U Barillari

Spatio-temporal hotspots and application on a disease analysis case via GIS

Hotspot analysis is a spatial analysis that uses cluster techniques for determining areas with elevated concentrations of localized events. We use the consolidated Extended Fuzzy C-Means algorithm to determine the hotspot areas on the map as circles, moreover the advantages of this technique are the linear computational complexity, the robustness to noise and outliers, the automatic determination of the optimal number C of clusters (in the classical FCM algorithm C is chosen a priori). Furthermore it prevents the problem of shifting the clusters with low density area of data points in areas with higher density of such points. We apply this method to study the spatio-temporal variations of the hotspot areas by testing this process on a specific disease problem, precisely we have clusterized 5,000 point-events correspondent to cases of brain cancer detected in the state of New Mexico from 1973 to 1991. We also show that the same results are obtained by using the Extended Gustafson–Kessel algorithm which gives elliptical clusters. We have implemented both algorithms in a Geographic Information System environment. Thus we establish the areas which seem not interested from the incidence of the disease and those areas in which the phenomenon appears to be temporarily attenuated either increased or constant or quite disappeared.

Communication and its disorders: Definition and taxonomy from a phoniatric perspective

Abstract Objective: The aim of the paper is to describe communication sciences and disorders from a phoniatric perspective, i.e. from the point of view of medical doctors involved in the rehabilitation management of a communication disorder. Communication: Communication is a complex behaviour, combining physical and mental events, with the aim of exchanging messages between two or more individuals. Communication is the execution of a task by an individual in his daily life. Different body structures and functions, as well as environmental factors, strongly impact on communication and related activities. Communication disorders: A communication disorder is an impairment in sending and/or receiving a message; it could be the consequence of a disease, a treatment or an environmental situation. There are several professions, both medical and non-medical, involved in the management of patients with a communication disorder. The phoniatrician is the only medical doctor whose focus is the diagnosis and rehabilitation of communication disorders. Taxonomy of communication disorders: There are several diseases, conditions and situations that can lead to a limitation and/or restriction in communication. A list of diseases would be misleading in describing possible communication disorders; it might be more useful to offer a framework of the impaired functions that may lead to a communication disorder. A communication disorder taxonomy based on the direct and indirect impairment of voice, speech, language and hearing functions is presented. Conclusion: The presented taxonomy may contribute to the assessment and management of patients with communication disorders and represents a framework for clinical research in the different disciplines involved in the large field of communication science and disorders.

WebGIS based on spatio-temporal hot spots: an application to oto-laryngo-pharyngeal diseases

We present a web geo-spatial framework for analyzing and continuously monitoring the spatio-temporal evolution of disease hot spots for detecting spatial areas with high concentrations of events in a geographic information system (GIS). To detect the hot spots, we adopt Extended Fuzzy C-Means algorithm. Each event is given by the geo-positional coordinates of the place of residence of the patient. The analyst can insert event data directly on the map or digitizing the address of the residence of the patient and using geo-coding services for locating the event. In our experiments, the data consist of geo-referenced patterns corresponding to the residence of patients in the district of Naples (Italy) submitted to a surgical intervention concerning the oto-laryngo-pharyngeal apparatus between the years 2008 and 2012. The results show the presence of two greatest hot spots: the first covers a geographical area that affects the city of Naples, the second covers parts of various towns around the famous vulcan Vesuvius, respectively.

Spatiotemporal hotspots analysis for exploring the evolution of diseases: an application to oto-laryngopharyngeal diseases

This paper presents a spatiotemporal analysis of hotspot areas based on the Extended Fuzzy C-Means method implemented in a geographic information system. This method has been adapted for detecting spatial areas with high concentrations of events and tested to study their temporal evolution. The data consist of georeferenced patterns corresponding to the residence of patients in the district of Naples (Italy) to whom a surgical intervention to the oto-laryngopharyngeal apparatus was carried out between the years 2008 and 2012.

THE FIRST CASE OF OSTEOMA IN THE FALSE VOCAL FOLD

OBJECTIVES This article reports the first evidence of a larynx osteoma of the false vocal fold. STUDY DESIGN Case report and literature review. METHODS Case report and review of previously published cases of larynx osteomas. RESULTS A 79-year-old patient was referred to our institution for dysphagia and hoarseness. Fibrolaryngoscopy showed a regular surface tumefaction of the false fold and the left ventricle, with preserved cordal motility. Patient underwent direct laryngoscopy with CO(2) laser excision of the lesion. Pathologic examination of the lesion (1.6cmx1cm) showed features consistent with an osteoma. Complete regression of symptoms was observed after surgery, with no lesions found on routine 1-year follow-up. CONCLUSIONS Osteomas are benign, slow growing tumors of the craniofacial bone area, very rarely located in the larynx. Although the etiology is unknown, accepted theories point to embryologic, post-traumatic and infectious causes. Surgical excision is indicated only in symptomatic cases. This case report is the fourth evidence of laryngeal osteoma and, to our knowledge, the first finding of a false vocal fold osteoma.

Speech-Language Evaluation and Rehabilitation Treatment in Floating-Harbor Syndrome: A Case Study.

UNLABELLED Floating-Harbor syndrome is a rare congenital disorder characterized by specific facial features, short stature associated with significantly delayed bone age and language impairment. Although language delay is a cardinal manifestation of this syndrome, few reports describe the specific language difficulties of these patients, particularly the development of language abilities in the long run. This paper reports on an Italian boy with Floating-Harbor syndrome and discusses his language evaluation at presentation (age 48 months) and development and progress of his language abilities after 4 years of rehabilitation treatment. At presentation he exhibited borderline mental retardation, with verbal abilities lower than performance abilities. He showed significant impairment of both expressive and receptive language, and also exhibited phonologic and articulations problems that lowered speech intelligibility. Neuropsychological assessment revealed cognitive problems. After speech-language rehabilitation treatment, he achieved significant improvement in language function. LEARNING OUTCOMES The reader will learn about (1) the distinctive clinical characteristics and (2) the speech-language abilities and their development after speech-language therapy in Floating-Harbor syndrome.

Normative and validation data of an articulation test for Italian-speaking children

OBJECTIVES As a standardized instrument to assess speech sound development in Italian-speaking children is currently lacking, norms used to diagnose speech sound disorders (SSD) are mainly based on studies including English-speaking participants. This application may result in misidentification of SSD due to linguistic differences. The aims of the study were to establish normative data on speech sound development of Italian-speaking children and to evaluate psychometric properties of Rossis articulation test, the picture-naming test selected to assess speech sound development. METHODS A cross-sectional study including 694 normally-developing Italian-speaking children aged from 3 to 7 years was conducted. Children were administered Rossis articulation test, and percentages of speech sound correct production were calculated. To evaluate inter-rater reliability of the test, audio-recordings of 50 children were scored by an additional examiner. The same rater scored the audio-recordings of 50 children twice with an interval of at least 1 week. To evaluate test-retest reliability, 144 participants were re-tested after 1-3 weeks by the same assessor. Scores were compared through Intraclass Correlation Coefficient (ICC). To assess construct validity, the developmental progression of total scores across age groups was verified by the estimation of the reference range for the test, using a regression procedure. RESULTS Almost all Italian children in the sample produced vowels and approximants correctly. Singleton consonants were acquired before consonant clusters. Ages of acquisition of each consonant were presented: plosives and nasals were early mastered by Italian children, while dental affricates, alveolar fricatives and the palatal lateral were the latest acquired segments. All ICCs were superior to 0.9 (reliability). A statistically significant improvement in test score with age was found (construct validity). CONCLUSIONS The paper provides normative data for speech sound development of Italian-speaking children; preliminary psychometric analysis of Rossis articulation test revealed satisfactory reliability and construct validity. Clinicians are recommended to use Rossis articulation test to assess speech sound development in Italian children.

WebGIS Platform for Detecting Spatio-Temporal Hotspots of Oto-Laryngo-Pharyngeal Diseases

This paper is a natural prosecution of two previous works. We present a web geospatial framework for analyzing and monitoring the spatio-temporal evolution of disease hotspots. In order to detect the hotspots, we adopt Extended Fuzzy C-Means method which has been adapted for calculating spatial areas with high concentrations of events in a Geographic Information System and tested to study the spatial and temporal evolution of hotspot areas. Each event is given by the geo-positional coordinates of the place of residence of the patient. The analyst can insert event data directly on the map or digitizing the address of the residence of the patient and by using geo-coding services for locating the event. The events can be grouped for time intervals for studying the temporal evolution of the phenomenon. Other services allow the analyst to study the spatio-temporal evolution of the hotspot areas. In our experiments, the data consist of geo-referenced patterns corresponding to the residence of patients in the district of Naples (Italy) to whom a surgical intervention to the oto-laryngo-pharyngeal apparatus was carried out between the years 2008 -2012. The results show the presence of two major hotspots for every type of oto-laryngo-pharyngeal disease, the former covering a geographical area that affects the city of Naples, the latter covering various towns around Vesuvius. Both hotspots are significantly increased in recent years.