Detecting subtle signs of depression with automated speech analysis in a non-clinical sample.

BACKGROUND: Automated speech analysis has gained increasing attention to help diagnosing depression. Most previous studies, however, focused on comparing speech in patients with major depressive disorder to that in healthy volunteers. An alternative may be to associate speech with depressive symptoms in a non-clinical sample as this may help to find early and sensitive markers in those at risk of depression. METHODS: We included n = 118 healthy young adults (mean age: 23.5 ± 3.7 years; 77% women) and asked them to talk about a positive and a negative event in their life. Then, we assessed the level of depressive symptoms with a self-report questionnaire, with scores ranging from 0-60. We transcribed speech data and extracted acoustic as well as linguistic features. Then, we tested whether individuals below or above the cut-off of clinically relevant depressive symptoms differed in speech features. Next, we predicted whether someone would be below or above that cut-off as well as the individual scores on the depression questionnaire. Since depression is associated with cognitive slowing or attentional deficits, we finally correlated depression scores with performance in the Trail Making Test. RESULTS: In our sample, n = 93 individuals scored below and n = 25 scored above cut-off for clinically relevant depressive symptoms. Most speech features did not differ significantly between both groups, but individuals above cut-off spoke more than those below that cut-off in the positive and the negative story. In addition, higher depression scores in that group were associated with slower completion time of the Trail Making Test. We were able to predict with 93% accuracy who would be below or above cut-off. In addition, we were able to predict the individual depression scores with low mean absolute error (3.90), with best performance achieved by a support vector machine. CONCLUSIONS: Our results indicate that even in a sample without a clinical diagnosis of depression, changes in speech relate to higher depression scores. This should be investigated in more detail in the future. In a longitudinal study, it may be tested whether speech features found in our study represent early and sensitive markers for subsequent depression in individuals at risk.

Validation of a digital, tablet-based version of the Trail Making Test in the ∆elta platform.

Using digital technology for neuropsychological assessment is gaining popularity in both clinical and research settings. Digital neuropsychology offers many benefits over the traditional paper-pencil assessments; however, their comparability requires further validation. The aim of this study was to compare a digital, tablet-based Trail Making Test to the standard paper version. In a within-subject design, 108 healthy adults completed both digital and paper Trail Making Test in a counterbalanced order. Each participant also performed other tasks measuring core executive abilities (inhibition, working memory, and flexibility) on the tablet. Our findings indicated that the Trail Making Test performance on the two different modalities correlated significantly. Furthermore, correlations of Trail Making Test performance with other cognitive tasks revealed that digital Trail Making Test is comparable with the paper version. However, the modality had a significant effect on Trail Making Test performance; that is, participants were generally faster on the digital platform. Taken together, our findings suggest that with new normative data, traditional Trail Making Test can be adapted successfully to a digital platform.

Avaliação de tampão apical em dentes bovinos permanentes jovens com hidróxido de cálcio e MTA: um estudo in vitro / Evaluation of apical plug in young permanent bovine teeth with calcium hydroxide and MTA: an in vitro study

O objetivo do presente estudo in vitro foi avaliar, por meio de radiografia digital, a qualidade de preenchimento dos canais de dentes incisivos bovinos permanentes jovens quando realizado tampão apical com hidróxido de cálcio e MTA associados a outros materiais e posteriormente obturados. Foram utilizados dentes incisivos permanentes bovinos com rizogênese incompleta preparados de forma manual com as limas tipo K, irrigados com hipoclorito de sódio 1% e soro fisiológico. Após, foram utilizados os materiais indicados para confecção do tampão apical: hidróxido de cálcio P.A associado ao propilenoglicol e ao iodofórmio; hidróxido de cálcio P.A juntamente com MTA e propilenoglicol e somente MTA, em seguida obturados com cones de guta percha e cimento AH Plus e radiografados para avaliação. Os dados foram submetidos ao teste Qui-Quadrado de Pearson e Teste exato de Fisher com nível de significância de 5%. Os resultados obtidos não apresentaram diferença estatisticamente significativa entre os três grupos, sendo que o valor resultado foi de p=0,442, porém o grupo composto pelo cimento de hidróxido de cálcio P.A associado ao MTA e propilenoglicol apresentou uma qualidade de preenchimento boa (100 %) em relação aos outros cimentos avaliados, que se mostraram satisfatório (40%) e bom (60%) no procedimento de apicificação. Não houve diferença significativa de qualidade de preenchimento de tampão apical nos grupos, no entanto o grupo composto pelo hidróxido de cálcio P.A. associado ao MTA e propilenoglicol apresentou resultado superior(AU)

The objective of the present in vitro study was to evaluate, through digital radiography, the quality of filling in the young permanent bovine incisor teeth canals when the apical buffer was performed with calcium hydroxide and MTA associated with other materials and subsequently filled. Permanent bovine incisor teeth with incomplete rhizogenesis were prepared manually with K files type, irrigated with 1% sodium hypochlorite and saline. Afterwards, the materials indicated for making the apical buffer were used: calcium hydroxide P.A associated with propylene glycol and iodoform; calcium hydroxide P.A together with MTA and propylene glycol and only MTA, then filled with gutta-percha cones and AH Plus cement and radiographed for evaluation. The data were submitted to the Pearson's Chi-square test and Fisher's exact test with a significance level of 5%, once the result value was p=0,442. The results obtained showed no statistically significant difference between the three groups, the result being p=0,442, however the group composed of calcium hydroxideP.A. cement associated with MTA and propylene glycol showed a good filling quality (100%) in relation to the other evaluated cements, which were satisfactory (40%) and good (60%) in apexification procedure. There was no significant difference in quality of plug apical filling in the groups, however the group composed of calcium hydroxide P.A cement associated with MTA and propylene glycol showed a superior result(AU)

Cine MRI during spontaneous cramps in women with menstrual pain.

BACKGROUND: The lack of noninvasive methods to study dysmenorrhea has resulted in poor understanding of the mechanisms underlying pain, insufficient diagnostic tests, and limited treatment options. To address this knowledge gap, we have developed a magnetic resonance imaging-based strategy for continuously monitoring the uterus in relationship to participants' spontaneous pain perception. OBJECTIVE: The study objective was to evaluate whether magnetic resonance imaging can detect real-time changes in myometrial activity during cramping episodes in women with dysmenorrhea, with a handheld squeeze bulb for pain reporting. STUDY DESIGN: Sixteen women with dysmenorrhea and 10 healthy control women both on and off their menses were evaluated with magnetic resonance imaging while not taking analgesic medication. Continuous magnetic resonance imaging was acquired using half-Fourier acquisition single-shot turbo spin echo sequence along with simultaneous reporting of pain severity with a squeeze bulb. Pearson's coefficient was used to compare results between reviewers. Proportional differences between women with dysmenorrhea and controls on/off menses were evaluated with a Fisher exact test. The temporal relationships between signal changes were evaluated with Monte Carlo simulations. RESULTS: Spontaneous progressive decreases in myometrial signal intensity were more frequently observed in women on their menses than in the absence of pain in the same women off their menses or participants without dysmenorrhea (P < .01). Women without reductions in myometrial signal intensity on their menses either had a history of endometriosis or were not in pain. Observations of myometrial events were consistently reported between 2 raters blinded to menstrual pain or day status (r = 0.97, P < .001). Episodes of cramping occurred either immediately before or 32-70 seconds after myometrial signal change onset (P < .05). CONCLUSION: Transient decreases in myometrial uterine T2-weighted signal intensity can be reliably measured in women with menstrual pain. The directionality of signal change and temporal relationship to pain onset suggest that cramping pain may be caused by a combination of uterine pressure and hemodynamic dysfunction.

Impact of a theory-based video on initiation of long-acting reversible contraception after abortion.

OBJECTIVE: Adoption of long-acting reversible contraception (LARC) (ie, the intrauterine device or the contraceptive implant) immediately after abortion is associated with high contraceptive satisfaction and reduced rates of repeat abortion. Theory-based counseling interventions have been demonstrated to improve a variety of health behaviors; data on theory-based counseling interventions for postabortion contraception are lacking. STUDY DESIGN: Informed by the transtheoretical model of behavioral change, a video intervention was developed to increase awareness of, and dispel misconceptions about, LARC methods. The intervention was evaluated in a randomized controlled trial among women aged 18-29 years undergoing surgical abortion at a clinic in Chicago, IL. Participants were randomized 1:1 to watch the intervention video or to watch a stress management video (control), both 7 minutes in duration. Contraceptive methods were supplied to all participants free of charge. Rates of LARC initiation immediately after abortion were compared. RESULTS: Rates of LARC initiation immediately after abortion were not significantly different between the 2 study arms; 59.6% in the intervention and 51.6% in the control arm chose a LARC method (P = .27). CONCLUSION: This study resulted in an unexpectedly high rate of LARC initiation immediately after abortion. High rates of LARC initiation could not be attributed to a theory-based counseling intervention.

Perceptual Relearning of Binocular Fusion and Stereoacuity After Brain Injury.

BACKGROUND: Brain lesions may disturb binocular fusion and stereopsis, leading to blurred vision, diplopia, and reduced binocular depth perception for which no evaluated treatment is currently available. Objective The study evaluated the effects of a novel binocular vision treatment designed to improve convergent fusional amplitude and stereoacuity in patients with stroke or traumatic brain injury (TBI). Methods Patients (20 in all: 11 with stroke, 9 with TBI) were tested in fusional convergence, stereoacuity, near/far visual acuity, accommodation, and subjective binocular reading time until diplopia emerged at 6 different time points. All participants were treated in a single subject baseline design, with 3 baseline assessments before treatment (pretherapy), an assessment immediately after a 6-week treatment period (posttherapy), and 2 follow-up tests 3 and 6 months after treatment. Patients received a novel fusion and dichoptic training using 3 different devices to slowly increase fusional and disparity angles. Results At pretherapy, the stroke and TBI groups showed severe impairments in convergent fusional range, stereoacuity, subjective reading duration, and partially in accommodation (only TBI group). After treatment, both groups showed considerable improvements in all these variables as well as slightly increased near visual acuity. No significant changes were observed during the pretherapy and follow-up periods, ruling out spontaneous recovery and demonstrating long-term stability of binocular treatment effects. Conclusions This proof-of-principle study indicates a substantial treatment-induced plasticity of the lesioned brain in the relearning of binocular fusion and stereovision, thus providing new, effective rehabilitation strategies to treat binocular vision deficits resulting from permanent visual cortical damage.

Perceptual relearning of binocular fusion after hypoxic brain damage: four controlled single-case treatment studies.

OBJECTIVE: Hypoxic brain damage is characterized by widespread, diffuse-disseminated brain lesions, which may cause severe disturbances in binocular vision, leading to diplopia and loss of stereopsis, for which no evaluated treatment is currently available. The study evaluated the effects of a novel binocular vision treatment designed to improve binocular fusion and stereopsis as well as to reduce diplopia in patients with cerebral hypoxia. METHOD: Four patients with severely reduced convergent fusion, stereopsis, and reading duration due to hypoxic brain damage were treated in a single-subject baseline design, with three baseline assessments before treatment to control for spontaneous recovery (pretherapy), an assessment immediately after a treatment period of 6 weeks (posttherapy), and two follow-up tests 3 and 6 months after treatment to assess stability of improvements. Patients received a novel fusion and dichoptic training using 3 different devices designed to slowly increase fusional and disparity angle. RESULTS: After the treatment, all 4 patients improved significantly in binocular fusion, subjective reading duration until diplopia emerged, and 2 of 4 patients improved significantly in local stereopsis. No significant changes were observed during the pretherapy baseline period and the follow-up period, thus ruling out spontaneous recovery and demonstrating long-term stability of treatment effects. CONCLUSIONS: This proof-of-principle study indicates a substantial treatment-induced plasticity after hypoxia in the relearning of binocular vision and offers a viable treatment option. Moreover, it provides new hope and direction for the development of effective rehabilitation strategies to treat neurovisual deficits resulting from hypoxic brain damage.

Relationship between the immunohistochemistry of the primary tumour and 18F-FDG-PET/CT at recurrence in patients with well-differentiated thyroid carcinoma.

PURPOSE: In patients thyroidectomized for well-differentiated thyroid carcinoma, the correlation between thyroglobulin (Tg) plasma level and F-fluoro-2-deoxy-D-glucose (F-FDG)-PET results is still a matter of debate. We evaluated whether the immunochemical profile of the primary tumour could be used as a predictor of positivity on F-FDG-PET/computed tomography (CT) when recurrence is confirmed. MATERIALS AND METHODS: A total of 26 patients (eight men, 18 women; 51±16 years old) were included. All of the patients had a histologically proven recurrence or a high level of Tg during follow-up and underwent a F-FDG-PET/CT following two intramuscular injections of rhTSH. The F-FDG-PET/CT scans were blindly analysed by three nuclear physicians. The results of the PET scans were classified as true positive, false positive or false negative. Nine antibodies were used for the immunochemical analysis (tissue microarray: hexokinase I, II and III; Tg; vascular endothelial growth factor; and glucose transporter type 1, CD31, CD68 and sodium iodide symporter). RESULTS: The PET scans were positive for 15 patients and negative for 11 patients. Hexokinase I was expressed in nine of the 26 primary tumours (7/26 for the isoforms). No single molecule expressed in the primary tumours was correlated with the F-FDG-PET/CT results. There was no association of antibody overexpression (clustering) in the primary tumours with the F-FDG-PET/CT results of the recurrences. CONCLUSION: In a larger series, we failed to confirm the preliminary results of Hooft and colleagues. This study did not allow for the determination of a single marker expressed in the primary tumours that would be predictive of F-FDG-PET/CT positivity when recurrence is suspected. Therefore, at present, immunochemistry does not appear to be a definitive tool for predicting the results of F-FDG-PET/CT in cases of recurrence.

Effects of feedback-based visual line-orientation discrimination training for visuospatial disorders after stroke.

BACKGROUND: Patients with right or more rarely left parietotemporal lesions after stroke may have profound visuospatial disorders that impair activities of daily living (ADL) and long-term outcome. Clinical studies indicate improvements with systematic training of perception. Studies of perceptual learning in healthy persons suggest rapid improvements in perceptual learning of spatial line orientation with partial transfer to nontrained line orientations. OBJECTIVE: The authors investigated a novel feedback-based perceptual training procedure for the rehabilitation of patients after stroke. METHODS: In an uncontrolled trial, 13 participants showing profound deficits in line orientation and related visuospatial tasks within 12 to 28 weeks of onset performed repetitive feedback-based, computerized training of visual line orientation over 4 weeks of treatment. Visual line-orientation discrimination and visuospatial and visuoconstructive tasks were assessed before and after training. RESULTS: The authors found (a) rapid improvements in trained but also in nontrained spatial orientation tests in all 13 participants, partially up to a normal level; (b) stability of the obtained improvements at 2-month follow-up; (c) interocular transfer of training effects to the nontrained eye in 2 participants suggesting a central, postchiasmatic locus for this perceptual improvement; and (d) graded transfer of improvements to related spatial tasks, such as horizontal writing, analog clock reading, and visuoconstructive capacities but no transfer to unrelated measures of visual performance. CONCLUSIONS: These results suggest the potential for treatment-induced improvements in visuospatial deficits by feedback-based, perceptual orientation training as a component of rehabilitation after stroke.