Omalizumab discontinuation in children with severe allergic asthma: an observational real life study

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Data-Driven Classification of Dysarthria Profiles in Children With Cerebral Palsy

Purpose

The objectives of this study were to examine different speech profiles among children with dysarthria secondary to cerebral palsy (CP) and to characterize the effect of different speech profiles on intelligibility.

Method

Twenty 5-year-old children with dysarthria secondary to CP and 20 typically developing children were included in this study. Six acoustic and perceptual speech measures were selected to quantify a range of segmental and suprasegmental speech characteristics and were measured from children's sentence productions. Hierarchical cluster analysis was used to identify naturally occurring subgroups of children who had similar profiles of speech features.

Results

Results revealed 4 naturally occurring speech clusters among children: 1 cluster of children with typical development and 3 clusters of children with dysarthria secondary to CP. Two of the 3 dysarthria clusters had statistically equivalent intelligibility levels but significantly differed in articulation rate and degree of hypernasality.

Conclusion

This study provides initial evidence that different speech profiles exist among 5-year-old children with dysarthria secondary to CP, even among children with similar intelligibility levels, suggesting the potential for developing a pediatric dysarthria classification system that could be used to stratify children with dysarthria into meaningful subgroups for studying speech motor development and efficacy of interventions.

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Identification of Affective State Change in Adults With Aphasia Using Speech Acoustics

Purpose

The current study aimed to identify objective acoustic measures related to affective state change in the speech of adults with post-stroke aphasia.

Method

The speech of 20 post-stroke adults with aphasia was recorded during picture description and administration of the Western Aphasia Battery–Revised (Kertesz, 2006). In addition, participants completed the Self-Assessment Manikin (Bradley & Lang, 1994) and the Stress Scale (Tobii Dynavox, 1981–2016) before and after the language tasks. Speech from each participant was used to detect a change in affective state test scores between the beginning and ending speech.

Results

Machine learning revealed moderate success in classifying depression, minimal success in predicting depression and stress numeric scores, and minimal success in classifying changes in affective state class between the beginning and ending speech.

Conclusions

The results suggest the existence of objectively measurable aspects of speech that may be used to identify changes in acute affect from adults with aphasia. This work is exploratory and hypothesis-generating; more work will be needed to make conclusive claims. Further work in this area could lead to automated tools to assist clinicians with their diagnoses of stress, depression, and other forms of affect in adults with aphasia.

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School-Aged Children's Phonological Accuracy in Multisyllabic Words on a Whole-Word Metric

Purpose

The purpose of this study is to examine differences in phonological accuracy in multisyllabic words (MSWs) on a whole-word metric, longitudinally and cross-sectionally, for elementary school–aged children with typical development (TD) and with history of protracted phonological development (PPD).

Method

Three mismatch subtotals, Lexical influence, Word Structure, and segmental Features (forming a Whole Word total), were evaluated in 3 multivariate analyses: (a) a longitudinal comparison (n = 22), at age 5 and 8 years; (b) a cross-sectional comparison of 8- to 10-year-olds (n = 12 per group) with TD and with history of PPD; and (c) a comparison of the group with history of PPD (n = 12) with a larger 5-year-old group (n = 62).

Results

Significant effect sizes (η_p ²) found for mismatch totals were as follows: (a) moderate (Lexical, Structure) and large (Features) between ages 5 and 8 to 10 years, mismatch frequency decreasing developmentally, and (b) large between 8- to 10-year-olds with TD and with history of PPD (Structure, Features; minimal lexical influences), in favor of participants with TD. Mismatch frequencies were equivalent for 8- to 10-year-olds with history of PPD and 5-year-olds with TD. Classification accuracy in original subgroupings was 100% and 91% for 8- to 10-year-olds with TD and with history of PPD, respectively, and 86% for 5-year-olds with TD.

Conclusion

Phonological accuracy in MSW production was differentiated for elementary school–aged children with TD and PPD, using a whole-word metric. To assist with the identification of children with ongoing PPD, the metric has the ability to detect weaknesses and track progress in global MSW phonological production.

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Philtrum reconstruction in unilateral cleft lip repair

The philtrum is an important aesthetic structure in the midface. A number of philtrum reconstruction techniques have been advocated for secondary cleft lip revision procedures. Conventional surgical management involves end-to-end orbicularis oris muscle approximation during primary cleft lip repair, often resulting in a flat lip appearance that requires secondary revision surgery at a later stage. A novel modification of the approximation of the orbicularis oris muscle is described that may be implemented with any cleft lip technique in order to create an accentuated philtrum column for a natural looking philtrum.

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Fluorescence imaging of invasive head and neck carcinoma cells with integrin αvβ6-targeting RGD-peptides: an approach to a fluorescence-assisted intraoperative cytological assessment of bony resection margins

We assessed the use of peptides containing arginylglycylaspartic acid (RGD) that target integrin αvβ6 as a potential approach for a fluorescence-assisted intraoperative cytological assessment of bony resection margins (F-AICAB) in patients who had bone-infiltrating squamous cell carcinoma (SCC) of the head and neck. This was assessed to demarcate invasive carcinoma cells that stained for αvβ6. Specimens from bony resection margins (n=362) were defined as either malignant or benign according to the results of cytological and histological examinations.

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Induction of smell through transethmoid electrical stimulation of the olfactory bulb

Background

Anosmia has an estimated prevalence of 5% of the general population. Outside of inflammatory causes, therapeutic options are limited despite research advances. Bypassing peripheral neuronal damage through central stimulation is a potential therapeutic option that has shown success in other sensory systems, most notably with hearing. We performed a pilot study to determine the feasibility of inducing smell through artificial electrical stimulation of the olfactory bulbs in humans.

Methods

Subjects with a history of sinus surgery, including total ethmoidectomy, with intact ability to smell were enrolled. The ability to smell was confirmed with a 40‐item smell identification test. Awake subjects underwent nasal endoscopy and either a monopolar or bipolar electrode was positioned at 3 areas along the lateral lamella of the cribriform plate within the ethmoid sinus cavity. A graded stimulation current of 1–20 mA at 3.17 Hz was administered while cortical evoked potential (CEP) recordings were collected. Subjective responses of perceived smell along with reports of discomfort were recorded. Subjects with artificially induced smell underwent repeat stimulation after medically induced anosmia.

Results

Five subjects (age, 43–72 years) were enrolled. Three subjects reported smell perception smell with electrical stimulation. This was reproducible after inducing anosmia, but CEP recordings could not provide objective support. All subjects tolerated the study with minimal discomfort.

Conclusion

This is the first report of induced smell through transethmoid electrical stimulation of the olfactory bulb. These results provide a proof of concept for efforts in development of an olfactory implant system.

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