bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emotional Speech Recognition Based on Weighted Distance Optimization System
Authors: ElBedwehy Mona Nagy , Behery G. M. , Elbarougy Reda 
Published: November 2019

Human emotion plays a major role in expressing their feelings through speech. Emotional speech recognition is an important research field in the human–computer interaction. Ultimately, the endowing machines that perceive the users’ emotions will enable a more intuitive and reliable interaction.The researchers presented many models to recognize the human emotion from the speech. One of the famous models is the Gaussian mixture model (GMM). Nevertheless, GMM may sometimes have one or more of its components as ill-conditioned or singular covariance matrices when the number of features is high and some features are correlated. In this research, a new system based on a weighted distance optimization (WDO) has been developed for recognizing the emotional speech. The main purpose of the WDO system (WDOS) is to address the GMM shortcomings and increase the recognition accuracy. We found that WDOS has achieved considerable success through a comparative study of all emotional states and the individual emotional state characteristics. WDOS has a superior performance accuracy of 86.03% for the Japanese language. It improves the Japanese emotion recognition accuracy by 18.43% compared with GMM and [Formula: see text]-mean.
Research and Application of Key Technologies for Medical Image Intelligence Knowledge Discovery and Data Processing
Authors: Hu Ruo , Li Ming , Xu Hong , Zhao Hui Min 
Published: November 2019

Hospitals have accumulated a large amount of medical image data which need to be analyzed and integrated so as to be able to find the needed medical image in time, which is the basis of key technologies such as intelligent diagnosis of diseases. Meanwhile, through the analysis and integrated processing of medical images, the potential value of existing medical image data can be fully explored. In this paper, the key technologies in the intelligent image knowledge discovery system and the characteristics of medical image data are studied and improved. In this paper, the characteristics of knowledge discovery and medical image data are comprehensively considered, and RDM texture features are selected as the feature representation of medical images. An improved RDM operator is proposed and proved by experimental results. Experimental results show that the improved RDM coding method can improve the stability of medical image data expression.
Reactive and Semi-Reactive Bargaining Sets for Games with Restricted Cooperation
Authors: Naumova Natalia 
Published: November 2019

Generalizations of reactive and semi-reactive bargaining sets of TU games are defined for the case when objections and counter-objections are permitted not between singletons but between elements of a family of coalitions [Formula: see text] and can use coalitions from [Formula: see text]. Necessary and sufficient conditions on [Formula: see text], [Formula: see text] that ensure existence results for generalizations of the reactive bargaining set and of the semi-reactive barganing set at each TU game [Formula: see text] with nonnegative values are obtained. The existence conditions for the generalized reactive bargaining set do not coincide with existence conditions for the generalized kernel and coincide with conditions for the generalized semi-reactive bargaining set only if [Formula: see text] and [Formula: see text]. The conditions for the generalized semi-reactive bargaining set coincide with conditions for the generalized classical bargaining set that were described in the previous papers of the author. For monotonic [Formula: see text], the condition on [Formula: see text] for existence of the generalized semi-reactive bargaining sets on the class of games with nonnegative values is also necessary and sufficient on the class of simple games, but similar result for the generalized classical bargaining sets is proved only for [Formula: see text].
Ortega’s Pragmatist Perspectivism: On the Problem of Relativism
Authors: Binder Marnie 
Published: November 2019

Abstract
Spanish Philosopher José Ortega y Gasset advanced a number of strong criticisms of American pragmatism, yet some pragmatist notions can also be detected in his own philosophy. Within Ortega’s pragmatist perspectivism one can locate the possibility of overcoming one of the principal perceived problems of pragmatism: namely, its tendency toward relativism. This paper focuses on the ways in which Ortega’s discussion of pragmatism pertains to history and historiography. Ortega’s position that history is written from a select number of perspectives is congenial to pragmatist pluralism. What is recorded and continues to thrive in the annals of history is, within a pragmatist framework, whatever continues to be interesting, relevant, useful, and meaningful because it makes a difference – from and for these perspectives. The more of these perspectives we study, the closer we approach what, on Ortega’s view, constitutes the “eternal truth which every period has lived,” because materials initially gathered and framed for pragmatic reasons can later on provide important opportunities for the reflexive analysis of historical knowledge.
The Usefulness of Respiratory Mechanic Instability in Evaluating the Effect of Continuous Positive Airway Pressure for Obstructive Sleep Apnea
Authors: Choi Ji Ho , Jung Jae Yeup , Moon Ji Eun , Hwang Se-Hwan 
Published: November 2019

Objectives: Respiratory mechanics instability (RMI) based on paradoxical movement is correlated with respiratory disturbance such as apnea-hypopnea index (AHI) and reflects the severity of obstructive sleep apnea (OSA). The purpose of this study was to identify RMI as a method for assessing the effectiveness of continuous positive airway pressure (CPAP) in the management for OSA. Methods: A total of 71 consecutive OSA patients with CPAP titration were included in this study. We compared sleep (sleep efficiency, arousal index, and sleep stages), respiratory (AHI, oxygen desaturation index ≥3% [ODI3], and lowest oxygen saturation), and RMI parameters (events, index, duration, and % of stage duration) between diagnostic polysomnography and CPAP titration data. Results: All RMI parameters (events [157.5 ± 80.9 vs 80.0 ± 47.1; P < .001], index [25.3 ± 12.4 vs 12.7 ± 7.0; P < .001], duration [182.6 ± 96.2 vs 79.8 ± 88.9; P < .001], and % of stage duration [49.0 ± 24.4 vs 20.5 ± 21.3; P < .001]) were significantly improved by the alleviation of obstructive respiratory disturbance parameters (AHI [45.1 ± 23.0 vs 4.2 ± 4.3; P < .001], ODI3 [44.9 ± 22.6 vs 4.8 ± 4.6; P < .001], and lowest oxygen saturation [77.7 ± 7.3 vs 89.3 ± 3.8; P < .001]) compared to diagnostic polysomnography and CPAP titration data. Conclusion: RMI may be a useful method for evaluating the effect of CPAP in OSA patients.
Assessing nutritional status in a cohort of liver cirrhosis outpatients: A prospective cross-sectional study
Authors: Luong Rebecca , Kim Marcellinus , Lee Alice , Carey Sharon 
Published: November 2019

Background: Malnutrition impairs prognosis in patients with liver cirrhosis (LC). There is limited research exploring the prevalence of malnutrition in patients with LC in an Australian population and in outpatient settings. Aims: One aim of this study was to investigate the prevalence of malnutrition in patients with LC in an outpatient liver clinic at a tertiary metropolitan hospital in Sydney, Australia, and explore other factors that may be associated with malnutrition. The second aim was to compare different versions of Subjective Global Assessment (SGA). Methods: This cross-sectional study evaluated the nutritional status of 42 prospectively recruited participants by SGA, SGA modified for liver disease (SGA-LD) and patient-generated SGA (PG-SGA). Anthropometric measures and handgrip strength (HGS) were also measured for comparison. Clinical and demographic data were compared with nutritional status. Results: SGA, SGA-LD and PG-SGA yielded the same prevalence of malnutrition of 40% with very good agreement (kappa value = 1.00). Malnourished patients had a lower median HGS% of normal than those who were well-nourished. Malnourished patients also had anthropometric measurements trending towards the lower percentiles of a healthy population. Nutritional status was significantly associated with ethnicity ( p = 0.02) and PG-SGA score ( p < 0.0001). Conclusion: The present study showed that nearly half of our study population were malnourished (40%). Thus, nutrition intervention in terms of nutrition support could improve patient outcomes. It appears that the standard SGA is suitable to assess nutritional status in patients in the early stages of LC compared to more time-consuming SGA versions.
Treatment-related adverse events and response rate to immune checkpoint inhibition
Authors: Li Yanmin , Wang Zhengping , Guo Ting , Liu Shenghua , Feng Chenchen 
Published: November 2019

Background Immune checkpoint inhibition (ICI) represents a novel treatment modality for refractory cancers, and improving prediction of potential responders is critical. Method We hypothesized that ICI is a systemic-effecting mechanism. The objective response rate (ORR) for anti-PD-1, anti-PD-L1, anti-CTLA-4, or combination therapy was plotted against the corresponding all-grade and grade 3–4 (G3/4) treatment-related adverse events (TRAEs) across several cancer types using an extensive literature search (MEDLINE and Google Scholar; December 1, 2012–December 30, 2017). Results Sixty-six eligible studies comprised 76 cohorts and 25 cancer types. A significant correlation was present between all-grade or G3/4 TRAEs and the ORR. The correlation coefficient was 0.5 for all-grade and 0.4 for G3/4 TRAEs, suggesting that >50% of the differences in the ORR across cancer types may be reflected by TRAEs and 40% of ORR differences may be predicted by G3/4 TRAEs. Hodgkin’s lymphoma and Merkel cell carcinoma showed a better response, while adrenocortical cancer, breast cancer, and uveal melanoma showed a worse response, compared with that predicted by TRAE. Conclusion There is a strong relationship between TRAEs and ICI activity across multiple cancers. The toxicity profile compared with the ORR to ICIs should be investigated in phase I trials.
Physical Activity as a Predictor of Clinical Trial Outcomes in Bipolar Depression: A Subanalysis of a Mitochondrial-Enhancing Nutraceutical Randomized Controlled Trial
Authors: Ashton Melanie M. , Mohebbi Mohammadreza , Turner Alyna , Marx Wolfgang , Berk Michael , Malhi Gin S. , Ng Chee H. , Cotton Sue M. , Dodd Seetal , Sarris Jerome , Hopwood Malcolm , Stubbs Brendon , Dean Olivia M. 
Published: November 2019

Objectives Individuals with bipolar disorder (BD) generally engage in low levels of physical activity (PA), and yet few studies have investigated the relationship between PA and change in BD symptom severity. The aim of this subanalysis of an adjunctive nutraceutical randomized controlled trial for the treatment of bipolar depression was to explore the relationship between PA, the active adjunctive treatments (a nutraceutical “mitochondrial cocktail”), and clinical outcomes. Methods Participants with bipolar depression were randomized to receive N-acetylcysteine alone, N-acetylcysteine with a combination of nutraceuticals (chosen for the potential to increase mitochondrial activity), or placebo for 16 weeks. Participants ( n = 145) who completed the International Physical Activity Questionnaire–Short Form (IPAQ-SF; measured at Week 4) were included in this exploratory subanalysis. Assessments of BD symptoms, functioning, and quality of life were completed at monthly visits up until Week 20. Generalised Estimating Equations were used to explore whether IPAQ-SF scores were a moderator of treatment received on outcomes of the study. Results Week-4 PA was not related to changes in Montgomery Åsberg Depression Rating Scale scores across the study until Week 20. However, participants who engaged in more PA and who received the combination treatment were more likely to have a reduction in scores on the Bipolar Depression Rating Scale ( P = 0.03). However, this was not consistent in all domains explored using the IPAQ-SF. Participants who engaged in higher levels of PA also experienced greater improvement in social and occupational functioning and less impairment in functioning due to their psychopathology and improvement in quality of life at Week 20, irrespective of treatment. Conclusions This study provides novel evidence of the association between PA and reduction in BD symptoms in a nutraceutical clinical trial. However, further research assessing the potential synergistic effects of PA in BD is required.
Stakeholder’s perceived value of surgical audit data provided by the Victorian Audit of Surgical Mortality
Authors: Cloney Thomas , Vinluan Jessele , Chen Andrew , Retegan Claudia , McCahy Philip 
Published: November 2019

Background: Clinical audits can vary in their effectiveness depending on how the information is provided and the relationship between those giving and receiving feedback. In the Australian state of Victoria, the Victorian Audit of Surgical Mortality (VASM) is a state-wide mortality audit that, prior to this study, did not have a bidirectional feedback mechanism in place to gauge perception of the audit held by its stakeholders. Objective: We aimed to investigate the perceived quality of the audit’s information and the effectiveness of the audit’s communication strategies from the stakeholder population. Methods: We used a mixed methods approach to provide open-ended explorations into stakeholders’ views while also providing structured tools for conducting annual reviews. The qualitative data were analysed using an inductive content analysis. Results: Between 2015 and 2017, 240 VASM stakeholders were contacted, of whom 82 (34.2%) agreed to be interviewed. The VASM’s data were perceived to be of high quality and used in a variety of ways. The audit’s communication strategies were seen to be adequate but could be more targeted to the stakeholder. There is a perception that the audit might not be relevant to hospital stakeholders that are not themselves clinicians, despite direct involvement with the audit. Conclusion: This study helps to explain the role the audit plays among its stakeholders and offers three overarching recommendations for improvement strategies: produce data sharing strategies that are relevant to rural or highly specialised surgical centres, improve communication to be targeted at stakeholders and explore methods to provide feedback to hospital management with more individualised feedback.
The role of a clinical nurse specialist in managing patients with trigeminal neuralgia
Authors: Ghiai Artemis , Mohamed Tay-Yibah , Hussain Mahrukh , Hayes Emma , Zakrzewska Joanna M 
Published: November 2019

Background and Aims: Patients with trigeminal neuralgia (TN) can be overwhelmed with information they are given when first seen in a specialist secondary care clinic. The purpose of this study is to evaluate the extent to which a telephone service provided by the clinical nurse specialist (CNS) with independent prescribing rights improves patient management and satisfaction and reduces costs. Methods: All patients with a diagnosis of TN who used the CNS telephone service in 2015 were contacted by two medical students (independent observers) using a semi-structured questionnaire. Patients who could not be contacted were sent the same questionnaire and asked to return it by post. Results: Fifty-two patients were identified and 34 replied to a telephone call and 10 to a questionnaire, response rate 85%. Overall, 61% of patients rated their care outstanding or excellent. Four patients could not remember their consultation, others had used it on multiple occasions. Reasons for the consultation were pain management 50%, changeover of drugs 25%, advice about drug schedules 17%, and dealing with side effects 8%. The number of general practitioner (GP) consultations decreased as a result of this service. Patients suggested that the service should be available more than once a week. Conclusion: The CNS telephone service cut down on the number of outpatient appointments needed and reduced travel costs. Patients were appreciative that the CNS was in contact with GPs and this ensured prescriptions were filled in a timely manner and strengthen links with practices.
Localized ulcerative nodular amyloidosis presenting as ulcerative panniculitis, an unusual clinical manifestation: A case report
Authors: Fernandes Carolina , Éthier Vincent , Marouan Sofia , Chababi-Atallah Myrna , Veilleux Mylène 
Published: November 2019

Introduction and objectives: The main objective of this article is to present and discuss a case of localized ulcerative nodular amyloidosis with deep involvement clinically manifesting as ulcerative panniculitis and discuss its impact on the choice of treatment. Methods and results: We present a 73-year-old woman with a history of painful ulcerated nodules on the inferior limbs. Microscopy confirmed amyloid deposits deep in the dermis and subcutaneous fat. No systemic involvement was found. Considering that skin-directed treatments often are not able to reach subcutaneous fat or were contraindicated because of the ulcers, she was successfully treated with cyclophosphamide and prednisone. Conclusion: Localized ulcerative nodular amyloidosis with deep involvement is a rare clinical presentation that can present as ulcerative panniculitis. Such a clinical manifestation might be misleading. Systemic treatment might be necessary to control symptoms when conventional skin-directed therapies are contraindicated.
Is There a Role for Preoperative Local Infiltration of Tranexamic Acid in Elective Spine Surgery? A Prospective Randomized Controlled Trial Analyzing the Efficacy of Intravenous, Local Infiltration, and Topical Administration of Tranexamic Acid
Authors: Arun-Kumar Viswanadha , Naresh-Babu J. 
Published: November 2019

Study Design: Randomized control trial. Objective: The purpose of the study is to evaluate the safety and efficacy of tranexamic acid in reducing blood loss when administered through various routes in instrumented spine surgeries. Methods: A total of 104 patients undergoing instrumented spine surgery were randomly assigned to 4 groups (n = 26 in each group). Groups included (1) ivTXA—intravenous administration of tranexamic acid (TXA) 1 hour prior to surgery, (2) loTXA—local infiltration of TXA bilaterally into the paraspinal musculature prior to incision, (3) tTXA—topical application of TXA just before wound closure, and (4) control group. Outcome measures included intraoperative blood loss, postoperative blood loss, need for blood transfusion, length of hospital stay, and hematological parameters. Results: All the 3 different modes of TXA administration were found to be effective in reducing blood loss in the treated groups compared with the control group. Intraoperative blood loss was significantly reduced in ivTXA (223.6 ± 40.1 mL, P < .0001) and loTXA (256.07 ± 119 mL, P = .0039) groups when compared with controls (344 ± 88.5 mL).The postoperative blood loss was least in tTXA followed by ivTXA, loTXA, and controls. There was 67% reduction in need for blood transfusion in tTXA group, 55.5% reduction in ivTXA group, and 33% reduction in loTXA group when compared with the control group. Conclusion: In instrumented spine surgery, ivTXA and loTXA were found to be equally effective in reducing the intraoperative blood loss. The tTXA has better postoperative blood conserving effects. This is the first study to detail about safety and efficacy on local infiltration of TXA in spine surgery, which is an effective and safe method for reducing intraoperative blood loss.
Opportunistic Computed Tomography and Spine Surgery: A Narrative Review
Authors: Shirley Matthew , Wanderman Nathan , Keaveny Tony , Anderson Paul , Freedman Brett A. 
Published: November 2019

Study Design: Narrative review. Objective: This article seeks to provide a narrative review regarding the ability of opportunistic information available from computed tomography (CT) scans to guide decisions in spine surgery related to patient bone quality. Methods: A review of the literature (limited to human and English language) was performed via PubMed and Google Scholar using the search terms; “osteoporosis” AND “opportunistic” AND “computed tomography” AND “spine surgery.” The titles and then abstracts of all identified citations were reviewed for inclusion by 2 of the authors (MS, BAF). Relevant articles were then studied in full text. Results: A review of the literature found 25 articles that were selected for inclusion in this narrative review. These articles were broadly divided into 4 subcategories: (1) opportunistic CT (oCT) and osteoporosis detection, (2) oCT data and the quality of screw fixation, (3) utilization of Hounsfield units to assess clinical and/or radiographic outcomes following spine fusion, and (4) virtual stress testing in spine surgery. Conclusion: The literature on oCT, as well as associated virtual stress-testing techniques, demonstrate the potential to enhance spine surgery outcomes by preoperatively identifying at-risk patients in need of bone health optimization and informing best techniques for performing spinal fusion surgery on patients with diminished bone quality. While our narrative summary of the limited literature to date suggests a promising future for oCT data, significant additional research and/or radiographic workflow standardization is needed to validate these methods for clinical use.