A Contextualized Real-Time Multimodal Emotion Recognition for Conversational Agents using Graph Convolutional Networks in Reinforcement Learning

Owing to the recent developments in Generative Artificial Intelligence (GenAI) and Large Language Models (LLM), conversational agents are becoming increasingly popular and accepted. They provide a human touch by interacting in ways familiar to us and by providing support as virtual companions. Therefore, it is important to understand the user's emotions in order to respond considerately. Compared to the standard problem of emotion recognition, conversational agents face an additional constraint in that recognition must be real-time. Studies on model architectures using audio, visual, and textual modalities have mainly focused on emotion classification using full video sequences that do not provide online features. In this work, we present a novel paradigm for contextualized Emotion Recognition using Graph Convolutional Network with Reinforcement Learning (conER-GRL). Conversations are partitioned into smaller groups of utterances for effective extraction of contextual information. The system uses Gated Recurrent Units (GRU) to extract multimodal features from these groups of utterances. More importantly, Graph Convolutional Networks (GCN) and Reinforcement Learning (RL) agents are cascade trained to capture the complex dependencies of emotion features in interactive scenarios. Comparing the results of the conER-GRL model with other state-of-the-art models on the benchmark dataset IEMOCAP demonstrates the advantageous capabilities of the conER-GRL architecture in recognizing emotions in real-time from multimodal conversational signals.Comment: 5 pages (4 main + 1 reference), 2 figures. Submitted to IEEE FG202

Simple Direct Drug Susceptibility Tests on Sputum Samples for Early Detection of Resistance in Tubercle Bacilli

Background: Direct sensitivity test either by sputum concentrate (DS) or swab method (DSM) set up along with the primary culture would avoid the delay of four or more weeks required for the indirect test. A comparison of these two methods against the standard indirect sensitivity method under routine laboratory conditions is necessary to prove their merit. Method: Smear positive sputum samples were aliquoted and sensitivity tests were set up by both the direct methods as also an indirect test set up from the primary culture of the same sample. Results: The agreement with the indirect test results for isoniazid (INH) ranged from 97-98% for the DS method and 93- 97% for the DSM method. The corresponding figures were 96-98% by the DS and 94-99% by the DSM method for rifampicin (R). The agreement was less satisfactory for ethambutol (Emb). Conclusion: This study showed that direct sensitivity tests such as DS and DSM methods can detect most of the cultures resistant to INH and R (MDR) from the time growth appears on the primary culture , even as early as the second week of setting up the tests

Consistency of standard laboratory strain Mycobacterium tuberculosis H37Rv with ethionamide susceptibility testing

Drug susceptibility pattern of standard Mycobacterium tuberculosis strain H37Rv showed discrepancy in minimum inhibitory concentration method for ethionamide and consistent results were obtained for the other second line drugs namely, kanamycin and ofloxacin. It is, therefore, necessary to revisit the susceptibility testing method for ethionamide for effective clinical management of patients with drug resistant tuberculosis

Gastro-intestinal absorption of isoniazid and rifampicin in patients with intestinal tuberculosis

The gastro-intestinal absorption of isoniazid and rifampicin was studied in 12 patients with intestinal tuberculosis (10 slow and 2 rapid acetylators of isoniazid) and compared with that in 18 patients with pulmonary tuberculosis (8 slow and 10 rapid acetylators). Exposure (area under the time-concentration curve), calculated on the basis of serum concentrations of the two drugs at 1, 2, 3, 6 and 8 hours, and the proportion of dose of isoniazid excreted in urine collected over the period (0-8½) hours as isoniccotinyl compounds after drug administration were similar in the 2 groups suggesting no impairment of gastro-intestinal absorption of the 2 drugs in patients with intestinal tuberculosis. It was also observed that there was no delay in the absorption of the 2 drugs in patients with intestinal tuberculosis as compared to that in patients with pulmonary tuberculosis. The absorption of D-xylose, used to assess the absorptive capacity of the proximal small intestine, was also similar and normal in both groups of patients

COVID-19 : psychological distress, fear, and coping strategies among community members across the United Arab Emirates

Background The COVID-19 pandemic impacted the psychosocial well-being of the United Arab Emirates [UAE] population like other communities internationally. Objectives We aimed to identify the factors associated with psychological distress, fear, and coping amongst community members across the UAE. Methods We conducted a cross-sectional online survey across the UAE during November 2020. Adults age

Stratifying low level Isoniazid resistance using additional intermediate drug concentration

AbstractIsoniazid (INH) susceptibility testing for 100 Mycobacterium tuberculosis performed by conventional minimum inhibitory concentration (MIC) method was stratified using additional drug concentrations. Introduction of additional drug concentrations did not greatly improve the discriminatory capacity, but can be used in specialized studies pertaining to cross resistance between structural analogues of INH

Sputum conversion at the end of intensive phase of Category-1 regimen in the treatment of pulmonary tuberculosis patients with diabetes mellitus or HIV infection: An analysis of risk factors

Background & objectives: New smear-positive pulmonary tuberculosis (PTB) patients in the Revised National Tuberculosis Control Programme (RNTCP) are treated with a 6-month short-course chemotherapy (SCC) regimen irrespective of co-morbid conditions. We undertook this retrospective analysis to compare sputum conversion rates (smear, culture) at the end of intensive phase (IP) of Category-1 regimen among patients admitted to concurrent controlled clinical trials: pulmonary tuberculosis alone (PTB) or with type 2 diabetes mellitus (DM-TB) or HIV infection (HIV-TB), and to identify the risk factors influencing sputum conversion. Methods: In this retrospective analysis sputum conversion rates at the end of intensive phase (IP) in three concurrent studies undertaken among PTB, DM-TB and HIV-TB patients, during 1998 – 2002 at the Tuberculosis Research Centre (TRC), Chennai, were compared. Sputum smears were examined by fluorescent microscopy. HIV infected patients did not receive anti-retroviral treatment (ART). Patients with DM were treated with oral hypoglycaemic drugs or insulin (sc). Results: The study population included 98, 92 and 88 patients in the PTB, DM-TB and HIV-TB studies. At the end of IP the smear conversion (58, 61, and 62%) and culture conversion (86, 88 and 92%) rates were similar in the three groups respectively. The variables associated with lack of sputum smear or culture conversion were age >45 yr, higher pre-treatment smear and culture grading, and extent of the radiographic involvement. Interpretation & conclusions: Our findings confirm that the current policy of the control programme to treat all pulmonary TB patients with or with out co-morbid conditions with Category-I regimen appears to be appropriate

Revisiting the susceptibility testing of Mycobacterium tuberculosis to ethionamide in solid culture medium.

BACKGROUND & OBJECTIVES Increase in the isolation of drug resistant phenotypes of Mycobacterium tuberculosis necessitates accuracy in the testing methodology. Critical concentration defining resistance for ethionamide (ETO), needs re-evaluation in accordance with the current scenario. Thus, re-evaluation of conventional minimum inhibitory concentration (MIC) and proportion sensitivity testing (PST) methods for ETO was done to identify the ideal breakpoint concentration defining resistance. METHODS Isolates of M. tuberculosis (n=235) from new and treated patients were subjected to conventional MIC and PST methods for ETO following standard operating procedures. RESULTS With breakpoint concentration set at 114 and 156 µg/ml, an increase in specificity was observed whereas sensitivity was high with 80 µg/ml as breakpoint concentration. Errors due to false resistant and susceptible isolates were least at 80 µg/ml concentration. INTERPRETATION & CONCLUSIONS Performance parameters at 80 µg/ml breakpoint concentration indicated significant association between PST and MIC methods

Declines in risk behaviour and sexually transmitted infection prevalence following a community-led HIV preventive intervention among female sex workers in Mysore, India.

OBJECTIVE: To investigate the impact on sexual behaviour and sexually transmitted infections (STI) of a comprehensive community-led intervention programme for reducing sexual risk among female sex workers (FSW) in Mysore, India. The key programme components were: community mobilization and peer-mediated outreach; increasing access to and utilization of sexual health services; and enhancing the enabling environment to support programme activities. METHODS: Two cross-sectional surveys among random samples of FSW were conducted 30 months apart, in 2004 and 2006. RESULTS: Of over 1000 women who sell sex in Mysore city, 429 participated in the survey at baseline and 425 at follow-up. The median age was 30 years, median duration in sex work 4 years, and the majority were street based (88%). Striking increases in condom use were seen between baseline and follow-up surveys: condom use at last sex with occasional clients was 65% versus 90%, P < 0001; with repeat clients 53% versus 66%, P < 0.001; and with regular partners 7% versus 30%, P < 0.001. STI prevalence declined from baseline to follow-up: syphilis 25% versus 12%, P < 0.001; trichomonas infection 33% versus 14%, P < 0.001; chlamydial infection 11% versus 5%, P = 0.001; gonorrhoea 5% versus 2%, P = 0.03. HIV prevalence remained stable (26% versus 24%), and detuned assay testing suggested a decline in recent HIV infections. CONCLUSION: This comprehensive HIV preventive intervention empowering FSW has resulted in striking increases in reported condom use and a concomitant reduction in the prevalence of curable STI. This model should be replicated in similar urban settings across India

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy