A Methodology to Differentiate Parkinson's Disease and Aging Speech Based on Glottal Flow Acoustic Analysis.

Speech is controlled by axial neuromotor systems, therefore, it is highly sensitive to the effects of neurodegenerative illnesses such as Parkinson's Disease (PD). Patients suffering from PD present important alterations in speech, which are manifested in phonation, articulation, prosody, and fluency. These alterations may be evaluated using statistical methods on features obtained from glottal, spectral, cepstral, or fractal descriptions of speech. This work introduces an evaluation paradigm based on Information Theory (IT) to differentiate the effects of PD and aging on glottal amplitude distributions. The study is conducted on a database including 48 PD patients (24 males, 24 females), 48 age-matched healthy controls (HC, 24 males, 24 females), and 48 mid-age normative subjects (NS, 24 males, 24 females). It may be concluded from the study that Hierarchical Clustering (HiCl) methods produce a clear separation between the phonation of PD patients from NS subjects (accuracy of 89.6% for both male and female subsets), but the separation between PD patients and HC subjects is less efficient (accuracy of 75.0% for the male subset and 70.8% for the female subset). Conversely, using feature selection and Support Vector Machine (SVM) classification, the differentiation between PD and HC is substantially improved (accuracy of 94.8% for the male subset and 92.8% for the female subset). This improvement was mainly boosted by feature selection, at a cost of information and generalization losses. The results point to the possibility that speech deterioration may affect HC phonation with aging, reducing its difference to PD phonation.

Non-stationary Group-Level Connectivity Analysis for Enhanced Interpretability of Oddball Tasks.

Neural responses of oddball tasks can be used as a physiological biomarker to evaluate the brain potential of information processing under the assumption that the differential contribution of deviant stimuli can be assessed accurately. Nevertheless, the non-stationarity of neural activity causes the brain networks to fluctuate hugely in time, deteriorating the estimation of pairwise synergies. To deal with the time variability of neural responses, we have developed a piecewise multi-subject analysis that is applied over a set of time intervals within the stationary assumption holds. To segment the whole stimulus-locked epoch into multiple temporal windows, we experimented with two approaches for piecewise segmentation of EEG recordings: a fixed time-window, at which the estimates of FC measures fulfill a given confidence level, and variable time-window, which is segmented at the change points of the time-varying classifier performance. Employing the weighted Phase Lock Index as a functional connectivity metric, we have presented the validation in a real-world EEG data, proving the effectiveness of variable time segmentation for connectivity extraction when combined with a supervised thresholding approach. Consequently, we performed a piecewise group-level analysis of electroencephalographic data that deals with non-stationary functional connectivity measures, evaluating more carefully the contribution of a link node-set in discriminating between the labeled oddball responses.

Optimization of Real-Time EEG Artifact Removal and Emotion Estimation for Human-Robot Interaction Applications.

Affective human-robot interaction requires lightweight software and cheap wearable devices that could further this field. However, the estimation of emotions in real-time poses a problem that has not yet been optimized. An optimization is proposed for the emotion estimation methodology including artifact removal, feature extraction, feature smoothing, and brain pattern classification. The challenge of filtering artifacts and extracting features, while reducing processing time and maintaining high accuracy results, is attempted in this work. First, two different approaches for real-time electro-oculographic artifact removal techniques are tested and compared in terms of loss of information and processing time. Second, an emotion estimation methodology is proposed based on a set of stable and meaningful features, a carefully chosen set of electrodes, and the smoothing of the feature space. The methodology has proved to perform on real-time constraints while maintaining high accuracy on emotion estimation on the SEED database, both under subject dependent and subject independent paradigms, to test the methodology on a discrete emotional model with three affective states.

Vowel Articulation Dynamic Stability Related to Parkinson's Disease Rating Features: Male Dataset.

Neurodegenerative pathologies as Parkinson's Disease (PD) show important distortions in speech, affecting fluency, prosody, articulation and phonation. Classically, measurements based on articulation gestures altering formant positions, as the Vocal Space Area (VSA) or the Formant Centralization Ratio (FCR) have been proposed to measure speech distortion, but these markers are based mainly on static positions of sustained vowels. The present study introduces a measurement based on the mutual information distance among probability density functions of kinematic correlates derived from formant dynamics. An absolute kinematic velocity associated to the position of the jaw and tongue articulation gestures is estimated and modeled statistically. The distribution of this feature may differentiate PD patients from normative speakers during sustained vowel emission. The study is based on a limited database of 53 male PD patients, contrasted to a very selected and stable set of eight normative speakers. In this sense, distances based on Kullback-Leibler divergence seem to be sensitive to PD articulation instability. Correlation studies show statistically relevant relationship between information contents based on articulation instability to certain motor and nonmotor clinical scores, such as freezing of gait, or sleep disorders. Remarkably, one of the statistically relevant correlations point out to the time interval passed since the first diagnostic. These results stress the need of defining scoring scales specifically designed for speech disability estimation and monitoring methodologies in degenerative diseases of neuromotor origin.

Neuromechanical Modelling of Articulatory Movements from Surface Electromyography and Speech Formants.

Speech articulation is produced by the movements of muscles in the larynx, pharynx, mouth and face. Therefore speech shows acoustic features as formants which are directly related with neuromotor actions of these muscles. The first two formants are strongly related with jaw and tongue muscular activity. Speech can be used as a simple and ubiquitous signal, easy to record and process, either locally or on e-Health platforms. This fact may open a wide set of applications in the study of functional grading and monitoring neurodegenerative diseases. A relevant question, in this sense, is how far speech correlates and neuromotor actions are related. This preliminary study is intended to find answers to this question by using surface electromyographic recordings on the masseter and the acoustic kinematics related with the first formant. It is shown in the study that relevant correlations can be found among the surface electromyographic activity (dynamic muscle behavior) and the positions and first derivatives of the first formant (kinematic variables related to vertical velocity and acceleration of the joint jaw and tongue biomechanical system). As an application example, it is shown that the probability density function associated to these kinematic variables is more sensitive than classical features as Vowel Space Area (VSA) or Formant Centralization Ratio (FCR) in characterizing neuromotor degeneration in Parkinson's Disease.

Combined Effect of Levels in Personal Self-Regulation and Regulatory Teaching on Meta-Cognitive, on Meta-Motivational, and on Academic Achievement Variables in Undergraduate Students.

The Theory of Self- vs. Externally-Regulated Learning™ (SRL vs. ERL) proposed different types of relationships among levels of variables in Personal Self-Regulation (PSR) and Regulatory Teaching (RT) to predict the meta-cognitive, meta-motivational and -emotional variables of learning, and of Academic Achievement in Higher Education. The aim of this investigation was empirical in order to validate the model of the combined effect of low-medium-high levels in PSR and RT on the dependent variables. For the analysis of combinations, a selected sample of 544 undergraduate students from two Spanish universities was used. Data collection was obtained from validated instruments, in Spanish versions. Using an ex-post-facto design, different Univariate and Multivariate Analyses (3 × 1, 3 × 3, and 4 × 1) were conducted. Results provide evidence for a consistent effect of low-medium-high levels of PSR and of RT, thus giving significant partial confirmation of the proposed rational model. As predicted, (1) the levels of PSR and positively and significantly effected the levels of learning approaches, resilience, engagement, academic confidence, test anxiety, and procedural and attitudinal academic achievement; (2) the most favorable type of interaction was a high level of PSR with a high level RT process. The limitations and implications of these results in the design of effective teaching are analyzed, to improve university teaching-learning processes.

Design of a wearable bio-patch for monitoring patient's temperature.

New communication technologies allow us developing useful and more practical medical applications, in particular for ambulatory monitoring. NFC communication has the advantages of low powering and low influence range area, what makes this technology suitable for health applications. This work presents an explanation of the design process of planar NFC antennas in a wearable biopatch. The problem of optimizing the communication distance is addressed. Design of a biopatch for continuous temperature monitoring and experimental results obtained wearing this biopatch during daily activities are presented.

The role of personal self-regulation and regulatory teaching to predict motivational-affective variables, achievement, and satisfaction: a structural model.

The present investigation examines how personal self-regulation (presage variable) and regulatory teaching (process variable of teaching) relate to learning approaches, strategies for coping with stress, and self-regulated learning (process variables of learning) and, finally, how they relate to performance and satisfaction with the learning process (product variables). The objective was to clarify the associative and predictive relations between these variables, as contextualized in two different models that use the presage-process-product paradigm (the Biggs and DEDEPRO models). A total of 1101 university students participated in the study. The design was cross-sectional and retrospective with attributional (or selection) variables, using correlations and structural analysis. The results provide consistent and significant empirical evidence for the relationships hypothesized, incorporating variables that are part of and influence the teaching-learning process in Higher Education. Findings confirm the importance of interactive relationships within the teaching-learning process, where personal self-regulation is assumed to take place in connection with regulatory teaching. Variables that are involved in the relationships validated here reinforce the idea that both personal factors and teaching and learning factors should be taken into consideration when dealing with a formal teaching-learning context at university.

Consenso sobre utilización de las infiltraciones en el deporte. Documento de Consenso de la Sociedad Española de Medicina del Deporte / Consensus on use of infiltration in sport. Document of Consensus of the Spanish Society of Sports Medicine

La infiltración es una opción terapéutica, utilizada para el tratamiento de diversas patologías, que consiste en la administración inyectada en localizaciones precisas de diferentes sustancias. Pueden tener un efecto analgésico y/o antiinflamatorio y curativo. Su uso es frecuente en el tratamiento de muchas lesiones de tejidos blandos como bursitis, sinovitis, fascitis plantar, esguinces, lesiones musculares, tendinopatías y lesiones condrales y deben de ir precedido del correspondiente diagnóstico. Casi todas las infiltraciones tienen efectos secundarios locales, leves y, en algunas ocasiones, sistémicos y pueden presentar algunas contraindicaciones específicas que dependen de la sustancia administrada. La mayor parte de los efectos adversos son debidos a uso inapropiado del medicamento. Los principios activos más utilizados son: Anestésicos locales que producen un alivio inmediato del dolor, como lidocaína y bupivacaína. Se pueden usar solos o en combinación con corticosteroides ejerciendo un efecto combinado analgésico inmediato del dolor local y un efecto terapéutico de mayor duración. Corticoides cuya propiedad fundamental es una acción antiinflamatoria muy potente. Los más utilizados son betametasona, metilprednisolona y triamcinolona. Ácido hialurónico, utilizado en el tratamiento de patologías articulares, especialmente la artrosis de rodilla y las condromalacias. Lubrifica las articulaciones y parece tener efectos directos sobre la función de las células sinoviales y el líquido sinovial. Escleroterapia, que es la introducción de una sustancia química en la luz de los vasos sanguíneos, provocando una obliteración y fibrosis secundaria. Está indicada fundamentalmente en las tendinopatías con proliferación vascular. Biorreguladores: Estimulan la curación al modular o activar diversas sustancias implicadas. Plasma rico en plaquetas: plasma autólogo que contiene más concentración de plaquetas que la sangre normal que segregan una gran cantidad de factores de crecimiento. Proloterapia, que consiste en la infiltración de sustancias que estimulan la regeneración y reparación de los tejidos. Otros: Antiinflamatorios no esteroideos, factores de crecimiento, células madre y terapias relacionadas

Infiltration is a therapeutic option used for the treatment of various diseases, which comprises injected administration into precise locations of different substances. They may have an analgesic and / or anti-inflammatory and healing effect. Its use is common in the treatment of many soft tissue injuries such as bursitis, synovitis, plantar fasciitis, sprains, muscle injuries, tendinopathies and chondral injuries and must be preceded by the appropriate diagnosis. Almost all local infiltrations have mild side effects and, sometimes, these may be systemic and may have some specific contraindications depending on the administered substance. Most of the adverse effects are caused by improper use of the drug. The most used active substances are: local anesthetics that produce immediate pain relief, such as lidocaine and bupivacaine. They can be used alone or in combination with corticosteroids producing an immediate analgesic combined effect on local pain and a therapeutic effect of longer duration. Corticosteroids, whose main property is a very powerful anti-inflammatory action. The most used are betamethasone, methylprednisolone and triamcinolone. Hyaluronic acid, used in the treatment of joint diseases, particularly knee osteoarthritis and chondromalacias/chondropathias . It lubricates joints and appears to have direct effects on the function of synovial cells and synovial fluid. Sclerotherapy, which is the introduction of a chemical substance in the light of the blood vessels, causing obliteration and secondary fibrosis. It is indicated mainly in tendinopathies with vascular proliferation. Biorregulators: They stimulate healing when modulate or activate various involved substances. Platelet-rich plasma: autologous plasma containing more platelet concentration that normal blood, secreting a large amount of growth factors. Prolotherapy, it consists in substances infiltration that stimulate regeneration and tissue repair. Other: Nonsteroidal anti-inflammatory drugs, growth factors, stem cells and related therapies

Consenso sobre utilización de la vía parenteral en el deporte. Utilización de medicación homeopática, terapias biológicas y biorreguladoras. Documento de Consenso de la Federación Española de Medicina del Deporte / Consensus on use of parenteral via in sports. use of homeopathic medication, biological and bio-regulatory therapy. Document of consensus of the Spanish Federation of Sports Medicine

En la elección del medicamento más adecuado para tratar las lesiones deportivas hay que tener en cuenta el tipo y gravedad de la patología, el grado de incapacidad funcional, la evolución de los síntomas, la vía de administración, los efectos secundarios y las preferencias de los pacientes. Entre todos los recursos posibles, se encuentra la medicina complementaria y alternativa (homeopatía, fitoterapia, acupuntura, terapias biológicas y biorreguladoras, ...).Este documento de consenso sobre la aplicación de terapias inyectables en la Medicina del Deporte se basa en la reunión de expertos celebrada en noviembre de 2011 en Madrid y tiene el objetivo de mejorar la calidad asistencial y ayudar a los profesionales de la Medicina en la toma de decisiones terapéuticas. La mayoría de los biorreguladores son sustancias compuestas por diferentes elementos a diluciones homeopáticas que ejercen efectos específicos a nivel individual. Entre otras funciones, algunos de sus componentes son capaces de modular la inflamación y los síntomas de las lesiones, tienen acción analgésica, estimulan la cicatrización y pueden tener efectos hemostáticos contribuyendo a eliminar el estasis venoso y el edema. Su objetivo final es restaurar el funcionamiento normal de los mecanismos de regulación. Una de las vías de administración de las terapias biológicas y biorreguladoras es la parenteral (intradérmica, subcutánea, intraarticular, intramuscular o intravenosa y diferentes técnicas terapéuticas (bioacupuntura, mesoterapia, ...). La elección de la vía inyectable estará en función del tipo de patología, de la gravedad de la lesión, de las condiciones generales del paciente y, también, de la experiencia clínica del médico prescriptor. Estas terapias inyectables se pueden administrar solas, asociadas entre sí o junto a otros medicamentos o técnicas. La vía de administración del inyectable (intradérmica, subcutánea, intraarticular, intramuscular o intravenosa) así como la posología serán elegidas por el médico en función del tipo y gravedad de la patología. El nivel de evidencia científica que apoya el uso de estos medicamentos, se puede considerar aceptable y cada vez existen más publicaciones que apoyan su utilización. Por tanto, las terapias biológicas inyectables son una alternativa más en el tratamiento de las lesiones deportivas y sus efectos se pueden equiparar a los de otros medicamentos y, generalmente, carecen de efectos secundarios (AU)

When choosing the most appropriate medication to treat sports injuries must take into account the disease type and severity, the degree of functional disability, the symptoms progression, the administration route, side effects and patients preferences must be taken into account. Among all possible resources, there is the complementary and alternative medicine (homeopathy, herbal medicine, acupuncture, bioregulatory and biologic therapies, ...).This consensus document on the implementation of injectable therapies in Sports Medicine is based on the experts meeting held in November2011 in Madrid and aims to improve the quality of care and assist medical professionals in making therapeutic decisions. Most bioregulators are composed of different substances to homeopathic dilutions elements which exert specific effects individually. Among other functions, some components can modulate inflammation and injury symptoms, they are analgesic, stimulate healing and may have hemostatic effects contributing to eliminate edema and venous stasisy. Their ultimate goal is to restore the normal functioning of the regulatory mechanisms. One route of administration of the biological and bioregulatory therapies is the parenteral (intradermal, subcutaneous, intraarticular, intramuscularor intravenous) and different therapeutic techniques (bioacupuncture, mesotherapy, ...). The choice of the injectable route will depend on the type of pathology, the injury severity, the patient’s general condition and also the clinical experience of the prescribing physician. These injectable therapies can be administered alone, associated with each other or with other medicines or techniques. The injectable administration route (intradermal, subcutaneous, intraarticular, intramuscular or intravenous) as well as the dosage will be chosen by the physician according to the type and severity of the pathology. The level of scientific evidence that supports the use of these drugs can be considered acceptable and there is a growing literature supporting its use. Therefore, injectable biologic therapies are an alternative in the treatment of sports injuries and their effects are comparable to those of other drugs and usually have no side effects (AU)

Consenso sobre utilización de la vía parenteral en el deporte. El tratamiento de los trastornos por calor. Documento de Consenso de la Federación Española de Medicina del Deporte / Consensus on the use of parenteral route in sport. Heat illness treatment. Consensus document of Spanish Federation of Sports Medicine

El ejercicio físico provoca una elevación de la temperatura corporal, que en condiciones ambientales desfavorables (temperatura y humedad elevadas, radiación solar intensa o ausencia de viento) y otros factores provocan un mayor estrés térmico lo que puede conducir al deportista a una situación de deshidratación. Si no hay una adecuada reposición de líquidos y electrolitos que pueda desencadenar deshidratación y/o hiponatremia, se pueden producir efectos adversos sobre el rendimiento y también sobre la salud. Este documento de consenso presenta los cuadros clínicos relacionados con el calor que pueden aparecer durante la práctica de actividades deportivas y que pueden requerir el tratamiento urgente del paciente en el propio lugar de la actividad. Idealmente el tratamiento debe realizarse en un medio sanitario, pero la urgencia de algunos cuadros, puede requerir una actuación médica inmediata que, desde un punto de vista deontológico no puede demorarse aunque ello requiera desatender normas de origen deportivo, como las normas de lucha contra el dopaje y las normas de algunas federaciones que prohíben la utilización de la vía parenteral en deportistas. Se describen especialmente las indicaciones para uso de la administración parenteral de fluidos en el contexto deportivo para tratar la deshidratación, calambres musculares por esfuerzo, agotamiento por calor, síncope por calor, hiponatremia por esfuerzo y golpe de calor por esfuerzo. La administración de perfusiones endovenosas está indicada en tratamiento del golpe de calor y ante su sospecha diagnóstica, de forma inmediata, lo que no permite la demora en su aplicación y que se debe realizar en el propio terreno. Además, la perfusiones endovenosas están indicadas en el tratamiento del resto de situaciones patológicas cuando el estado de conciencia del paciente no permite la administración de fluidos orales o cuando se presentan nauseas o vómitos. Por último se describe la rehidratación como ayuda ergogénica con las ventajas e inconvenientes de las vías oral y parenteral (AU)

Exercise causes a rise in body temperature, which in unfavorable environmental conditions (high temperature and humidity, intense solar radiation or absence of wind) and other factors causes higher thermal stress which can cause a dehydration situation on the athlete. If there is no suitable replacement of fluids and electrolytes, which can cause dehydration and / or hyponatremia, adverse effects may occur on performance and health. This consensus document shows clinical symptoms related to heat that can occur while practicing sport activities and may require urgent treatment in the patient’s activity place. Ideally, treatment should be done in a sanitary environment, but the urgency of some symptoms may require immediate medical intervention which, due to the medical ethics involved, cannot be delayed even if this implies neglecting sports rules, such anti-doping rules or some federations regulations that forbid the use of parenteral route in athlete. Indications for using the parenteral fluids administration in sports are specially described, which are used to treat dehydration, exertional muscle cramps caused by effort, heat exhaustion, heat syncope, exertional hyponatremia and exertional heat stroke. The administration of intravenous infusions is indicated in the heat stroke treatment and must be immediately applied when its diagnosis is suspected, being no delay allowed and performing it in the field. Furthermore, intravenous infusions are indicated in the treatment of other pathological situations where the consciousn ess state of the patient does not permitoral administration of fluids or in case of nausea or vomiting. Finally, rehydration is described as an ergogenic aid with the advantages and disadvantages of oral and parenteral routes (AU)

Consenso sobre utilización de la vía parenteral en el deporte. Aspectos generales. Documento de consenso de la Federación Española de Medicina del Deporte / Consensus on use of parenteral via in sports. Document of Consensus of the Spanish Federation of Sports Medicine

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