Total Pause Time Research Articles

Harnessing Speech-Derived Digital Biomarkers to Detect and Quantify Cognitive Decline Severity in Older Adults

Introduction: Current cognitive assessments suffer from floor/ceiling and practice effects, poor psychometric performance in mild cases, and repeated assessment effects. This study explores the use of digital speech analysis as an alternative tool for determining cognitive impairment. The study specifically focuses on identifying the digital speech biomarkers associated with cognitive impairment and its severity. Methods: We recruited older adults with varying cognitive health. Their speech data, recorded via a wearable microphone during the reading aloud of a standard passage, were processed to derive digital biomarkers such as timing, pitch, and loudness. Cohen’s d effect size highlighted group differences, and correlations were drawn to the Montreal Cognitive Assessment (MoCA). A stepwise approach using a Random Forest model was implemented to distinguish cognitive states using speech data and predict MoCA scores based on highly correlated features. Results: The study comprised 59 participants, with 36 demonstrating cognitive impairment and 23 serving as cognitively intact controls. Among all assessed parameters, similarity, as determined by Dynamic Time Warping (DTW), exhibited the most substantial positive correlation (rho = 0.529, p < 0.001), while timing parameters, specifically the ratio of extra words, revealed the strongest negative correlation (rho = −0.441, p < 0.001) with MoCA scores. Optimal discriminative performance was achieved with a combination of four speech parameters: total pause time, speech-to-pause ratio, similarity via DTW, and intelligibility via DTW. Precision and balanced accuracy scores were found to be 88.1 ± 1.2% and 76.3 ± 1.3%, respectively. Discussion: Our research proposes that reading-derived speech data facilitates the differentiation between cognitively impaired individuals and cognitively intact, age-matched older adults. Specifically, parameters based on timing and similarity within speech data provide an effective gauge of cognitive impairment severity. These results suggest speech analysis as a viable digital biomarker for early detection and monitoring of cognitive impairment, offering novel approaches in dementia care.

Factors Affecting Holmium Laser Efficiency: Comparison of Laryngeal Mask Airway and Endotracheal Intubation During Ureteroscopy for Renal Stones.

Introduction: Holmium laser lithotripsy is a standard energy source used for treatment of kidney stones during flexible ureteroscopy. Efficiency of laser surgery may be affected by patient and operator characteristics or perioperative management. Here, we sought to examine intraoperative data from patients undergoing high frequency dusting with high-powered holmium laser lithotripsy to evaluate surgical and demographic factors associated with lasing efficiency (LE). Methods: A total of 82 intraoperative reports were analyzed from an ongoing laser lithotripsy clinical trial evaluating the Lumenis Pulse™ 120H holmium laser with renal stones up to 20 mm in diameter with and without Moses 2.0 technology. For each case, the total pause time between lasing activations was corrected to remove lengthy pauses and divided by the total lasing time to calculate an efficiency percentage. This was then compared with patient demographics, anesthesia administration, stone burden, postoperative complications, and stone-free rates using both univariate and multivariate analyses. Results: Of the 82 included patients, 36 received endotracheal tube (ETT) intubation and 46 had a laryngeal mask airway (LMA). Patients with ETT had significantly higher LE (78.7%) compared to those with an LMA (73.3%) in our univariate analysis (p < 0.01) as well as in the multivariate model that adjusted for maximum stone size, number of stones, stone density, and patient body mass index (p < 0.05). There was also significantly higher mean LE in patients with no postoperative complications (76.3%) compared to those with any grade (I-V) Clavien-Dindo complication within 30 days after surgery (70.0%) (p < 0.05). Conclusions: Flexible ureteroscopy and laser lithotripsy cases with higher LE are associated with lower rates of postoperative complications. The data also support the use of ETT over LMA to improve overall LE; however, this remains one consideration among many for choosing anesthesia administration. Clinical Trial Registration number: NCT04505956.

Effects of mechanical cardiopulmonary resuscitation during vertical spatial pre-hospital transport in patients with cardiac arrest: a historical cohort study

To analyze the effect of mechanical cardiopulmonary resuscitation (CPR) on patients with cardiac arrest with the vertical spatial pre-hospital emergency transport. A retrospective cohort study was conducted. The clinical data of 102 patients with out-of-hospital cardiac arrest (OHCA) who were transferred to the emergency medicine department of Huzhou Central Hospital from the Huzhou Emergency Center from July 2019 to June 2021 were collected. Among them, the patients who performed artificial chest compression during the pre-hospital transfer from July 2019 to June 2020 served as the control group, and the patients who performed artificial-mechanical chest compression (implemented artificial chest compression first, and implemented mechanical chest compression immediately after the mechanical chest compression device was ready) during pre-hospital transfer from July 2020 to June 2021 served as the observation group. The clinical data of patients of the two groups were collected, including basic data (gender, age, etc.), pre-hospital emergency process evaluation indicators [chest compression fraction (CCF), total CPR pause time, pre-hospital transfer time, vertical spatial transfer time], and in-hospital advanced resuscitation effect evaluation indicators [initial end-expiratory partial pressure of carbon dioxide (PETCO2), rate of restoration of spontaneous circulation (ROSC), time of ROSC]. Finally, a total of 84 patients were enrolled, including 46 patients in the control group and 38 in the observation group. There was no significant difference in gender, age, whether to accept bystander resuscitation or not, initial cardiac rhythm, time-consuming pre-hospital emergency response, floor location at the time of onset, estimated vertical height, and whether there was any vertical transfer elevator/escalator, etc. between the two groups. In the evaluation of the pre-hospital emergency process, the CCF during the pre-hospital emergency treatment of patients in the observation group was significantly higher than that in the control group [69.05% (67.35%, 71.73%) vs. 61.88% (58.18%, 65.04%), P < 0.01], the total pause time of CPR was significantly shorter than that in the control group [s: 266 (214, 307) vs. 332 (257, 374), P < 0.05]. However, there was no significant difference in the pre-hospital transfer time and vertical spatial transfer time between the observation group and the control group [pre-hospital transfer time (minutes): 14.50 (12.00, 16.75) vs. 14.00 (11.00, 16.00), vertical spatial transfer time (s): 32.15±17.43 vs. 27.96±18.67, both P > 0.05]. It indicated that mechanical CPR could improve the CPR quality in the process of pre-hospital first aid, and did not affect the transfer of patients by pre-hospital emergency medical personnel. In the evaluation of the in-hospital advanced resuscitation effect, the initial PETCO2 of the patients in the observation group was significantly higher than that of the patients in the control group [mmHg (1 mmHg ≈ 0.133 kPa): 15.00 (13.25, 16.00) vs. 12.00 (11.00, 13.00), P < 0.01], the time of ROSC was significantly shorter than that in the control group (minutes: 11.00±3.25 vs. 16.64±2.54, P < 0.01), and the rate of ROSC was slightly higher than that in the control group (31.58% vs. 23.91%, P > 0.05). It indicated that continuous mechanical compression during pre-hospital transfer helped to ensure continuous high-quality CPR. Mechanical chest compression can improve the quality of continuous CPR during the pre-hospital transfer of patients with OHCA, and improve the initial resuscitation outcome of patients.

Conducting Language Production Research Online: A Web-based Study of Semantic Context and Name Agreement Effects in Multi-Word Production

Few web-based experiments have explored spoken language production, perhaps due to concerns of data quality, especially for measuring onset latencies. The present study highlights how speech production research can be done outside of the laboratory by measuring utterance durations and speech fluency in a multiple-object naming task when examining two effects related to lexical selection: semantic context and name agreement. A web-based modified blocked-cyclic naming paradigm was created, in which participants named a total of sixteen simultaneously presented pictures on each trial. The pictures were either four tokens from the same semantic category (homogeneous context), or four tokens from different semantic categories (heterogeneous context). Name agreement of the pictures was varied orthogonally (high, low). In addition to onset latency, five dependent variables were measured to index naming performance: accuracy, utterance duration, total pause time, the number of chunks (word groups pronounced without intervening pauses), and first chunk length. Bayesian analyses showed effects of semantic context and name agreement for some of the dependent measures, but no interaction. We discuss the methodological implications of the current study and make best practice recommendations for spoken language production research in an online environment.

Time-motion analysis in elite female Wushu Sanda athletes according to competitive phases and weight categories

Introduction: Wushu Sanda is a Chinese combat sport. Objective: To measure the time-motion structure of elite female wushu sanda athletes during the 13th World Wushu Championships in different weight divisions (light, middle, and heavy categories) and competition phases (eliminatory, quarterfinals, semifinals and finals). Material and methods: Fifty-five female athletes from 31 countries participated in 46 matches during the competition. All 46 matches, accounting 95 rounds, 35 in light, 25 in middle and 35 in heavyweight divisions, took part in the study. Matches were analyzed using the software Kinovea™. Each match was reproduced in slow motion (50%) twice; therefore, one athlete was observed each time to ensure that all activities would be registered, totalizing 92 observations (46 matches, 2 observations per match). We registered the time in observation, preparation, interaction, effort, pause, high-intensity and low-intensity activities. Results: Descriptive data showed an effort:pause ratio of 2.2:1, a high:low intensity efforts ratio of 1:1.3, and mean observation-preparation-interaction times of 4.5-1.2-4.2 seconds. When comparing by weight category, heavyweight categories had higher total fighting time per round than the light and middle categories. Also, heavyweight categories had longer preparation and interaction mean-time; and referee interruption time frequency, total and mean times than the light and middle categories. Total pause time was also higher for heavyweights. According to the competitive phase, semifinal matches had shorter observation times than eliminatory and final matches. Also, semifinal matches had lower low-intensity time than quarterfinals and finals. Conclusions: Wushu sanda is an intermittent combat sport, and female athletes present some time-motion differences according to weight division and competitive phase.

EFL Students’ Cognitive Performance during Argumentative Essay Writing: A log-file data analysis

Abstract The continuing growth of technology has led to a growing interest in online writing tools to gain an in-depth insight into students' cognitive performance. Using Inputlog 8.0, the present work explored undergraduate male and female students’ (N = 72, mean age = 19.7 years) Online Argumentative Writing Performance (OAWP). Participants were provided argumentative writing tasks in two temporal phases: a) composing and b) revision. The log-file data were analyzed using structural equation modeling (SEM) to explore any linear or quadratic relations among manifest (i.e., revision frequency, text length, mean R-bursts, total pause time, total active writing time, pause frequency, P-burst frequency, mean typed in P-burst and geometric mean of within-word, between-word, sentence, paragraph pauses) and latent (OAWP) variables simultaneously. The result showed significant linear relations between all variables and OAWP but no quadric relations were observed. Overall, findings suggest that students who employed between-word or between-sentence pause strategy (PS), active writing plus planned pause showed better OAWP, while high frequency of revision and pause at between word boundaries indicated much less successful OAWP. The result indicates that scaffolded revision, worked for L2 students' advantage in making strategic use of time for planning and improvement of written argumentation.

Pausas em uma tarefa de tradução e percepção do nível de Dificuldade da Tarefa de Tradução

A translation task from English into Spanish (Castilian) was carried out by 5 graduate students and 1 undergraduate student highly proficient in English and Spanish. The software Inputlog was used to record all pauses and keystrokes during the translation task. Various relations were examined in attempt to draw conclusions about cognitive effort during the translation task. The first relation examined was between self-reported L1 and Verbal Fluency Scores in L1 and L2. We predicted that participants would score higher on the Verbal Fluency Test in their L1 and found this to be true for 4 out of 6 participants. We also investigated the relation between verbal fluency score and perceived level of task difficulty. We predicted that the translation task into Spanish would be perceived as less difficult for the participants who scored higher in Spanish on the verbal fluency score. This result was only the case for one out of 3 participants who scored higher in Spanish on the Verbal Fluency Test. We also looked at the relation between degree of satisfaction with the target text and perceived level of task difficulty and predicted that participants who perceived the translation task as more difficult would be less satisfied with the final product. This was the case for 4 out of 6 participants. Next, we looked at total task time and total pause time, we hypothesized that variations in pause time across participants may be due to differences in L1 however the lowest and highest pause times recorded in our data were both L1 Spanish. Finally, we looked at the number of pauses and mean time of pauses at different segment levels and found results consistent with prior research where as pauses were more frequent at lower segment levels as opposed to higher segment levels. These results suggest that pauses are in fact an indicator of cognitive load during a translation task and that translating into the participant’s L1 may help to alleviate some of this cognitive load.

Analysing the impact of TAPs on temporal, technical and cognitive effort in monolingual post-editing

ABSTRACTThis study analyses the impact of TAPs on effort in monolingual post-editing tasks involving two machine-translated texts from English into Brazilian Portuguese. The analysis focuses on indicators of temporal effort (task execution time, text production time, total pause time, and pause count), technical effort (numbers of insertions, deletions, navigation and return keystrokes, copy/cut-and-paste keystrokes, and mouse operations, as well as the total number of keystrokes and mouse operations), and cognitive effort (average fixation duration, fixation count, total gaze time, average pupil size, and duration of the longest fixation). Results from 43 participants indicate that temporal, technical and cognitive aspects of effort are significantly influenced by verbalization, i.e., the TAP condition, on the basis of 13 indicators: all four indicators of temporal effort, four out of seven indicators of technical effort (numbers of insertions, deletions, and mouse operations, and the total number of keystrokes and mouse operations), and all five indicators of cognitive effort. The results also point out that the impact of TAPs on post-editing effort does not depend on participants’ translation experience.

Are Male Judokas with Visual Impairments Training Properly? Findings from an Observational Study

Introduction One aim of the study was to describe the temporal structure of judo combat among male judokas with visual impairments. Another aim was to determine the possible differences between the judokas with visual impairments and sighted male judokas to determine whether judokas with visual impairments need specific training to achieve their maximum performance level. Methods Observational methodology was used in 184 combats (n = 92 male senior judokas with visual impairments). A T-Patterns study (THEME) and a descriptive statistical analysis (SPSS) were conducted. Results The results showed that most of the observed combats ended before the regulation time was over (81%). The temporal structure observed in judokas with visual impairments was as follows: total combat time: 4 minutes, 26 seconds; total pause time: 2 minutes, 38 seconds; total stand-up fight time: 1 minute, 22 seconds; and total ground fight time: 60 seconds. The number of sequences were as follows: 6.9 pause sequences with a duration of 19.6 seconds each, 12.4 work sequences with a duration of 22 seconds each, 7.9 work sequences in stand-up judo with a duration of 11.7 seconds each, and 4.5 work sequences in ground judo with a duration of 12.9 seconds each. Discussion The combats’ mean values revealed that, compared to male sighted judokas, judokas with visual impairments perform shorter work sequences and need longer pause sequences because of their impairment. Implications for Practitioners These data indicate that the temporal structure of judo combat in athletes with visual impairments is different from the temporal structure of judo combat in sighted athletes, which indicates that the appropriate training for each group should be different. This article describes a specific temporal structure that is applicable to traditional judo training methods, fits these athletes’ needs, and is available for coaches who train judokas with visual impairments.

Immune And Inflammatory Responses And Exercise Performance During 135 Miles Mountain Foot Race

Pronounced increases in white blood cells and C-reactive protein (CRP) have been found after ultramarathon races, however, their relationships with exercise performance are unclear. PURPOSE: Verify the relationship between immune and inflammatory responses and exercise performance during 135 miles race METHODS: It was studied 11 athletes (43±3 years; 170.4±1.9 cm height; 70.7±3.1 kg body weight; 16±3 years of race training; 122±18km/week of training volume) that participated of the "BAD 135 World Cup" mountain race called "Brazil 135 Ultramarathon". One week before the competition and in subsequent days, the athletes individually determined the critical velocity (CV) from 4 maximal running of 800, 1200, 1600, 2000m. So, the CV was determined by the angular coefficient of the linear fit of distance versus running time. Race and pause time were obtained by official race reports. Blood samples were collected pre and post race for determination of blood counts with five-part leucocyte differential (neutrophils, lymphocytes, monocytes, eosinophils, basophils) by automated haematology analyser and CRP by an auto-analyzer. All data were expressed by mean ± SEM, t Student test for dependent sample was used to comparisons and Pearson`s correlation coefficient was used for analyzing relationships (statistical significance P<0.05). RESULTS: The subjects completed the race in 46.6±3.1h, speed average of 3.1±0.2 mph, corresponding to 34.5±1.9% of CV and total pause time of 3.7±0.9 h. Leucocyte (123±23%) neutrophils (170±70%), monocytes (122±16%), basophils (-51±19%) and CRP (35,467±18,376%) changed significantly (P<0.05) from baseline to post race. Leucocyte and neutrophils levels at 135 miles were positively correlated (P<0.05) with absolute running velocity (r=0.70; 0.76, respectively) and running velocity relative to CV (r=0.92; 0.96, respectively) as well as inversely correlated (P<0.05) with race time (r= -0.75; - 0.80, respectively) and pause time (r= -0.66; -0.69, respectively). CONCLUSIONS: These data strengthen that the immune and inflammatory responses are elevated post race as well as they show that higher running intensity and lower race and pause time may be related to greater white blood cells levels in 135 miles ultramarathon mountain race. Supported by Capes, CNPq and FAPESP/BRAZIL.

Increasing short‐term output in assembly work

AbstractMaximization of flexibility is one of the major challenges in assembly line design. This article addresses the question of how to temporarily (in times of peak demand) increase the output of a line, which is already optimized to attain the “normal” output rate. Instead of a costly reconfiguration of the line creating extra workstations for more operators, we applied an approach of keeping the line intact, adding two extra operators, and applying a scheme wherein the operators took their breaks alternately. For two different alternating break schemes, we compared the productivity rates, the physical load on operators, and the operators' experiences to those of the traditional situation. The new approach resulted in an increase in line output of 12–16%, depending on which alternating break scheme was applied. On the operator level, we observed no differences in productivity among conditions, despite the differences in total pause time per operator. Simultaneously, physical loads on the neck and shoulders, expressed by level of discomfort, were found to be significantly lower in one of the new alternating break schemes. A majority of the operators rated this alternating break scheme as “pleasant” (90%), but wanted the scheme to be applied only during the periods of peak demand because of social aspects (80%). In conclusion, an increase in volume flexibility can be achieved by adding two extra workers and applying an alternating work/rest scheme without a costly reconfiguration of the line. © 2010 Wiley Periodicals, Inc.

Skilled motor deficits in rats induced by ventrolateral striatal dopamine depletions: behavioral and pharmacological characterization

Rats were tested in an instrumental lever pressing procedure, in which a computer program recorded detailed parameters of responding such as response initiation and duration. Initially, rats with ventrolateral striatal dopamine depletions and control rats were tested on days 3–5 after surgery. Dopamine depletions produced by local injections of 6-hydroxydopamine substantially reduced the number of lever presses emitted. Dopamine depleted animals showed significant increases in average response initiation times, average length of fast initiation times, average length of pauses and total pause time. The distribution of initiation times was altered so that DA depleted rats showed significant reductions in the relative number of very high rate responses and also showed increases in the relative number of pauses. On day 7 after surgery, dopamine-depleted rats received one of three drug treatments: injections of ascorbate vehicle, injections of 20.0 mg/kg l-DOPA, and injections of 40.0 mg/kg l-DOPA. Injections of 40.0 mg/kg l-DOPA led to some improvement in several parameters of instrumental responding. Compared to the previous baseline day, the group that received 40.0 mg/kg l-DOPA showed a significant increase in number of responses on the drug treatment day, and also showed significant decreases in average response initiation time and total pause time. The group that received 40.0 mg/kg l-DOPA also showed significant increases in number of responses (expressed as a percent of the previous day) when compared to the control group that received injections of ascorbate vehicle. These results indicate that l-DOPA can partially reverse the skilled motor deficits produced by ventrolateral striatal dopamine depletions, and suggest that this test may be useful for the assessment of antiparkinsonian drugs.

Global- and local-temporal effects of a stuttering event in the context of a clausal utterance

The two main purposes of the study were (a) to relate the course of the global variables, Total Articulation Time (TAT) and Total Pause Time (TPT), with the frequency of stuttering events during adaptation; and (b) to examine the duration of words in various locations in the vicinity of stuttering events in the context of clausal utterances. Four stutterers provided two corpora of utterances comprising of (1) 40 utterances (8 clauses x 5 readings), with only the first reading of each clause containing a stuttering event, and (2) 40 fluent utterances (2 clauses x 5 readings x 4 stutterers). Utterances of identical clauses were obtained from matched control speakers to form two additional corpora. The main findings based on spectrographic durational measurements were that (a) the reduction of TAT and TPT through the readings paralleled the reduction of stuttering events, (b) the TAT and TPT functions were similar in stutterer's corpora, and (c) stutterers reduced TAT and TPT through the readings more than the control speakers. The analysis of the duration of words in the vicinity of stuttering events revealed that (a) there are anticipatory and carryover effects in the immediate vicinity of stuttering events in a clausal utterance; (b) the anticipatory effects were more pronounced than the carryover effects; and (c) a significant durational difference between stutterers and fluent speakers, in the duration of the last word of a clausal utterance preceding a clausal utterance containing a stuttering event, was noted. The results have been discussed in the context of literature on planning and production of speech.

Temporal analyses of children's comprehension during oral reading

Second- and fourth-grade children read aloud one normal story then two stories that contained an anomalous phrase in the third of five sentences. The anomalies were produced by reversing the order of two predicate nouns. The rate of articulation was slower and total pause time was greater when children read the anomalous sentences than when they read the normal sentences. While the anomalous sentences were read literally, all but a few children restored the anomalous phrase to its original meaning or changed some of the words to make the anomalous event more plausible. The results of the study suggest that temporal measures are highly sensitive to comprehension processes and that children comprehend the story as they read and compare what they read with what they know about the world.

The consistency of temporal speech characteristics in a repetitive oral reading task.

The purpose of this investigation was to explore the consistency of subjects' temporal speech characteristics in a repetitive oral reading task. Thirteen subjects read " The Rainbow Passage " fifteen consecutive times in each of three experimental sessions. Analysis of the readings indicates that the subjects' temporal speech characteristics, including overall rate, total time, speech time, total pause time, intra-sentence pause time, inter-sentence pause time, number of intra-sentence pauses, number of inter-sentence pauses, speech-time ratio, and pause-time ratio appear to be highly consistent from reading to reading as well as from session to session. Implications of these findings for future research on oral reading rate are discussed.

An investigation of the effects of temporal alterations in auditory feedback upon stutterers and clutterers

This paper presents an investigation of the differential performance of stutterers, clutterers, mixed stutterer-clutterers, and normal talkers when exposed to temporal alterations in auditory feedback during oral reading. The independent variables chosen were: a simulated normal auditory feedback condition (0.001 sec), two accelerated auditory feedback conditions (0.00015 and 0.0005 sec), and three delayed auditory feedback conditions (0.100, 0.200, and 0.300 sec). Four dependent variables were investigated: total reading time, total pause time, total residual phonation time, and word production errors. On all dependent variables the stutterers and clutterers were significantly differentiated. The mixed stutterer clutterers tended to demonstrate behavior indicative of an interaction of the two component disorders. The results are discussed with reference to auditory self-monitoring and differential diagnosis.

Methods for quantifying on-off speech patterns under delayed auditory feedback

Changes in the on-off patterns of speech under delayed auditory feedback (DAF) have been represented by gross measures such as total reading time, percent phonation time, and total pause time. The research reported in the present paper employed an analog-to-digital converter to assess changes (from normal speech to DAF speech) in 11 descriptive measures derived from the distribution of pause and vocalization durations. These measures reflected variations in individual speech performance under DAF which were consistent with the subjective ratings of the authors. It was concluded that independent correlates of subject, task, and environmental variables would be required to determine the usefulness of these measures.