scholarly journals Predicting Intelligibility Gains in Individuals With Dysarthria From Baseline Speech Features

2017 ◽  
Vol 60 (11) ◽  
pp. 3043-3057 ◽  
Author(s):  
Annalise R. Fletcher ◽  
Megan J. McAuliffe ◽  
Kaitlin L. Lansford ◽  
Donal G. Sinex ◽  
Julie M. Liss
Keyword(s):  
Voice Quality ◽  
Treatment Strategies ◽  
Treatment Programs ◽  
Older Individuals ◽  
Acoustic Measurements ◽  
Baseline Severity ◽  
Appropriate Treatment ◽  
Slow Condition ◽  
Speech Features ◽  
Further Development

Purpose Across the treatment literature, behavioral speech modifications have produced variable intelligibility changes in speakers with dysarthria. This study is the first of two articles exploring whether measurements of baseline speech features can predict speakers’ responses to these modifications. Methods Fifty speakers (7 older individuals and 43 speakers with dysarthria) read a standard passage in habitual, loud, and slow speaking modes. Eighteen listeners rated how easy the speech samples were to understand. Baseline acoustic measurements of articulation, prosody, and voice quality were collected with perceptual measures of severity. Results Cues to speak louder and reduce rate did not confer intelligibility benefits to every speaker. The degree to which cues to speak louder improved intelligibility could be predicted by speakers' baseline articulation rates and overall dysarthria severity. Improvements in the slow condition could be predicted by speakers' baseline severity and temporal variability. Speakers with a breathier voice quality tended to perform better in the loud condition than in the slow condition. Conclusions Assessments of baseline speech features can be used to predict appropriate treatment strategies for speakers with dysarthria. Further development of these assessments could provide the basis for more individualized treatment programs.

Evaluation of Acoustic Analyses of Voice in Nonoptimized Conditions

2020 ◽  
Vol 63 (12) ◽  
pp. 3991-3999
Author(s):  
Benjamin van der Woerd ◽  
Min Wu ◽  
Vijay Parsa ◽  
Philip C. Doyle ◽  
Kevin Fung
Keyword(s):  
Repeated Measures ◽  
Voice Quality ◽  
Data Sets ◽  
Acoustic Measurements ◽  
Sample Collection ◽  
Experimental Conditions ◽  
Environment Analysis ◽  
Acoustic Measures ◽  
Recording Conditions ◽  
Cepstral Peak Prominence

Objectives This study aimed to evaluate the fidelity and accuracy of a smartphone microphone and recording environment on acoustic measurements of voice. Method A prospective cohort proof-of-concept study. Two sets of prerecorded samples (a) sustained vowels (/a/) and (b) Rainbow Passage sentence were played for recording via the internal iPhone microphone and the Blue Yeti USB microphone in two recording environments: a sound-treated booth and quiet office setting. Recordings were presented using a calibrated mannequin speaker with a fixed signal intensity (69 dBA), at a fixed distance (15 in.). Each set of recordings (iPhone—audio booth, Blue Yeti—audio booth, iPhone—office, and Blue Yeti—office), was time-windowed to ensure the same signal was evaluated for each condition. Acoustic measures of voice including fundamental frequency ( f o ), jitter, shimmer, harmonic-to-noise ratio (HNR), and cepstral peak prominence (CPP), were generated using a widely used analysis program (Praat Version 6.0.50). The data gathered were compared using a repeated measures analysis of variance. Two separate data sets were used. The set of vowel samples included both pathologic ( n = 10) and normal ( n = 10), male ( n = 5) and female ( n = 15) speakers. The set of sentence stimuli ranged in perceived voice quality from normal to severely disordered with an equal number of male ( n = 12) and female ( n = 12) speakers evaluated. Results The vowel analyses indicated that the jitter, shimmer, HNR, and CPP were significantly different based on microphone choice and shimmer, HNR, and CPP were significantly different based on the recording environment. Analysis of sentences revealed a statistically significant impact of recording environment and microphone type on HNR and CPP. While statistically significant, the differences across the experimental conditions for a subset of the acoustic measures (viz., jitter and CPP) have shown differences that fell within their respective normative ranges. Conclusions Both microphone and recording setting resulted in significant differences across several acoustic measurements. However, a subset of the acoustic measures that were statistically significant across the recording conditions showed small overall differences that are unlikely to have clinical significance in interpretation. For these acoustic measures, the present data suggest that, although a sound-treated setting is ideal for voice sample collection, a smartphone microphone can capture acceptable recordings for acoustic signal analysis.

Perceived Voice Disorders in Older Adults and Impact on Social Interactions

2021 ◽  
pp. 1-8
Author(s):  
Connie K. Porcaro ◽  
Clare Singer ◽  
Boris Djokic ◽  
Ali A. Danesh ◽  
Ruth Tappen ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Interactions ◽  
Social Engagement ◽  
Leisure Activities ◽  
Treatment Strategies ◽  
Voice Disorders ◽  
Community Dwelling ◽  
Vocal Performance ◽  
Older Individuals ◽  
Cross Sectional

Purpose Many aging individuals, even those who are healthy, report voice changes that can impact their ability to communicate as they once did. While this is commonly reported, most do not seek evaluation or management for this issue. The purpose of this study was to investigate the prevalence and differences in voice disorders in older adults, along with the effect of fatigue on their social interactions. Method This is a cross-sectional investigation of a community-dwelling sample of individuals aged 60 years or older. Participants completed the Questionnaire on Vocal Performance, the Social Engagement Index subset “Engagement in Social or Leisure Activities,” and the Fatigue Severity Scale. Results Results indicated 32.5% of the 332 participants reported symptoms of voice problems with no difference found between male and female respondents. A slight increase in report of voice problems was noted with each year of age. Participants who self-reported voice problems indicated less interaction in social activities involving communication than those who did not. Finally, as severity of self-reported voice problems increased, an increase was reported by the same individuals for signs of fatigue. Conclusions Voice problems and resulting decreased social interaction are commonly experienced by older individuals. Voice symptoms in older adults have been found to benefit from evidence-based treatment strategies. It is critical to provide education to encourage older individuals to seek appropriate evaluation and management for voice issues through a speech-language pathologist or medical professional.

Non-invasive ultrasound-based imaging of atherosclerosis

VASA ◽  
2019 ◽  
Vol 48 (2) ◽  
pp. 126-133 ◽  
Author(s):  
Mathias Kaspar ◽  
Iris Baumgartner ◽  
Daniel Staub ◽  
Heinz Drexel ◽  
Christoph Thalhammer
Keyword(s):  
Large Population ◽  
Treatment Strategies ◽  
Intima Media Thickness ◽  
Scientific Work ◽  
Flow Mediated Dilation ◽  
Non Invasive ◽  
Grey Scale ◽  
Current Review ◽  
Appropriate Treatment ◽  
Contrast Enhanced

Abstract. Early detection of vascular damage in atherosclerosis and accurate assessment of cardiovascular risk factors are the basis for appropriate treatment strategies in cardiovascular medicine. The current review focuses on non-invasive ultrasound-based methods for imaging of atherosclerosis. Endothelial dysfunction is an accepted early manifestation of atherosclerosis. The most widely used technique to study endothelial function is non-invasive, flow-mediated dilation of the brachial artery under high-resolution ultrasound imaging. Although an increased intima-media thickness value is associated with future cardiovascular events in several large population studies, systematic use is not recommended in clinical practice for risk assessment of individual persons. Carotid plaque analysis with grey-scale median, 3-D ultrasound or contrast-enhanced ultrasound are promising techniques for further scientific work in prevention and therapy of generalized atherosclerosis.

scholarly journals A Closer Look at the Cellular and Molecular Components of the Deep/Muscular Fasciae

2021 ◽  
Vol 22 (3) ◽  
pp. 1411
Author(s):  
Caterina Fede ◽  
Carmelo Pirri ◽  
Chenglei Fan ◽  
Lucia Petrelli ◽  
Diego Guidolin ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Connective Tissue ◽  
Treatment Strategies ◽  
Clear Understanding ◽  
Pathological Characteristics ◽  
Appropriate Treatment ◽  
Different Types ◽  
Molecular Components ◽  
Entire Network ◽  
Shed Light

The fascia can be defined as a dynamic highly complex connective tissue network composed of different types of cells embedded in the extracellular matrix and nervous fibers: each component plays a specific role in the fascial system changing and responding to stimuli in different ways. This review intends to discuss the various components of the fascia and their specific roles; this will be carried out in the effort to shed light on the mechanisms by which they affect the entire network and all body systems. A clear understanding of fascial anatomy from a microscopic viewpoint can further elucidate its physiological and pathological characteristics and facilitate the identification of appropriate treatment strategies.

scholarly journals Detection of Amyotrophic Lateral Sclerosis (ALS) via Acoustic Analysis

2018 ◽  
Author(s):  
Raquel Norel ◽  
Mary Pietrowicz ◽  
Carla Agurto ◽  
Shay Rishoni ◽  
Guillermo Cecchi
Keyword(s):  
Disease Progression ◽  
Acoustic Analysis ◽  
Voice Quality ◽  
Non Invasive ◽  
Frequent Monitoring ◽  
In The Wild ◽  
A Cell ◽  
Speech Features ◽  
Severity Of The Disease ◽  
Lateral Sclerosis

ABSTRACTALS is a fatal neurodegenerative disease with no cure. Experts typically measure disease progression via the ALSFRS-R score, which includes measurements of various abilities known to decline. We propose instead the use of speech analysis as a proxy for ALS progression. This technique enables 1) frequent non-invasive, inexpensive, longitudinal analysis, 2) analysis of data recorded in the wild, and 3) creation of an extensive ALS databank for future analysis. Patients and trained medical professionals need not be co-located, enabling more frequent monitoring of more patients from the convenience of their own homes. The goals of this study are the identification of acoustic speech features in naturalistic contexts which characterize disease progression and development of machine models which can recognize the presence and severity of the disease. We evaluated subjects from the Prize4Life Israel dataset, using a variety of frequency, spectral, and voice quality features. The dataset was generated using the ALS Mobile Analyzer, a cell-phone app that collects data regarding disease progress using a self-reported ALSFRS-R questionnaire and several active tasks that measure speech and motor skills. Classification via leave-five-subjects-out cross-validation resulted in an accuracy rate of 79% (61% chance) for males and 83% (52% chance) for females.

scholarly journals Evaluation of Different Treatment Strategies Between Right-sided and Left-sided Pneumonectomy for Stage I-IIIA Non-small Cell Lung Cancer Patients

2020 ◽  
Author(s):  
Bo Jia ◽  
Qiwen Zheng ◽  
Jianjie Li ◽  
Jun Zhao ◽  
Meina Wu ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Treatment Strategies ◽  
The United States ◽  
Stage I ◽  
Cancer Specific Survival ◽  
Lung Cancer Patients ◽  
Propensity Score Matching Analysis ◽  
Appropriate Treatment ◽  
Iiia Nsclc ◽  
Nsclc Patients

Abstract BackgroundThis study aimed to assess the different survival outcome of stage I-IIIA NSCLC patients who received right-sided and left-sided pneumonectomy, and to further develop the most appropriate treatment strategies. MethodsWe accessed data from the Surveillance, Epidemiology, and End Results database in the United States for the present study. An innovative propensity score matching analysis was used to minimize the variance between groups.ResultsFor 2,683 patients who received pneumonectomy, cancer-specific survival (HR=0.863, 95%CI: 0.771 to 0.965, P=0.010) and overall survival (OS) (HR=0.875, 95%CI: 0.793 to 0.967, P=0.008) were significantly superior of left-sided pneumonectomy compared with right-sided pneumonectomy. Cancer-specific survival (HR=0.847, 95%CI: 0.745 to 0.963, P=0.011) and OS (HR=0.858, 95%CI: 0.768 to 0.959, P=0.007) were also significantly longer with left-sided over opposite-sided pneumonectomy after matching analysis for 2,050 patients. Adjuvant therapy could significantly prolong cancer-specific survival (67 versus 51 months, HR=1.314, 95%CI: 1.093 to 1.579, P=0.004) and OS (46 versus 30 months, HR=1.458, 95%CI: 1.239 to 1.715, P<0.001) among left-sided pneumonectomy patients after matching procedure. While adjuvant therapy did not increase cancer-specific survival for right-sided pneumonectomy patients (46 versus 42 months, HR=1.112, 95%CI: 0.933 to 1.325, P=0.236). Subgroup analysis showed that adjuvant chemotherapy could significantly improve cancer-specific survival and OS for all pneumonectomy patients. But radiotherapy was associated with worse survival for patients with right-sided pneumonectomy. ConclusionsPneumonectomy side could be deemed as an important factor when physicians choosing the most optimal treatment strategies.

scholarly journals Prediction of Post-hepatectomy Liver Failure in Patients With Hepatocellular Carcinoma Based on Radiomics Using Gd-EOB-DTPA-Enhanced MRI: The Liver Failure Model

2021 ◽  
Vol 11 ◽  
Author(s):  
Yuyan Chen ◽  
Zelong Liu ◽  
Yunxian Mo ◽  
Bin Li ◽  
Qian Zhou ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Failure ◽  
Treatment Strategies ◽  
Area Under The Curve ◽  
Training Cohort ◽  
Clinical Model ◽  
Preoperative Prediction ◽  
Medical Centers ◽  
Appropriate Treatment ◽  
Magnetic Resonance Imaging Mri

Objectives: Preoperative prediction of post-hepatectomy liver failure (PHLF) in patients with hepatocellular carcinoma (HCC) is significant for developing appropriate treatment strategies. We aimed to establish a radiomics-based clinical model for preoperative prediction of PHLF in HCC patients using gadolinium-ethoxybenzyl-diethylenetriamine (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI).Methods: A total of 144 HCC patients from two medical centers were included, with 111 patients as the training cohort and 33 patients as the test cohort, respectively. Radiomics features and clinical variables were selected to construct a radiomics model and a clinical model, respectively. A combined logistic regression model, the liver failure (LF) model that incorporated the developed radiomics signature and clinical risk factors was then constructed. The performance of these models was evaluated and compared by plotting the receiver operating characteristic (ROC) curve and calculating the area under the curve (AUC) with 95% confidence interval (CI).Results: The radiomics model showed a higher AUC than the clinical model in the training cohort and the test cohort for predicting PHLF in HCC patients. Moreover, the LF model had the highest AUCs in both cohorts [0.956 (95% CI: 0.955–0.962) and 0.844 (95% CI: 0.833–0.886), respectively], compared with the radiomics model and the clinical model.Conclusions: We evaluated quantitative radiomics features from MRI images and presented an externally validated radiomics-based clinical model, the LF model for the prediction of PHLF in HCC patients, which could assist clinicians in making treatment strategies before surgery.

scholarly journals Using Innovative Acoustic Analysis to Predict the Postoperative Outcomes of Unilateral Vocal Fold Paralysis

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Yung-An Tsou ◽  
Yi-Wen Liu ◽  
Wen-Dien Chang ◽  
Wei-Chen Chen ◽  
Hsiang-Chun Ke ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Linear Prediction ◽  
Acoustic Analysis ◽  
Characteristic Curve ◽  
Voice Quality ◽  
Treatment Strategies ◽  
Vocal Fold Paralysis ◽  
Unilateral Vocal Fold Paralysis ◽  
Outcome Predictor ◽  
Laryngeal Framework Surgery

Objective.Autologous fat injection laryngoplasty is ineffective for some patients with iatrogenic vocal fold paralysis, and additional laryngeal framework surgery is often required. An acoustically measurable outcome predictor for lipoinjection laryngoplasty would assist phonosurgeons in formulating treatment strategies.Methods.Seventeen thyroid surgery patients with unilateral vocal fold paralysis participated in this study. All subjects underwent lipoinjection laryngoplasty to treat postsurgery vocal hoarseness. After treatment, patients were assigned to success and failure groups on the basis of voice improvement. Linear prediction analysis was used to construct a new voice quality indicator, the number of irregular peaks (NIrrP). It compared with the measures used in the Multi-Dimensional Voice Program (MDVP), such as jitter (frequency perturbation) and shimmer (perturbation of amplitude).Results.By comparing the [i] vowel produced by patients before the lipoinjection laryngoplasty (AUC = 0.98, 95% CI = 0.78–0.99), NIrrP was shown to be a more accurate predictor of long-term surgical outcomes than jitter (AUC = 0.73, 95% CI = 0.47–0.91) and shimmer (AUC = 0.63, 95% CI = 0.37–0.85), as identified by the receiver operating characteristic curve.Conclusions.NIrrP measured using the LP model could be a more accurate outcome predictor than the parameters used in the MDVP.

Diagnosis and Treatment of MODY: An Updated Mini Review

2021 ◽  
Vol 11 (20) ◽  
pp. 9436
Author(s):  
Abegail Tshivhase ◽  
Tandi Matsha ◽  
Shanel Raghubeer
Keyword(s):  
Type 2 Diabetes ◽  
Single Gene ◽  
Treatment Strategies ◽  
Diagnosis And Treatment ◽  
Endogenous Insulin ◽  
Appropriate Treatment ◽  
Mild Hyperglycemia ◽  
Onset Of Diabetes

Maturity-Onset Diabetes of the Young (MODY) is the most common form of monogenic diabetes resulting from a single gene mutation. It is characterized by mild hyperglycemia, autosomal dominant inheritance, early onset of diabetes (<25 years), insulin resistance, and preservation of endogenous insulin secretion. Currently, 14 MODY subtypes have been identified, with differences in incidence, clinical features, diabetes severity and related complications, and treatment response. This type of diabetes is mostly misdiagnosed as either type 1 or type 2 diabetes mellitus because it is difficult to differentiate between these forms of diabetes due to clinical similarities, the high cost of genetic testing, and lack of awareness. As a result, thousands of patients are not receiving appropriate treatment. Accurate diagnosis would allow for more effective therapeutic management and treatment strategies that are distinct from those used for type 1 and type 2 diabetes. This review serves to explore MODY subtypes, diagnosis, and treatment, and increase awareness of MODY incidence.

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