vocal signal analysis in patients affected by multiple sclerosis

Abstract Multiple Sclerosis (MS) is one of the most common neurodegenerative disorder that presents specific manifestations among which the impaired speech (known also as dysarthria). The evaluation of the speech plays a crucial role in the diagnosis and follow-up since the identification of anomalous patterns in vocal signal may represent a valid support to physician in diagnosis and monitoring of these neurological diseases. In this contribution, we present a method to perform voice analysis of neurologically impaired patients affected by MS aiming to early detection, differential diagnosis, and monitoring of disease progression. This method integrates two well-known methodologies to support the health structure in MS diagnosis in clinical practice. Acoustic analysis and vowel metric methodologies have been considered to implement this procedure to better define the pathological voices compared to healthy voices. Specifically, the method acquires and analyzes vocal signals performing features extraction and identifying possible important patterns useful to associate impaired speech with this neurological disease. The contribution consists in furnishing to physician a guide method to support MS trend. As result, this method furnishes patterns that could be valid indicators for physician in monitoring of patients affected by MS. Moreover, the procedure is appropriate to be used in early diagnosis that is critical in order to improve the patient's quality of life

Applying Mining Techniques to Analyze Vestibular Data

AbstractThe vestibular apparatus allows to perform audiological and equilibrium human functions and to capture movements with respect to gravity. Damages to the vestibular system causes diseases that can be measured by using Vestibular Evoked Myogenic Potentials (VEMPs) test. The test produces a lot of data that has to be collected and analyzed to allow a disease study and classification. We propose a framework that includes algorithms able to perform pathology distribution and classification. It has been tested on electronic patient records loaded from the University Hospital database. The software allows to manage the structure and framework and a blind application of one of the available classification techniques shows a relation among gender and vestibular apparatus disease

Vitamin D status and the relationship with bone fragility fractures in HIV-infected patients: A case control study

HIV-infected patients show high risk of fracture. The aims of our study were to determine the prevalence of vertebral fractures (VFs) and their associations with vitamin D in HIV patients. 100 patients with HIV infection and 100 healthy age-and sex-matched controls were studied. Bone mineral density was measured by quantitative ultrasound at the non-dominant heel. Serum osteocalcin and C-terminal telopeptide of collagen type 1 served as bone turnover markers. Bone ultrasound measurements were significantly lower in patients compared with controls (Stiffness Index (SI): 80.58 ± 19.95% vs. 93.80 ± 7.10%, respectively, p < 0.001). VFs were found in 16 patients and in 2 controls. HIV patients with vertebral fractures showed lower stiffness index (SI) (70.75 ± 10.63 vs. 83.36 ± 16.19, respectively, p = 0.045) and lower vitamin D levels (16.20 ± 5.62 vs. 28.14 ± 11.94, respectively, p < 0.02). The majority of VFs (87.5%) were observed in HIV-infected patients with vitamin D insufficiency, and regression analysis showed that vitamin D insufficiency was significantly associated with vertebral fractures (OR 9.15, 95% CI 0.18-0.52, p < 0.04). VFs and are a frequent occurrence in HIV-infected patients and may be associated with vitamin D insufficiency

On the Use of Voice Signals for Studying Sclerosis Disease

Multiple sclerosis (MS) is a chronic demyelinating autoimmune disease affecting the central nervous system. One of its manifestations concerns impaired speech, also known as dysarthria. In many cases, a proper speech evaluation can play an important role in the diagnosis of MS. The identification of abnormal voice patterns can provide valid support for a physician in the diagnosing and monitoring of this neurological disease. In this paper, we present a method for vocal signal analysis in patients affected by MS. The goal is to identify the dysarthria in MS patients to perform an early diagnosis of the disease and to monitor its progress. The proposed method provides the acquisition and analysis of vocal signals, aiming to perform feature extraction and to identify relevant patterns useful to impaired speech associated with MS. This method integrates two well-known methodologies, acoustic analysis and vowel metric methodology, to better define pathological compared to healthy voices. As a result, this method provides patterns that could be useful indicators for physicians in identifying patients affected by MS. Moreover, the proposed procedure could be a valid support in early diagnosis as well as in monitoring treatment success, thus improving a patient’s life quality

Data mining techniques for vestibular data classification

generally estimated with the vestibular evoked myogenic potentials (VEMPs) test. In the proposed work the data of this test are analyzed using a specific algorithm and developing a dedicate framework to support clinical activity, with an easy-to-use GUI. The data have been collected and used for extracting a prediction of a pathology distribution by using data mining techniques. In to the studies two different algorithms. In a first step, the Bayesian classifier has been chosen to extract the predisposition of female to lodge diseases of the auditory system compared to the male. In the final contribution, the nearest neighbour classification algorithm has been choosing for as classifier. Results show a better classification of the pathologies as a function of sex respect to the results obtained with the previous classifier

Predicting Functional Recovery and Quality of Life in Older Patients Undergoing Colorectal Cancer Surgery: Real-World Data From the International GOSAFE Study

PURPOSE The GOSAFE study evaluates risk factors for failing to achieve good quality of life (QoL) and functional recovery (FR) in older patients undergoing surgery for colon and rectal cancer.METHODS Patients age 70 years and older undergoing major elective colorectal surgery were prospectively enrolled. Frailty assessment was performed and outcomes, including QoL (EQ-5D-3L) recorded (3/6 months postoperatively). Postoperative FR was defined as a combination of Activity of Daily Living >= 5 + Timed Up & Go test <20 seconds + MiniCog >2.RESULTS Prospective complete data were available for 625/646 consecutive patients (96.9%; 435 colon and 190 rectal cancer), 52.6% men, and median age was 79.0 years (IQR, 74.6-82.9 years). Surgery was minimally invasive in 73% of patients (321/435 colon; 135/190 rectum). At 3-6 months, 68.9%-70.3% patients experienced equal/better QoL (72.8%-72.9% colon, 60.1%-63.9% rectal cancer). At logistic regression analysis, preoperative Flemish Triage Risk Screening Tool >= 2 (3-month odds ratio [OR], 1.68; 95% CI, 1.04 to 2.73; P = .034, 6-month OR, 1.71; 95% CI, 1.06 to 2.75; P = .027) and postoperative complications (3-month OR, 2.03; 95% CI, 1.20 to 3.42; P = .008, 6-month OR, 2.56; 95% CI, 1.15 to 5.68; P = .02) are associated with decreased QoL after colectomy. Eastern Collaborative Oncology Group performance status (ECOG PS) >= 2 is a strong predictor of postoperative QoL decline in the rectal cancer subgroup (OR, 3.81; 95% CI, 1.45 to 9.92; P = .006). FR was reported by 254/323 (78.6%) patients with colon and 94/133 (70.6%) with rectal cancer. Charlson Age Comorbidity Index >= 7 (OR, 2.59; 95% CI, 1.26 to 5.32; P = .009), ECOG >= 2 (OR, 3.12; 95% CI, 1.36 to 7.20; P = .007 colon; OR, 4.61; 95% CI, 1.45 to 14.63; P = .009 rectal surgery), severe complications (OR, 17.33; 95% CI, 7.30 to 40.8; P < .001), fTRST >= 2 (OR, 2.71; 95% CI, 1.40 to 5.25; P = .003), and palliative surgery (OR, 4.11; 95% CI, 1.29 to 13.07; P = .017) are risk factors for not achieving FR.CONCLUSION The majority of older patients experience good QoL and stay independent after colorectal cancer surgery. Predictors for failing to achieve these essential outcomes are now defined to guide patients' and families' preoperative counseling

Quality of life in older adults after major cancer surgery: the GOSAFE international study

Abstract Background Accurate quality of life (QoL) data and functional results after cancer surgery are lacking for older patients. The international, multicenter Geriatric Oncology Surgical Assessment and Functional rEcovery after Surgery (GOSAFE) Study compares QoL before and after surgery and identifies predictors of decline in QoL. Methods GOSAFE prospectively collected data before and after major elective cancer surgery on older adults (≥70 years). Frailty assessment was performed and postoperative outcomes recorded (30, 90, and 180 days postoperatively) together with QoL data by means of the three-level version of the EuroQol five-dimensional questionnaire (EQ-5D-3L), including 2 components: an index (range = 0-1) generated by 5 domains (mobility, self-care, ability to perform the usual activities, pain or discomfort, anxiety or depression) and a visual analog scale. Results Data from 26 centers were collected (February 2017-March 2019). Complete data were available for 942/1005 consecutive patients (94.0%): 492 male (52.2%), median age 78 years (range = 70-95 years), and primary tumor was colorectal in 67.8%. A total 61.2% of all surgeries were via a minimally invasive approach. The 30-, 90-, and 180-day mortality was 3.7%, 6.3%, and 9%, respectively. At 30 and 180 days, postoperative morbidity was 39.2% and 52.4%, respectively, and Clavien-Dindo III-IV complications were 13.5% and 18.7%, respectively. The mean EQ-5D-3L index was similar before vs 3 months but improved at 6 months (0.79 vs 0.82; P < .001). Domains showing improvement were pain and anxiety or depression. A Flemish Triage Risk Screening Tool score greater than or equal to 2 (odds ratio [OR] = 1.58, 95% confidence interval [CI] = 1.13 to 2.21, P = .007), palliative surgery (OR = 2.14, 95% CI = 1.01 to 4.52, P = .046), postoperative complications (OR = 1.95, 95% CI = 1.19 to 3.18, P = .007) correlated with worsening QoL. Conclusions GOSAFE shows that older adults’ preoperative QoL is preserved 3 months after cancer surgery, independent of their age. Frailty screening tools, patient-reported outcomes, and goals-of-care discussions can guide decisions to pursue surgery and direct patients’ expectations