Number Of Pauses Research Articles

RADT-25. IMPACT OF SAME-DAY MASK CREATION ON GAMMA KNIFE TREATMENT

Abstract OBJECTIVE Technological advances have allowed stereotactic radiosurgery (SRS) to be administered using fixation with a noninvasive mask, rather than with a stereotactic frame. While the use of such masks offers advantages including the ability to hypofractionate SRS and improved patient comfort, there has been criticism that it eliminates the possibility of same-day, “wheels in to wheels out” SRS. Our study examines the feasibility of conducting mask fitting and SRS treatment on the same day versus the conventional different-day approach. METHODS Eligible participants had either underwent single-fraction-SRS (SF-SRS) or were in their initial session of hypofractionated-SRS (HF-SRS). 100 patients who underwent SRS from September 2020 to June 2021 were assessed. 52 patients underwent same-day fabrication and treatment, and 48 patients received treatment at least one day following mask fabrication. The Leksell Gamma Knife (LGK) console data was processed, and operator reports from each patient were extracted and analyzed. RESULTS The average number of pauses, pause time, and number of gates was greater for same-day patients. There was no significant difference in the number of positioning alarms between the groups. There were no significant differences in percent overestimation of treatment time or number of treatment alarms. Treatment gates occurred on average 19 minutes earlier for same-day patients then different-day patients, which likely corresponds to “mask fatigue,” due to spending 20 minutes longer on the treatment table, while the masks are being fabricated. CONCLUSION Mask-based SRS can be done safely and efficiently in a single day, mirroring the approach of frame-based treatments.

Pallidal neuronal activity in Gilles de la Tourette syndrome and dystonic patients: A comparative study.

Gilles de la Tourette syndrome (GTS) and dystonia (DYS) are both hyperkinetic movement disorders effectively treated by deep brain stimulation (DBS) of the internal part of the globus pallidus (GPi). In this study, we compared single-neuron activity in the GPi between 18 GTS patients (with an average of 41 cells per patient) and 17 DYS patients (with an average of 54 cells per patient), all of whom underwent bilateral pallidal stimulation surgery, under general anesthesia or while awake at rest. We found no significant differences in GPi neuronal activity characteristics between patients operated on under general anesthesia versus those who were awake, irrespective of their diagnosis (GTS or DYS). We found higher firing rates, firing rate in bursts, pause duration and interspike interval coefficient of variation in GTS patients compared to DYS patients. On the opposite, we found higher number of pauses and bursts frequency in DYS patients. Lastly, we found a higher proportion of GPi oscillatory activities in DYS compared to GTS patients, with predominant activity within the low-frequency band (theta/alpha) in both patient groups. These findings underscore the complex relationship between the different neuronal discharge characteristic such as oscillatory or bursting activity within the GPi in shaping the clinical phenotypes of hyperkinetic disorders. Further research is warranted to deepen our understanding of how neuronal patterns are transmitted within deep brain structures and to develop strategies aimed at normalizing these pathological activities, by refining DBS techniques to enhance treatment efficacy and individual outcomes.

Role of pause duration in primary progressive aphasia

ABSTRACT Aims To detect differences in speech fluency in separate primary progressive aphasia syndromes (PPA) using automated analysis techniques. The resulting linguistic features are evaluated for their use in a predictive model to identify common patterns in speakers with PPA. As fluency is observable in audio recordings, its quantification may provide a low-cost instrument that augments spontaneous speech analyses in clinical practice. Methods and Procedures Speech was recorded in 14 controls, 7 nonfluent variant (nfvPPA) and 8 semantic variant (svPPA) speakers. The recordings were annotated for speech and non-speech with Kaldi, a common toolkit for speech processing software. Variables relating to fluency (pause rate, number of pauses, length of pauses) were analyzed. Outcomes and Results The best fitting distribution of pause duration was a combination of two Gaussian distributions, corresponding with pause categories short vs. long. Group level differences were found in the rate of pauses and proportion of silence: nfvPPA speakers use more short pauses relative to long pauses than control speakers, and the duration of short and long pauses is longer; svPPA speakers use more longer pauses relative to short pauses. Their short pauses are significantly shorter than those from control speakers. Participants in both PPA groups pause more frequently. SvPPA speakers are typically perceived as fluent. However, our analysis shows their fluency patterns to be distinct from control speakers, if the long-short distinction is observed. Conclusions Automatic measurements of pause duration show meaningful distinctions across the groups and might provide future aid in clinical assessment.

PAUSING IN THE ORAL SPEECH OF PATIENTS WITH SCHIZOPHRENIA

The article examines the psycholinguistic analysis of pauses in the spontaneous oral speech of patients with schizophrenia. The purpose of the study is to identify the characteristics of speech pauses in patients with schizophrenia and compare them with pauses in the speech of mentally healthy individuals. The object of the study is the oral speech of patients diagnosed with "schizophrenia", and the subject is the peculiarities of speech pauses in these patients. The study employs general scientific methods (observation, quantitative, descriptive) and specialized methods of psycholinguistic analysis. The research material includes recorded fragments of the oral speech of patients with schizophrenia, totaling 36 minutes and 16 seconds, and the oral speech of mentally healthy individuals, totaling 45 minutes and 23 seconds. The scientific novelty of the research lies in presenting a psycholinguistic analysis of pauses in the speech of patients with schizophrenia and comparing the obtained results with the speech of mentally healthy individuals. The results showed that the average number of pauses in the oral speech of schizophrenic patients is nearly five times higher than the average number of pauses in the speech of mentally healthy individuals (3 pauses versus 14, respectively). It was also found that the speech of mentally ill individuals is quantitatively dominated by filled and unfilled pauses, with hesitation pauses being present only in the speech of schizophrenic patients. The average pause length in schizophrenic patients’ speech is 240 ms longer than in healthy individuals’ speech. The conclusions of the study may indicate difficulties in the organization and planning of speech activity in patients with schizophrenia. The research perspectives involve further study of the psycholinguistic aspects of speech disorders in schizophrenia, which may contribute to the development of diagnostic and speech correction methods for mentally ill individuals at the early stages of the disease.

Injection Laryngoplasty of Unilateral Vocal Fold Paralysis Evaluated With Pause and Speech Measurements

ObjectiveThe purpose of this study was to examine a number of pause and speech measurements in patients with unilateral vocal fold paralysis, before and after injection laryngoplasty. The non-invasive measurements were selected to investigate and explain the treatment effect on connected speech in these patients. Study designRetrospective study with repeated measurements design. MethodVoice recordings of 24 patients with unilateral vocal fold paralysis from before and after injection laryngoplasty in local anesthesia were analyzed retrospectively with the computer program Praat. Measurements examined were number of pauses, average pause duration, pause ratio (expressing the amount of pausing during a reading aloud task), number of breath groups, average duration of breath groups, articulation rate, speaking rate, maximum phonation time and voice handicap index. ResultsInjection laryngoplasty had a significant improving effect on the number of pauses, pause ratio, number of breath groups, average duration of breath groups, articulation rate, speaking rate, maximum phonation time and voice handicap index. Maximum phonation time before treatment correlated with several pause- and speech measurements. ConclusionThe results showed that treatment with injection laryngoplasty had a clear effect on several pause and speech measurements and that these measurements correlated with maximum phonation time, but not with voice handicap index.

First modified Delphi consensus statement on robotic-assisted da Vinci sleeve gastrectomy

BackgroundSleeve gastrectomy (SG) is the most commonly performed metabolic and bariatric surgery (MBS) procedure. Technical considerations related to the performance of SG are well established and reported in the literature but not in relation to robotic-assisted (RA) SG. We report the results of the first modified Delphi consensus-building exercise addressing technical considerations of RA da Vinci (dV) SG. ObjectivesDevelop best practices for the performance of robotic-assisted da Vinci sleeve gastrectomy. SettingSurvey based consensus statement. MethodsA consensus building committee (CBC) was created comprising 10 experts in the field of RA surgery and MBS based on strict selection criteria. The CBC developed 49 consensus statements which were then shared with 240 experts in RA surgery. Our stopping criterion was stability in responses (≤15%). The consensus cut point was 70%. ResultsThe overall response rate was 49%. In the first round of voting, there was consensus agreement on 25 statements (51%), consensus disagreement on 14 (28%), and no consensus on the remaining statements (21%). In the second round of voting, we reached agreement on 3 additional statements. Experts recommended the use of the number of pauses generated by the stapler to guide choice of staple height (91.2%) and to upsize the staple height when using buttressing (92%). There was also consensus (81.4%) that the use of the closed staple height of 1.00 mm (white) is acceptable and that stapling of the antrum using a 1.5-mm staple (blue load) is also acceptable (73%). ConclusionsCollective expert opinion structured through a modified Delphi consensus statement presents a practical guide for surgeons interested in performing dV-SG.

Language Processing Units Are Not Equivalent to Sentences: Evidence from Writing Tasks in Typical and Dyslexic Children

Despite recent research on the building blocks of language processing, the nature of the units involved in the production of written texts remains elusive: intonation units, which are evidenced by empirical results across a growing body of work, are not suitable for writing, where the sentence remains the common reference. Drawing on the analysis of the writing product and process, our study explores how children with and without dyslexia handle sentences. The children were asked to write a short story and the writing process was recorded using keystroke logging software (Inputlog 7 & 8). We measured the number of pauses, the nature of the language sequences segmented by pauses, and the revision operations performed throughout the process. We analyzed sentences both in product and process. Our results showed that both the written product and the writing process reflect the establishment of a syntactic schema during language processing in typical children, in line with the first functional step in processing. This was not clearly evidenced in the case of dyslexic children, due to their limited production: beyond spelling, syntactic elaboration was also affected. In contrast, it appeared that the units of language processing cannot be equated with sentences in writing: the information flow is produced through usually smaller bursts that each carry part of the meaning or correspond to a specific operation of text crafting and revision.

Association Between Chest Compression Pause Duration and Survival After Pediatric In-Hospital Cardiac Arrest.

The association between chest compression (CC) pause duration and pediatric in-hospital cardiac arrest survival outcomes is unknown. The American Heart Association has recommended minimizing pauses in CC in children to <10 seconds, without supportive evidence. We hypothesized that longer maximum CC pause durations are associated with worse survival and neurological outcomes. In this cohort study of index pediatric in-hospital cardiac arrests reported in pediRES-Q (Quality of Pediatric Resuscitation in a Multicenter Collaborative) from July of 2015 through December of 2021, we analyzed the association in 5-second increments of the longest CC pause duration for each event with survival and favorable neurological outcome (Pediatric Cerebral Performance Category ≤3 or no change from baseline). Secondary exposures included having any pause >10 seconds or >20 seconds and number of pauses >10 seconds and >20 seconds per 2 minutes. We identified 562 index in-hospital cardiac arrests (median [Q1, Q3] age 2.9 years [0.6, 10.0], 43% female, 13% shockable rhythm). Median length of the longest CC pause for each event was 29.8 seconds (11.5, 63.1). After adjustment for confounders, each 5-second increment in the longest CC pause duration was associated with a 3% lower relative risk of survival with favorable neurological outcome (adjusted risk ratio, 0.97 [95% CI, 0.95-0.99]; P=0.02). Longest CC pause duration was also associated with survival to hospital discharge (adjusted risk ratio, 0.98 [95% CI, 0.96-0.99]; P=0.01) and return of spontaneous circulation (adjusted risk ratio, 0.93 [95% CI, 0.91-0.94]; P<0.001). Secondary outcomes of any pause >10 seconds or >20 seconds and number of CC pauses >10 seconds and >20 seconds were each significantly associated with adjusted risk ratio of return of spontaneous circulation, but not survival or neurological outcomes. Each 5-second increment in longest CC pause duration during pediatric in-hospital cardiac arrest was associated with lower chance of survival with favorable neurological outcome, survival to hospital discharge, and return of spontaneous circulation. Any CC pause >10 seconds or >20 seconds and number of pauses >10 seconds and >20 seconds were significantly associated with lower adjusted probability of return of spontaneous circulation, but not survival or neurological outcomes.

Speech Fluency Production and Perception in L1 (Slovak) and L2 (English) Read Speech.

Research on fluency in native (L1) and non-native (L2) speech production and perception helps us understand how individual L1 speaking style might affect perceived L2 fluency and how this relationship might be reflected in L1 versus L2 oral assessment. While the relationship between production and perception of fluency in spontaneous speech has been studied, the information provided by reading has been overlooked. We argue that reading provides a direct and controlled way to assess language proficiency that might complement information gained from spontaneous speaking. This work analyzes the relationship between speech fluency production and perception in passages of L1 (Slovak) and L2 (English) read by 57 undergraduate Slovak students of English and rated for fluency by 15 English teachers who are Slovak natives. We compare acoustic production measures between L1 and L2 and analyze how their effect on perceived fluency differs for the two languages. Our main finding is that the articulation rate, the overall number of pauses, and the number of between-clause and mid-clause pauses predict ratings differently in L1 Slovak versus L2 English. The speech rate and durations of pauses predict ratings similarly in both languages. The contribution of our results to understanding fluency aspects of spontaneous and read speech, the relationship between L1 and L2, the relationship between production and perception, and to the teaching of L2 English are discussed.

Characterization of parameters for the analysis of objective measures of non-nutritive sucking of newborns.

To propose a methodology for analyzing data generated by an instrument measuring non-nutritive sucking pressure in newborns. An analytical observational study was developed, with a cross-sectional design, considering the data collected from 24 full-term newborns without complications. Three collections from each neonate were analyzed, with duration of 2 minutes and a 2-minute interval between them. The defined parameters were extracted using a program developed in Matlab®. The results were obtained by analyzing and comparing 12 variables at a 5% confidence level. Comparison of manual and computerized analyzes was also carried out using the intraclass correlation coefficient. The multiple comparison between the three collection moments showed that the significant statistical differences occurred between collections one and two and two and three. When analyzing and comparing each variable separately, it was noted that the second collection showed: greater number of sucking groups, greater number of suctions, less time to start the sucking groups, longer time of sucking groups, less number of sporadic suctions, higher mean pressure values and with less standard deviation, more number of pauses with shorter time of pauses. The intraclass correlation coefficient revealed almost perfect agreement for the 12 evaluated parameters. The 12 variables analyzed are relevant, especially in the second collection. The Matlab® program proved to be viable and effective in extracting and analyzing parameters, showing high agreement when compared to manual evaluation.

Automated lexical analysis of story recall in healthy controls

AbstractBackgroundImpaired episodic memory is one of the earliest and most prominent symptoms of Alzheimer’s disease (AD). Examining how patients produce words and phrases in story recall tasks is useful for tracking and understanding progression of their disease. Traditional approaches rely on manual assessments of recalled stories which can be limited, time‐consuming, and not applicable in large‐scale studies. Here, we implement an automated, computational approach to measure verbal episodic memory in a digitally recorded story recall task performed by young healthy speakers using natural language processing models.MethodWe analyzed digitized speech samples of pre‐recorded immediate and delayed Craft Story recall tasks performed by healthy speakers (n = 67, mean age = 20.31 years, SD = 2.17, 45 (67%) females). All transcripts were transcribed by trained annotators and automatically scored for number of verbatim and paraphrase recall, total recall score ( = verbatim+paraphrase), and semantic distance from the original story (degree of semantic similarity between the original craft story and the recalled story based on the Word2vec module in python). We also calculated total word count and number of unique words, and rated all recalled words for word familiarity, concreteness, and semantic ambiguity based on published norms. Number of pauses and total durations of speech and silent pauses were also measured.ResultWe found larger semantic distance between successive words in the delayed recall task compared with immediate recall within speaker (p&lt;.001). Delayed recall also elicited lower total recall scores than immediate recall (p = .03). Comparing the effect sizes of semantic distance vs. total recall scores, our model comparison showed a smaller prediction error for semantic distance (AIC = 95.45) than total recall score (AIC = 736.18). In addition, speakers in the delayed recall task performed more paraphrase recall, had higher total word count, number of unique words, more ambiguous words, and produced more speech (all p‐values&lt;.001).ConclusionOur findings suggest that automated speech analysis can provide informative and cost‐effective measures from a recorded story recall task. The study provides an automated and quantitative way to better measure memory abilities by including semantic distance. Future work will test procedures in patients with AD or other neurodegenerative diseases.

Phonetic‐phonological disturbances of spontaneous speech in autosomal dominant Alzheimer disease due to A431E PSEN1 mutation

AbstractBackgroundConsiderable cognitive research in Alzheimer Disease (AD) has focused on memory as it is often the primary symptom; nevertheless, in A431E PSEN1 mutation carriers in Jalisco, a rapidly language impairment and verbal fluency decrease during the disease is reported (Petersen‐Dumois, et al., 2020) though this deficit is not well‐characterized. The aim of this study was to identify and characterize phonetic‐phonological abnormalities in the spontaneous speech through different stages of A431E PSEN1 mutation‐related AD.MethodEleven symptomatic A431E PSEN1 mutation carriers, with a mean age of 42.54 years (DE = 4.17) participated in the study: five with Mild Cognitive Impairment (MCI), three with Mild Dementia (MiD) and five with Moderate Dementia (MoD). We used three language tasks: trip planning, picture description, and narrative discourse of a risky and happy moment of their lives which were recorded and transcribed. For each participant, we computed the frequency of phonetic‐phonological features: stuttering, unintelligible productions, phonological paraphasias, fillers and pauses (≥2 seconds) and then converted into percentages dividing the number of occurrences of each feature by the number of words used on the speech sample (for pauses, time in seconds). Then, we obtained the percentage mean of each feature per group.ResultWe analyzed a total of 134.65 minutes of speech sample. Regarding verbal fluency, words per minute (means) varied across the groups MCI: 85.55 (SD = 39.34); MiD: 128.56 (SD = 34.14) MoD: 67.80. (SD = 32.71). All phonological features were present, stuttering: MCI: 1.38%; MiD: 3.2%; MoD: 4.05%; unintelligible productions: MCI: .22%; MiD: .64%; MoD: .76%; phonological paraphasias; MCI: 0.002%; MiD: .01% MoD: .01%; fillers: MCI: 2.05%; MiD: .29%; MoD: 2.88%; number of pauses: MCI: .04%; MiD: .05%; MoD: .03%. and pauses average: MCI: 3.42 (SD = .62); MiD: 2.55 (SD = .03) MoD = 3.43. (SD: 1.61).ConclusionWe found that A431E PSEN1 mutation carriers present phonetic‐phonological traits even in the earliest stage (MCI) and for three of them (stuttering, unintelligible productions, and phonological paraphasias) their frequency is greater the more severe the impairment (MoD). Stuttering is their most prominent feature. These disturbances in the spontaneous speech could be a phenotype trait of this ADAD mutation.

Potential Implications of Task-Based Language Teaching on Developing EFL Learners' Oral Fluency

Task-based language teaching (TBLT) is an instructional approach that cultivates communicative competence by exposing learners to English speaking practice. This study examined the perceptions and implications of implementing ten fluency-based tasks with twenty EFL learners at a private university in Medellin, Colombia. These tasks addressed barriers, including a significant frequency of pauses, a low speech rate, and limited speech length, which hindered learners' ability to express themselves fluently. The research used qualitative date collected by means of a questionnaire, interviews, and oral production rubrics. The findings indicated that 100% of the learners held a positive perspective of TBL as a qualified methodology that assisted them in reducing the considerable number of pauses in communicating their ideas, moderating their pacing smoothness, and balancing their speech rate to speak with a moderate clearness and consistency. Learners valued the strategy as a potential method that enabled them to communicate their ideas, regardless of occasional mistakes. In conclusion, the tasks aided them in increasing their speech rate and enhancing speech fluency during conversations.

Fluency in Speaking as a Dynamic Construct

In current research into second language (L2) speaking, aspects of fluency are measured as static constructs. Averaged over a complete speaking performance, for instance, syllables per minute is calculated. Similarly, the number of pauses is calculated per minute, averaged over a complete speaking task. This paper argues, however, that we need to investigate fluency as a dynamic construct. Research into L1 speaking has shown that L1 fluency aspects may show cyclical temporal patterns (Roberts &amp; Kirsner, 2000). In addition, research into the changes in perception of L2 comprehensibility during task performance has shown that L2 comprehensibility may show dynamic patterns, with implications for ratings on comprehensibility (Nagle et al., 2019). This paper, therefore, argues that L2 fluency should be investigated as a dynamic construct as well. The paper finishes by sketching pedagogical implications and directions for future research.

96 Proof of Principle: Can Paragraph Recall Pauses and Speech Frequencies Correctly Classify Cognitively Compromised Older Adults?

Objective:Recent research has found that machine learning based analysis of patient speech can be used to classify Alzheimer’s Disease. We know of no studies, however, which systematically explore the value of pausing events in speech for detecting cognitive limitations. Using retrospectively acquired voice data from paragraph memory tests, we created two types of pause features: a) the number and duration of pauses, and b) frequency components in speech immediately following pausing. Multiple machine learning models were used to assess how these features could effectively discriminate individuals classified into two groups: Cognitively Compromised versus Cognitively Well.Participants and Methods:Participants (age&gt; 65 years, n= 67) completed the Newcomer paragraph memory test and a neuropsychological protocol as part of a federally funded prospective IRB approved investigation at the University of Florida. Participant vocal recordings were acquired for the immediate and delay conditions of the test. Speaker diarization was performed on the immediate free recall test condition to separate voices of patients from examiners. Features extracted from both test conditions included a) 3 pause characteristics (total number of pauses, total pause duration, and length of the longest pause), and b) 20 Mel Frequency Cepstral Coefficients (MFCC) pertaining to speech immediately (2.7 seconds) following pauses. These were combined with demographics (age, sex, race, education, and handedness) to create a total of 105 features that were used as inputs for multiple machine learning analytic models (random forest, logistic regression, naive Bayes, AdaBoost, Gradient Boost, and multi-layered perceptron). External neuropsychological metrics were used to initially classify Cognitively Compromised (i.e., &lt; -1.0 standard deviation on &gt; two of five test metrics: total immediate, delay, discrimination Hopkins Verbal Learning Test-Revised (HVLT-R),Controlled Oral Word Association (COWA) test, category fluency ('animals')). Pearson Product Moment Correlations were used to assess the linear relationships between pauses and speech frequency categories and neuropsychological metrics.Results:Neuropsychology metric classification using -1SD cut-off identified 27% (18/67 participants) as Cognitively Compromised. The Cognitively Compromised group and the Cognitively Well group did not show any difference in distributions of individual pause/frequency features (Mann Whitney U-test, p&gt; 0.11). A negative correlation was found between total duration of short pauses and HVLT total immediate free recall, while a positive correlation was found between MFCC-10 and HVLT total immediate free recall. The best classification model was AdaBoost Classifier which predicted the Cognitively Compromised label with 0.91 area under receiver operating curve, 0.81 accuracy, 0.43 sensitivity, 1.0 specificity, 1.0 precision, 0.6 f1 score.Conclusions:Pause characteristics and frequency profiles of speech immediately following pauses from a paragraph memory test accurately identified older adults with compromised cognition, as measured by verbal learning and verbal fluency metrics. Furthermore, individuals with reduced HVLT immediate free recall generated more pauses, while individuals who recalled more words had higher power in mid-frequency bands (10th MFCC). Future research needs to replicate how paragraph recall pause characteristics and frequency the profile of speech immediately following pauses potentially provides a low resource alternative to automatic speech recognition models for detecting cognitive impairments.

A Wearable Vibratory Device (The Emma Watch) to Address Action Tremor in Parkinson Disease: Pilot Feasibility Study.

Parkinson disease (PD) is a neurodegenerative disease that has a wide range of motor symptoms, such as tremor. Tremors are involuntary movements that occur in rhythmic oscillations and are typically categorized into rest tremor or action tremor. Action tremor occurs during voluntary movements and is a debilitating symptom of PD. As noninvasive interventions are limited, there is an ever-increasing need for an effective intervention for individuals experiencing action tremors. The Microsoft Emma Watch, a wristband with 5 vibrating motors, is a noninvasive, nonpharmaceutical intervention for tremor attenuation. This pilot study investigated the use of the Emma Watch device to attenuate action tremor in people with PD. The sample included 9 people with PD who were assessed on handwriting and hand function tasks performed on a digitized tablet. Tasks included drawing horizontal or vertical lines, tracing a star, spiral, writing "elelelel" in cursive, and printing a standardized sentence. Each task was completed 3 times with the Emma Watch programmed at different vibration intensities, which were counterbalanced: high intensity, low intensity (sham), and no vibration. Digital analysis from the tablet captured kinematic, dynamic, and spatial attributes of drawing and writing samples to calculate mathematical indices that quantify upper limb motor function. APDM Opal sensors (APDM Wearable Technologies) placed on both wrists were used to calculate metrics of acceleration and jerk. A questionnaire was provided to each participant after using the Emma Watch to gain a better understanding of their perspectives of using the device. In addition, drawings were compared to determine whether there were any visual differences between intensities. In total, 9 people with PD were tested: 4 males and 5 females with a mean age of 67 (SD 9.4) years. There were no differences between conditions in the outcomes of interest measured with the tablet (duration, mean velocity, number of peaks, pause time, and number of pauses). Visual differences were observed within a small subset of participants, some of whom reported perceived improvement. The majority of participants (8/9) reported the Emma Watch was comfortable, and no problems with the device were reported. There were visually depicted and subjectively reported improvements in handwriting for a small subset of individuals. This pilot study was limited by a small sample size, and this should be taken into consideration with the interpretation of the quantitative results. Combining vibratory devices, such as the Emma Watch, with task specific training, or personalizing the frequency to one's individual tremor may be important steps to consider when evaluating the effect of vibratory devices on hand function or writing ability in future studies. While the Emma Watch may help attenuate action tremor, its efficacy in improving fine motor or handwriting skills as a stand-alone tool remains to be demonstrated.

Six-month effects of supervised exercise on walking ability and health-related factors in peripheral arterial disease: a pilot study.

In peripheral arterial disease (PAD) patients with intermittent claudication (IC), the combination of aerobic and resistance exercises could counteract muscle loss and attenuate disease progression. This study analyzed the effects of six months of a combined exercise program on walking ability, lower limb body composition, cardiovascular risk factors, and Ankle-Brachial Index (ABI). Twenty-three patients (age 63.2±1.5 years and ABI 0.58±0.07) with PAD and IC were allocated to a control group (CG) or a supervised exercise group (SUP). Ten patients underwent six months of treadmill walking combined with resistance exercises, three times a week. The CG (N.=13) received a recommendation for walking. All patients were measured at baseline (M0), after three months (M3), and six months (M6). During constant treadmill protocol, the claudication onset time/distance (COT/COD), absolute claudication time/distance (ACT/ACD), and number of pauses of overall patients significantly improved at M3 and M6. Between groups were found significant differences in COT and COD at M6 (P=0.005 and P=0.007, respectively); and in ACT and ACD at M3 (P=0.003 for both) and at M6 (P=0.005 and P=0.005, respectively), with major improvements in the SUP. Over the six months, a significant group effect was found in fat-free mass (P=0.041) and predicted muscle mass (P=0.039) of the lower ABI leg, with greater improvements in the SUP. A supervised exercise program that combines aerobic and resistance training improves PAD symptoms and has additional benefits for patients. Patients in the program showed improvements in walking ability, lower-limb body composition, perceived exertion, and heart rate during treadmill walking.

Relative importance of speech and voice features in the classification of schizophrenia and depression

Speech is a promising biomarker for schizophrenia spectrum disorder (SSD) and major depressive disorder (MDD). This proof of principle study investigates previously studied speech acoustics in combination with a novel application of voice pathology features as objective and reproducible classifiers for depression, schizophrenia, and healthy controls (HC). Speech and voice features for classification were calculated from recordings of picture descriptions from 240 speech samples (20 participants with SSD, 20 with MDD, and 20 HC each with 4 samples). Binary classification support vector machine (SVM) models classified the disorder groups and HC. For each feature, the permutation feature importance was calculated, and the top 25% most important features were used to compare differences between the disorder groups and HC including correlations between the important features and symptom severity scores. Multiple kernels for SVM were tested and the pairwise models with the best performing kernel (3-degree polynomial) were highly accurate for each classification: 0.947 for HC vs. SSD, 0.920 for HC vs. MDD, and 0.932 for SSD vs. MDD. The relatively most important features were measures of articulation coordination, number of pauses per minute, and speech variability. There were moderate correlations between important features and positive symptoms for SSD. The important features suggest that speech characteristics relating to psychomotor slowing, alogia, and flat affect differ between HC, SSD, and MDD.

Global Acoustic Speech Temporal Characteristics for Mandarin Speakers With Parkinson's Disease During Syllable Repetition and Passage Reading.

Previous research has revealed considerable variation in speech rates among English speakers with Parkinson's disease (PD) with slower, faster, or similar rates than controls. The purpose of this study was to characterize speech rates of Mandarin speakers with PD and the corresponding articulation and pause characteristics explaining the speech rates to enhance rate control therapies. Eighteen Mandarin speakers with PD and 18 controls produced syllable repetitions and passage reading using their typical speech style. Speech rates, articulation rates, mean pause durations (≥ 10 ms), and the number of pauses with duration between 10 ms and 300 ms and greater than 300 ms were measured and compared between groups and tasks as well as across the initial, middle, and final periods of the passage. Two-way, mixed-model analyses of variance were employed for data analysis. Compared to controls, individuals with PD spoke with similar speech rates and faster articulation rates during passage reading, whereas during syllable repetitions, they produced slower speech rates and comparable articulation rates. The slower syllable repetitions produced by speakers with PD may be explained by longer pauses and more perceptual pauses, whereas faster articulation rates may explain the trend of faster speech rates during reading. Speech and articulation rates accelerated for both groups during passage reading. Speech rates of Mandarin speakers with PD were characterized by faster articulation, longer pauses, and more perceptual pauses for passage reading. A descriptive model of speech rate suggested that speakers with PD and dysarthria in this study would benefit from rate reduction therapy decreasing articulation rate. https://doi.org/10.23641/asha.23982282.

Locomotor performance differs between foraging and predator escape but is not related to survival in hatchling lizards

Abstract Behaviour is influenced by many factors, including morphology, performance capabilities and the surrounding environment. Behavioural adjustments in response to these factors have important fitness consequences, and therefore behaviour should be considered when evaluating relationships among morphology, performance and fitness. We used hatchling fence lizards (Sceloporus undulatus) to test if sprinting speed and movement behaviours (e.g. latency to approach prey, number of pauses when fleeing or foraging) differ between foraging and anti-predator contexts and if these behaviours are associated with body size, locomotor performance capacity and survival. We quantified maximal sprint performance of individuals and evaluated their running speed in laboratory trials of foraging (moving towards crickets) and predator escape (response to a swooping avian predator). We show that hatchlings run at ~17–36% of total capacity when foraging. Although the most common anti-predator behaviour was to remain still, those that fled from the predator ran at full burst speed. However, foraging and escape speed/behaviours were not associated with body size or locomotor capacity. Hatchlings were subsequently released at our field site for a recapture study to assess phenotypic relationships with survival. We found no evidence that survival was influenced by performance or behaviour, but body size was positively related to survival in the field. These results highlight how seemingly important fitness-relevant behavioural and performance traits may not mediate the relationship between body size and survival.