused on myosin heavy chain isoform abundance, there is a paucity of data addressing the effects of therapeutic BoNT injection on the TA muscle proteome. In this study, 12 adult Sprague Dawley rats underwent unilateral TA muscle BoNT serotype A injection followed by tissue harvest at 72 hrs, 7 days, 14 days, and 56 days post-injection. Three additional rats were reserved as controls. Proteomic analysis was performed using 2D SDS-PAGE followed by MALDI-MS. Vocal fold movement was significantly reduced by 72 hrs, with complete return of function by 56 days. Twenty-five protein spots demonstrated significant protein abundance changes following BoNT injection, and were associated with alterations in energy metabolism, muscle contractile function, cellular stress response, transcription, translation, and cell proliferation. A number of protein abundance changes persisted beyond the return of gross physiologic TA function. These findings represent the first report of BoNT induced changes in any skeletal muscle proteome, and reinforce the utility of applying proteomic tools to the study of system-wide biological processes in normal and perturbed TA muscle function. PMID:18442174

Development of a voice disorder work productivity inventory utilizing cognitive interviewing technique.

PubMed

Giliberto, John Paul; Zhu, Qiubei; Meyer, Tanya K

2016-12-01

Voice disorders have been shown to impair workplace productivity primarily by reduced efficiency while at work (presenteeism) versus increased days missed (absenteeism). Work productivity measures such as the Work Productivity and Activity Impairment (WPAI) Questionnaire or the World Health Organization Health - Work Performance Questionnaire (HPQ) can be customized to a specific disease but do not fully capture impaired work productivity associated with voice disorders. The purpose of this study was to develop a novel questionnaire to evaluate work productivity in patients with voice disorders. Descriptive. At a tertiary medical center, patients with gainful employment and with chronic voice disorders were given the WPAI, HPQ, and 20 voice-related statements (VRS-20). Cognitive interviews were conducted and recorded with all patients. Ten patients (7 females, 3 males) completed the questionnaires and subsequent cognitive interviews. One patient had spasmodic dysphonia, 6 had benign vocal fold lesions, and 3 had vocal fold motion disorders. The median VHI-10 was 18 (9-40). Themes that emerged during interviews include: avoiding oral communication/telephone, use of voice associated with strain/fatigue, frustration and stress at work, and workplace integrity. Conclusions : In cognitive interviews, participants felt the VRS-20 captured the impact of their voice disorder at work better than the WPAI and HPQ. Participants also felt some statements were more important than others. 5.

Looking outside the (voice)box.

PubMed

Gartrell, Nanette; Rothblum, Esther

2014-01-01

Laura S. Brown, PhD, is a clinical and forensic psychologist in independent practice in Seattle, Washington. The bulk of her scholarly work has been in the fields of feminist therapy theory, trauma treatment, lesbian and gay issues, assessment and diagnosis, ethics and standards of care in psychotherapy, and cultural competence. She has authored or edited ten professional books, including the award-winning Subversive Dialogues: Theory in Feminist Therapy, as well as more than 140 other professional publications. She has also recently published her first book for general audiences, Your turn for care: Surviving the aging and death of the adults who harmed you. Laura has been featured in five psychotherapy training videos produced by the American Psychological Association. She was President of American Psychological Association Divisions 35 (Society for the Psychology of Women), 44 (Society for the Psychological Study of Lesbian, Gay and Bisexual Issues), and 56 (Trauma Psychology). Laura was also President of the Washington State Psychological Association. She is the founder and Director of the Fremont Community Therapy Project, a low-fee psychotherapy training clinic in Seattle. In the fall of 2000, she was the on-site psychologist for the reality show Survivor: The Australian Outback. In 1987, Laura lost her voice and was diagnosed with spasmodic dysphonia. In 1988, she found her voice again.

Irony in Tennyson's "Little Hamlet".

ERIC Educational Resources Information Center

Harrison, Antony H.

1981-01-01

Points out similarities between the events and characters of Tennyson's "Maud" and Shakespeare's "Hamlet." Identifies traits which "Maud" shares with Spasmodic poetry. Argues that Tennyson consciously employed these similarities to expose the deficiencies of the Spasmodic school. (DMM)

Clinical Mass Spectrometry: Achieving Prominence in Laboratory Medicine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Annesley, Thomas M.; Cooks, Robert G.; Herold, David A.

Each year the journal Clinical Chemistry publishes a January special issue on a topic that is relevant to the laboratory medicine community. In January 2016 the topic is mass spectrometry, and the issue is entitled “Clinical Mass Spectrometry: Achieving Prominence in Laboratory Medicine”. One popular feature in our issues is a Q&A on a topic, clearly in this case mass spectrometry. The journal is assembling a panel of 5-6 experts from various areas of mass spectrometry ranging from instrument manufacturing to practicing clinical chemists. Dick Smith is one of the scientist requested to participate in this special issue Q&A onmore » Mass Spectrometry. The Q&A Transcript is attached« less

DYNAMICS OF A SOLAR PROMINENCE TORNADO OBSERVED BY SDO/AIA ON 2012 NOVEMBER 7–8

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mghebrishvili, Irakli; Zaqarashvili, Teimuraz V.; Kukhianidze, Vasil

We study the detailed dynamics of a solar prominence tornado using time series of 171, 304, 193, and 211 Å spectral lines obtained by the Solar Dynamics Observatory/Atmospheric Imaging Assembly during 2012 November 7–8. The tornado first appeared at 08:00 UT, November 07, near the surface, gradually rose upwards with the mean speed of ∼1.5 km s{sup −1} and persisted over 30 hr. Time–distance plots show two patterns of quasi-periodic transverse displacements of the tornado axis with periods of 40 and 50 minutes at different phases of the tornado evolution. The first pattern occurred during the rising phase and canmore » be explained by the upward motion of the twisted tornado. The second pattern occurred during the later stage of evolution when the tornado already stopped rising and could be caused either by MHD kink waves in the tornado or by the rotation of two tornado threads around a common axis. The later hypothesis is supported by the fact that the tornado sometimes showed a double structure during the quasi-periodic phase. 211 and 193 Å spectral lines show a coronal cavity above the prominence/tornado, which started expansion at ∼13:00 UT and continuously rose above the solar limb. The tornado finally became unstable and erupted together with the corresponding prominence as coronal mass ejection (CME) at 15:00 UT, November 08. The final stage of the evolution of the cavity and the tornado-related prominence resembles the magnetic breakout model. On the other hand, the kink instability may destabilize the twisted tornado, and consequently prominence tornadoes can be used as precursors for CMEs.« less

Topographic prominence discriminator for the detection of short-latency spikes of retinal ganglion cells

NASA Astrophysics Data System (ADS)

Choi, Myoung-Hwan; Ahn, Jungryul; Park, Dae Jin; Lee, Sang Min; Kim, Kwangsoo; Cho, Dong-il Dan; Senok, Solomon S.; Koo, Kyo-in; Goo, Yong Sook

2017-02-01

Objective. Direct stimulation of retinal ganglion cells in degenerate retinas by implanting epi-retinal prostheses is a recognized strategy for restoration of visual perception in patients with retinitis pigmentosa or age-related macular degeneration. Elucidating the best stimulus-response paradigms in the laboratory using multielectrode arrays (MEA) is complicated by the fact that the short-latency spikes (within 10 ms) elicited by direct retinal ganglion cell (RGC) stimulation are obscured by the stimulus artifact which is generated by the electrical stimulator. Approach. We developed an artifact subtraction algorithm based on topographic prominence discrimination, wherein the duration of prominences within the stimulus artifact is used as a strategy for identifying the artifact for subtraction and clarifying the obfuscated spikes which are then quantified using standard thresholding. Main results. We found that the prominence discrimination based filters perform creditably in simulation conditions by successfully isolating randomly inserted spikes in the presence of simple and even complex residual artifacts. We also show that the algorithm successfully isolated short-latency spikes in an MEA-based recording from degenerate mouse retinas, where the amplitude and frequency characteristics of the stimulus artifact vary according to the distance of the recording electrode from the stimulating electrode. By ROC analysis of false positive and false negative first spike detection rates in a dataset of one hundred and eight RGCs from four retinal patches, we found that the performance of our algorithm is comparable to that of a generally-used artifact subtraction filter algorithm which uses a strategy of local polynomial approximation (SALPA). Significance. We conclude that the application of topographic prominence discrimination is a valid and useful method for subtraction of stimulation artifacts with variable amplitudes and shapes. We propose that our algorithm

Tethered Prominence-CME Systems Captured during the 2012 November 13 and 2013 November 3 Total Solar Eclipses

NASA Astrophysics Data System (ADS)

Druckmüller, Miloslav; Habbal, Shadia R.; Alzate, Nathalia; Emmanouilidis, Constantinos

2017-12-01

We report on white light observations of high latitude tethered prominences acquired during the total solar eclipses of 2012 November 13 and 2013 November 3, at solar maximum, with a field of view spanning several solar radii. Distinguished by their pinkish hue, characteristic of emission from neutral hydrogen and helium, the four tethered prominences were akin to twisted flux ropes, stretching out to the limit of the field of view, while remaining anchored at the Sun. Cotemporal observations in the extreme ultraviolet from the Solar Dynamics Observatory (SDO/AIA) clearly showed that the pinkish emission from the cool (≈ {10}4-{10}5 K) filamentary prominences was cospatial with the 30.4 nm He II emission, and was directly linked to filamentary structures emitting at coronal temperatures ≥slant {10}6 K in 17.1 and 19.3 nm. The tethered prominences evolved from typical tornado types. Each one formed the core of different types of coronal mass ejections (CMEs), as inferred from coordinated LASCO C2, C3, and STEREO A and B coronagraph observations. Two of them evolved into a series of faint, unstructured puffs. One was a normal CME. The most striking one was a “light-bulb” type CME, whose three-dimensional structure was confirmed from all four coronagraphs. These first uninterrupted detections of prominence-CME systems anchored at the Sun, and stretching out to at least the edge of the field of view of LASCO C3, provide the first observational confirmation for the source of counter-streaming electron fluxes measured in interplanetary CMEs, or ICMEs.

Validity and Reliability of Surface Electromyography in the Assessment of Primary Muscle Tension Dysphonia.

PubMed

Khoddami, Seyyedeh Maryam; Talebian, Saeed; Izadi, Farzad; Ansari, Noureddin Nakhostin

2017-05-01

The study aims to evaluate the reliability and the discriminative validity of surface electromyography (sEMG) in the assessment of patients with primary muscle tension dysphonia (MTD). The study design is cross-sectional. Fifteen patients with primary MTD (mean age: 34.07 ± 10.99 years) and 15 healthy volunteers (mean age: 34.53 ± 10.63 years) were included. All participants underwent evaluation of sEMG to record the electrical activity of the thyrohyoid and cricothyroid muscles. The outcome measures were the root mean square (RMS), activity peak, duration, and time to the peak activity, which were obtained during /a/ and /i/ prolongation for test-retest reliability. The test-retest reliability was good to excellent for the RMS and peak activity measures (intraclass correlation coefficient [agreement] [ICC agreement ] = 0.49-0.98). The reliability for the activity duration was poor to excellent (ICC agreement  = 0.19-0.9). Poor test-retest reliability was found for the time to peak measure (ICC agreement  = 0.15-0.37). The standard error of measurement for all sEMG measures was between 0.41 and 2.05. The smallest detectable change (SDC) was calculated between 1.13 and 5.66. The highest SDC values were obtained for the peak and the lowest SDCs were documented for the duration (5.66 and 1.13, respectively). All sEMG measures were not able to discriminate between the MTD patients and healthy subjects (P > 0.05). The sEMG is a reliable tool to measure the RMS, the peak activity, and the activity duration in primary MTD. However, it is not able to discriminate the patients with primary MTD from healthy subjects. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Multiple, short-lived "stellar prominences" on the O giant ξ Persei: a magnetic star?

NASA Astrophysics Data System (ADS)

Sudnik, N.; Henrichs, H. F.

2018-01-01

We present strong evidence for a rotation period of 2.0406 d of the O giant ξ Persei, derived from the NIV λ1718 wind line in 12 yr of IUE data. We predict that ξ Per has a magnetic dipole field, with superposed variable magnetic prominences. Favorable dates for future magnetic measurements can be predicted. We also analysed time-resolved HeII 4686 spectra from a campaign in 1989 by using the same simplified model as before for λ Cephei, in terms of multiple spherical blobs attached to the surface, called stellar prominences (Sudnik & Henrichs, 2016). These represent transient multiple magnetic loops on the surface, for which we find lifetimes of mostly less than 5 h.

Earfold Implantable Clip System for Correction of Prominent Ears: Analysis of Safety in 403 Patients

PubMed Central

Sojitra, Nilesh; Glumicic, Sinisa; Vlok, Jacobus A.; O’Toole, Greg; Hannan, S. Alam; Sabbagh, Walid

2018-01-01

Background: The Earfold system, a new treatment for the correction of prominent ears, consists of 3 components: the Earfold implant, the Earfold introducer, and the Prefold positioner. Methods: This is an interim report based on an ongoing analysis of safety in a series of patients treated for prominent ears with the Earfold implant between February 2013 and September 2014. Safety was assessed based on adverse event reports and the need for implant revision; follow-up is ongoing. Results: Seven surgeons used 1,200 Earfold implants to treat 403 patients (ages, 7–70 years; 63% male); the time since the initial implant procedure now ranges from 30 to 48 months. To date, 145 patients (36%) have returned for a follow-up visit (mean, 7.7 months [range, 1–34 months]). Adverse events requiring intervention have affected 39 of 403 (9.7%) patients; these include implant revisions (n = 17 [4.2%], most often due to implant visibility), skin erosion over the implant (n = 15 [3.7%]), and infection (n = 7 [1.7%]). Bleeding, recurrence of prominence, hematoma, deformity, or adverse scarring did not occur. Conclusions: This interim analysis has shown that Earfold prominent ear correction system is associated with relatively few adverse events that require intervention; a small number of patients experienced infection, implant extrusion, or implant visibility that required revision. Most adverse events were related to either patient selection or technical errors at implantation. It is expected that with continued use of Earfold by surgeons experienced in otoplasty, the adverse event incidence will decrease. PMID:29464160

Examining the conspicuousness and prominence of two required warnings on OTC pain relievers

PubMed Central

Bix, Laura; Bello, Nora M.; Auras, Rafael; Ranger, Jon; Lapinski, Maria K.

2009-01-01

The labeling of over-the-counter (OTC) drugs is critical to their safe and effective use, and certain warnings are meant to be read at the point of purchase (POP). Examples include (i) warnings that alert consumers to the fact that the package is not child-resistant and (ii) warnings that alert consumers to potential product tampering. U.S. law mandates these warnings be “conspicuous” and “prominent” so that it is likely that consumers will read them before leaving the store. Our objective was to quantify the relative prominence and conspicuousness of these warnings. Sixty-one participants reviewed the packages of 5 commercially available analgesics to evaluate the prominence and conspicuousness of these warnings. Evaluated data included (i) the time spent examining the warnings compared with other areas of the label (using a bright pupil eye tracker), (ii) the ability to recall information from the OTCs viewed, and (iii) the legibility of the warnings relative to other elements of the labels (as measured by ASTM D7298-06). Eye-tracking data indicated that warnings were viewed by fewer participants and for less time than other elements of the packages. Recall and legibility data also indicated that the warning statements compared unfavorably with other elements of the labels tested. Evidence presented in this study suggests that 2 required warnings on 5 different OTCs are not prominent or conspicuous when compared with other elements of tested labels. PMID:19332798

STELLAR DYNAMO MODELS WITH PROMINENT SURFACE TOROIDAL FIELDS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bonanno, Alfio

2016-12-20

Recent spectro-polarimetric observations of solar-type stars have shown the presence of photospheric magnetic fields with a predominant toroidal component. If the external field is assumed to be current-free it is impossible to explain these observations within the framework of standard mean-field dynamo theory. In this work, it will be shown that if the coronal field of these stars is assumed to be harmonic, the underlying stellar dynamo mechanism can support photospheric magnetic fields with a prominent toroidal component even in the presence of axisymmetric magnetic topologies. In particular, it is argued that the observed increase in the toroidal energy inmore » low-mass fast-rotating stars can be naturally explained with an underlying α Ω mechanism.« less

Effects of risk disclosure prominence in direct-to-consumer advertising (DTCA) of prescription drugs: An integrative cognitive process model.

PubMed

Ju, Ilwoo; Park, Jin Seong

2018-01-01

The literature shows that the prominence of risk disclosure influences consumer responses to direct-to-consumer advertising of prescription drugs. However, little is known about the psychological process whereby disclosure prominence exerts its influences on health beliefs and behavior. Based on a review of the literature on health cognition and behavior, the current study proposed and tested a model to show that risk disclosure prominence affects consumers' drug choice intention through the mediating roles of awareness of drug adverse reactions (ARs), perceived control over ARs, and perceived risk of ARs. The findings were discussed in terms of their theoretical and managerial implications.

A SOLAR TORNADO OBSERVED BY AIA/SDO: ROTATIONAL FLOW AND EVOLUTION OF MAGNETIC HELICITY IN A PROMINENCE AND CAVITY

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, Xing; Morgan, Huw; Leonard, Drew

During 2011 September 24, as observed by the Atmospheric Imaging Assembly instrument of the Solar Dynamic Observatory and ground-based H{alpha} telescopes, a prominence and associated cavity appeared above the southwest limb. On 2011 September 25 8:00 UT, material flows upward from the prominence core along a narrow loop-like structure, accompanied by a rise ({>=}50,000 km) of the prominence core and the loop. As the loop fades by 10:00, small blobs and streaks of varying brightness rotate around the top part of the prominence and cavity, mimicking a cyclone. The most intense and coherent rotation lasts for over three hours, withmore » emission in both hot ({approx}1 MK) and cold (hydrogen and helium) lines. We suggest that the cyclonic appearance and overall evolution of the structure can be interpreted in terms of the expansion of helical structures into the cavity, and the movement of plasma along helical structures which appears as a rotation when viewed along the helix axis. The coordinated movement of material between prominence and cavity suggests that they are structurally linked. Complexity is great due to the combined effect of these actions and the line-of-sight integration through the structure which contains tangled fields.« less

22. GENERAL VIEW OF MILL FROM SOUTHEAST. PROMINENT ARE THE ...

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