Atraumatic Acromioclavicular Joint Dislocation: A Case Report Treated with Excision of the Distal Clavicle Margin and Button Slide System with Allograft Tendon Reinforcement at Coracoclavicular and Acromioclavicular Joint.

Although acromioclavicular joint (ACJ) dislocation is a common injury following trauma involving the shoulder, it is rare in the absence of trauma. In this manuscript, we describe a case of ACJ in a 15-year-old girl who presented a painful dislocation with spontaneous shortening of the right acromioclavicular joint that forced her to temporarily abandon her sports career. After failure of conservative physiotherapy treatment, surgical intervention was proposed by performing an arthroscopic-assisted button slide combined with augmented hamstring allograft reconstruction. After the intervention and the subsequent recovery period, the athlete was able to return to her semi-professional training. The follow-up of the patient is 5.5 years post-surgery. The result obtained could help in planning the treatment of future cases.

C1-C2 Rotatory Subluxation in Adults "A Narrative Review".

The atlantoaxial joint C2 (axis) with the anterior arch of C1 (atlas) allows 50% of cervical lateral rotation. It is responsible for precise and important movements that allow us to perform precise actions, both in normal and working life. Due to low incidence in adults, this condition often goes undiagnosed, or the diagnosis is delayed and the outcome is worse. An early diagnosis and treatment are essential to ensure satisfactory neurological and functional outcomes. The aim of this review is to analyze C1-C2 rotatory subluxation in adults, given its rarity. The time between injury and reduction is key, as it is directly related to prognosis and the severity of the treatment options. Due to low incidence in adults, this condition often goes undiagnosed, or the diagnosis is delayed as a lot of cases are not related to a clear trauma, with a poor prognosis just because of the late diagnosis and the outcome is worse. The correct approach and treatment of atlantoaxial dislocation requires a careful study of the radiological findings to decide the direction and plane of the dislocation, and the search for associated skeletal anomalies.

Analysis of Measured and Simulated Supraglottal Acoustic Waves.

To date, although much attention has been paid to the estimation and modeling of the voice source (ie, the glottal airflow volume velocity), the measurement and characterization of the supraglottal pressure wave have been much less studied. Some previous results have unveiled that the supraglottal pressure wave has some spectral resonances similar to those of the voice pressure wave. This makes the supraglottal wave partially intelligible. Although the explanation for such effect seems to be clearly related to the reflected pressure wave traveling upstream along the vocal tract, the influence that nonlinear source-filter interaction has on it is not as clear. This article provides an insight into this issue by comparing the acoustic analyses of measured and simulated supraglottal and voice waves. Simulations have been performed using a high-dimensional discrete vocal fold model. Results of such comparative analysis indicate that spectral resonances in the supraglottal wave are mainly caused by the regressive pressure wave that travels upstream along the vocal tract and not by source-tract interaction. On the contrary and according to simulation results, source-tract interaction has a role in the loss of intelligibility that happens in the supraglottal wave with respect to the voice wave. This loss of intelligibility mainly corresponds to spectral differences for frequencies above 1500 Hz.

Colorimetric detection of hazardous gases using a remotely operated capturing and processing system.

This paper presents an electronic system for the automatic detection of hazardous gases. The proposed system implements colorimetric sensing algorithms, thus providing a low-cost solution to the problem of gas sensing. It is remotely operated and it performs the tasks of image capturing and processing, hence obtaining colour measurements in RGB (Red-Green-Blue) space that are subsequently sent to a remote operator via the internet. A prototype of the system has been built to test its performance. Specifically, experiments have been carried out aimed at the detection of CO, CO2, NO, NO2, SO2 and formaldehyde at diverse concentrations by using a chromogenic array composed by 13 active and 2 inert compounds. Statistical analyses of the results reveal a good performance of the electronic system and the feasibility of remote hazardous gas detection using colorimetric sensor arrays.

Characterization of dysphonic voices by means of a filterbank-based spectral analysis: sustained vowels and running speech.

OBJECTIVES: This article presents a comparative study of the spectral power distribution for normal and dysphonic voices, both for sustained vowels and running speech. The objective of this study was to find robust cues of dysphonia in spectral domain. For this purpose, recordings from two databases are processed, one of them including both sustained vowels and running speech. Additionally, a new measure of stability is introduced (decorrelation time). The application of this measure to the power spectrum is also tested as a cue of dysphonia. MATERIALS AND METHODS: The spectral analysis is done having both an auditory model and the filterbank approach as references to the computation of discrete spectrograms. Results are obtained from three sets of recordings belonging to two different databases. RESULTS: The reported results indicate that only minor differences exist in the shape of the power spectrum of normal and dysphonic voices when performing sustained vowel phonation tasks. However, the calculated band power decorrelation times indicate that power in bands between 2000 and 6400Hz is significantly less stable in dysphonic voices. As for running speech, the stability of spectral power is not such a good indicator of dysphonia, but there is a significant difference between normal and dysphonic voices in the power level of high-frequency bands (above 5300Hz). In addition, this means that sampling rates above 10.6ksps are needed for assessing running speech in spectral domain. Also, the results involving decorrelation times indicate that for short-time spectral analysis, frame rates above 100 frames/s should be preferred.

Towards objective evaluation of perceived roughness and breathiness: an approach based on mel-frequency cepstral analysis.

Within this paper, the authors report on an experiment on automatic labelling of perceived voice roughness (R) and breathiness (B), according to the GRBAS scale. The main objective of the experiment has not been to correlate objective measures to perceived R and B, but to automatically evaluate R and B. For this purpose, a system has been trained that extracts the first mel-frequency cepstral coefficients (MFCC) of available sustained vowel phonations. Afterwards, a classifier has been trained to estimate the corresponding degrees of roughness and breathiness. The obtained results reveal a significant correlation between subjective and automatic labelling, hence indicating the feasibility of objective evaluation of voice quality by means of perceptually meaningful measures.

Pathological likelihood index as a measurement of the degree of voice normality and perceived hoarseness.

A new index is introduced in this article to measure the degree of normality in the speech. The proposed parameter has demonstrated to be correlated with the perceived hoarseness, giving an indication of the degree of normality. The calculation of such a parameter is based on a statistical model developed to represent normal and pathological voices. The modeling is built around Gaussian mixture models and Mel frequency cepstral coefficients. The proposed index has been named pathological likelihood index (PLI). PLI is compared with other aperiodicity features (such as jitter and shimmer), and measurements sensitive to additive noise (such as harmonics-to-noise ratio (HNR), cepstrum-based HNR, normalized noise energy, and glottal-to-noise excitation ratio). The proposed parameter is revealed to be a good estimator of the presence of pathology, showing lower correlation with noise, frequency, and amplitude perturbation parameters than these classical features among them.

Segmentation of the glottal space from laryngeal images using the watershed transform.

The present work describes a new method for the automatic detection of the glottal space from laryngeal images obtained either with high speed or with conventional video cameras attached to a laryngoscope. The detection is based on the combination of several relevant techniques in the field of digital image processing. The image is segmented with a watershed transform followed by a region merging, while the final decision is taken using a simple linear predictor. This scheme has successfully segmented the glottal space in all the test images used. The method presented can be considered a generalist approach for the segmentation of the glottal space because, in contrast with other methods found in literature, this approach does not need either initialization or finding strict environmental conditions extracted from the images to be processed. Therefore, the main advantage is that the user does not have to outline the region of interest with a mouse click. In any case, some a priori knowledge about the glottal space is needed, but this a priori knowledge can be considered weak compared to the environmental conditions fixed in former works.