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Nature Aug 2023Speech brain-computer interfaces (BCIs) have the potential to restore rapid communication to people with paralysis by decoding neural activity evoked by attempted speech...
Speech brain-computer interfaces (BCIs) have the potential to restore rapid communication to people with paralysis by decoding neural activity evoked by attempted speech into text or sound. Early demonstrations, although promising, have not yet achieved accuracies sufficiently high for communication of unconstrained sentences from a large vocabulary. Here we demonstrate a speech-to-text BCI that records spiking activity from intracortical microelectrode arrays. Enabled by these high-resolution recordings, our study participant-who can no longer speak intelligibly owing to amyotrophic lateral sclerosis-achieved a 9.1% word error rate on a 50-word vocabulary (2.7 times fewer errors than the previous state-of-the-art speech BCI) and a 23.8% word error rate on a 125,000-word vocabulary (the first successful demonstration, to our knowledge, of large-vocabulary decoding). Our participant's attempted speech was decoded at 62 words per minute, which is 3.4 times as fast as the previous record and begins to approach the speed of natural conversation (160 words per minute). Finally, we highlight two aspects of the neural code for speech that are encouraging for speech BCIs: spatially intermixed tuning to speech articulators that makes accurate decoding possible from only a small region of cortex, and a detailed articulatory representation of phonemes that persists years after paralysis. These results show a feasible path forward for restoring rapid communication to people with paralysis who can no longer speak.
Topics: Humans; Amyotrophic Lateral Sclerosis; Brain-Computer Interfaces; Cerebral Cortex; Microelectrodes; Paralysis; Speech; Vocabulary; Neural Prostheses
PubMed: 37612500
DOI: 10.1038/s41586-023-06377-x -
Nature Aug 2023Speech neuroprostheses have the potential to restore communication to people living with paralysis, but naturalistic speed and expressivity are elusive. Here we use...
Speech neuroprostheses have the potential to restore communication to people living with paralysis, but naturalistic speed and expressivity are elusive. Here we use high-density surface recordings of the speech cortex in a clinical-trial participant with severe limb and vocal paralysis to achieve high-performance real-time decoding across three complementary speech-related output modalities: text, speech audio and facial-avatar animation. We trained and evaluated deep-learning models using neural data collected as the participant attempted to silently speak sentences. For text, we demonstrate accurate and rapid large-vocabulary decoding with a median rate of 78 words per minute and median word error rate of 25%. For speech audio, we demonstrate intelligible and rapid speech synthesis and personalization to the participant's pre-injury voice. For facial-avatar animation, we demonstrate the control of virtual orofacial movements for speech and non-speech communicative gestures. The decoders reached high performance with less than two weeks of training. Our findings introduce a multimodal speech-neuroprosthetic approach that has substantial promise to restore full, embodied communication to people living with severe paralysis.
Topics: Humans; Cerebral Cortex; Clinical Trials as Topic; Communication; Deep Learning; Face; Gestures; Movement; Neural Prostheses; Paralysis; Speech; Vocabulary; Voice
PubMed: 37612505
DOI: 10.1038/s41586-023-06443-4 -
Revista Gaucha de Enfermagem 2023To analyze the evidence of content validity of telephone messages regarding preventive measures against COVID-19. (Review)
Review
OBJECTIVE
To analyze the evidence of content validity of telephone messages regarding preventive measures against COVID-19.
METHOD
Methodological study, in which messages containing text and image were developed through a narrative literature review and whose content was evaluated by eight judges in terms of clarity, practical relevance, theoretical relevance and vocabulary. The content validity index (CVI) was calculated, and messages that reached levels above 90% were considered to have adequate evidence of validity.
RESULTS
Eighteen text messages/images were developed containing information about COVID-19, hand hygiene, use and handling of masks and the importance of social distancing. After second round of evaluation, a content validity index above 90% was obtained in all evaluated indicators.
CONCLUSION
The telephone messages were developed and showedadequate evidence of content validity.
Topics: Humans; COVID-19; Hand Hygiene; Masks; Physical Distancing; Telephone
PubMed: 37672404
DOI: 10.1590/1983-1447.2023.20220328.en -
Journal of Infection and Public Health Jul 2023The use of central venous catheters (CVC) is associated with higher morbidity and mortality, related to infectious complications, contributing to poorer clinical... (Review)
Review
BACKGROUND
The use of central venous catheters (CVC) is associated with higher morbidity and mortality, related to infectious complications, contributing to poorer clinical outcomes and increased healthcare costs. According to the literature, the incidence of local infections related to CVC for hemodialysis is highly variable. This variability is related to differences in definitions of catheter-related infections.
OBJECTIVE
To identify signs and symptoms for determining local infections (exit site and tunnel tract infections) used in the literature in tunnelled and nontunnelled CVC for hemodialysis.
DESIGN
Systematic review METHODS: Structured electronic searches were conducted in five electronic databases, from 1 January 2000-31 August 2022, using key words and specific vocabulary, as well as manual searches in several journals. Additionally, vascular access clinical guidelines and infection control clinical guidelines were reviewed.
RESULTS
After validity analysis, we selected 40 studies and seven clinical guidelines. The definitions of exit site infection and tunnel infection used in the different studies were heterogeneous. Among the studies, seven (17,5 %) used the definitions of exit site and tunnel infection based on a clinical practice guideline. Three of the studies (7.5 %) used the Twardowski scale definition of exit site infection or a modification. The remaining 30 studies (75 %) used different combinations of signs and symptoms.
CONCLUSIONS
Definitions of local CVC infections are highly heterogeneous in the revised literature. It is necessary to establish a consensus regarding the definitions of hemodialysis CVC exit site and tunnel infections.
REGISTRATION
PROSPERO (CRD42022351097).
Topics: Humans; Central Venous Catheters; Renal Dialysis; Catheter-Related Infections; Risk Assessment; Incidence; Catheters, Indwelling
PubMed: 37178476
DOI: 10.1016/j.jiph.2023.04.012 -
Frontiers in Psychology 2023Writing difficulties frequently manifest comorbidly with reading challenges, and reading is implicated in particular acts of writing, such as reviewing and editing....
INTRODUCTION
Writing difficulties frequently manifest comorbidly with reading challenges, and reading is implicated in particular acts of writing, such as reviewing and editing. Despite what is known, however, there remain significant barriers to understanding the nature of reading-writing relations, as few studies are comprehensive in the number and types of literacy skills evaluated. This study consists of a secondary data analysis of two studies employing structural equation modeling (SEM) to evaluate relations among reading and writing components skills independently, using the Direct and Inferential Mediation Model (DIME) of reading comprehension and Not-so-Simple View of Writing (NSVW) as theoretical frameworks.
METHODS
We examine relations between reading and writing components from these models with a sample of upper elementary students with/at-risk for learning disabilities ( = 405). Lower-order components included word reading, vocabulary, handwriting and spelling. Higher-order components included background knowledge, reading strategies, inferencing, planning, editing, and revision. The literacy outcomes were oral and silent reading fluency, reading comprehension, and writing quality and productivity. We systematically build a Reading-to-Writing Mediation (RWM) model by first merging the DIME and NSVW components in a direct effects model (Aim 1), expanding the joint model to include reading and writing fluency (Aim 2), evaluating indirect effects between DIME and NSVW component skills (Aim 3), and finally, evaluating indirect effects with reading and writing fluency (Aim 4).
RESULTS
The findings suggest that higher order fluency and comprehension skills are differentially related to writing activities and products.
DISCUSSION
The pattern of results helps elucidate the mechanisms of how various reading and writing skills transfer and relate. The results have implications for targeted and implicit instruction in multicomponent interventions and the use of screeners to identify areas of risk.
PubMed: 37457074
DOI: 10.3389/fpsyg.2023.1033970 -
Heliyon Apr 2024Rotenone is a toxic chemical found in various plants, including some used as food. Rotenone poisoning can be fatal and there is no antidote. Mechanistically, rotenone...
CONTEXT
Rotenone is a toxic chemical found in various plants, including some used as food. Rotenone poisoning can be fatal and there is no antidote. Mechanistically, rotenone inhibits mitochondrial complex I, leading to reduced ATP production, compensatory glycolytic upregulation and secondary lactate production, and oxidative stress. Our literature review examined acute rotenone poisoning in humans, including exposure scenarios, clinical presentations, and treatments.
METHODS
We searched five databases for relevant literature from database inception through the search date: July 12, 2022, pairing controlled vocabulary and keywords for "rotenone" with terms relating to human exposures and outcomes, such as "ingestion," "exposure," and "poisoning." We included all peer-reviewed reports found using the search terms where the full English text was available. Data abstracted included the number, age, weight, and sex of the exposed person(s), country where exposure happened, exposure scenario, ingestion context, estimated dose, clinical features, whether hospitalization occurred, treatments, and outcomes.
RESULTS
After removing non-qualifying sources from 2,631 publications, we identified 11 case reports describing 18 victims, 15 of whom were hospitalized and five died. Most cases occurred in private quarters where victims unknowingly consumed rotenone-containing plants. Vomiting and metabolic acidosis occurred most commonly. Some patients exhibited impaired cardiopulmonary function. Supportive treatment addressed symptoms and included gastric lavage and/or activated charcoal to remove rotenone from the stomach, vasopressors for hypotension, mechanical ventilation for respiratory insufficiency, and sodium bicarbonate for acidosis. Some patients received N-acetylcysteine to counter oxidative stress.
CONCLUSIONS
Rotenone poisoning, though rare, can be fatal. Exposure prevention is impractical since rotenone is found in some plants used as food or pesticides. Cases may be under-diagnosed because symptoms are non-specific and under-reported in English-language journals since most cases occurred in non-English speaking countries. Treatments are supportive. Exploring antioxidant therapy in animal models of rotenone poisoning may be indicated considering rotenone's mechanism of toxicity.
PubMed: 38633629
DOI: 10.1016/j.heliyon.2024.e28334 -
Journal of Speech, Language, and... Sep 2023This study explored approaches for measuring vocabulary among bilingual children with varying levels of proficiency in Spanish and English.
PURPOSE
This study explored approaches for measuring vocabulary among bilingual children with varying levels of proficiency in Spanish and English.
METHOD
One hundred fifteen kindergarten and first-grade Spanish-English-speaking children completed measures of vocabulary and sentence repetition in Spanish and English. Scores were derived from their responses to the vocabulary measure: Spanish-only vocabulary, English-only vocabulary, conceptual vocabulary, and total vocabulary. Best language sentence repetition was also obtained. Using both visualization of data and statistical analysis, we tested for potential associations between children's relative language skills in Spanish and English and the scores they received on each of the vocabulary metrics.
RESULTS
Participants' single-language vocabulary scores were linearly associated with their relative language scores. Higher relative Spanish language skills corresponded with higher Spanish-only vocabulary scores, and higher English language skills corresponded with higher English-only vocabulary scores. A quadratic association between children's relative language and their conceptual vocabulary scores was observed. Children with more balanced skills in Spanish and English received lower scores for conceptual vocabulary. No association between total vocabulary and relative language was observed.
CONCLUSIONS
Results revealed evidence of differential test bias for single-language vocabulary scores and conceptual vocabulary scores. Spanish-only vocabulary underestimated knowledge of participants with higher English proficiency, whereas English-only vocabulary underestimated knowledge of participants with higher Spanish proficiency. Conceptual scoring yielded lower values for participants with relatively balanced proficiency in Spanish and English. There is need for further consideration of score and test functioning across the full continuum of bilinguals with dynamic proficiencies in each of their languages.
SUPPLEMENTAL MATERIAL
https://doi.org/10.23641/asha.23796330.
Topics: Child; Humans; Vocabulary; Multilingualism; Hispanic or Latino; Language Tests; Language
PubMed: 37541317
DOI: 10.1044/2023_JSLHR-22-00573 -
NeuroImage Aug 2023Microstates represent electroencephalographic (EEG) activity as a sequence of switching, transient, metastable states. Growing evidence suggests the useful information...
Microstates represent electroencephalographic (EEG) activity as a sequence of switching, transient, metastable states. Growing evidence suggests the useful information on brain states is to be found in the higher-order temporal structure of these sequences. Instead of focusing on transition probabilities, here we propose "Microsynt", a method designed to highlight higher-order interactions that form a preliminary step towards understanding the syntax of microstate sequences of any length and complexity. Microsynt extracts an optimal vocabulary of "words" based on the length and complexity of the full sequence of microstates. Words are then sorted into classes of entropy and their representativeness within each class is statistically compared with surrogate and theoretical vocabularies. We applied the method on EEG data previously collected from healthy subjects undergoing propofol anesthesia, and compared their "fully awake" (BASE) and "fully unconscious" (DEEP) conditions. Results show that microstate sequences, even at rest, are not random but tend to behave in a more predictable way, favoring simpler sub-sequences, or "words". Contrary to high-entropy words, lowest-entropy binary microstate loops are prominent and favored on average 10 times more than what is theoretically expected. Progressing from BASE to DEEP, the representation of low-entropy words increases while that of high-entropy words decreases. During the awake state, sequences of microstates tend to be attracted towards "A - B - C" microstate hubs, and most prominently A - B binary loops. Conversely, with full unconsciousness, sequences of microstates are attracted towards "C - D - E" hubs, and most prominently C - E binary loops, confirming the putative relation of microstates A and B to externally-oriented cognitive processes and microstate C and E to internally-generated mental activity. Microsynt can form a syntactic signature of microstate sequences that can be used to reliably differentiate two or more conditions.
Topics: Humans; Electroencephalography; Brain; Brain Mapping; Wakefulness; Propofol
PubMed: 37286153
DOI: 10.1016/j.neuroimage.2023.120196