Code-Switched Urdu ASR for Noisy Telephonic Environment using Data Centric Approach with Hybrid HMM and CNN-TDNN

Call Centers have huge amount of audio data which can be used for achieving valuable business insights and transcription of phone calls is manually tedious task. An effective Automated Speech Recognition system can accurately transcribe these calls for easy search through call history for specific context and content allowing automatic call monitoring, improving QoS through keyword search and sentiment analysis. ASR for Call Center requires more robustness as telephonic environment are generally noisy. Moreover, there are many low-resourced languages that are on verge of extinction which can be preserved with help of Automatic Speech Recognition Technology. Urdu is the $10^{th}$ most widely spoken language in the world, with 231,295,440 worldwide still remains a resource constrained language in ASR. Regional call-center conversations operate in local language, with a mix of English numbers and technical terms generally causing a "code-switching" problem. Hence, this paper describes an implementation framework of a resource efficient Automatic Speech Recognition/ Speech to Text System in a noisy call-center environment using Chain Hybrid HMM and CNN-TDNN for Code-Switched Urdu Language. Using Hybrid HMM-DNN approach allowed us to utilize the advantages of Neural Network with less labelled data. Adding CNN with TDNN has shown to work better in noisy environment due to CNN's additional frequency dimension which captures extra information from noisy speech, thus improving accuracy. We collected data from various open sources and labelled some of the unlabelled data after analysing its general context and content from Urdu language as well as from commonly used words from other languages, primarily English and were able to achieve WER of 5.2% with noisy as well as clean environment in isolated words or numbers as well as in continuous spontaneous speech.Comment: 32 pages, 19 figures, 2 tables, preprin

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Sustainability assessment of virtual water flows through cereal and milled grain trade among US counties

Transference of the embedded water, so-called virtual water, in the trade of crops among regions within a country is often neglected, leading to no information about the impacts on the water resources of exporting regions, especially if those regions are water-stressed or, worse, water-scarce. Virtual water trade, if not considered through the lens of sustainability, could lead to adverse effects on the water resources of an exporting region. Previous related studies have quantified virtual water trade among the states in the United States providing valuable insights; however, information for specific crop trade among counties, its water footprint (WF) at the county scale, the resultant virtual water flow among counties, and the sustainability assessment of those virtual water flows are lacking. In this study, we calculate the green and blue WF of cereal and milled grain products at the county level and then, using trade data, calculate the virtual water flows among the counties. Then, we assess the sustainability of the import by introducing unsustainable import fraction (UIF), which is the ratio of virtual water imported from water-scarce counties to that of total virtual water imported in the form of cereal and milled grains. Finally, we quantify the change in UIF from the 2007–2017 period. A few of the significant insights discovered through this analysis include: (i) most of the cereal and milled grains trade is occurring among neighboring counties; ii) one-third of US counties import 75% or more virtual water from water scarce regions; (iii) in 2017, Texas and Missouri were the largest importer and exporter, respectively; and (iv) the number of counties importing cereals and milled grains from water-scarce counties increased from 2007 to 2017. Recommendations on alleviating the negative effects of the unsustainable import of cereal and milled grain are provided toward the end of the discussion

Addressing quality medication use among migrant patients: Establishment of an organization to provide culturally competent medication care

As the global landscape continues to witness an increase in migration, the healthcare community faces an evolving challenge: the provision of quality medication care to migrant patients. Language barriers, cultural differences, and a lack of understanding of the local healthcare system can often impede the effective management of medications and access to healthcare services among migrant populations. Pharmacists, as medication experts, are dignified to make a substantial impact in bridging the gap between migrants and quality healthcare. Their expertise in medication management, accessibility, and counseling positions them as critical healthcare providers for this patient population. Pharmacies and pharmacists can serve as trusted hubs where migrants receive not only essential medications but also culturally sensitive support in navigating the healthcare system. This commentary article highlights the critical importance of culturally competent medication care for migrant patients and the central role that pharmacists can play in this endeavor. By establishing organization dedicated to this cause lead by pharmacists, we can not only address an urgent healthcare concern but also set a precedent for a healthcare system that values inclusivity, cultural competence, and equitable access to quality medication care for all, regardless of their cultural background

Trend analysis of common disabilities and causes among in-patients of paraplegic center Peshawar during last five year

Objectives: To assess the trend of common disabilities in paraplegic Centre Peshawar during last 5 years. To assess the trend of common causes of disabilities in Paraplegic Centre Peshawar. Methodology: - A retrospective study was conducted in The Paraplegic Centre Peshawar irrespective of age and gender to assess the common disabilities, causes and which gender, age and occupational group is more susceptible in the patients presented during last 5 years. The Data was collected manually through chart review. The data was collected from 600 charts. All relevant data will be recorded and analyzed using the SPSS 19.0 Software package. Results: A total of 500 patients including both Genders of all age groups & profession were included in this study. Male were the most commonly affected gender (77.6%) Followed by Female (22.4%). Disability was found highest among age group 21-30 third decade (33.4%). Disability is common in uneducated people (45.2 %). Among disabilities type paraplegia was most common (79.6%) followed by tetraplegia (20%) & others (0.4%). In all disabilities the most important cause was Fall from height.&nbsp

Systems Thinking for Planning Sustainable Desert Agriculture Systems with Saline Groundwater Irrigation: A Review

Agricultural land expansion is a solution to address global food security challenges in the context of climate change. However, the sustainability of expansion in arid countries is difficult because of scarce surface water resources, groundwater salinity, and the health of salt-affected soil. Developing expansion and sustainability plans for agriculture requires systems thinking, considering the complex feedback interactions between saline groundwater, salt-affected soil, plant growth, freshwater mixing with saline groundwater, irrigation systems, and the application of soil amendments to alleviate the salinity impacts. This study presents an extensive literature review on the effects of salinity on soil and plant health, the constraints and opportunities for sustainable agriculture in Egypt, and a systems thinking approach to the feedback interactions between saline water, salt-affected soil, and the application of soil amendments to achieve required crop yields. Insights and strategies are discussed, including a system-dynamics-based decision model, irrigation systems with diversified and decentralized water sources, urban water demand management, energy availability, smart irrigation systems, and active participation of stakeholders to achieve sustainable agriculture under climate and socioeconomic changes. The insights are expected to encourage stakeholders and academic communities in the water, agriculture, and related food security sectors to develop a quantitative and systematic decision-making framework for sustainable agriculture systems in arid regions