Untrained listeners demonstrate implicit knowledge of syntactic patternsand principles. Untrained generative music ability, for example singing,humming, and whistling, is a largely unconscious or intuitive applicationof these patterns and principles. From the viewpoint of embodied cognition,listening to music should evoke an internal representation or motorimage which, together with the perception of organized music, shouldform the basis of musical cognition. Indeed, that is what listeners demonstratewhen they sing, hum, or whistle familiar and unfamiliar tunes orwhen they vocally or orally improvise continuations to interruptedphrases. Research on vocal improvisation using continuations sung to aninterrupted musical phrase, has shown that one’s cultural backgroundinfluences the music generated. That should be the case for instrumentalistsas well: when they play familiar or unfamiliar tunes by ear in differentkeys (transposition) or when they improvise variations,accompaniments, or continuations to interrupted phrases, the music theygenerate should reflect the same cognitive structures as their oral improvisations.This study is attempting to validate a test of (non) scoredependencythat will enable assessment of the music student’s implicitknowledge of these structures during performance on the principal instrument.
DOCUMENT
Untrained listeners demonstrate implicit knowledge of syntactic patternsand principles. Untrained generative music ability, for example singing,humming, and whistling, is a largely unconscious or intuitive applicationof these patterns and principles. From the viewpoint of embodied cognition,listening to music should evoke an internal representation or motorimage which, together with the perception of organized music, shouldform the basis of musical cognition. Indeed, that is what listeners demonstratewhen they sing, hum, or whistle familiar and unfamiliar tunes orwhen they vocally or orally improvise continuations to interruptedphrases. Research on vocal improvisation using continuations sung to aninterrupted musical phrase, has shown that one’s cultural backgroundinfluences the music generated. That should be the case for instrumentalistsas well: when they play familiar or unfamiliar tunes by ear in differentkeys (transposition) or when they improvise variations,accompaniments, or continuations to interrupted phrases, the music theygenerate should reflect the same cognitive structures as their oral improvisations.This study is attempting to validate a test of (non) scoredependencythat will enable assessment of the music student’s implicitknowledge of these structures during performance on the principal instrument.
DOCUMENT
The historically developed practice of learning to play a music instrument from notes instead of by imitation or improvisation makes it possible to contrast two types of skilled musicians characterized not only by dissimilar performance practices, but also disparate methods of audiomotor learning. In a recent fMRI study comparing these two groups of musicians while they either imagined playing along with a recording or covertly assessed the quality of the performance, we observed activation of a right-hemisphere network of posterior superior parietal and dorsal premotor cortices in improvising musicians, indicating more efficient audiomotor transformation. In the present study, we investigated the detailed performance characteristics underlying the ability of both groups of musicians to replicate music on the basis of aural perception alone. Twenty-two classically trained improvising and score-dependent musicians listened to short, unfamiliar two-part excerpts presented with headphones. They played along or replicated the excerpts by ear on a digital piano, either with or without aural feedback. In addition, they were asked to harmonize or transpose some of the excerpts either to a different key or to the relative minor. MIDI recordings of their performances were compared with recordings of the aural model. Concordance was expressed in an audiomotor alignment score computed with the help of music information retrieval algorithms. Significantly higher alignment scores were found when contrasting groups, voices, and tasks. The present study demonstrates the superior ability of improvising musicians to replicate both the pitch and rhythm of aurally perceived music at the keyboard, not only in the original key, but also in other tonalities. Taken together with the enhanced activation of the right dorsal frontoparietal network found in our previous fMRI study, these results underscore the conclusion that the practice of improvising music can be associated with enhanced audiomotor transformation in response to aurally perceived music.
LINK
Introduction: Retrospective studies suggest that a rapid initiation of treatment results in a better prognosis for patients in the emergency department. There could be a difference between the actual medication administration time and the documented time in the electronic health record. In this study, the difference between the observed medication administration time and documentation time was investigated. Patient and nurse characteristics were also tested for associations with observed time differences. Methods: In this prospective study, emergency nurses were followed by observers for a total of 3 months. Patient inclusion was divided over 2 time periods. The difference in the observed medication administration time and the corresponding electronic health record documentation time was measured. The association between patient/nurse characteristics and the difference in medication administration and documentation time was tested with a Spearman correlation or biserial correlation test. Results: In 34 observed patients, the median difference in administration and documentation time was 6.0 minutes (interquartile range 2.0-16.0). In 9 (26.5%) patients, the actual time of medication administration differed more than 15 minutes with the electronic health record documentation time. High temperature, lower saturation, oxygen-dependency, and high Modified Early Warning Score were all correlated with an increasing difference between administration and documentation times. Discussion: A difference between administration and documentation times of medication in the emergency department may be common, especially for more acute patients. This could bias, in part, previously reported time-to-treatment measurements from retrospective research designs, which should be kept in mind when outcomes of retrospective time-to-treatment studies are evaluated.
DOCUMENT
The realization of one’s musical ideas at the keyboard is dependent on the ability to transform sound into movement, a process called audiomotor transformation. Using fMRI, we investigated cerebral activations while classically-trained improvising and non-improvising musicians imagined playing along with recordings of familiar and unfamiliar music excerpts. We hypothesized that audiomotor transformation would be associated with the recruitment of dedicated cerebral networks, facilitating aurally-cued performance. Results indicate that while all classically-trained musicians engage a left-hemisphere network involved in motor skill and action recognition, only improvising musicians additionally recruit a right dorsal frontoparietal network dedicated to spatially-driven motor control. Mobilization of this network, which plays a crucial role in the real-time transformation of imagined or perceived music into goal-directed action, may be held responsible not only for the stronger activation of auditory cortex we observed in improvising musicians in response to the aural perception of music, but also for the superior ability to play ‘by ear’ which they demonstrated in a follow-up study. The results of this study suggest that the practice of improvisation promotes the implicit acquisition of hierarchical music syntax which is then recruited in top-down manner via the dorsal stream during music performance. In a study of audiomotor transformation in Parkinson patients, we demonstrated a dissociation between dysprosody in speech and music. While patients’ speech could reliably be distinguished from that of healthy individuals, purely on the basis of aural perception, no difference was observed between patients and healthy controls in their ability to sing improvised melodies.
LINK
Mirror neurons in the cerebral cortex have been shown to fire not onlyduring performance but also during visual and auditory observation ofactivity. This phenomenon is commonly called cerebral resonance behavior.This would mean that cortical motor regions would not only beactivated while singing, but also while listening to music. The sameshould hold true for playing a music instrument. Although most individualsare able to sing along when they hear a melody, even highlyskilled instrumentalists, however, are frequently unable to play by ear.They are score-dependent—i.e. they are only able to play a piece of musicwhen they have access to the notes—while musicians who are able to playby ear and improvise are non score-dependent; they are able to playwithout notes. Our hypothesis is that score-dependent instrumentalistswill exhibit less cerebral resonance behavior than non score-dependentmusicians while listening to music. Using fMRI to measure BOLD response,subjects listen to two-part harmony presented with headphones.The following experimental conditions are distinguished: (1) well-knownvs. unknown music (2) motor imagery vs. attentive listening. A voxelbasedanalysis of differences between the condition-related cerebral activationsis performed using Statistical Parametric Mapping.
LINK
Objective: To predict mortality by disability in a sample of 479 Dutch community-dwelling people aged 75 years or older. Methods: A longitudinal study was carried out using a follow-up of seven years. The Groningen Activity Restriction Scale (GARS), a self-reported questionnaire with good psychometric properties, was used for data collection about total disability, disability in activities in daily living (ADL) and disability in instrumental activities in daily living (IADL). The mortality dates were provided by the municipality of Roosendaal (a city in the Netherlands). For analyses of survival, we used Kaplan–Meier analyses and Cox regression analyses to calculate hazard ratios (HR) with 95% confidence intervals (CI). Results: All three disability variables (total, ADL and IADL) predicted mortality, unadjusted and adjusted for age and gender. The unadjusted HRs for total, ADL and IADL disability were 1.054 (95%-CI: [1.039;1.069]), 1.091 (95%-CI: [1.062;1.121]) and 1.106 (95%-CI: [1.077;1.135]) with p-values <0.001, respectively. The AUCs were <0.7, ranging from 0.630 (ADL) to 0.668 (IADL). Multivariate analyses including all 18 disability items revealed that only “Do the shopping” predicted mortality. In addition, multivariate analyses focusing on 11 ADL items and 7 IADL items separately showed that only the ADL item “Get around in the house” and the IADL item “Do the shopping” significantly predicted mortality. Conclusion: Disability predicted mortality in a seven years follow-up among Dutch community-dwelling older people. It is important that healthcare professionals are aware of disability at early stages, so they can intervene swiftly, efficiently and effectively, to maintain or enhance the quality of life of older people.
MULTIFILE
Background: Due to differences in the definition of frailty, many different screening instruments have been developed. However, the predictive validity of these instruments among community-dwelling older people remains uncertain. Objective: To investigate whether combined (i.e. sequential or parallel) use of available frailty instruments improves the predictive power of dependency in (instrumental) activities of daily living ((I)ADL), mortality and hospitalization. Design, setting and participants: A prospective cohort study with two-year followup was conducted among pre-frail and frail community-dwelling older people in the Netherlands. Measurements: Four combinations of two highly specific frailty instruments (Frailty Phenotype, Frailty Index) and two highly sensitive instruments (Tilburg Frailty Indicator, Groningen Frailty Indicator) were investigated. We calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for all single instruments as well as for the four combinations, sequential and parallel. Results: 2,420 individuals participated (mean age 76.3 ± 6.6 years, 60.5% female) in our study. Sequential use increased the levels of specificity, as expected, whereas the PPV hardly increased. Parallel use increased the levels of sensitivity, although the NPV hardly increased. Conclusions: Applying two frailty instruments sequential or parallel might not be a solution for achieving better predictions of frailty in community-dwelling older people. Our results show that the combination of different screening instruments does not improve predictive validity. However, as this is one of the first studies to investigate the combined use of screening instruments, we recommend further exploration of other combinations of instruments among other study populations.
DOCUMENT
The aim of this study was to assess the predictive ability of the frailty phenotype (FP), Groningen Frailty Indicator (GFI), Tilburg Frailty Indicator (TFI) and frailty index (FI) for the outcomes mortality, hospitalization and increase in dependency in (instrumental) activities of daily living ((I)ADL) among older persons. This prospective cohort study with 2-year follow-up included 2420 Dutch community-dwelling older people (65+, mean age 76.3±6.6 years, 39.5% male) who were pre-frail or frail according to the FP. Mortality data were obtained from Statistics Netherlands. All other data were self-reported. Area under the receiver operating characteristic curves (AUC) was calculated for each frailty instrument and outcome measure. The prevalence of frailty, sensitivity and specifcity were calculated using cutoff values proposed by the developers and cutoff values one above and one below the proposed ones (0.05 for FI). All frailty instruments poorly predicted mortality, hospitalization and (I)ADL dependency (AUCs between 0.62–0.65, 0.59–0.63 and 0.60–0.64, respectively). Prevalence estimates of frailty in this population varied between 22.2% (FP) and 64.8% (TFI). The FP and FI showed higher levels of specifcity, whereas sensitivity was higher for the GFI and TFI. Using a different cutoff point considerably changed the prevalence, sensitivity and specifcity. In conclusion, the predictive ability of the FP, GFI, TFI and FI was poor for all outcomes in a population of pre-frail and frail community-dwelling older people. The FP and the FI showed higher values of specifcity, whereas sensitivity was higher for the GFI and TFI.
DOCUMENT
Abstract Background: COVID-19 was first identified in December 2019 in the city of Wuhan, China. The virus quickly spread and was declared a pandemic on March 11, 2020. After infection, symptoms such as fever, a (dry) cough, nasal congestion, and fatigue can develop. In some cases, the virus causes severe complications such as pneumonia and dyspnea and could result in death. The virus also spread rapidly in the Netherlands, a small and densely populated country with an aging population. Health care in the Netherlands is of a high standard, but there were nevertheless problems with hospital capacity, such as the number of available beds and staff. There were also regions and municipalities that were hit harder than others. In the Netherlands, there are important data sources available for daily COVID-19 numbers and information about municipalities. Objective: We aimed to predict the cumulative number of confirmed COVID-19 infections per 10,000 inhabitants per municipality in the Netherlands, using a data set with the properties of 355 municipalities in the Netherlands and advanced modeling techniques. Methods: We collected relevant static data per municipality from data sources that were available in the Dutch public domain and merged these data with the dynamic daily number of infections from January 1, 2020, to May 9, 2021, resulting in a data set with 355 municipalities in the Netherlands and variables grouped into 20 topics. The modeling techniques random forest and multiple fractional polynomials were used to construct a prediction model for predicting the cumulative number of confirmed COVID-19 infections per 10,000 inhabitants per municipality in the Netherlands. Results: The final prediction model had an R2 of 0.63. Important properties for predicting the cumulative number of confirmed COVID-19 infections per 10,000 inhabitants in a municipality in the Netherlands were exposure to particulate matter with diameters <10 μm (PM10) in the air, the percentage of Labour party voters, and the number of children in a household. Conclusions: Data about municipality properties in relation to the cumulative number of confirmed infections in a municipality in the Netherlands can give insight into the most important properties of a municipality for predicting the cumulative number of confirmed COVID-19 infections per 10,000 inhabitants in a municipality. This insight can provide policy makers with tools to cope with COVID-19 and may also be of value in the event of a future pandemic, so that municipalities are better prepared.
LINK
