Audio Hiding based on Wavelet Transform and Linear Predictive Coding

In this work an efficient method for hiding a speech in audio is proposed. The features of secretspeech is extracted with LPC (Linear Predictive Coding), and these parameters embedded in audio inchaotic order. Discrete Wavelet Transform (DWT) is applied on audio frames to split the signal in high andlow frequencies. The embedding parameters are embedded in high frequency. The stego audio isperceptually indistinguishable from the equivalent cover audio. The proposed method allows hiding a sameduration of speech (secret) and audio (cover). The stego audio is subjected to objective tests such signal to noiseratio (SNR), signal to noise ratio segmental (SNRseg), Segmental Spectral SNR, Log Likelihood Ratio (LLR)and Correlation (Rxy) to determine the similarity with original audio

A Need for Further Education on Buprenorphine in Pain Medicine

With the ongoing opioid epidemic in the United States there has been a strong transition towards utilizing multi-modal analgesia, interventional procedures, and non-opioid medications when managing acute and chronic pain. There has also been an increased interest in utilizing buprenorphine. Buprenorphine is a novel long-acting analgesic with partial mu-opioid agonist activity that can be utilized for analgesia as well as opioid use disorder. Buprenorphine also has a unique set of side effects as well pharmacodynamic and pharmacokinetic properties that require special attention, especially if these patients require future surgical interventions. Given the increased interest in this medication we believe that there needs to be increased education and awareness regarding this medication amongst physicians, specifically pain management physicians and trainees

Buprenorphine and its formulations: a comprehensive review.

Buprenorphine, a novel long-acting analgesic, was developed with the intention of two purposes: analgesia and opioid use disorder. Regarding its pharmacodynamics, it is a partial agonist at mu receptors, an inverse agonist at kappa receptors, and an antagonist at delta receptors. For the purpose of analgesia, three formulations of buprenorphine were developed: IV/IM injectable formulation (Buprenex®), transdermal patch formulation (Butrans®), and buccal film formulation (Belbuca®). Related to opioid dependence, the formulations developed were subcutaneous extended release (Sublocade®), subdermal implant (Probuphine®), and sublingual tablets (Subutex®). Lastly, in order to avoid misuse of buprenorphine for opioid dependence, two combination formulations paired with naloxone were developed: film formulation (Suboxone®) and tablet formulation (Zubsolv®). In this review, we present details of each formulation along with their similarities and differences between each other and clinical considerations

Suvorexant, a Novel Dual Orexin Receptor Antagonist, for the Management of Insomnia.

PURPOSE OF REVIEW: The present investigation is a comprehensive review regarding the use of Suvorexant for insomnia treatment. It covers the background, pathophysiology, and significance of addressing insomnia, the pharmaceutical details of Suvorexant, and its safety, efficacy, and implications in treating insomnia. We further discuss Suvorexant\u27s role in targeting insomnia with other comorbidities. RECENT FINDINGS: Insomnia refers to poor quality and/or quantity of sleep. While there are many existing treatments such as benzodiazepines, melatonin agonists, TCAs, and atypical antipsychotics used to target various receptors involved in normal induction and maintenance of sleep, Suvorexant is an antagonist that specifically targets orexin receptors. Recent clinical studies suggest that Suvorexant is both clinically safe and effective. Quantity and quality of sleep are measured in various ways, yet the consensus points towards Suvorexant\u27s effectiveness in improving sleep time, onset, latency, and quality compared to placebo. In addition to helping improve isolated insomnia, Suvorexant helps improve sleep in patients that have other comorbidities such as obstructive sleep apnea, Alzheimer\u27s disease, dementia, acute stroke, and delirium. While Suvorexant is safe, there are still adverse effects associated with the drug that needs to be considered. The most common adverse effects include dizziness, somnolence, headaches, and cognitive impairment. SUMMARY: Insomnia is a major public health concern that affects many people worldwide and has been linked to many adverse health outcomes. While there are existing treatments that target different receptors and pathways of normal sleep induction and maintenance, Suvorexant is a novel drug that targets dual orexin receptors. Its safety and efficacy, mechanism of action, pharmacokinetic parameters, and relative lack of rebound and withdrawal effects render suvorexant a reliable choice for the treatment of insomnia

COVID-19 anomaly detection and classification method based on supervised machine learning of chest X-ray images

The term COVID-19 is an abbreviation of Coronavirus 2019, which is considered a global pandemic that threatens the lives of millions of people. Early detection of the disease offers ample opportunity of recovery and prevention of spreading. This paper proposes a method for classification and early detection of COVID-19 through image processing using X-ray images. A set of procedures are applied, including preprocessing (image noise removal, image thresholding, and morphological operation), Region of Interest (ROI) detection and segmentation, feature extraction, (Local binary pattern (LBP), Histogram of Gradient (HOG), and Haralick texture features) and classification (K-Nearest Neighbor (KNN) and Support Vector Machine (SVM)). The combinations of the feature extraction operators and classifiers results in six models, namely LBP-KNN, HOG-KNN, Haralick-KNN, LBP-SVM, HOG-SVM, and Haralick-SVM. The six models are tested based on test samples of 5,000 images with the percentage of training of 5-folds cross-validation. The evaluation results show high diagnosis accuracy from 89.2% up to 98.66%. The LBP-KNN model outperforms the other models in which it achieves an average accuracy of 98.66%, a sensitivity of 97.76%, specificity of 100%, and precision of 100%. The proposed method for early detection and classification of COVID-19 through image processing using X-ray images is proven to be usable in which it provides an end-to-end structure without the need for manual feature extraction and manual selection methods.Web of Science31art. no. 10504

Lower Urinary Tract Symptoms in Depression: A Review

Lower Urinary Tract Symptoms (LUTS) are frequently present in the general population as patients age with approximately a third of individuals experiencing LUTS during their lifetime. LUTS can be further defined as having any of the following symptoms: urinary hesitancy, straining, nocturia, increased urination frequency, and dysuria. LUTS has the potential for patients to contribute their symptoms to what can normally occur as we age. This can lead to a decrease in patients seeking care and could negatively impact patients’ health-related quality of life (HRQL). In conjunction with LUTS, we obtained from our analysis that LUTS and depression are closely related and worsening depressive symptoms may increase the severity of LUTS. We also discerned three categories of factors that can yield major depression namely adversity, internalizing, and externalizing factors. Within these categories, trauma, social support, genetic factors, and minimal education appeared to increase the risk of depression in patients. With the recent increase in mental health awareness and more access to mental health care amid the COVID-19 Pandemic, further screening, and collaboration between providers to treat both urological and psychiatric symptoms could improve patient outcomes. It is important for providers to have an increased understanding of the mental and physical impact both LUTS and depression can have on patients’ wellbeing. This has the potential to help patients be more open about their symptoms with the aim of better addressing LUTS and depression to positively impact their HRQL

Rimegepant for the treatment of migraine.

Migraine is a common form of primary headache, affecting up to 1 in every 6 Americans. The pathophysiology is an intricate interplay of genetic factors and environmental influence and is still being elucidated in ongoing studies. The trigeminovascular system is now known to have a significant role in the initiation of migraines, including the release of pain mediators such as CGRP and substance P. Traditional treatment of migraine is usually divided into acute and preventive treatment. Acute therapy includes non-specific therapy, such as NSAIDs and other analgesics, which may provide relief in mild to moderate migraines. 5-HT1 agonists may provide relief in severe migraine, but are not universally effective and carry a significant side-effect profile with frequent redosing requirement. Prophylactic therapy may reduce the occurrence of acute migraine attacks in selected patients, but does not completely eliminate it. More recently, CGRP antagonism has been studied and shown to be effective in both abortion and prevention of migraine. Novel medications, targeting CGRP, divide into CGRP antibodies and receptor antagonists (gepants). Rimegepant, a second-generation gepant, has shown efficacy in several clinical trials in treating acute migraine. Ongoing trials are also evaluating its role in migraine prophylaxis, and results are promising. It is also generally safer for use than existing options, does not appear to increase the chance of developing chronic migraines, and carries a very tolerable side effects profile. It is a part of a growing arsenal in migraine treatment, and may present the silver bullet for treatment of this disease

Review of Interventional Therapies for Refractory Pediatric Migraine.

This is a review of the latest and seminal evidence in pediatric migraine. It covers the etiology and pathophysiology known today, and then will review treatment options, efficacy and safety, quality of data and indications. Though migraine is usually regarded as an infliction in adults, it is not uncommon in the pediatric population and affects up to 8% of children. Children may experience migraine differently than adults, and present not only with headache but also frequent gastrointestinal symptoms. They are frequently shorter in duration than in adults. Traditional migraine treatment in adults is less effective in children. In this population, adjunct therapies - such as interventional techniques - should be considered when traditional treatment fails, including Botulinum Toxin A (BTA) injections, peripheral nerve and ganglion blocks. BTA injections are FDA approved for migraine prophylaxis in adults, but currently not in children; however, recent evidence shows efficacy and safety in pediatric migraine management. Nerve blocks stop nociceptive afferent fibers through injection of local anesthetics, and it may be associated with the local injection of corticosteroids. Although more common in adults, recent data suggests they are safe and effective in children and adolescents. Blocking the sphenopalatine ganglion can be achieved through nasal approach, and achieves a similar action by blocking the entire ganglion. Interventional techniques may provide a key component in the alleviation of this otherwise debilitating chronic migraine pain. Though most studies have been performed in adults, new studies provide encouraging results for treatment in children

A look at the incidence and risk factors for dog bites in unincorporated Harris County, Texas, USA

Aim: This study examined the incidence, demographic predictors, and map patterns of dog bites to humans in unincorporated Harris County, Texas, USA. Materials and Methods: Dog bites reported to Harris County Veterinary Public Health (HCVPH) between January 1, 2013, and December 31, 2016, were analyzed in this retrospective cohort study. Canine and victim characteristics and bite circumstances were evaluated to establish risk factors for bites. Geographic location was used to produce choropleth maps. Results: There were 6683 dog bites reported to HCVPH between the years of 2013 and 2016, with stable incidence rates over time. The incidence was highest for both children and older adults. Dogs with the primary breed of Pit Bull had the greatest frequency of bites (25.07%), with the second highest breed being Labrador Retrievers (13.72%). Bites were more common from intact dogs of both genders, especially from intact males. Persons aged 70+ had the greatest incidence of severe injury (14.09/100,000). A strong correlation between dog bite incidences and stray dogs was found after controlling for the human population and income. Conclusion: Dog bites remain a largely preventable issue, and risk factors identified in this study can help direct preventative efforts to reduce the incidence of dog bites