Voice activity detection based on density ratio estimation and system combination

Abstract-We propose a robust voice activity detection (VAD) based on density ratio estimation. In highly noisy environments, the likelihood ratio test (LRT) is effective. Conventional LRT estimates both speech and noise models, calculates the likelihood of each model, and uses ratios of such likelihood to detect speech. However, in LRT, the likelihood ratio of speech and noise models is required, whereas likelihood of individual models is not necessarily required. The framework of the density ratio estimation models likelihood ratio functions by a kernel and directly generates a likelihood ratio. Applying density ratio estimation to VAD requires that feature selection and noise adaptation must be considered. This is because the density ratio estimation constrains the shape of the likelihood ratio functions and speech is dynamic. This paper addresses these problems. To improve accuracy, the proposed method is combined with conventional LRT. Experimental results using CENSREC-1-C show that the proposed method is more effective than conventional methods, especially in non-stationary noisy environments

Rapid measurement of serum caffeine concentrations in acuteclinical settings

AbstractThe number of acute caffeine poisoning cases have increased in Japan. We can use serum caffeine concentrations to evaluate the severity of caffeine poisoning and determine whether or not we should perform hemodialysis. In this study, we sought to develop a rapid method for measuring serum caffeine concentrations. We used liquid chromatography-tandem mass spectrometry (LC-MS/MS) in the new method. We chose caffeine-d9 as the internal standard, and we used the standard addition method to quantify caffeine concentrations. We collected six blood samples from three patients with acute caffeine poisoning to measure serum caffeine concentrations. In our method, retention time for caffeine was 0.4 min, and the time required for the total LC-MS/MS analysis was 1 min per sample. We obtained accurate serum caffeine concentrations 7 min after injection into the LC-MS/MS instrument. Further, time-consuming sample pretreatment was not required because each sample was diluted 10,000-fold. As a result, we could obtain serum caffeine concentrations for each patient in a total of 40 min. Our findings suggest that rapid, accurate measurement of serum caffeine concentrations by LC-MS/MS could contribute to real-time evaluation of poisoning severity and determination of appropriate therapeutic strategies in acute clinical settings

Effect of amlodipine, efonidipine, and trichlormethiazide on home blood pressure and upper-normal microalbuminuria assessed by casual spot urine test in essential hypertensive patients

The aim of this study was to assess the effects of irbesartan alone and combined with amlodipine, efonidipine, or trichlormethiazide on blood pressure (BP) and urinary albumin (UA) excretion in hypertensive patients with microalbuminuria (30≤UA/creatinine (Cr) ratio [UACR] <300 mg/g Cr) and upper-normal microalbuminuria (10≤UACR<30 mg/g Cr). This randomized controlled trial enrolled 175 newly diagnosed and untreated hypertensive patients (home systolic blood pressure [SBP]≥135 mmHg; 10≤UACR<300 mg/g Cr of casual spot urine at the first visit to clinic). All patients were treated with irbesartan (week 0). Patients who failed to achieve home SBP ≤125 mmHg on 8-week irbesartan monotherapy (nonresponders, n = 115) were randomized into three additional drug treatment groups: trichlormethiazide (n = 42), efonidipine (n = 39), or amlodipine (n = 34). Irbesartan monotherapy decreased home SBP and first morning urine samples (morning UACR) for 8 weeks (p < 0.0001). At 8 weeks after randomization, all three additional drugs decreased home SBP (p < 0.0002) and trichlormethiazide significantly decreased morning UACR (p = 0.03). Amlodipine decreased morning UACR in patients with microalbuminuria based on casual spot urine samples (p = 0.048). However, multivariate analysis showed that only higher home SBP and UACR at week 8, but not any additional treatments, were significantly associated with UACR reduction between week 8 and week 16. In conclusion, crucial points of the effects of combination therapy on UACR were basal UACR and SBP levels. The effect of trichlormethiazide or amlodipine treatment in combination with irbesartan treatment on microalbuminuria needs to be reexamined based on a larger sample size after considering basal UACR and SBP levels

Does Antihypertensive Drug Class Affect Day-to-Day Variability of Self-Measured Home Blood Pressure? The HOMED-BP Study

BACKGROUND: Recent literature suggests that blood pressure variability (BPV) predicts outcome beyond blood pressure level (BPL) and that antihypertensive drug classes differentially influence BPV. We compared calcium channel blockers, angiotensin‐converting enzyme inhibitors, and angiotensin receptor blockade for effects on changes in self‐measured home BPL and BPV and for their prognostic significance in newly treated hypertensive patients. METHODS AND RESULTS: We enrolled 2484 patients randomly allocated to first‐line treatment with a calcium channel blocker (n=833), an angiotensin‐converting enzyme inhibitor (n=821), or angiotensin receptor blockade (n=830). Home blood pressures in the morning and evening were measured for 5 days off treatment before randomization and for 5 days after 2 to 4 weeks of randomized drug treatment. We assessed BPL and BPV changes as estimated by variability independent of the mean and compared cardiovascular outcomes. Home BPL response in each group was significant (P≤0.0001) but small in the angiotensin‐converting enzyme inhibitor group (systolic/diastolic: 4.6/2.8 mm Hg) compared with the groups treated with a calcium channel blocker (systolic/diastolic: 8.3/3.9 mm Hg) and angiotensin receptor blockade (systolic/diastolic: 8.2/4.5 mm Hg). In multivariable adjusted analyses, changes in home variability independent of the mean did not differ among the 3 drug classes (P≥0.054). Evening variability independent of the mean before treatment significantly predicted hard cardiovascular events independent of the corresponding home BPL (P≤0.022), whereas BPV did not predict any cardiovascular outcome based on the morning measurement (P≥0.056). Home BPV captured after monotherapy had no predictive power for cardiovascular outcome (P≥0.22). CONCLUSIONS: Self‐measured home evening BPV estimated by variability independent of the mean had prognostic significance, whereas antihypertensive drug classes had no significant impact on BPV changes. Home BPL should remain the primary focus for risk stratification and treatment. CLINICAL TRIAL REGISTRATION: URL: http://www.umin.ac.jp/ctr/index.htm. Unique identifier: C000000137

Does Antihypertensive Drug Class Affect Day-to-Day Variability of Self-Measured Home Blood Pressure? The HOMED-BP Study

Recent literature suggests that blood pressure variability (BPV) predicts outcome beyond blood pressure level (BPL) and that antihypertensive drug classes differentially influence BPV. We compared calcium channel blockers, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockade for effects on changes in self-measured home BPL and BPV and for their prognostic significance in newly treated hypertensive patients.status: publishe