Psychogenic dysphonia: Peeling back the layers

Resolution of psychogenic dysphonia is often quick and effortlessfor client and therapist alike. In such instances, the therapeutic interventions are simple and straightforward, insights are reached without difficulty, and once normal voice has been established, resumption of dysphonia or other psychosomatic symptoms rarely occurs. Sometimes, however, psychogenic dysphonia is extremely difficult to overcome, requiring considerable time, effort, and determination on the part of the client, coupled with confident, skilled persistence and psychotherapeutic insight from the therapist. In such cases one feels a sense of working through many complex layers before obtaining satisfactory voice or reaching an understanding of the psychogenic factors that precipitated onset and/or maintenance of the dysphonia.

Two cases that illustrate this involved process of peeling back the layers are presented. For resolution of severe psychogenic dysphonia, the therapist must be able to recognize and establish the complex relationship between the neurophysiological, intrapsychic, and interpersonal levels of function as they affect the client's voice and person, as a whole. This work requires considerable courage and skill on the part of the therapist to question, explore, change direction, and select alternative approaches. It is important that the problem can be resolved with a depth of understanding which is relevant for the client, and with due attention to the social context and wider systems of which he or she is a part.     

Basis set and correlation effects on computed proton affinities of some oxygen and nitrogen bases

Basis set expansion and correlation effects on the computed proton affinities of the oxygen and nitrogen bases CH₃OH, H₂CO, CO, CH₃NH₂, CH₂NH, and HCN have been evaluated. Basis set enhancements lead to systematic changes in computed proton affinities. These effects appear to be additive, and are greater for correlated proton affinities than for Hartree-Fock energies. Inclusion of correlation decreases proton affinities, with fourth-order Møller-Plesset energies bracketed by second and third order energies.     

On the finite element approximation of incompressible flows of an electrically conducting fluid

We consider the finite element approximation of incompressible flows field of an electrically conducing fluid in the presence of a magnetic where it is assumed that this field is prescribed. A weak form is chosen that is similar in some respects to a weak form used by many authors for the Navier-Stokes equations. Existence and uniqueness results are presented for the weak problem. A finite element Algorithm is given for the approximate solution of the weak problem and error estimates are derived.     

Crystal and molecular structure of the triflate salt of diprotonated 1,4,8,11-tetrakis(2-hydroxyethyl)-1,4,8,11-tetraazacyclotetradecane, [C10H22N4(CH2CH2OH)4 2+]−[CF3SO3 −]2: geometry of a diprotonated octadenate ligand

The title complex crystallizes in the centrosymmetric monoclinic space group P2₁/n with Z=2. The cation is the diprotonated derivative of the neutral octadentate macrocyclic ligand C₁₀H₂₀N₄(CH₂CH₂OH)₄; the two protonated nitrogen atoms are as far apart as is possible in the 14-membered ring (1-and 8-positions) so as to minimize electrostatic repulsions. Each of the [C₁₀H₂₂N₄(CH₂CH₂OH)₄ ²⁺] cations is involved in hydrogen bonding (through the four hydroxy groups) to oxygen atoms on four different peripheral [CF₃SO₃ ⁻] anions.     

Nonautonomous locally Lipschitz continuous functional differential equations in spaces of continuous functions

A local existence and uniqueness result for the functional differential equation in a Banach space X (FDE) $$\begin{gathered} x\prime (t) \in f(t)x(t) + g(t)x_t ,0 \leqslant t \leqslant T, \hfill \\ x_0 = \phi \in C( - R,0;X) \hfill \\ \end{gathered} $$ is obtained, for the case where the operatorsf(t) satisfy only a local dissipativity condition and the operatorsg(t) are only locally Lipschitz continuous. The conditions include equations defined on cones.     

Random reals and the relation 171-1171-1171-1

It is consistent that ₁(₁,(:n))² holds in any random extension for n finite and countable.     

A novel synthesis of 3′-deoxy-3′-nitrothymidine via nucleophilic substitution with nitrite anion

Nucleophilic substitution at C3′ of 1-(2-deoxy-5-O-trityl-β-D-erythr-pentofuranosyl)-2-methoxy-5-methyl-4(1H)-pyrimidinone (5) with methyl iodide/triphenylphosphine/diethyl azodicarboxylate gave the expected inverted iodide 6 and minor epimer 7 . Treatment of 6 with lithium nitrite/phloroglucinol yielded the desired nitro derivative 8 and subsequent acidic deprotection afforded the title compound 1 . This represents a novel method for the introduction of a nitro group into the furanosyl moiety of a nucleoside. The nmr spectroscopic techniques (COSY, NOESY, nOe, HMQC and HMBC) were used to determine the stereochemistry at C3′ of the nucleosides. Spectral analysis of H-D exchange at the 3′-position of 1 did not indicate the formation of its epimer 10 .