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Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3666-3669, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018796


This study has investigated the efficiency of voice features in estimating the motor Unified Parkinson's Disease Rating Scale (UPDRS) score in Parkinson's disease (PD) patients. A total of 26 PD patients (mean age = 72) and 22 control subjects (mean age = 66.91) were recruited for the study. The sustained phonation /a/, /u/ and /m/ were collected in both off-state and on-state of Levodopa medication. The average motor UPDRS for PD off-state patients was 27.31, on-state was 20.42 and that of controls was 2.63. Voice features were extracted from the phonation tasks and were reduced to the most relevant 6 features for each phonation task using the Least Absolute Shrinkage and Selection Operator (LASSO) feature ranking method. The correlation between the reduced features and motor UPDRS was tested using the Spearman correlation coefficient test. AdaBoost regression learner was trained and used for automatically estimating the motor UPDRS score using the voice features. The results show that the vocal features for /m/ performed best by estimating the motor UPDRS score for PD off-state with the mean absolute error (MAE) of 3.52 and 5.90 for PD on-state. This study shows that assessment of voice can be used for day to day remote monitoring of PD patients.

Doença de Parkinson , Voz , Humanos , Levodopa/uso terapêutico , Doença de Parkinson/tratamento farmacológico , Fonação
Biosensors (Basel) ; 10(1)2019 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-31861890


In this paper, we have investigated the differences in the voices of Parkinson's disease (PD) and age-matched control (CO) subjects when uttering three phonemes using two complexity measures: fractal dimension (FD) and normalised mutual information (NMI). Three sustained phonetic voice recordings, /a/, /u/ and /m/, from 22 CO (mean age = 66.91) and 24 PD (mean age = 71.83) participants were analysed. FD was first computed for PD and CO voice recordings, followed by the computation of NMI between the test groups: PD-CO, PD-PD and CO-CO. Four features reported in the literature-normalised pitch period entropy (Norm. PPE), glottal-to-noise excitation ratio (GNE), detrended fluctuation analysis (DFA) and glottal closing quotient (ClQ)-were also computed for comparison with the proposed complexity measures. The statistical significance of the features was tested using a one-way ANOVA test. Support vector machine (SVM) with a linear kernel was used to classify the test groups, using a leave-one-out validation method. The results showed that PD voice recordings had lower FD compared to CO (p < 0.008). It was also observed that the average NMI between CO voice recordings was significantly lower compared with the CO-PD and PD-PD groups (p < 0.036) for the three phonetic sounds. The average NMI and FD demonstrated higher accuracy (>80%) in differentiating the test groups compared with other speech feature-based classifications. This study has demonstrated that the voices of PD patients has reduced FD, and NMI between voice recordings of PD-CO and PD-PD is higher compared with CO-CO. This suggests that the use of NMI obtained from the sample voice, when paired with known groups of CO and PD, can be used to identify PD voices. These findings could have applications for population screening.

Técnicas Biossensoriais , Doença de Parkinson/diagnóstico , Máquina de Vetores de Suporte , Voz , Idoso , Humanos , Fonética
Biosensors (Basel) ; 9(2)2019 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-31027153


This study investigated the difference in the gait of patients with Parkinson's disease (PD), age-matched controls and young controls during three walking patterns. Experiments were conducted with 24 PD, 24 age-matched controls and 24 young controls, and four gait intervals were measured using inertial measurement units (IMU). Group differences between the mean and variance of the gait parameters (stride interval, stance interval, swing interval and double support interval) for the three groups were calculated and statistical significance was tested. The results showed that the variance in each of the four gait parameters of PD patients was significantly higher compared with the controls, irrespective of the three walking patterns. This study showed that the variance of any of the gait interval parameters obtained using IMU during any of the walking patterns could be used to differentiate between the gait of PD and control people.

Marcha , Doença de Parkinson/fisiopatologia , Idoso , Algoritmos , Fenômenos Biomecânicos , Estudos de Casos e Controles , Interpretação Estatística de Dados , Feminino , Humanos , Masculino
Int J Low Extrem Wounds ; 17(2): 78-86, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30012069


Diabetic foot infections are a major cause of hospitalization, and delayed treatment can lead to numerous complications. The aim of this research was to investigate high-resolution spectroscopy of the wound center and periwound area for real-time estimation of multispectral signature of bacteria at the base of diabetic foot ulcers. We investigated the spectrum of the reflected visual light from diabetic foot ulcers and developed a method that identifies the presence of bacteria in the wound infections. We undertook a prospective pilot study on 18 patients with type 1 and type 2 diabetes and chronic diabetic foot ulcers. The spectral coefficients were directly compared with the results from the wound swab. The results of the multispectral analysis demonstrated 100% sensitivity, with 100% negative predictive values of identifying the presence of the bacteria, which was the cause of the infection in the wound. The results of our study suggest that the changes in the multispectral properties of the wound can be used to identify the presence of bacteria in the infected area using a noninvasive device without any contact with the wound. This technique holds great promise for real-time objective evaluation of the wound infection status beyond the standard visual assessment of diabetic foot ulcers.

Antibacterianos/farmacologia , Bactérias , Técnicas Bacteriológicas/métodos , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Pé Diabético , Infecção dos Ferimentos , Bactérias/efeitos dos fármacos , Bactérias/isolamento & purificação , Pé Diabético/diagnóstico , Pé Diabético/tratamento farmacológico , Pé Diabético/microbiologia , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana/métodos , Pessoa de Meia-Idade , Projetos Piloto , Valor Preditivo dos Testes , Estudos Prospectivos , Infecção dos Ferimentos/diagnóstico , Infecção dos Ferimentos/tratamento farmacológico , Infecção dos Ferimentos/microbiologia
J Biomed Opt ; 21(2): 26001, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26836210


Previous studies suggest that altered corneal temperature may be a feature of schizophrenia, but the association between major depressive disorder (MDD) and corneal temperature has yet to be assessed. The aim of this study is to investigate whether eye temperature is different among MDD patients than among healthy individuals. We used a thermographic camera to measure and compare the temperature profile across the corneas of 16 patients with MDD and 16 age- and sex-matched healthy subjects. We found that the average corneal temperature between the two groups did not differ statistically, although clinical severity correlated positively with right corneal temperature. Corneal temperature may be an indicator of clinical severity in psychiatric disorders, including depression.

Temperatura Corporal/fisiologia , Córnea/fisiologia , Transtorno Depressivo Maior/fisiopatologia , Termografia/métodos , Adolescente , Adulto , Idoso , Análise de Variância , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
Health Policy Plan ; 28(4): 367-74, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22826516


In 2005, due to slow global progress in the scale-up of prevention of mother-to-child transmission (PMTCT) and paediatric HIV programmes, the Inter-agency Task Team (IATT) on the Prevention of HIV infection among Pregnant Women, Mothers, and their Children initiated joint technical missions (JTMs) to countries of high HIV disease burden. The JTMs were intended to galvanize country actions for a more comprehensive response to PMTCT and paediatric HIV by bringing national and global stakeholders together to review national policies and programmes and develop country-specific recommendations for accelerating scale-up. Between 2005 and 2010, the IATT conducted JTMs in 18 low- and middle-income countries. In 2007, to assess the role played by the missions, a review in the first eight countries (Burkina Faso, Cameroon, Côte d'Ivoire, India, Malawi, Rwanda, Tanzania and Zambia) that hosted JTMs was undertaken. Country progress was assessed through desk review and key informant interviews. For each country, documents reviewed included JTM reports, baseline data for PMTCT and paediatric HIV care and treatment, and 2004 to 2007 trend data on key PMTCT and paediatric HIV indicators. Drawing upon the findings, this paper posits that JTMs contributed to national scale-up of PMTCT and paediatric HIV programmes through strengthening governance and co-ordination mechanisms for the programmes, promoting enabling policy environments, and supporting the development of national scale-up plans, which have been critical for leveraging additional financial resources for scale-up. Although the impact of the JTMs could be enhanced through greater follow-up and continued targeted assistance in technical areas such as infant and young child feeding, community-based programming and supply chain management, findings indicate that the JTMs are a useful mechanism for informing policy and programme decisions necessary for scaling up PMTCT and paediatric HIV responses. Moreover, by bringing stakeholders together around unified action plans, the JTMs created a platform for common action-a key tenet of the 'Three Ones' principles for effective HIV/AIDS responses.

Comportamento Cooperativo , Tomada de Decisões , Infecções por HIV/transmissão , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Formulação de Políticas , Complicações Infecciosas na Gravidez , Países em Desenvolvimento , Feminino , Infecções por HIV/diagnóstico , Acesso aos Serviços de Saúde , Humanos , Gravidez , Pesquisa Qualitativa