Development of the Arabic Voice Pathology Database and Its Evaluation by Using Speech Features and Machine Learning Algorithms

A voice disorder database is an essential element in doing research on automatic voice disorder detection and classification. Ethnicity affects the voice characteristics of a person, and so it is necessary to develop a database by collecting the voice samples of the targeted ethnic group. This will enhance the chances of arriving at a global solution for the accurate and reliable diagnosis of voice disorders by understanding the characteristics of a local group. Motivated by such idea, an Arabic voice pathology database (AVPD) is designed and developed in this study by recording three vowels, running speech, and isolated words. For each recorded samples, the perceptual severity is also provided which is a unique aspect of the AVPD. During the development of the AVPD, the shortcomings of different voice disorder databases were identified so that they could be avoided in the AVPD. In addition, the AVPD is evaluated by using six different types of speech features and four types of machine learning algorithms. The results of detection and classification of voice disorders obtained with the sustained vowel and the running speech are also compared with the results of an English-language disorder database, the Massachusetts Eye and Ear Infirmary (MEEI) database

Health promotion, disease prevention and periodic health checks: perceptions and practice among family physicians in eastern Mediterranean region

Introduction: The aim of this study was to identify the current practices and perceptions of family physicians regarding health promotion, disease prevention including periodic screening and health checks in Eastern Mediterranean Region. Methods: A multi-country cross-sectional study was conducted in six countries of EMR, from September 2014 to March 2015. Family Physicians who were currently practicing in different countries of EMR were invited to participate in the study through email. A pre-tested structured questionnaire was used for data collection. Data was entered and analyzed on SPSS 19 and logistic regression analysis was performed. Results: A total of 100 physicians data was included in the final analysis. The majority were female physicians (76%): 63% were 25 to 35 years of age. Approximately 53% of Family physicians always recommend periodic screening and health checks to their patients. The common screening question asked to patients in medical history was related to their blood pressure (86%). Almost all (99%) of the Family physicians believe they should conduct periodic health checks. Those who had postgraduate training in Family Medicine (OR: 0.5; 95% CI: 0.39-1.67) and attended CME sessions regularly (OR: 0.11; 95% CI: 0.01-0.93), are more likely to recommend periodic screening and health checks to their patients. Conclusion: Periodic screening and health check is an important strategy to prevent disease and maintain health. It is an underutilized practice and a great need exists for its implementation in family practice

An Investigation of Multidimensional Voice Program Parameters in Three Different Databases for Voice Pathology Detection and Classification

Background and Objective Automatic voice-pathology detection and classification systems may help clinicians to detect the existence of any voice pathologies and the type of pathology from which patients suffer in the early stages. The main aim of this paper is to investigate Multidimensional Voice Program (MDVP) parameters to automatically detect and classify the voice pathologies in multiple databases, and then to find out which parameters performed well in these two processes. Materials and Methods Samples of the sustained vowel /a/ of normal and pathological voices were extracted from three different databases, which have three voice pathologies in common. The selected databases in this study represent three distinct languages: (1) the Arabic voice pathology database; (2) the Massachusetts Eye and Ear Infirmary database (English database); and (3) the Saarbruecken Voice Database (German database). A computerized speech lab program was used to extract MDVP parameters as features, and an acoustical analysis was performed. The Fisher discrimination ratio was applied to rank the parameters. A t test was performed to highlight any significant differences in the means of the normal and pathological samples. Results The experimental results demonstrate a clear difference in the performance of the MDVP parameters using these databases. The highly ranked parameters also differed from one database to another. The best accuracies were obtained by using the three highest ranked MDVP parameters arranged according to the Fisher discrimination ratio: these accuracies were 99.68%, 88.21%, and 72.53% for the Saarbruecken Voice Database, the Massachusetts Eye and Ear Infirmary database, and the Arabic voice pathology database, respectively

Intra- and Inter-database Study for Arabic, English, and German Databases:Do Conventional Speech Features Detect Voice Pathology?

A large population around the world has voice complications. Various approaches for subjective and objective evaluations have been suggested in the literature. The subjective approach strongly depends on the experience and area of expertise of a clinician, and human error cannot be neglected. On the other hand, the objective or automatic approach is noninvasive. Automatic developed systems can provide complementary information that may be helpful for a clinician in the early screening of a voice disorder. At the same time, automatic systems can be deployed in remote areas where a general practitioner can use them and may refer the patient to a specialist to avoid complications that may be life threatening. Many automatic systems for disorder detection have been developed by applying different types of conventional speech features such as the linear prediction coefficients, linear prediction cepstral coefficients, and Mel-frequency cepstral coefficients (MFCCs). This study aims to ascertain whether conventional speech features detect voice pathology reliably, and whether they can be correlated with voice quality. To investigate this, an automatic detection system based on MFCC was developed, and three different voice disorder databases were used in this study. The experimental results suggest that the accuracy of the MFCC-based system varies from database to database. The detection rate for the intra-database ranges from 72% to 95%, and that for the inter-database is from 47% to 82%. The results conclude that conventional speech features are not correlated with voice, and hence are not reliable in pathology detection

New leadership model for family physicians in the Eastern Mediterranean region: a pilot study across selected countries

Background: Family Medicine is growing rapidly across the Eastern Mediterranean Region. However, it needs support in terms of overall health system development. This will require strong leadership in family medicine to implement the change required to improve current conditions. Objective: To collect data that will support the development of a leadership program for the future family physicians in the region. Methods: A cross-sectional study was conducted from July 2016 to September 2016 in eight countries of the Eastern Mediterranean Region, (Bahrain, Egypt, Iraq, Jordan, Kuwait, Qatar, Pakistan, and Saudi Arabia). These countries were selected to obtain perceptions of Family Physicians (FPs) regarding the current leadership model and to explore the need for a new future innovative model in Family Medicine (FM) across the region. Results: The information of 68 family physicians was included in the final analysis. The majority of the FPs was females as compared to males (71% vs. 29%). Forty-four percent of the FPs had 10 to 19 years of experience. Almost all of the FPs (96%) had completed some training in family medicine after graduation. About three fifths of the FPs had completed postgraduate qualifications and out of those, 64% had passed Board or Membership Examinations. Twenty-one percent of them are currently in a leadership role and 45% who were not in any leadership role responded that the current situation of FM in their country is poor. All of the leaders believed that it is important to develop strong leadership in FM to take the specialty forward. Almost similar proportions (67% and 64%) of leaders and non-leaders thought that establishing regional associations would enhance the FM practice model. Approximately two thirds of leaders (67%) responded that the current role of decision makers in the Ministry of Health (MOH) regarding capacity building in FM is not effective. The majority of the FPs (54% and 38%) considers that the existing postgraduate curriculum does not address leadership skill development in FM. Eighty-eight percent of the FPs both from leadership and non-leadership groups agreed that academic institutions and practicing FPs can play an effective leadership role in taking FM forward. Conclusion: The Family Medicine specialty will have to develop leadership capabilities in line with today’s fast-moving changes in healthcare for it to obtain the due recognition in the healthcare delivery system

Petrogenesis and Tectonic Implications of the Cryogenian I-Type Granodiorites from Gabgaba Terrane (NE Sudan)

The widely distributed granitic intrusions in the Nubian Shield can provide comprehensive data for understanding its crustal evolution. We present new bulk-rock geochemistry and isotopic (zircon U-Pb and Lu-Hf) data from the Haweit granodiorites in the Gabgaba Terrane (NE Sudan). The dated zircons presented a 206Pb/238U Concordia age of 718.5 ± 2.2 Ma, indicating that they crystallized during the Cryogenian. The granodiorites contain both biotite and amphibole as the main mafic constituents. The samples exhibit metaluminous (A/CNK = 0.84–0.94) and calc-alkaline signatures. Their mineralogical composition and remarkable low P2O5, Zr, Ce, and Nb concentrations confirm that they belong to I-type granites. They exhibit subduction-related magma geochemical characters such as enrichment in LILEs and LREEs and depletion in HFSEs and HREEs, with a low (La/Yb)N ratio (3.0–5.9) and apparent negative Nb anomaly. The positive Hf(t) values (+7.34 to +11.21) and young crustal model age (TDMC = 734–985 Ma) indicates a juvenile composition of the granodiorites. The data suggest that the Haweit granodiorites may have formed from partially melting a juvenile low-K mafic source. During subduction, the ascending asthenosphere melts might heat and partially melt the pre-existing lower crust mafic materials to generate the Haweit granodiorites in the middle segment of the Nubian Shield. © 2023 by the authors.King Saud University, KSUThis research was supported by Researchers Supporting Project number (RSP2023R496), King Saud University, Riyadh, Saudi Arabia. The author AE would like to thank “Dunarea de Jos” University of Galati, Romania, INPOLDE infrastructure, for the material and technical support.This research was supported by Researchers Supporting Project number (RSP2023R496), King Saud University, Riyadh, Saudi Arabia. The author A.E. would like to thank “Dunarea de Jos” University of Galati, Romania, INPOLDE infrastructure, for the material and technical support. The authors would like to thank the editors and the reviewers for their precious time, detailed and constructive reviews, and additional comments which significantly improved the manuscript

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London