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Cardiovascular engineering and technology : CVET 13(2), 318-330 (2022). doi:10.1007/s13239-021-00579-y, Published by Springer, New York, NY

The most common technical complication during ECMO is clot formation. A large clot inside a membrane oxygenator reduces effective membrane surface area and therefore gas transfer capabilities, and restricts blood flow through the device, resulting in an increased membrane oxygenator pressure drop (dpMO). The reasons for thrombotic events are manifold and highly patient specific. Thrombus formation inside the oxygenator during ECMO is usually unpredictable and remains an unsolved problem. Clot sizes and positions are well documented in literature for the Maquet Quadrox-i Adult oxygenator based on CT data extracted from devices after patient treatment. Based on this data, the present study was designed to investigate the effects of large clots on purely technical parameters, for example, dpMO and gas transfer. Therefore, medical grade silicone was injected into the fiber bundle of the devices to replicate large clot positions and sizes. A total of six devices were tested in vitro with silicone clot volumes of 0, 30, 40, 50, 65, and 85 mL in accordance with ISO 7199. Gas transfer was measured by sampling blood pre and post device, as well as by sampling the exhaust gas at the devices' outlet at blood flow rates of 0.5, 2.5, and 5.0 L/min. Pre and post device pressure was monitored to calculate the dpMO at the different blood flow rates. The dpMO was found to be a reliable parameter to indicate a large clot only in already advanced "clotting stages." The CO2 concentration in the exhaust gas, however, was found to be sensitive to even small clot sizes and at low blood flows. Exhaust gas CO2 concentration can be monitored continuously and without any risks for the patient during ECMO therapy to provide additional information on the endurance of the oxygenator. This may help detect a clot formation and growth inside a membrane oxygenator during ECMO even if the increase in dpMO remains moderate.

OBJECTIVES: The aim of this investigation was to analyze longitudinal data concerning physical and psychological health, playing-related problems, and preventive behavior among music students across their complete 4- to 5-year study period. METHODS: In a longitudinal, observational study, we followed students during their university training and measured their psychological and physical health status and preventive behavior using standardized questionnaires at four different times. RESULTS: The data were in accordance with previous findings. They demonstrated three groups of health characteristics observed in beginners of music study: healthy students (cluster 1), students with preclinical symptoms (cluster 2), and students who are clinically symptomatic (cluster 3). In total, 64% of all students remained in the same cluster group during their whole university training. About 10% of the students showed considerable health problems and belonged to the third cluster group. CONCLUSION: The three clusters of health characteristics found in this longitudinal study with music students necessitate that prevention programs for musicians must be adapted to the target audience.

Objectives: This study examined the physical and mental health of orchestra musicians of different types of orchestras compared to a reference sample of the general population and of two other professions. Methods: Professional musicians (n = 429) from nine opera and/or concert orchestras were surveyed with the Short Form-12 general health questionnaire (SF-12). Data were compared with a reference sample (n = 2805) with a sample of physicians (n = 549) and aircraft manufacturers (n = 822). Results: Compared to the reference sample and the two other professional groups, the musicians had a higher physical health score: 53.07 (SD 5.89) vs 49.03 (SD 9.35) reference, 51.26 (SD 7.53) physicians, and 49.31 (SD 7.99) aircraft manufacturers. The musicians’ mental health score was lower compared to the reference sample but did not differ from the other professional groups: 48.33 (SD 9.52) for musicians vs 52.24 (SD 8.10) reference, 48.26 (SD 10.06) physicians, and 48.54 (SD 9.59) aircraft manufacturers. Physical health but not mental health decreased with age in all groups. In physical and mental health, women scored lower than men. There was no significant difference in physical and mental health scores between musicians of concert and opera orchestras. Age and gender accounted for 3.6% of the variance of the physical health score, but none of the demographic characteristics or orchestral roles and functions was predictive for mental health scores. Conclusions: Musicians report better physical but poorer mental health than the general population, but they did not differ in mental health scores from physicians or aircraft manufacturers.

Summary Purpose Voice periodicity during transitions from modal to falsetto register still remains an unclarified question. Method We examined the acoustic and electroglottographic signals of 20 healthy untrained male voices' transitions from modal to falsetto register on the vowels /a, e, i, o, u, and ae/. Results In addition to discontinuities in fundamental frequency (F0), an independent increase of jitter, relative average perturbation, and shimmer was observed during and apparently caused by the register transition. In falsetto, the jitter was higher than in the modal register. The contact quotient derived from the electroglottographic signal tended to be lower for higher than for lower F0. Conclusion Register transitions are associated with increase of perturbation.

Der HNO-Arzt und Musikermediziner ist immer wieder mit dem Thema Gehorschutz bei Musikern konfrontiert, da sich Musiker an ihn wenden, welche bei der Musikausubung hohen Schalldruckpegeln ausgesetzt sind und die sich haufig Sorgen um ihr Gehor machen. Zudem hat das Thema neu an Aktualitat gewonnen, da seit Februar 2008 infolge der neuen EG-Arbeitsschutzrichtlinie „Larm“ 2003/10/EG und der deutschen Larm- und Vibrations-Arbeitschutzverordnung neue Grenzwerte fur Profimusiker gelten. Der Artikel gibt anhand der Literatur und eigener Forschungsergebnisse einen Uberblick uber den aktuellen Wissensstand hinsichtlich Schalldruckpegelbelastungen, Horgefahrdung sowie der Anwendung von Gehorschutz bei Musikern.

Vocal fold oscillation patterns in vocal register transitions are still unclarified. The vocal fold oscillations and the open quotient were analyzed with high-speed digital imaging (HSDI) and electroglottography (EGG) in 18 male untrained subjects singing a glissando from modal to the falsetto register. Results reveal that the open quotient changed with register in both HSDI and EGG. The in-class correlations for different HSDI and EGG determinations of the open quotient were high. However, we found only weak interclass correlations between both methods. In 10 subjects, irregularities of vocal fold vibration occurred during the register transition. Our results confirm previous observations that falsetto register is associated with a higher open quotient compared with modal register. These data suggest furthermore that irregularities typically observed in audio and electroglottographic signals during register transitions are caused by irregularities in vocal fold vibration.

OBJECTIVES: Music-related symptoms can already be found among student musicians during their years of university training. The goals of the present study were to ascertain the state and developmental course of the student musicians’ health and to test the effectiveness of a preventive curriculum given to student musicians during their first two semesters at university. METHODS: Within a longitudinal, observational study, we assessed students’ psychological and physical health during the first 2 years of university training. We compared data from the group of students who had followed the prevention program (intervention group, IG, n = 144) with data of a comparison group (CG, n = 103) of students who had not followed the program. Using standardized questionnaires, we measured physical and psychological symptoms as well as health behavior in a sequential plan (duration, 3.5 yrs). RESULTS: Student musicians (n = 247) showed elevated ratings in psychological and physical health in comparison with nonmusicians of the same age. These ratings decreased at the end of the students’ second year. The prevention program had a preventive effect on the students’ psychological health: while IG students remained stable in their performance and powers of concentration, CG students got worse in those same areas. However, the prevention program did not reduce physical symptoms. In comparison with their younger colleagues, upper-level students took more courses in body-oriented methods, relaxation, and mental techniques, which focus on preventive measures for musicians. CONCLUSION: At present, the study offers evidence supporting the use of the prevention curriculum for young musicians. In higher music education, preventive education has a positive impact on students’ performance and their attitude toward health. The preventive curriculum does not have an effect on preexisting physical symptoms, and those symptoms related to the student musicians’ activity should rather be treated in an additional therapeutic setting.

Zur Evaluation von Stimmleistungsparametern wurde ein Protokoll der Europaischen Laryngologischen Gesellschaft (ELS) erstellt. Mit diesem evaluierten wir 17 professionelle Sopranistinnen, von denen 11 organische Stimmlippenveranderungen und 6 keine organischen Stimmlippenveranderungen in der Stroboskopie aufwiesen. Die Sangerinnen mit erhohten subjektiven Stimmbeschwerden und Auffalligkeiten in der auditiven Beurteilung durch den Untersucher unterschieden sich von nicht beeintrachtigten Sangerinnen signifikant hinsichtlich der Tonhaltedauer, des Frequenzspektrums und des Dysphonia-Severity-Index. Keine Unterschiede hinsichtlich dieser Parameter wurden in Bezug auf das Vorliegen von Stimmlippenveranderungen gefunden. Die Daten unterstreichen, dass stroboskopisch sichtbare organische Stimmlippenveranderungen nicht notwendigerweise mit Veranderungen der stimmlichen Leistungsfahigkeit oder der Messwerte im ELS-Protokoll einhergehen mussen. Eine Indikation zur Therapie sollte bei professionellen Sangerinnen deshalb nicht allein aufgrund der Stroboskopie, sondern anhand von multifaktoriellen Stimmanalysen, wie sie das ELS-Protokoll vorsieht, auf eine breite Basis gestellt werden.

Objectives: Music performance anxiety (MPA) is an issue frequently experienced by musicians. It occurs not only in experienced musicians but also in children and adolescents. Furthermore, most research on MPA has been done with musicians who specialized in classical music. This study investigated the development of MPA across the ages in young musicians focusing on the classical and popular genres. Methods: In a cross-sectional survey, 239 students at German music schools, aged between 7 and 20 yrs, were asked about their perceived MPA and musical background. The data were analyzed according to musical genre and age. Multiple regression analyses were performed to investigate the influences of musical experiences on MPA. Results: The analyses yielded high levels of MPA for classical musicians between 7 and 16 yrs, which was reduced in older students; for popular musicians, low MPA was seen in the younger (7–11 yrs) and high MPA in the older (16+ yrs) musicians. MPA was influenced by gender and the number of performances in the classical music group and only by gender and age in the popular music group. Conclusion: The results showed clear different trends for the development of MPA between musical genres that should be taken into account for educational aspects in musical training.

The ability of music to create differentiating effects on subjects’ impressions of product endorsers and brands of an advertisement were examined based on the theory of ‘musical fit’. Subjects ( N = 132) listened to one of three versions of a radio commercial in which the music varied in each version. The music selections differed in style, tempo, rhythm, etc., but matched product and message of the commercial in terms of ‘musical fit’. After listening to the commercial, subjects rated the endorser's personality via the external version of a personality inventory. Impressions of the brand were measured using semantic differentials. The results concur with previous findings: depending on musical style, music can lead to significantly different impressions of the endorser as well as the brand without affecting general evaluations of the product. Based on sex, interesting differences concerning music perception and its impacts were found. Self-critical annotations and suggestions for practitioners and future studies are discussed.

Music performance anxiety (MPA) represents a high challenge every vocal performer has to meet. MPA can be defined on a continuum going from a low to a high level. MPA and its phenomena can be considered in terms of four levels: affect, cognition, behaviour, and physiology. A study carried out on seven opera singers and two instrumentalists during performance situations showed highly elevated values for the performers' heart rate and blood pressure. This study, as several others, yielded no clear evidence pointing to a correspondence between the level of anxiety and of physiological arousal. At the end of the article a multimodal approach to the treatment of MPA is illustrated consisting of different psychotherapeutic and body-oriented methods.

The ability of music to create differentiating effects on subjects’ impressions of product endorsers and brands of an advertisement were examined based on the theory of ‘musical fit’. Subjects (N = 405) listened to one of three versions of a radio commercial in which the music varied in each version. The music selections differed in style, tempo, rhythm, etc., but matched product and message of the commercial in terms of ‘musical fit’. After listening to the commercial, subjects rated the endorser’s personality via the external version of a personality inventory. Impressions of the brand were measured using Likert-type scales. The results concur with previous findings: depending on musical style, music can lead to significantly different impressions of the endorser as well as the brand.

Prior to this study, it was not clear how familiar orchestral musicians were with the various insertable models of hearing protectors. The present study focuses on musicians and entertainers and proposes the maintenance of a noise exposure limit through the use of a hearing protector.This study was conducted by distributing a questionnaire to musicians ( n = 429) in nine orchestras in order to obtain information on the use of hearing protection and the musicians' hearing sensitivity.Hearing protectors were found to be seldom used by orchestral musicians. During orchestral rehearsals,1/6 of the test persons used Type 1 (individually fitted) hearing protectors although80% of the respondents indicated that they knew about them. A gap emerged between what seemed most important to musicians in hearing protectors and what was provided by the manufacturers.The subject of hearing protection in orchestral musicians should be investigated with a multidimensional approach which considers the following in equal measure: legal regulations, the requirements and limits of the music sector and the individual characteristics of the musicians involved.