Discriminative Speaker Representation via Contrastive Learning with Class-Aware Attention in Angular Space

The challenges in applying contrastive learning to speaker verification (SV) are that the softmax-based contrastive loss lacks discriminative power and that the hard negative pairs can easily influence learning. To overcome the first challenge, we propose a contrastive learning SV framework incorporating an additive angular margin into the supervised contrastive loss in which the margin improves the speaker representation's discrimination ability. For the second challenge, we introduce a class-aware attention mechanism through which hard negative samples contribute less significantly to the supervised contrastive loss. We also employed gradient-based multi-objective optimization to balance the classification and contrastive loss. Experimental results on CN-Celeb and Voxceleb1 show that this new learning objective can cause the encoder to find an embedding space that exhibits great speaker discrimination across languages.Comment: Accepted by ICASSP 2023, 5 pages, 2 figure

Mindfulness-based cognitive therapy v. group psychoeducation for people with generalised anxiety disorder: randomised controlled trial

Background: Research suggests that an 8-week mindfulness-based cognitive therapy (MBCT) course may be effective for generalised anxiety disorder (GAD). Aims: To compare changes in anxiety levels among participants with GAD randomly assigned to MBCT, cognitive–behavioural therapy-based psychoeducation and usual care. Method: In total, 182 participants with GAD were recruited (trial registration number: CUHK_CCT00267) and assigned to the three groups and followed for 5 months after baseline assessment with the two intervention groups followed for an additional 6 months. Primary outcomes were anxiety and worry levels. Results: Linear mixed models demonstrated significant group × time interaction (F(4,148) = 5.10, P = 0.001) effects for decreased anxiety for both the intervention groups relative to usual care. Significant group × time interaction effects were observed for worry and depressive symptoms and mental health-related quality of life for the psychoeducation group only. Conclusions: These results suggest that both of the interventions appear to be superior to usual care for the reduction of anxiety symptoms

Nurses' knowledge of universal health coverage for inclusive and sustainable elderly care services

Objectives: to explore nurses' knowledge of universal health coverage (UHC) for inclusive and sustainable development of elderly care services. Method: this was a cross-sectional survey. A convenience sample of 326 currently practicing enrolled nurses (EN) or registered nurses (RN) was recruited. Respondents completed a questionnaire which was based on the implementation strategies advocated by the WHO Global Forum for Governmental Chief Nursing Officers and Midwives (GCNOMs). Questions covered the government initiative, healthcare financing policy, human resources policy, and the respondents' perception of importance and contribution of nurses in achieving UHC in elderly care services. Results: the knowledge of nurses about UHC in elderly care services was fairly satisfactory. Nurses in both clinical practice and management perceived themselves as having more contribution and importance than those in education. They were relatively indifferent to healthcare policy and politics. Conclusion: the survey uncovered a considerable knowledge gap in nurses' knowledge of UHC in elderly care services, and shed light on the need for nurses to be more attuned to healthcare policy. The educational curriculum for nurses should be strengthened to include studies in public policy and advocacy. Nurses can make a difference through their participation in the development and implementation of UHC in healthcare services.Objetivos: explorar o conhecimento dos enfermeiros sobre a cobertura universal de saúde (CUS) para o desenvolvimento inclusivo e sustentável de serviços de saúde a idosos. Método: estudo transversal. Foi recrutada uma amostra de conveniência de 326 enrolled nurses (EN) ou registered nurses (RN). Os entrevistados responderam a um questionário com base nas estratégias de implementação preconizadas pelo Fórum Global da OMS para Governmental Chief Nursing Officers and Midwives (GCNOMs). As perguntas abordavam iniciativas do governo, políticas de financiamento da saúde, políticas de recursos humanos e percepção dos entrevistados sobre a importância e contribuição do enfermeiro no alcance da CUS em serviços de cuidados a idosos. Resultado: o conhecimento de enfermeiros sobre a CUS em serviço de atenção ao idoso foi razoavelmente satisfatório. Enfermeiros tanto da prática clínica como da gestão perceberam-se contribuindo mais e tendo mais importância do que aqueles que trabalham na educação. Eles eram relativamente indiferentes à política de saúde e à política. Conclusão: a pesquisa revelou uma lacuna de conhecimento considerável no conhecimento da CUS pelos enfermeiros nos serviços de cuidados a idosos e evidenciou a necessidade de enfermeiros terem mais sintonia com a política de saúde. O currículo de formação para preparar os enfermeiros deve ser reforçado para incluir estudos em política pública e advocacia. Os enfermeiros podem fazer a diferença por meio de sua participação no desenvolvimento e implementação da CUS nos serviços de saúde.Objetivos: explorar los conocimientos que tienen las enfermeras sobre la cobertura universal de salud (CUS) para el desarrollo inclusivo y sostenible de servicios para el cuidado de adultos mayores. Método: se utilizó una encuesta transversal. Se formó una muestra de conveniencia de 326 enrolled nurses (EN) o registered nurses (RN) que actualmente estuvieran ejerciendo. Los encuestados respondieron a un cuestionario basado en las estrategias de implementación apoyadas por el WHO Global Forum for Government Chief Nursing and Midwifery Officers (WGFGCNO). Las preguntas abarcaban la iniciativa del gobierno, políticas de financiamiento de la salud, las políticas de recursos humanos y la percepción de los encuestados sobre la importancia y la contribución de las enfermeras en el logro de la CUS en los servicios de cuidado para adultos mayores. Resultados: el conocimiento de las enfermeras sobre CUS en el servicio de cuidado para los adultos mayores fue bastante satisfactorio. Tanto las enfermeras de práctica clínica y como las de gestión perciben tener un mayor aporte e importancia que las de que están en educación. Tenían un punto de vista relativamente indiferente a la política sanitaria y la política. Conclusión: la encuesta descubrió una considerable brecha en el conocimiento de las enfermeras sobre CUS en los servicios de cuidado para adultos mayores y puso de manifiesto la necesidad de que las enfermeras estén más en sintonía con la política sanitaria. El plan de estudios para la preparación de las enfermeras debe fortalecerse para incluir estudios en las políticas públicas y promoción. Las enfermeras pueden hacer una diferencia a través de su participación en el desarrollo e implementación de CUS en los servicios de salud

Gametogenesis, Embryogenesis, and Fertilization Ecology of Platygyra acuta

Understanding the reproductive biology of dominant coral species in subtropical nonreefal coral communities is critical in providing important information on the processes underlying the distribution limits of coral species and communities. This is the first study that investigates the reproduction cycle, gametogenesis, and fertilization ecology of Platygyra acuta. Results indicated that P. acuta is hermaphroditic and exhibits a single annual gametogenic cycle. Oogenic and spermatogenic cycle occurs for 6-7 months and for 2 months, respectively, prior to annual mass spawning event in May to June in Hong Kong. It took 18 hours for P. acuta to complete embryonic development, develop cilia, and start to rotate. High (>70%) fertilization success can be achieved under a broad range of sperm concentrations from 104 to 107 sperms mL−1. Fertilization success remained consistently high 6 h after spawning, indicating a prolonged viability of its gametes that is much longer than that recorded for other coral species. Significantly higher percentage of fertilization success was recorded in the first of the two consecutive nights of spawning, suggesting differences in the quality of the eggs and/or sperms between days of spawning. These results serve as important baseline information for better understanding of corals in marginal communities

Oil palm waste: An abundant and promising feedstock for microwave pyrolysis conversion into good quality biochar with potential multi-applications

Oil palm waste (OPW), comprising mainly of empty fruit bunch, mesocarp fiber, frond, trunk, and palm kernel shell generated from palm oil industry, was collected, characterized, and then pyrolyzed to evaluate their potential to be converted into biochar with desirable properties for use in multi-applications. The OPW was detected to have considerable amounts of carbon (43–51 wt%) and fixed carbon (30–39 wt%), showing potential to be converted into carbon-rich biochar. Microwave pyrolysis of palm kernel shell as the selected OPW produced a biochar with zero sulphur content and high heating value (23–26 MJ/kg) that is nearly comparable to conventional coal, thus indicating its potential as an eco-friendly solid fuel. The biochar obtained was also showed low moisture (<3 wt%) and ash (3 wt%), and a highly porous structure with high BET surface area (210 m2/g), indicating the presence of many adsorption sites and thus showing desirable characteristics for potential use as pollutant adsorbent in wastewater treatment, or bio-fertilizer to absorb nutrient and promote plant growth. Our results demonstrate that OPW is a biowaste that shows exceptional promise to be transformed into high-grade biochar rather than simply disposed by landfilling or burned as low-grade fuel in boiler

Elevated adipogenesis of marrow mesenchymal stem cells during early steroid-associated osteonecrosis development

<p>Abstract</p> <p>Background</p> <p>Increased bone marrow lipid deposition in steroid-associated osteonecrosis (ON) implies that abnormalities in fat metabolism play an important role in ON development. The increase in lipid deposition might be explained by elevated adipogenesis of marrow mesenchymal stem cells (MSCs). However, it remains unclear whether there is a close association between elevated adipogenesis and steroid-associated ON development.</p> <p>Objective</p> <p>The present study was designed to test the hypothesis that there might be a close association between elevated adipogenesis and steroid-associated ON development.</p> <p>Methods</p> <p>ON rabbit model was induced based on our established protocol. Dynamic-MRI was employed for local intra-osseous perfusion evaluation in bilateral femora. Two weeks after induction, bone marrow was harvested for evaluating the ability of adipogenic differentiation of marrow MSCs at both cellular and mRNA level involving adipogenesis-related gene peroxisome proliferator-activated receptor gamma2 (PPARγ2). The bilateral femora were dissected for examining marrow lipid deposition by quantifying fat cell number, fat cell size, lipid deposition area and ON lesions. For investigating association among adipogenesis, lipid deposition and perfusion function with regard to ON occurrence, the rabbits were divided into ON⁺(with at least one ON lesion) group and ON^-(without ON lesion) group. For investigating association among adipogenesis, lipid deposition and perfusion function with regard to ON extension, the ON⁺rabbits were further divided into sub-single-lesion group (SON group: with one ON lesion) and sub-multiple-lesion group (MON group: with more than one ON lesion).</p> <p>Results</p> <p>Local intra-osseous perfusion index was found lower in either ON⁺or MON group when compared to either ON^-or SON group, whereas the marrow fat cells number and area were much larger in either ON⁺or MON group as compared with ON^-and SON group. The adipogenic differentiation ability of MSCs and PPARγ2 expression in either ON⁺or MON group were elevated significantly as compared with either ON^-or SON group.</p> <p>Conclusion</p> <p>These findings support our hypothesis that there is a close association between elevated adipogenesis and steroid-associated osteonecrosis development.</p

Sulfonylurea is associated with higher risks of ventricular arrhythmia or sudden cardiac death compared with metformin: A population-based cohort study

Background Commonly prescribed diabetic medications such as metformin and sulfonylurea may be associated with different arrhythmogenic risks. This study compared the risk of ventricular arrhythmia or sudden cardiac death between metformin and sulfonylurea users in patients with type 2 diabetes. Methods and Results Patients aged ≥40 years who were diagnosed with type 2 diabetes or prescribed antidiabetic agents in Hong Kong between January 1, 2009, and December 31, 2009, were included and followed up until December 31, 2019. Patients prescribed with both metformin and sulfonylurea or had prior myocardial infarction were excluded. The study outcome was a composite of ventricular arrhythmia or sudden cardiac death. Metformin users and sulfonylurea users were matched at a 1:1 ratio by propensity score matching. The matched cohort consisted of 16 596 metformin users (47.70% men; age, 68±11 years; mean follow‐up, 4.92±2.55 years) and 16 596 sulfonylurea users (49.80% men; age, 70±11 years; mean follow‐up, 4.93±2.55 years). Sulfonylurea was associated with higher risk of ventricular arrhythmia or sudden cardiac death than metformin hazard ratio (HR, 1.90 [95% CI, 1.73–2.08]). Such difference was consistently observed in subgroup analyses stratifying for insulin usage or known coronary heart disease. Conclusions Sulfonylurea use is associated with higher risk of ventricular arrhythmia or sudden cardiac death than metformin in patients with type 2 diabetes

Herpes zoster related hospitalization after inactivated (CoronaVac) and mRNA (BNT162b2) SARS-CoV-2 vaccination: A self-controlled case series and nested case-control study

BACKGROUND: Stimulation of immunity by vaccination may elicit adverse events. There is currently inconclusive evidence on the relationship between herpes zoster related hospitalization and COVID-19 vaccination. This study aimed to evaluate the effect of inactivated virus (CoronaVac, Sinovac) and mRNA (BNT162b2, BioNTech/Fosun Pharma) COVID-19 vaccine on the risk of herpes zoster related hospitalization. METHODS: Self-controlled case series (SCCS) analysis was conducted using the data from the electronic health records in Hospital Authority and COVID-19 vaccination records in the Department of Health in Hong Kong. We conducted the SCCS analysis including patients with a first primary diagnosis of herpes zoster in the hospital inpatient setting between February 23 and July 31, 2021. A confirmatory analysis by nested case-control method was also conducted. Each herpes zoster case was randomly matched with ten controls according to sex, age, Charlson comorbidity index, and date of hospital admission. Conditional Poisson regression and logistic regression models were used to assess the potential excess rates of herpes zoster after vaccination. FINDINGS: From February 23 to July 31, 2021, a total of 16 and 27 patients were identified with a first primary hospital diagnosis of herpes zoster within 28 days after CoronaVac and BNT162b2 vaccinations. The incidence of herpes zoster was 7.9 (95% Confidence interval [CI]: 5.2–11.5) for CoronaVac and 7.1 (95% CI: 4.1–11.5) for BNT162b2 per 1,000,000 doses administered. In SCCS analysis, CoronaVac vaccination was associated with significantly higher risk of herpes zoster within 14 days after first dose (adjusted incidence rate ratio [aIRR]=2.67, 95% CI: 1.08–6.59) but not in other periods afterwards compared to the baseline period. Regarding BNT162b2 vaccination, a significantly increased risk of herpes zoster was observed after first dose up to 14 days after second dose (0-13 days after first dose: aIRR=5.23, 95% CI: 1.61–17.03; 14–27 days after first dose: aIRR=5.82, 95% CI: 1.62–20.91; 0-13 days after second dose: aIRR=5.14, 95% CI: 1.29–20.47). Using these relative rates, we estimated that there has been an excess of approximately 5 and 7 cases of hospitalization as a result of herpes zoster after every 1,000,000 doses of CoronaVac and BNT162b2 vaccination, respectively. The findings in the nested case control analysis showed similar results. INTERPRETATION: We identified an increased risk of herpes zoster related hospitalization after CoronaVac and BNT162b2 vaccinations. However, the absolute risks of such adverse event after CoronaVac and BNT162b2 vaccinations were very low. In locations where COVID-19 is prevalent, the protective effects on COVID-19 from vaccinations will greatly outweigh the potential side effects of vaccination. FUNDING: The project was funded by Research Grant from the Food and Health Bureau, The Government of the Hong Kong Special Administrative Region (Ref. No.COVID19F01). FTTL (Francisco Tsz Tsun Lai) and ICKW (Ian Chi Kei Wong)’s posts were partly funded by D(2)4H; hence this work was partly supported by AIR@InnoHK administered by Innovation and Technology Commission