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A new classification of wind instruments: Orofacial considerations.

ABSTRACT: Background/objective:Playing a wind instrument implies rhythmic jaw movements where the embouchure applies forces with different directions and intensities towards the orofacial structures. These features are relevant when comparing the differences between a clarinettist and a saxophone player embouchure, independently to the fact that both belong to the single-reed instrument group, making therefore necessary to update the actual classification. Methods:Lateral cephalograms were taken to single-reed, double-reed and brass instrumentalists with the purpose of analyzing the relationship of the mouthpiece and the orofacial structures. Results:The comparison of the different wind instruments showed substantial differences. Therefore the authors purpose a new classification of wind instruments: Class 1 single-reed mouthpiece, division 1- clarinet, division 2 -saxophone; Class 2 double-reed instruments, division 1- oboe, division 2- bassoon; Class 3 cup-shaped mouthpiece, division 1- trumpet and French horn, division 2- trombone and tuba; Class 4 aperture mouthpieces, division 1- flute, division 2 - transversal flute and piccolo. Conclusions:Elements such as dental arches, teeth and lips, assume vital importance at a new nomenclature and classification of woodwind instruments that were in the past mainly classified by the type of mouthpiece and not taking into consideration its relationship with their neighboring structures.

SUBMITTER: Clemente M

PROVIDER: S-EPMC6587030 | biostudies-literature | 2019 Jul-Sep

REPOSITORIES: biostudies-literature

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A new classification of wind instruments: Orofacial considerations.

Clemente Miguel M Mendes Joaquim J Moreira André A Bernardes Gilberto G Van Twillert Henk H Ferreira Afonso A Amarante José Manuel JM

Journal of oral biology and craniofacial research 20190615 3

<h4>Background/objective</h4>Playing a wind instrument implies rhythmic jaw movements where the embouchure applies forces with different directions and intensities towards the orofacial structures. These features are relevant when comparing the differences between a clarinettist and a saxophone player embouchure, independently to the fact that both belong to the single-reed instrument group, making therefore necessary to update the actual classification.<h4>Methods</h4>Lateral cephalograms were ...[more]

PMID: 31249774

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Project description:BACKGROUND:The outcomes of weaning processes are not well known in pediatric patients, and the International Conference Classification on weaning from mechanical ventilation showed limited application. We evaluate the relationship between the new Weaning according to a New Definition (WIND) classification and outcome in pediatric patients. METHODS:We conducted a retrospective cohort study in a tertiary pediatric intensive care unit (ICU). We included patients under 18 years of age who received invasive mechanical ventilation for more than 24 h and excluded cases with other than the first ICU admissions, tracheostomy with home ventilation before admission, intubation or weaning processes conducted in other ICU, and weaning with extracorporeal membrane oxygenation. Weaning processes were classified into four groups according to weaning duration after the first separation attempt (SA): no-SA, short weaning (< 24 h), difficult weaning (24 h-7 days), and prolonged weaning (> 7 days). Mortality rates were compared across groups using the Kruskal-Wallis test, and risk factors for the no-SA group were analyzed by multivariate logistic regression tests with age, sex, severity score at admission, admission type, and underlying disease as variables. RESULTS:Among 313 patients, 224 were enrolled and had a median age of 2.1 (interquartile range 0.5-6.6) years. Spontaneous breathing tests were done in 70.1% of enrolled patients. The median duration of intubation to the first SA was 4 (range 0-36) days, and 92.8% patients underwent the first SA within 14 days. The mortality rate was 0% in the short (0/99) and difficult (0/53) weaning groups and 17.9% (5/28) in the prolonged weaning group (p < 0.001). The mortality rate of the no-SA group was 93.2% (41/44). Admission severity (hazard ratio 1.036, confidence interval 1.022-1.050) and underlying oncologic disease (hazard ratio 7.341, confidence interval 3.008-17.916) were independent risk factors for lack of SA. CONCLUSIONS:In conclusion, WIND classification is associated with ICU mortality in pediatric patients. Further studies of this association are required to improve protocols associated with the weaning process and clinical outcomes. Trial registration Retrospectively registered.

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A new classification of wind instruments: Orofacial considerations.

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A new classification of wind instruments: Orofacial considerations.

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