Attention-based speech feature transfer between speakers.

In this study, we propose a simple yet effective method for incorporating the source speaker's characteristics in the target speaker's speech. This allows our model to generate the speech of the target speaker with the style of the source speaker. To achieve this, we focus on the attention model within the speech synthesis model, which learns various speaker features such as spectrogram, pitch, intensity, formant, pulse, and voice breaks. The model is trained separately using datasets specific to the source and target speakers. Subsequently, we replace the attention weights learned from the source speaker's dataset with the attention weights from the target speaker's model. Finally, by providing new input texts to the target model, we generate the speech of the target speaker with the styles of the source speaker. We validate the effectiveness of our model through similarity analysis utilizing five evaluation metrics and showcase real-world examples.

Intraoperative Brainstem Auditory Evoked Potentials and Postoperative Nausea and Vomiting After Microvascular Decompression.

BACKGROUND: We performed this study to investigate the effect of intraoperative brainstem auditory evoked potential (IBAEP) changes on the development of postoperative nausea and vomiting (PONV) after microvascular decompression (MVD) for neurovascular cross compression. METHODS: A total of 373 consecutive cases were treated with MVD. The use of rescue antiemetics after surgery was used as an objective indicator of PONV. IBAEP monitoring was routinely performed in all. RESULTS: The use of rescue antiemetics was significantly associated with female sex (OR = 3.427; 95% CI, 2.077-5.654; P < 0.001), PCA use (OR = 3.333; 95% CI, 1.861-5.104; P < 0.001), and operation time (OR = 1.017; 95% CI, 1.008-1.026; P < 0.001). A Wave V peak delay of more than 1.0 milliseconds showed a significant relation with the use of rescue antiemetics (OR = 1.787; 95% CI, 1.114-2.867; P = 0.016) and a strong significant relation with the use of rescue antiemetics more than 5 times (OR = 2.426; 95% CI, 1.372-4.290; P = 0.002). CONCLUSIONS: A wave V peak delay of more than 1.0 milliseconds might have value as a predictor of PONV after MVD. More detailed neurophysiological studies will identify the exact pathophysiology underlying PONV after MVD.

Soft Artificial Muscle Based on Pre-Detwinned Shape Memory Alloy Spring Actuator Achieving High Passive Assistive Torque for Wearable Robot.

For designing the assistive wearable rehabilitation robots, it is challenging to design the robot as energy efficient because the actuators have to be capable of overcoming human loads such as gravity of the body and spastic torque continuously during the assistance. To address these challenges, we propose a novel design of soft artificial muscle that utilizes shape memory alloy (SMA) spring actuators with pre-detwinning process. The SMA spring was fabricated through a process called pre-detwinning, which enhances the linearity of the SMA spring in martensite phase and unpowered restoring force, which is called passive force. The fabricated SMA spring can contract >60%. Finally, the soft wearable robot that can assist not only the gravitational torque exerted on the elbow by passive force, but also the elbow movements with active force was designed with a soft artificial muscle. A soft artificial muscle consists of the bundles of pre-detwinned SMA springs integrated with the stretchable coolant vessel. The stiffness of the muscle was measured as 1125 N/m in martensite phase and 1732 N/m in austenite phase. In addition, the muscle showed great actuation frequency performances, the bandwidth of which was measured as 0.5 Hz. The proposed wearable mechanism can fully compensate the gravitational torque for all the angles in passive mode. In addition, the proposed mechanism can produce high torque up to 3.5 Nm and movements in active mode.

Control of fibrosis with enhanced safety via asymmetric inhibition of prolyl-tRNA synthetase 1.

Prolyl-tRNA synthetase 1 (PARS1) has attracted much interest in controlling pathologic accumulation of collagen containing high amounts of proline in fibrotic diseases. However, there are concerns about its catalytic inhibition for potential adverse effects on global protein synthesis. We developed a novel compound, DWN12088, whose safety was validated by clinical phase 1 studies, and therapeutic efficacy was shown in idiopathic pulmonary fibrosis model. Structural and kinetic analyses revealed that DWN12088 binds to catalytic site of each protomer of PARS1 dimer in an asymmetric mode with different affinity, resulting in decreased responsiveness at higher doses, thereby expanding safety window. The mutations disrupting PARS1 homodimerization restored the sensitivity to DWN12088, validating negative communication between PARS1 promoters for the DWN12088 binding. Thus, this work suggests that DWN12088, an asymmetric catalytic inhibitor of PARS1 as a novel therapeutic agent against fibrosis with enhanced safety.

Short-term and long-term predictors of balance function in stroke patients: a 6-month follow-up study.

We aimed to determine early predictors of balance function (Berg Balance Scale, BBS) at 3 and 6 months after stroke using clinical, neurophysiological, and neuroimaging variables. Seventy-nine patients with hemiparesis after a stroke were included. Demographics, stroke characteristics, and clinical variables [Mini-Mental State Examination, BBS, strength in the hemiparetic hip, knee, and ankle muscles, and Fugl-Meyer Assessment Lower Extremity (FMA-LE)] were evaluated 2 weeks post-stroke, on average. Somatosensory-evoked potentials (SEP) from both tibial nerves and diffusion tensor imaging data were collected respectively within 3 weeks and 4 weeks post-onset to calculate the SEP amplitude ratio and the laterality index of fractional anisotropy of the corticospinal tract. In multiple linear regression analysis, younger age, higher FMA-LE score, and stronger hemiparetic hip extensors were independent predictors of higher BBS at 3 months post-stroke (adjusted R2 = 0.563, P < 0.001). At 6 months post-stroke, significant predictors of higher BBS were younger age, higher FMA-LE, stronger hemiparetic hip extensors, and larger SEP amplitude ratio (adjusted R2 = 0.552, P < 0.001), although the incremental contribution of the latter was rather small ( R2 = 0.019). We conclude that age and the initial motor impairment of the affected lower limb can inform the state of balance function at 3 and 6 months after stroke.

Structural Changes in the Arcuate Fasciculus and Recovery of Post-stroke Aphasia: A 6-Month Follow-up Study using Diffusion Tensor Imaging.

BACKGROUND: Temporal changes in the structural connectivity of major language tracts after stroke and their contribution to aphasia recovery are unclear. OBJECTIVE: To investigate longitudinal arcuate fasciculus (AF) integrity changes and their relationship with post-stroke aphasia recovery using diffusion tensor imaging (DTI). METHODS: Thirty-five patients with aphasia due to first-ever left hemispheric stroke underwent the Korean version of the Western Aphasia Battery and DTI at 1- and 6-month post stroke onset. Fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) of both AF tracts were analyzed to evaluate the temporal changes in tract integrity and determine the correlation between changes (Δ; follow-up - initial) in DTI parameters and language scores. RESULTS: At 6 months post-stroke, the mean FA decreased, and mean MD and RD increased in both hemispheres; however, compared with mean AD observed after 1 month, the mean observed at 6 months increased only in the left hemisphere (P < .05). ΔFA of the left AF and proportional change in the aphasia quotient showed a significant positive correlation (r = 0.365, P = .031). No correlation was found between changes in the right AF parameters and language score. The group with increased FA in the left AF showed more significant language improvement than the group with decreased FA. CONCLUSIONS: During the subacute stage, the integrity of AF decreased in both hemispheres in patients with aphasia, and the change in structural connectivity of the left AF was associated with language improvement.

Clinical Factors Associated With Balance Function in the Early Subacute Phase After Stroke.

OBJECTIVE: The aim of the study was to investigate the key factors of balance function in the early subacute phase after stroke. DESIGN: Ninety-four stroke patients were included. Multiple variables were evaluated, including demographic factors, clinical variables (stroke type; lesion site; Mini-Mental State Examination; motor strength of the hip, knee, and ankle joints; Fugl-Meyer Assessment of lower extremity), neurophysiological variables (amplitude ratio of somatosensory evoked potential of the tibial nerves), and laterality index of fractional anisotropy of the corticospinal tract using diffusion tensor imaging. Balance function was measured using the Berg Balance Scale. RESULTS: The Berg Balance Scale score was significantly negatively correlated with age and laterality index of fractional anisotropy and positively correlated with Mini-Mental State Examination; Fugl-Meyer Assessment of lower extremity; motor strength of the affected hip, knee, and ankle joint; and somatosensory evoked potential amplitude ratio (P < 0.05). The abnormal somatosensory evoked potential group and poor integrity of the corticospinal tract group showed significantly decreased Berg Balance Scale scores. In multivariable logistic regression analysis, age, Fugl-Meyer Assessment of lower extremity score, and ankle plantar flexion strength were significantly associated with balance function (odds ratios = 0.919, 1.181, and 15.244, respectively, P < 0.05). CONCLUSIONS: Higher age, severe initial motor impairment, and strength of the affected lower limb muscles, especially the ankle plantar flexor, are strongly associated with poor balance function early after stroke. TO CLAIM CME CREDITS: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME. CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Enhance ability to evaluate motor and balance function of stroke patients by learning common assessment tools including clinical tests, neurophysiological and neuroimaging studies; (2) Explain the important factors associated with balance function impairment in early subacute stroke patients; and (3) Enhance planning rehabilitation strategies for improvement of balance function according to recovery stage after stroke. LEVEL: Advanced. ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

The novel prognostic value of postoperative follow-up lateral spread response after microvascular decompression for hemifacial spasm.

OBJECTIVE: The lateral spread response (LSR) is an aberrant electrophysiological response in which a stimulus on one branch of the facial nerve spills over to other branches of the nerve, which can be captured by electrodes near each branch. The authors performed this study to evaluate the prognostic value of the follow-up LSR with a sufficient time interval from intraoperative LSR (IO-LSR) after microvascular decompression (MVD) for hemifacial spasm (HFS), excluding the interference of various intraoperative situations. METHODS: A total of 247 patients treated with MVD for HFS between June 2011 and March 2019 were enrolled in this study. The IO-LSR was routinely evaluated in all patients. The LSR was checked again on postoperative day (POD) 2 after surgery (POD2-LSR). A total of 228 patients (92.3%) were considered cured at the last clinical follow-up. RESULTS: The IO-LSR disappeared in 189 patients (76.5%), and among them, 181 patients (95.8%) were cured 1 year after surgery. The POD2-LSR disappeared in 193 patients (78.1%), and 185 patients (95.9%) among them were cured. Among the 189 patients in which the IO-LSR disappeared, the POD2-LSR reappeared in 26 patients (13.8%). In contrast, the POD2-LSR disappeared in 30 (51.7%) of 58 patients for whom the IO-LSR continued at the end of surgery. When classified into groups according to the status of the IO-LSR and POD2-LSR, in the group of patients in whom both LSRs disappeared, the cure rate was 98.2%, which was significantly higher than that of the other 3 groups (p < 0.05, Cochran-Armitage trend test). The use of both LSRs was found to be significantly associated with better predictability (p < 0.05, McNemar's test). CONCLUSIONS: Postoperative follow-up LSR examination may be beneficial in predicting clinical outcomes after MVD for HFS, especially when considered together with IO-LSR.

Second-Line Bismuth-Containing Quadruple Therapy for Helicobacterpylori Infection: A 12-Year Study of Annual Eradication Rates.

BACKGROUND: Bismuth-containing quadruple therapy (BQT) consisting of a proton-pump inhibitor (PPI), bismuth, metronidazole and tetracycline is recommended as a second-line treatment for Helicobacter pylori (H. pylori) infection when PPI-based standard triple therapy (STT) consisting of a PPI, amoxicillin and clarithromycin is unsuccessful. The purpose of this study was to analyze the long-term results of BQT as a second-line therapy to determine its effectiveness. METHODS: This study included 643 subjects who failed first-line STT and received 7 or 10-14 days of BQT as a second-line therapy. We retrospectively analyzed the annual H. pylori eradication rates, demographic factors and adverse events. RESULTS: The overall eradication rates by intention-to-treat (ITT) and per-protocol (PP) analyses were 80.7% (519/643) and 93.3% (519/556), respectively. By PP analysis, the eradication rates for 2008-2011, 2012-2015, and 2016-2019 were 93.3%, 91.0%, and 96.4%, respectively (p = 0.145). There were no significant differences between the 7-day group and the 10-14-day group in both the ITT (79.7% vs. 86.0%, p = 0.148) and the PP analyses (92.7% vs. 96.6%, p = 0.187). A multivariate analysis showed that current smoking was associated with eradication failure. Eighty-nine subjects (16.0%) suffered adverse events, mainly gastrointestinal symptoms, but only six cases were severe. CONCLUSIONS: BQT as a second-line therapy is an effective treatment for H. pylori. Treatment for 10-14 days showed a higher eradication rate compared with a 7-day regimen, but not significantly.

The Influence of Gastroesophageal Reflux Disease on Daytime Sleepiness and Depressive Symptom in Patients With Obstructive Sleep Apnea.

BACKGROUND/AIMS: As there is insufficient evidence for a relationship between gastroesophageal reflux disease (GERD) and obstructive sleep apnea (OSA), we investigated whether OSA diagnosed by polysomnography (PSG) is related to GERD. METHODS: A total of 402 subjects was evaluated. Overnight PSG was performed and a few questionnaires on GERD, anxiety, depression, and daytime sleepiness were administered. An apnea-hypopnea index < 5 was the classification criterion for subjects without OSA. Subjects with heartburn or acid regurgitation at least once a week were classified as having GERD. RESULTS: Among the 402 subjects, 318 had OSA and 84 did not. The prevalence of GERD was 12.9% among patients with OSA and 10.7% among those without (P = 0.590). The prevalence of GERD did not correlate with OSA severity (P = 0.474). Patients with OSA with GERD had higher Stanford Sleepiness Scale (P = 0.004), Epworth Sleepiness Scale (P = 0.001), and depression (P < 0.001) scores than patients with OSA without GERD. Subjects with nocturnal gastroesophageal reflux symptoms had a higher body mass index, waist-to-height ratio, and waist circumference-to-height index than those without symptoms. Multiple logistic regression showed that higher Epworth Sleepiness Scale and depression scores were independent factors associated with GERD in patients with OSA. CONCLUSIONS: The prevalence of GERD in patients with OSA was 12.9%. The prevalence of GERD did not correlate with OSA severity. Daytime sleepiness and depression seem to be associated with GERD in patients with OSA, while nocturnal reflux symptoms seem to be related to obesity in OSA.

The Role of Adjuvant Treatment in Patients with High-Grade Meningioma.

OBJECTIVE: To investigate the efficacy of adjuvant treatment in patients with high-grade meningioma. METHODS: A retrospective analysis was performed for patients with high-grade meningioma, World Health Organization grade 2 or 3, in a single center between 2003 and 2014. The patients were reviewed according to age at diagnosis, sex, the location of meningioma, degree of tumor resection, histological features, and type of adjuvant treatment. These factors were analyzed by Firth logistic regression analyses. RESULTS: Fifty-three patients with high-grade meningioma were enrolled. Thirty-four patients received adjuvant treatment; conventional radiotherapy or radiosurgery. Clinical follow-up ranged from 13-113 months with a median follow-up of 35.5 months. Gross total removal (GTR), Simpson grade 1 or 2, was achieved in 29 patients and, among them, 13 patients received adjuvant treatment. In the other 24 patients with non-GTR, conventional adjuvant radiotherapy and radiosurgery were performed in 11 and 10 patients, respectively. The other 3 patients did not receive any adjuvant treatment. Radiation-related complications did not occur. Of the 53 patients, 19 patients had suffered from recurrence. The recurrence rate in the adjuvant treatment group was 23.5% (8 out of 34). On the other hand, the rate for the non-adjuvant treatment group was 57.9% (11 out of 19) (odds ratio [OR]=0.208, p=0.017). In the GTR group, the recurrence rate was 7.5% (1 out of 13) for patients with adjuvant treatment and 50% (8 out of 16) for patients without adjuvant treatment (OR=0.121, p=0.04). CONCLUSION: Adjuvant treatment appears to be safe and effective, and could lead to a lower recurrence rate in high-grade meningioma, regardless of the extent of removal. Our results might be used as a reference for making decisions when planning adjuvant treatments for patients with high-grade meningioma after surgery.

Hypothalamic Extraventricular Neurocytoma (EVN) in a Pediatric Patient: A Case of EVN Treated with Subtotal Removal Followed by Adjuvant Radiotherapy.

Extra ventricular neurocytoma (EVN) is a rare brain tumor with histologic features similar with a central neurocytoma, but located outside of the ventricular system. In this study, we present an unusual case of hypothalamic EVN in a 14-year-old patient. The patient underwent subtotal removal and had tumor relapse. The patient was then treated using intensity modulated radiation therapy, and the tumor remained stable for 24 months. This case report may be important in that this is the first pediatric case of EVN located in the hypothalamic region. EVN has similar radiologic features with pilocytic astrocytomas and therefore a hypothalamic EVN may be misdiagnosed as a hypothalamic glioma. Also, the pathologic-radiologic-clinical correlation of EVN located in the hypothalamic area may be different from that of EVNs originating from other usual sites.

Design and Evaluation of ω-Hydroxy Fatty Acids Containing α-GalCer Analogues for CD1d-Mediated NKT Cell Activation.

CD1d molecules recognize glycolipid antigens with straight chain fatty acid moieties. Although most of the residues in the CD1d binding groove are hydrophobic, some of the amino acids can form hydrogen bonds. Consequently, we have designed ω-hydroxy fatty acid-containing glycolipid derivatives of the prototypical CD1d ligand α-GalCer. The potency of the ω-hydroxy analogues of the proper length is comparable to that of α-GalCer. We propose, based on the biological results and molecular modeling studies, that a hydrogen bonding interaction is involved between the ω-hydroxy group and a polar amino acid residue in the hydrophobic binding groove.

Enhanced switching behavior of iron oxide nanoparticle-doped liquid-crystal display.

It is well known that doping nanoparticles (NPs) in liquid crystals (LCs) can easily change the physical and electro-optical properties of LC mixture. In this paper, we demonstrate homogeneous, aligned nematic LC (N-LC) system dispersed in iron oxide (Fe2O3) NPs. The prepared Fe2O3 NPs have an average particle size of 50 nm. By changing the doping concentration of Fe2O3 NPs, we observed the characteristics of LC systems. Electrooptical (EO) characteristics included faster rising and falling times (2.14 ms and 10.24 ms, respectively) and lower driving voltage (1.45 V) compared with a pure N-LC cell. We demonstrated these results via the relationship between dielectric con- stant and LC device properties. The results were verified by software simulation based on general physical properties. Moreover, we observed that LC system with Fe2O3 NPs could be accomplished without capacitance hysteresis by capturing charged impurities. Superior performance of LC cell with Fe2O3 NPs indicates that the proposed LC system have strong potential for use in the production of advanced LC displays.

CIS-ZnS quantum dots for self-aligned liquid crystal molecules with superior electro-optic properties.

We demonstrate self-aligned and high-performance liquid crystal (LC) systems doped with 1-dimensional (1D) chain-like clusters of CuInS(2) (CIS)-ZnS core-shell quantum dots (QDs). By changing the cell fabrication method of the LC-QD composites, we can selectively control the orientation of the LC molecules between the homogeneous and homeotropic states without conventional LC alignment layers. The homeotropic alignment of LCs was achieved by random dropcasting and the homogeneous alignment was performed using a capillary injection of LC-QDs due to the random or linear diffusion of QD clusters into ITO defects. The electrically compensated bend (ECB)- and vertically aligned (VA) mode LC displays (LCDs) containing our LC-QD composite both showed superior electro-optic (EO) properties. A 37.1% reduction in the threshold voltage (V(th)) and a 36.6% decrease in the response time were observed for ECB mode LCDs, and a 47.0% reduction in the V(th) and a 38.3% decrease in the response time were observed for VA mode LCDs, meaning that the proposed LC-QD composites have a great potential for the production of advanced flexible LCDs.

Design, synthesis, and preliminary biological evaluation of a novel triazole analogue of ceramide.

The amide bond of ceramide was replaced by the non-hydrolyzable 1,2,3-triazole functionality. Click chemistry was employed for synthesis of the designed analogues. Our preliminary biological evaluation indicated that the amide moiety of ceramide is amenable to bioisosteric substitution with the triazole moiety. Some of the analogues were more potent than C2-ceramide as cytotoxic agents, and the observed cytotoxicity was possibly mediated through the induction of apoptosis.

Synthesis and evaluation of 1,2,3-triazole containing analogues of the immunostimulant alpha-GalCer.

alpha-GalCer is the first defined and most potent agonistic antigen of the T cell receptor of natural killer T cells. We have prepared a series of 1,2,3-triazole-containing alpha-GalCer analogues in which the lipid chain lengths have been incrementally varied. We found that this isosteric replacement of alpha-GalCer's amide moiety with triazole increases the IL-4 versus IFN-gamma bias of released cytokines. The stimulatory effect was influenced by the length of the attached chain. In particular, the long-chained triazole analogues have a comparable stimulatory effect on cytokine production as alpha-GalCer and exhibit a stronger Th2 cytokine response.