Purpose: This study aims to investigate the effects of dysphonic voice on speech intelligibility in Cantonese-speaking adults. Method: Speech recordings from three speakers with dysphonia secondary ...to phonotrauma and three speakers with healthy voices were presented to 30 healthy listeners (15 men and 15 women; Msubscript age = 22.7 years) under six noise conditions (signal-to-noise ratio SNR -10, SNR -5, SNR 0, SNR +5, SNR +10) and quiet conditions. The speech recordings were composed of sentences with five different lengths: five syllables, eight syllables, 10 syllables, 12 syllables, and 15 syllables. The effects of speaker's voice quality, background noise condition, and sentence length on speech intelligibility were examined. Speech intelligibility scores were calculated based on the listener's correct judgment of the number of syllables heard as a percentage of the total syllables in each stimulus. Results: Dysphonic voices, as compared to healthy voices, were significantly more affected by background noise. Speech presented with dysphonic voices was significantly less intelligible than speech presented with healthy voices under unfavorable SNR conditions (SNR -10, SNR -5, and SNR 0 conditions). However, there was no sufficient evidence to suggest effects of sentence length on intelligibility, regardless of the speaker's voice quality or the level of background noise. Conclusions: This study provides empirical data on the impacts of dysphonic voice on speech intelligibility in Cantonese speakers. The findings highlight the importance of educating the public about the impacts of voice quality and background noise on speech intelligibility and the potential of compensatory strategies that specifically address these barriers.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
We conducted a prospective randomized controlled trial with two screening rounds to evaluate the effectiveness of combining HPV testing with liquid‐based cytology (LBC) as a co‐test, compared to LBC ...only in cervical cancer screening of a Chinese population. First, 15,955 women aged 30–60 were randomized at a 1:1 ratio into an intervention group (Digene Hybrid Capture 2 HPV test with LBC) and a control group (LBC alone). Women in the intervention group would be referred for colposcopy and biopsy immediately if they were found to have high‐risk HPV regardless of cytology results. The detection of cervical intraepithelial neoplasia grade 2 or above (CIN2+) lesions was significantly higher in the intervention group compared to the control (0.95% vs. 0.38%, OR 2.50, 95% CI 1.65–3.88). At the subsequent round of screening approximately 36 months later, CIN2+ detection was significantly lower in the intervention group (0.08% vs. 0.35%, OR 0.23, 95% CI 0.08–0.57). Over the two rounds of screening, the total detection of CIN2+ was higher in the intervention group (1.01% vs. 0.66%, OR 1.53, 95% CI 1.09–2.19). There was a fourfold increase (10.6% vs. 2.4%, p < 0.001) in the number of colposcopies performed in the intervention arm. Adding a high‐risk HPV test to cytology for primary cervical screening led to earlier detection of clinically significant preinvasive lesions, resulting in a reduced detection of CIN2+ lesions in subsequent rounds and an increased rate of colposcopy.
What's new?
High‐risk human papillomavirus (HPV) testing can reduce the likelihood of detecting cervical intraepithelial neoplasia grade 3 or above (CIN3+) in subsequent rounds of cervical screening, lowering the risk of cervical cancer. The present study shows that co‐testing with HPV testing and liquid‐based cytology (LBC) may be even more effective in reducing CIN3+ risk than cytology alone. In a randomized controlled study in a Chinese population in which two rounds of cervical screening were carried out, HPV plus LBC co‐testing resulted in earlier detection of clinically significant pre‐malignant lesions. Fewer high‐grade lesions were detected in later screening rounds, while colposcopy rate increased.
Objectives
To evaluate MRI texture analysis in differentiating clinicopathological characteristics of cervical carcinoma (CC).
Methods
Patients with newly diagnosed CC who underwent pre-treatment MRI ...were retrospectively reviewed. Texture analysis was performed using commercial software (TexRAD). Largest single-slice ROIs were manually drawn around the tumour on T2-weighted (T2W) images, apparent diffusion coefficient (ADC) maps and contrast-enhanced T1-weighted (T1c) images. First-order texture features were calculated and compared among histological subtypes, tumour grades, FIGO stages and nodal status using the Mann-Whitney
U
test. Feature selection was achieved by elastic net. Selected features from different sequences were used to build the multivariable support vector machine (SVM) models and the performances were assessed by ROC curves and AUC.
Results
Ninety-five patients with FIGO stage IB~IVB were evaluated. A number of texture features from multiple sequences were significantly different among all the clinicopathological subgroups (
p
< 0.05). Texture features from different sequences were selected to build the SVM models. The AUCs of SVM models for discriminating histological subtypes, tumour grades, FIGO stages and nodal status were 0.841, 0.850, 0.898 and 0.879, respectively.
Conclusions
Texture features derived from multiple sequences were helpful in differentiating the clinicopathological signatures of CC. The SVM models with selected features from different sequences offered excellent diagnostic discrimination of the tumour characteristics in CC.
Key Points
• First-order texture features are able to differentiate clinicopathological signatures of cervical carcinoma.
• Combined texture features from different sequences can offer excellent diagnostic discrimination of the tumour characteristics in cervical carcinoma
.
Background and Purpose
We have previously shown that isoprenaline‐induced cardiac hypertrophy causes significant changes in the expression of cytochromes P450 (CYP) and soluble epoxide hydrolase ...(sEH) genes. Therefore, it is important to examine whether the inhibition of sEH by 1‐(1‐methanesulfonyl‐piperidin‐4‐yl)‐3‐(4‐trifluoromethoxy‐phenyl)‐urea (TUPS) will protect against isoprenaline‐induced cardiac hypertrophy.
Experimental Approach
Male Sprague–Dawley rats were treated with TUPS (0.65 mg kg−1 day−1, p.o.), isoprenaline (5 mg kg−1 day−1, i.p.) or the combination of both. In vitro H9c2 cells were treated with isoprenaline (100 μM) in the presence and absence of either TUPS (1 μM) or 11,12 EET (1 μM). The expression of hypertrophic, fibrotic markers and different CYP genes were determined by real‐time PCR.
Key Results
Isoprenaline significantly induced the hypertrophic, fibrotic markers as well as the heart to body weight ratio, which was significantly reversed by TUPS. Isoprenaline also caused an induction of CYP1A1, CYP1B1, CYP2B1, CYP2B2, CYP4A3 and CYP4F4 gene expression and TUPS significantly inhibited this isoprenaline‐mediated effect. Moreover, isoprenaline significantly reduced 5,6‐, 8,9‐, 11,12‐ and 14,15‐EET and increased their corresponding 8,9‐, 11,12‐ and 14,15‐dihydroxyeicosatrienoic acid (DHET) and the 20‐HETE metabolites. TUPS abolished these isoprenaline‐mediated changes in arachidonic acid (AA) metabolites. In H9c2 cells, isoprenaline caused a significant induction of ANP, BNP and EPHX2 mRNA levels. Both TUPS and 11,12‐EET significantly decreased this isoprenaline‐mediated induction of ANP, BNP and EPHX2.
Conclusions and Implications
TUPS partially protects against isoprenaline‐induced cardiac hypertrophy, which confirms the role of sEH and CYP enzymes in the development of cardiac hypertrophy.
This study aimed to assess the feasibility of patient-initiated follow-up (PIFU) in combination with regular tumour marker monitoring as an alternative to conventional hospital follow-up for ovarian ...cancer survivors. Women who had recently completed treatment for ovarian cancer and had a raised pre-treatment tumour marker were recruited. Participants were allocated to PIFU (intervention group) or conventional hospital follow-up (control group) according to their own preference. Both groups had regular tumour marker monitoring. The change in fear of cancer recurrence (FCR) score as measured by the FCR inventory, and the supportive care need (SCN) scores as measured by the SCN survey at baseline and at 6 months between PIFU and hospital follow-up were compared. Out of 64 participants, 37 (58%) opted for hospital follow-up and 27 (42%) opted for PIFU. During the 6-month study period, there was no significant difference in the change of FCR between the two groups (
= 0.35). There was a significant decrease in the sexuality unmet needs score in the intervention group from baseline to 6-month FU (mean difference -8.7, 95% confidence interval -16.1 to -1.4,
= 0.02). PIFU with tumour marker monitoring is a feasible follow-up approach in ovarian cancer survivorship care. FCR and SCN were comparable between PIFU and conventional hospital follow-up.
Abstract
A plethora of studies have demonstrated the expression of cytochrome P450 (CYP) and soluble epoxide hydrolase (sEH) enzymes in the heart and other cardiovascular tissues. In addition, the ...expression of these enzymes is altered during several cardiovascular diseases (CVDs), including cardiac hypertrophy (CH). The alteration in CYP and sEH expression results in derailed CYP-mediated arachidonic acid (AA) metabolism. In animal models of CH, it has been reported that there is an increase in 20-hydroxyeicosatetraenoic acid (20-HETE) and a decrease in epoxyeicosatrienoic acids (EETs). Further, inhibiting 20-HETE production by CYP ω-hydroxylase inhibitors and increasing EET stability by sEH inhibitors have been proven to protect against CH as well as other CVDs. Therefore, CYP-mediated AA metabolites 20-HETE and EETs are potential key players in the pathogenesis of CH. Some studies have investigated the molecular mechanisms by which these metabolites mediate their effects on cardiomyocytes and vasculature leading to pathological CH. Activation of several intracellular signaling cascades, such as nuclear factor of activated T cells, nuclear factor kappa B, mitogen-activated protein kinases, Rho-kinases, Gp130/signal transducer and activator of transcription, extracellular matrix degradation, apoptotic cascades, inflammatory cytokines, and oxidative stress, has been linked to the pathogenesis of CH. In this review, we discuss how 20-HETE and EETs can affect these signaling pathways to result in, or protect from, CH, respectively. However, further understanding of these metabolites and their effects on intracellular cascades will be required to assess their potential translation to therapeutic approaches for the prevention and/or treatment of CH and heart failure.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Cervical cancer is one of the leading causes of cancer death in women globally, despite the widespread use of cytology/human papillomavirus (HPV) screening. In the present study, we aimed to identify ...the potential role of microRNA (miRNA) as a diagnostic biomarker in the detection of cervical pre‐malignant lesions and cancer. In total, we recruited 582 patients with cervical diseases and 145 control individuals. The expression levels of six miRNAs (miR‐20a, miR‐92a, miR‐141, miR‐183*, miR‐210 and miR‐944) were found to be significantly up‐regulated in cervical cancer and pre‐malignant lesions compared to normal cervical samples, indicating that they are oncogenic miRNAs. Receiver operating characteristic curve analysis showed that these six miRNAs can be used to distinguish patients with cervical pre‐malignant lesions or cancer from normal individuals and they also had a good predictive performance, particularly in cervical lesions. Combined use of these six miRNAs further enhanced the diagnostic accuracy over any single miRNA marker, with an area under the curve of 0.998, 0.996 and 0.959, a diagnostic sensitivity of 97.9%, 97.2% and 91.4%, and a specificity of 98.6%, 96.6% and 87.6% for low‐grade lesions, high‐grade lesions and cancer, respectively. This six oncogenic miRNA signature may be suitable for use as diagnostic marker for cervical pre‐malignant lesions and cancer in the near future.
Early detection of cervical pre‐malignant lesions prevents cervical cancer. Current screening methods (cytology or HPV test) have limitations when used as stand‐alone screening tests. The present study identified a unique six miRNA signature with superior diagnostic assurance for the detection of cervical pre‐malignant lesions and cancer. It may provide a potential option for cervical cancer screening in the future.
The accurate prediction of malignancy for a pelvic mass detected on ultrasound allows for appropriate referral to specialised care. IOTA simple rules are one of the best methods but are inconclusive ...in 25% of cases, where subjective assessment by an expert sonographer is recommended but may not always be available. In the present paper, we evaluate the methods for assessing the nature of a pelvic mass, including IOTA with subjective assessment by expert ultrasound, RMI and ROMA. In particular, we investigate whether ROMA can replace expert ultrasound when IOTA is inconclusive. This prospective study involves one cancer centre and three general units. Women scheduled for an operation for a pelvic mass underwent a pelvic ultrasound pre-operatively. The final histology was obtained from the operative sample. The sensitivity, specificity and accuracy for each method were compared with the McNemar test. Of the 690 women included in the study, 171 (25%) had an inconclusive IOTA. In this group, expert ultrasound was more sensitive in diagnosing a malignant mass compared to ROMA (81% vs. 63%,
= 0.009) with no significant difference in the specificity or accuracy. All assessment methods involving IOTA had similar accuracies and were more accurate than RMI or ROMA alone. In conclusion, when IOTA was inconclusive, assessment by expert ultrasound was more sensitive than ROMA, with similar specificity.
Objective
To assess clinical and psychosocial outcomes of nurse‐led follow‐up in survivorship care of gynaecological malignancies.
Methods
Women with endometrial or ovarian cancer who were attending ...regular post‐treatment follow‐up at a tertiary referral centre were randomised into two groups—group‐1: telephone follow‐up by nurses and group‐2: gynaecologists‐led clinic follow‐up. Women in group‐1 were asked about their symptoms and quality of life (QoL) by nurses. Women in group‐2 were followed up by gynaecologists and underwent symptom reviews and physical examinations. All ovarian cancer patients in both groups also had CA125 measured. All recruited women completed a QoL questionnaire (EORTC QLQ‐C30), HADS‐anxiety questionnaire and symptom checklist.
Results
385 women (215 with endometrial and 170 with ovarian cancer) were randomised. There was no significant difference in the detection of recurrence according to the two follow‐up protocols. However, women in the nurse‐led arm scored higher on emotional (p = 0.023) and cognitive functioning (p = 0.012). Those in the gynaecologist‐led arm scored higher on the HADS‐anxiety scale (p = 0.001) and were more likely to report symptoms.
Conclusions
Our results demonstrate a preliminary non‐inferiority of nurse‐led follow‐up, with improved psychological morbidity and QoL. Thus, nurse‐led follow‐up can be considered an effective substitute for hospital‐based care.
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