Effects of forensically-relevant facial concealment on acoustic and perceptual properties of consonants

This thesis offers a thorough investigation into the effects of forensically-relevant facial concealment on speech acoustics and perception. Specifically, it explores the extent to which selected acoustic-phonetic and auditory-perceptual properties of consonants are affected when the talker is wearing ‘facewear’ while speaking. In this context, the term ‘facewear’ refers to the various types of face-concealing garments and headgear that are worn by people in common daily communication situations; for work and leisure, or as an expression of religious, social and cultural affiliation (e.g. surgical masks, motorcycle helmets, ski and cycling masks, or full-face veils such as the niqāb). It also denotes the face or head coverings that are typically used as deliberate (visual) disguises during the commission of crimes and in situations of public disorder (e.g. balaclavas, hooded sweatshirts, or scarves). The present research centres on the question: does facewear influence the way that consonants are produced, transmitted, and perceived? To examine the effects of facewear on the acoustic speech signal, various intensity, spectral, and temporal properties of spoken English consonants were measured. It was found that facewear can considerably alter the acoustic-phonetic characteristics of consonants. This was likely to be the result of both deliberate and involuntary changes to the talker’s speech productions, and of sound energy absorption by the facewear material. The perceptual consequences of the acoustic modifications to speech were assessed by way of a consonant identification study and a talker discrimination study. The results of these studies showed that auditory-only and auditory-visual consonant intelligibility, as well as the discrimination of unfamiliar talkers, may be greatly compromised when the observer’s judgements are based on ‘facewear speech’. The findings reported in this thesis contribute to our understanding of how auditory and visual information interact during natural speech processing. Furthermore, the results have important practical implications for legal cases in which speech produced through facewear is of pivotal importance. Forensic speech scientists are therefore advised to take the possible effects of facewear on speech into account when interpreting the outcome of their acoustic and auditory analyses of evidential speech recordings, and when evaluating the reliability of earwitness testimony

Interplay of Immunosuppression and Immunotherapy Among Patients With Cancer and COVID-19

IMPORTANCE: Cytokine storm due to COVID-19 can cause high morbidity and mortality and may be more common in patients with cancer treated with immunotherapy (IO) due to immune system activation. OBJECTIVE: To determine the association of baseline immunosuppression and/or IO-based therapies with COVID-19 severity and cytokine storm in patients with cancer. DESIGN, SETTING, AND PARTICIPANTS: This registry-based retrospective cohort study included 12 046 patients reported to the COVID-19 and Cancer Consortium (CCC19) registry from March 2020 to May 2022. The CCC19 registry is a centralized international multi-institutional registry of patients with COVID-19 with a current or past diagnosis of cancer. Records analyzed included patients with active or previous cancer who had a laboratory-confirmed infection with SARS-CoV-2 by polymerase chain reaction and/or serologic findings. EXPOSURES: Immunosuppression due to therapy; systemic anticancer therapy (IO or non-IO). MAIN OUTCOMES AND MEASURES: The primary outcome was a 5-level ordinal scale of COVID-19 severity: no complications; hospitalized without requiring oxygen; hospitalized and required oxygen; intensive care unit admission and/or mechanical ventilation; death. The secondary outcome was the occurrence of cytokine storm. RESULTS: The median age of the entire cohort was 65 years (interquartile range [IQR], 54-74) years and 6359 patients were female (52.8%) and 6598 (54.8%) were non-Hispanic White. A total of 599 (5.0%) patients received IO, whereas 4327 (35.9%) received non-IO systemic anticancer therapies, and 7120 (59.1%) did not receive any antineoplastic regimen within 3 months prior to COVID-19 diagnosis. Although no difference in COVID-19 severity and cytokine storm was found in the IO group compared with the untreated group in the total cohort (adjusted odds ratio [aOR], 0.80; 95% CI, 0.56-1.13, and aOR, 0.89; 95% CI, 0.41-1.93, respectively), patients with baseline immunosuppression treated with IO (vs untreated) had worse COVID-19 severity and cytokine storm (aOR, 3.33; 95% CI, 1.38-8.01, and aOR, 4.41; 95% CI, 1.71-11.38, respectively). Patients with immunosuppression receiving non-IO therapies (vs untreated) also had worse COVID-19 severity (aOR, 1.79; 95% CI, 1.36-2.35) and cytokine storm (aOR, 2.32; 95% CI, 1.42-3.79). CONCLUSIONS AND RELEVANCE: This cohort study found that in patients with cancer and COVID-19, administration of systemic anticancer therapies, especially IO, in the context of baseline immunosuppression was associated with severe clinical outcomes and the development of cytokine storm. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04354701