Virtual Reality Technology and Speech Analysis for People Who Stutter

Virtual reality (VR) technology provides an interactive computer-generated experience that artificially simulates real-life situations by creating a virtual environment that looks real and stimulates the user’s feelings. During the past few years, the use of VR technology in clinical interventions for assessment, rehabilitation and treatment have received increased attention. Accordingly, many clinical studies and applications have been proposed in the field of mental health, including anxiety disorders. Stuttering is a speech disorder in which affected individuals have a problem with the flow of speech. This can manifest in the repetition and prolongation of words or phrases, as well as in involuntary silent pauses or blocks during which the individual is unable to produce sounds. Stuttering is often accompanied by a social anxiety disorder as a secondary symptom, which requires separate treatment. In this study, we evaluated the effectiveness of using a VR environment as a medium for presenting speech training tasks. In addition, we evaluated the accuracy of a speech analyzer module in detecting stuttering events.

Efficacy of Shenqi Runchang Tongbian Decoction in Treatment of Children with Constipation and Its Effect on Clinical Symptoms of Children

To investigate the efficacy of Shenqi Runchang Tongbian Decoction in the treatment of children with constipation and its effect on the clinical symptoms of children. Methods: From January 2016 to January 2020, 100 patients with constipation were randomly divided into two groups. The control group was treated with lactulose oral solution, and the study group was treated with Shenqi Runchang Tongbian Decoction. Both groups were administered with drugs for 14 days, and the two groups were followed up on the 28th day. The effectiveness of the two groups was compared before treatment and during follow-up. The changes of various symptom scores were compared before treatment, after treatment and during follow-up, and the changes of primary symptom score, secondary symptom score and total score were compared before treatment, after treatment and during follow-up. Results: After treatment, the effectiveness of the study group was higher than that of the control group at follow-up (P <0.05). After treatment and during the follow-up, the scores of facial color, lips, sleep, urination, hand-foot-heart-chest, appetite, halitosis, abdominal distension and abdominal pain, defecation duration, defecation difficulty, defecation frequency and stool property of the two groups were lower than those before treatment (P < 0.05). There was no significant difference in the scores of facial color, sleep, urination and hand-foot-heart-chest symptoms before and after treatment of the control group and the study group (P > 0.05). There was no significant difference in the scores of facial color, lips, sleep, urination and hand-foot-heart-chest symptoms before treatment and during follow-up between the control group and the study group (P > 0.05). The scores of lip symptoms after treatment in the study group were lower than those in the control group (P < 0.05). The scores of appetites, halitosis, abdominal distension and abdominal pain, defecation duration, defecation difficulty, defecation frequency, stool property after treatment and during follow-up in the study group were lower than those in the control group (P <0.05). The total score, the secondary symptom score and the primary symptom score of the two groups before treatment and during follow-up were lower than those before treatment (P < 0.05). The total score, the secondary symptom score and the primary symptom score in the study group were lower than those in the control group after treatment and during follow-up (P < 0.05). Conclusion: The treatment of children with constipation with Shenqi Runchang Tongbian Decoction can improve the secondary symptoms and primary symptoms of children and improve the comprehensive curative effect, especially in the aspects of improving appetite, halitosis, abdominal distension and abdominal pain, defecation duration, defecation difficulty, defecation frequency and stool property. It can effectively enhance the gastrointestinal function and promote the rehabilitation of children. It is worthy of being popularized in clinical practice.

Psychometric Properties of the Italian Version of the Burnout Assessment Tool (BAT)

The most popular instrument to measure burnout is the Maslach Burnout Inventory (MBI). Recently, to overcome some of the limitations of the MBI, a new instrument has been proposed, namely the Burnout Assessment Tool. The purpose of this study is to examine the psychometric properties of the Italian version of the BAT. This tool is comprised of a set of four core dimensions (BAT-C; i.e., exhaustion, mental distance, cognitive and emotional impairment) and two secondary symptom dimensions (BAT-S; i.e., psychological and psychosomatic complaints). Data were collected on a sample of 738 participants from heterogeneous sectors and professional roles. In the sample women were slightly overrepresented (52.9%), the participants had a mean age of 41.57 years (SD = 10.51) and a mean organizational tenure of 9.65 years (SD = 8.50). The reliability and factorial structure of the BAT-C and BAT-S, together with the convergent and discriminant validity of BAT-C and MBI were explored, as well as the incremental validity to the BAT-C, over and beyond the MBI. Our results confirmed the factorial validity of a two-factor second-order factor model (BAT-C and BAT-S) represented by 4 first-order factors in the case of BAT-C and 2 first-order factors for BAT-S. Results also attested that BAT-C explains additional variance of the BAT-S, above and beyond what is explained by the MBI-GS. All in all, this study provided evidence that the Italian version of BAT represents a reliable and valid tool for measuring burnout in the work context.

Fatigue-management strategies among women with endometriosis in South Africa: a qualitative study

Fatigue is a common, secondary symptom of endometriosis that has not been qualitatively explored. We conducted individual, face-to-face interviews with 25 women in South Africa about their experiences of endometriosis-related fatigue. Participants were recruited at a public hospital in Cape Town and through several South African endometriosis organizations. Interviews were conducted in English and Afrikaans and ranged from 30 min to 1 hr 16 min in duration. All interviews were audio recorded and transcribed. Interviews were analyzed using thematic analysis. We found that both the experience of fatigue and fatigue-management strategies were highly personalized. Participants reported using a variety of cognitive strategies, such as planning, pacing, and pushing through their fatigue to reduce the levels of fatigue. Participants also employed physical strategies such as rest, dietary changes, using supplements, and exercise. We found that while participants often tried fatigue-management strategies suggested to them by others, they struggled to maintain these strategies even when they were successful. There are currently no interventions aimed at reducing endometriosis-related fatigue. The findings of this study provide insight into the management of fatigue in women with endometriosis and may be used to develop a psychosocial intervention for fatigue among women with the disease.

483 Neuroanatomical and Neurofunctional Correlates of Unexplained Excessive Daytime Sleepiness

Introduction Excessive daytime sleepiness (EDS) frequently presents as a secondary symptom, but some experience EDS in the absence of an explanatory medical condition, psychiatric illness, sleep disorder, or medication/substance use. The neurobiology underlying unexplained EDS (uEDS) is poorly understood, which contributes to the existing limitations in uEDS classification, assessment, and treatment. This investigation was designed to identify potential neuroanatomical and neurofunctional correlates of uEDS. Methods Data were acquired from the open-access Stockholm Sleepy Brain (SSB) Project, which included either young (20–30 years old) or older (65–75 years old) adults. SSB criteria ruled out common EDS explanations. A uEDS sample (N = 18; Percentage Female = 33%; Percentage Young = 33%) was established using Epworth Sleepiness Scale (ESS) ≥ 11. Age-and-sex matched controls without EDS (noEDS) were identified. T1-weighted MRI and resting-state fMRI (rs-fMRI) data were compiled for each subject, as well as depression, anxiety, and global health self-ratings. Processing pipelines were performed on T1-weighted and rs-fMRI data. Neuroanatomical analyses compared groups using voxel-based morphometry and across gray matter (GM), white matter (WM), and cerebral spinal fluid volume. Threshold free cluster enhancement was used across all neuroanatomical comparisons. For neurofunctional analyses, seed-based connectivity analysis was performed with a seed placed in the left hemisphere of the medial prefrontal cortex (MNI coordinates: 2 -46 12). Fischer Z-transformed functional connectivity maps were compared across groups. Depression, anxiety, and global health scores were included as covariates and corrections were applied for multiple comparisons, across all analyses. Results Group characteristics were comparable, except for ESS. Significantly increased GM volume (middle occipital gyrus and precuneus) was associated with uEDS, relative to noEDS. Robust, bilateral increases in WM matter (thalamus, cerebellum, and middle frontal gyrus) were observed for uEDS, relative to noEDS. No significant group differences were observed in rs-fMRI. Conclusion Significant neuroanatomical alterations were associated with uEDS that included increases in both GM and WM. These findings converge on previous research associating anatomical differences within the default mode network with uEDS. Future research using more sensitive quantitative measures of WM is warranted. Support (if any) This project was supported by a National Institute Nursing Research grant (NR018288).

Altered sleep behavior in a genetic mouse model of impaired fear extinction

Sleep disturbances are a common complaint of anxiety patients and constitute a hallmark feature of post-traumatic stress disorder (PTSD). Emerging evidence suggests that poor sleep is not only a secondary symptom of anxiety- and trauma-related disorders but represents a risk factor in their development, for example by interfering with emotional memory processing. Fear extinction is a critical mechanism for the attenuation of fearful and traumatic memories and multiple studies suggest that healthy sleep is crucial for the formation of extinction memories. However, fear extinction is often impaired in anxiety- and trauma-related disorders—an endophenotype that is perfectly modelled in the 129S1/SvImJ inbred mouse strain. To investigate whether these mice exhibit altered sleep at baseline that could predispose them towards maladaptive fear processing, we compared their circadian sleep/wake patterns to those of typically extinction-competent C57BL/6 mice. We found significant differences regarding diurnal distribution of sleep and wakefulness, but also sleep architecture, spectral features and sleep spindle events. With regard to sleep disturbances reported by anxiety- and PTSD patients, our findings strengthen the 129S1/SvImJ mouse models’ face validity and highlight it as a platform to investigate novel, sleep-focused diagnostic and therapeutic strategies. Whether the identified alterations causally contribute to its pathological anxiety/PTSD-like phenotype will, however, have to be addressed in future studies.

Yoga as an Intervention for Students With Attention Deficit Hyperactivity Disorder

Research conducted in both the field of yoga and the field of behavioural disorders in children and adolescents leads to the speculation that the benefits of yoga practice demonstrated with respect to physiological, psychological, emotional, and psychosocial functioning may be applicable to the impairments evidenced in these areas in behavioural disorders. The intervention—20 weekly one-hour sessions of yoga—required a large commitment for the participants, their families, and the yoga instructor. The results suggested that yoga appears to exert its impact on stabilising the emotions (a secondary symptom) and reducing oppositional behaviour, frequently co-morbid (40%) with attention deficit hyperactivity disorder (ADHD). Given the limitations of this study, the results do indicate some significant changes in the behaviour of some of the boys with ADHD. In conclusion, yoga shows promise as a non-invasive, inexpensive, adjuvant treatment for boys with ADHD.

Late-Onset of Keratocysts in De Novo Mutation c.1347+1G>A on Intron 9 PTCH1- (NBCCS) – Diagnosis and Therapy

Introduction: The occurrence of two main symptoms (calcification of the falx cerebri, odontogenic keratocysts, basal cell carcinoma) and a minimum of one secondary symptom is necessary for de-novo diagnosing a Basal Cell Nevus Syndrome (BCNS). Late diagnosing is usual if the primary symptoms are absent. Subtypes of BCNS may express phenotypes at different ages. Early recognition is needed. The adhesion of keratocysts to the basal bone layer varies, so different treatment options are standard. Aim: A 47-year-old woman without clinical signs of BCNS except macrocephaly suffered from de-novomutation of the PTCH1 gene. Odontogenic keratocysts were recognized sporadically by CB-CT ten years later, as late-onset; Compared to subsequent generations, who often present the main symptoms in childhood. The indication of resection, marsupialization, or enucleation with or without Carnoy-solution is a clinical decision. Conclusion: Despite 100% penetrance, intrafamilial expression of the clinical phenomenon is variable. In child morbidity, the parents’ lifelong co-screening should be mandatory by radiological and clinical investigation. Late-onset KCOT should be resected en-bloc, including soft tissue movement. Enucleation has less morbidity for mandibular keratocysts near the nerve. Carnoy-solution helps minimize the risk of relapse.

Swine Conjunctivitis Associated with a Novel Mycoplasma Species Closely Related to Mycoplasma hyorhinis

Conjunctivitis in swine is a common finding, usually considered to be a secondary symptom of respiratory or viral systemic disease, or a result of irritation by dust or ammonia, or of local infections with Mycoplasma (M.) hyorhinis or chlamydia. In three unrelated swine farms in Germany with a high prevalence of conjunctivitis, a novel mycoplasma species, tentatively named Mycoplasma sp. 1654_15, was isolated from conjunctival swabs taken from affected pigs. Although 16S rRNA gene sequences shared highest nucleotide similarities with M. hyorhinis, matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry, partial rpoB sequencing, and comparative whole genome analyses indicated the identification of a novel species within genus Mycoplasma. Noticeable differences between Mycoplasma sp. 1654_15 and M. hyorhinis were the lack of a vlp locus and the presence of a myo-inositol pathway in the genome of strain 1654_15. Since myo-inositol might be used as an alternative energy source by this pathogen on the conjunctival surface, robust colonization by outcompeting other bacteria could be the consequence. In summary, abundant isolation of Mycoplasma sp. 1654_15 from the conjunctiva of affected pigs, its close relationship to M. hyorhinis, and identification of a panel of coding sequences (CDSs) potentially associated with virulence and pathogenicity suggested a local eye disease caused by a so far unknown, highly specialized mycoplasma species.

Acoustic Model of Perceived Overall Severity of Dysphonia in Adductor-Type Laryngeal Dystonia

Purpose This study is a secondary analysis of existing data. The goal of the study was to construct an acoustic model of perceived overall severity of dysphonia in adductory laryngeal dystonia (AdLD). We predicted that acoustic measures (a) related to voice and pitch breaks and (b) related to vocal effort would form the primary elements of a model corresponding to auditory-perceptual ratings of overall severity of dysphonia. Method Twenty inexperienced listeners evaluated the overall severity of dysphonia of speech stimuli from 19 individuals with AdLD. Acoustic features related to primary signs of AdLD (hyperadduction resulting in pitch and voice breaks) and to a potential secondary symptom of AdLD (vocal effort, measures of relative fundamental frequency) were computed from the speech stimuli. Multiple linear regression analysis was applied to construct an acoustic model of the overall severity of dysphonia. Results The acoustic model included an acoustic feature related to pitch and voice breaks and three acoustic measures derived from relative fundamental frequency; it explained 84.9% of the variance in the auditory-perceptual ratings of overall severity of dysphonia in the speech samples. Conclusions Auditory-perceptual ratings of overall severity of dysphonia in AdLD were related to acoustic features of primary signs (pitch and voice breaks, hyperadduction associated with laryngeal spasms) and were also related to acoustic features of vocal effort. This suggests that compensatory vocal effort may be a secondary symptom in AdLD. Future work to generalize this acoustic model to a larger, independent data set is necessary before clinical translation is warranted.