Semilocal convergence of a continuation method with Hölder continuous second derivative in Banach spaces

AbstractIn this paper, the semilocal convergence of a continuation method combining the Chebyshev method and the convex acceleration of Newton’s method used for solving nonlinear equations in Banach spaces is established by using recurrence relations under the assumption that the second Frëchet derivative satisfies the Hölder continuity condition. This condition is mild and works for problems in which the second Frëchet derivative fails to satisfy Lipschitz continuity condition. A new family of recurrence relations are defined based on two constants which depend on the operator. The existence and uniqueness regions along with a closed form of the error bounds in terms of a real parameter α∈[0,1] for the solution x∗ is given. Two numerical examples are worked out to demonstrate the efficacy of our approach. On comparing the existence and uniqueness regions for the solution obtained by our analysis with those obtained by using majorizing sequences under Hölder continuity condition on F″, it is found that our analysis gives improved results. Further, we have observed that for particular values of the α, our analysis reduces to those for the Chebyshev method (α=0) and the convex acceleration of Newton’s method (α=1) respectively with improved results

AffectEcho: Speaker Independent and Language-Agnostic Emotion and Affect Transfer for Speech Synthesis

Affect is an emotional characteristic encompassing valence, arousal, and intensity, and is a crucial attribute for enabling authentic conversations. While existing text-to-speech (TTS) and speech-to-speech systems rely on strength embedding vectors and global style tokens to capture emotions, these models represent emotions as a component of style or represent them in discrete categories. We propose AffectEcho, an emotion translation model, that uses a Vector Quantized codebook to model emotions within a quantized space featuring five levels of affect intensity to capture complex nuances and subtle differences in the same emotion. The quantized emotional embeddings are implicitly derived from spoken speech samples, eliminating the need for one-hot vectors or explicit strength embeddings. Experimental results demonstrate the effectiveness of our approach in controlling the emotions of generated speech while preserving identity, style, and emotional cadence unique to each speaker. We showcase the language-independent emotion modeling capability of the quantized emotional embeddings learned from a bilingual (English and Chinese) speech corpus with an emotion transfer task from a reference speech to a target speech. We achieve state-of-art results on both qualitative and quantitative metrics

How do specialist trainee doctors acquire skills to practice patient-centred care? A qualitative exploration

Objectives: The importance of patient centred care (PCC) has been increasingly recognised. However, there is limited work exploring what doctors actually understand by PCC, and how they perceive they acquire PCC skills in the workplace. The objectives of our study were to explore (1) what UK doctors, in specialist training, perceive to be the essential components of PCC, and (2) if/how they acquire these skills; (3) any facilitators/barriers for engaging in PCC; and (4) views on their PCC training. Design: Qualitative study using in-depth individual semi-structured interviews with UK specialist trainees. Interview transcripts were thematically analysed.Setting and Participants: Thirty-one specialist trainee doctors, with at least 4 years postgraduate experience, were interviewed. Participants worked in various medical specialities within the Medical Directorate of an acute hospital in the East Midlands of England (UK). Results: Interview data were transcribed verbatim and categorised into three main themes. The first theme was ‘Understanding PCC’ where the doctors gave varied perspectives on what they understood by PCC. Although many were able to highlight key components of PCC there were also some accounts which demonstrated a lack of understanding. The second theme was ‘Learning PCC skills: A work in progress’. Learning to be patient-centred was perceived to be an on-going process. Within this, trainee doctors reported ‘on-the-job’ learning as the main means of acquiring PCC skills, but they also saw a place for formal training (e.g., educational sessions focussing on PCC, clinical scenarios/role play). ‘Delivering PCC: Beyond the physician’ referred to the many influences the doctors reported in learning and delivering PCC including patients, the organisation and colleagues. Observing consultants taking a patient-centred approach was cited as an important learning tool. Conclusions: Our findings may assist clinical educators in understanding how trainee doctors perceive PCC, and the factors that influence their learning; thereby, helping them shape PCC skills training

Divergent evolution of Corynebacterium diphtheriae in India: An update from National Diphtheria Surveillance network.

Diphtheria is caused by a toxigenic bacterium Corynebacterium diphtheria which is being an emerging pathogen in India. Since diphtheria morbidity and mortality continues to be high in the country, the present study aimed to study the molecular epidemiology of C. diphtheriae strains from India. A total of 441 diphtheria suspected specimens collected as part of the surveillance programme between 2015 and 2020 were studied. All the isolates were confirmed as C. diphtheriae with standard biochemical tests, ELEK's test, and real-time PCR. Antimicrobial susceptibility testing for the subset of isolates showed intermediate susceptibility to penicillin and complete susceptible to erythromycin and cefotaxime. Isolates were characterized using multi locus sequence typing method. MLST analysis for the 216 C. diphtheriae isolates revealed major diversity among the sequence types. A total of 34 STs were assigned with majority of the isolates belonged to ST466 (30%). The second most common ST identified was ST405 that was present in 14% of the isolates. The international clone ST50 was also seen. The identified STs were grouped into 8 different clonal complexes (CC). The majority belongs to CC5 followed by CC466, CC574 and CC209, however a single non-toxigenic strain belongs to CC42. This epidemiological analysis revealed the emergence of novel STs and the clones with better dissemination properties. This study has also provided information on the circulating strains of C. diphtheriae among the different regions of India. The molecular data generated through surveillance system can be utilized for further actions in concern

Systems Genomics of Thigh Adipose Tissue From Asian Indian Type-2 Diabetics Revealed Distinct Protein Interaction Hubs

We performed a systematic analysis of genes implicated in thigh subcutaneous adipose tissue of Asian Indian Type 2 Diabetes Mellitus (AIT2DM) and created a phenome-interactome network. This analysis was performed on 60 subjects specific to limb thigh fat by integrating phenotypic traits and similarity scores associated with AIT2DM. Using a phenotypic attribute, a contextual neighbor was identified across all the traits, viz. body mass index (BMI) statistics, adipocyte size, lipid parameters, homeostatic model assessment- insulin resistance (HOMA-IR), HOMA-ß. In this work, we have attempted to characterize transcription signatures using the phenome-interactome maps where each of the traits under study including the intermediary phenotypes has a distinct set of genes forming the hubs. Furthermore, we have identified various clinical, biochemical, and radiological parameters which show significant correlation with distinct hubs. We observed a number of novel pathways and genes including those that are non-coding RNAs implicated in AIT2DM.We showed that they appear to be associated with pathways, viz. tyrosine kinase JAK2, NOTCH thereby recruiting signaling molecules such as STAT5 and Src family kinases on the cell surface regulated them and our analyses comprising significant hubs suggest that thigh subcutaneous adipose tissue plays a role in pathophysiology of AIT2DM

Quantification and characterisation of porosity in selectively laser melted Al–Si10–Mg using x-ray computed tomography

We used X-ray computed tomography (CT), microscopy and hardness measurements to study Al–Si10–Mg produced by selective laser melting (SLM). Specimens were subject to a series of heat treatments including annealing and precipitation hardening. The specimen interiors were imaged with X-ray CT, allowing the non-destructive quantification and characterisation of pores, including their spatial distribution. The specimens had porosities less than 0.1%, but included some pores with effective cross-sectional diameters up to 260 μm. The largest pores were highly anisotropic, being flat and lying in the plane normal to the build direction. Annealing cycles caused significant coarsening of the microstructure and a reduction of the hardness from (114 ± 3) HV, in the as-built state, to (45 ± 1) HV, while precipitation hardening increased this to a final hardness of (59 ± 1) HV. The pore size and shape distributions were unaffected by the heat treatments. We demonstrate the applicability of CT measurements and quantitative defect analysis for the purposes of SLM process monitoring and refinement

The feasibility of the PAM intervention to support treatment-adherence in people with hypertension in primary care: a randomised clinical controlled trial

Abstract: The PAM intervention is a behavioural intervention to support adherence to anti-hypertensive medications and therefore to lower blood pressure. This feasibility trial recruited 101 nonadherent patients (54% male, mean age 65.8 years) with hypertension and high blood pressure from nine general practices in the UK. The trial had 15.5% uptake and 7.9% attrition rate. Patients were randomly allocated to two groups: the intervention group (n = 61) received the PAM intervention as an adjunct to usual care; the control group (n = 40) received usual care only. At 3 months, biochemically validated medication adherence was improved by 20% (95% CI 3–36%) in the intervention than control, and systolic blood pressure was reduced by 9.16 mmHg (95% CI 5.69–12.64) in intervention than control. Improvements in medication adherence and reductions in blood pressure suggested potential intervention effectiveness. For a subsample of patients, improvements in medication adherence and reductions in full lipid profile (cholesterol 1.39 mmol/mol 95% CI 0.64–1.40) and in glycated haemoglobin (3.08 mmol/mol, 95% CI 0.42–5.73) favoured the intervention. A larger trial will obtain rigorous evidence about the potential clinical effectiveness and cost-effectiveness of the intervention. Trial registration Trial date of first registration 28/01/2019. ISRCTN74504989. https://doi.org/10.1186/ISRCTN74504989

How to screen for non-adherence to antihypertensive therapy

The quality of assessment of non-adherence to treatment in hypertensive is poor. Within this review, we discuss the different methods used to assess adherence to blood-pressure-lowering medications in hypertension patients. Subjective reports such as physicians’ perceptions are inaccurate, and questionnaires completed by patients tend to overreport adherence and show a low diagnostic specificity. Indirect objective methods such as pharmacy database records can be useful, but they are limited by the robustness of the recorded data. Electronic medication monitoring devices are accurate but usually track adherence to only a single medication and can be expensive. Overall, the fundamental issue with indirect objective measures is that they do not fully confirm ingestion of antihypertensive medications. Detection of antihypertensive medications in body fluids using liquid chromatography–tandem mass spectrometry is currently, in our view, the most robust and clinically useful method to assess non-adherence to blood-pressure-lowering treatment. It is particularly helpful in patients presenting with resistant, refractory or uncontrolled hypertension despite the optimal therapy. We recommend using this diagnostic strategy to detect non-adherence alongside a no-blame approach tailoring support to address the perceptions (e.g. beliefs about the illness and treatment) and practicalities (e.g. capability and resources) influencing motivation and ability to adhere