The Cardiovascular Effects of a Meal: J-Tpeak and Tpeak -Tend Assessment and Further Insights Into the Physiological Effects.

Meal intake leads to a significant and prolonged increase in cardiac output to supply the splanchnic vasculature. A meal is associated with sympathetic activation of the cardiovascular system, and food ingestion is correlated with an increase in heart rate, an increase in cardiac stroke volume, and QTc interval shortening for up to 7 hours. Given the complexity of the system, one or several of many mechanisms could explain this observation. The shortening of the QTc interval was correlated with a rise of C-peptide following food ingestion, but the mechanisms by which C-peptide may be involved in the modulation of cardiac repolarization are still unknown. This shortening of the myocardial action potential caused by the ingestion of food was further investigated in the present study by measuring the QRS, J-Tpeak , and Tpeak -Tend intervals in search of further clues to better understand the underlying mechanisms. A retrospective analysis was conducted based on data collected in a formal thorough QT/QTc study in which 32 subjects received a carbohydrate-rich "continental" breakfast, moxifloxacin without food, and moxifloxacin with food. We assessed the effect of food on T-wave morphology using validated algorithms for measurement of J-Tpeak and Tpeak -Tend intervals. Our findings demonstrate that a standardized meal significantly shortened J-Tpeak for 4 hours after a meal and to a much lesser extent and shorter duration (up to 1 hour) prolonged the Tpeak -Tend and QRS intervals. This suggests that the QTc shortening occurs mainly during phase 2 of the cardiac action potential. As there was no corresponding effect on Tpeak -Tend beyond the first hour, we conclude that a meal does not interfere with the outward correcting potassium channels but possibly with Ca2+ currents. An effect on mainly Ca2+ aligns well with our understanding of physiology whereby an increase in stroke volume, as observed after a meal, is associated with changes in Ca2+ cycling in and out of the sarcoplasmic reticulum during cardiac myocyte contraction

Multifractality in Human Heartbeat Dynamics

Recent evidence suggests that physiological signals under healthy conditions may have a fractal temporal structure. We investigate the possibility that time series generated by certain physiological control systems may be members of a special class of complex processes, termed multifractal, which require a large number of exponents to characterize their scaling properties. We report on evidence for multifractality in a biological dynamical system --- the healthy human heartbeat. Further, we show that the multifractal character and nonlinear properties of the healthy heart rate are encoded in the Fourier phases. We uncover a loss of multifractality for a life-threatening condition, congestive heart failure.Comment: 19 pages, latex2e using rotate and epsf, with 5 ps figures; to appear in Nature, 3 June, 199

Automatic Assessment of Speech Capability Loss in Disordered Speech

International audienceIn this article, we report on the use of an automatic technique to assess pronunciation in the context of several types of speech disorders. Even if such tools already exist, they are more widely used in a different context, namely, Computer-Assisted Language Learning, in which the objective is to assess nonnative pronunciation by detecting learners' mispronunciations at segmental and/or suprasegmental levels. In our work, we sought to determine if the Goodness of Pronunciation (GOP) algorithm, which aims to detect phone-level mispronunciations by means of automatic speech recognition, could also detect segmental deviances in disordered speech. Our main experiment is an analysis of speech from people with unilateral facial palsy. This pathology may impact the realization of certain phonemes such as bilabial plosives and sibilants. Speech read by 32 speakers at four different clinical severity grades was automatically aligned and GOP scores were computed for each phone realization. The highest scores, which indicate large dissimilarities with standard phone realizations, were obtained for the most severely impaired speakers. The corresponding speech subset was manually transcribed at phone level; 8.3% of the phones differed from standard pronunciations extracted from our lexicon. The GOP technique allowed the detection of 70.2% of mispronunciations with an equal rate of about 30% of false rejections and false acceptances. Finally, to broaden the scope of the study, we explored the correlation between GOP values and speech comprehensibility scores on a second corpus, composed of sentences recorded by six people with speech impairments due to cancer surgery or neurological disorders. Strong correlations were achieved between GOP scores and subjective comprehensibility scores (about 0.7 absolute). Results from both experiments tend to validate the use of GOP to measure speech capability loss, a dimension that could be used as a complement to physiological measures in pathologies causing speech disorders

The financial cost of doctors emigrating from sub-Saharan Africa: human capital analysis

Objective To estimate the lost investment of domestically educated doctors migrating from sub-Saharan African countries to Australia, Canada, the United Kingdom, and the United States