Developing Innovative Payment Approaches: Finding the Path to High Performance

Discusses issues in facilitating, under the 2010 health reform law, initiatives to identify, develop, implement, and monitor payment and delivery system reforms to improve quality and control costs while supporting the fiscal integrity of public programs

Recognizing Uncertainty in Speech

We address the problem of inferring a speaker's level of certainty based on prosodic information in the speech signal, which has application in speech-based dialogue systems. We show that using phrase-level prosodic features centered around the phrases causing uncertainty, in addition to utterance-level prosodic features, improves our model's level of certainty classification. In addition, our models can be used to predict which phrase a person is uncertain about. These results rely on a novel method for eliciting utterances of varying levels of certainty that allows us to compare the utility of contextually-based feature sets. We elicit level of certainty ratings from both the speakers themselves and a panel of listeners, finding that there is often a mismatch between speakers' internal states and their perceived states, and highlighting the importance of this distinction.Comment: 11 page

A Review of Epstein Barr Virus Immunity, Pathogenesis and Immunotherapies

Epstein – Barr Virus (EBV), a member of the Herpesviridae family, is commonly known as the cause of infectious mononucleosis. While EBV infection has acute effects, its primary significance in human health stems from its association with multiple cancers resulting from chronic infection. EBV first establishes infection in epithelial cells of the oropharynx, where it is lytic, and later establishes latent infection in B cells, where it exists in latency for remainder of the host’s lifetime. Dendritic cells and natural killer cells are first to control expansion of the infection followed by cytotoxic T cells and helper T cells. Through mechanisms involving EBV lytic proteins, BGLF5, BNLF2, gp42, BILF1, BZLF1, EBV evades the initial immune response and adapts a latency program where EBNA1 and microRNAs enable the virus to further evade host immune mechanisms throughout all latency stages. During the latent stage, EBV acts on cell proliferative and cancer protecting mechanisms to cause cancers of epithelial and lymphatic origins. First discovered in Burkitt’s lymphoma, EBV is now known to cause nasopharyngeal carcinoma, gastric carcinoma, Hodgkin’s and non-Hodgkin’s lymphomas. EBV’s major oncogene, LMP1, induces signaling pathways involving NF-ƙB and PI3K to cause cellular proliferation and survival. EBV’s nuclear antigen, EBNA1, which is present in all latency stages, is able to induce anti-apoptotic effects through inhibition of p53. EBNA2, the EBNA3 family, LMP2, EBERs, and microRNAs also aid in cellular proliferation, survival, and migration through mechanisms involving PI3K, PKR, and induction of cellular gene expression. A wide range of approaches are being studied to treat EBV-associated cancers, including vaccines, adoptive cell therapies, and monoclonal antibodies reviewed here. Vaccination and cell therapy aim to enhance T cell response to specific EBV latent antigens including EBNA1, LMP1, and LMP2. Many vaccines aim to increase the number of cytotoxic T cells that recognize infected cells that present the selected EBV antigen at their surface. Clinical trials demonstrate that increased cytotoxic T cell levels track with median survival. Adoptive cell therapy uses autologous T cells specific for viral antigens that are expanded ex vivo and reinfused into patients. This approach has been shown to be effective in treating tumors and in preventing relapse. Monoclonal antibody therapy directed at EBV antigens, although less developed an approach, has shown efficacy in preclinical studies targeting EBV antigen BARF1. This strategy holds promise for a new way to treat EBV-associated cancer that may stand on its own or be combined with the others. Although there is currently no vaccine to prevent EBV from establishing chronic infection, these therapies show potential to treat its pathogenic sequelae

Genome size variation in deep-sea amphipods

Funding: This work was supported by the HADEEP projects, funded by the Nippon Foundation, Japan (2009765188); the Natural Environment Research Council (NERC), UK (NE/E007171/1); Total Foundation, France; National Institute of Water and Atmospheric Research (NIWA), New Zealand (CO1_0906); Schmidt Ocean Institute, USA (FK141109) (A.J.J. and S.B.P); Marine Alliance for Science and Technology for Scotland (MASTS) (HR09011 and DSSG15) (H.R., A.J.J., S.B.P); and the Leverhulme Trust (S.B.P.). Acknowledgements: We thank the chief scientists, crew and company of the New Zealand RV Kaharoa (KAH1301 and KAH1310) and the United States RV Falkor (Cruise FK141109). From NIWA, we thank Malcolm Clark, Ashley Rowden, Kareen Schnabel, and Sadie Mills for logistical support at the NIWA Invertebrate Collection. We thank NOAA Marine National Monuments, Richard Hall and Eric Breuer for their support and collaboration. We also thank Attila Bebes and the Iain Fraser Cytometry Centre (IFCC) for technical assistance. Electronic supplementary material is available online at https://dx.doi.org/10.6084/m9.figshare.c.3868216.Peer reviewedPublisher PD

Improving Students’ Oral Communication Skills Through an Interdisciplinary Problem-Based Learning Opportunity in a Sport Management Course

This study adopted several pedagogical foundations to determine if an interdisciplinary, problem-based learning (PBL) opportunity applied to teaching sport marketing would improve student’ individual and group oral communication skills. Faculty from two departments collaborated to create an assignment that was a hands-on class project designed around formative assessment, lecture intervention, and final PBL deliverable. The PBL and interdisciplinary design addressed the need for enhanced communication skills in the sport management industry. The study results indicate a successful development of the students’ data analysis and presentation skills. Findings confirm an interdisciplinary approach to PBL by implementing communication skill development across disciplines

The Importance of Sub-Utterance Prosody in Predicting Level of Certainty

We present an experiment aimed at understanding how to optimally use acoustic and prosodic information to predict a speaker's level of certainty. With a corpus of utterances where we can isolate a single word or phrase that is responsible for the speaker's level of certainty we use different sets of sub-utterance prosodic features to train models for predicting an utterance's perceived level of certainty. Our results suggest that using prosodic features of the word or phrase responsible for the level of certainty and of its surrounding context improves the prediction accuracy without increasing the total number of features when compared to using only features taken from the utterance as a whole.Engineering and Applied Science

Identifying Uncertain Words within an Utterance via Prosodic Features

We describe an experiment that investigates whether sub-utterance prosodic features can be used to detect uncertainty at the wordlevel. That is, given an utterance that is classified as uncertain, we want to determine which word or phrase the speaker is uncertain about. We have a corpus of utterances spoken under varying degrees of certainty. Using combinations of sub-utterance prosodic features we train models to predict the level of certainty of an utterance. On a set of utterances that were perceived to be uncertain, we compare the predictions of our models for two candidate target word segmentations: (a) one with the actual word causing uncertainty as the proposed target word, and (b) one with a control word as the proposed target word. Our best model correctly identifies the word causing the uncertainty rather than the control word 91% of the time.Engineering and Applied Science

What Do Caregivers Tell Us about Infant Babbling?

Phonetic repertoires in babbling are an important marker of prelinguistic development. Typical phonetic development, however, is difficult to identify given variability within and across infants. Prior to 18 months of infant age, caregiver report of prelinguistic vocal development is often an important part of clinical practice for early intervention. As a first step toward understanding the utility of caregiver report of babbling, the purpose of this exploratory study was to determine how the phonetic makeup of sounds reported by caregivers in infant babbling would develop, in particular comparison to markedness theory and established norms. In a longitudinal design, caregiver report was tracked through weekly interviews from 7 to 18 months of infant age (N = 15). Reports were phonetically transcribed and examined in terms of the number of utterances; place, manner, and voicing for consonants; and tongue position for vowels. In general, the number of utterances and phonetic segments reported by caregivers increased significantly with infant age (p < .05) and phonetic feature patterns were similar to what one would expect in the vocal development of English-learning infants. Results support the notion that caregiver report of infant vocalizations may provide a valuable means for describing early infant babbling development

Eliciting and annotating uncertainty in spoken language

A major challenge in the field of automatic recognition of emotion and affect in speech is the subjective nature of affect labels. The most common approach to acquiring affect labels is to ask a panel of listeners to rate a corpus of spoken utterances along one or more dimensions of interest. For applications ranging from educational technology to voice search to dictation, a speaker’s level of certainty is a primary dimension of interest. In such applications, we would like to know the speaker’s actual level of certainty, but past research has only revealed listeners’ perception of the speaker’s level of certainty. In this paper, we present a method for eliciting spoken utterances using stimuli that we design such that they have a quantitative, crowdsourced legibility score. While we cannot control a speaker’s actual internal level of certainty, the use of these stimuli provides a better estimate of internal certainty compared to existing speech corpora. The Harvard Uncertainty Speech Corpus, containing speech data, certainty annotations, and prosodic features, is made available to the research community.Engineering and Applied Science

Phonetic categorisation and cue weighting in adolescents with Specific Language Impairment (SLI)

This study investigates phonetic categorisation and cue weighting in adolescents and young adults with Specific Language Impairment (SLI). We manipulated two acoustic cues, vowel duration and F1 offset frequency, that signal word-final stop consonant voicing ([t] and [d]) in English. Ten individuals with SLI (14.0–21.4 years), 10 age-matched controls (CA; 14.6–21.9 years) and 10 non-matched adult controls (23.3–36.0 years) labelled synthetic CVC non-words in an identification task. The results showed that the adolescents and young adults with SLI were less consistent than controls in the identification of the good category representatives. The group with SLI also assigned less weight to vowel duration than the adult controls. However, no direct relationship between phonetic categorisation, cue weighting and language skills was found. These findings indicate that some individuals with SLI have speech perception deficits but they are not necessarily associated with oral language skills