Automatic Quantification of Speech Intelligibility of Adults with Oral Squamous Cell Carcinoma

Objective: It has been the aim of the present study to introduce a novel automatic technique for the objective and quantitative assessment of speech intelligibility to the evaluation of postoperative outcome. Patients and Methods: Forty-six patients with oral carcinomas, mean age 59.8 8 10.1 years, and an age-matched control group of 40 subjects without oral diseases. Recordings of a standard text read by the patients and the control group were analyzed by an automatic speech recognition system. Results: For the patients, automatic speech recognition yielded word recognition rates between 8 and 82% (mean 49 8 19%), for the control group between 60 and 91% (76 8 7%). Automatic evaluation closely correlated with the experts’ perceptual evaluation of intelligibility (r = –0.93; p ! 0.01). The multirater kappa of the experts alone (0.55) differed only slightly from the multi-rater kappa of the experts and the speech recognition system (0.58). Conclusion: For adults with speech disorders, automatic speech recognition may serve as a valuable tool to assess global speech outcome after treatment of oral squamous cell carcinoma objectively and quantitatively for clinical and research purposes

Automatic detection of sigmatism in children

We propose in this paper an automatic system to detect sigmatism from the speech signal. Sigmatism occurs when the tongue is positioned incorrectly during articulation of sibilant phones like /s / and /z/. For our task we extracted various sets of features from speech: Mel frequency cepstral coefficients, energies in specific bandwidths of the spectral envelope, and the so-called supervectors, which are the parameters of an adapted speaker model. We then trained several classifiers on a speech database of German adults simulating three different types of sigmatism. Recognition results were calculated at a phone, word and speaker level for both the simulated database and for a database of pathological speakers. For the simulated database, we achieved recognition rates of up to 86%, 87 % and 94 % at a phone, word and speaker level. The best classifier was then integrated as part of a Java applet that allows patients to record their own speech, either by pronouncing isolated phones, a specific word or a list of words, and provides them with a feedback whether the sibilant phones are being correctly pronounced

Major biological obstacles for persistent cell-based regeneration of articular cartilage

Hyaline articular cartilage, the load-bearing tissue of the joint, has very limited repair and regeneration capacities. The lack of efficient treatment modalities for large chondral defects has motivated attempts to engineer cartilage constructs in vitro by combining cells, scaffold materials and environmental factors, including growth factors, signaling molecules, and physical influences. Despite promising experimental approaches, however, none of the current cartilage repair strategies has generated long lasting hyaline cartilage replacement tissue that meets the functional demands placed upon this tissue in vivo. The reasons for this are diverse and can ultimately result in matrix degradation, differentiation or integration insufficiencies, or loss of the transplanted cells and tissues. This article aims to systematically review the different causes that lead to these impairments, including the lack of appropriate differentiation factors, hypertrophy, senescence, apoptosis, necrosis, inflammation, and mechanical stress. The current conceptual basis of the major biological obstacles for persistent cell-based regeneration of articular cartilage is discussed, as well as future trends to overcome these limitations

In situ guided tissue regeneration in musculoskeletal diseases and aging: Implementing pathology into tailored tissue engineering strategies

In situ guided tissue regeneration, also addressed as in situ tissue engineering or endogenous regeneration, has a great potential for population-wide “minimal invasive” applications. During the last two decades, tissue engineering has been developed with remarkable in vitro and preclinical success but still the number of applications in clinical routine is extremely small. Moreover, the vision of population-wide applications of ex vivo tissue engineered constructs based on cells, growth and differentiation factors and scaffolds, must probably be deemed unrealistic for economic and regulation-related issues. Hence, the progress made in this respect will be mostly applicable to a fraction of post-traumatic or post-surgery situations such as big tissue defects due to tumor manifestation. Minimally invasive procedures would probably qualify for a broader application and ideally would only require off the shelf standardized products without cells. Such products should mimic the microenvironment of regenerating tissues and make use of the endogenous tissue regeneration capacities. Functionally, the chemotaxis of regenerative cells, their amplification as a transient amplifying pool and their concerted differentiation and remodeling should be addressed. This is especially important because the main target populations for such applications are the elderly and diseased. The quality of regenerative cells is impaired in such organisms and high levels of inhibitors also interfere with regeneration and healing. In metabolic bone diseases like osteoporosis, it is already known that antagonists for inhibitors such as activin and sclerostin enhance bone formation. Implementing such strategies into applications for in situ guided tissue regeneration should greatly enhance the efficacy of tailored procedures in the future

Expandierte Zellen, Knochenmark, Fettgewebe: Was ist in Deutschland und Österreich erlaubt?

The options for articular cartilage therapy have been enriched in recent years by the use of concentrated bone marrow and adipose tissue aspirates as well as culture-expanded cells. Especially single step procedures with sampling of bone marrow or adipose tissue aspirates with intraoperative fabrication of cell concentrates seem to be attractive and are aggressively advertised by various manufactures as unproblematic point of care (PoC) procedures; however, by the use of such systems the surgeon effectively becomes the manufacturer of a drug within the statutory framework of the German Medicines Act (AMG). It is compulsory to notify the authorities about the usage, who then classify the procedure according to the method of processing (substantial or non-substantial) and application (homologous or nonhomologous). As cell products classified as advanced therapy medicinal products (ATMP), they require permission for sampling and manufacturing, which can only be gained in cooperation with the competent authorities (e.g. Paul Ehrlich Institute, state authorities). In this context the regulatory framework for the application of intraoperatively harvested bone marrow and adipose tissue aspirates as well as expanded cells for the treatment of articular cartilage diseases in Germany and Austria are discussed