Verification of feature regions for stops and fricatives in natural speech

The presence of acoustic cues and their importance in speech perception have long remained debatable topics. In spite of several studies that exist in this eld, very little is known about what exactly humans perceive in speech. This research takes a novel approach towards understanding speech perception. A new method, named three-dimensional deep search (3DDS), was developed to explore the perceptual cues of 16 consonant-vowel (CV) syllables, namely /pa/, /ta/, /ka/, /ba/, /da/, /ga/, /fa/, /Ta/, /sa/, /Sa/, /va/, /Da/, /za/, /Za/, from naturally produced speech. A veri cation experiment was then conducted to further verify the ndings of the 3DDS method. For this pur- pose, the time-frequency coordinate that de nes each CV was ltered out using the short-time Fourier transform (STFT), and perceptual tests were then conducted. A comparison between unmodi ed speech sounds and those without the acoustic cues was made. In most of the cases, the scores dropped from 100% to chance levels even at 12 dB SNR. This clearly emphasizes the importance of features in identifying each CV. The results con rm earlier ndings that stops are characterized by a short-duration burst preceding the vowel by 10 cs in the unvoiced case, and appearing almost coincident with the vowel in the voiced case. As has been previously hypothesized, we con rmed that the F2 transition plays no signi cant role in consonant identi cation. 3DDS analysis labels the /sa/ and /za/ perceptual features as an intense frication noise around 4 kHz, preceding the vowel by 15{20 cs, with the /za/ feature being around 5 cs shorter in duration than that of /sa/; the /Sa/ and /Za/ events are found to be frication energy near 2 kHz, preceding the vowel by 17{20 cs. /fa/ has a relatively weak burst and frication energy over a wide-band including 2{6 kHz, while /va/ has a cue in the 1.5 kHz mid-frequency region preceding the vowel by 7{10 cs. New information is established regarding /Da/ and /Ta/, especially with regards to the nature of their signi cant confusions

Role of Probiotics in Oral Health - A Review

Probiotic is defined as “live microbial food ingredient that, when ingested in sufficient quantities, exerts health benefits on the consumer” (International Life Science Institute). Probiotic is derived from Greek language meaning “for life” and it was first used by Lilly and Stillman in 1965 to describe “substances secreted by one microorganism which stimulates the growth of another.” The original observation of the positive role played by some selected bacteria was scientifically investigated by Eli Metchnikoff who proposed that lactic acid-producing strain Lactobacillus bulgaricus (contained in the Bulgarian yogurt) is able to displace pathological intestinal microbiota. Probiotics’ role for treatment of general diseases like intestinal diseases, lactose intolerance, diabetes, etc., has been documented in literature. During the past few years, extensive research has been done to know the role of dietary as well as oral probiotics for treatment of oral diseases. Present article documents health benefits of probiotics for maintainence of oral health

Brachial plexopathy in breast cancer: is it radiation related? An analysis technique and dose volume parameters to brachial plexus in breast cancer radiotherapy

Background: Brachial plexus dysfunction is a rare but well-recognized complication of breast cancer surgery and radiotherapy. Most of the time it presents as paraesthesia of the arm. In an earlier publication Dan Lundstedt et al from Sweden, quantitatively assessed the radiation related brachial plexopathy (mainly paraesthesia) with the help of dose volume histograms and its co relation between patient reported paraesthesia. Paraesthesia was reported by 25% after radiation therapy to the supraclavicular fossa, with a V40 Gy 13.5 cm3 and maximum dose to brachial plexus (Dmax) was not found to correlate with paraesthesia. In order to predict the risk brachial plexopathy in our patients we decided to analyze the dose volume parameters for brachial plexus in carcinoma breast patients treated at our institution with modern radiotherapy techniques.Methods: Twenty five consecutive patients who received post mastectomy radiation during the period September 2015 to January 2016 with a dose of 50Gy in 25 fractions were included for this analysis. Brachial plexus contoured using RTOG guidelines, and dose volume parameters for brachial plexus were documented from the existing treatment plans.Results: The maximum dose to the brachial plexus ranged from 5045cGy to 5679cGy with a mean value of 5312.8cGy. The mean dose received by the brachial plexus ranged from 3093cGy to 4714cGy and the mean value was 4137.28cGy. Volume receiving 40Gy, that is V40, ranged from 2.0078cc to 11.56cc with a mean value of 7.57cc.Conclusions: Maximum dose and V40 Gy values were well below the tolerance limit of plexus, and hence post mastectomy irradiation with modern techniques is unlikely to produce significant brachial plexus neuropathy

Real work experiences, practices and adverse events associated with long term usage of N95 respirators during the COVID-19 pandemic – A cross-sectional survey amongst Indian physicians

Introduction: Doctors are at increased risk of exposure to SARS-CoV-2 virus, and use of N95 respirators has emerged as a key preventive measure. This study aimed to study the real-world experiences, practices and adverse effects of N95 respirator usage amongst doctors of India. Methods: An analytical, cross-sectional online survey was conducted between November 2020 and January 2021. Real-world usage characteristics of N-95 respirators were collected via a pre-validated questionnaire (use, reuse, wearing and disposal practices) and compared amongst different sub-cohorts. Results: 453 responses from physicians were analyzed. The most important adjunct to the N95 respirator perceived by the respondents was the full-face shield (81.9%). Most doctors had to purchase extra mask per month (median = 5) and this was more amongst the medical specialties (p = 0.006). Highest mean VAS scores for adverse events were reported for breathing on exertion (6.62 ± 2.25) and ear pain (6.34 ± 2.69). VAS ear pain was higher in ages < 40 and doctors working in the public sector (p = 0.017 and p = 0.019 respectively). Conclusion: There are many inadequacies with regard to proper mask removal and doffing techniques among doctors in India. The major adverse effects faced by the doctors on prolonged mask usage were ear pain and breathing on exertion. However, it can be noted in spite of these deficiencies; there is generally good adherence to protocols and good practices of mask usage in hospital setting

COVID-19 Disrupted Provision and Utilization of Health and Nutrition Services in Uttar Pradesh, India: Insights From Service Providers, Household Phone Surveys, and Administrative Data

BACKGROUND: The coronavirus (COVID-19) pandemic may substantially affect health systems, but little primary evidence is available on disruption of health and nutrition services. OBJECTIVES: This study aimed to 1) determine the extent of disruption in provision and utilization of health and nutrition services induced by the pandemic in Uttar Pradesh, India; and 2) identify how adaptations were made to restore service provision in response to the pandemic. METHODS: We conducted longitudinal surveys with frontline workers (FLWs, n = 313) and mothers of children \u3c 2 y old (n = 659) in December 2019 (in-person) and July 2020 (by phone). We also interviewed block-level managers and obtained administrative data. We examined changes in service provision and utilization using Wilcoxon matched-pairs signed-rank tests. RESULTS: Compared with prepandemic, service provision reduced substantially during lockdown (83-98 percentage points, pp), except for home visits and take-home rations (∼ 30%). Most FLWs (68%-90%) restored service provision in July 2020, except for immunization and hot cooked meals (\u3c 10%). Administrative data showed similar patterns of disruption and restoration. FLW fears, increased workload, inadequate personal protective equipment (PPE), and manpower shortages challenged service provision. Key adaptations made to provide services were delivering services to beneficiary homes (∼ 40%-90%), social distancing (80%), and using PPE (40%-50%) and telephones for communication (∼ 20%). On the demand side, service utilization reduced substantially (40-80 pp) during the lockdown, but about half of mothers received home visits and food supplementation. Utilization for most services did not improve after the lockdown, bearing the challenges of limited travel (30%), nonavailability of services (26%), and fear of catching the virus when leaving the house (22%) or meeting service providers (14%). CONCLUSIONS: COVID-19 disrupted the provision and use of health and nutrition services in Uttar Pradesh, India, despite adaptations to restore services. Strengthening logistical support, capacity enhancement, performance management, and demand creation are needed to improve service provision and utilization during and post-COVID-19

Delayed puberty and abnormal anthropometry and its associations with quality of life in young Fontan survivors: A multicenter crossâ sectional study

IntroductionWe sought to evaluate the prevalence of delayed puberty and abnormal anthropometry and its association with quality of life (QoL) in young Fontan survivors.MethodsThis was a crossâ sectional study at 11 Pediatric Heart Network centers. Demographic and clinical data, anthropomety, and Tanner stage were collected. Anthropometric measurements and pubertal stage were compared to US norms. QoL was assessed using Pediatric Quality of Life inventory (PedsQL). Mixed effects regression modeling adjusting for clustering by center was used to evaluate factors associated with abnormal anthropometry and delayed puberty and associations with QoL.ResultsOf the 299 subjects, 42% were female. The median enrollment age was 13.9 years, and the median age at Fontan was 3 years. Fontan survivors had a higher prevalence of short stature relative to normative data (20% vs 5%, P 2 surgeries before Fontan was associated with delayed puberty. Lower family income (<$25 000) and hypoplastic left heart syndrome were associated with lower QoL.ConclusionCompared to the normal population, Fontan survivors have high prevalence of short stature, abnormal BMI and delayed puberty. Abnormal anthropometry, but not delayed puberty, was associated with lower overall QoL and perceived physical appearance scores. Routine screening for abnormal anthropometry, especially in HLHS and in lower socioeconomic status families, should be considered to allow interventions, which might ameliorate the negative psychosocial impact.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/144293/1/chd12597.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/144293/2/chd12597_am.pd

Rapid assessment of facilitators and barriers related to the acceptance, challenges and community perception of daily regimen for treating tuberculosis in India

Introduction: The Revised National Tuberculosis Control Program (RNTCP) is the largest tuberculosis (TB) control program in the world based on Directly Observed Treatment Short-Course (DOTS) strategy. Globally, most countries have been using a daily regimen and in India a shift towards a daily regimen for TB treatment has already begun. The daily strategy is known to improve program coverage along with compliance. Such strategic shifts have both management and operational implications. We undertook a rapid assessment to understand the facilitators and barriers in adopting the daily regimen for TB treatment in three Indian states. Methods: In-depth interviews were planned across six districts of three purposively selected states of Maharashtra, Bihar and Sikkim, among health system personnel at various levels to identify their perspectives on adoption of a daily regimen for TB. These districts were sampled on the basis of TB notification rates. Thematic analysis of the qualitative data was undertaken. Results: 62 respondents were interviewed from these 6 districts. During the analysis, it was observed that an easily accessible, patient-centred and personalized outreach is an enabling factor for adherence to treatment. Lack of transportation facilities, out-of-pocket expenses and loss of wages for accessing DOTS at institutions are major identified barriers for treatment adherence at individual level. At program level, lack of trained service providers, poor administration of treatment protocols and inadequate supervision by health care providers and program managers are key factors that influence program outcomes. Conclusion: A major observation that emerged from the interviews is that the key to achieve a relapse-free cure is ensuring that a patient receives all doses of the prescribed treatment regimen. However, switching to a daily regimen makes adherence difficult and thus new strategies are needed for its implementation at patient and health provider levels. Most stakeholders appreciate the reasons for switching to a daily regimen. The stakeholders recognised the efforts of the Ministry of Health & Family Welfare (MoHFW) in spearheading the program. Strategies like the 99 DOTS call-centre approach may also further ensure treatment adherence

Safety of procuring research tissue during a clinically indicated kidney biopsy from patients with lupus: data from the Accelerating Medicines Partnership RA/SLE Network

Objectives In lupus nephritis the pathological diagnosis from tissue retrieved during kidney biopsy drives treatment and management. Despite recent approval of new drugs, complete remission rates remain well under aspirational levels, necessitating identification of new therapeutic targets by greater dissection of the pathways to tissue inflammation and injury. This study assessed the safety of kidney biopsies in patients with SLE enrolled in the Accelerating Medicines Partnership, a consortium formed to molecularly deconstruct nephritis.Methods 475 patients with SLE across 15 clinical sites in the USA consented to obtain tissue for research purposes during a clinically indicated kidney biopsy. Adverse events (AEs) were documented for 30 days following the procedure and were determined to be related or unrelated by all site investigators. Serious AEs were defined according to the National Institutes of Health reporting guidelines.Results 34 patients (7.2%) experienced a procedure-related AE: 30 with haematoma, 2 with jets, 1 with pain and 1 with an arteriovenous fistula. Eighteen (3.8%) experienced a serious AE requiring hospitalisation; four patients (0.8%) required a blood transfusion related to the kidney biopsy. At one site where the number of cores retrieved during the biopsy was recorded, the mean was 3.4 for those who experienced a related AE (n=9) and 3.07 for those who did not experience any AE (n=140). All related AEs resolved.Conclusions Procurement of research tissue should be considered feasible, accompanied by a complication risk likely no greater than that incurred for standard clinical purposes. In the quest for targeted treatments personalised based on molecular findings, enhanced diagnostics beyond histology will likely be required

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals &lt;1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data