Long Term Suboxone™ Emotional Reactivity As Measured by Automatic Detection in Speech

Addictions to illicit drugs are among the nation’s most critical public health and societal problems. The current opioid prescription epidemic and the need for buprenorphine/naloxone (Suboxone®; SUBX) as an opioid maintenance substance, and its growing street diversion provided impetus to determine affective states (“true ground emotionality”) in long-term SUBX patients. Toward the goal of effective monitoring, we utilized emotion-detection in speech as a measure of “true” emotionality in 36 SUBX patients compared to 44 individuals from the general population (GP) and 33 members of Alcoholics Anonymous (AA). Other less objective studies have investigated emotional reactivity of heroin, methadone and opioid abstinent patients. These studies indicate that current opioid users have abnormal emotional experience, characterized by heightened response to unpleasant stimuli and blunted response to pleasant stimuli. However, this is the first study to our knowledge to evaluate “true ground” emotionality in long-term buprenorphine/naloxone combination (Suboxone™). We found in long-term SUBX patients a significantly flat affect (p<0.01), and they had less self-awareness of being happy, sad, and anxious compared to both the GP and AA groups. We caution definitive interpretation of these seemingly important results until we compare the emotional reactivity of an opioid abstinent control using automatic detection in speech. These findings encourage continued research strategies in SUBX patients to target the specific brain regions responsible for relapse prevention of opioid addiction.United States. Dept. of Defense. Assistant Secretary of Defense for Research & Engineering (Air Force Contract FA8721-05-C-0002

A Dynamic Neuro-Fuzzy Model Providing Bio-State Estimation and Prognosis Prediction for Wearable Intelligent Assistants

BACKGROUND: Intelligent management of wearable applications in rehabilitation requires an understanding of the current context, which is constantly changing over the rehabilitation process because of changes in the person's status and environment. This paper presents a dynamic recurrent neuro-fuzzy system that implements expert-and evidence-based reasoning. It is intended to provide context-awareness for wearable intelligent agents/assistants (WIAs). METHODS: The model structure includes the following types of signals: inputs, states, outputs and outcomes. Inputs are facts or events which have effects on patients' physiological and rehabilitative states; different classes of inputs (e.g., facts, context, medication, therapy) have different nonlinear mappings to a fuzzy "effect." States are dimensionless linguistic fuzzy variables that change based on causal rules, as implemented by a fuzzy inference system (FIS). The FIS, with rules based on expertise and evidence, essentially defines the nonlinear state equations that are implemented by nuclei of dynamic neurons. Outputs, a function of weighing of states and effective inputs using conventional or fuzzy mapping, can perform actions, predict performance, or assist with decision-making. Outcomes are scalars to be extremized that are a function of outputs and states. RESULTS: The first example demonstrates setup and use for a large-scale stroke neurorehabilitation application (with 16 inputs, 12 states, 5 outputs and 3 outcomes), showing how this modelling tool can successfully capture causal dynamic change in context-relevant states (e.g., impairments, pain) as a function of input event patterns (e.g., medications). The second example demonstrates use of scientific evidence to develop rule-based dynamic models, here for predicting changes in muscle strength with short-term fatigue and long-term strength-training. CONCLUSION: A neuro-fuzzy modelling framework is developed for estimating rehabilitative change that can be applied in any field of rehabilitation if sufficient evidence and/or expert knowledge are available. It is intended to provide context-awareness of changing status through state estimation, which is critical information for WIA's to be effective

Future bathroom: A study of user-centred design principles affecting usability, safety and satisfaction in bathrooms for people living with disabilities

Research and development work relating to assistive technology 2010-11 (Department of Health) Presented to Parliament pursuant to Section 22 of the Chronically Sick and Disabled Persons Act 197

Technology-enhanced Personalised Learning: Untangling the Evidence

Technology-enhanced personalised learning is not yet common in Germany, which is why we have tasked scientists with summarising the current status of international research on the matter. This study demonstrates the great potential of technology in implementing effective personalised learning. Nevertheless, it has not been assessed yet whether the practical implementation actually works: Even in countries such as the U.S., which lead the way in using techology in classroom settings, hardly any evaluation studies have been done to prove the effectiveness of technology-enhanced personalised learning. In the light of the above, the authors make recommendations for actions to be taken in Germany to make best use of the potential of technology in providing individual support and guidance to students

A clinical patient vital signs parameter measurement, processing and predictive algorithm using ECG

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.In the modern clinical and healthcare setting, the electronic collection and analysis of patient related vital signs and parameters are a fundamental part of the relevant treatment plan and positive patient response. Modern analytical techniques combined with readily available computer software today allow for the near real time analysis of digitally acquired measurements. In the clinical context, this can directly relate to patient survival rates and treatment success. The processing of clinical parameters, especially the Electrocardiogram (ECG) in the critical care setting has changed little in recent years and the analytical processes have mostly been managed by highly trained and experienced cardiac specialists. Warning, detection and measurement techniques are focused on the post processing of events relying heavily on averaging and analogue filtering to accurately capture waveform morphologies and deviations. This Ph.D. research investigates an alternative and the possibility to analyse, in the digital domain, bio signals with a focus on the ECG to determine if the feasibility of bit by bit or near real time analysis is indeed possible but more so if the data captured has any significance in the analysis and presentation of the wave patterns in a patient monitoring environment. The research and experiments have shown the potential for the development of logical models that address both the detection and short term predication of possible follow-on events with a focus on Myocardial Ischemic (MI) and Infraction based deviations. The research has shown that real time waveform processing compared to traditional graph based analysis, is both accurate and has the potential to be of benefit to the clinician by detecting deviations and morphologies in a real time domain. This is a significant step forward and has the potential to embed years of clinical experience into the measurement processes of clinical devices, in real terms. Also, providing expert analytical and identification input electronically at the patient bedside. The global human population is testing the healthcare systems and care capabilities with the shortage of clinical and healthcare providers in ever decreasing coverage of treatment that can be provided. The research is a moderate step in further realizing this and aiding the caregiver by providing true and relevant information and data, which assists in the clinical decision process and ultimately improving the required standard of patient care