Review of prognostic factors for esophageal voice

Plan A of this study was completed. Plan B of the study is the subject for future research. A review of the laryngectomy literature, from the earliest mention of the laryngectomy surgical procedure to the present was conducted; with specific emphasis upon factors pertinent to laryngectomee rehabilitation and esophageal speech development. Psychological, idiosyncratic, social, therapeutic and physiological factors were reported as affecting esophageal voice development. There were a great diversity of variables that might be predictive in judging acquisition of esophageal voice. However, much of the information regarding predictive variables was based on subjective reports, poorly controlled statistical research, or insignificant correlations. A Preliminary Esophageal Voice Checklist was developed to provide a systematic survey of variables frequently reported in the literature as affecting esophageal voice development. A proposal for experimental study, Plan B, was made for development of a pre-intervention assessment tool. Such a tool would allow the clinician to judge a laryngectomee\u27s potential for esophageal development or an alternate form of communication. [Keywords: Alaryngeal speech; Esophageal speech or voice; Esophagus; Laryngectomee; Laryngectomy; Larynx

Artificial Intelligence for Suicide Assessment using Audiovisual Cues: A Review

Death by suicide is the seventh leading death cause worldwide. The recent advancement in Artificial Intelligence (AI), specifically AI applications in image and voice processing, has created a promising opportunity to revolutionize suicide risk assessment. Subsequently, we have witnessed fast-growing literature of research that applies AI to extract audiovisual non-verbal cues for mental illness assessment. However, the majority of the recent works focus on depression, despite the evident difference between depression symptoms and suicidal behavior and non-verbal cues. This paper reviews recent works that study suicide ideation and suicide behavior detection through audiovisual feature analysis, mainly suicidal voice/speech acoustic features analysis and suicidal visual cues. Automatic suicide assessment is a promising research direction that is still in the early stages. Accordingly, there is a lack of large datasets that can be used to train machine learning and deep learning models proven to be effective in other, similar tasks.Comment: Manuscript submitted to Arificial Intelligence Reviews (2022

Effects of oral and oropharyngeal cancer on speech intelligibility using acoustic analysis: Systematic review

Background: The development of automatic tools based on acoustic analysis allows to overcome the limitations of perceptual assessment for patients with head and neck cancer. The aim of this study is to provide a systematic review of literature describing the effects of oral and oropharyngeal cancer on speech intelligibility using acoustic analysis. Methods: Two databases (PubMed and Embase) were surveyed. The selection process, according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement, led to a final set of 22 articles. Results: Nasalance is studied mainly in oropharyngeal patients. The vowels are mostly studied using formant analysis and vowel space area, the consonants by means of spectral moments with specific parameters according to their phonetic characteristic. Machine learning methods allow classifying “intelligible” or “unintelligible” speech for T3 or T4 tumors. Conclusions: The development of comprehensive models combining different acoustic measures would allow a better consideration of the functional impact of the speech disorder

Models and Analysis of Vocal Emissions for Biomedical Applications

The MAVEBA Workshop proceedings, held on a biannual basis, collect the scientific papers presented both as oral and poster contributions, during the conference. The main subjects are: development of theoretical and mechanical models as an aid to the study of main phonatory dysfunctions, as well as the biomedical engineering methods for the analysis of voice signals and images, as a support to clinical diagnosis and classification of vocal pathologies

Ergebnisse und zugrundeliegende Mechanismen der Hypoglossusnerv-Stimulation bei Patienten mit obstruktiver Schlafapnoe

Since 2001, hypoglossal nerve stimulation (HNS) has been used worldwide to treat adult patients with obstructive sleep apnea (OSA). However, the long-term outcomes following HNS and the underlying mechanisms have not been comprehensively investigated, and no studies have reported a persistent development course of a severe complication treatment-emergent central sleep apnea (TECSA) following HNS. Moreover, the prognostic indicators associated with successful HNS therapy to treat OSA and the occurrence of TECSA remain controversial. Therefore, this retrospective study aimed to evaluate the long-term outcomes of HNS and explore the prognostic indicators and underlying mechanisms to improve clinical effectiveness and avoid complications following HNS. Twenty-seven patients who underwent HNS implantation since 2016 were included in this study. Demographic, pre- and postoperative sleep study characteristics and device settings data were collected to evaluate the effects of HNS during evaluation. We compared the difference between the HNS success (n=13) and failure groups (n=14), and postoperative elevated central sleep apnea (n=3) and non-elevated CSA groups (n=24), respectively, and identified possible factors associated with the successful response to HNS and postoperative elevated CSA. Based on the persistent developmental course and phenotype of TECSA during evaluation, we hypothesized that an appropriate stimulation amplitude would resolve the development of TECSA and performed a titration study to help explore the underlying mechanisms. During 3 years of evaluation after device activation, HNS reduced OSA events and improved oxygenation with a success rate of 50%. An elevated preoperative Epworth sleepiness scale (ESS) score was associated with treatment failure, while other baseline demographic characteristics and polysomnography data could not predict the effects of HNS. Regarding complications following HNS, three patients had elevated CSA (CAI ≥ 5), which was associated with an increased preoperative ESS and mixed sleep apnea index (MAI). The persistent course of TECSA as well as a strong negative correlation between CSA and OSA revealed that the underlying mechanisms might be multiple combinations of the upper airway effect and high loop gain. In conclusion, HNS is an effective and promising treatment method for patients with OSA who cannot tolerate continuous positive airway pressure therapy (CPAP). Precise patient selection, individual titration configuration and scheduled follow-ups could help improve the effectiveness and reduce complications following HNS. In addition, a better understanding of the subtypes and endotypes of OSA should be translated into clinical use in the future to identify more predictive factors.Seit 2001 wird Hypoglossusnerv-Stimulation (HNS) weltweit zur Behandlung erwachsener Patienten mit obstruktiver Schlafapnoe (OSA) eingesetzt. Die Langzeitergebnisse nach HNS und die zugrundeliegenden Mechanismen sind jedoch nicht umfassend untersucht worden, und in keiner Studie wurde über einen anhaltenden Entwicklungsverlauf -Treatment-emergent central sleep apnea (TECSA)-nach HNS berichtet. Darüber hinaus sind die prognostischen Indikatoren für eine erfolgreiche HNS-Therapie zur Behandlung von OSA und das Auftreten von TECSA nach wie vor umstritten. Ziel dieser Studie war es daher, die Langzeitergebnisse der HNS zu prüfen und die prognostischen Indikatoren sowie die zugrunde liegenden Mechanismen zu untersuchen, um die klinische Wirksamkeit zu verbessern und Komplikationen nach der HNS zu vermeiden. In diese Studie wurden 27 Patienten aufgenommen, die sich seit 2016 einer HNS-Implantation unterzogen. Präoperative demografische Merkmale, Merkmale der Schlafstudie von Polysomnografie /Polygrafie für zu Hause vor und nach der Implantation und Gerätekonfiguration wurden gesammelt, um die Wirkung von HNS während der Auswertung zu bewerten. Aufgrund des anhaltenden Entwicklungsverlaufs und Phänotyps von TECSA während der Auswertung stellten wir die Hypothese auf, dass eine geeignete Stimulationsamplitude die Entwicklung von TECSA auflösen würde, und führten eine Titrationsstudie durch, um die zugrundeliegenden Mechanismen zu erforschen. Während der dreijährigen Auswertung nach der Aktivierung des Geräts konnte HNS die OSAEreignisse reduzieren und die Oxygenierung mit einer Erfolgsrate von 50% verbessern. Ein erhöhter präoperativer Epworth-Sleepiness-Scale (ESS) wert war mit einem Behandlungsversagen assoziiert, während andere Präoperative demografische Merkmale und Merkmale der Polysomnographie die Wirkung von HNS nicht vorhersagen konnten. Was die Komplikationen nach der HNS betrifft, so wiesen drei Patienten einen erhöhten CSA (CAI ≥ 5) auf, der mit einem erhöhten präoperativen ESS wert und einem gemischten Schlafapnoe-Index (MAI) verbunden war. Der anhaltende Verlauf von TECSA und eine starke negative Korrelation zwischen CSA und OSA zeigten, dass die zugrundeliegenden Mechanismen mehrere Kombinationen aus dem Effekt der oberen Atemwege und einer hohen Schleifenverstärkung sein könnten. Zusammenfassend lässt sich sagen, dass HNS eine wirksame und vielversprechende Behandlungsmethode für Patienten mit OSA ist, die eine kontinuierliche positive Atemwegsdrucktherapie (CPAP) nicht vertragen. Eine genaue Patientenauswahl, eine individuelle Titrationskonfiguration und geplante Nachuntersuchungen könnten dazu beitragen, die Wirksamkeit zu verbessern und Komplikationen nach der HNS zu verringern. Darüber hinaus sollte ein besseres Verständnis der Subtypen und Endtypen der OSA in Zukunft in die klinische Praxis umgesetzt werden, um weitere prädiktive Faktoren zu ermitteln

Medical-Data-Models.org:A collection of freely available forms (September 2016)

MDM-Portal (Medical Data-Models) is a meta-data repository for creating, analysing, sharing and reusing medical forms, developed by the Institute of Medical Informatics, University of Muenster in Germany. Electronic forms for documentation of patient data are an integral part within the workflow of physicians. A huge amount of data is collected either through routine documentation forms (EHRs) for electronic health records or as case report forms (CRFs) for clinical trials. This raises major scientific challenges for health care, since different health information systems are not necessarily compatible with each other and thus information exchange of structured data is hampered. Software vendors provide a variety of individual documentation forms according to their standard contracts, which function as isolated applications. Furthermore, free availability of those forms is rarely the case. Currently less than 5 % of medical forms are freely accessible. Based on this lack of transparency harmonization of data models in health care is extremely cumbersome, thus work and know-how of completed clinical trials and routine documentation in hospitals are hard to be re-used. The MDM-Portal serves as an infrastructure for academic (non-commercial) medical research to contribute a solution to this problem. It already contains more than 4,000 system-independent forms (CDISC ODM Format, www.cdisc.org, Operational Data Model) with more than 380,000 dataelements. This enables researchers to view, discuss, download and export forms in most common technical formats such as PDF, CSV, Excel, SQL, SPSS, R, etc. A growing user community will lead to a growing database of medical forms. In this matter, we would like to encourage all medical researchers to register and add forms and discuss existing forms

Negative vaccine voices in Swedish social media

Vaccinations are one of the most significant interventions to public health, but vaccine hesitancy creates concerns for a portion of the population in many countries, including Sweden. Since discussions on vaccine hesitancy are often taken on social networking sites, data from Swedish social media are used to study and quantify the sentiment among the discussants on the vaccination-or-not topic during phases of the COVID-19 pandemic. Out of all the posts analyzed a majority showed a stronger negative sentiment, prevailing throughout the whole of the examined period, with some spikes or jumps due to the occurrence of certain vaccine-related events distinguishable in the results. Sentiment analysis can be a valuable tool to track public opinions regarding the use, efficacy, safety, and importance of vaccination

Lived Experiences of Individuals Quality of Life on Prolonged Home Mechanical Ventilation

Improvements in technology have allowed people with tracheostomies to live at home on mechanical ventilation (HMV). Quality of life (QOL) for HMV users has been studied quantitatively, but few qualitative studies have been published. The purpose of this phenomenological study was to explore QOL for individuals with tracheostomies on prolonged HMV focusing on activities of daily living (ADLs) and the role of decision- making. The Roper, Logan, and Tierney activities of living theory were used to categorize activities. Ten participants, 18 years and older, with a tracheostomy and on HMV for at least 6 months were enrolled using purposive sampling. Data were collected through structured, in-depth, face-to-face interviews. Themes that emerged were (a) autonomy, (b) significance of ventilator for well-being, (c) feeling tied up, (d) creating meaning, (e) tipping point, (f) reminiscence, (g) building trust and confidence, (h) adjusting to technology, (i) family support and relationships, and (g) meaning of life. The participants were relatively healthy and their QOL was improved when they were on HMV compared to the hospital. The participants felt empowered that they had control in their daily lives at home when they had competent caregivers and family members for continuity of care. Recommendations for future research would include exploring improved methods of collaboration among health care workers and families in providing holistic care and reducing role strain and isolation in young HMV users. The study may promote positive social change through education for family, health care workers, and the public about strategies to promote independence and subsequent improvement in QOL for individuals on HMV