Auditory brainstem response (ABR)
Approximately 1 of every 1000 children is born deaf. Many more are born with less severe degrees of hearing impairment, while others may acquire hearing loss during early childhood.
combination of technological advances in ABR and otoacoustic emissions (OAE) testing methods are used for evaluation of hearing in newborns.
Auditory brainstem response (ABR)
Approximately 1 of every 1000 children is born deaf. Many more are born with less severe degrees of hearing impairment, while others may acquire hearing loss during early childhood.
combination of technological advances in ABR and otoacoustic emissions (OAE) testing methods are used for evaluation of hearing in newborns.
The use of voice is an integral part of communication; our voice is one of the defining features of our individuality, and it shares a lot of information about you, your voice tells others if you are happy or sad, healthy or unwell, young or old. Our voice can also reveal to others our background, such as the region of the world where we live, and even our social economic status, when a voice produced that perceived by others as unusual or strange and draws attention to the person who is speaking, it is quite likely the person is demonstrating a voice disorder.
So, I am happy to introduce this presentation about Pubertal voice disorders & Puberphonia, I would like this presentation to be useful and add a lot of information on this topic.
Assessment of voice in professional voice usersSoorya Sunil
The assessment of voice in professional voice users is different considering the fact that they have unique vocal needs.This is a brief introduction outlining how assessment of voice should be done.
Voice therapy to treat voice disorders, basics , different techniques, methods advantages and disadvantages, where and what method to choose? otorhinolaryngology ent
Revealing and evaluating the influence of filters position in cascaded filter...nooriasukmaningtyas
In this paper, a new optimization on windowing technique based on finite
impulse response (FIR) filters is proposed for revealing and evaluating the
Influence of filters position in cascaded filter tested on the ECG signal denoising. baseline wander (BLW), power line interference (PLI) and
electromyography (EMG) noises are gettingremoved. The performance of the
adopted method is evaluated on the PTB diagnostic database. Subsequently,
the comparisons are based on signal to noise ratio (SNR) improvement and
mean square error (MSE) minimization. Where the Rectangular, and Kaiser
windows have been used for the more potent performances. The disparity
average (DA) of SNR values is detected; in both Kaiser and Rectangular
windows are assessed by ±0.38046dB and ±0.70278dB respectively, while
the MSE values were constant. The excellent configuration or filters position
(H-B-L) of the filtration system is selected according to high measurements
of SNR and low MSE too, to de-noise the ECG signals. First of all, this
applied approach has led to 31.30 dB SNR improvement with MSE
minimization of 26. 43%. This means that there is a significant contribution
to improving the field of filtration.
The use of voice is an integral part of communication; our voice is one of the defining features of our individuality, and it shares a lot of information about you, your voice tells others if you are happy or sad, healthy or unwell, young or old. Our voice can also reveal to others our background, such as the region of the world where we live, and even our social economic status, when a voice produced that perceived by others as unusual or strange and draws attention to the person who is speaking, it is quite likely the person is demonstrating a voice disorder.
So, I am happy to introduce this presentation about Pubertal voice disorders & Puberphonia, I would like this presentation to be useful and add a lot of information on this topic.
Assessment of voice in professional voice usersSoorya Sunil
The assessment of voice in professional voice users is different considering the fact that they have unique vocal needs.This is a brief introduction outlining how assessment of voice should be done.
Voice therapy to treat voice disorders, basics , different techniques, methods advantages and disadvantages, where and what method to choose? otorhinolaryngology ent
Revealing and evaluating the influence of filters position in cascaded filter...nooriasukmaningtyas
In this paper, a new optimization on windowing technique based on finite
impulse response (FIR) filters is proposed for revealing and evaluating the
Influence of filters position in cascaded filter tested on the ECG signal denoising. baseline wander (BLW), power line interference (PLI) and
electromyography (EMG) noises are gettingremoved. The performance of the
adopted method is evaluated on the PTB diagnostic database. Subsequently,
the comparisons are based on signal to noise ratio (SNR) improvement and
mean square error (MSE) minimization. Where the Rectangular, and Kaiser
windows have been used for the more potent performances. The disparity
average (DA) of SNR values is detected; in both Kaiser and Rectangular
windows are assessed by ±0.38046dB and ±0.70278dB respectively, while
the MSE values were constant. The excellent configuration or filters position
(H-B-L) of the filtration system is selected according to high measurements
of SNR and low MSE too, to de-noise the ECG signals. First of all, this
applied approach has led to 31.30 dB SNR improvement with MSE
minimization of 26. 43%. This means that there is a significant contribution
to improving the field of filtration.
A new eliminating EOG artifacts technique using combined decomposition method...TELKOMNIKA JOURNAL
Normally, the collected EEG signals from the human scalp cortex by using the non-invasive EEG collection methods were contaminated with artifacts, like an eye electrical activity, leading to increases in the challenges in analyzing the electroencephalogram for obtaining useful clinical information. In this paper, we do a comparison of using two decomposing methods (DWT and EMD) with CCA technique or High Pass Filter, for the elimination of eye artifacts from EEG. The eye artifacts (EOG) signals were extracted from the un-cleaned or raw EEG signals by DWT and EMD with CCA approach or H.P.F. The root means square error ratio of the uncontaminated EEG signal to the contaminated EEG signal with eye artifacts were the performance indicators for both elimination methods, which indicate that the combined CCA method outperforms the combined H.P.F method in the elimination of eye blinking contamination artifact from the EEG signal.
ECochG is a variant of brainstem audio evoked response (ABR) where the recording electrode is placed as close as practical to the cochlea. We will use the abbreviation ECOG and ECochG interchangeably below. ECOG is preferable to us as it is shorter.
ECOG is intended to diagnose Meniere's disease, and particular, hydrops (swelling of the inner ear). ECOG may also be abnormal in perilymph fistula, and in superior canal dehiscence. The common feature connecting these illnesses is an imbalance in pressure between the endolymphatic and perilymphatic compartment of the inner ear.
ECOG can also be used to show that the cochlea is normal, in persons who are deaf. The cochlear microphonic of ECOG may be normal in auditory neuropathy (Santarelli and Arslan 2002) as well as other disorders in which the cochlea is preserved but the auditory nerve is damaged (Yokoyama, Nishida et al. 1999).
Finally, ECOG's have also been used to as a indicator of the temporary threshold shift that may follow noise injury (Nam et al, 2004).
Significant variables extraction of post-stroke EEG signal using wavelet and ...TELKOMNIKA JOURNAL
Stroke patients require a long recovery. One success of the treatment given is the evaluation and
monitoring during recovery. One device for monitoring the development of post-stroke patients is
Electroencephalogram (EEG). This research proposed a method for extracting variables of EEG signals for
post-stroke patient analysis using Wavelet and Self-Organizing Map Kohonen clustering. EEG signal was
extracted by Wavelet to obtain Alpha, beta, theta, gamma, and Mu waves. These waves, the amplitude
and asymmetric of the symmetric channel pairs are features in Self Organizing Map Kohonen Clustering.
Clustering results were compared with actual clusters of post-stroke and no-stroke subjects to extract
significant variable. These results showed that the configuration of Alpha, Beta, and Mu waves, amplitude
together with the difference between the variable of symmetric channel pairs are significant in the analysis
of post-stroke patients. The results gave using symmetric channel pairs provided 54-74% accuracy.
The Effect of Kronecker Tensor Product Values on ECG Rates: A Study on Savitz...IIJSRJournal
This article presents a study on ECG signal filtering algorithms to denoise signals corrupted by various types of noise sources. The study also examines the effect of Kronecker tensor product values on ECG rates. The study is conducted in a Matlab environment, and the results demonstrate that a constant number for the respective codes can effectively denoise ECG signals without any trouble. These findings have significant implications for diagnosing abnormal heart rhythms and investigating chest pains. The present study is novel in that it explores the relationship between ECG rate and Kronecker delta values across different age groups, which has not been extensively studied in previous literature. The study's unique contribution is the determination of age-specific values of the constant K required to represent this relationship accurately in different populations, which could inform the development of more effective algorithms for denoising ECG signals in clinical settings. Additionally, this study's finding of an inverse relationship between ECG rate and Kronecker delta values could have broader implications for understanding the physiological factors that contribute to variability in ECG measurements. The study provides valuable insights into ECG signal processing and suggests that the implemented techniques can improve the accuracy of ECG signal analysis in real-time clinical settings. Overall, the manuscript is a valuable contribution to the field of biomedical signal processing and provides important information for researchers and healthcare professionals.
EEG based Brain Computer Interface (BCI) establishes a new channel between human brain and the
surrounding environment in order to disseminate instructions to the outside world. It is based on the
recording of temporary EEG changes during different types of motor imagery such as imagination of
different hand movements. The spatial pattern of activated cortical areas during motor imagery is similar
to that of real time executed movement. Time domain features and frequency domain features are extracted
with emphasis on recognizing discriminative features representing EEG trials recorded during imagination
of different hand movements. Then, classification into different hand movements is carried out.
Removal of artifacts in EEG by averaging andNamratha Dcruz
This is a presentation on removal of artifacts in EEG by averaging and adaptive algorithms which covers a small topic in the elective Bio medical signal processing for M.Tech in Signal Processing
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
1. Topic – Electroglottography & Inverse Filtering Procedures
Submitted To – Mrs. Garima Dixit Garge
Presented By – Mr. Piyush Malviya
2. ELECTROGLOTTOGRAPHY -
Electroglottography (EGG) is a noninvasive technique for obtaining an estimate of vocal fold
contact patterns during phonation.
A gold electrode is placed on each side of the thyroid cartilage at a level corresponding to
the position of the vocal folds.
A weak high‐frequency electrical current is passed between the electrodes.
As vocal fold contact area changes, there are changes in the electrical resistance between the
electrodes.
When the glottis is opening or open, resistance increases; when the glottis is closing or
closed, resistance decreases.
The resulting Lx waveform, called an electroglottogram or laryngogram, reveals summary
information about vocal fold contact over time.
The EGG can be used to visualize various types of voice quality. For example, Figure 6.14
shows electroglottograms for a prolonged /i/ vowel produced with a normal voice quality, a
breathy voice quality, and a hoarse voice quality.
3. Electroglottography (EGG) is a technique for the measurement of vocal fold contact area based
on the principle that tissue conducts current.
A high frequency low current signal is passed between the vocal folds via electrodes located
on the externa neck over the thyroid lamina.
When the vocal folds touch, greater current flows than when they are open.
There 13 a proportional variation of current when the vocal folds are less than maximally open
or closed.
4.
5. Electroglottographic recordings can be used to determine when the vocal folds are closed and
how fast they are closing.
If carefully interpreted, it is possible to determine characteristics of the opening of the vocal
folds from an electroglottographic recording.
Devices to record the electroglottographic signal are readily available.
Currently these include the Voiscope and Laryngograph (Laryngograph, Ltd.), the single
channel SCI or the dual channel MCZ-l (Glottal Enterprises), and the unit from F] Electronics.
Electrical output of the electroglottograph can easily be converted to hard copy using
oscillograph or similar graphic recording device, or from a computer generated display.
The literature on EGG is primarily qualitative in nature, based on interpretation of the
waveform.
Several studies have related the shape of the EGG waveform to the underlying physiology of
vocal fold vibration.
Information has also been reported on characteristic waveforms in patients with vocal
pathology.
6. There have been many attempts to quantify the electroglottograph signal.
EGG reflects the state of the vocal folds in a way that can be easily demonstrated and
interpreted to patients.
However, a limitation of the technique is that it cannot be used with all patients.
Because the technique depends on vocal fold contact, the signal is considerably diminished
or even absent in patients with lack of good contact, such as those with unilateral paralysis, or
aphonia.
It may also be difficult to obtain a clear waveform in the presence of severe hoarseness.
The thick or large necks of some patients hinder transduction of the current and result in a
poor EGG tracing.
Manufacturers of EGGS have greatly enhanced its clinical value. For example, the MCZ-l EGG
made by Glottal Enterprises uses two identical circuits and two sets of electrodes.
The output of each electrode pair is compared and displayed 'on a meter. When the meter
reading is O, the output of the two channels is identical and the vocal folds are centered
between the two electrode pairs.
This simple monitoring device helps to insure the proper placement of the electrodes and an
optimal EGG signal.
7. INVERSE FILTERING PROCEDURES –
In the inverse filtering procedure, the voice signal emitted at the lips is analyzed to
remove the resonant effects of the vocal tract, producing an estimate of the waveform
produced at the waveform.
According to the acoustic theory of speech production, speech is the product of a sound
source and a filter.
That is, the sound output of the vocal folds is modified by the resonant characteristics of
the vocal tract.
If the resonant characteristics of the vocal tract are known, it should be possible to
retrieve the characteristics of the output of the vocal folds from the orally emitted
speech signal.
Inverse filtering has been performed on the acoustic sound pressure waveform.
We have used the airflow waveform for inverse filtering of normal and voice-disordered
subjects.
We routinely record the EGG signal simultaneously with the inverse filtered airflow signal
to extract information about the vibratory characteristics of the vocal folds during the
complete cycle.
8. The techniques complement each other in that airflow will often not be present during
the closed phase of the vocal folds, but the EGG provides information about vibratory
characteristics of the vocal folds during that phase.
Thus, with both techniques, we are able to obtain a more complete picture of vocal fold
vibratory characteristics during speech.
The result of inverse filtering the oral airflow waveform is called a flow glottogram and an
example is shown in Figure 7.13.
Four channels are collected directly into the computer using CSpeech.
These are the (a) acoustic waveform, (b) raw oral airflow waveform, (c) EGG waveform,
and (d) intraoral air pressure pulses associated with the stop plosives in the utterance
(not shown in Figure 7.13 but see Figure 7.14).
9.
10.
11. The oral airflow waveform is inverse filtered using CGlott, a computer program
separate from but complementary to CSpeech.
The result is the inverse filtered or flow glottogram shown in Figure 7.13.
Collection of electroglottographic and inverse filtered airflow waveforms is routine
in our clinic.
The following measures are obtained from computer-assisted analysis of the
waveform: (a) each cycle’s minimum (or leakage) and ac airflows, (b) the ratio of the
time of the airflow pulse relative to the total period (airflow duty cycle), (c) the ratio
of the closing and opening slopes of the airflow pulse (airflow speed quotient), (d)
the ratio of the open time to the total period of the electroglottographic waveform
(abduction quotient),(e) the closing time of the electroglottogram waveform, and
(f) lung pressure.
12. REFERENCES
Boone, D. R., McFarlane, S. C, Von Berg, S. L. & Zraick, R, I. (2013): The Voice and
Voice Therapy. (9th Ed.). Englewood Cliffs, Prentice-Hall, Inc. New Jersy.
Colton, R. H, Casper, J. K. & Leonard, R. (2006). Understanding voice problems.
Baltimore: Williams & Wilkins.