A study on the application of voice interaction in automotive human machine interface experience design

NASA Astrophysics Data System (ADS)

Huang, Zhaohui; Huang, Xiemin

2018-04-01

This paper, firstly, introduces the application trend of the integration of multi-channel interactions in automotive HMI ((Human Machine Interface) from complex information models faced by existing automotive HMI and describes various interaction modes. By comparing voice interaction and touch screen, gestures and other interaction modes, the potential and feasibility of voice interaction in automotive HMI experience design are concluded. Then, the related theories of voice interaction, identification technologies, human beings' cognitive models of voices and voice design methods are further explored. And the research priority of this paper is proposed, i.e. how to design voice interaction to create more humane task-oriented dialogue scenarios to enhance interactive experiences of automotive HMI. The specific scenarios in driving behaviors suitable for the use of voice interaction are studied and classified, and the usability principles and key elements for automotive HMI voice design are proposed according to the scenario features. Then, through the user participatory usability testing experiment, the dialogue processes of voice interaction in automotive HMI are defined. The logics and grammars in voice interaction are classified according to the experimental results, and the mental models in the interaction processes are analyzed. At last, the voice interaction design method to create the humane task-oriented dialogue scenarios in the driving environment is proposed.

Systems concept for speech technology application in general aviation

NASA Technical Reports Server (NTRS)

North, R. A.; Bergeron, H.

1984-01-01

The application potential of voice recognition and synthesis circuits for general aviation, single-pilot IFR (SPIFR) situations is examined. The viewpoint of the pilot was central to workload analyses and assessment of the effectiveness of the voice systems. A twin-engine, high performance general aviation aircraft on a cross-country fixed route was employed as the study model. No actual control movements were considered and other possible functions were scored by three IFR-rated instructors. The SPIFR was concluded helpful in alleviating visual and manual workloads during take-off, approach and landing, particularly for data retrieval and entry tasks. Voice synthesis was an aid in alerting a pilot to in-flight problems. It is expected that usable systems will be available within 5 yr.

Physician Perspectives of CYP2C19 and Clopidogrel Drug-Gene Interaction Active Clinical Decision Support Alerts

PubMed Central

Nishimura, Adam A.; Shirts, Brian H.; Salama, Joseph; Smith, Joe W.; Devine, Beth; Tarczy-Hornoch, Peter

2015-01-01

Objective To determine if physicians find clinical decision support alerts for pharmacogenomic drug-gene interactions useful and assess their perceptions of usability aspects that impact usefulness. Materials and Methods 52 physicians participated in an online simulation and questionnaire involving a prototype alert for the clopidogrel and CYP2C19 drug-gene interaction. Results Only 4% of participants stated they would override the alert. 92% agreed that the alerts were useful. 87% found the visual interface appropriate, 91% felt the timing of the alert was appropriate and 75% were unfamiliar with the specific drug-gene interaction. 80% of providers preferred the ability to order the recommended medication within the alert. Qualitative responses suggested that supplementary information is important, but should be provided as external links, and that the utility of pharmacogenomic alerts depends on the broader ecosystem of alerts. Principal Conclusions Pharmacogenomic alerts would be welcomed by many physicians, can be built with minimalist design principles, and are appropriately placed at the end of the prescribing process. Since many physicians lack familiarity with pharmacogenomics but have limited time, information and educational resources within the alert should be carefully selected and presented in concise ways. PMID:26642939

Physician perspectives of CYP2C19 and clopidogrel drug-gene interaction active clinical decision support alerts.

PubMed

Nishimura, Adam A; Shirts, Brian H; Salama, Joseph; Smith, Joe W; Devine, Beth; Tarczy-Hornoch, Peter

2016-02-01

To determine if physicians find clinical decision support alerts for pharmacogenomic drug-gene interactions useful and assess their perceptions of usability aspects that impact usefulness. 52 physicians participated in an online simulation and questionnaire involving a prototype alert for the clopidogrel and CYP2C19 drug-gene interaction. Only 4% of participants stated they would override the alert. 92% agreed that the alerts were useful. 87% found the visual interface appropriate, 91% felt the timing of the alert was appropriate and 75% were unfamiliar with the specific drug-gene interaction. 80% of providers preferred the ability to order the recommended medication within the alert. Qualitative responses suggested that supplementary information is important, but should be provided as external links, and that the utility of pharmacogenomic alerts depends on the broader ecosystem of alerts. Pharmacogenomic alerts would be welcomed by many physicians, can be built with minimalist design principles, and are appropriately placed at the end of the prescribing process. Since many physicians lack familiarity with pharmacogenomics but have limited time, information and educational resources within the alert should be carefully selected and presented in concise ways. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

47 CFR 80.1077 - Frequencies.

Code of Federal Regulations, 2012 CFR

2012-10-01

... System: Alerting: 406.0-406.1 EPIRBs 406.0-406.1 MHz (Earth-to-space).1544-1545 MHz (space-to-Earth). INMARSAT Ship Earth Stations capable of voice and/or direct printing 1626.5-1645.5 MHz (Earth-to-space... safety communications and calling: Satellite 1530-1544 MHz (space-to-Earth) and 1626.5-1645.5 MHz (Earth...

47 CFR 80.1077 - Frequencies.

Code of Federal Regulations, 2013 CFR

2013-10-01

... System: Alerting: 406.0-406.1 EPIRBs 406.0-406.1 MHz (Earth-to-space).1544-1545 MHz (space-to-Earth). INMARSAT Ship Earth Stations capable of voice and/or direct printing 1626.5-1645.5 MHz (Earth-to-space... safety communications and calling: Satellite 1530-1544 MHz (space-to-Earth) and 1626.5-1645.5 MHz (Earth...

47 CFR 80.1077 - Frequencies.

Code of Federal Regulations, 2014 CFR

2014-10-01

... System: Alerting: 406.0-406.1 EPIRBs 406.0-406.1 MHz (Earth-to-space).1544-1545 MHz (space-to-Earth). INMARSAT Ship Earth Stations capable of voice and/or direct printing 1626.5-1645.5 MHz (Earth-to-space... safety communications and calling: Satellite 1530-1544 MHz (space-to-Earth) and 1626.5-1645.5 MHz (Earth...

47 CFR 80.1077 - Frequencies.

Code of Federal Regulations, 2011 CFR

2011-10-01

... System: Alerting: 406.0-406.1 EPIRBs 406.0-406.1 MHz (Earth-to-space).1544-1545 MHz (space-to-Earth). INMARSAT-E EPIRBs 12 1626.5-1645.5 MHz (Earth-to-space). INMARSAT Ship Earth Stations capable of voice and... MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS) General Provisions § 80.1077...

Reduced Effectiveness of Interruptive Drug-Drug Interaction Alerts after Conversion to a Commercial Electronic Health Record.

PubMed

Wright, Adam; Aaron, Skye; Seger, Diane L; Samal, Lipika; Schiff, Gordon D; Bates, David W

2018-05-15

Drug-drug interaction (DDI) alerts in electronic health records (EHRs) can help prevent adverse drug events, but such alerts are frequently overridden, raising concerns about their clinical usefulness and contribution to alert fatigue. To study the effect of conversion to a commercial EHR on DDI alert and acceptance rates. Two before-and-after studies. 3277 clinicians who received a DDI alert in the outpatient setting. Introduction of a new, commercial EHR and subsequent adjustment of DDI alerting criteria. Alert burden and proportion of alerts accepted. Overall interruptive DDI alert burden increased by a factor of 6 from the legacy EHR to the commercial EHR. The acceptance rate for the most severe alerts fell from 100 to 8.4%, and from 29.3 to 7.5% for medium severity alerts (P < 0.001). After disabling the least severe alerts, total DDI alert burden fell by 50.5%, and acceptance of Tier 1 alerts rose from 9.1 to 12.7% (P < 0.01). Changing from a highly tailored DDI alerting system to a more general one as part of an EHR conversion decreased acceptance of DDI alerts and increased alert burden on users. The decrease in acceptance rates cannot be fully explained by differences in the clinical knowledge base, nor can it be fully explained by alert fatigue associated with increased alert burden. Instead, workflow factors probably predominate, including timing of alerts in the prescribing process, lack of differentiation of more and less severe alerts, and features of how users interact with alerts.

Reconstruction in Dewey's Pragmatism: Home, Neighborhood, and Otherness

ERIC Educational Resources Information Center

Saito, Naoko

2009-01-01

The purpose of this paper, states the author, is to revive and reconstruct John Dewey's pragmatism so that it becomes an alerting and inspiring voice in response to the nihilistic crisis of today's democracy and education. In other words this is a Deweyan task of reconstruction in philosophy, and it prompts the present endeavor in the continuing…

Alertness and cognitive control: Toward a spatial grouping hypothesis.

PubMed

Schneider, Darryl W

2018-05-01

A puzzling interaction involving alertness and cognitive control is indicated by the finding of faster performance but larger congruency effects on alert trials (on which alerting cues are presented before the task stimuli) than on no-alert trials in selective attention tasks. In the present study, the author conducted four experiments to test hypotheses about the interaction. Manipulation of stimulus spacing revealed a difference in congruency effects between alert and no-alert trials for narrowly spaced stimuli but not for widely spaced stimuli, inconsistent with the hypothesis that increased alertness is associated with more diffuse attention. Manipulation of color grouping revealed similar differences in congruency effects between alert and no-alert trials for same-color and different-color groupings of targets and distractors, inconsistent with the general hypothesis that increased alertness is associated with more perceptual grouping. To explain the results, the author proposes that increased alertness is associated specifically with more spatial grouping of stimuli, possibly by modulating the threshold for parsing stimulus displays into distinct objects.

47 CFR 80.1077 - Frequencies.

Code of Federal Regulations, 2010 CFR

2010-10-01

... System: Alerting: 406.0-406.1 EPIRBs 406.0-406.1 MHz (Earth-to-space).1544-1545 MHz (space-to-Earth). INMARSAT-E EPIRBs 12 1626.5-1645.5 MHz (Earth-to-space). INMARSAT Ship Earth Stations capable of voice and/or direct printing 1626.5-1645.5 MHz (Earth-to-space). VHF DSC Ch. 70 156.525 MHz. 1 MF/HF DSC 2 2187...

Florida manatee avoidance technology: A pilot program by the Florida Fish and Wildlife Conservation Commission

NASA Astrophysics Data System (ADS)

Frisch, Katherine; Haubold, Elsa

2003-10-01

Since 1976, approximately 25% of the annual Florida manatee (Trichechus manatus latirostris) mortality has been attributed to collisions with watercraft. In 2001, the Florida Legislature appropriated $200,000 in funds for research projects using technological solutions to directly address the problem of collisions between manatees and watercraft. The Florida Fish & Wildlife Conservation Commission initially funded seven projects for the first two fiscal years. The selected proposals were designed to explore technology that had not previously been applied to the manatee/boat collision problem and included many acoustic concepts related to voice recognition, sonar, and an alerting device to be put on boats to warn manatees. The most promising results to date are from projects employing voice-recognition techniques to identify manatee vocalizations and warn boaters of the manatees' presence. Sonar technology, much like that used in fish finders, is promising but has met with regulatory problems regarding permitting and remains to be tested, as has the manatee-alerting device. The state of Florida found results of the initial years of funding compelling and plans to fund further manatee avoidance technology research in a continued effort to mitigate the problem of manatee/boat collisions.

Adherence to drug-drug interaction alerts in high-risk patients: a trial of context-enhanced alerting.

PubMed

Duke, Jon D; Li, Xiaochun; Dexter, Paul

2013-05-01

Drug-drug interaction (DDI) alerting is an important form of clinical decision support, yet physicians often fail to attend to critical DDI warnings due to alert fatigue. We previously described a model for highlighting patients at high risk of a DDI by enhancing alerts with relevant laboratory data. We sought to evaluate the effect of this model on alert adherence in high-risk patients. A 6-month randomized controlled trial involving 1029 outpatient physicians was performed. The target interactions were all DDIs known to cause hyperkalemia. Alerts in the intervention group were enhanced with the patient's most recent potassium and creatinine levels. The control group received unmodified alerts. High -risk patients were those with baseline potassium >5.0 mEq/l and/or creatinine ≥1.5 mg/dl (132 μmol/l). We found no significant difference in alert adherence in high-risk patients between the intervention group (15.3%) and the control group (16.8%) (p=0.71). Adherence in normal risk patients was significantly lower in the intervention group (14.6%) than in the control group (18.6%) (p<0.01). In neither group did physicians increase adherence in patients at high risk. Physicians adhere poorly to hyperkalemia-associated DDI alerts even in patients with risk factors for a clinically significant interaction, and the display of relevant laboratory data in these alerts did not improve adherence levels in the outpatient setting. Further research is necessary to determine optimal strategies for conveying patient-specific DDI risk.

Interactive Augmentation of Voice Quality and Reduction of Breath Airflow in the Soprano Voice.

PubMed

Rothenberg, Martin; Schutte, Harm K

2016-11-01

In 1985, at a conference sponsored by the National Institutes of Health, Martin Rothenberg first described a form of nonlinear source-tract acoustic interaction mechanism by which some sopranos, singing in their high range, can use to reduce the total airflow, to allow holding the note longer, and simultaneously enrich the quality of the voice, without straining the voice. (M. Rothenberg, "Source-Tract Acoustic Interaction in the Soprano Voice and Implications for Vocal Efficiency," Fourth International Conference on Vocal Fold Physiology, New Haven, Connecticut, June 3-6, 1985.) In this paper, we describe additional evidence for this type of nonlinear source-tract interaction in some soprano singing and describe an analogous interaction phenomenon in communication engineering. We also present some implications for voice research and pedagogy. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

A Novel Design for Drug-Drug Interaction Alerts Improves Prescribing Efficiency.

PubMed

Russ, Alissa L; Chen, Siying; Melton, Brittany L; Johnson, Elizabette G; Spina, Jeffrey R; Weiner, Michael; Zillich, Alan J

2015-09-01

Drug-drug interactions (DDIs) are common in clinical care and pose serious risks for patients. Electronic health records display DDI alerts that can influence prescribers, but the interface design of DDI alerts has largely been unstudied. In this study, the objective was to apply human factors engineering principles to alert design. It was hypothesized that redesigned DDI alerts would significantly improve prescribers' efficiency and reduce prescribing errors. In a counterbalanced, crossover study with prescribers, two DDI alert designs were evaluated. Department of Veterans Affairs (VA) prescribers were video recorded as they completed fictitious patient scenarios, which included DDI alerts of varying severity. Efficiency was measured from time-stamped recordings. Prescribing errors were evaluated against predefined criteria. Efficiency and prescribing errors were analyzed with the Wilcoxon signed-rank test. Other usability data were collected on the adequacy of alert content, prescribers' use of the DDI monograph, and alert navigation. Twenty prescribers completed patient scenarios for both designs. Prescribers resolved redesigned alerts in about half the time (redesign: 52 seconds versus original design: 97 seconds; p<.001). Prescribing errors were not significantly different between the two designs. Usability results indicate that DDI alerts might be enhanced by facilitating easier access to laboratory data and dosing information and by allowing prescribers to cancel either interacting medication directly from the alert. Results also suggest that neither design provided adequate information for decision making via the primary interface. Applying human factors principles to DDI alerts improved overall efficiency. Aspects of DDI alert design that could be further enhanced prior to implementation were also identified.

Sounding the Alert: Designing an Effective Voice for Earthquake Early Warning

NASA Astrophysics Data System (ADS)

Burkett, E. R.; Given, D. D.

2015-12-01

The USGS is working with partners to develop the ShakeAlert Earthquake Early Warning (EEW) system (http://pubs.usgs.gov/fs/2014/3083/) to protect life and property along the U.S. West Coast, where the highest national seismic hazard is concentrated. EEW sends an alert that shaking from an earthquake is on its way (in seconds to tens of seconds) to allow recipients or automated systems to take appropriate actions at their location to protect themselves and/or sensitive equipment. ShakeAlert is transitioning toward a production prototype phase in which test users might begin testing applications of the technology. While a subset of uses will be automated (e.g., opening fire house doors), other applications will alert individuals by radio or cellphone notifications and require behavioral decisions to protect themselves (e.g., "Drop, Cover, Hold On"). The project needs to select and move forward with a consistent alert sound to be widely and quickly recognized as an earthquake alert. In this study we combine EEW science and capabilities with an understanding of human behavior from the social and psychological sciences to provide insight toward the design of effective sounds to help best motivate proper action by alert recipients. We present a review of existing research and literature, compiled as considerations and recommendations for alert sound characteristics optimized for EEW. We do not yet address wording of an audible message about the earthquake (e.g., intensity and timing until arrival of shaking or possible actions), although it will be a future component to accompany the sound. We consider pitch(es), loudness, rhythm, tempo, duration, and harmony. Important behavioral responses to sound to take into account include that people respond to discordant sounds with anxiety, can be calmed by harmony and softness, and are innately alerted by loud and abrupt sounds, although levels high enough to be auditory stressors can negatively impact human judgment.

Differential effects of phasic and tonic alerting on the efficiency of executive attention.

PubMed

Asanowicz, Dariusz; Marzecová, Anna

2017-05-01

The study examined how alerting and executive attention interact in a task involving conflict resolution. We proposed a tentative scenario in which an initial exogenous phasic alerting phase is followed by an endogenous tonic alerting phase, and hypothesized that these two processes may have distinct effects on conflict resolution. Phasic alerting was expected to increase the conflict, whereas tonic alerting was expected to decrease the conflict. Three experiments were conducted using different variants of the flanker task with visual alerting cues and varied cue-target intervals (SOA), to differentiate between effects of phasic alerting (short SOA) and tonic alerting (long SOA). The results showed that phasic alerting consistently decreased the efficiency of conflict resolution indexed by response time and accuracy, whereas tonic alerting increased the accuracy of conflict resolution, but at a cost in the speed of processing the conflict. The third experiment additionally showed that the effects of phasic alerting may be modulated by the psychophysical strength of alerting cues. Discussed are possible mechanisms that could account for the observed interactions between alerting and conflict resolution, as well as some discrepancies between the current and previous studies. Copyright © 2017 Elsevier B.V. All rights reserved.

Connecting Our Nation’s Crisis Information Management Systems

DTIC Science & Technology

2008-12-01

Voice Alert is a communications solution that uses a combination of database and GIS mapping technologies to deliver outbound notifications.85 EOC...needing to be accessed through an extension is necessary. With many businesses, hotels , and other locations requiring an extension to reach...built around five major management activities of an incident.130  Command  Operations  Planning  Logistics  Finance/administration. The new

NOAA Weather Wire Service

Science.gov Websites

& Imagery; includes NWS alerts and warnings No 6 Wireless Emergency Alerts (WEA) Mobile Phone Alerts & Warnings only No 7 Interactive NWS (iNWS) - NOTE 1 https://inws.ncep.noaa.gov/ Mobile Phone $$$$) Internet/ Mobile Phone Alerts and Warnings No 15 County or Local Emergency Management Telephone alert

mHealth: Using Mobile Technology to Support Healthcare

PubMed Central

Okuboyejo, Senanu; Eyesan, Omatseyin

2014-01-01

Adherence to long-term therapy in outpatient setting is required to reduce the prevalence of chronic diseases such as HIV/AIDS, Diabetes, Tuberculosis and Malaria. This paper presents a mobile technology-based medical alert system for outpatient adherence in Nigeria. The system makes use of the SMS and voice features of mobile phones. The system has the potential of improving adherence to medication in outpatient setting by reminding patients of dosing schedules and attendance to scheduled appointments through SMS and voice calls. It will also inform patients of benefits and risks associated with adherence. Interventions aimed at improving adherence would provide significant positive return on investment through primary prevention (of risk factors) and secondary prevention of adverse health outcomes. PMID:24678384

Decision Support Alerts for Medication Ordering in a Computerized Provider Order Entry (CPOE) System

PubMed Central

Beccaro, M. A. Del; Villanueva, R.; Knudson, K. M.; Harvey, E. M.; Langle, J. M.; Paul, W.

2010-01-01

Objective We sought to determine the frequency and type of decision support alerts by location and ordering provider role during Computerized Provider Order Entry (CPOE) medication ordering. Using these data we adjusted the decision support tools to reduce the number of alerts. Design Retrospective analyses were performed of dose range checks (DRC), drug-drug interaction and drug-allergy alerts from our electronic medical record. During seven sampling periods (each two weeks long) between April 2006 and October 2008 all alerts in these categories were analyzed. Another audit was performed of all DRC alerts by ordering provider role from November 2008 through January 2009. Medication ordering error counts were obtained from a voluntary error reporting system. Measurement/Results Between April 2006 and October 2008 the percent of medication orders that triggered a dose range alert decreased from 23.9% to 7.4%. The relative risk (RR) for getting an alert was higher at the start of the interventions versus later (RR= 2.40, 95% CI 2.28-2.52; p< 0.0001). The percentage of medication orders that triggered alerts for drug-drug interactions also decreased from 13.5% to 4.8%. The RR for getting a drug interaction alert at the start was 1.63, 95% CI 1.60-1.66; p< 0.0001. Alerts decreased in all clinical areas without an increase in reported medication errors. Conclusion We reduced the quantity of decision support alerts in CPOE using a systematic approach without an increase in reported medication errors PMID:23616845

Reducing warfarin medication interactions: an interrupted time series evaluation.

PubMed

Feldstein, Adrianne C; Smith, David H; Perrin, Nancy; Yang, Xiuhai; Simon, Steven R; Krall, Michael; Sittig, Dean F; Ditmer, Diane; Platt, Richard; Soumerai, Stephen B

2006-05-08

Computerized decision support reduces medication errors in inpatients, but limited evidence supports its effectiveness in reducing the coprescribing of interacting medications, especially in the outpatient setting. The usefulness of academic detailing to enhance the effectiveness of medication interaction alerts also is uncertain. This study used an interrupted time series design. In a health maintenance organization with an electronic medical record, we evaluated the effectiveness of electronic medical record alerts and group academic detailing to reduce the coprescribing of warfarin and interacting medications. Participants were 239 primary care providers at 15 primary care clinics and 9910 patients taking warfarin. All 15 clinics received electronic medical record alerts for the coprescription of warfarin and 5 interacting medications: acetaminophen, nonsteroidal anti-inflammatory medications, fluconazole, metronidazole, and sulfamethoxazole. Seven clinics were randomly assigned to receive group academic detailing. The primary outcome, the interacting prescription rate (ie, the number of coprescriptions of warfarin-interacting medications per 10 000 warfarin users per month), was analyzed with segmented regression models, controlling for preintervention trends. At baseline, nearly a third of patients had an interacting prescription. Coinciding with the alerts, there was an immediate and continued reduction in the warfarin-interacting medication prescription rate (from 3294.0 to 2804.2), resulting in a 14.9% relative reduction (95% confidence interval, -19.5 to -10.2) at 12 months. Group academic detailing did not enhance alert effectiveness. This study, using a strong and quasi-experimental design in ambulatory care, found that medication interaction alerts modestly reduced the frequency of coprescribing of interacting medications. Additional efforts will be required to further reduce rates of inappropriate prescribing of warfarin with interacting drugs.

A systematic review of the effectiveness of interruptive medication prescribing alerts in hospital CPOE systems to change prescriber behavior and improve patient safety.

PubMed

Page, N; Baysari, M T; Westbrook, J I

2017-09-01

To assess the evidence of the effectiveness of different categories of interruptive medication prescribing alerts to change prescriber behavior and/or improve patient outcomes in hospital computerized provider order entry (CPOE) systems. PubMed, Embase, CINAHL and the Cochrane Library were searched for relevant articles published between January 2000 and February 2016. Studies were included if they compared the outcomes of automatic, interruptive medication prescribing alert/s to a control/comparison group to determine alert effectiveness. Twenty-three studies describing 32 alerts classified into 11 alert categories were identified. The most common alert categories studied were drug-condition interaction (n=6), drug-drug interaction alerts (n=6) and corollary order alerts (n=6). All 23 papers investigated the effect of the intervention alert on at least one outcome measure of prescriber behavior. Just over half of the studies (53%, n=17) reported a statistically significant beneficial effect from the intervention alert; 34% (n=11) reported no statistically significant effect, and 6% (n=2) reported a significant detrimental effect. Two studies also evaluated the effect of alerts on patient outcome measures; neither finding that patient outcomes significantly improved following alert implementation (6%, n=2). The greatest volume of evidence relates to three alert categories: drug-condition, drug-drug and corollary order alerts. Of these, drug-condition alerts had the greatest number of studies reporting positive effects (five out of six studies). Only two of six studies of drug-drug interaction and one of six of corollary alerts reported positive benefits. The current evidence-base does not show a clear indication that particular categories of alerts are more effective than others. While the majority of alert categories were shown to improve outcomes in some studies, there were also many cases where outcomes did not improve. This lack of evidence hinders decisions about the amount and type of decision support that should be integrated into CPOE systems to increase safety while reducing the risk of alert fatigue. Virtually no studies have sought to investigate the impact on changes to prescriber behavior and outcomes overall when alerts from multiple categories are incorporated within the same system. Copyright © 2017 Elsevier B.V. All rights reserved.

Participatory design for drug-drug interaction alerts.

PubMed

Luna, Daniel; Otero, Carlos; Almerares, Alfredo; Stanziola, Enrique; Risk, Marcelo; González Bernaldo de Quirós, Fernán

2015-01-01

The utilization of decision support systems, in the point of care, to alert drug-drug interactions has been shown to improve quality of care. Still, the use of these systems has not been as expected, it is believed, because of the difficulties in their knowledge databases; errors in the generation of the alerts and the lack of a suitable design. This study expands on the development of alerts using participatory design techniques based on user centered design process. This work was undertaken in three stages (inquiry, participatory design and usability testing) it showed that the use of these techniques improves satisfaction, effectiveness and efficiency in an alert system for drug-drug interactions, a fact that was evident in specific situations such as the decrease of errors to meet the specified task, the time, the workload optimization and users overall satisfaction in the system.

Practitioners’ Views on Computerized Drug–Drug Interaction Alerts in the VA System

PubMed Central

Ko, Yu; Abarca, Jacob; Malone, Daniel C.; Dare, Donna C.; Geraets, Doug; Houranieh, Antoun; Jones, William N.; Nichol, W. Paul; Schepers, Gregory P.; Wilhardt, Michelle

2007-01-01

Objectives To assess Veterans Affairs (VA) prescribers’ and pharmacists’ opinions about computer-generated drug–drug interaction (DDI) alerts and obtain suggestions for improving DDI alerts. Design A mail survey of 725 prescribers and 142 pharmacists from seven VA medical centers across the United States. Measurements A questionnaire asked respondents about their sources of drug and DDI information, satisfaction with the combined inpatient and outpatient computerized prescriber order entry (CPOE) system, attitude toward DDI alerts, and suggestions for improving DDI alerts. Results The overall response rate was 40% (prescribers: 36%; pharmacists: 59%). Both prescribers and pharmacists indicated that the CPOE system had a neutral to positive impact on their jobs. DDI alerts were not viewed as a waste of time and the majority (61%) of prescribers felt that DDI alerts had increased their potential to prescribe safely. However, only 30% of prescribers felt DDI alerts provided them with what they needed most of the time. Both prescribers and pharmacists agreed that DDI alerts should be accompanied by management alternatives (73% and 82%, respectively) and more detailed information (65% and 89%, respectively). When asked about suggestions for improving DDI alerts, prescribers most preferred including management options whereas pharmacists most preferred making it more difficult to override lethal interactions. Prescribers and pharmacists reported primarily relying on electronic references for general drug information (62% and 55%, respectively) and DDI information (51% and 79%, respectively). Conclusion Respondents reported neutral to positive views regarding the effect of CPOE on their jobs. Their opinions suggest DDI alerts are useful but still require additional work to increase their clinical utility. PMID:17068346

Knowledge Integration and Use-Case Analysis for a Customized Drug-Drug Interaction CDS Service

NASA Astrophysics Data System (ADS)

Kam, Hye Jin; Park, Man Young; Kim, Woojae; Yoon, Duk Yong; Ahn, Eun Kyoung; Park, Rae Woong

Clinical decision support systems (CDSSs) are thought to reduce adverse drug events (ADEs) by monitoring drug-drug interactions(DDIs). However, clinically improper or excessive alerts can result in high alert overrides. A tailored CDS service, which is appropriate for clinicians and their ordering situations, is required to increase alert acceptance. In this study, we conducted a 12-week pilot project adopting a tailed CDSS at an emergency department. The new CDSS was conducted via a stepwise integration of additional new rules. The alert status with changes in acceptance rate was analyzed. The most frequent DDI alerts were related to prescriptions of anti-inflammatory drugs. The percentages of alert overrides for each stage were 98.0%, 96.0%, 96.9%, and 98.1%, respectively. 91.5% of overridden alerts were related to discharge medications. To reduce the potential hazards of ADEs, the development of an effective customized DDI CDSS is required, via in-depth analysis on alert patterns and overridden reasons.

Age Differences in Voice Evaluation: From Auditory-Perceptual Evaluation to Social Interactions

ERIC Educational Resources Information Center

Lortie, Catherine L.; Deschamps, Isabelle; Guitton, Matthieu J.; Tremblay, Pascale

2018-01-01

Purpose: The factors that influence the evaluation of voice in adulthood, as well as the consequences of such evaluation on social interactions, are not well understood. Here, we examined the effect of listeners' age and the effect of talker age, sex, and smoking status on the auditory-perceptual evaluation of voice, voice-related psychosocial…

Core drug-drug interaction alerts for inclusion in pediatric electronic health records with computerized prescriber order entry.

PubMed

Harper, Marvin B; Longhurst, Christopher A; McGuire, Troy L; Tarrago, Rod; Desai, Bimal R; Patterson, Al

2014-03-01

The study aims to develop a core set of pediatric drug-drug interaction (DDI) pairs for which electronic alerts should be presented to prescribers during the ordering process. A clinical decision support working group composed of Children's Hospital Association (CHA) members was developed. CHA Pharmacists and Chief Medical Information Officers participated. Consensus was reached on a core set of 19 DDI pairs that should be presented to pediatric prescribers during the order process. We have provided a core list of 19 high value drug pairs for electronic drug-drug interaction alerts to be recommended for inclusion as high value alerts in prescriber order entry software used with a pediatric patient population. We believe this list represents the most important pediatric drug interactions for practical implementation within computerized prescriber order entry systems.

The Voice as Computer Interface: A Look at Tomorrow's Technologies.

ERIC Educational Resources Information Center

Lange, Holley R.

1991-01-01

Discussion of voice as the communications device for computer-human interaction focuses on voice recognition systems for use within a library environment. Voice technologies are described, including voice response and voice recognition; examples of voice systems in use in libraries are examined; and further possibilities, including use with…

78 FR 71676 - Submission for Review: 3206-0201, Federal Employees Health Benefits (FEHB) Open Season Express...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-29

... (FEHB) Open Season Express Interactive Voice Response (IVR) System and Open Season Web site AGENCY: U.S... Benefits (FEHB) Open Season Express Interactive Voice Response (IVR) System and the Open Season Web site... Season Express Interactive Voice Response (IVR) System, and the Open Season Web site, Open Season Online...

Alert dwell time: introduction of a measure to evaluate interruptive clinical decision support alerts

PubMed Central

McDaniel, Robert B; Burlison, Jonathan D; Baker, Donald K; Hasan, Murad; Robertson, Jennifer; Hartford, Christine; Howard, Scott C; Sablauer, Andras

2016-01-01

Metrics for evaluating interruptive prescribing alerts have many limitations. Additional methods are needed to identify opportunities to improve alerting systems and prevent alert fatigue. In this study, the authors determined whether alert dwell time—the time elapsed from when an interruptive alert is generated to when it is dismissed—could be calculated by using historical alert data from log files. Drug–drug interaction (DDI) alerts from 3 years of electronic health record data were queried. Alert dwell time was calculated for 25,965 alerts, including 777 unique DDIs. The median alert dwell time was 8 s (range, 1–4913 s). Resident physicians had longer median alert dwell times than other prescribers (P < .001). The 10 most frequent DDI alerts (n = 8759 alerts) had shorter median dwell times than alerts that only occurred once (P < .001). This metric can be used in future research to evaluate the effectiveness and efficiency of interruptive prescribing alerts. PMID:26499101

Design and construction of smart cane using infrared laser-based tracking system

NASA Astrophysics Data System (ADS)

Wong, Chi Fung; Phitagragsakul, Narikorn; Jornsamer, Patcharaporn; Kaewmeesri, Pimsin; Jantakot, Pimsunan; Locharoenrat, Kitsakorn

2018-06-01

Our work is aimed to design and construct the smart cane. The infrared laser-based sensor was used as a distance detector and Arduino board was used as a microcontroller. On the other hand, Bluetooth was used as a wireless communicator and MP3 module together with the headset were used as a voice alert player. Our smart cane is a very effective device for the users under the indoor guidance. That is, the obstacle was detectable 3,000 cm away from the blind people. The white cane was assembled with the laser distance sensor and distance alert sensor served as the compact and light-weight device. Distance detection was very fast and precise when the smart cane was tested for the different obstacles, such as human, wall and wooden table under the indoor area.

Development of attention networks and their interactions in childhood.

PubMed

Pozuelos, Joan P; Paz-Alonso, Pedro M; Castillo, Alejandro; Fuentes, Luis J; Rueda, M Rosario

2014-10-01

In the present study, we investigated developmental trajectories of alerting, orienting, and executive attention networks and their interactions over childhood. Two cross-sectional experiments were conducted with different samples of 6- to 12-year-old children using modified versions of the attention network task (ANT). In Experiment 1 (N = 106), alerting and orienting cues were independently manipulated, thus allowing examination of interactions between these 2 networks, as well as between them and the executive attention network. In Experiment 2 (N = 159), additional changes were made to the task in order to foster exogenous orienting cues. Results from both studies consistently revealed separate developmental trajectories for each attention network. Children younger than 7 years exhibited stronger benefits from having an alerting auditory signal prior to the target presentation. Developmental changes in orienting were mostly observed on response accuracy between middle and late childhood, whereas executive attention showed increases in efficiency between 7 years and older ages, and further improvements in late childhood. Of importance, across both experiments, significant interactions between alerting and orienting, as well as between each of these and the executive attention network, were observed. Alerting cues led to speeding shifts of attention and enhancing orienting processes. Also, both alerting and orienting cues modulated the magnitude of the flanker interference effect. These findings inform current theoretical models of human attention and its development, characterizing for the first time, the age-related course of attention networks interactions that, present in adults, stem from further refinements over childhood.

Military and Government Applications of Human-Machine Communication by Voice

NASA Astrophysics Data System (ADS)

Weinstein, Clifford J.

1995-10-01

This paper describes a range of opportunities for military and government applications of human-machine communication by voice, based on visits and contacts with numerous user organizations in the United States. The applications include some that appear to be feasible by careful integration of current state-of-the-art technology and others that will require a varying mix of advances in speech technology and in integration of the technology into applications environments. Applications that are described include (1) speech recognition and synthesis for mobile command and control; (2) speech processing for a portable multifunction soldier's computer; (3) speech- and language-based technology for naval combat team tactical training; (4) speech technology for command and control on a carrier flight deck; (5) control of auxiliary systems, and alert and warning generation, in fighter aircraft and helicopters; and (6) voice check-in, report entry, and communication for law enforcement agents or special forces. A phased approach for transfer of the technology into applications is advocated, where integration of applications systems is pursued in parallel with advanced research to meet future needs.

INITIATE: An Intelligent Adaptive Alert Environment.

PubMed

Jafarpour, Borna; Abidi, Samina Raza; Ahmad, Ahmad Marwan; Abidi, Syed Sibte Raza

2015-01-01

Exposure to a large volume of alerts generated by medical Alert Generating Systems (AGS) such as drug-drug interaction softwares or clinical decision support systems over-whelms users and causes alert fatigue in them. Some of alert fatigue effects are ignoring crucial alerts and longer response times. A common approach to avoid alert fatigue is to devise mechanisms in AGS to stop them from generating alerts that are deemed irrelevant. In this paper, we present a novel framework called INITIATE: an INtellIgent adapTIve AlerT Environment to avoid alert fatigue by managing alerts generated by one or more AGS. We have identified and categories the lifecycle of different alerts and have developed alert management logic as per the alerts' lifecycle. Our framework incorporates an ontology that represents the alert management strategy and an alert management engine that executes this strategy. Our alert management framework offers the following features: (1) Adaptability based on users' feedback; (2) Personalization and aggregation of messages; and (3) Connection to Electronic Medical Records by implementing a HL7 Clinical Document Architecture parser.

IP telephony based danger alert communication system and its implementation

NASA Astrophysics Data System (ADS)

Rezac, Filip; Safarik, Jakub; Voznak, Miroslav; Tomala, Karel; Partila, Pavol

2013-05-01

This article discusses a danger alert system created as a part of the research project at Department of Telecommunications of Technical University of Ostrava. The aim of the system is to distribute pre-recorded voice messages in order to alert the called party in danger. This article describes individual technologies, which the application uses for its operation as well as issues relating to hardware requirements and transfer line bandwidth load. The article also describes new algorithms, which had to be developed in order to ensure the reliability of the system. Our intent is focused on disaster management, the message, which should be delivered within specified time span, is typed in the application and text-to-speech module ensures its transformation to a speech format, after that a particular scenario or warned area is selected and a target group is automatically unloaded. For this purpose, we have defined XML format for delivery of phone numbers which are located in the target area and these numbers are obtained from mobile BTS's (Base transmission stations). The benefit of such communication compared to others, is the fact, that it uses a phone call and, therefore, it is possible to get feedback who accepted the message and to improve efficiency of alert system. Finally, the list of unanswered calls is exported and these users can be informed via SMS.

Attentional networks in developmental dyscalculia

PubMed Central

2010-01-01

Background Very little is known about attention deficits in developmental dyscalculia, hence, this study was designed to provide the missing information. We examined attention abilities of participants suffering from developmental dyscalculia using the attention networks test - interactions. This test was designed to examine three different attention networks--executive function, orienting and alerting--and the interactions between them. Methods Fourteen university students that were diagnosed as suffering from developmental dyscalculia--intelligence and reading abilities in the normal range and no indication of attention-deficit hyperactivity disorder--and 14 matched controls were tested using the attention networks test - interactions. All participants were given preliminary tests to measure mathematical abilities, reading, attention and intelligence. Results The results revealed deficits in the alerting network--a larger alerting effect--and in the executive function networks--a larger congruity effect in developmental dyscalculia participants. The interaction between the alerting and executive function networks was also modulated by group. In addition, developmental dyscalculia participants were slower to respond in the non-cued conditions. Conclusions These results imply specific attentional deficits in pure developmental dyscalculia. Namely, those with developmental dyscalculia seem to be deficient in the executive function and alertness networks. They suffer from difficulty in recruiting attention, in addition to the deficits in numerical processing. PMID:20157427

Attentional networks in developmental dyscalculia.

PubMed

Askenazi, Sarit; Henik, Avishai

2010-01-07

Very little is known about attention deficits in developmental dyscalculia, hence, this study was designed to provide the missing information. We examined attention abilities of participants suffering from developmental dyscalculia using the attention networks test - interactions. This test was designed to examine three different attention networks--executive function, orienting and alerting--and the interactions between them. Fourteen university students that were diagnosed as suffering from developmental dyscalculia--intelligence and reading abilities in the normal range and no indication of attention-deficit hyperactivity disorder--and 14 matched controls were tested using the attention networks test-interactions. All participants were given preliminary tests to measure mathematical abilities, reading, attention and intelligence. The results revealed deficits in the alerting network--a larger alerting effect--and in the executive function networks--a larger congruity effect in developmental dyscalculia participants. The interaction between the alerting and executive function networks was also modulated by group. In addition, developmental dyscalculia participants were slower to respond in the non-cued conditions. These results imply specific attentional deficits in pure developmental dyscalculia. Namely, those with developmental dyscalculia seem to be deficient in the executive function and alertness networks. They suffer from difficulty in recruiting attention, in addition to the deficits in numerical processing.

Optimization of drug-drug interaction alert rules in a pediatric hospital's electronic health record system using a visual analytics dashboard.

PubMed

Simpao, Allan F; Ahumada, Luis M; Desai, Bimal R; Bonafide, Christopher P; Gálvez, Jorge A; Rehman, Mohamed A; Jawad, Abbas F; Palma, Krisha L; Shelov, Eric D

2015-03-01

To develop and evaluate an electronic dashboard of hospital-wide electronic health record medication alerts for an alert fatigue reduction quality improvement project. We used visual analytics software to develop the dashboard. We collaborated with the hospital-wide Clinical Decision Support committee to perform three interventions successively deactivating clinically irrelevant drug-drug interaction (DDI) alert rules. We analyzed the impact of the interventions on care providers' and pharmacists' alert and override rates using an interrupted time series framework with piecewise regression. We evaluated 2 391 880 medication alerts between January 31, 2011 and January 26, 2014. For pharmacists, the median alert rate prior to the first DDI deactivation was 58.74 alerts/100 orders (IQR 54.98-60.48) and 25.11 alerts/100 orders (IQR 23.45-26.57) following the three interventions (p<0.001). For providers, baseline median alert rate prior to the first round of DDI deactivation was 19.73 alerts/100 orders (IQR 18.66-20.24) and 15.11 alerts/100 orders (IQR 14.44-15.49) following the three interventions (p<0.001). In a subgroup analysis, we observed a decrease in pharmacists' override rates for DDI alerts that were not modified in the system from a median of 93.06 overrides/100 alerts (IQR 91.96-94.33) to 85.68 overrides/100 alerts (IQR 84.29-87.15, p<0.001). The medication serious safety event rate decreased during the study period, and there were no serious safety events reported in association with the deactivated alert rules. An alert dashboard facilitated safe rapid-cycle reductions in alert burden that were temporally associated with lower pharmacist override rates in a subgroup of DDIs not directly affected by the interventions; meanwhile, the pharmacists' frequency of selecting the 'cancel' option increased. We hypothesize that reducing the alert burden enabled pharmacists to devote more attention to clinically relevant alerts. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

An Investigation of Drug-Drug Interaction Alert Overrides at a Pediatric Hospital.

PubMed

Humphrey, Kate; Jorina, Maria; Harper, Marvin; Dodson, Brenda; Kim, Seung-Yeon; Ozonoff, Al

2018-05-01

Drug-drug interactions (DDIs) can result in patient harm. DDI alerts are intended to help prevent harm; when the majority of alerts presented to providers are being overridden, their value is diminished. Our objective was to evaluate the overall rates of DDI alert overrides and how rates varied by specialty, clinician type, and patient complexity. A retrospective study of DDI alert overrides that occurred during 2012 and 2013 within the inpatient setting described at the medication-, hospital-, provider-, and patient encounter-specific levels was performed at an urban, quaternary-care, pediatric hospital. There were >41 000 DDI alerts presented to clinicians; ∼90% were overridden. The 5 DDI pairs that were most frequently presented and overridden included the following: potassium chloride-spironolactone, methadone-ondansetron, ketorolac-ibuprofen, cyclosporine-fluconazole, and potassium chloride-enalapril, each with an alert override rate of ≥0.89. Override rates across provider groups ranged between 0.84 and 0.97. In general, patients with high complexity had a higher frequency of alert overrides, but the rates of alert overrides for each DDI pairing did not differ significantly. High rates of DDI alert overrides occur across medications, provider groups, and patient encounters. Methods to decrease DDI alerts which are likely to be overridden exist, but it is also clear that more robust and intelligent tools are needed. Characteristics exist at the medication, hospital, provider, and patient levels that can be used to help specialize and enhance information transmission. Copyright © 2018 by the American Academy of Pediatrics.

Voice to Voice: Developing In-Service Teachers' Personal, Collaborative, and Public Voices.

ERIC Educational Resources Information Center

Thurber, Frances; Zimmerman, Enid

1997-01-01

Describes a model for inservice education that begins with an interchange of teachers' voices with those of the students in an interactive dialog. The exchange allows them to develop their private voices through self-reflection and validation of their own experiences. (JOW)

The "VoiceForum" Platform for Spoken Interaction

ERIC Educational Resources Information Center

Fynn, Fohn; Wigham, Chiara R.

2011-01-01

Showcased in the courseware exhibition, "VoiceForum" is a web-based software platform for asynchronous learner interaction in threaded discussions using voice and text. A dedicated space is provided for the tutor who can give feedback on a posted message and dialogue with the participants at a separate level from the main interactional…

Voices on Voice: Perspectives, Definitions, Inquiry.

ERIC Educational Resources Information Center

Yancey, Kathleen Blake, Ed.

This collection of essays approaches "voice" as a means of expression that lives in the interactions of writers, readers, and language, and examines the conceptualizations of voice within the oral rhetorical and expressionist traditions, and the notion of voice as both a singular and plural phenomenon. An explanatory introduction by the…

The effect of voice quality and competing speakers in a passage comprehension task: performance in relation to cognitive functioning in children with normal hearing.

PubMed

von Lochow, Heike; Lyberg-Åhlander, Viveka; Sahlén, Birgitta; Kastberg, Tobias; Brännström, K Jonas

2018-04-01

This study explores the effect of voice quality and competing speaker/-s on children's performance in a passage comprehension task. Furthermore, it explores the interaction between passage comprehension and cognitive functioning. Forty-nine children (27 girls and 22 boys) with normal hearing (aged 7-12 years) participated. Passage comprehension was tested in six different listening conditions; a typical voice (non-dysphonic voice) in quiet, a typical voice with one competing speaker, a typical voice with four competing speakers, a dysphonic voice in quiet, a dysphonic voice with one competing speaker, and a dysphonic voice with four competing speakers. The children's working memory capacity and executive functioning were also assessed. The findings indicate no direct effect of voice quality on the children's performance, but a significant effect of background listening condition. Interaction effects were seen between voice quality, background listening condition, and executive functioning. The children's susceptibility to the effect of the dysphonic voice and the background listening conditions are related to the individual's executive functions. The findings have several implications for design of interventions in language learning environments such as classrooms.

Alert dwell time: introduction of a measure to evaluate interruptive clinical decision support alerts.

PubMed

McDaniel, Robert B; Burlison, Jonathan D; Baker, Donald K; Hasan, Murad; Robertson, Jennifer; Hartford, Christine; Howard, Scott C; Sablauer, Andras; Hoffman, James M

2016-04-01

Metrics for evaluating interruptive prescribing alerts have many limitations. Additional methods are needed to identify opportunities to improve alerting systems and prevent alert fatigue. In this study, the authors determined whether alert dwell time-the time elapsed from when an interruptive alert is generated to when it is dismissed-could be calculated by using historical alert data from log files. Drug-drug interaction (DDI) alerts from 3 years of electronic health record data were queried. Alert dwell time was calculated for 25,965 alerts, including 777 unique DDIs. The median alert dwell time was 8 s (range, 1-4913 s). Resident physicians had longer median alert dwell times than other prescribers (P < 001). The 10 most frequent DDI alerts (n = 8759 alerts) had shorter median dwell times than alerts that only occurred once (P < 001). This metric can be used in future research to evaluate the effectiveness and efficiency of interruptive prescribing alerts. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Clinical reasoning in the context of active decision support during medication prescribing.

PubMed

Horsky, Jan; Aarts, Jos; Verheul, Leonie; Seger, Diane L; van der Sijs, Heleen; Bates, David W

2017-01-01

Describe and analyze reasoning patterns of clinicians responding to drug-drug interaction alerts in order to understand the role of patient-specific information in the decision-making process about the risks and benefits of medication therapy. Insights could be used to inform the design of decision-support interventions. Thirty-two clinicians working with five EHRs in two countries completed sets of six medication orders each and responded to high- and low-severity drug-drug interaction alerts while verbalizing their thoughts in a standard think-aloud protocol. Tasks were recorded and analyzed to describe reasoning patterns about patient-risk assessment and strategies to avoid or mitigate it. We observed a total of 171 prescribing decisions. Clinicians actively sought to reduce risk when responding to high-severity alerts, mostly by monitoring patients and making dose adjustments (52 alerts, 40%). In contrast, they routinely left prescriptions unchanged after low-severity alerts when they felt confident that patients would tolerate the drug combination and that treatment benefits outweighed the risks (30 alerts, 71%). Clinicians used similar reasoning patterns regardless of the EHR used and differences in alert design. Clinicians conceptualized risk as a complex set of interdependent tradeoffs specific to individual patients and had a tendency not to follow advice they considered of low clinical value. Omission of patient-specific data, which was not shown in alerts or included in trigger logic, may have contributed to the constancy of reasoning and to similarities in risk-control strategies we observed despite significant differences in interface design and system function. Declining an alert suggestion was preceded by sometimes brief but often complex reasoning, prioritizing different aspects of care quality and safety, especially when the perceived risk was higher. Clinicians believed that the risk indicated in drug-drug interaction alerts needs to be interpreted as one factor in the broader context of care, specific to a patient. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Wide variation and patterns of physicians' responses to drug-drug interaction alerts.

PubMed

Cho, Insook; Lee, Yura; Lee, Jae-Ho; Bates, David W

2018-05-08

Providing physicians with alerts about potentially harmful drug-drug interactions (DDIs) is only moderately effective due to high alert override rates. To understand high override behavior on DDI alerts, we investigated how physicians respond to DDIs and their behavior patterns and variations. Retrospective system log data analysis and records review (sampling 2% of total overrides). A large tertiary academic hospital. About 560 physicians and their override responses to DDI alerts generated from 1 September to 31 December 2014. Not applicable. DDI alert frequency and override rate. We found significant variation in both the number of alerts and override rates at the levels of physicians, departments and drug-class pairs. Physician-level variations were wider for residents than for faculty staff (number of alerts: t = 254.17, P = 0.011; override rates: t = -4.77, P < 0.0001). Using the number of alerts and their override rate, we classified physicians into four groups: inexperienced incautious users, inexperienced cautious users, experienced cautious users and experienced incautious users. Medical department influenced both alert numbers and override rates. Nearly 90% of the overrides involved only five drug-class combinations, which had a wide range of appropriateness in the chart review. The variations at drug-class levels suggest issues with system design and the DDI rules. Department-level variation may be best addressed at the department level, and the rest of the variation appears related to individual physician responses, suggesting the need for interventions at an individual level.

Evaluation of medication alerts in electronic health records for compliance with human factors principles

PubMed Central

Phansalkar, Shobha; Zachariah, Marianne; Seidling, Hanna M; Mendes, Chantal; Volk, Lynn; Bates, David W

2014-01-01

Introduction Increasing the adoption of electronic health records (EHRs) with integrated clinical decision support (CDS) is a key initiative of the current US healthcare administration. High over-ride rates of CDS alerts strongly limit these potential benefits. As a result, EHR designers aspire to improve alert design to achieve better acceptance rates. In this study, we evaluated drug–drug interaction (DDI) alerts generated in EHRs and compared them for compliance with human factors principles. Methods We utilized a previously validated questionnaire, the I-MeDeSA, to assess compliance with nine human factors principles of DDI alerts generated in 14 EHRs. Two reviewers independently assigned scores evaluating the human factors characteristics of each EHR. Rankings were assigned based on these scores and recommendations for appropriate alert design were derived. Results The 14 EHRs evaluated in this study received scores ranging from 8 to 18.33, with a maximum possible score of 26. Cohen's κ (κ=0.86) reflected excellent agreement among reviewers. The six vendor products tied for second and third place rankings, while the top system and bottom five systems were home-grown products. The most common weaknesses included the absence of characteristics such as alert prioritization, clear and concise alert messages indicating interacting drugs, actions for clinical management, and a statement indicating the consequences of over-riding the alert. Conclusions We provided detailed analyses of the human factors principles which were assessed and described our recommendations for effective alert design. Future studies should assess whether adherence to these recommendations can improve alert acceptance. PMID:24780721

Testing the Behavioral Interaction and Integration of Attentional Networks

ERIC Educational Resources Information Center

Fan, Jin; Gu, Xiaosi; Guise, Kevin G.; Liu, Xun; Fossella, John; Wang, Hongbin; Posner, Michael I.

2009-01-01

One current conceptualization of attention subdivides it into functions of alerting, orienting, and executive control. Alerting describes the function of tonically maintaining the alert state and phasically responding to a warning signal. Automatic and voluntary orienting are involved in the selection of information among multiple sensory inputs.…

Crossmodal interactions during non-linguistic auditory processing in cochlear-implanted deaf patients.

PubMed

Barone, Pascal; Chambaudie, Laure; Strelnikov, Kuzma; Fraysse, Bernard; Marx, Mathieu; Belin, Pascal; Deguine, Olivier

2016-10-01

Due to signal distortion, speech comprehension in cochlear-implanted (CI) patients relies strongly on visual information, a compensatory strategy supported by important cortical crossmodal reorganisations. Though crossmodal interactions are evident for speech processing, it is unclear whether a visual influence is observed in CI patients during non-linguistic visual-auditory processing, such as face-voice interactions, which are important in social communication. We analyse and compare visual-auditory interactions in CI patients and normal-hearing subjects (NHS) at equivalent auditory performance levels. Proficient CI patients and NHS performed a voice-gender categorisation in the visual-auditory modality from a morphing-generated voice continuum between male and female speakers, while ignoring the presentation of a male or female visual face. Our data show that during the face-voice interaction, CI deaf patients are strongly influenced by visual information when performing an auditory gender categorisation task, in spite of maximum recovery of auditory speech. No such effect is observed in NHS, even in situations of CI simulation. Our hypothesis is that the functional crossmodal reorganisation that occurs in deafness could influence nonverbal processing, such as face-voice interaction; this is important for patient internal supramodal representation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Interactions between voice clinics and singing teachers: a report on the British Voice Association questionnaire to voice clinics in the UK.

PubMed

Davies, J; Anderson, S; Huchison, L; Stewart, G

2007-01-01

Singers with vocal problems are among patients who present at multidisciplinary voice clinics led by Ear Nose and Throat consultants and laryngologists or speech and language therapists. However, the development and care of the singing voice are also important responsibilities of singing teachers. We report here on the current extent and nature of interactions between voice clinics and singing teachers, based on data from a recent survey undertaken on behalf of the British Voice Association. A questionnaire was sent to all 103 voice clinics at National Health Service (NHS) hospitals in the UK. Responses were received and analysed from 42 currently active clinics. Eight (19%) clinics reported having a singing teacher as an active member of the team. They were all satisfied with the singing teacher's knowledge and expertise, which had been acquired by several different means. Of 32 clinics without a singing teacher regularly associated with the team, funding and difficulty of finding an appropriate singing voice expert (81% and 50%, respectively) were among the main reasons for their absence. There was an expressed requirement for more interaction between voice clinics and singing teachers, and 86% replied that they would find it useful to have a list of singing teachers in their area. On the matter of gaining expertise and training, 74% of the clinics replying would enable singing teachers to observe clinic sessions for experience and 21% were willing to assist in training them for clinic-associated work.

Effects of the Interaction of Caffeine and Water on Voice Performance: A Pilot Study

ERIC Educational Resources Information Center

Franca, Maria Claudia; Simpson, Kenneth O.

2013-01-01

The objective of this "pilot" investigation was to study the effects of the interaction of caffeine and water intake on voice as evidenced by acoustic and aerodynamic measures, to determine whether ingestion of 200 mg of caffeine and various levels of water intake have an impact on voice. The participants were 48 females ranging in age…

Military and government applications of human-machine communication by voice.

PubMed Central

Weinstein, C J

1995-01-01

This paper describes a range of opportunities for military and government applications of human-machine communication by voice, based on visits and contacts with numerous user organizations in the United States. The applications include some that appear to be feasible by careful integration of current state-of-the-art technology and others that will require a varying mix of advances in speech technology and in integration of the technology into applications environments. Applications that are described include (1) speech recognition and synthesis for mobile command and control; (2) speech processing for a portable multifunction soldier's computer; (3) speech- and language-based technology for naval combat team tactical training; (4) speech technology for command and control on a carrier flight deck; (5) control of auxiliary systems, and alert and warning generation, in fighter aircraft and helicopters; and (6) voice check-in, report entry, and communication for law enforcement agents or special forces. A phased approach for transfer of the technology into applications is advocated, where integration of applications systems is pursued in parallel with advanced research to meet future needs. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 PMID:7479718

Identification of Patients Expected to Benefit from Electronic Alerts for Acute Kidney Injury.

PubMed

Biswas, Aditya; Parikh, Chirag R; Feldman, Harold I; Garg, Amit X; Latham, Stephen; Lin, Haiqun; Palevsky, Paul M; Ugwuowo, Ugochukwu; Wilson, F Perry

2018-06-07

Electronic alerts for heterogenous conditions such as AKI may not provide benefit for all eligible patients and can lead to alert fatigue, suggesting that personalized alert targeting may be useful. Uplift-based alert targeting may be superior to purely prognostic-targeting of interventions because uplift models assess marginal treatment effect rather than likelihood of outcome. This is a secondary analysis of a clinical trial of 2278 adult patients with AKI randomized to an automated, electronic alert system versus usual care. We used three uplift algorithms and one purely prognostic algorithm, trained in 70% of the data, and evaluated the effect of targeting alerts to patients with higher scores in the held-out 30% of the data. The performance of the targeting strategy was assessed as the interaction between the model prediction of likelihood to benefit from alerts and randomization status. The outcome of interest was maximum relative change in creatinine from the time of randomization to 3 days after randomization. The three uplift score algorithms all gave rise to a significant interaction term, suggesting that a strategy of targeting individuals with higher uplift scores would lead to a beneficial effect of AKI alerting, in contrast to the null effect seen in the overall study. The prognostic model did not successfully stratify patients with regards to benefit of the intervention. Among individuals in the high uplift group, alerting was associated with a median reduction in change in creatinine of -5.3% ( P =0.03). In the low uplift group, alerting was associated with a median increase in change in creatinine of +5.3% ( P =0.005). Older individuals, women, and those with a lower randomization creatinine were more likely to receive high uplift scores, suggesting that alerts may benefit those with more slowly developing AKI. Uplift modeling, which accounts for treatment effect, can successfully target electronic alerts for AKI to those most likely to benefit, whereas purely prognostic targeting cannot. Copyright © 2018 by the American Society of Nephrology.

Dialogism and Carnival in Virginia Woolf's "To the Lighthouse": A Bakhtinian Reading

ERIC Educational Resources Information Center

Faizi, Hamed; Taghizadeh, Ali

2015-01-01

Mikhail Bakhtin's dialogism in a novel promises the creation of a domain of interactive context for different voices which results in a polyphonic discourse. Instead of trying to suppress each other, the voices of the novel interact upon the other voices in a way that none of them tries to silent the other ones, and each one has the opportunity to…

Incidence of potential drug interactions in a transplant centre setting and relevance of electronic alerts for clinical practice support.

PubMed

Polidori, Piera; Di Giorgio, Concetta; Provenzani, Alessio

2012-01-01

Adverse drug events may occur as a result of drug-drug interactions (DDIs). Information technology (IT) systems can be an important decision-making tool for healthcare workers to identify DDIs. The aim of the study is to analyse drug prescriptions in our main hospital units, in order to measure the incidence and severity of potential DDIs. The utility of clinical decision-support systems (CDSSs) and computerised physician order entry (CPOE) in term of alerts adherence was also assessed. DDIs were assessed using a Micromedex® healthcare series database. The system, adopted by the hospital, generates alerts for prescriptions with negative interactions and thanks to an 'acknowledgement function' it is possible to verify physician adherence to alerts. This function, although used previously, became mandatory from September 2010. Physician adherence to alerts and mean monthly incidence of potential DDIs in analysed units, before and after the mandatory 'acknowledgement function', were calculated. The intensive care unit (ICU) registered the greatest incidence of potential DDIs (49.0%), followed by the abdominal surgery unit and dialysis (43.4 and 42.0%, respectively). The cardiothoracic surgery unit (41.6%), step-down unit (38.3%) and post-anaesthesia care unit (30.0%) were comparable. The operating theatre and endoscopy registered the fewest potential DDIs (28.2 and 22.7%, respectively). Adherence to alerts after the 'acknowledgement function' increased by 25.0% in the ICU, 54.0% in the cardiothoracic surgery unit, 52.5% in the abdominal surgery unit, 58.0% in the stepdown unit, 67.0% in dialysis, 51.0% in endoscopy and 48.0% in the post-anaesthesia care unit. In the operating theatre, adherence to alerts decreased from 34.0 to 30.0%. The incidence of potential DDIs after mandatory use of the 'acknowledgement function' decreased slightly in endoscopy (-2.9%), the abdominal surgery unit (-2.7%), dialysis (-1.9%) and the step-down unit (-1.4%). Improving DDI alerts will improved patient safety by more appropriately alerting clinicians.

Individual versus Interactive Task-Based Performance through Voice-Based Computer-Mediated Communication

ERIC Educational Resources Information Center

Granena, Gisela

2016-01-01

Interaction is a necessary condition for second language (L2) learning (Long, 1980, 1996). Research in computer-mediated communication has shown that interaction opportunities make learners pay attention to form in a variety of ways that promote L2 learning. This research has mostly investigated text-based rather than voice-based interaction. The…

The interaction of tone with voicing and foot structure: evidence from Kera phonetics and phonology

NASA Astrophysics Data System (ADS)

Pearce, Mary Dorothy

This thesis uses acoustic measurements as a basis for the phonological analysis of the interaction of tone with voicing and foot structure in Kera (a Chadic language). In both tone spreading and vowel harmony, the iambic foot acts as a domain for spreading. Further evidence for the foot comes from measurements of duration, intensity and vowel quality. Kera is unusual in combining a tone system with a partially independent metrical system based on iambs. In words containing more than one foot, the foot is the tone bearing unit (TBU), but in shorter words, the TBU is the syllable. In perception and production experiments, results show that Kera speakers, unlike English and French, use the fundamental frequency as the principle cue to 'Voicing" contrast. Voice onset time (VOT) has only a minor role. Historically, tones probably developed from voicing through a process of tonogenesis, but synchronically, the feature voice is no longer contrastive and VOT is used in an enhancing role. Some linguists have claimed that Kera is a key example for their controversial theory of long-distance voicing spread. But as voice is not part of Kera phonology, this thesis gives counter-evidence to the voice spreading claim. An important finding from the experiments is that the phonological grammars are different between village women, men moving to town and town men. These differences are attributed to French contact. The interaction between Kera tone and voicing and contact with French have produced changes from a 2-way voicing contrast, through a 3-way tonal contrast, to a 2-way voicing contrast plus another contrast with short VOT. These diachronic and synchronic tone/voicing facts are analysed using laryngeal features and Optimality Theory. This thesis provides a body of new data, detailed acoustic measurements, and an analysis incorporating current theoretical issues in phonology, which make it of interest to Africanists and theoreticians alike.

Subjective assessment of usefulness and appropriate presentation mode of alerts and reminders in the outpatient setting.

PubMed Central

Krall, M. A.; Sittig, D. F.

2001-01-01

There is very little known about the limits of alerting in the setting of the outpatient Electronic Medical Record (EMR). We are interested in how users value and prefer such alerts. One hundred Kaiser Permanente primary care clinicians were sent a four-page questionnaire. It contained questions related to the usability and usefulness of different approaches to presenting reminder and alert information. The survey also contained questions about the desirability of six categories of alerts. Forty-three of 100 questionnaires were returned. Users generally preferred an active, more intrusive interaction model for "alerts" and a passive, less intrusive model for order messages and other types of reminders and notifications. Drug related alerts were more highly rated than health maintenance or disease state reminders. Users indicated that more alerts would make the system "more useful" but "less easy to use". PMID:11825206

Subjective assessment of usefulness and appropriate presentation mode of alerts and reminders in the outpatient setting.

PubMed

Krall, M A; Sittig, D F

2001-01-01

There is very little known about the limits of alerting in the setting of the outpatient Electronic Medical Record (EMR). We are interested in how users value and prefer such alerts. One hundred Kaiser Permanente primary care clinicians were sent a four-page questionnaire. It contained questions related to the usability and usefulness of different approaches to presenting reminder and alert information. The survey also contained questions about the desirability of six categories of alerts. Forty-three of 100 questionnaires were returned. Users generally preferred an active, more intrusive interaction model for "alerts" and a passive, less intrusive model for order messages and other types of reminders and notifications. Drug related alerts were more highly rated than health maintenance or disease state reminders. Users indicated that more alerts would make the system "more useful" but "less easy to use".

Comparative evaluation of the drug interaction screening programs MediQ and ID PHARMA CHECK in neurological inpatients.

PubMed

Zorina, Olesya I; Haueis, Patrick; Semmler, Alexander; Marti, Isabelle; Gonzenbach, Roman R; Guzek, Markus; Kullak-Ublick, Gerd A; Weller, Michael; Russmann, Stefan

2012-08-01

The comparative evaluation of clinical decision support software (CDSS) programs regarding their sensitivity and positive predictive value for the identification of clinically relevant drug interactions. In this research, we used a cross-sectional study that identified potential drug interactions using the CDSS MediQ and the ID PHARMA CHECK in 484 neurological inpatients. Interactions were reclassified according to the Zurich Interaction System, a multidimensional classification that incorporates the Operational Classification of Drug Interactions. In 484 patients with 2812 prescriptions, MediQ and ID PHARMA CHECK generated a total of 1759 and 1082 alerts, respectively. MediQ identified 658 unique potentially interacting combinations, 8 classified as "high danger," 164 as "average danger," and 486 as "low danger." ID PHARMA CHECK detected 336 combinations assigned to one or several of 12 risk and management categories. Altogether, both CDSS issued alerts relating to 808 unique potentially interacting combinations. According to the Zurich Interaction System, 6 of these were contraindicated, 25 were provisionally contraindicated, 190 carried a conditional risk, and 587 had a minimal risk of adverse events. The positive predictive value for alerts having at least a conditional risk was 0.24 for MediQ and 0.48 for ID PHARMA CHECK. CDSS showed major differences in the identification and grading of interactions, and many interactions were only identified by one of the two CDSS. For both programs, only a small proportion of all identified interactions appeared clinically relevant, and the selected display of alerts that imply management changes is a key issue in the further development and local setup of such programs. Copyright © 2012 John Wiley & Sons, Ltd.

The Effect of Automated Alerts on Provider Ordering Behavior in an Outpatient Setting

PubMed Central

Steele, Andrew W; Eisert, Sheri; Witter, Joel; Lyons, Pat; Jones, Michael A; Gabow, Patricia; Ortiz, Eduardo

2005-01-01

Background Computerized order entry systems have the potential to prevent medication errors and decrease adverse drug events with the use of clinical-decision support systems presenting alerts to providers. Despite the large volume of medications prescribed in the outpatient setting, few studies have assessed the impact of automated alerts on medication errors related to drug–laboratory interactions in an outpatient primary-care setting. Methods and Findings A primary-care clinic in an integrated safety net institution was the setting for the study. In collaboration with commercial information technology vendors, rules were developed to address a set of drug–laboratory interactions. All patients seen in the clinic during the study period were eligible for the intervention. As providers ordered medications on a computer, an alert was displayed if a relevant drug–laboratory interaction existed. Comparisons were made between baseline and postintervention time periods. Provider ordering behavior was monitored focusing on the number of medication orders not completed and the number of rule-associated laboratory test orders initiated after alert display. Adverse drug events were assessed by doing a random sample of chart reviews using the Naranjo scoring scale. The rule processed 16,291 times during the study period on all possible medication orders: 7,017 during the pre-intervention period and 9,274 during the postintervention period. During the postintervention period, an alert was displayed for 11.8% (1,093 out of 9,274) of the times the rule processed, with 5.6% for only “missing laboratory values,” 6.0% for only “abnormal laboratory values,” and 0.2% for both types of alerts. Focusing on 18 high-volume and high-risk medications revealed a significant increase in the percentage of time the provider stopped the ordering process and did not complete the medication order when an alert for an abnormal rule-associated laboratory result was displayed (5.6% vs. 10.9%, p = 0.03, Generalized Estimating Equations test). The provider also increased ordering of the rule-associated laboratory test when an alert was displayed (39% at baseline vs. 51% during post intervention, p < 0.001). There was a non-statistically significant difference towards less “definite” or “probable” adverse drug events defined by Naranjo scoring (10.3% at baseline vs. 4.3% during postintervention, p = 0.23). Conclusion Providers will adhere to alerts and will use this information to improve patient care. Specifically, in response to drug–laboratory interaction alerts, providers will significantly increase the ordering of appropriate laboratory tests. There may be a concomitant change in adverse drug events that would require a larger study to confirm. Implementation of rules technology to prevent medication errors could be an effective tool for reducing medication errors in an outpatient setting. PMID:16128621

Clinical Decision Support Alert Appropriateness: A Review and Proposal for Improvement

PubMed Central

McCoy, Allison B.; Thomas, Eric J.; Krousel-Wood, Marie; Sittig, Dean F.

2014-01-01

Background Many healthcare providers are adopting clinical decision support (CDS) systems to improve patient safety and meet meaningful use requirements. Computerized alerts that prompt clinicians about drug-allergy, drug-drug, and drug-disease warnings or provide dosing guidance are most commonly implemented. Alert overrides, which occur when clinicians do not follow the guidance presented by the alert, can hinder improved patient outcomes. Methods We present a review of CDS alerts and describe a proposal to develop novel methods for evaluating and improving CDS alerts that builds upon traditional informatics approaches. Our proposal incorporates previously described models for predicting alert overrides that utilize retrospective chart review to determine which alerts are clinically relevant and which overrides are justifiable. Results Despite increasing implementations of CDS alerts, detailed evaluations rarely occur because of the extensive labor involved in manual chart reviews to determine alert and response appropriateness. Further, most studies have solely evaluated alert overrides that are appropriate or justifiable. Our proposal expands the use of web-based monitoring tools with an interactive dashboard for evaluating CDS alert and response appropriateness that incorporates the predictive models. The dashboard provides 2 views, an alert detail view and a patient detail view, to provide a full history of alerts and help put the patient's events in context. Conclusion The proposed research introduces several innovations to address the challenges and gaps in alert evaluations. This research can transform alert evaluation processes across healthcare settings, leading to improved CDS, reduced alert fatigue, and increased patient safety. PMID:24940129

Medication-related clinical decision support alert overrides in inpatients.

PubMed

Nanji, Karen C; Seger, Diane L; Slight, Sarah P; Amato, Mary G; Beeler, Patrick E; Her, Qoua L; Dalleur, Olivia; Eguale, Tewodros; Wong, Adrian; Silvers, Elizabeth R; Swerdloff, Michael; Hussain, Salman T; Maniam, Nivethietha; Fiskio, Julie M; Dykes, Patricia C; Bates, David W

2018-05-01

To define the types and numbers of inpatient clinical decision support alerts, measure the frequency with which they are overridden, and describe providers' reasons for overriding them and the appropriateness of those reasons. We conducted a cross-sectional study of medication-related clinical decision support alerts over a 3-year period at a 793-bed tertiary-care teaching institution. We measured the rate of alert overrides, the rate of overrides by alert type, the reasons cited for overrides, and the appropriateness of those reasons. Overall, 73.3% of patient allergy, drug-drug interaction, and duplicate drug alerts were overridden, though the rate of overrides varied by alert type (P < .0001). About 60% of overrides were appropriate, and that proportion also varied by alert type (P < .0001). Few overrides of renal- (2.2%) or age-based (26.4%) medication substitutions were appropriate, while most duplicate drug (98%), patient allergy (96.5%), and formulary substitution (82.5%) alerts were appropriate. Despite warnings of potential significant harm, certain categories of alert overrides were inappropriate >75% of the time. The vast majority of duplicate drug, patient allergy, and formulary substitution alerts were appropriate, suggesting that these categories of alerts might be good targets for refinement to reduce alert fatigue. Almost three-quarters of alerts were overridden, and 40% of the overrides were not appropriate. Future research should optimize alert types and frequencies to increase their clinical relevance, reducing alert fatigue so that important alerts are not inappropriately overridden.

Practical applications of interactive voice technologies: Some accomplishments and prospects

NASA Technical Reports Server (NTRS)

Grady, Michael W.; Hicklin, M. B.; Porter, J. E.

1977-01-01

A technology assessment of the application of computers and electronics to complex systems is presented. Three existing systems which utilize voice technology (speech recognition and speech generation) are described. Future directions in voice technology are also described.

Sounds of Education: Teacher Role and Use of Voice in Interactions with Young Children

ERIC Educational Resources Information Center

Koch, Anette Boye

2017-01-01

Voice is a basic tool in communication between adults. However, in early educational settings, adult professionals use their voices in different paralinguistic ways when they communicate with children. A teacher's use of voice is important because it serves to communicate attitudes and emotions in ways that are often ignored in early childhood…

17 Ways to Say Yes: Toward Nuanced Tone of Voice in AAC and Speech Technology

PubMed Central

Pullin, Graham; Hennig, Shannon

2015-01-01

Abstract People with complex communication needs who use speech-generating devices have very little expressive control over their tone of voice. Despite its importance in human interaction, the issue of tone of voice remains all but absent from AAC research and development however. In this paper, we describe three interdisciplinary projects, past, present and future: The critical design collection Six Speaking Chairs has provoked deeper discussion and inspired a social model of tone of voice; the speculative concept Speech Hedge illustrates challenges and opportunities in designing more expressive user interfaces; the pilot project Tonetable could enable participatory research and seed a research network around tone of voice. We speculate that more radical interactions might expand frontiers of AAC and disrupt speech technology as a whole. PMID:25965913

Double Voicing and Personhood in Collaborative Life Writing about Autism: the Transformative Narrative of Carly's Voice.

PubMed

Orlando, Monica

2018-06-01

Collaborative memoirs by co-writers with and without autism can enable the productive interaction of the voices of the writers in ways that can empower rather than exploit the disabled subject. Carly's Voice, co-written by Arthur Fleischmann and his autistic daughter Carly, demonstrates the capacity for such life narratives to facilitate the relational interaction between writers in the negotiation of understandings of disability. Though the text begins by focusing on the limitations of life with autism, it develops into a collaboration which helps both writers move toward new ways of understanding disability and their own and one another's life stories.

Design and Implementation of an Interactive Website for Pediatric Voice Therapy-The Concept of In-Between Care: A Telehealth Model.

PubMed

Doarn, Charles R; Zacharias, Stephanie; Keck, Casey Stewart; Tabangin, Meredith; DeAlarcon, Alessandro; Kelchner, Lisa

2018-06-05

This article describes the design and implementation of a web-based portal developed to provide supported home practice between weekly voice therapy sessions delivered through telehealth to children with voice disorders. This in-between care consisted of supported home practice that was remotely monitored by speech-language pathologists (SLPs). A web-based voice therapy portal (VTP) was developed as a platform so participants could complete voice therapy home practice by an interdisciplinary team of SLPs (specialized in pediatric voice therapy), telehealth specialists, biomedical informaticians, and interface designers. The VTP was subsequently field tested in a group of children with voice disorders, participating in a larger telehealth study. Building the VTP for supported home practice for pediatric voice therapy was challenging, but successful. Key interactive features of the final site included 11 vocal hygiene questions, traditional voice therapy exercises grouped into levels, audio/visual voice therapy demonstrations, a store-and-retrieval system for voice samples, message/chat function, written guidelines for weekly therapy exercises, and questionnaires for parents to complete after each therapy session. Ten participants (9-14 years of age) diagnosed with a voice disorder were enrolled for eight weekly telehealth voice therapy sessions with follow-up in-between care provided using the VTP. The development and implementation of the VTP as a novel platform for the delivery of voice therapy home practice sessions were effective. We found that a versatile individual, who can work with all project staff (speak the language of both SLPs and information technologists), is essential to the development process. Once the website was established, participants and SLPs effectively utilized the web-based VTP. They found it feasible and useful for needed in-between care and reinforcement of therapeutic exercises.

Using the World Wide Web for GIDEP Problem Data Processing at Marshall Space Flight Center

NASA Technical Reports Server (NTRS)

McPherson, John W.; Haraway, Sandra W.; Whirley, J. Don

1999-01-01

Since April 1997, Marshall Space Flight Center has been using electronic transfer and the web to support our processing of the Government-Industry Data Exchange Program (GIDEP) and NASA ALERT information. Specific aspects include: (1) Extraction of ASCII text information from GIDEP for loading into Word documents for e-mail to ALERT actionees; (2) Downloading of GIDEP form image formats in Adobe Acrobat (.pdf) for internal storage display on the MSFC ALERT web page; (3) Linkage of stored GRDEP problem forms with summary information for access from the MSFC ALERT Distribution Summary Chart or from an html table of released MSFC ALERTs (4) Archival of historic ALERTs for reference by GIDEP ID, MSFC ID, or MSFC release date; (5) On-line tracking of ALERT response status using a Microsoft Access database and the web (6) On-line response to ALERTs from MSFC actionees through interactive web forms. The technique, benefits, effort, coordination, and lessons learned for each aspect are covered herein.

Development of a SNOMED CT based national medication decision support system.

PubMed

Greibe, Kell

2013-01-01

Physicians often lack the time to familiarize themselves with the details of particular allergies or other drug restrictions. Clinical Decision Support (CDS), based on a structured terminology as SNOMED CT (SCT), can help physicians get an overview, by automatically alerting allergy, interactions and other important information. The centralized CDS platform based on SCT, controls Allergy, Interactions, Risk Situation Drugs and Max Dose restrictions by the help of databases developed for these specific purposes. The CDS will respond to automatic web service requests from the hospital or GP electronic medication system (EMS) during prescription, and return alerts and information. The CDS also contains a Physicians Preference Database where the physicians individually can set which kind of alerts they want to see. The result is clinically useful information physicians can use as a base for a more effective and safer treatment, without developing alert fatigue.

Mechanics of human voice production and control

PubMed Central

Zhang, Zhaoyan

2016-01-01

As the primary means of communication, voice plays an important role in daily life. Voice also conveys personal information such as social status, personal traits, and the emotional state of the speaker. Mechanically, voice production involves complex fluid-structure interaction within the glottis and its control by laryngeal muscle activation. An important goal of voice research is to establish a causal theory linking voice physiology and biomechanics to how speakers use and control voice to communicate meaning and personal information. Establishing such a causal theory has important implications for clinical voice management, voice training, and many speech technology applications. This paper provides a review of voice physiology and biomechanics, the physics of vocal fold vibration and sound production, and laryngeal muscular control of the fundamental frequency of voice, vocal intensity, and voice quality. Current efforts to develop mechanical and computational models of voice production are also critically reviewed. Finally, issues and future challenges in developing a causal theory of voice production and perception are discussed. PMID:27794319

Mechanics of human voice production and control.

PubMed

Zhang, Zhaoyan

2016-10-01

As the primary means of communication, voice plays an important role in daily life. Voice also conveys personal information such as social status, personal traits, and the emotional state of the speaker. Mechanically, voice production involves complex fluid-structure interaction within the glottis and its control by laryngeal muscle activation. An important goal of voice research is to establish a causal theory linking voice physiology and biomechanics to how speakers use and control voice to communicate meaning and personal information. Establishing such a causal theory has important implications for clinical voice management, voice training, and many speech technology applications. This paper provides a review of voice physiology and biomechanics, the physics of vocal fold vibration and sound production, and laryngeal muscular control of the fundamental frequency of voice, vocal intensity, and voice quality. Current efforts to develop mechanical and computational models of voice production are also critically reviewed. Finally, issues and future challenges in developing a causal theory of voice production and perception are discussed.

The professional voice.

PubMed

Benninger, M S

2011-02-01

The human voice is not only the key to human communication but also serves as the primary musical instrument. Many professions rely on the voice, but the most noticeable and visible are singers. Care of the performing voice requires a thorough understanding of the interaction between the anatomy and physiology of voice production, along with an awareness of the interrelationships between vocalisation, acoustic science and non-vocal components of performance. This review gives an overview of the care and prevention of professional voice disorders by describing the unique and integrated anatomy and physiology of singing, the roles of development and training, and the importance of the voice care team.

Design and realization of intelligent tourism service system based on voice interaction

NASA Astrophysics Data System (ADS)

Hu, Lei-di; Long, Yi; Qian, Cheng-yang; Zhang, Ling; Lv, Guo-nian

2008-10-01

Voice technology is one of the important contents to improve the intelligence and humanization of tourism service system. Combining voice technology, the paper concentrates on application needs and the composition of system to present an overall intelligent tourism service system's framework consisting of presentation layer, Web services layer, and tourism application service layer. On the basis, the paper further elaborated the implementation of the system and its key technologies, including intelligent voice interactive technology, seamless integration technology of multiple data sources, location-perception-based guides' services technology, and tourism safety control technology. Finally, according to the situation of Nanjing tourism, a prototype of Tourism Services System is realized.

Integrating cues of social interest and voice pitch in men's preferences for women's voices.

PubMed

Jones, Benedict C; Feinberg, David R; Debruine, Lisa M; Little, Anthony C; Vukovic, Jovana

2008-04-23

Most previous studies of vocal attractiveness have focused on preferences for physical characteristics of voices such as pitch. Here we examine the content of vocalizations in interaction with such physical traits, finding that vocal cues of social interest modulate the strength of men's preferences for raised pitch in women's voices. Men showed stronger preferences for raised pitch when judging the voices of women who appeared interested in the listener than when judging the voices of women who appeared relatively disinterested in the listener. These findings show that voice preferences are not determined solely by physical properties of voices and that men integrate information about voice pitch and the degree of social interest expressed by women when forming voice preferences. Women's preferences for raised pitch in women's voices were not modulated by cues of social interest, suggesting that the integration of cues of social interest and voice pitch when men judge the attractiveness of women's voices may reflect adaptations that promote efficient allocation of men's mating effort.

Alertness and cognitive control: Testing the early onset hypothesis.

PubMed

Schneider, Darryl W

2018-05-01

Previous research has revealed a peculiar interaction between alertness and cognitive control in selective-attention tasks: Congruency effects are larger on alert trials (on which an alerting cue is presented briefly in advance of the imperative stimulus) than on no-alert trials, despite shorter response times (RTs) on alert trials. One explanation for this finding is the early onset hypothesis, which is based on the assumptions that increased alertness shortens stimulus-encoding time and that cognitive control involves gradually focusing attention during a trial. The author tested the hypothesis in 3 experiments by manipulating alertness and stimulus quality (which were intended to shorten and lengthen stimulus-encoding time, respectively) in an arrow-based flanker task involving congruent and incongruent stimuli. Replicating past findings, the alerting manipulation led to shorter RTs but larger congruency effects on alert trials than on no-alert trials. The stimulus-quality manipulation led to longer RTs and larger congruency effects for degraded stimuli than for intact stimuli. These results provide mixed support for the early onset hypothesis, but the author discusses how data and theory might be reconciled if stimulus quality affects stimulus-encoding time and the rate of evidence accumulation in the decision process. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Factors influencing alert acceptance: a novel approach for predicting the success of clinical decision support

PubMed Central

Seidling, Hanna M; Phansalkar, Shobha; Seger, Diane L; Paterno, Marilyn D; Shaykevich, Shimon; Haefeli, Walter E

2011-01-01

Background Clinical decision support systems can prevent knowledge-based prescription errors and improve patient outcomes. The clinical effectiveness of these systems, however, is substantially limited by poor user acceptance of presented warnings. To enhance alert acceptance it may be useful to quantify the impact of potential modulators of acceptance. Methods We built a logistic regression model to predict alert acceptance of drug–drug interaction (DDI) alerts in three different settings. Ten variables from the clinical and human factors literature were evaluated as potential modulators of provider alert acceptance. ORs were calculated for the impact of knowledge quality, alert display, textual information, prioritization, setting, patient age, dose-dependent toxicity, alert frequency, alert level, and required acknowledgment on acceptance of the DDI alert. Results 50 788 DDI alerts were analyzed. Providers accepted only 1.4% of non-interruptive alerts. For interruptive alerts, user acceptance positively correlated with frequency of the alert (OR 1.30, 95% CI 1.23 to 1.38), quality of display (4.75, 3.87 to 5.84), and alert level (1.74, 1.63 to 1.86). Alert acceptance was higher in inpatients (2.63, 2.32 to 2.97) and for drugs with dose-dependent toxicity (1.13, 1.07 to 1.21). The textual information influenced the mode of reaction and providers were more likely to modify the prescription if the message contained detailed advice on how to manage the DDI. Conclusion We evaluated potential modulators of alert acceptance by assessing content and human factors issues, and quantified the impact of a number of specific factors which influence alert acceptance. This information may help improve clinical decision support systems design. PMID:21571746

Insider Alert 1.0 Beta Version

DOE Office of Scientific and Technical Information (OSTI.GOV)

Abbott, Robert

2004-02-01

Insider Alert 1.0 Beta Version supports interactive selection and graphical display of data generated by the Sandia Cognitive Framework, which simulates the examination of security data by experts of various specialties. Insider Alert also encompasses the configuration and data files input to the Cognitive Framework for this application. Insider Alert 1.0 Beta Version is a computer program for analyzing data indicative of possible espionage or improper handling of data by employees at Sandia National Laboratories (or other facilities with comparable policies and procedures for managing sensitive information) It prioritizes and displays information for review by security analysts.

CISN ShakeAlert Earthquake Early Warning System Monitoring Tools

NASA Astrophysics Data System (ADS)

Henson, I. H.; Allen, R. M.; Neuhauser, D. S.

2015-12-01

CISN ShakeAlert is a prototype earthquake early warning system being developed and tested by the California Integrated Seismic Network. The system has recently been expanded to support redundant data processing and communications. It now runs on six machines at three locations with ten Apache ActiveMQ message brokers linking together 18 waveform processors, 12 event association processes and 4 Decision Module alert processes. The system ingests waveform data from about 500 stations and generates many thousands of triggers per day, from which a small portion produce earthquake alerts. We have developed interactive web browser system-monitoring tools that display near real time state-of-health and performance information. This includes station availability, trigger statistics, communication and alert latencies. Connections to regional earthquake catalogs provide a rapid assessment of the Decision Module hypocenter accuracy. Historical performance can be evaluated, including statistics for hypocenter and origin time accuracy and alert time latencies for different time periods, magnitude ranges and geographic regions. For the ElarmS event associator, individual earthquake processing histories can be examined, including details of the transmission and processing latencies associated with individual P-wave triggers. Individual station trigger and latency statistics are available. Detailed information about the ElarmS trigger association process for both alerted events and rejected events is also available. The Google Web Toolkit and Map API have been used to develop interactive web pages that link tabular and geographic information. Statistical analysis is provided by the R-Statistics System linked to a PostgreSQL database.

It doesn't matter what you say: FMRI correlates of voice learning and recognition independent of speech content.

PubMed

Zäske, Romi; Awwad Shiekh Hasan, Bashar; Belin, Pascal

2017-09-01

Listeners can recognize newly learned voices from previously unheard utterances, suggesting the acquisition of high-level speech-invariant voice representations during learning. Using functional magnetic resonance imaging (fMRI) we investigated the anatomical basis underlying the acquisition of voice representations for unfamiliar speakers independent of speech, and their subsequent recognition among novel voices. Specifically, listeners studied voices of unfamiliar speakers uttering short sentences and subsequently classified studied and novel voices as "old" or "new" in a recognition test. To investigate "pure" voice learning, i.e., independent of sentence meaning, we presented German sentence stimuli to non-German speaking listeners. To disentangle stimulus-invariant and stimulus-dependent learning, during the test phase we contrasted a "same sentence" condition in which listeners heard speakers repeating the sentences from the preceding study phase, with a "different sentence" condition. Voice recognition performance was above chance in both conditions although, as expected, performance was higher for same than for different sentences. During study phases activity in the left inferior frontal gyrus (IFG) was related to subsequent voice recognition performance and same versus different sentence condition, suggesting an involvement of the left IFG in the interactive processing of speaker and speech information during learning. Importantly, at test reduced activation for voices correctly classified as "old" compared to "new" emerged in a network of brain areas including temporal voice areas (TVAs) of the right posterior superior temporal gyrus (pSTG), as well as the right inferior/middle frontal gyrus (IFG/MFG), the right medial frontal gyrus, and the left caudate. This effect of voice novelty did not interact with sentence condition, suggesting a role of temporal voice-selective areas and extra-temporal areas in the explicit recognition of learned voice identity, independent of speech content. Copyright © 2017 Elsevier Ltd. All rights reserved.

Physician access to drug profiles to reduce adverse reactions

NASA Astrophysics Data System (ADS)

Yasnoff, William A.; Tomkins, Edward L.; Dunn, Louise M.

1995-10-01

Adverse drug reactions (ADRs) are a major source of preventable morbidity and mortality, especially among the elderly, who use more drugs and are more sensitive to them. The insurance industry has recently addressed this problem through the implementation of drug interaction alerts to pharmacists in conjunction with immediate online claims adjudication for almost 60% of prescriptions (expected to reach 90% within 5 years). These alerts are based on stored patient drug profiles maintained by pharmacy benefit managers (PBMs) which are updated whenever prescriptions are filled. While these alerts are very helpful, the pharmacist does not prescribe, resulting in time-consuming and costly delays to contact the physician and remedy potential interactions. We have developed and demonstrated the feasibility of the PINPOINT (Pharmaceutical Information Network for prevention of interactions) system for making the drug profile and interaction information easily available to the physician before the prescription is written. We plan to test the cost-effectiveness of the system in a prospective controlled clinical trial.

Toward a Trustworthy Voice: Increasing the Effectiveness of Automated Outreach Calls to Promote Colorectal Cancer Screening among African Americans

PubMed Central

Albright, Karen; Richardson, Terri; Kempe, Karin L; Wallace, Kristin

2014-01-01

Introduction: Colorectal cancer screening rates are lower among African-American members of Kaiser Permanente Colorado (KPCO) than among members of other races and ethnicities. This study evaluated use of a linguistically congruent voice in interactive voice response outreach calls about colorectal cancer screening as a strategy to increase call completion and response. Methods: After an initial discussion group to assess cultural acceptability of the project, 6 focus groups were conducted with 33 KPCO African-American members. Participants heard and discussed recordings of 5 female voices reading the same segment of the standard-practice colorectal cancer message using interactive voice response. The linguistic palette included the voices of a white woman, a lightly accented Latina, and 3 African-American women. Results: Participants strongly preferred the African-American voices, particularly two voices. Participants considered these voices the most trustworthy and reported that they would be the most effective at increasing motivation to complete an automated call. Participants supported the use of African-American voices when designing outgoing automated calls for African Americans because the sense of familiarity engendered trust among listeners. Participants also indicated that effective automated messages should provide immediate clarity of purpose; explain why the issue is relevant to African Americans; avoid sounding scripted; emphasize that the call is for the listener’s benefit only; sound personable, warm, and positive; and not create fear among listeners. Discussion: Establishing linguistic congruence between African Americans and the voices used in automated calls designed to reach them may increase the effectiveness of outreach efforts. PMID:24867548

Auditory and visual modulation of temporal lobe neurons in voice-sensitive and association cortices.

PubMed

Perrodin, Catherine; Kayser, Christoph; Logothetis, Nikos K; Petkov, Christopher I

2014-02-12

Effective interactions between conspecific individuals can depend upon the receiver forming a coherent multisensory representation of communication signals, such as merging voice and face content. Neuroimaging studies have identified face- or voice-sensitive areas (Belin et al., 2000; Petkov et al., 2008; Tsao et al., 2008), some of which have been proposed as candidate regions for face and voice integration (von Kriegstein et al., 2005). However, it was unclear how multisensory influences occur at the neuronal level within voice- or face-sensitive regions, especially compared with classically defined multisensory regions in temporal association cortex (Stein and Stanford, 2008). Here, we characterize auditory (voice) and visual (face) influences on neuronal responses in a right-hemisphere voice-sensitive region in the anterior supratemporal plane (STP) of Rhesus macaques. These results were compared with those in the neighboring superior temporal sulcus (STS). Within the STP, our results show auditory sensitivity to several vocal features, which was not evident in STS units. We also newly identify a functionally distinct neuronal subpopulation in the STP that appears to carry the area's sensitivity to voice identity related features. Audiovisual interactions were prominent in both the STP and STS. However, visual influences modulated the responses of STS neurons with greater specificity and were more often associated with congruent voice-face stimulus pairings than STP neurons. Together, the results reveal the neuronal processes subserving voice-sensitive fMRI activity patterns in primates, generate hypotheses for testing in the visual modality, and clarify the position of voice-sensitive areas within the unisensory and multisensory processing hierarchies.

Auditory and Visual Modulation of Temporal Lobe Neurons in Voice-Sensitive and Association Cortices

PubMed Central

Perrodin, Catherine; Kayser, Christoph; Logothetis, Nikos K.

2014-01-01

Effective interactions between conspecific individuals can depend upon the receiver forming a coherent multisensory representation of communication signals, such as merging voice and face content. Neuroimaging studies have identified face- or voice-sensitive areas (Belin et al., 2000; Petkov et al., 2008; Tsao et al., 2008), some of which have been proposed as candidate regions for face and voice integration (von Kriegstein et al., 2005). However, it was unclear how multisensory influences occur at the neuronal level within voice- or face-sensitive regions, especially compared with classically defined multisensory regions in temporal association cortex (Stein and Stanford, 2008). Here, we characterize auditory (voice) and visual (face) influences on neuronal responses in a right-hemisphere voice-sensitive region in the anterior supratemporal plane (STP) of Rhesus macaques. These results were compared with those in the neighboring superior temporal sulcus (STS). Within the STP, our results show auditory sensitivity to several vocal features, which was not evident in STS units. We also newly identify a functionally distinct neuronal subpopulation in the STP that appears to carry the area's sensitivity to voice identity related features. Audiovisual interactions were prominent in both the STP and STS. However, visual influences modulated the responses of STS neurons with greater specificity and were more often associated with congruent voice-face stimulus pairings than STP neurons. Together, the results reveal the neuronal processes subserving voice-sensitive fMRI activity patterns in primates, generate hypotheses for testing in the visual modality, and clarify the position of voice-sensitive areas within the unisensory and multisensory processing hierarchies. PMID:24523543

Engaged Voices--Dialogic Interaction and the Construction of Shared Social Meanings

ERIC Educational Resources Information Center

Cruddas, Leora

2007-01-01

The notion of "pupil voice" reproduces the binary distinction between adult and child, pupil and teacher and therefore serves to reinforce "conventional" constructions of childhood. The concept of "voice" invokes an essentialist construction of self that is singular, coherent, consistent and rational. It is arguably…

Voice and choice in health care in England: understanding citizen responses to dissatisfaction.

PubMed

Dowding, Keith; John, Peter

2011-01-01

Using data from a five-year online survey the paper examines the effects of relative satisfaction with health services on individuals' voice-and-choice activity in the English public health care system. Voice is considered in three parts – individual voice (complaints), collective voice voting and participation (collective action). Exercising choice is seen in terms of complete exit (not using health care), internal exit (choosing another public service provider) and private exit (using private health care). The interaction of satisfaction and forms of voice and choice are analysed over time. Both voice and choice are correlated with dissatisfaction with those who are unhappy with the NHS more likely to privately voice and to plan to take up private health care. Those unable to choose private provision are likely to use private voice. These factors are not affected by items associated with social capital – indeed, being more trusting leads to lower voice activity.

Interface Anywhere: Development of a Voice and Gesture System for Spaceflight Operations

NASA Technical Reports Server (NTRS)

Thompson, Shelby; Haddock, Maxwell; Overland, David

2013-01-01

The Interface Anywhere Project was funded through Innovation Charge Account (ICA) at NASA JSC in the Fall of 2012. The project was collaboration between human factors and engineering to explore the possibility of designing an interface to control basic habitat operations through gesture and voice control; (a) Current interfaces require the users to be physically near an input device in order to interact with the system; and (b) By using voice and gesture commands, the user is able to interact with the system anywhere they want within the work environment.

Applying human factors principles to alert design increases efficiency and reduces prescribing errors in a scenario-based simulation

PubMed Central

Russ, Alissa L; Zillich, Alan J; Melton, Brittany L; Russell, Scott A; Chen, Siying; Spina, Jeffrey R; Weiner, Michael; Johnson, Elizabette G; Daggy, Joanne K; McManus, M Sue; Hawsey, Jason M; Puleo, Anthony G; Doebbeling, Bradley N; Saleem, Jason J

2014-01-01

Objective To apply human factors engineering principles to improve alert interface design. We hypothesized that incorporating human factors principles into alerts would improve usability, reduce workload for prescribers, and reduce prescribing errors. Materials and methods We performed a scenario-based simulation study using a counterbalanced, crossover design with 20 Veterans Affairs prescribers to compare original versus redesigned alerts. We redesigned drug–allergy, drug–drug interaction, and drug–disease alerts based upon human factors principles. We assessed usability (learnability of redesign, efficiency, satisfaction, and usability errors), perceived workload, and prescribing errors. Results Although prescribers received no training on the design changes, prescribers were able to resolve redesigned alerts more efficiently (median (IQR): 56 (47) s) compared to the original alerts (85 (71) s; p=0.015). In addition, prescribers rated redesigned alerts significantly higher than original alerts across several dimensions of satisfaction. Redesigned alerts led to a modest but significant reduction in workload (p=0.042) and significantly reduced the number of prescribing errors per prescriber (median (range): 2 (1–5) compared to original alerts: 4 (1–7); p=0.024). Discussion Aspects of the redesigned alerts that likely contributed to better prescribing include design modifications that reduced usability-related errors, providing clinical data closer to the point of decision, and displaying alert text in a tabular format. Displaying alert text in a tabular format may help prescribers extract information quickly and thereby increase responsiveness to alerts. Conclusions This simulation study provides evidence that applying human factors design principles to medication alerts can improve usability and prescribing outcomes. PMID:24668841

Applying human factors principles to alert design increases efficiency and reduces prescribing errors in a scenario-based simulation.

PubMed

Russ, Alissa L; Zillich, Alan J; Melton, Brittany L; Russell, Scott A; Chen, Siying; Spina, Jeffrey R; Weiner, Michael; Johnson, Elizabette G; Daggy, Joanne K; McManus, M Sue; Hawsey, Jason M; Puleo, Anthony G; Doebbeling, Bradley N; Saleem, Jason J

2014-10-01

To apply human factors engineering principles to improve alert interface design. We hypothesized that incorporating human factors principles into alerts would improve usability, reduce workload for prescribers, and reduce prescribing errors. We performed a scenario-based simulation study using a counterbalanced, crossover design with 20 Veterans Affairs prescribers to compare original versus redesigned alerts. We redesigned drug-allergy, drug-drug interaction, and drug-disease alerts based upon human factors principles. We assessed usability (learnability of redesign, efficiency, satisfaction, and usability errors), perceived workload, and prescribing errors. Although prescribers received no training on the design changes, prescribers were able to resolve redesigned alerts more efficiently (median (IQR): 56 (47) s) compared to the original alerts (85 (71) s; p=0.015). In addition, prescribers rated redesigned alerts significantly higher than original alerts across several dimensions of satisfaction. Redesigned alerts led to a modest but significant reduction in workload (p=0.042) and significantly reduced the number of prescribing errors per prescriber (median (range): 2 (1-5) compared to original alerts: 4 (1-7); p=0.024). Aspects of the redesigned alerts that likely contributed to better prescribing include design modifications that reduced usability-related errors, providing clinical data closer to the point of decision, and displaying alert text in a tabular format. Displaying alert text in a tabular format may help prescribers extract information quickly and thereby increase responsiveness to alerts. This simulation study provides evidence that applying human factors design principles to medication alerts can improve usability and prescribing outcomes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Interactive Communication: A Few Research Answers for a Technological Explosion.

ERIC Educational Resources Information Center

Chapanis, Alphonse

The techniques, procedures, and principal findings of 15 different experiments in a research program on interactive communication are summarized in this paper. Among the principal findings reported are that: problems are solved faster in communication modes that have a voice channel than in those that do not have a voice channel, modes of…

Collaborative Scaffolding in Online Task-Based Voice Interactions between Advanced Learners

ERIC Educational Resources Information Center

Kenning, Marie-Madeleine

2010-01-01

This paper reports some of the findings of a distinctive innovative use of audio-conferencing involving a population (campus-based advanced learners) and a type of application (task-based language learning) that have received little attention to date: the use of Wimba Voice Tools to provide additional opportunities for spoken interactions between…

Voice Interactive Analysis System Study. Final Report, August 28, 1978 through March 23, 1979.

ERIC Educational Resources Information Center

Harry, D. P.; And Others

The Voice Interactive Analysis System study continued research and development of the LISTEN real-time, minicomputer based connected speech recognition system, within NAVTRAEQUIPCEN'S program of developing automatic speech technology in support of training. An attempt was made to identify the most effective features detected by the TTI-500 model…

Scientific bases of human-machine communication by voice.

PubMed Central

Schafer, R W

1995-01-01

The scientific bases for human-machine communication by voice are in the fields of psychology, linguistics, acoustics, signal processing, computer science, and integrated circuit technology. The purpose of this paper is to highlight the basic scientific and technological issues in human-machine communication by voice and to point out areas of future research opportunity. The discussion is organized around the following major issues in implementing human-machine voice communication systems: (i) hardware/software implementation of the system, (ii) speech synthesis for voice output, (iii) speech recognition and understanding for voice input, and (iv) usability factors related to how humans interact with machines. PMID:7479802

Discourse-voice regulatory strategies in the psychotherapeutic interaction: a state-space dynamics analysis.

PubMed

Tomicic, Alemka; Martínez, Claudio; Pérez, J Carola; Hollenstein, Tom; Angulo, Salvador; Gerstmann, Adam; Barroux, Isabelle; Krause, Mariane

2015-01-01

This study seeks to provide evidence of the dynamics associated with the configurations of discourse-voice regulatory strategies in patient-therapist interactions in relevant episodes within psychotherapeutic sessions. Its central assumption is that discourses manifest themselves differently in terms of their prosodic characteristics according to their regulatory functions in a system of interactions. The association between discourse and vocal quality in patients and therapists was analyzed in a sample of 153 relevant episodes taken from 164 sessions of five psychotherapies using the state space grid (SSG) method, a graphical tool based on the dynamic systems theory (DST). The results showed eight recurrent and stable discourse-voice regulatory strategies of the patients and three of the therapists. Also, four specific groups of these discourse-voice strategies were identified. The latter were interpreted as regulatory configurations, that is to say, as emergent self-organized groups of discourse-voice regulatory strategies constituting specific interactional systems. Both regulatory strategies and their configurations differed between two types of relevant episodes: Change Episodes and Rupture Episodes. As a whole, these results support the assumption that speaking and listening, as dimensions of the interaction that takes place during therapeutic conversation, occur at different levels. The study not only shows that these dimensions are dependent on each other, but also that they function as a complex and dynamic whole in therapeutic dialog, generating relational offers which allow the patient and the therapist to regulate each other and shape the psychotherapeutic process that characterizes each type of relevant episode.

Micro-Based Speech Recognition: Instructional Innovation for Handicapped Learners.

ERIC Educational Resources Information Center

Horn, Carin E.; Scott, Brian L.

A new voice based learning system (VBLS), which allows the handicapped user to interact with a microcomputer by voice commands, is described. Speech or voice recognition is the computerized process of identifying a spoken word or phrase, including those resulting from speech impediments. This new technology is helpful to the severely physically…

Empowering Student Voice through Interactive Design and Digital Making

ERIC Educational Resources Information Center

Kim, Yanghee; Searle, Kristin

2017-01-01

Over the last two decades online technology and digital media have provided space for students to participate and express their voices. This paper further explores how new digital technologies, such as humanoid robots and wearable electronics, can be used to offer additional spaces where students' voices are heard. In these spaces, young students…

Gender in Voice Perception in Autism

ERIC Educational Resources Information Center

Groen, Wouter B.; van Orsouw, Linda; Zwiers, Marcel; Swinkels, Sophie; van der Gaag, Rutger Jan; Buitelaar, Jan K.

2008-01-01

Deficits in the perception of social stimuli may contribute to the characteristic impairments in social interaction in high functioning autism (HFA). Although the cortical processing of voice is abnormal in HFA, it is unclear whether this gives rise to impairments in the perception of voice gender. About 20 children with HFA and 20 matched…

The value of visualizing tone of voice.

PubMed

Pullin, Graham; Cook, Andrew

2013-10-01

Whilst most of us have an innate feeling for tone of voice, it is an elusive quality that even phoneticians struggle to describe with sufficient subtlety. For people who cannot speak themselves this can have particularly profound repercussions. Augmentative communication often involves text-to-speech, a technology that only supports a basic choice of prosody based on punctuation. Given how inherently difficult it is to talk about more nuanced tone of voice, there is a risk that its absence from current devices goes unremarked and unchallenged. Looking ahead optimistically to more expressive communication aids, their design will need to involve more subtle interactions with tone of voice-interactions that the people using them can understand and engage with. Interaction design can play a role in making tone of voice visible, tangible, and accessible. Two projects that have already catalysed interdisciplinary debate in this area, Six Speaking Chairs and Speech Hedge, are introduced together with responses. A broader role for design is advocated, as a means to opening up speech technology research to a wider range of disciplinary perspectives, and also to the contributions and influence of people who use it in their everyday lives.

Measures of voiced frication for automatic classification

NASA Astrophysics Data System (ADS)

Jackson, Philip J. B.; Jesus, Luis M. T.; Shadle, Christine H.; Pincas, Jonathan

2004-05-01

As an approach to understanding the characteristics of the acoustic sources in voiced fricatives, it seems apt to draw on knowledge of vowels and voiceless fricatives, which have been relatively well studied. However, the presence of both phonation and frication in these mixed-source sounds offers the possibility of mutual interaction effects, with variations across place of articulation. This paper examines the acoustic and articulatory consequences of these interactions and explores automatic techniques for finding parametric and statistical descriptions of these phenomena. A reliable and consistent set of such acoustic cues could be used for phonetic classification or speech recognition. Following work on devoicing of European Portuguese voiced fricatives [Jesus and Shadle, in Mamede et al. (eds.) (Springer-Verlag, Berlin, 2003), pp. 1-8]. and the modulating effect of voicing on frication [Jackson and Shadle, J. Acoust. Soc. Am. 108, 1421-1434 (2000)], the present study focuses on three types of information: (i) sequences and durations of acoustic events in VC transitions, (ii) temporal, spectral and modulation measures from the periodic and aperiodic components of the acoustic signal, and (iii) voicing activity derived from simultaneous EGG data. Analysis of interactions observed in British/American English and European Portuguese speech corpora will be compared, and the principal findings discussed.

Warfarin monitoring in nursing homes assessed by case histories. Do recommendations and electronic alerts affect judgements?

PubMed

Teruel, Reyes Serrano; Thue, Geir; Fylkesnes, Svein Ivar; Sandberg, Sverre; Kristoffersen, Ann Helen

2017-09-01

Older adults treated with warfarin are prone to complications, and high-quality monitoring is essential. The aim of this case history based study was to assess the quality of warfarin monitoring in a routine situation, and in a situation with an antibiotic-warfarin interaction, before and after receiving an electronic alert. In April 2014, a national web-based survey with two case histories was distributed among Norwegian nursing home physicians and general practitioners working part-time in nursing homes. Case A represented a patient on stable warfarin treatment, but with a substantial INR increase within the therapeutic interval. Case B represented a more challenging patient with trimethoprim sulfamethoxazole (TMS) treatment due to pyelonephritis. In both cases, the physicians were asked to state the next warfarin dose and the INR recall interval. In case B, the physicians could change their suggestions after receiving an electronic alert on the TMS-warfarin interaction. Three hundred and ninety eight physicians in 292 nursing homes responded. Suggested INR recall intervals and warfarin doses varied substantially in both cases. In case A, 61% gave acceptable answers according to published recommendations, while only 9% did so for case B. Regarding the TMS-warfarin interaction in case history B, the electronic alert increased the percentage of respondents correctly suggesting a dose reduction from 29% to 53%. Having an INR instrument in the nursing home was associated with shortened INR recall times. Practical advice on handling of warfarin treatment and drug interactions is needed. Electronic alerts as presented in electronic medical records seem insufficient to change practice. Availability of INR instruments may be important regarding recall time.

Teaching and Learning Foreign Languages via System of "Voice over Internet Protocol" and Language Interactions Case Study: Skype

ERIC Educational Resources Information Center

Wahid, Wazira Ali Abdul; Ahmed, Eqbal Sulaiman; Wahid, Muntaha Ali Abdul

2015-01-01

This issue expresses a research study based on the online interactions of English teaching specially conversation through utilizing VOIP (Voice over Internet Protocol) and cosmopolitan online theme. Data has been achieved by interviews. Simplifiers indicate how oral tasks require to be planned upon to facilitate engagement models propitious to…

Effects of a Voice Output Communication Aid on Interactions between Support Personnel and an Individual with Multiple Disabilities.

ERIC Educational Resources Information Center

Schepis, Maureen M.; Reid, Dennis H.

1995-01-01

A young adult with multiple disabilities (profound mental retardation, spastic quadriplegia, and visual impairment) was provided with a voice output communication aid (VOCA) which allowed communication through synthesized speech. Both educational and residential staff members interacted with the individual more frequently when she had access to…

The Interaction of Eye-Voice Span with Syntactic Chunking and Predictability in Right- and Left-Embedded Sentences.

ERIC Educational Resources Information Center

Balajthy, Ernest P., Jr.

Sixty tenth graders participated in this study of relationships between eye/voice span, phrase and clause boundaries, reading ability, and sentence structure. Results indicated that sentences apparently are "chunked" into surface constituents during processing. Better tenth grade readers had longer eye/voice spans than did poorer readers and…

Strategies for the Production of Spanish Stop Consonants by Native Speakers of English.

ERIC Educational Resources Information Center

Zampini, Mary L.

A study examined patterns in production of Spanish voiced and voiceless stop consonants by native English speakers, focusing on the interaction between two acoustic cues of stops: voice closure interval and voice onset time (VOT). The study investigated whether learners acquire the appropriate phonetic categories with regard to these stops and if…

Relating to the Speaker behind the Voice: What Is Changing?

PubMed Central

Deamer, Felicity; Hayward, Mark

2018-01-01

We introduce therapeutic techniques that encourage voice hearers to view their voices as coming from intentional agents whose behavior may be dependent on how the voice hearer relates to and interacts with them. We suggest that this approach is effective because the communicative aspect of voice hearing might fruitfully be seen as explanatorily primitive, meaning that the agentive aspect, the auditory properties, and the intended meaning (interpretation) are all necessary parts of the experience, which contribute to the impact the experience has on the voice hearer. We examine the experiences of a patient who received Relating Therapy, and explore the kinds of changes that can result from this therapeutic approach. PMID:29422879

Learned face-voice pairings facilitate visual search.

PubMed

Zweig, L Jacob; Suzuki, Satoru; Grabowecky, Marcia

2015-04-01

Voices provide a rich source of information that is important for identifying individuals and for social interaction. During search for a face in a crowd, voices often accompany visual information, and they facilitate localization of the sought-after individual. However, it is unclear whether this facilitation occurs primarily because the voice cues the location of the face or because it also increases the salience of the associated face. Here we demonstrate that a voice that provides no location information nonetheless facilitates visual search for an associated face. We trained novel face-voice associations and verified learning using a two-alternative forced choice task in which participants had to correctly match a presented voice to the associated face. Following training, participants searched for a previously learned target face among other faces while hearing one of the following sounds (localized at the center of the display): a congruent learned voice, an incongruent but familiar voice, an unlearned and unfamiliar voice, or a time-reversed voice. Only the congruent learned voice speeded visual search for the associated face. This result suggests that voices facilitate the visual detection of associated faces, potentially by increasing their visual salience, and that the underlying crossmodal associations can be established through brief training.

Discourse-voice regulatory strategies in the psychotherapeutic interaction: a state-space dynamics analysis

PubMed Central

Tomicic, Alemka; Martínez, Claudio; Pérez, J. Carola; Hollenstein, Tom; Angulo, Salvador; Gerstmann, Adam; Barroux, Isabelle; Krause, Mariane

2015-01-01

This study seeks to provide evidence of the dynamics associated with the configurations of discourse-voice regulatory strategies in patient–therapist interactions in relevant episodes within psychotherapeutic sessions. Its central assumption is that discourses manifest themselves differently in terms of their prosodic characteristics according to their regulatory functions in a system of interactions. The association between discourse and vocal quality in patients and therapists was analyzed in a sample of 153 relevant episodes taken from 164 sessions of five psychotherapies using the state space grid (SSG) method, a graphical tool based on the dynamic systems theory (DST). The results showed eight recurrent and stable discourse-voice regulatory strategies of the patients and three of the therapists. Also, four specific groups of these discourse-voice strategies were identified. The latter were interpreted as regulatory configurations, that is to say, as emergent self-organized groups of discourse-voice regulatory strategies constituting specific interactional systems. Both regulatory strategies and their configurations differed between two types of relevant episodes: Change Episodes and Rupture Episodes. As a whole, these results support the assumption that speaking and listening, as dimensions of the interaction that takes place during therapeutic conversation, occur at different levels. The study not only shows that these dimensions are dependent on each other, but also that they function as a complex and dynamic whole in therapeutic dialog, generating relational offers which allow the patient and the therapist to regulate each other and shape the psychotherapeutic process that characterizes each type of relevant episode. PMID:25932014

Selective attention modulates early human evoked potentials during emotional face-voice processing.

PubMed

Ho, Hao Tam; Schröger, Erich; Kotz, Sonja A

2015-04-01

Recent findings on multisensory integration suggest that selective attention influences cross-sensory interactions from an early processing stage. Yet, in the field of emotional face-voice integration, the hypothesis prevails that facial and vocal emotional information interacts preattentively. Using ERPs, we investigated the influence of selective attention on the perception of congruent versus incongruent combinations of neutral and angry facial and vocal expressions. Attention was manipulated via four tasks that directed participants to (i) the facial expression, (ii) the vocal expression, (iii) the emotional congruence between the face and the voice, and (iv) the synchrony between lip movement and speech onset. Our results revealed early interactions between facial and vocal emotional expressions, manifested as modulations of the auditory N1 and P2 amplitude by incongruent emotional face-voice combinations. Although audiovisual emotional interactions within the N1 time window were affected by the attentional manipulations, interactions within the P2 modulation showed no such attentional influence. Thus, we propose that the N1 and P2 are functionally dissociated in terms of emotional face-voice processing and discuss evidence in support of the notion that the N1 is associated with cross-sensory prediction, whereas the P2 relates to the derivation of an emotional percept. Essentially, our findings put the integration of facial and vocal emotional expressions into a new perspective-one that regards the integration process as a composite of multiple, possibly independent subprocesses, some of which are susceptible to attentional modulation, whereas others may be influenced by additional factors.

Determining Inappropriate Medication Alerts from "Inaccurate Warning" Overrides in the Intensive Care Unit.

PubMed

Rehr, Christine A; Wong, Adrian; Seger, Diane L; Bates, David W

2018-04-01

 This article aims to understand provider behavior around the use of the override reason "Inaccurate warning," specifically whether it is an effective way of identifying unhelpful medication alerts.  We analyzed alert overrides that occurred in the intensive care units (ICUs) of a major academic medical center between June and November 2016, focused on the following high-significance alert types: dose, drug-allergy alerts, and drug-drug interactions (DDI). Override appropriateness was analyzed by two independent reviewers using predetermined criteria.  A total of 268 of 26,501 ICU overrides (1.0%) used the reason "Inaccurate warning," with 93 of these overrides associated with our included alert types. Sixty-one of these overrides (66%) were identified to be appropriate. Twenty-one of 30 (70%) dose alert overrides were appropriate. Forty of 48 drug-allergy alert overrides (83%) were appropriate, for reasons ranging from prior tolerance ( n  = 30) to inaccurate ingredient matches ( n  = 5). None of the 15 DDI overrides were appropriate.  The "Inaccurate warning" reason was selectively used by a small proportion of providers and overrides using this reason identified important opportunities to reduce excess alerts. Potential opportunities include improved evaluation of dosing mechanisms based on patient characteristics, inclusion of institutional dosing protocols to alert logic, and evaluation of a patient's prior tolerance to a medication that they have a documented allergy for. This resource is not yet routinely used for alert tailoring at our institution but may prove to be a valuable resource to evaluate available alerts. Schattauer GmbH Stuttgart.

Is there a link between the hospital-acquired injurious fall rates in US acute care hospitals and these institutions' implementation levels of computerized systems?

PubMed

Tzeng, Huey-Ming; Hu, Hsou Mei; Yin, Chang-Yi

2011-12-01

Medicare no longer reimburses acute care hospitals for the costs of additional care required due to hospital-acquired injuries. Consequently, this study explored the effective computerized systems to inform practice for better interventions to reduce fall risk. It provided a correlation between type of computerized system and hospital-acquired injurious fall rates at acute care hospitals in California, Florida, and New York. It used multiple publicly available data sets, with the hospital as the unit of analysis. Descriptive and Pearson correlation analyses were used. The analysis included 462 hospitals. Significant correlations could be categorized into two groups: (1) meaningful computerized systems that were associated with lower injurious fall rates: the decision support systems for drug allergy alerts, drug-drug interaction alerts, and drug-laboratory interaction alerts; and (2) computerized systems that were associated with higher injurious fall rates: the decision support system for drug-drug interaction alerts and the computerized provider order entry system for radiology tests. Future research may include additional states, multiple years of data, and patient-level data to validate this study's findings. This effort may further inform policy makers and the public about effective clinical computerized systems provided to clinicians to improve their practice decisions and care outcomes.

Use of speech generating devices can improve perception of qualifications for skilled, verbal, and interactive jobs.

PubMed

Stern, Steven E; Chobany, Chelsea M; Beam, Alexander A; Hoover, Brittany N; Hull, Thomas T; Linsenbigler, Melissa; Makdad-Light, Courtney; Rubright, Courtney N

2017-01-01

We have previously demonstrated that when speech generating devices (SGD) are used as assistive technologies, they are preferred over the users' natural voices. We sought to examine whether using SGDs would affect listener's perceptions of hirability of people with complex communication needs. In a series of three experiments, participants rated videotaped actors, one using SGD and the other using their natural, mildly dysarthric voice, on (a) a measurement of perceptions of speaker credibility, strength, and informedness and (b) measurements of hirability for jobs coded in terms of skill, verbal ability, and interactivity. Experiment 1 examined hirability for jobs varying in terms of skill and verbal ability. Experiment 2 was a replication that examined hirability for jobs varying in terms of interactivity. Experiment 3 examined jobs in terms of skill and specific mode of interaction (face-to-face, telephone, computer-mediated). Actors were rated more favorably when using SGD than their own voices. Actors using SGD were also rated more favorably for highly skilled and highly verbal jobs. This preference for SGDs over mildly dysarthric voice was also found for jobs entailing computer-mediated-communication, particularly skillful jobs.

Low is large: spatial location and pitch interact in voice-based body size estimation.

PubMed

Pisanski, Katarzyna; Isenstein, Sari G E; Montano, Kelyn J; O'Connor, Jillian J M; Feinberg, David R

2017-05-01

The binding of incongruent cues poses a challenge for multimodal perception. Indeed, although taller objects emit sounds from higher elevations, low-pitched sounds are perceptually mapped both to large size and to low elevation. In the present study, we examined how these incongruent vertical spatial cues (up is more) and pitch cues (low is large) to size interact, and whether similar biases influence size perception along the horizontal axis. In Experiment 1, we measured listeners' voice-based judgments of human body size using pitch-manipulated voices projected from a high versus a low, and a right versus a left, spatial location. Listeners associated low spatial locations with largeness for lowered-pitch but not for raised-pitch voices, demonstrating that pitch overrode vertical-elevation cues. Listeners associated rightward spatial locations with largeness, regardless of voice pitch. In Experiment 2, listeners performed the task while sitting or standing, allowing us to examine self-referential cues to elevation in size estimation. Listeners associated vertically low and rightward spatial cues with largeness more for lowered- than for raised-pitch voices. These correspondences were robust to sex (of both the voice and the listener) and head elevation (standing or sitting); however, horizontal correspondences were amplified when participants stood. Moreover, when participants were standing, their judgments of how much larger men's voices sounded than women's increased when the voices were projected from the low speaker. Our results provide novel evidence for a multidimensional spatial mapping of pitch that is generalizable to human voices and that affects performance in an indirect, ecologically relevant spatial task (body size estimation). These findings suggest that crossmodal pitch correspondences evoke both low-level and higher-level cognitive processes.

Great expectations: top-down attention modulates the costs of clutter and eccentricity.

PubMed

Steelman, Kelly S; McCarley, Jason S; Wickens, Christopher D

2013-12-01

An experiment and modeling effort examined interactions between bottom-up and top-down attentional control in visual alert detection. Participants performed a manual tracking task while monitoring peripheral display channels for alerts of varying salience, eccentricity, and spatial expectancy. Spatial expectancy modulated the influence of salience and eccentricity; alerts in low-probability locations engendered higher miss rates, longer detection times, and larger costs of visual clutter and eccentricity, indicating that top-down attentional control offset the costs of poor bottom-up stimulus quality. Data were compared to the predictions of a computational model of scanning and noticing that incorporates bottom-up and top-down sources of attentional control. The model accounted well for the overall pattern of miss rates and response times, predicting each of the observed main effects and interactions. Empirical results suggest that designers should expect the costs of poor bottom-up visibility to be greater for low expectancy signals, and that the placement of alerts within a display should be determined based on the combination of alert expectancy and response priority. Model fits suggest that the current model can serve as a useful tool for exploring a design space as a precursor to empirical data collection and for generating hypotheses for future experiments. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Voice interactive electronic warning systems (VIEWS) - An applied approach to voice technology in the helicopter cockpit

NASA Technical Reports Server (NTRS)

Voorhees, J. W.; Bucher, N. M.

1983-01-01

The cockpit has been one of the most rapidly changing areas of new aircraft design over the past thirty years. In connection with these developments, a pilot can now be considered a decision maker/system manager as well as a vehicle controller. There is, however, a trend towards an information overload in the cockpit, and information processing problems begin to occur for the rotorcraft pilot. One approach to overcome the arising difficulties is based on the utilization of voice technology to improve the information transfer rate in the cockpit with respect to both input and output. Attention is given to the background of speech technology, the application of speech technology within the cockpit, voice interactive electronic warning system (VIEWS) simulation, and methodology. Information subsystems are considered along with a dynamic simulation study, and data collection.

High-priority and low-priority drug-drug interactions in different international electronic health record systems: A comparative study.

PubMed

Cornu, Pieter; Phansalkar, Shobha; Seger, Diane L; Cho, Insook; Pontefract, Sarah; Robertson, Alexandra; Bates, David W; Slight, Sarah P

2018-03-01

To investigate whether alert warnings for high-priority and low-priority drug-drug interactions (DDIs) were present in five international electronic health record (EHR) systems, to compare and contrast the severity level assigned to them, and to establish the proportion of alerts that were overridden. We conducted a comparative, retrospective, multinational study using a convenience sample of 5 EHRs from the U.S., U.K., Republic of Korea and Belgium. Of the 15 previously defined, high-priority, class-based DDIs, alert warnings were found to exist for 11 in both the Korean and UK systems, 9 in the Belgian system, and all 15 in the two US systems. The specific combinations that were included in these class-based DDIs varied considerably in number, type and level of severity amongst systems. Alerts were only active for 8.4% (52/619) and 52.4% (111/212) of the specific drug-drug combinations contained in the Belgian and UK systems, respectively. Hard stops (not possible to override) existed in the US and UK systems only. The override rates for high-priority alerts requiring provider action ranged from 56.7% to 83.3%. Of the 33 previously defined low-priority DDIs, active alerts existed only in the US systems, for three class-based DDIs. The majority were non-interruptive. Alert warnings existed for most of the high-priority DDIs in the different EHRs but overriding them was easy in most of the systems. In addition to validating the high- and low-priority DDIs, this study reported a lack of standardization in DDI levels across different international knowledge bases. Copyright © 2017. Published by Elsevier B.V.

Bilingual Voicing: A Study of Code-Switching in the Reported Speech of Finnish Immigrants in Estonia

ERIC Educational Resources Information Center

Frick, Maria; Riionheimo, Helka

2013-01-01

Through a conversation analytic investigation of Finnish-Estonian bilingual (direct) reported speech (i.e., voicing) by Finns who live in Estonia, this study shows how code-switching is used as a double contextualization device. The code-switched voicings are shaped by the on-going interactional situation, serving its needs by opening up a context…

Eye-movements and Voice as Interface Modalities to Computer Systems

NASA Astrophysics Data System (ADS)

Farid, Mohsen M.; Murtagh, Fionn D.

2003-03-01

We investigate the visual and vocal modalities of interaction with computer systems. We focus our attention on the integration of visual and vocal interface as possible replacement and/or additional modalities to enhance human-computer interaction. We present a new framework for employing eye gaze as a modality of interface. While voice commands, as means of interaction with computers, have been around for a number of years, integration of both the vocal interface and the visual interface, in terms of detecting user's eye movements through an eye-tracking device, is novel and promises to open the horizons for new applications where a hand-mouse interface provides little or no apparent support to the task to be accomplished. We present an array of applications to illustrate the new framework and eye-voice integration.

The role of voice input for human-machine communication.

PubMed Central

Cohen, P R; Oviatt, S L

1995-01-01

Optimism is growing that the near future will witness rapid growth in human-computer interaction using voice. System prototypes have recently been built that demonstrate speaker-independent real-time speech recognition, and understanding of naturally spoken utterances with vocabularies of 1000 to 2000 words, and larger. Already, computer manufacturers are building speech recognition subsystems into their new product lines. However, before this technology can be broadly useful, a substantial knowledge base is needed about human spoken language and performance during computer-based spoken interaction. This paper reviews application areas in which spoken interaction can play a significant role, assesses potential benefits of spoken interaction with machines, and compares voice with other modalities of human-computer interaction. It also discusses information that will be needed to build a firm empirical foundation for the design of future spoken and multimodal interfaces. Finally, it argues for a more systematic and scientific approach to investigating spoken input and performance with future language technology. PMID:7479803

Understanding the mechanisms of familiar voice-identity recognition in the human brain.

PubMed

Maguinness, Corrina; Roswandowitz, Claudia; von Kriegstein, Katharina

2018-03-31

Humans have a remarkable skill for voice-identity recognition: most of us can remember many voices that surround us as 'unique'. In this review, we explore the computational and neural mechanisms which may support our ability to represent and recognise a unique voice-identity. We examine the functional architecture of voice-sensitive regions in the superior temporal gyrus/sulcus, and bring together findings on how these regions may interact with each other, and additional face-sensitive regions, to support voice-identity processing. We also contrast findings from studies on neurotypicals and clinical populations which have examined the processing of familiar and unfamiliar voices. Taken together, the findings suggest that representations of familiar and unfamiliar voices might dissociate in the human brain. Such an observation does not fit well with current models for voice-identity processing, which by-and-large assume a common sequential analysis of the incoming voice signal, regardless of voice familiarity. We provide a revised audio-visual integrative model of voice-identity processing which brings together traditional and prototype models of identity processing. This revised model includes a mechanism of how voice-identity representations are established and provides a novel framework for understanding and examining the potential differences in familiar and unfamiliar voice processing in the human brain. Copyright © 2018 Elsevier Ltd. All rights reserved.

Deficits in voice and multisensory processing in patients with Prader-Willi syndrome.

PubMed

Salles, Juliette; Strelnikov, Kuzma; Carine, Mantoulan; Denise, Thuilleaux; Laurier, Virginie; Molinas, Catherine; Tauber, Maïthé; Barone, Pascal

2016-05-01

Prader-Willi syndrome (PWS) is a rare neurodevelopmental and genetic disorder that is characterized by various expression of endocrine, cognitive and behavioral problems, among which a true obsession for food and a deficit of satiety that leads to hyperphagia and severe obesity. Neuropsychological studies have reported that PWS display altered social interactions with a specific weakness in interpreting social information and in responding to them, a symptom closed to that observed in autism spectrum disorders (ASD). Based on the hypothesis that atypical multisensory integration such as face and voice interactions would contribute in PWS to social impairment we investigate the abilities of PWS to process communication signals including the human voice. Patients with PWS recruited from the national reference center for PWS performed a simple detection task of stimuli presented in an uni-o or bimodal condition, as well as a voice discrimination task. Compared to control typically developing (TD) individuals, PWS present a specific deficit in discriminating human voices from environmental sounds. Further, PWS present a much lower multisensory benefits with an absence of violation of the race model indicating that multisensory information do not converge and interact prior to the initiation of the behavioral response. All the deficits observed in PWS were stronger for the subgroup of patients suffering from Uniparental Disomy, a population known to be more sensitive to ASD. Altogether, our study suggests that the deficits in social behavior observed in PWS derive at least partly from an impairment in deciphering the social information carried by voice signals, face signals, and the combination of both. In addition, our work is in agreement with the brain imaging studies revealing an alteration in PWS of the "social brain network" including the STS region involved in processing human voices. Copyright © 2016 Elsevier Ltd. All rights reserved.

Voice and endocrinology

PubMed Central

Hari Kumar, K. V. S.; Garg, Anurag; Ajai Chandra, N. S.; Singh, S. P.; Datta, Rakesh

2016-01-01

Voice is one of the advanced features of natural evolution that differentiates human beings from other primates. The human voice is capable of conveying the thoughts into spoken words along with a subtle emotion to the tone. This extraordinary character of the voice in expressing multiple emotions is the gift of God to the human beings and helps in effective interpersonal communication. Voice generation involves close interaction between cerebral signals and the peripheral apparatus consisting of the larynx, vocal cords, and trachea. The human voice is susceptible to the hormonal changes throughout life right from the puberty until senescence. Thyroid, gonadal and growth hormones have tremendous impact on the structure and function of the vocal apparatus. The alteration of voice is observed even in physiological states such as puberty and menstruation. Astute clinical observers make out the changes in the voice and refer the patients for endocrine evaluation. In this review, we shall discuss the hormonal influence on the voice apparatus in normal and endocrine disorders. PMID:27730065

Successful Outcomes of a Clinical Decision Support System in an HIV Practice: A Randomized Controlled Trial

PubMed Central

Robbins, Gregory K.; Lester, William; Johnson, Kristin L.; Chang, Yuchiao; Estey, Gregory; Surrao, Dominic; Zachary, Kimon; Lammert, Sara M.; Chueh, Henry; Meigs, James B.; Freedberg, Kenneth A.

2013-01-01

Background Data to support improved patient outcomes from clinical decision support systems (CDSS) are lacking in HIV care. Objective To conduct a randomized controlled trial testing the efficacy of a CDSS to improve HIV outcomes in an outpatient clinic. Design We conducted a randomized controlled trial where half of each provider’s patients were randomized to interactive or static computer alerts (ClinicalTrials.gov #NCT00678600). Setting The study was conducted at the Massachusetts General Hospital HIV Clinic. Subjects Participants were HIV providers and their HIV-infected patients. Intervention Computer alerts were generated for virologic failure (HIV RNA >400 c/mL after HIV RNA ≤400 c/mL), evidence of suboptimal follow-up, and 11 abnormal laboratory tests. Providers received interactive computer alerts, facilitating appointment rescheduling and repeat laboratory testing, for half of their patients and static alerts for the other half. Measurements The primary endpoint was change in CD4 count. Other endpoints included time-to-clinical event, 6-month suboptimal follow-up, and severe laboratory toxicity. Results Thirty-three HIV providers followed 1,011 HIV-infected patients. For the intervention arm, the mean CD4 count increase was greater (5.3 versus 3.2 cells/mm3/month; difference = 2.0 cells/mm3/month 95% CI [0.1, 4.0], p=0.040) and the rate of 6-month suboptimal follow-up was lower (20.6 versus 30.1 events per 100 patient-years, p=0.022). Median time-to-next scheduled appointment was shorter in the intervention arm after a suboptimal follow-up alert (1.71 versus 3.48 months; p<0.001) and after a toxicity alert (2.79 versus >6 months for control); p=0.072). Ninety-six percent of providers supported adopting the CDSS as part of standard care. Limitations This was a one-year informatics study conducted at a single hospital sub-specialty clinic. Conclusion A CDSS using interactive provider alerts improved CD4 counts and clinic follow-up for HIV-infected patients. Wider implementation of such systems can provide important clinical benefits. PMID:23208165

Real-Time Mapping alert system; user's manual

USGS Publications Warehouse

Torres, L.A.

1996-01-01

The U.S. Geological Survey has an extensive hydrologic network that records and transmits precipitation, stage, discharge, and other water- related data on a real-time basis to an automated data processing system. Data values are recorded on electronic data collection platforms at field monitoring sites. These values are transmitted by means of orbiting satellites to receiving ground stations, and by way of telecommunication lines to a U.S. Geological Survey office where they are processed on a computer system. Data that exceed predefined thresholds are identified as alert values. These alert values can help keep water- resource specialists informed of current hydrologic conditions. The current alert status at monitoring sites is of critical importance during floods, hurricanes, and other extreme hydrologic events where quick analysis of the situation is needed. This manual provides instructions for using the Real-Time Mapping software, a series of computer programs developed by the U.S. Geological Survey for quick analysis of hydrologic conditions, and guides users through a basic interactive session. The software provides interactive graphics display and query of real-time information in a map-based, menu-driven environment.

Adoption of medication alert systems in hospital outpatient departments in Taiwan.

PubMed

Kuo, Yu-Chun; Cheng, Shou-Hsia

2017-06-01

The adoption of medication alert systems in the health care sector varies among regions. In Taiwan, the health authority introduced policies in 2005 to encourage the adoption of medication alert systems in hospitals. This study aimed to understand the adoption of medication alert systems in the outpatient departments of hospitals in Taiwan using a nationwide survey. A questionnaire was developed and mailed to 380 accredited general hospitals in Taiwan in 2013. The information collected from the questionnaire concerning the outpatient department included (1) the time of adoption of a medication alert system; (2) the operation of individual alert functions: availability, management, and stability; and (3) hospital characteristics: accreditation level, teaching status, ownership, and number of beds. A total of 216 hospitals completed and returned the questionnaire, corresponding to a response rate of 56.8%. The adoption rate of medication alert systems in hospital outpatient departments increased from less than 10% in 1997-95.83% in 2012. Approximately two-thirds of the hospitals developed and maintained the alert systems independently or collaboratively with vendors. Teaching and large hospitals tended to develop more advanced alert functions such as drug-drug interaction functions. Improving the safety and quality of pharmaceutical services and meeting the policy requirements are reasons for hospitals to establish medication alert systems. The adoption rate of medication alert systems reached 95% in accredited general hospitals in Taiwan. Government policy and available health information professionals and vendors may somewhat contribute to the high adoption rate. Copyright © 2017 Elsevier B.V. All rights reserved.

Computational Modeling of Fluid–Structure–Acoustics Interaction during Voice Production

PubMed Central

Jiang, Weili; Zheng, Xudong; Xue, Qian

2017-01-01

The paper presented a three-dimensional, first-principle based fluid–structure–acoustics interaction computer model of voice production, which employed a more realistic human laryngeal and vocal tract geometries. Self-sustained vibrations, important convergent–divergent vibration pattern of the vocal folds, and entrainment of the two dominant vibratory modes were captured. Voice quality-associated parameters including the frequency, open quotient, skewness quotient, and flow rate of the glottal flow waveform were found to be well within the normal physiological ranges. The analogy between the vocal tract and a quarter-wave resonator was demonstrated. The acoustic perturbed flux and pressure inside the glottis were found to be at the same order with their incompressible counterparts, suggesting strong source–filter interactions during voice production. Such high fidelity computational model will be useful for investigating a variety of pathological conditions that involve complex vibrations, such as vocal fold paralysis, vocal nodules, and vocal polyps. The model is also an important step toward a patient-specific surgical planning tool that can serve as a no-risk trial and error platform for different procedures, such as injection of biomaterials and thyroplastic medialization. PMID:28243588

Pilot evaluation of a method to assess prescribers' information processing of medication alerts.

PubMed

Russ, Alissa L; Melton, Brittany L; Daggy, Joanne K; Saleem, Jason J

2017-02-01

Prescribers commonly receive alerts during medication ordering. Prescribers work in a complex, time-pressured environment; to enhance the effectiveness of safety alerts, the effort needed to cognitively process these alerts should be minimized. Methods to evaluate the extent to which computerized alerts support prescribers' information processing are lacking. To develop a methodological protocol to assess the extent to which alerts support prescribers' information processing at-a-glance; specifically, the incorporation of information into their working memory. We hypothesized that the method would be feasible and that we would be able to detect a significant difference in prescribers' information processing with a revised alert display that incorporates warning design guidelines compared to the original alert display. A counterbalanced, within-subject study was conducted with 20 prescribers in a human-computer interaction laboratory. We tested a single alert that was displayed in two different ways. Prescribers were informed that an alert would appear for 10s. After the alert was shown, a white screen was displayed, and prescribers were asked to verbally describe what they saw; indicate how many total warnings; and describe anything else they remembered about the alert. We measured information processing via the accuracy of prescribers' free recall and their ability to identify that three warning messages were present. Two analysts independently evaluated participants' responses against a comprehensive catalog of alert elements and then discussed discrepancies until reaching consensus. This feasibility study demonstrated that the method seemed to be effective for evaluating prescribers' information processing of medication alert displays. With this method, we were able to detect significant differences in prescribers' recall of alert information. The proportion of total data elements that prescribers were able to accurately recall was significantly greater for the revised versus original alert display (p=0.006). With the revised display, more prescribers accurately reported that three warnings were shown (p=0.002). The methodological protocol was feasible for evaluating the alert display and yielded important findings on prescribers' information processing. Study methods supplement traditional usability evaluation methods and may be useful for evaluating information processing of other healthcare technologies. Published by Elsevier Inc.

Potential drug related problems detected by electronic expert support system in patients with multi-dose drug dispensing.

PubMed

Tora, Hammar; Bo, Hovstadius; Bodil, Lidström; Göran, Petersson; Birgit, Eiermann

2014-10-01

Background Drug related problems (DRPs) are frequent and cause suffering for patients and substantial costs for society. Multi-dose drug dispensing (MDDD) is a service by which patients receive their medication packed in bags with one unit for each dose occasion. The clinical decision support system (CDSS) electronic expert support (EES) analyses patients' prescriptions in the Swedish national e-prescription repository and provides alerts if potential DRPs are detected, i.e. drug-drug interactions, duplicate therapy, drug-disease contraindications, high dose, gender warnings, geriatric, and paediatric alerts. Objective To analyse potential DRPs in patients with MDDD, detected by means of EES. Setting A register study of all electronically stored prescriptions for patients with MDDD in Sweden (n = 180,059) March 5-June 5, 2013. Method Drug use and potential DRPs detected in the study population during the 3 month study period by EES were analysed. The potential DRPs were analysed in relation to patients' age, gender, number of drugs, and type of medication. Main outcome measure Prevalence of potential DRPs measured as EES alerts. Results The study population was on average 75.8 years of age (± 17.5, range 1-110) and had 10.0 different medications (± 4.7, range 1-53). EES alerted for potential DRPs in 76 % of the population with a mean of 2.2 alerts per patient (± 2.4, range 0-27). The older patients received a lower number of alerts compared to younger patients despite having a higher number of drugs. The most frequent alert categories were drug-drug interactions (37 % of all alerts), duplicate therapy (30 %), and geriatric warnings for high dose or inappropriate drugs (23 %). Psycholeptics, psychoanaleptics, antithrombotic agents, anti-epileptics, renin-angiotensin system agents, and analgesics represented 71 % of all drugs involved in alerts. Conclusions EES detected potential DRPs in the majority of patients with MDDD. The number of potential DRPs was associated with the number of drugs, age, gender, and type of medication. A CDSS such as EES might be a useful tool for physicians and pharmacists to assist in the important task of monitoring patients with MDDD for potential DRPs.

Negotiating Voice Construction between Writers and Readers in College Writing: A Case Study of an L2 Writer

ERIC Educational Resources Information Center

Jwa, Soomin

2018-01-01

Voice is co-constructed, a result of the "text-mediated interaction between the writer and the reader." The present study, using the context of U.S. college writing, explores the complicated process by which an L2 novice writer--one who has a growing awareness of, yet peripheral access to, discourse practices--constructs a voice. Through…

Increased appropriateness of customized alert acknowledgement reasons for overridden medication alerts in a computerized provider order entry system.

PubMed

Dekarske, Brian M; Zimmerman, Christopher R; Chang, Robert; Grant, Paul J; Chaffee, Bruce W

2015-12-01

Computerized provider order entry systems commonly contain alerting mechanisms for patient allergies, incorrect doses, or drug-drug interactions when ordering medications. Providers have the option to override (bypass) these alerts and continue with the order unchanged. This study examines the effect of customizing medication alert override options on the appropriateness of override selection related to patient allergies, drug dosing, and drug-drug interactions when ordering medications in an electronic medical record. In this prospective, randomized crossover study, providers were randomized into cohorts that required a reason for overriding a medication alert from a customized or non-customized list of override reasons and/or by free-text entry. The primary outcome was to compare override responses that appropriately correlate with the alert type between the customized and non-customized configurations. The appropriateness of a subset of free-text responses that represented an affirmative and active acknowledgement of the alert without further explanation was classified as "indeterminate." Results were analyzed in three different ways by classifying indeterminate answers as either appropriate, inappropriate, or excluded entirely. Secondary outcomes included the appropriateness of override reasons when comparing cohorts and individual providers, reason selection based on order within the override list, and the determination of the frequency of free-text use, nonsensical responses, and multiple selection responses. Twenty-two clinicians were randomized into 2 cohorts and a total of 1829 alerts with a required response were generated during the study period. The customized configuration had a higher rate of appropriateness when compared to the non-customized configuration regardless of how indeterminate responses were classified (p<0.001). When comparing cohorts, appropriateness was significantly higher in the customized configuration regardless of the classification of indeterminate responses (p<0.001) with one exception: when indeterminate responses were considered inappropriate for the cohort of providers that were first exposed to the non-customized list (p=0.103). Free-text use was higher in the customized configuration overall (p<0.001), and there was no difference in nonsensical response between configurations (p=0.39). There is a benefit realized by using a customized list for medication override reasons. Poor application design or configuration can negatively affect provider behavior when responding to important medication alerts. Copyright © 2015. Published by Elsevier Ireland Ltd.

Voice emotion perception and production in cochlear implant users.

PubMed

Jiam, N T; Caldwell, M; Deroche, M L; Chatterjee, M; Limb, C J

2017-09-01

Voice emotion is a fundamental component of human social interaction and social development. Unfortunately, cochlear implant users are often forced to interface with highly degraded prosodic cues as a result of device constraints in extraction, processing, and transmission. As such, individuals with cochlear implants frequently demonstrate significant difficulty in recognizing voice emotions in comparison to their normal hearing counterparts. Cochlear implant-mediated perception and production of voice emotion is an important but relatively understudied area of research. However, a rich understanding of the voice emotion auditory processing offers opportunities to improve upon CI biomedical design and to develop training programs benefiting CI performance. In this review, we will address the issues, current literature, and future directions for improved voice emotion processing in cochlear implant users. Copyright © 2017 Elsevier B.V. All rights reserved.

Development and validation of a survey instrument for assessing prescribers' perception of computerized drug-drug interaction alerts.

PubMed

Zheng, Kai; Fear, Kathleen; Chaffee, Bruce W; Zimmerman, Christopher R; Karls, Edward M; Gatwood, Justin D; Stevenson, James G; Pearlman, Mark D

2011-12-01

To develop a theoretically informed and empirically validated survey instrument for assessing prescribers' perception of computerized drug-drug interaction (DDI) alerts. The survey is grounded in the unified theory of acceptance and use of technology and an adapted accident causation model. Development of the instrument was also informed by a review of the extant literature on prescribers' attitude toward computerized medication safety alerts and common prescriber-provided reasons for overriding. To refine and validate the survey, we conducted a two-stage empirical validation study consisting of a pretest with a panel of domain experts followed by a field test among all eligible prescribers at our institution. The resulting survey instrument contains 28 questionnaire items assessing six theoretical dimensions: performance expectancy, effort expectancy, social influence, facilitating conditions, perceived fatigue, and perceived use behavior. Satisfactory results were obtained from the field validation; however, a few potential issues were also identified. We analyzed these issues accordingly and the results led to the final survey instrument as well as usage recommendations. High override rates of computerized medication safety alerts have been a prevalent problem. They are usually caused by, or manifested in, issues of poor end user acceptance. However, standardized research tools for assessing and understanding end users' perception are currently lacking, which inhibits knowledge accumulation and consequently forgoes improvement opportunities. The survey instrument presented in this paper may help fill this methodological gap. We developed and empirically validated a survey instrument that may be useful for future research on DDI alerts and other types of computerized medication safety alerts more generally.

Cockpit display of hazardous wind shear information

NASA Technical Reports Server (NTRS)

Wanke, Craig; Hansman, R. John, Jr.

1990-01-01

Information on cockpit display of wind shear information is given in viewgraph form. Based on the current status of windshear sensors and candidate data dissemination systems, the near-term capabilities for windshear avoidance will most likely include: (1) Ground-based detection: TDWR (Terminal Doppler Weather Radar), LLWAS (Low-Level Windshear Alert System), Automated PIREPS; (2) Ground-Air datalinks: Air traffic control voice channels, Mode-S digital datalink, ACARS alphanumeric datalink. The possible datapaths for integration of these systems are illustrated in a diagram. In the future, airborne windshear detection systems such as lidars, passive IR detectors, or airborne Doppler radars may also become available. Possible future datalinks include satellite downlink and specialized en route weather channels.

Phonological experience modulates voice discrimination: Evidence from functional brain networks analysis.

PubMed

Hu, Xueping; Wang, Xiangpeng; Gu, Yan; Luo, Pei; Yin, Shouhang; Wang, Lijun; Fu, Chao; Qiao, Lei; Du, Yi; Chen, Antao

2017-10-01

Numerous behavioral studies have found a modulation effect of phonological experience on voice discrimination. However, the neural substrates underpinning this phenomenon are poorly understood. Here we manipulated language familiarity to test the hypothesis that phonological experience affects voice discrimination via mediating the engagement of multiple perceptual and cognitive resources. The results showed that during voice discrimination, the activation of several prefrontal regions was modulated by language familiarity. More importantly, the same effect was observed concerning the functional connectivity from the fronto-parietal network to the voice-identity network (VIN), and from the default mode network to the VIN. Our findings indicate that phonological experience could bias the recruitment of cognitive control and information retrieval/comparison processes during voice discrimination. Therefore, the study unravels the neural substrates subserving the modulation effect of phonological experience on voice discrimination, and provides new insights into studying voice discrimination from the perspective of network interactions. Copyright © 2017. Published by Elsevier Inc.

Voice disorders in teachers and the general population: effects on work performance, attendance, and future career choices.

PubMed

Roy, Nelson; Merrill, Ray M; Thibeault, Susan; Gray, Steven D; Smith, Elaine M

2004-06-01

To examine the frequency and adverse effects of voice disorders on job performance and attendance in teachers and the general population, 2,401 participants from Iowa and Utah (n1 = 1,243 teachers and n2 = 1,279 nonteachers) were randomly selected and were interviewed by telephone using a voice disorder questionnaire. Teachers were significantly more likely than nonteachers to have experienced multiple voice symptoms and signs including hoarseness, discomfort, and increased effort while using their voice, tiring or experiencing a change in voice quality after short use, difficulty projecting their voice, trouble speaking or singing softly, and a loss of their singing range (all odds ratios [ORs] p <.05). Furthermore, teachers consistently attributed these voice symptoms to their occupation and were significantly more likely to indicate that their voice limited their ability to perform certain tasks at work, and had reduced activities or interactions as a result. Teachers, as compared with nonteachers, had missed more workdays over the preceding year because of voice problems and were more likely to consider changing occupations because of their voice (all comparisons p <.05). These findings strongly suggest that occupationally related voice dysfunction in teachers can have significant adverse effects on job performance, attendance, and future career choices.

Inadequate vocal hygiene habits associated with the presence of self-reported voice symptoms in telemarketers.

PubMed

Fuentes-López, Eduardo; Fuente, Adrian; Contreras, Karem V

2017-12-18

The aim of this study is to determine possible associations between vocal hygiene habits and self-reported vocal symptoms in telemarketers. A cross-sectional study that included 79 operators from call centres in Chile was carried out. Their vocal hygiene habits and self-reported symptoms were investigated using a validated and reliable questionnaire created for the purposes of this study. Forty-five percent of telemarketers reported having one or more vocal symptoms. Among them, 16.46% reported that their voices tense up when talking and 10.13% needed to clear their throat to make their voices clearer. Five percent mentioned that they always talk without taking a break and 40.51% reported using their voices in noisy environments. The number of working hours per day and inadequate vocal hygiene habits were associated with the presence of self-reported symptoms. Additionally, an interaction between the use of the voice in noisy environments and not taking breaks during the day was observed. Finally, the frequency of inadequate vocal hygiene habits was associated with the number of symptoms reported. Using the voice in noisy environments and talking without taking breaks were both associated with the presence of specific vocal symptoms. This study provides some evidence about the interaction between these two inadequate vocal hygiene habits that potentiates vocal symptoms.

Shielding voices: The modulation of binding processes between voice features and response features by task representations.

PubMed

Bogon, Johanna; Eisenbarth, Hedwig; Landgraf, Steffen; Dreisbach, Gesine

2017-09-01

Vocal events offer not only semantic-linguistic content but also information about the identity and the emotional-motivational state of the speaker. Furthermore, most vocal events have implications for our actions and therefore include action-related features. But the relevance and irrelevance of vocal features varies from task to task. The present study investigates binding processes for perceptual and action-related features of spoken words and their modulation by the task representation of the listener. Participants reacted with two response keys to eight different words spoken by a male or a female voice (Experiment 1) or spoken by an angry or neutral male voice (Experiment 2). There were two instruction conditions: half of participants learned eight stimulus-response mappings by rote (SR), and half of participants applied a binary task rule (TR). In both experiments, SR instructed participants showed clear evidence for binding processes between voice and response features indicated by an interaction between the irrelevant voice feature and the response. By contrast, as indicated by a three-way interaction with instruction, no such binding was found in the TR instructed group. These results are suggestive of binding and shielding as two adaptive mechanisms that ensure successful communication and action in a dynamic social environment.

Analysis of Measured and Simulated Supraglottal Acoustic Waves.

PubMed

Fraile, Rubén; Evdokimova, Vera V; Evgrafova, Karina V; Godino-Llorente, Juan I; Skrelin, Pavel A

2016-09-01

To date, although much attention has been paid to the estimation and modeling of the voice source (ie, the glottal airflow volume velocity), the measurement and characterization of the supraglottal pressure wave have been much less studied. Some previous results have unveiled that the supraglottal pressure wave has some spectral resonances similar to those of the voice pressure wave. This makes the supraglottal wave partially intelligible. Although the explanation for such effect seems to be clearly related to the reflected pressure wave traveling upstream along the vocal tract, the influence that nonlinear source-filter interaction has on it is not as clear. This article provides an insight into this issue by comparing the acoustic analyses of measured and simulated supraglottal and voice waves. Simulations have been performed using a high-dimensional discrete vocal fold model. Results of such comparative analysis indicate that spectral resonances in the supraglottal wave are mainly caused by the regressive pressure wave that travels upstream along the vocal tract and not by source-tract interaction. On the contrary and according to simulation results, source-tract interaction has a role in the loss of intelligibility that happens in the supraglottal wave with respect to the voice wave. This loss of intelligibility mainly corresponds to spectral differences for frequencies above 1500 Hz. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Neurobiological correlates of emotional intelligence in voice and face perception networks

PubMed Central

Karle, Kathrin N; Ethofer, Thomas; Jacob, Heike; Brück, Carolin; Erb, Michael; Lotze, Martin; Nizielski, Sophia; Schütz, Astrid; Wildgruber, Dirk; Kreifelts, Benjamin

2018-01-01

Abstract Facial expressions and voice modulations are among the most important communicational signals to convey emotional information. The ability to correctly interpret this information is highly relevant for successful social interaction and represents an integral component of emotional competencies that have been conceptualized under the term emotional intelligence. Here, we investigated the relationship of emotional intelligence as measured with the Salovey-Caruso-Emotional-Intelligence-Test (MSCEIT) with cerebral voice and face processing using functional and structural magnetic resonance imaging. MSCEIT scores were positively correlated with increased voice-sensitivity and gray matter volume of the insula accompanied by voice-sensitivity enhanced connectivity between the insula and the temporal voice area, indicating generally increased salience of voices. Conversely, in the face processing system, higher MSCEIT scores were associated with decreased face-sensitivity and gray matter volume of the fusiform face area. Taken together, these findings point to an alteration in the balance of cerebral voice and face processing systems in the form of an attenuated face-vs-voice bias as one potential factor underpinning emotional intelligence. PMID:29365199

Neurobiological correlates of emotional intelligence in voice and face perception networks.

PubMed

Karle, Kathrin N; Ethofer, Thomas; Jacob, Heike; Brück, Carolin; Erb, Michael; Lotze, Martin; Nizielski, Sophia; Schütz, Astrid; Wildgruber, Dirk; Kreifelts, Benjamin

2018-02-01

Facial expressions and voice modulations are among the most important communicational signals to convey emotional information. The ability to correctly interpret this information is highly relevant for successful social interaction and represents an integral component of emotional competencies that have been conceptualized under the term emotional intelligence. Here, we investigated the relationship of emotional intelligence as measured with the Salovey-Caruso-Emotional-Intelligence-Test (MSCEIT) with cerebral voice and face processing using functional and structural magnetic resonance imaging. MSCEIT scores were positively correlated with increased voice-sensitivity and gray matter volume of the insula accompanied by voice-sensitivity enhanced connectivity between the insula and the temporal voice area, indicating generally increased salience of voices. Conversely, in the face processing system, higher MSCEIT scores were associated with decreased face-sensitivity and gray matter volume of the fusiform face area. Taken together, these findings point to an alteration in the balance of cerebral voice and face processing systems in the form of an attenuated face-vs-voice bias as one potential factor underpinning emotional intelligence.

Phasic and tonic alerting in mild cognitive impairment: A preliminary study.

PubMed

Martella, Diana; Manzanares, Salvadora; Campoy, Guillermo; Roca, Javier; Antúnez, Carmen; Fuentes, Luis J

2014-01-01

In this preliminary study we assessed the functioning of the different attentional networks in mild cognitive impairment (MCI) patients, taking as theoretical framework the Posner's cognitive neuroscience approach. Two groups of participants were tested in a single short experiment: 20 MCI patients (6 amnestic, 6 non-amnestic and 8 multiple-domain) and 18 healthy matched controls (HC). For attentional assessment we used a version of the Attention Network Test (the ANTI-V) that provided not only a score of the orienting, the executive, and the alerting networks and their interactions, but also an independent measure of vigilance (tonic alerting). The results showed that all subtypes of MCI patients exhibited a selective impairment in the tonic component of alerting, as indexed by a decrease in the d' sensitivity index, and their performance in executive network increased up to the HC group level when phasic alerting was provided by a warning tone. Our findings suggest that a core attentional deficit, especially the endogenous component of alerting, may significantly contribute to the behavioral and cognitive deficits associated with MCI. Copyright © 2013 Elsevier Inc. All rights reserved.

Predicting patient aggression against nurses in all hospital areas.

PubMed

Chapman, Rose; Perry, Laura; Styles, Irene; Combs, Shane

Workplace violence directed at nurses is an alarming phenomenon across the world. To intervene and manage these episodes as quickly as possible, nurses need to identify those factors that can alert them to the possibility that a violent event may occur. However, frameworks to help nurses predict episodes of workplace violence are limited. This article presents the findings of a study of nurses experience of workplace violence and identifies those factors and behaviours that nurses reported as indicating that an episode of workplace violence is likely to occur. A case study approach was used involving quantitative and qualitative data. One hundred and thirteen questionnaires were completed and 20 interviews were conducted in 2006. Nurses identified nine behaviours and factors that assist them to predict workplace violence. The first five factors comprising staring, tone of voice, anxiety, mumbling and pacing (STAMP) matched those identified in a previous study. However, the last four factors, comprising emotions, disease process, assertive/non-assertive behaviour and resources (EDAR) expand upon that study. Therefore, the acronym STAMPEDAR was used to classify the nine components. Being alert to these behaviours and factors may help nurses predict that an episode of workplace violence is likely to occur.

Study on intelligent processing system of man-machine interactive garment frame model

NASA Astrophysics Data System (ADS)

Chen, Shuwang; Yin, Xiaowei; Chang, Ruijiang; Pan, Peiyun; Wang, Xuedi; Shi, Shuze; Wei, Zhongqian

2018-05-01

A man-machine interactive garment frame model intelligent processing system is studied in this paper. The system consists of several sensor device, voice processing module, mechanical parts and data centralized acquisition devices. The sensor device is used to collect information on the environment changes brought by the body near the clothes frame model, the data collection device is used to collect the information of the environment change induced by the sensor device, voice processing module is used for speech recognition of nonspecific person to achieve human-machine interaction, mechanical moving parts are used to make corresponding mechanical responses to the information processed by data collection device.it is connected with data acquisition device by a means of one-way connection. There is a one-way connection between sensor device and data collection device, two-way connection between data acquisition device and voice processing module. The data collection device is one-way connection with mechanical movement parts. The intelligent processing system can judge whether it needs to interact with the customer, realize the man-machine interaction instead of the current rigid frame model.

Voice hearing within the context of hearers' social worlds: an interpretative phenomenological analysis.

PubMed

Mawson, Amy; Berry, Katherine; Murray, Craig; Hayward, Mark

2011-09-01

Research has found relational qualities of power and intimacy to exist within hearer-voice interactions. The present study aimed to provide a deeper understanding of the interpersonal context of voice hearing by exploring participants' relationships with their voices and other people in their lives. This research was designed in consultation with service users and employed a qualitative, phenomenological, and idiographic design using semi-structured interviews. Ten participants, recruited via mental health services, and who reported hearing voices in the previous week, completed the interviews. These were transcribed verbatim and analysed using interpretative phenomenological analysis. Five themes resulted from the analysis. Theme 1: 'person and voice' demonstrated that participants' voices often reflected the identity, but not always the quality of social acquaintances. Theme 2: 'voices changing and confirming relationship with the self' explored the impact of voice hearing in producing an inferior sense-of-self in comparison to others. Theme 3: 'a battle for control' centred on issues of control and a dilemma of independence within voice relationships. Theme 4: 'friendships facilitating the ability to cope' and theme 5: 'voices creating distance in social relationships' explored experiences of social relationships within the context of voice hearing, and highlighted the impact of social isolation for voice hearers. The study demonstrated the potential role of qualitative research in developing theories of voice hearing. It extended previous research by highlighting the interface between voices and the social world of the hearer, including reciprocal influences of social relationships on voices and coping. Improving voice hearers' sense-of-self may be a key factor in reducing the distress caused by voices. ©2010 The British Psychological Society.

Driving While Interacting With Google Glass: Investigating the Combined Effect of Head-Up Display and Hands-Free Input on Driving Safety and Multitask Performance.

PubMed

Tippey, Kathryn G; Sivaraj, Elayaraj; Ferris, Thomas K

2017-06-01

This study evaluated the individual and combined effects of voice (vs. manual) input and head-up (vs. head-down) display in a driving and device interaction task. Advances in wearable technology offer new possibilities for in-vehicle interaction but also present new challenges for managing driver attention and regulating device usage in vehicles. This research investigated how driving performance is affected by interface characteristics of devices used for concurrent secondary tasks. A positive impact on driving performance was expected when devices included voice-to-text functionality (reducing demand for visual and manual resources) and a head-up display (HUD) (supporting greater visibility of the driving environment). Driver behavior and performance was compared in a texting-while-driving task set during a driving simulation. The texting task was completed with and without voice-to-text using a smartphone and with voice-to-text using Google Glass's HUD. Driving task performance degraded with the addition of the secondary texting task. However, voice-to-text input supported relatively better performance in both driving and texting tasks compared to using manual entry. HUD functionality further improved driving performance compared to conditions using a smartphone and often was not significantly worse than performance without the texting task. This study suggests that despite the performance costs of texting-while-driving, voice input methods improve performance over manual entry, and head-up displays may further extend those performance benefits. This study can inform designers and potential users of wearable technologies as well as policymakers tasked with regulating the use of these technologies while driving.

SymptomCare@Home: Developing an Integrated Symptom Monitoring and Management System for Outpatients Receiving Chemotherapy.

PubMed

Beck, Susan L; Eaton, Linda H; Echeverria, Christina; Mooney, Kathi H

2017-10-01

SymptomCare@Home, an integrated symptom monitoring and management system, was designed as part of randomized clinical trials to help patients with cancer who receive chemotherapy in ambulatory clinics and often experience significant symptoms at home. An iterative design process was informed by chronic disease management theory and features of assessment and clinical decision support systems used in other diseases. Key stakeholders participated in the design process: nurse scientists, clinical experts, bioinformatics experts, and computer programmers. Especially important was input from end users, patients, and nurse practitioners participating in a series of studies testing the system. The system includes both a patient and clinician interface and fully integrates two electronic subsystems: a telephone computer-linked interactive voice response system and a Web-based Decision Support-Symptom Management System. Key features include (1) daily symptom monitoring, (2) self-management coaching, (3) alerting, and (4) nurse practitioner follow-up. The nurse practitioner is distinctively positioned to provide assessment, education, support, and pharmacologic and nonpharmacologic interventions to intensify management of poorly controlled symptoms at home. SymptomCare@Home is a model for providing telehealth. The system facilitates using evidence-based guidelines as part of a comprehensive symptom management approach. The design process and system features can be applied to other diseases and conditions.

Live maternal speech and singing have beneficial effects on hospitalized preterm infants.

PubMed

Filippa, Manuela; Devouche, Emmanuel; Arioni, Cesare; Imberty, Michel; Gratier, Maya

2013-10-01

To study the effects of live maternal speaking and singing on physiological parameters of preterm infants in the NICU and to test the hypothesis that vocal stimulation can have differential effects on preterm infants at a behavioural level. Eighteen mothers spoke and sang to their medically stable preterm infants in their incubators over 6 days, between 1 and 2 pm. Heart rate (HR), oxygen saturation (OxSat), number of critical events (hypoxemia, bradycardia and apnoea) and change in behavioural state were measured. Comparisons of periods with and without maternal vocal stimulation revealed significantly greater oxygen saturation level and heart rate and significantly fewer negative critical events (p < 0.0001) when the mother was speaking and singing. Unexpected findings were the comparable effects of maternal talk and singing on infant physiological parameters and the differential ones on infant behavioural state. A renewed connection to the mother's voice can be an important and significant experience for preterm infants. Exposure to maternal speech and singing shows significant early beneficial effects on physiological state, such as oxygen saturation levels, number of critical events and prevalence of calm alert state. These findings have implications for NICU interventions, encouraging maternal interaction with their medically stable preterm infants. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Telehealth: voice therapy using telecommunications technology.

PubMed

Mashima, Pauline A; Birkmire-Peters, Deborah P; Syms, Mark J; Holtel, Michael R; Burgess, Lawrence P A; Peters, Leslie J

2003-11-01

Telehealth offers the potential to meet the needs of underserved populations in remote regions. The purpose of this study was a proof-of-concept to determine whether voice therapy can be delivered effectively remotely. Treatment outcomes were evaluated for a vocal rehabilitation protocol delivered under 2 conditions: with the patient and clinician interacting within the same room (conventional group) and with the patient and clinician in separate rooms, interacting in real time via a hard-wired video camera and monitor (video teleconference group). Seventy-two patients with voice disorders served as participants. Based on evaluation by otolaryngologists, 31 participants were diagnosed with vocal nodules, 29 were diagnosed with edema, 9 were diagnosed with unilateral vocal fold paralysis, and 3 presented with vocal hyperfunction with no laryngeal pathology. Fifty-one participants (71%) completed the vocal rehabilitation protocol. Outcome measures included perceptual judgments of voice quality, acoustic analyses of voice, patient satisfaction ratings, and fiber-optic laryngoscopy. There were no differences in outcome measures between the conventional group and the remote video teleconference group. Participants in both groups showed positive changes on all outcome measures after completing the vocal rehabilitation protocol. Reasons for participants discontinuing therapy prematurely provided support for the telehealth model of service delivery.

Sounding the 'citizen-patient': the politics of voice at the Hospice Des Quinze-vingts in post-revolutionary Paris.

PubMed

Sykes, Ingrid

2011-10-01

This essay explores new models of the citizen-patient by attending to the post-Revolutionary blind 'voice'. Voice, in both a literal and figurative sense, was central to the way in which members of the Hospice des Quinze-Vingts, an institution for the blind and partially sighted, interacted with those in the community. Musical voices had been used by members to collect alms and to project the particular spiritual principle of their institution since its foundation in the thirteenth century. At the time of the Revolution, the Quinze-Vingts voice was understood by some political authorities as an exemplary call of humanity. Yet many others perceived it as deeply threatening. After 1800, productive dialogue between those in political control and Quinze-Vingts blind members broke down. Authorities attempted to silence the voice of members through the control of blind musicians and institutional management. The Quinze-Vingts blind continued to reassert their voices until around 1850, providing a powerful form of resistance to political control. The blind 'voice' ultimately recognised the right of the citizen-patient to dialogue with their political carers.

A voice region in the monkey brain.

PubMed

Petkov, Christopher I; Kayser, Christoph; Steudel, Thomas; Whittingstall, Kevin; Augath, Mark; Logothetis, Nikos K

2008-03-01

For vocal animals, recognizing species-specific vocalizations is important for survival and social interactions. In humans, a voice region has been identified that is sensitive to human voices and vocalizations. As this region also strongly responds to speech, it is unclear whether it is tightly associated with linguistic processing and is thus unique to humans. Using functional magnetic resonance imaging of macaque monkeys (Old World primates, Macaca mulatta) we discovered a high-level auditory region that prefers species-specific vocalizations over other vocalizations and sounds. This region not only showed sensitivity to the 'voice' of the species, but also to the vocal identify of conspecific individuals. The monkey voice region is located on the superior-temporal plane and belongs to an anterior auditory 'what' pathway. These results establish functional relationships with the human voice region and support the notion that, for different primate species, the anterior temporal regions of the brain are adapted for recognizing communication signals from conspecifics.

Giving Voice to Emotion: Voice Analysis Technology Uncovering Mental States is Playing a Growing Role in Medicine, Business, and Law Enforcement.

PubMed

Allen, Summer

2016-01-01

It's tough to imagine anything more frustrating than interacting with a call center. Generally, people don't reach out to call centers when they?re happy-they're usually trying to get help with a problem or gearing up to do battle over a billing error. Add in an automatic phone tree, and you have a recipe for annoyance. But what if that robotic voice offering you a smorgasbord of numbered choices could tell that you were frustrated and then funnel you to an actual human being? This type of voice analysis technology exists, and it's just one example of the many ways that computers can use your voice to extract information about your mental and emotional state-including information you may not think of as being accessible through your voice alone.

The distress of voice-hearing: the use of simulation for awareness, understanding and communication skill development in undergraduate nursing education.

PubMed

Orr, Fiona; Kellehear, Kevin; Armari, Elizabeth; Pearson, Arana; Holmes, Douglas

2013-11-01

Role-play scenarios are frequently used with undergraduate nursing students enrolled in mental health nursing subjects to simulate the experience of voice-hearing. However, role-play has limitations and typically does not involve those who hear voices. This collaborative project between mental health consumers who hear voices and nursing academics aimed to develop and assess simulated voice-hearing as an alternative learning tool that could provide a deeper understanding of the impact of voice-hearing, whilst enabling students to consider the communication skills required when interacting with voice-hearers. Simulated sounds and voices recorded by consumers on mp3 players were given to eighty final year nursing students undertaking a mental health elective. Students participated in various activities whilst listening to the simulations. Seventy-six (95%) students completed a written evaluation following the simulation, which assessed the benefits of the simulation and its implications for clinical practice. An analysis of the students' responses by an external evaluator indicated that there were three major learning outcomes: developing an understanding of voice-hearing, increasing students' awareness of its impact on functioning, and consideration of the communication skills necessary to engage with consumers who hear voices. Copyright © 2013 Elsevier Ltd. All rights reserved.

Initial Progress Toward Development of a Voice-Based Computer-Delivered Motivational Intervention for Heavy Drinking College Students: An Experimental Study

PubMed Central

Lechner, William J; MacGlashan, James; Wray, Tyler B; Littman, Michael L

2017-01-01

Background Computer-delivered interventions have been shown to be effective in reducing alcohol consumption in heavy drinking college students. However, these computer-delivered interventions rely on mouse, keyboard, or touchscreen responses for interactions between the users and the computer-delivered intervention. The principles of motivational interviewing suggest that in-person interventions may be effective, in part, because they encourage individuals to think through and speak aloud their motivations for changing a health behavior, which current computer-delivered interventions do not allow. Objective The objective of this study was to take the initial steps toward development of a voice-based computer-delivered intervention that can ask open-ended questions and respond appropriately to users’ verbal responses, more closely mirroring a human-delivered motivational intervention. Methods We developed (1) a voice-based computer-delivered intervention that was run by a human controller and that allowed participants to speak their responses to scripted prompts delivered by speech generation software and (2) a text-based computer-delivered intervention that relied on the mouse, keyboard, and computer screen for all interactions. We randomized 60 heavy drinking college students to interact with the voice-based computer-delivered intervention and 30 to interact with the text-based computer-delivered intervention and compared their ratings of the systems as well as their motivation to change drinking and their drinking behavior at 1-month follow-up. Results Participants reported that the voice-based computer-delivered intervention engaged positively with them in the session and delivered content in a manner consistent with motivational interviewing principles. At 1-month follow-up, participants in the voice-based computer-delivered intervention condition reported significant decreases in quantity, frequency, and problems associated with drinking, and increased perceived importance of changing drinking behaviors. In comparison to the text-based computer-delivered intervention condition, those assigned to voice-based computer-delivered intervention reported significantly fewer alcohol-related problems at the 1-month follow-up (incident rate ratio 0.60, 95% CI 0.44-0.83, P=.002). The conditions did not differ significantly on perceived importance of changing drinking or on measures of drinking quantity and frequency of heavy drinking. Conclusions Results indicate that it is feasible to construct a series of open-ended questions and a bank of responses and follow-up prompts that can be used in a future fully automated voice-based computer-delivered intervention that may mirror more closely human-delivered motivational interventions to reduce drinking. Such efforts will require using advanced speech recognition capabilities and machine-learning approaches to train a program to mirror the decisions made by human controllers in the voice-based computer-delivered intervention used in this study. In addition, future studies should examine enhancements that can increase the perceived warmth and empathy of voice-based computer-delivered intervention, possibly through greater personalization, improvements in the speech generation software, and embodying the computer-delivered intervention in a physical form. PMID:28659259

The voices of seduction: cross-gender effects in processing of erotic prosody

PubMed Central

Ethofer, Thomas; Wiethoff, Sarah; Anders, Silke; Kreifelts, Benjamin; Grodd, Wolfgang

2007-01-01

Gender specific differences in cognitive functions have been widely discussed. Considering social cognition such as emotion perception conveyed by non-verbal cues, generally a female advantage is assumed. In the present study, however, we revealed a cross-gender interaction with increasing responses to the voice of opposite sex in male and female subjects. This effect was confined to erotic tone of speech in behavioural data and haemodynamic responses within voice sensitive brain areas (right middle superior temporal gyrus). The observed response pattern, thus, indicates a particular sensitivity to emotional voices that have a high behavioural relevance for the listener. PMID:18985138

A General Purpose Connections type CTI Server Based on SIP Protocol and Its Implementation

NASA Astrophysics Data System (ADS)

Watanabe, Toru; Koizumi, Hisao

In this paper, we propose a general purpose connections type CTI (Computer Telephony Integration) server that provides various CTI services such as voice logging where the CTI server communicates with IP-PBX using the SIP (Session Initiation Protocol), and accumulates voice packets of external line telephone call flowing between an IP telephone for extension and a VoIP gateway connected to outside line networks. The CTI server realizes CTI services such as voice logging, telephone conference, or IVR (interactive voice response) with accumulating and processing voice packets sampled. Furthermore, the CTI server incorporates a web server function which can provide various CTI services such as a Web telephone directory via a Web browser to PCs, cellular telephones or smart-phones in mobile environments.

Accessibility of Mobile Devices for Visually Impaired Users: An Evaluation of the Screen-Reader VoiceOver.

PubMed

Smaradottir, Berglind; Håland, Jarle; Martinez, Santiago

2017-01-01

A mobile device's touchscreen allows users to use a choreography of hand gestures to interact with the user interface. A screen reader on a mobile device is designed to support the interaction of visually disabled users while using gestures. This paper presents an evaluation of VoiceOver, a screen reader in Apple Inc. products. The evaluation was a part of the research project "Visually impaired users touching the screen - a user evaluation of assistive technology".

Comparison of Overridden Medication-related Clinical Decision Support in the Intensive Care Unit between a Commercial System and a Legacy System.

PubMed

Wong, Adrian; Wright, Adam; Seger, Diane L; Amato, Mary G; Fiskio, Julie M; Bates, David

2017-08-23

Electronic health records (EHRs) with clinical decision support (CDS) have shown to be effective at improving patient safety. Despite this, alerts delivered as part of CDS are overridden frequently, which is of concern in the critical care population as this group may have an increased risk of harm. Our organization recently transitioned from an internally-developed EHR to a commercial system. Data comparing various EHR systems, especially after transitions between EHRs, are needed to identify areas for improvement. To compare the two systems and identify areas for potential improvement with the new commercial system at a single institution. Overridden medication-related CDS alerts were included from October to December of the systems' respective years (legacy, 2011; commercial, 2015), restricted to three intensive care units. The two systems were compared with regards to CDS presentation and override rates for four types of CDS: drug-allergy, drug-drug interaction (DDI), geriatric and renal alerts. A post hoc analysis to evaluate for adverse drug events (ADEs) potentially resulting from overridden alerts was performed for 'contraindicated' DDIs via chart review. There was a significant increase in provider exposure to alerts and alert overrides in the commercial system (commercial: n=5,535; legacy: n=1,030). Rates of overrides were higher for the allergy and DDI alerts (p<0.001) in the commercial system. Geriatric and renal alerts were significantly different in incidence and presentation between the two systems. No ADEs were identified in an analysis of 43 overridden contraindicated DDI alerts. The vendor system had much higher rates of both alerts and overrides, although we did not find evidence of harm in a review of DDIs which were overridden. We propose recommendations for improving our current system which may be helpful to other similar institutions; improving both alert presentation and the underlying knowledge base appear important.

How Regrouping Alerts in Computerized Physician Order Entry Layout Influences Physicians' Prescription Behavior: Results of a Crossover Randomized Trial.

PubMed

Wipfli, Rolf; Ehrler, Frederic; Bediang, Georges; Bétrancourt, Mireille; Lovis, Christian

2016-06-02

As demonstrated in several publications, low positive predictive value alerts in computerized physician order entry (CPOE) induce fatigue and may interrupt physicians unnecessarily during prescription of medication. Although it is difficult to increase the consideration of medical alerts by physician through an improvement of their predictive value, another approach consists to act on the way they are presented. The interruption management model inspired us to propose an alternative alert display strategy of regrouping the alerts in the screen layout, as a possible solution for reducing the interruption in physicians' workflow. In this study, we compared 2 CPOE designs based on a particular alert presentation strategy: one design involved regrouping the alerts in a single place on the screen, and in the other, the alerts were located next to the triggering information. Our objective was to evaluate experimentally whether the new design led to fewer interruptions in workflow and if it affected alert handling. The 2 CPOE designs were compared in a controlled crossover randomized trial. All interactions with the system and eye movements were stored for quantitative analysis. The study involved a group of 22 users consisting of physicians and medical students who solved medical scenarios containing prescription tasks. Scenario completion time was shorter when the alerts were regrouped (mean 117.29 seconds, SD 36.68) than when disseminated on the screen (mean 145.58 seconds, SD 75.07; P=.045). Eye tracking revealed that physicians fixated longer on alerts in the classic design (mean 119.71 seconds, SD 76.77) than in the centralized alert design (mean 70.58 seconds, SD 33.53; P=.001). Visual switches between prescription and alert areas, indicating interruption, were reduced with centralized alerts (mean 41.29, SD 21.26) compared with the classic design (mean 57.81, SD 35.97; P=.04). Prescription behavior (ie, prescription changes after alerting), however, did not change significantly between the 2 strategies of display. The After-Scenario Questionnaire (ASQ) that was filled out after each scenario showed that overall satisfaction was significantly rated lower when alerts were regrouped (mean 4.37, SD 1.23) than when displayed next to the triggering information (mean 5.32, SD 0.94; P=.02). Centralization of alerts in a table might be a way to motivate physicians to manage alerts more actively, in a meaningful way, rather than just being interrupted by them. Our study could not provide clear recommendations yet, but provides objective data through a cognitive psychological approach. Future tests should work on standardized scenarios that would enable to not only measure physicians' behavior (visual fixations and handling of alerts) but also validate those actions using clinical criteria.

78 FR 30896 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-23

..., Associated Form and OMB Number: Interactive Customer Evaluation (ICE)/Enterprise Voice of the Customer (EVoC...)/ Enterprise Voice of the Customer (EVoC) System automates and minimizes the use of the current manual paper... service provider on the quality of their experience and their satisfaction level. This is a management...

Speaker's voice as a memory cue.

PubMed

Campeanu, Sandra; Craik, Fergus I M; Alain, Claude

2015-02-01

Speaker's voice occupies a central role as the cornerstone of auditory social interaction. Here, we review the evidence suggesting that speaker's voice constitutes an integral context cue in auditory memory. Investigation into the nature of voice representation as a memory cue is essential to understanding auditory memory and the neural correlates which underlie it. Evidence from behavioral and electrophysiological studies suggest that while specific voice reinstatement (i.e., same speaker) often appears to facilitate word memory even without attention to voice at study, the presence of a partial benefit of similar voices between study and test is less clear. In terms of explicit memory experiments utilizing unfamiliar voices, encoding methods appear to play a pivotal role. Voice congruency effects have been found when voice is specifically attended at study (i.e., when relatively shallow, perceptual encoding takes place). These behavioral findings coincide with neural indices of memory performance such as the parietal old/new recollection effect and the late right frontal effect. The former distinguishes between correctly identified old words and correctly identified new words, and reflects voice congruency only when voice is attended at study. Characterization of the latter likely depends upon voice memory, rather than word memory. There is also evidence to suggest that voice effects can be found in implicit memory paradigms. However, the presence of voice effects appears to depend greatly on the task employed. Using a word identification task, perceptual similarity between study and test conditions is, like for explicit memory tests, crucial. In addition, the type of noise employed appears to have a differential effect. While voice effects have been observed when white noise is used at both study and test, using multi-talker babble does not confer the same results. In terms of neuroimaging research modulations, characterization of an implicit memory effect reflective of voice congruency is currently lacking. Copyright © 2014 Elsevier B.V. All rights reserved.

Loud and angry: sound intensity modulates amygdala activation to angry voices in social anxiety disorder

PubMed Central

Simon, Doerte; Becker, Michael; Mothes-Lasch, Martin; Miltner, Wolfgang H.R.

2017-01-01

Abstract Angry expressions of both voices and faces represent disorder-relevant stimuli in social anxiety disorder (SAD). Although individuals with SAD show greater amygdala activation to angry faces, previous work has failed to find comparable effects for angry voices. Here, we investigated whether voice sound-intensity, a modulator of a voice’s threat-relevance, affects brain responses to angry prosody in SAD. We used event-related functional magnetic resonance imaging to explore brain responses to voices varying in sound intensity and emotional prosody in SAD patients and healthy controls (HCs). Angry and neutral voices were presented either with normal or high sound amplitude, while participants had to decide upon the speaker’s gender. Loud vs normal voices induced greater insula activation, and angry vs neutral prosody greater orbitofrontal cortex activation in SAD as compared with HC subjects. Importantly, an interaction of sound intensity, prosody and group was found in the insula and the amygdala. In particular, the amygdala showed greater activation to loud angry voices in SAD as compared with HC subjects. This finding demonstrates a modulating role of voice sound-intensity on amygdalar hyperresponsivity to angry prosody in SAD and suggests that abnormal processing of interpersonal threat signals in amygdala extends beyond facial expressions in SAD. PMID:27651541

Whispering - The hidden side of auditory communication.

PubMed

Frühholz, Sascha; Trost, Wiebke; Grandjean, Didier

2016-11-15

Whispering is a unique expression mode that is specific to auditory communication. Individuals switch their vocalization mode to whispering especially when affected by inner emotions in certain social contexts, such as in intimate relationships or intimidating social interactions. Although this context-dependent whispering is adaptive, whispered voices are acoustically far less rich than phonated voices and thus impose higher hearing and neural auditory decoding demands for recognizing their socio-affective value by listeners. The neural dynamics underlying this recognition especially from whispered voices are largely unknown. Here we show that whispered voices in humans are considerably impoverished as quantified by an entropy measure of spectral acoustic information, and this missing information needs large-scale neural compensation in terms of auditory and cognitive processing. Notably, recognizing the socio-affective information from voices was slightly more difficult from whispered voices, probably based on missing tonal information. While phonated voices elicited extended activity in auditory regions for decoding of relevant tonal and time information and the valence of voices, whispered voices elicited activity in a complex auditory-frontal brain network. Our data suggest that a large-scale multidirectional brain network compensates for the impoverished sound quality of socially meaningful environmental signals to support their accurate recognition and valence attribution. Copyright © 2016 Elsevier Inc. All rights reserved.

Loud and angry: sound intensity modulates amygdala activation to angry voices in social anxiety disorder.

PubMed

Simon, Doerte; Becker, Michael; Mothes-Lasch, Martin; Miltner, Wolfgang H R; Straube, Thomas

2017-03-01

Angry expressions of both voices and faces represent disorder-relevant stimuli in social anxiety disorder (SAD). Although individuals with SAD show greater amygdala activation to angry faces, previous work has failed to find comparable effects for angry voices. Here, we investigated whether voice sound-intensity, a modulator of a voice's threat-relevance, affects brain responses to angry prosody in SAD. We used event-related functional magnetic resonance imaging to explore brain responses to voices varying in sound intensity and emotional prosody in SAD patients and healthy controls (HCs). Angry and neutral voices were presented either with normal or high sound amplitude, while participants had to decide upon the speaker's gender. Loud vs normal voices induced greater insula activation, and angry vs neutral prosody greater orbitofrontal cortex activation in SAD as compared with HC subjects. Importantly, an interaction of sound intensity, prosody and group was found in the insula and the amygdala. In particular, the amygdala showed greater activation to loud angry voices in SAD as compared with HC subjects. This finding demonstrates a modulating role of voice sound-intensity on amygdalar hyperresponsivity to angry prosody in SAD and suggests that abnormal processing of interpersonal threat signals in amygdala extends beyond facial expressions in SAD. © The Author (2016). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Voice discrimination in four primates.

PubMed

Candiotti, Agnès; Zuberbühler, Klaus; Lemasson, Alban

2013-10-01

One accepted function of vocalisations is to convey information about the signaller, such as its age-sex class, motivation, or relationship with the recipient. Yet, in natural habitats individuals not only interact with conspecifics but also with members of other species. This is well documented for African forest monkeys, which form semi-permanent mixed-species groups that can persist for decades. Although members of such groups interact with each other on a daily basis, both physically and vocally, it is currently unknown whether they can discriminate familiar and unfamiliar voices of heterospecific group members. We addressed this question with playbacks on monkey species known to form polyspecific associations in the wild: red-capped mangabeys, Campbell's monkeys and Guereza colobus monkeys. We tested subjects' discrimination abilities of contact calls of familiar and unfamiliar female De Brazza monkeys. When pooling all species, subjects looked more often towards the speaker when hearing contact calls of unfamiliar than familiar callers. When testing De Brazza monkeys with their own calls, we found the same effect with the longest gaze durations after hearing unfamiliar voices. This suggests that primates can discriminate, not only between familiar and unfamiliar voices of conspecifics, but also between familiar and unfamiliar voices of heterospecifics living within a close proximity. Copyright © 2013 Elsevier B.V. All rights reserved.

Measuring positive and negative affect in the voiced sounds of African elephants (Loxodonta africana).

PubMed

Soltis, Joseph; Blowers, Tracy E; Savage, Anne

2011-02-01

As in other mammals, there is evidence that the African elephant voice reflects affect intensity, but it is less clear if positive and negative affective states are differentially reflected in the voice. An acoustic comparison was made between African elephant "rumble" vocalizations produced in negative social contexts (dominance interactions), neutral social contexts (minimal social activity), and positive social contexts (affiliative interactions) by four adult females housed at Disney's Animal Kingdom®. Rumbles produced in the negative social context exhibited higher and more variable fundamental frequencies (F(0)) and amplitudes, longer durations, increased voice roughness, and higher first formant locations (F1), compared to the neutral social context. Rumbles produced in the positive social context exhibited similar shifts in most variables (F(0 )variation, amplitude, amplitude variation, duration, and F1), but the magnitude of response was generally less than that observed in the negative context. Voice roughness and F(0) observed in the positive social context remained similar to that observed in the neutral context. These results are most consistent with the vocal expression of affect intensity, in which the negative social context elicited higher intensity levels than the positive context, but differential vocal expression of positive and negative affect cannot be ruled out.

Exploring expressivity and emotion with artificial voice and speech technologies.

PubMed

Pauletto, Sandra; Balentine, Bruce; Pidcock, Chris; Jones, Kevin; Bottaci, Leonardo; Aretoulaki, Maria; Wells, Jez; Mundy, Darren P; Balentine, James

2013-10-01

Emotion in audio-voice signals, as synthesized by text-to-speech (TTS) technologies, was investigated to formulate a theory of expression for user interface design. Emotional parameters were specified with markup tags, and the resulting audio was further modulated with post-processing techniques. Software was then developed to link a selected TTS synthesizer with an automatic speech recognition (ASR) engine, producing a chatbot that could speak and listen. Using these two artificial voice subsystems, investigators explored both artistic and psychological implications of artificial speech emotion. Goals of the investigation were interdisciplinary, with interest in musical composition, augmentative and alternative communication (AAC), commercial voice announcement applications, human-computer interaction (HCI), and artificial intelligence (AI). The work-in-progress points towards an emerging interdisciplinary ontology for artificial voices. As one study output, HCI tools are proposed for future collaboration.

The pattern of educator voice in clinical counseling in an educational hospital in Shiraz, Iran: a conversation analysis

PubMed Central

Kalateh Sadati, Ahmad; Bagheri Lankarani, Kamran

2017-01-01

Doctor-patient interaction (DPI) includes different voices, of which the educator voice is of considerable importance. Physicians employ this voice to educate patients and their caregivers by providing them with information in order to change the patients’ behavior and improve their health status. The subject has not yet been fully understood, and therefore the present study was conducted to explore the pattern of educator voice. For this purpose, conversation analysis (CA) of 33 recorded clinical consultations was performed in outpatient educational clinics in Shiraz, Iran between April 2014 and September 2014. In this qualitative study, all utterances, repetitions, lexical forms, chuckles and speech particles were considered and interpreted as social actions. Interpretations were based on inductive data-driven analysis with the aim to find recurring patterns of educator voice. The results showed educator voice to have two general features: descriptive and prescriptive. However, the pattern of educator voice comprised characteristics such as superficiality, marginalization of patients, one-dimensional approach, ignoring a healthy lifestyle, and robotic nature. The findings of this study clearly demonstrated a deficiency in the educator voice and inadequacy in patient-centered dialogue. In this setting, the educator voice was related to a distortion of DPI through the physicians’ dominance, leading them to ignore their professional obligation to educate patients. Therefore, policies in this regard should take more account of enriching the educator voice through training medical students and faculty members in communication skills. PMID:29296258

The pattern of educator voice in clinical counseling in an educational hospital in Shiraz, Iran: a conversation analysis.

PubMed

Kalateh Sadati, Ahmad; Bagheri Lankarani, Kamran

2017-01-01

Doctor-patient interaction (DPI) includes different voices, of which the educator voice is of considerable importance. Physicians employ this voice to educate patients and their caregivers by providing them with information in order to change the patients' behavior and improve their health status. The subject has not yet been fully understood, and therefore the present study was conducted to explore the pattern of educator voice. For this purpose, conversation analysis (CA) of 33 recorded clinical consultations was performed in outpatient educational clinics in Shiraz, Iran between April 2014 and September 2014. In this qualitative study, all utterances, repetitions, lexical forms, chuckles and speech particles were considered and interpreted as social actions. Interpretations were based on inductive data-driven analysis with the aim to find recurring patterns of educator voice. The results showed educator voice to have two general features: descriptive and prescriptive. However, the pattern of educator voice comprised characteristics such as superficiality, marginalization of patients, one-dimensional approach, ignoring a healthy lifestyle, and robotic nature. The findings of this study clearly demonstrated a deficiency in the educator voice and inadequacy in patient-centered dialogue. In this setting, the educator voice was related to a distortion of DPI through the physicians' dominance, leading them to ignore their professional obligation to educate patients. Therefore, policies in this regard should take more account of enriching the educator voice through training medical students and faculty members in communication skills.

Matching Speaking to Singing Voices and the Influence of Content.

PubMed

Peynircioğlu, Zehra F; Rabinovitz, Brian E; Repice, Juliana

2017-03-01

We tested whether speaking voices of unfamiliar people could be matched to their singing voices, and, if so, whether the content of the utterances would influence this matching performance. Our hypothesis was that enough acoustic features would remain the same between speaking and singing voices such that their identification as belonging to the same or different individuals would be possible even upon a single hearing. We also hypothesized that the contents of the utterances would influence this identification process such that voices uttering words would be easier to match than those uttering vowels. We used a within-participant design with blocked stimuli that were counterbalanced using a Latin square design. In one block, mode (speaking vs singing) was manipulated while content was held constant; in another block, content (word vs syllable) was manipulated while mode was held constant, and in the control block, both mode and content were held constant. Participants indicated whether the voices in any given pair of utterances belonged to the same person or to different people. Cross-mode matching was above chance level, although mode-congruent performance was better. Further, only speaking voices were easier to match when uttering words. We can identify speaking and singing voices as the same or different even on just a single hearing. However, content interacts with mode such that words benefit matching of speaking voices but not of singing voices. Results are discussed within an attentional framework. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Understanding mSOS: A qualitative study examining the implementation of a text-messaging outbreak alert system in rural Kenya

PubMed Central

Toda, Mitsuru; O-Tipo, Shikanga; Mwau, Matilu; Morita, Kouichi

2017-01-01

Outbreaks of epidemic diseases pose serious public health risks. To overcome the hurdles of sub-optimal disease surveillance reporting from the health facilities to relevant authorities, the Ministry of Health in Kenya piloted mSOS (mobile SMS-based disease outbreak alert system) in 2013–2014. In this paper, we report the results of the qualitative study, which examined factors that influence the performances of mSOS implementation. In-depth interviews were conducted with 11 disease surveillance coordinators and 32 in-charges of rural health facilities that took part in the mSOS intervention. Drawing from the framework analysis, dominant themes that emerged from the interviews are presented. All participants voiced their excitement in using mSOS. The results showed that the technology was well accepted, easy to use, and both health workers and managers unanimously recommended the scale-up of the system despite challenges encountered in the implementation processes. The most challenging components were the context in which mSOS was implemented, including the lack of strong existing structure for continuous support supervision, feedback and response action related to disease surveillance. The study revealed broader health systems issues that should be addressed prior to and during the intervention scale-up. PMID:28628629

Development and preliminary evidence for the validity of an instrument assessing implementation of human-factors principles in medication-related decision-support systems—I-MeDeSA

PubMed Central

Zachariah, Marianne; Seidling, Hanna M; Neri, Pamela M; Cresswell, Kathrin M; Duke, Jon; Bloomrosen, Meryl; Volk, Lynn A; Bates, David W

2011-01-01

Background Medication-related decision support can reduce the frequency of preventable adverse drug events. However, the design of current medication alerts often results in alert fatigue and high over-ride rates, thus reducing any potential benefits. Methods The authors previously reviewed human-factors principles for relevance to medication-related decision support alerts. In this study, instrument items were developed for assessing the appropriate implementation of these human-factors principles in drug–drug interaction (DDI) alerts. User feedback regarding nine electronic medical records was considered during the development process. Content validity, construct validity through correlation analysis, and inter-rater reliability were assessed. Results The final version of the instrument included 26 items associated with nine human-factors principles. Content validation on three systems resulted in the addition of one principle (Corrective Actions) to the instrument and the elimination of eight items. Additionally, the wording of eight items was altered. Correlation analysis suggests a direct relationship between system age and performance of DDI alerts (p=0.0016). Inter-rater reliability indicated substantial agreement between raters (κ=0.764). Conclusion The authors developed and gathered preliminary evidence for the validity of an instrument that measures the appropriate use of human-factors principles in the design and display of DDI alerts. Designers of DDI alerts may use the instrument to improve usability and increase user acceptance of medication alerts, and organizations selecting an electronic medical record may find the instrument helpful in meeting their clinicians' usability needs. PMID:21946241

The Provision of Feedback Types to EFL Learners in Synchronous Voice Computer Mediated Communication

ERIC Educational Resources Information Center

Ko, Chao-Jung

2015-01-01

This study examined the relationship between Synchronous Voice Computer Mediated Communication (SVCMC) interaction and the use of feedback types, especially pronunciation feedback types, in distance tutoring contexts. The participants, divided into two groups (explicit and recast), were twelve beginning/low-intermediate level English as a Foreign…

What Does Class Origin and Education Mean for the Capabilities of Agency and Voice?

ERIC Educational Resources Information Center

Nordlander, Erica; Strandh, Mattias; Brännlund, Annica

2015-01-01

This article investigates the relationship between class origin, educational attainment, and the capabilities of agency and voice. The main objectives are to investigate how class origin and educational attainment interact and to consider whether higher education reduces any structural inequalities in the social aspects of life. A longitudinal…

Female Middle School Principals' Voices: Implications for School Leadership Preparation

ERIC Educational Resources Information Center

Jones, Cathy; Ovando, Martha; High, Cynthia

2009-01-01

This study was an attempt to add the voices of women to the discourse of school leadership. It focused on the nature of the middle school leadership experiences of three female middle school principals, their social interactions based on gender role expectations and their own leadership perspectives. Findings suggest that middle school leadership…

Sequoyah Foreign Language Translation System - Business Case Analysis

DTIC Science & Technology

2007-12-01

Interactive Natural Dialogue System (S-MINDS)..................................................................20 j. Voice Response Translator ( VRT ...20 Figure 8. U.S. Marine Military Policeman Demonstrating VRT (From: Ref. U.S...www.languagerealm.com/Files/usmc_mt_test_2004.pdf. 21 j. Voice Response Translator ( VRT ) The VRT is a S2S human language translation device that uses

Obligatory and facultative brain regions for voice-identity recognition

PubMed Central

Roswandowitz, Claudia; Kappes, Claudia; Obrig, Hellmuth; von Kriegstein, Katharina

2018-01-01

Abstract Recognizing the identity of others by their voice is an important skill for social interactions. To date, it remains controversial which parts of the brain are critical structures for this skill. Based on neuroimaging findings, standard models of person-identity recognition suggest that the right temporal lobe is the hub for voice-identity recognition. Neuropsychological case studies, however, reported selective deficits of voice-identity recognition in patients predominantly with right inferior parietal lobe lesions. Here, our aim was to work towards resolving the discrepancy between neuroimaging studies and neuropsychological case studies to find out which brain structures are critical for voice-identity recognition in humans. We performed a voxel-based lesion-behaviour mapping study in a cohort of patients (n = 58) with unilateral focal brain lesions. The study included a comprehensive behavioural test battery on voice-identity recognition of newly learned (voice-name, voice-face association learning) and familiar voices (famous voice recognition) as well as visual (face-identity recognition) and acoustic control tests (vocal-pitch and vocal-timbre discrimination). The study also comprised clinically established tests (neuropsychological assessment, audiometry) and high-resolution structural brain images. The three key findings were: (i) a strong association between voice-identity recognition performance and right posterior/mid temporal and right inferior parietal lobe lesions; (ii) a selective association between right posterior/mid temporal lobe lesions and voice-identity recognition performance when face-identity recognition performance was factored out; and (iii) an association of right inferior parietal lobe lesions with tasks requiring the association between voices and faces but not voices and names. The results imply that the right posterior/mid temporal lobe is an obligatory structure for voice-identity recognition, while the inferior parietal lobe is only a facultative component of voice-identity recognition in situations where additional face-identity processing is required. PMID:29228111

Obligatory and facultative brain regions for voice-identity recognition.

PubMed

Roswandowitz, Claudia; Kappes, Claudia; Obrig, Hellmuth; von Kriegstein, Katharina

2018-01-01

Recognizing the identity of others by their voice is an important skill for social interactions. To date, it remains controversial which parts of the brain are critical structures for this skill. Based on neuroimaging findings, standard models of person-identity recognition suggest that the right temporal lobe is the hub for voice-identity recognition. Neuropsychological case studies, however, reported selective deficits of voice-identity recognition in patients predominantly with right inferior parietal lobe lesions. Here, our aim was to work towards resolving the discrepancy between neuroimaging studies and neuropsychological case studies to find out which brain structures are critical for voice-identity recognition in humans. We performed a voxel-based lesion-behaviour mapping study in a cohort of patients (n = 58) with unilateral focal brain lesions. The study included a comprehensive behavioural test battery on voice-identity recognition of newly learned (voice-name, voice-face association learning) and familiar voices (famous voice recognition) as well as visual (face-identity recognition) and acoustic control tests (vocal-pitch and vocal-timbre discrimination). The study also comprised clinically established tests (neuropsychological assessment, audiometry) and high-resolution structural brain images. The three key findings were: (i) a strong association between voice-identity recognition performance and right posterior/mid temporal and right inferior parietal lobe lesions; (ii) a selective association between right posterior/mid temporal lobe lesions and voice-identity recognition performance when face-identity recognition performance was factored out; and (iii) an association of right inferior parietal lobe lesions with tasks requiring the association between voices and faces but not voices and names. The results imply that the right posterior/mid temporal lobe is an obligatory structure for voice-identity recognition, while the inferior parietal lobe is only a facultative component of voice-identity recognition in situations where additional face-identity processing is required. © The Author (2017). Published by Oxford University Press on behalf of the Guarantors of Brain.

Initial Progress Toward Development of a Voice-Based Computer-Delivered Motivational Intervention for Heavy Drinking College Students: An Experimental Study.

PubMed

Kahler, Christopher W; Lechner, William J; MacGlashan, James; Wray, Tyler B; Littman, Michael L

2017-06-28

Computer-delivered interventions have been shown to be effective in reducing alcohol consumption in heavy drinking college students. However, these computer-delivered interventions rely on mouse, keyboard, or touchscreen responses for interactions between the users and the computer-delivered intervention. The principles of motivational interviewing suggest that in-person interventions may be effective, in part, because they encourage individuals to think through and speak aloud their motivations for changing a health behavior, which current computer-delivered interventions do not allow. The objective of this study was to take the initial steps toward development of a voice-based computer-delivered intervention that can ask open-ended questions and respond appropriately to users' verbal responses, more closely mirroring a human-delivered motivational intervention. We developed (1) a voice-based computer-delivered intervention that was run by a human controller and that allowed participants to speak their responses to scripted prompts delivered by speech generation software and (2) a text-based computer-delivered intervention that relied on the mouse, keyboard, and computer screen for all interactions. We randomized 60 heavy drinking college students to interact with the voice-based computer-delivered intervention and 30 to interact with the text-based computer-delivered intervention and compared their ratings of the systems as well as their motivation to change drinking and their drinking behavior at 1-month follow-up. Participants reported that the voice-based computer-delivered intervention engaged positively with them in the session and delivered content in a manner consistent with motivational interviewing principles. At 1-month follow-up, participants in the voice-based computer-delivered intervention condition reported significant decreases in quantity, frequency, and problems associated with drinking, and increased perceived importance of changing drinking behaviors. In comparison to the text-based computer-delivered intervention condition, those assigned to voice-based computer-delivered intervention reported significantly fewer alcohol-related problems at the 1-month follow-up (incident rate ratio 0.60, 95% CI 0.44-0.83, P=.002). The conditions did not differ significantly on perceived importance of changing drinking or on measures of drinking quantity and frequency of heavy drinking. Results indicate that it is feasible to construct a series of open-ended questions and a bank of responses and follow-up prompts that can be used in a future fully automated voice-based computer-delivered intervention that may mirror more closely human-delivered motivational interventions to reduce drinking. Such efforts will require using advanced speech recognition capabilities and machine-learning approaches to train a program to mirror the decisions made by human controllers in the voice-based computer-delivered intervention used in this study. In addition, future studies should examine enhancements that can increase the perceived warmth and empathy of voice-based computer-delivered intervention, possibly through greater personalization, improvements in the speech generation software, and embodying the computer-delivered intervention in a physical form. ©Christopher W Kahler, William J Lechner, James MacGlashan, Tyler B Wray, Michael L Littman. Originally published in JMIR Mental Health (http://mental.jmir.org), 28.06.2017.

Fluid-acoustic interactions and their impact on pathological voiced speech

NASA Astrophysics Data System (ADS)

Erath, Byron D.; Zanartu, Matias; Peterson, Sean D.; Plesniak, Michael W.

2011-11-01

Voiced speech is produced by vibration of the vocal fold structures. Vocal fold dynamics arise from aerodynamic pressure loadings, tissue properties, and acoustic modulation of the driving pressures. Recent speech science advancements have produced a physiologically-realistic fluid flow solver (BLEAP) capable of prescribing asymmetric intraglottal flow attachment that can be easily assimilated into reduced order models of speech. The BLEAP flow solver is extended to incorporate acoustic loading and sound propagation in the vocal tract by implementing a wave reflection analog approach for sound propagation based on the governing BLEAP equations. This enhanced physiological description of the physics of voiced speech is implemented into a two-mass model of speech. The impact of fluid-acoustic interactions on vocal fold dynamics is elucidated for both normal and pathological speech through linear and nonlinear analysis techniques. Supported by NSF Grant CBET-1036280.

The interaction of criminal procedure and outcome.

PubMed

Laxminarayan, Malini; Pemberton, Antony

2014-01-01

Procedural quality is an important aspect of crime victims' experiences in criminal proceedings and consists of different dimensions. Two of these dimensions are procedural justice (voice) and interpersonal justice (respectful treatment). Social psychological research has suggested that both voice and respectful treatment are moderated by the impact of outcomes of justice procedures on individuals' reactions. To add to this research, we extend this assertion to the criminal justice context, examining the interaction between the assessment of procedural quality and outcome favorability with victim's trust in the legal system and self-esteem. Hierarchical regression analyses reveal that voice, respectful treatment and outcome favorability are predictive of trust in the legal system and self-esteem. Further investigation reveals that being treated with respect is only related to trust in the legal system when outcome favorability is high. Copyright © 2014 Elsevier Ltd. All rights reserved.

Interactive Voice/Web Response System in clinical research

PubMed Central

Ruikar, Vrishabhsagar

2016-01-01

Emerging technologies in computer and telecommunication industry has eased the access to computer through telephone. An Interactive Voice/Web Response System (IxRS) is one of the user friendly systems for end users, with complex and tailored programs at its backend. The backend programs are specially tailored for easy understanding of users. Clinical research industry has experienced revolution in methodologies of data capture with time. Different systems have evolved toward emerging modern technologies and tools in couple of decades from past, for example, Electronic Data Capture, IxRS, electronic patient reported outcomes, etc. PMID:26952178

Interactive Voice/Web Response System in clinical research.

PubMed

Ruikar, Vrishabhsagar

2016-01-01

Emerging technologies in computer and telecommunication industry has eased the access to computer through telephone. An Interactive Voice/Web Response System (IxRS) is one of the user friendly systems for end users, with complex and tailored programs at its backend. The backend programs are specially tailored for easy understanding of users. Clinical research industry has experienced revolution in methodologies of data capture with time. Different systems have evolved toward emerging modern technologies and tools in couple of decades from past, for example, Electronic Data Capture, IxRS, electronic patient reported outcomes, etc.

Designing interaction, voice, and inclusion in AAC research.

PubMed

Pullin, Graham; Treviranus, Jutta; Patel, Rupal; Higginbotham, Jeff

2017-09-01

The ISAAC 2016 Research Symposium included a Design Stream that examined timely issues across augmentative and alternative communication (AAC), framed in terms of designing interaction, designing voice, and designing inclusion. Each is a complex term with multiple meanings; together they represent challenging yet important frontiers of AAC research. The Design Stream was conceived by the four authors, researchers who have been exploring AAC and disability-related design throughout their careers, brought together by a shared conviction that designing for communication implies more than ensuring access to words and utterances. Each of these presenters came to AAC from a different background: interaction design, inclusive design, speech science, and social science. The resulting discussion among 24 symposium participants included controversies about the role of technology, tensions about independence and interdependence, and a provocation about taste. The paper concludes by proposing new directions for AAC research: (a) new interdisciplinary research could combine scientific and design research methods, as distant yet complementary as microanalysis and interaction design, (b) new research tools could seed accessible and engaging contextual research into voice within a social model of disability, and (c) new open research networks could support inclusive, international and interdisciplinary research.

Depressed mothers' infants are less responsive to faces and voices.

PubMed

Field, Tiffany; Diego, Miguel; Hernandez-Reif, Maria

2009-06-01

A review of our recent research suggests that infants of depressed mothers appeared to be less responsive to faces and voices as early as the neonatal period. At that time they have shown less orienting to the live face/voice stimulus of the Brazelton scale examiner and to their own and other infants' cry sounds. This lesser responsiveness has been attributed to higher arousal, less attentiveness and less "empathy." Their delayed heart rate decelerations to instrumental and vocal music sounds have also been ascribed to their delayed attention and/or slower processing. Later at 3-6 months they showed less negative responding to their mothers' non-contingent and still-face behavior, suggesting that they were more accustomed to this behavior in their mothers. The less responsive behavior of the depressed mothers was further compounded by their comorbid mood states of anger and anxiety and their difficult interaction styles including withdrawn or intrusive interaction styles and their later authoritarian parenting style. Pregnancy massage was effectively used to reduce prenatal depression and facilitate more optimal neonatal behavior. Interaction coaching was used during the postnatal period to help these dyads with their interactions and ultimately facilitate the infants' development.

Infants of Depressed Mothers Are Less Responsive To Faces and Voices: A Review

PubMed Central

Field, Tiffany; Diego, Miguel; Hernandez-Reif, Maria

2009-01-01

A review of our recent research suggests that infants of depressed mothers appeared to be less responsive to faces and voices as early as the neonatal period. At that time they have shown less orienting to the live face/voice stimulus of the Brazelton scale examiner and to their own and other infants’ cry sounds. This lesser responsiveness has been attributed to higher arousal, less attentiveness and less “empathy.” Their delayed heart rate decelerations to instrumental and vocal music sounds have also been ascribed to their delayed attention and/or slower processing. Later at 3–6 months they showed less negative responding to their mothers’ non-contingent and still-face behavior, suggesting that they were more accustomed to this behavior in their mothers. The less responsive behavior of the depressed mothers was further compounded by their comorbid mood states of anger and anxiety and their difficult interaction styles including withdrawn or intrusive interaction styles and their later authoritarian parenting style. Pregnancy massage was effectively used to reduce prenatal depression and facilitate more optimal neonatal behavior. Interaction coaching was used during the postnatal period to help these dyads with their interactions and ultimately facilitate the infants’ development PMID:19439359

Latencies in BOLD response during visual attention processes.

PubMed

Kellermann, Thilo; Reske, Martina; Jansen, Andreas; Satrapi, Peyman; Shah, N Jon; Schneider, Frank; Habel, Ute

2011-04-22

One well-investigated division of attentional processes focuses on alerting, orienting and executive control, which can be assessed applying the attentional network test (ANT). The goal of the present study was to add further knowledge about the temporal dynamics of relevant neural correlates. As a right hemispheric dominance for alerting and orienting has previously been reported for intrinsic but not for phasic alertness, we additionally addressed a potential impact of this lateralization of attention by employing a lateralized version of the ANT, capturing phasic alertness processes. Sixteen healthy subjects underwent event-related functional magnetic resonance imaging (fMRI) while performing the ANT. Analyses of BOLD magnitude replicated the engagement of a fronto-parietal network in the attentional subsystems. The amplitudes of the attentional contrasts interacted with visual field presentation in the sense that the thalamus revealed a greater involvement for spatially cued items presented in the left visual field. Comparisons of BOLD latencies in visual cortices, first, verified faster BOLD responses following contra-lateral stimulus presentation. Second and more importantly, we identified attention-modulated activation in secondary visual and anterior cingulate cortices. Results are discussed in terms of bottom-up and lateralization processes. Although intrinsic and phasic alertness are distinct cognitive processes, we propose that neural substrates of intrinsic alertness may be accessed by phasic alertness provided that the attention-dominant (i.e., the right) hemisphere is activated directly by a warning stimulus. Copyright © 2011 Elsevier B.V. All rights reserved.

Time-of-day effects on voice range profile performance in young, vocally untrained adult females.

PubMed

van Mersbergen, M R; Verdolini, K; Titze, I R

1999-12-01

Time-of-day effects on voice range profile performance were investigated in 20 vocally healthy untrained women between the ages of 18 and 35 years. Each subject produced two complete voice range profiles: one in the morning and one in the evening, about 36 hours apart. The order of morning and evening trials was counterbalanced across subjects. Dependent variables were (1) average minimum and average maximum intensity, (2) Voice range profile area and (3) center of gravity (median semitone pitch and median intensity). In this study, the results failed to reveal any clear evidence of time-of-day effects on voice range profile performance, for any of the dependent variables. However, a reliable interaction of time-of-day and trial order was obtained for average minimum intensity. Investigation of other subject populations, in particular trained vocalists or those with laryngeal lesions, is required for any generalization of the results.

How well does voice interaction work in space?

NASA Technical Reports Server (NTRS)

Morris, Randy B.; Whitmore, Mihriban; Adam, Susan C.

1993-01-01

The methods and results of an evaluation of the Voice Navigator software package are discussed. The first phase or ground phase of the study consisted of creating, or training, computer voice files of specific commands. This consisted of repeating each of six commands eight times. The files were then tested for recognition accuracy by the software aboard the microgravity aircraft. During the second phase, both voice training and testing were performed in microgravity. Inflight training was done due to problems encountered in phase one which were believed to be caused by ambient noise levels. Both quantitative and qualitative data were collected. Only one of the commands was found to offer consistently high recognition rates across subjects during the second phase.

Comparisons of voice onset time for trained male singers and male nonsingers during speaking and singing.

PubMed

McCrea, Christopher R; Morris, Richard J

2005-09-01

This study was designed to examine the temporal acoustic differences between male trained singers and nonsingers during speaking and singing across voiced and voiceless English stop consonants. Recordings were made of 5 trained singers and 5 nonsingers, and acoustically analyzed for voice onset time (VOT). A mixed analysis of variance showed that the male trained singers had significantly longer mean VOT than did the nonsingers during voiceless stop production. Sung productions of voiceless stops had significantly longer mean VOTs than did the spoken productions. No significant differences were observed for the voiced stops, nor were any interactions observed. These results indicated that vocal training and phonatory task have a significant influence on VOT.

Genius in the shadows

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lanouette, W.; Silard, B.

1993-01-01

This book is a well-researched, anecdote-rich biography of Leo Szilard, the inventive Hungarian physicist who pressed Einstein in 1939 to alert President Roosevelt to the possible wartime uses of atomic energy. Withdrawing from nuclear physics after the bombing of Hiroshima, Szilard studied biology, advocated international arms control, and wrote, among other things, [open quotes]The Voice of the Dolphins[close quotes], a utopian novel offering his ideas for reducing Cold War tensions. Based on research in the Leo Szilard papers, extensive interviews with Szilard's colleagues and friends, and on material and recollections provided by Szilard's younger brother, Bela Szilard, the book offersmore » a detailed picture of the physicist. The book provides a record of Szilard's life before 1939 and a thorough, readable account of a significant historical figure.« less

Processing of voices in deafness rehabilitation by auditory brainstem implant.

PubMed

Coez, Arnaud; Zilbovicius, Monica; Ferrary, Evelyne; Bouccara, Didier; Mosnier, Isabelle; Ambert-Dahan, Emmanuèle; Kalamarides, Michel; Bizaguet, Eric; Syrota, André; Samson, Yves; Sterkers, Olivier

2009-10-01

The superior temporal sulcus (STS) is specifically involved in processing the human voice. Profound acquired deafness by post-meningitis ossified cochlea and by bilateral vestibular schwannoma in neurofibromatosis type 2 patients are two indications for auditory brainstem implantation (ABI). In order to objectively measure the cortical voice processing of a group of ABI patients, we studied the activation of the human temporal voice areas (TVA) by PET H(2)(15)O, performed in a group of implanted deaf adults (n=7) with more than two years of auditory brainstem implant experience, with an intelligibility score average of 17%+/-17 [mean+/-SD]. Relative cerebral blood flow (rCBF) was measured in the three following conditions: during silence, while passive listening to human voice, and to non-voice stimuli. Compared to silence, the activations induced by voice and non-voice stimuli were bilaterally located in the superior temporal regions. However, compared to non-voice stimuli, the voice stimuli did not induce specific supplementary activation of the TVA along the STS. The comparison of ABI group with a normal-hearing controls group (n=7) showed that TVA activations were significantly enhanced among controls group. ABI allowed the transmission of sound stimuli to temporal brain regions but lacked transmitting the specific cues of the human voice to the TVA. Moreover, among groups, during silent condition, brain visual regions showed higher rCBF in ABI group, although temporal brain regions had higher rCBF in the controls group. ABI patients had consequently developed enhanced visual strategies to keep interacting with their environment.

Whose Voice Is It Anyway? Hushing and Hearing "Voices" in Speech and Language Therapy Interactions with People with Chronic Schizophrenia

ERIC Educational Resources Information Center

Walsh, Irene P.

2008-01-01

Background: Some people with schizophrenia are considered to have communication difficulties because of concomitant language impairment and/or because of suppressed or "unusual" communication skills due to the often-chronic nature and manifestation of the illness process. Conversations with a person with schizophrenia pose many pragmatic…

Monitoring daily affective symptoms and memory function using interactive voice response in outpatients receiving electroconvulsive therapy.

PubMed

Fazzino, Tera L; Rabinowitz, Terry; Althoff, Robert R; Helzer, John E

2013-12-01

Recently, there has been a gradual shift from inpatient-only electroconvulsive therapy (ECT) toward outpatient administration. Potential advantages include convenience and reduced cost. But providers do not have the same opportunity to monitor treatment response and adverse effects as they do with inpatients. This can obviate some of the potential advantages of outpatient ECT, such as tailoring treatment intervals to clinical response. Scheduling is typically algorithmic rather than empirically based. Daily monitoring through an automated telephone, interactive voice response (IVR), is a potential solution to this quandary. To test feasibility of clinical monitoring via IVR, we recruited 26 patients (69% female; mean age, 51 years) receiving outpatient ECT to make daily IVR reports of affective symptoms and subjective memory for 60 days. The IVR also administered a word recognition task daily to test objective memory. Every seventh day, a longer IVR weekly interview included questions about suicidal ideation. Overall daily call compliance was high (mean, 80%). Most participants (96%) did not consider the calls to be time-consuming. Longitudinal regression analysis using generalized estimating equations revealed that participant objective memory functioning significantly improved during the study (P < 0.05). Of 123 weekly IVR interviews, 41 reports (33%) in 14 patients endorsed suicidal ideation during the previous week. Interactive voice response monitoring of outpatient ECT can provide more detailed clinical information than standard outpatient ECT assessment. Interactive voice response data offer providers a comprehensive, longitudinal picture of patient treatment response and adverse effects as a basis for treatment scheduling and ongoing clinical management.

Prediction of Vigilant Attention and Cognitive Performance Using Self-Reported Alertness, Circadian Phase, Hours since Awakening, and Accumulated Sleep Loss

PubMed Central

Bermudez, Eduardo B.; Klerman, Elizabeth B.; Czeisler, Charles A.; Cohen, Daniel A.; Wyatt, James K.; Phillips, Andrew J. K.

2016-01-01

Sleep restriction causes impaired cognitive performance that can result in adverse consequences in many occupational settings. Individuals may rely on self-perceived alertness to decide if they are able to adequately perform a task. It is therefore important to determine the relationship between an individual’s self-assessed alertness and their objective performance, and how this relationship depends on circadian phase, hours since awakening, and cumulative lost hours of sleep. Healthy young adults (aged 18–34) completed an inpatient schedule that included forced desynchrony of sleep/wake and circadian rhythms with twelve 42.85-hour “days” and either a 1:2 (n = 8) or 1:3.3 (n = 9) ratio of sleep-opportunity:enforced-wakefulness. We investigated whether subjective alertness (visual analog scale), circadian phase (melatonin), hours since awakening, and cumulative sleep loss could predict objective performance on the Psychomotor Vigilance Task (PVT), an Addition/Calculation Test (ADD) and the Digit Symbol Substitution Test (DSST). Mathematical models that allowed nonlinear interactions between explanatory variables were evaluated using the Akaike Information Criterion (AIC). Subjective alertness was the single best predictor of PVT, ADD, and DSST performance. Subjective alertness alone, however, was not an accurate predictor of PVT performance. The best AIC scores for PVT and DSST were achieved when all explanatory variables were included in the model. The best AIC score for ADD was achieved with circadian phase and subjective alertness variables. We conclude that subjective alertness alone is a weak predictor of objective vigilant or cognitive performance. Predictions can, however, be improved by knowing an individual’s circadian phase, current wake duration, and cumulative sleep loss. PMID:27019198

Developmental trends in the interaction between auditory and linguistic processing.

PubMed

Jerger, S; Pirozzolo, F; Jerger, J; Elizondo, R; Desai, S; Wright, E; Reynosa, R

1993-09-01

The developmental course of multidimensional speech processing was examined in 80 children between 3 and 6 years of age and in 60 adults between 20 and 86 years of age. Processing interactions were assessed with a speeded classification task (Garner, 1974a), which required the subjects to attend selectively to the voice dimension while ignoring the linguistic dimension, and vice versa. The children and adults exhibited both similarities and differences in the patterns of processing dependencies. For all ages, performance for each dimension was slower in the presence of variation in the irrelevant dimension; irrelevant variation in the voice dimension disrupted performance more than irrelevant variation in the linguistic dimension. Trends in the degree of interference, on the other hand, showed significant differences between dimensions as a function of age. Whereas the degree of interference for the voice-dimension-relevant did not show significant age-related change, the degree of interference for the word-dimension-relevant declined significantly with age in a linear as well as a quadratic manner. A major age-related change in the relation between dimensions was that word processing, relative to voice-gender processing, required significantly more time in the children than in the adults. Overall, the developmental course characterizing multidimensional speech processing evidenced more pronounced change when the linguistic dimension, rather than the voice dimension, was relevant.

Design of decision support interventions for medication prescribing.

PubMed

Horsky, Jan; Phansalkar, Shobha; Desai, Amrita; Bell, Douglas; Middleton, Blackford

2013-06-01

Describe optimal design attributes of clinical decision support (CDS) interventions for medication prescribing, emphasizing perceptual, cognitive and functional characteristics that improve human-computer interaction (HCI) and patient safety. Findings from published reports on success, failures and lessons learned during implementation of CDS systems were reviewed and interpreted with regard to HCI and software usability principles. We then formulated design recommendations for CDS alerts that would reduce unnecessary workflow interruptions and allow clinicians to make informed decisions quickly, accurately and without extraneous cognitive and interactive effort. Excessive alerting that tends to distract clinicians rather than provide effective CDS can be reduced by designing only high severity alerts as interruptive dialog boxes and less severe warnings without explicit response requirement, by curating system knowledge bases to suppress warnings with low clinical utility and by integrating contextual patient data into the decision logic. Recommended design principles include parsimonious and consistent use of color and language, minimalist approach to the layout of information and controls, the use of font attributes to convey hierarchy and visual prominence of important data over supporting information, the inclusion of relevant patient data in the context of the alert and allowing clinicians to respond with one or two clicks. Although HCI and usability principles are well established and robust, CDS and EHR system interfaces rarely conform to the best known design conventions and are seldom conceived and designed well enough to be truly versatile and dependable tools. These relatively novel interventions still require careful monitoring, research and analysis of its track record to mature. Clarity and specificity of alert content and optimal perceptual and cognitive attributes, for example, are essential for providing effective decision support to clinicians. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Short-Term Effect of Two Semi-Occluded Vocal Tract Training Programs on the Vocal Quality of Future Occupational Voice Users: "Resonant Voice Training Using Nasal Consonants" Versus "Straw Phonation".

PubMed

Meerschman, Iris; Van Lierde, Kristiane; Peeters, Karen; Meersman, Eline; Claeys, Sofie; D'haeseleer, Evelien

2017-09-18

The purpose of this study was to determine the short-term effect of 2 semi-occluded vocal tract training programs, "resonant voice training using nasal consonants" versus "straw phonation," on the vocal quality of vocally healthy future occupational voice users. A multigroup pretest-posttest randomized control group design was used. Thirty healthy speech-language pathology students with a mean age of 19 years (range: 17-22 years) were randomly assigned into a resonant voice training group (practicing resonant exercises across 6 weeks, n = 10), a straw phonation group (practicing straw phonation across 6 weeks, n = 10), or a control group (receiving no voice training, n = 10). A voice assessment protocol consisting of both subjective (questionnaire, participant's self-report, auditory-perceptual evaluation) and objective (maximum performance task, aerodynamic assessment, voice range profile, acoustic analysis, acoustic voice quality index, dysphonia severity index) measurements and determinations was used to evaluate the participants' voice pre- and posttraining. Groups were compared over time using linear mixed models and generalized linear mixed models. Within-group effects of time were determined using post hoc pairwise comparisons. No significant time × group interactions were found for any of the outcome measures, indicating no differences in evolution over time among the 3 groups. Within-group effects of time showed a significant improvement in dysphonia severity index in the resonant voice training group, and a significant improvement in the intensity range in the straw phonation group. Results suggest that the semi-occluded vocal tract training programs using resonant voice training and straw phonation may have a positive impact on the vocal quality and vocal capacities of future occupational voice users. The resonant voice training caused an improved dysphonia severity index, and the straw phonation training caused an expansion of the intensity range in this population.

Academic voice: On feminism, presence, and objectivity in writing.

PubMed

Mitchell, Kim M

2017-10-01

Academic voice is an oft-discussed, yet variably defined concept, and confusion exists over its meaning, evaluation, and interpretation. This paper will explore perspectives on academic voice and counterarguments to the positivist origins of objectivity in academic writing. While many epistemological and methodological perspectives exist, the feminist literature on voice is explored here as the contrary position. From the feminist perspective, voice is a socially constructed concept that cannot be separated from the experiences, emotions, and identity of the writer and, thus, constitutes a reflection of an author's way of knowing. A case study of how author presence can enhance meaning in text is included. Subjective experience is imperative to a practice involving human interaction. Nursing practice, our intimate involvement in patient's lives, and the nature of our research are not value free. A view is presented that a visible presence of an author in academic writing is relevant to the nursing discipline. The continued valuing of an objective, colorless academic voice has consequences for student writers and the faculty who teach them. Thus, a strategically used multivoiced writing style is warranted. © 2017 John Wiley & Sons Ltd.

Performance, Accuracy, Data Delivery, and Feedback Methods in Order Selection: A Comparison of Voice, Handheld, and Paper Technologies

ERIC Educational Resources Information Center

Ludwig, Timothy D.; Goomas, David T.

2007-01-01

Field study was conducted in auto-parts after-market distribution centers where selectors used handheld computers to receive instructions and feedback about their product selection process. A wireless voice-interaction technology was then implemented in a multiple baseline fashion across three departments of a warehouse (N = 14) and was associated…

Listening to Voices at the Educational Frontline: New Administrators' Experiences of the Transition from Teacher to Vice-Principal

ERIC Educational Resources Information Center

Armstrong, Denise E.

2015-01-01

This qualitative study explored the transition from teaching to administration through the voices of four novice vice-principals. An integrative approach was used to capture the interaction between new vice-principals, their external contexts, and the resulting leadership outcomes. The data revealed that in spite of these new administrators'…

Voice/Data Integration in Mobile Radio Networks: Overview and Future Research Directions

DTIC Science & Technology

1989-09-30

degradation in interactive speech when delays are less than about 300 ms (Gold 1977; Gitman and Frank, 1978). When delays are larger (between 300 ms and 1.5...222-267. Gitman , 1. and H. Frank (1978), "Economic Analysis of Integrated Voice and Data Networks: A Case Study," Proc. IEEE 66 1549-1570. Glynn, P.W

On Pitch Lowering Not Linked to Voicing: Nguni and Shona Group Depressors

ERIC Educational Resources Information Center

Downing, Laura J.

2009-01-01

This paper tests how well two theories of tone-segment interactions account for the lowering effect of so-called depressor consonants on tone in languages of the Shona and Nguni groups of Southern Bantu. I show that single source theories, which propose that pitch lowering is inextricably linked to consonant voicing, as they are reflexes of the…

Elements of Collaborative Discussion and Shared Problem Solving in a Voice-Enhanced Multiplayer Game

ERIC Educational Resources Information Center

Bluemink, Johanna; Jarvela, Sanna

2011-01-01

This study focuses on investigating the nature of small-group collaborative interaction in a voice-enhanced multiplayer game called "eScape". The aim was to analyse the elements of groups' collaborative discussion and to explore the nature of the players' shared problem solving activity during the solution critical moments in the game. The data…

English Voicing in Dimensional Theory*

PubMed Central

Iverson, Gregory K.; Ahn, Sang-Cheol

2007-01-01

Assuming a framework of privative features, this paper interprets two apparently disparate phenomena in English phonology as structurally related: the lexically specific voicing of fricatives in plural nouns like wives or thieves and the prosodically governed “flapping” of medial /t/ (and /d/) in North American varieties, which we claim is itself not a rule per se, but rather a consequence of the laryngeal weakening of fortis /t/ in interaction with speech-rate determined segmental abbreviation. Taking as our point of departure the Dimensional Theory of laryngeal representation developed by Avery & Idsardi (2001), along with their assumption that English marks voiceless obstruents but not voiced ones (Iverson & Salmons 1995), we find that an unexpected connection between fricative voicing and coronal flapping emerges from the interplay of familiar phonemic and phonetic factors in the phonological system. PMID:18496590

Effects of cognitive appraisal and mental workload factors on performance in an arithmetic task.

PubMed

Galy, Edith; Mélan, Claudine

2015-12-01

We showed in a previous study an additive interaction between intrinsic and extraneous cognitive loads and of participants' alertness in an 1-back working memory task. The interaction between intrinsic and extraneous cognitive loads was only observed when participants' alertness was low (i.e. in the morning). As alertness is known to reflect an individual's general functional state, we suggested that the working memory capacity available for germane cognitive load depends on a participant's functional state, in addition to intrinsic and extraneous loads induced by the task and task conditions. The relationships between the different load types and their assessment by specific load measures gave rise to a modified cognitive load model. The aim of the present study was to complete the model by determining to what extent and at what processing level an individual's characteristics intervene in order to implement efficient strategies in a working memory task. Therefore, the study explored participants' cognitive appraisal of the situation in addition to the load factors considered previously-task difficulty, time pressure and alertness. Each participant performed a mental arithmetic task in four different cognitive load conditions (crossover of two task difficulty conditions and of two time pressure conditions), both while their alertness was low (9 a.m.) and high (4 p.m.). Results confirmed an additive effect of task difficulty and time pressure, previously reported in the 1-back memory task, thereby lending further support to the modified cognitive load model. Further, in the high intrinsic and extraneous load condition, performance was reduced on the morning session (i.e. when alertness was low) on one hand, and in those participants' having a threat appraisal of the situation on the other hand. When these factors were included into the analysis, a performance drop occurred in the morning irrespective of cognitive appraisal, and with threat appraisal in the afternoon (i.e. high alertness). Taken together, these findings indicate that mental overload can be the result of a combination of subject-related characteristics, including alertness and cognitive appraisal, in addition to well-documented task-related components (intrinsic and extraneous load). As the factors investigated in the study are known to be critically involved in a number of real job-activities, the findings suggest that solutions designed to reduce incidents and accidents at work should consider the situation from a global perspective, including individual characteristics, task parameters, and work organization, rather than dealing with each factor separately.

Increasing the Interaction with Distant Learners on an Interactive Telecommunications System.

ERIC Educational Resources Information Center

Schlenker, Jon

1994-01-01

Suggests a variety of ways to increase interaction with distance learners on an interactive telecommunications system, based on experiences at the University of Maine at Augusta. Highlights include establishing the proper environment; telephone systems; voice mail; fax; electronic mail; computer conferencing; postal mail; printed materials; and…

Interactions between observer and stimuli fertility status: Endocrine and perceptual responses to intrasexual vocal fertility cues.

PubMed

Ostrander, Grant M; Pipitone, R Nathan; Shoup-Knox, Melanie L

2018-02-01

Both men and women find female voices more attractive at higher fertility times in the menstrual cycle, suggesting the voice is a cue to fertility and/or hormonal status. Preference for fertile females' voices provides males with an obvious reproduction advantage, however the advantage for female listeners is less clear. One possibility is that attention to the fertility status of potential rivals may enable women to enhance their own reproductive strategies through intrasexual competition. If so, the response to having high fertility voices should include hormonal changes that promote competitive behavior. Furthermore, attention and response to such cues should vary as a function of the observer's own fertility, which influences her ability to compete for mates. The current study monitored variation in cortisol and testosterone levels in response to evaluating the attractiveness of voices of other women. All 33 participants completed this task once during ovulation then again during the luteal phase. The voice stimuli were recorded from naturally cycling women at both high and low fertility, and from women using hormonal birth control. We found that listeners rated high fertility voices as more attractive compared to low fertility, with the effect being stronger when listeners were ovulating. Testosterone was elevated following voice ratings suggesting threat detection or the anticipation of competition, but no stress response was found. Copyright © 2017 Elsevier Inc. All rights reserved.

DAIDALUS: Detect and Avoid Alerting Logic for Unmanned Systems

NASA Technical Reports Server (NTRS)

Munoz, Cesar; Narkawicz, Anthony; Hagen, George; Upchurch, Jason; Dutle, Aaron; Consiglio, Maria; Chamberlain, James

2015-01-01

This paper presents DAIDALUS (Detect and Avoid Alerting Logic for Unmanned Systems), a reference implementation of a detect and avoid concept intended to support the integration of Unmanned Aircraft Systems into civil airspace. DAIDALUS consists of self-separation and alerting algorithms that provide situational awareness to UAS remote pilots. These algorithms have been formally specified in a mathematical notation and verified for correctness in an interactive theorem prover. The software implementation has been verified against the formal models and validated against multiple stressing cases jointly developed by the US Air Force Research Laboratory, MIT Lincoln Laboratory, and NASA. The DAIDALUS reference implementation is currently under consideration for inclusion in the appendices to the Minimum Operational Performance Standards for Unmanned Aircraft Systems presently being developed by RTCA Special Committee 228.

Perceptual fluency and judgments of vocal aesthetics and stereotypicality.

PubMed

Babel, Molly; McGuire, Grant

2015-05-01

Research has shown that processing dynamics on the perceiver's end determine aesthetic pleasure. Specifically, typical objects, which are processed more fluently, are perceived as more attractive. We extend this notion of perceptual fluency to judgments of vocal aesthetics. Vocal attractiveness has traditionally been examined with respect to sexual dimorphism and the apparent size of a talker, as reconstructed from the acoustic signal, despite evidence that gender-specific speech patterns are learned social behaviors. In this study, we report on a series of three experiments using 60 voices (30 females) to compare the relationship between judgments of vocal attractiveness, stereotypicality, and gender categorization fluency. Our results indicate that attractiveness and stereotypicality are highly correlated for female and male voices. Stereotypicality and categorization fluency were also correlated for male voices, but not female voices. Crucially, stereotypicality and categorization fluency interacted to predict attractiveness, suggesting the role of perceptual fluency is present, but nuanced, in judgments of human voices. © 2014 Cognitive Science Society, Inc.

Human vocal attractiveness as signaled by body size projection.

PubMed

Xu, Yi; Lee, Albert; Wu, Wing-Li; Liu, Xuan; Birkholz, Peter

2013-01-01

Voice, as a secondary sexual characteristic, is known to affect the perceived attractiveness of human individuals. But the underlying mechanism of vocal attractiveness has remained unclear. Here, we presented human listeners with acoustically altered natural sentences and fully synthetic sentences with systematically manipulated pitch, formants and voice quality based on a principle of body size projection reported for animal calls and emotional human vocal expressions. The results show that male listeners preferred a female voice that signals a small body size, with relatively high pitch, wide formant dispersion and breathy voice, while female listeners preferred a male voice that signals a large body size with low pitch and narrow formant dispersion. Interestingly, however, male vocal attractiveness was also enhanced by breathiness, which presumably softened the aggressiveness associated with a large body size. These results, together with the additional finding that the same vocal dimensions also affect emotion judgment, indicate that humans still employ a vocal interaction strategy used in animal calls despite the development of complex language.

Digital signal processing algorithms for automatic voice recognition

NASA Technical Reports Server (NTRS)

Botros, Nazeih M.

1987-01-01

The current digital signal analysis algorithms are investigated that are implemented in automatic voice recognition algorithms. Automatic voice recognition means, the capability of a computer to recognize and interact with verbal commands. The digital signal is focused on, rather than the linguistic, analysis of speech signal. Several digital signal processing algorithms are available for voice recognition. Some of these algorithms are: Linear Predictive Coding (LPC), Short-time Fourier Analysis, and Cepstrum Analysis. Among these algorithms, the LPC is the most widely used. This algorithm has short execution time and do not require large memory storage. However, it has several limitations due to the assumptions used to develop it. The other 2 algorithms are frequency domain algorithms with not many assumptions, but they are not widely implemented or investigated. However, with the recent advances in the digital technology, namely signal processors, these 2 frequency domain algorithms may be investigated in order to implement them in voice recognition. This research is concerned with real time, microprocessor based recognition algorithms.

Establishing the "Fit" between the Patient and the Therapy: The Role of Patient Gender in Selecting Psychological Therapy for Distressing Voices.

PubMed

Hayward, Mark; Slater, Luke; Berry, Katherine; Perona-Garcelán, Salvador

2016-01-01

The experience of hearing distressing voices has recently attracted much attention in the literature on psychological therapies. A new "wave" of therapies is considering voice hearing experiences within a relational framework. However, such therapies may have limited impact if they do not precisely target key psychological variables within the voice hearing experience and/or ensure there is a "fit" between the profile of the hearer and the therapy (the so-called "What works for whom" debate). Gender is one aspect of both the voice and the hearer (and the interaction between the two) that may be influential when selecting an appropriate therapy, and is an issue that has thus far received little attention within the literature. The existing literature suggests that some differences in voice hearing experience are evident between the genders. Furthermore, studies exploring interpersonal relating in men and women more generally suggest differences within intimate relationships in terms of distancing and emotionality. The current study utilized data from four published studies to explore the extent to which these gender differences in social relating may extend to relating within the voice hearing experience. The findings suggest a role for gender as a variable that can be considered when identifying an appropriate psychological therapy for a given hearer.

‘Inner voices’: the cerebral representation of emotional voice cues described in literary texts

PubMed Central

Kreifelts, Benjamin; Gößling-Arnold, Christina; Wertheimer, Jürgen; Wildgruber, Dirk

2014-01-01

While non-verbal affective voice cues are generally recognized as a crucial behavioral guide in any day-to-day conversation their role as a powerful source of information may extend well beyond close-up personal interactions and include other modes of communication such as written discourse or literature as well. Building on the assumption that similarities between the different ‘modes’ of voice cues may not only be limited to their functional role but may also include cerebral mechanisms engaged in the decoding process, the present functional magnetic resonance imaging study aimed at exploring brain responses associated with processing emotional voice signals described in literary texts. Emphasis was placed on evaluating ‘voice’ sensitive as well as task- and emotion-related modulations of brain activation frequently associated with the decoding of acoustic vocal cues. Obtained findings suggest that several similarities emerge with respect to the perception of acoustic voice signals: results identify the superior temporal, lateral and medial frontal cortex as well as the posterior cingulate cortex and cerebellum to contribute to the decoding process, with similarities to acoustic voice perception reflected in a ‘voice’-cue preference of temporal voice areas as well as an emotion-related modulation of the medial frontal cortex and a task-modulated response of the lateral frontal cortex. PMID:24396008

Novel sublingual low-dose zolpidem tablet reduces latency to sleep onset following spontaneous middle-of-the-night awakening in insomnia in a randomized, double-blind, placebo-controlled, outpatient study.

PubMed

Roth, Thomas; Krystal, Andrew; Steinberg, Frank J; Singh, Nikhilesh N; Moline, Margaret

2013-02-01

To evaluate efficacy and safety of 3.5-mg zolpidem tartrate sublingual tablets (ZST) on latency to sleep onset after middle-of-the-night (MOTN) awakenings in patients with insomnia characterized by difficulty returning to sleep after MOTN awakenings. Multicenter randomized, double-blind, placebo-controlled, parallel-group. Outpatient. There were 295 adults (median age 43 y; 68.1% female) with primary insomnia and difficulty returning to sleep after MOTN awakenings (three or more MOTN awakenings/wk during screening). After a 2-wk, single-blind placebo eligibility period, participants were randomized 1:1 to as-needed MOTN dosing with 3.5 mg ZST or placebo for 28 nights. An interactive voice response system determined if the study drug could be taken and recorded sleep/wake efficacy measures. ZST significantly (P < 0.0001) decreased latency to sleep onset over 4 wk (baseline 68.1 min; ZST 38.2 min) compared with placebo (baseline 69.4 min; placebo 56.4 min). Ratings of morning sleepiness/alertness significantly (P = 0.0041) favored the ZST group on nights medication was taken but not on other nights. Participants in the ZST group took the study drug on 62% of nights during the 4 wk; members of the placebo group took study medication on 64% of nights. Adverse events were generally mild and at the same rate (19.3% of participants) in both groups. There were no treatment-related serious adverse events (SAEs), and one adverse event-related study discontinuation from the placebo group. Dosing/week did not increase across the study. 3.5 mg ZST used as needed significantly reduced latency to return to sleep in comparison with placebo in these patients with insomnia. Sleep quality was improved, and morning sleepiness/alertness scores also improved. ZST was well tolerated. These data demonstrate the utility of a sleep-promoting agent when used as needed in the MOTN. NCT00466193: "A Study of Zolpidem Tartrate Tablet in Adult Patients with Insomnia" http://www.clinicaltrials.gov/ct2/show/NCT00466193?spons=%22Transcept+Pharmaceuticals%22&spons_ex=Y&rank=2

Recommendations for Selecting Drug-Drug Interactions for Clinical Decision Support

PubMed Central

Tilson, Hugh; Hines, Lisa E.; McEvoy, Gerald; Weinstein, David M.; Hansten, Philip D.; Matuszewski, Karl; le Comte, Marianne; Higby-Baker, Stefanie; Hanlon, Joseph T.; Pezzullo, Lynn; Vieson, Kathleen; Helwig, Amy L.; Huang, Shiew-Mei; Perre, Anthony; Bates, David W.; Poikonen, John; Wittie, Michael A.; Grizzle, Amy J.; Brown, Mary; Malone, Daniel C.

2016-01-01

Purpose To recommend principles for including drug-drug interactions (DDIs) in clinical decision support. Methods A conference series was conducted to improve clinical decision support (CDS) for DDIs. The Content Workgroup met monthly by webinar from January 2013 to February 2014, with two in-person meetings to reach consensus. The workgroup consisted of 20 experts in pharmacology, drug information, and CDS from academia, government agencies, health information (IT) vendors, and healthcare organizations. Workgroup members addressed four key questions: (1) What process should be used to develop and maintain a standard set of DDIs?; (2) What information should be included in a knowledgebase of standard DDIs?; (3) Can/should a list of contraindicated drug pairs be established?; and (4) How can DDI alerts be more intelligently filtered? Results To develop and maintain a standard set of DDIs for CDS in the United States, we recommend a transparent, systematic, and evidence-driven process with graded recommendations by a consensus panel of experts and oversight by a national organization. We outline key DDI information needed to help guide clinician decision-making. We recommend judicious classification of DDIs as contraindicated, as only a small set of drug combinations are truly contraindicated. Finally, we recommend more research to identify methods to safely reduce repetitive and less relevant alerts. Conclusion A systematic ongoing process is necessary to select DDIs for alerting clinicians. We anticipate that our recommendations can lead to consistent and clinically relevant content for interruptive DDIs, and thus reduce alert fatigue and improve patient safety. PMID:27045070

"You Know Doctor, I Need to Tell You Something": A Discourse Analytical Study of Patients' Voices in the Medical Consultation

ERIC Educational Resources Information Center

Cordella, Marisa

2004-01-01

Most studies in the area of doctor-patient communication focus on the talk that doctors perform during the consultation, leaving under-researched the discourse developed by patients. This article deconstructs and identifies the functions and forms of the voices (i.e. specific forms of talk) that Chilean patients employ in their interactions with…

A unified coding strategy for processing faces and voices

PubMed Central

Yovel, Galit; Belin, Pascal

2013-01-01

Both faces and voices are rich in socially-relevant information, which humans are remarkably adept at extracting, including a person's identity, age, gender, affective state, personality, etc. Here, we review accumulating evidence from behavioral, neuropsychological, electrophysiological, and neuroimaging studies which suggest that the cognitive and neural processing mechanisms engaged by perceiving faces or voices are highly similar, despite the very different nature of their sensory input. The similarity between the two mechanisms likely facilitates the multi-modal integration of facial and vocal information during everyday social interactions. These findings emphasize a parsimonious principle of cerebral organization, where similar computational problems in different modalities are solved using similar solutions. PMID:23664703

Correlated colour temperature of morning light influences alertness and body temperature.

PubMed

Te Kulve, Marije; Schlangen, Luc; Schellen, Lisje; Souman, Jan L; van Marken Lichtenbelt, Wouter

2018-03-01

Though several studies have reported human alertness to be affected by the intensity and spectral composition of ambient light, the mechanism behind this effect is still largely unclear, especially for daytime exposure. Alerting effects of nocturnal light exposure are correlated with melatonin suppression, but melatonin levels are generally low during the day. The aim of this study was to explore the alerting effect of light in the morning for different correlated colour temperature (CCT) values, as well as its interaction with ambient temperature. Body temperature and perceived comfort were included in the study as possible mediating factors. In a randomized crossover design, 16 healthy females participated in two sessions, once under 2700K and once under 6500K light (both 55lx). Each session consisted of a baseline, a cool, a neutral and a warm thermal environment. Alertness as measured in a reaction time task was lower for the 6500K exposure, while subjective sleepiness was not affected by CCT. Also, core body temperature was higher under 6500K. Skin temperature parameters and perceived comfort were positively correlated with subjective sleepiness. Reaction time correlated with heat loss, but this association did not explain why the reaction time was improved for 2700K. Copyright © 2017 Elsevier Inc. All rights reserved.

Emotional self-other voice processing in schizophrenia and its relationship with hallucinations: ERP evidence.

PubMed

Pinheiro, Ana P; Rezaii, Neguine; Rauber, Andréia; Nestor, Paul G; Spencer, Kevin M; Niznikiewicz, Margaret

2017-09-01

Abnormalities in self-other voice processing have been observed in schizophrenia, and may underlie the experience of hallucinations. More recent studies demonstrated that these impairments are enhanced for speech stimuli with negative content. Nonetheless, few studies probed the temporal dynamics of self versus nonself speech processing in schizophrenia and, particularly, the impact of semantic valence on self-other voice discrimination. In the current study, we examined these questions, and additionally probed whether impairments in these processes are associated with the experience of hallucinations. Fifteen schizophrenia patients and 16 healthy controls listened to 420 prerecorded adjectives differing in voice identity (self-generated [SGS] versus nonself speech [NSS]) and semantic valence (neutral, positive, and negative), while EEG data were recorded. The N1, P2, and late positive potential (LPP) ERP components were analyzed. ERP results revealed group differences in the interaction between voice identity and valence in the P2 and LPP components. Specifically, LPP amplitude was reduced in patients compared with healthy subjects for SGS and NSS with negative content. Further, auditory hallucinations severity was significantly predicted by LPP amplitude: the higher the SAPS "voices conversing" score, the larger the difference in LPP amplitude between negative and positive NSS. The absence of group differences in the N1 suggests that self-other voice processing abnormalities in schizophrenia are not primarily driven by disrupted sensory processing of voice acoustic information. The association between LPP amplitude and hallucination severity suggests that auditory hallucinations are associated with enhanced sustained attention to negative cues conveyed by a nonself voice. © 2017 Society for Psychophysiological Research.

Voice - How humans communicate?

PubMed

Tiwari, Manjul; Tiwari, Maneesha

2012-01-01

Voices are important things for humans. They are the medium through which we do a lot of communicating with the outside world: our ideas, of course, and also our emotions and our personality. The voice is the very emblem of the speaker, indelibly woven into the fabric of speech. In this sense, each of our utterances of spoken language carries not only its own message but also, through accent, tone of voice and habitual voice quality it is at the same time an audible declaration of our membership of particular social regional groups, of our individual physical and psychological identity, and of our momentary mood. Voices are also one of the media through which we (successfully, most of the time) recognize other humans who are important to us-members of our family, media personalities, our friends, and enemies. Although evidence from DNA analysis is potentially vastly more eloquent in its power than evidence from voices, DNA cannot talk. It cannot be recorded planning, carrying out or confessing to a crime. It cannot be so apparently directly incriminating. As will quickly become evident, voices are extremely complex things, and some of the inherent limitations of the forensic-phonetic method are in part a consequence of the interaction between their complexity and the real world in which they are used. It is one of the aims of this article to explain how this comes about. This subject have unsolved questions, but there is no direct way to present the information that is necessary to understand how voices can be related, or not, to their owners.

Interactions between traditional Chinese medicine and western drugs in Taiwan: A population-based study.

PubMed

Chen, Kuan Chen; Lu, Richard; Iqbal, Usman; Hsu, Ko-Ching; Chen, Bi-Li; Nguyen, Phung-Anh; Yang, Hsuan-Chia; Huang, Chih-Wei; Li, Yu-Chuan Jack; Jian, Wen-Shan; Tsai, Shin-Han

2015-12-01

Drug-drug interactions have long been an active research area in clinical medicine. In Taiwan, however, the widespread use of traditional Chinese medicines (TCM) presents additional complexity to the topic. Therefore, it is important to see the interaction between traditional Chinese and western medicine. (1) To create a comprehensive database of multi-herb/western drug interactions indexed according to the ways in which physicians actually practice and (2) to measure this database's impact on the detection of adverse effects between traditional Chinese medicine compounds and western medicines. First, a multi-herb/western medicine drug interactions database was created by separating each TCM compound into its constituent herbs. Each individual herb was then checked against an existing single-herb/western drug interactions database. The data source comes from the National Health Insurance research database, which spans the years 1998-2011. This study estimated the interaction prevalence rate and further separated the rates according to patient characteristics, distribution by county, and hospital accreditation levels. Finally, this new database was integrated into a computer order entry module of the electronic medical records system of a regional teaching hospital. The effects it had were measured for two months. The most commonly interacting Chinese herbs were Ephedrae Herba and Angelicae Sinensis Radix/Angelicae Dahuricae Radix. Ephedrae Herba contains active ingredients similar to in ephedrine. 15 kinds of traditional Chinese medicine compounds contain Ephedrae Herba. Angelicae Sinensis Radix and Angelicae Dahuricae Radix contain ingredients similar to coumarin, a blood thinner. 9 kinds of traditional Chinese medicine compounds contained Angelicae Sinensis Radix/Angelicae Dahuricae Radix. In the period from 1998 to 2011, the prevalence of herb-drug interactions related to Ephedrae Herba was 0.18%. The most commonly prescribed traditional Chinese compounds were MA SHING GAN SHYR TANG (23.1%), followed by SHEAU CHING LONG TANG (15.5%) and DINQ CHUAN TANG (13.2%). The prevalence of herb-drug interactions related to Angelicae Sinensis Radix, Angelicae Dahuricae Radix was 4.59%. The most common traditional Chinese compound formula were TSANG EEL SAAN (32%), followed by HUOH SHIANG JENQ CHIH SAAN (31.4%) and SHY WUH TANG (10.7%). Once the multi-herb drug interaction database was deployed in a hospital system, there were 480 prescriptions that indicated a TCM-western drug interaction. Physicians were alerted 24 times during two months. These alerts resulted in a prescription change four times (16.7%). Due to the unique cultural factors that have resulted in widespread acceptance of both western and traditional Chinese medicine, Taiwan stands well positioned to report on the prevalence of interactions between western drugs and traditional Chinese medicine and devise ways to reduce their incidence. This study built a multi-herb/western drug interactions database, embedded inside a hospital clinical information system, and then examined the effects that drug interaction alerts had on clinician prescribing behaviour. The results demonstrated that western drug/traditional Chinese medicine interactions are prevalent and that western-trained physicians tend to change their prescribing behaviour more than traditional Chinese medicine physicians in their response to medication interaction alerts. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Sounding the ‘Citizen–Patient’: The Politics of Voice at the Hospice des Quinze-Vingts in Post-Revolutionary Paris

PubMed Central

Sykes, Ingrid

2011-01-01

This essay explores new models of the citizen–patient by attending to the post-Revolutionary blind ‘voice’. Voice, in both a literal and figurative sense, was central to the way in which members of the Hospice des Quinze-Vingts, an institution for the blind and partially sighted, interacted with those in the community. Musical voices had been used by members to collect alms and to project the particular spiritual principle of their institution since its foundation in the thirteenth century. At the time of the Revolution, the Quinze-Vingts voice was understood by some political authorities as an exemplary call of humanity. Yet many others perceived it as deeply threatening. After 1800, productive dialogue between those in political control and Quinze-Vingts blind members broke down. Authorities attempted to silence the voice of members through the control of blind musicians and institutional management. The Quinze-Vingts blind continued to reassert their voices until around 1850, providing a powerful form of resistance to political control. The blind ‘voice’ ultimately recognised the right of the citizen–patient to dialogue with their political carers. PMID:22025797

What is the relationship between mental workload factors and cognitive load types?

PubMed

Galy, Edith; Cariou, Magali; Mélan, Claudine

2012-03-01

The present study tested the hypothesis of an additive interaction between intrinsic, extraneous and germane cognitive load, by manipulating factors of mental workload assumed to have a specific effect on either type of cognitive load. The study of cognitive load factors and their interaction is essential if we are to improve workers' wellbeing and safety at work. High cognitive load requires the individual to allocate extra resources to entering information. It is thought that this demand for extra resources may reduce processing efficiency and performance. The present study tested the effects of three factors thought to act on either cognitive load type, i.e. task difficulty, time pressure and alertness in a working memory task. Results revealed additive effects of task difficulty and time pressure, and a modulation by alertness on behavioral, subjective and psychophysiological workload measures. Mental overload can be the result of a combination of task-related components, but its occurrence may also depend on subject-related characteristics, including alertness. Solutions designed to reduce incidents and accidents at work should consider work organization in addition to task constraints in so far that both these factors may interfere with mental workload. Copyright © 2011 Elsevier B.V. All rights reserved.

Using voice input and audio feedback to enhance the reality of a virtual experience

DOE Office of Scientific and Technical Information (OSTI.GOV)

Miner, N.E.

1994-04-01

Virtual Reality (VR) is a rapidly emerging technology which allows participants to experience a virtual environment through stimulation of the participant`s senses. Intuitive and natural interactions with the virtual world help to create a realistic experience. Typically, a participant is immersed in a virtual environment through the use of a 3-D viewer. Realistic, computer-generated environment models and accurate tracking of a participant`s view are important factors for adding realism to a virtual experience. Stimulating a participant`s sense of sound and providing a natural form of communication for interacting with the virtual world are equally important. This paper discusses the advantagesmore » and importance of incorporating voice recognition and audio feedback capabilities into a virtual world experience. Various approaches and levels of complexity are discussed. Examples of the use of voice and sound are presented through the description of a research application developed in the VR laboratory at Sandia National Laboratories.« less

Ocular exposure to blue-enriched light has an asymmetric influence on neural activity and spatial attention.

PubMed

Newman, Daniel P; Lockley, Steven W; Loughnane, Gerard M; Martins, Ana Carina P; Abe, Rafael; Zoratti, Marco T R; Kelly, Simon P; O'Neill, Megan H; Rajaratnam, Shantha M W; O'Connell, Redmond G; Bellgrove, Mark A

2016-06-13

Brain networks subserving alertness in humans interact with those for spatial attention orienting. We employed blue-enriched light to directly manipulate alertness in healthy volunteers. We show for the first time that prior exposure to higher, relative to lower, intensities of blue-enriched light speeds response times to left, but not right, hemifield visual stimuli, via an asymmetric effect on right-hemisphere parieto-occipital α-power. Our data give rise to the tantalising possibility of light-based interventions for right hemisphere disorders of spatial attention.

Ocular exposure to blue-enriched light has an asymmetric influence on neural activity and spatial attention

PubMed Central

Newman, Daniel P.; Lockley, Steven W.; Loughnane, Gerard M.; Martins, Ana Carina P.; Abe, Rafael; Zoratti, Marco T. R.; Kelly, Simon P.; O’Neill, Megan H.; Rajaratnam, Shantha M. W.; O’Connell, Redmond G.; Bellgrove, Mark A.

2016-01-01

Brain networks subserving alertness in humans interact with those for spatial attention orienting. We employed blue-enriched light to directly manipulate alertness in healthy volunteers. We show for the first time that prior exposure to higher, relative to lower, intensities of blue-enriched light speeds response times to left, but not right, hemifield visual stimuli, via an asymmetric effect on right-hemisphere parieto-occipital α-power. Our data give rise to the tantalising possibility of light-based interventions for right hemisphere disorders of spatial attention. PMID:27291291

Prototype app for voice therapy: a peer review.

PubMed

Lavaissiéri, Paula; Melo, Paulo Eduardo Damasceno

2017-03-09

Voice speech therapy promotes changes in patients' voice-related habits and rehabilitation. Speech-language therapists use a host of materials ranging from pictures to electronic resources and computer tools as aids in this process. Mobile technology is attractive, interactive and a nearly constant feature in the daily routine of a large part of the population and has a growing application in healthcare. To develop a prototype application for voice therapy, submit it to peer assessment, and to improve the initial prototype based on these assessments. a prototype of the Q-Voz application was developed based on Apple's Human Interface Guidelines. The prototype was analyzed by seven speech therapists who work in the voice area. Improvements to the product were made based on these assessments. all features of the application were considered satisfactory by most evaluators. All evaluators found the application very useful; evaluators reported that patients would find it easier to make changes in voice behavior with the application than without it; the evaluators stated they would use this application with their patients with dysphonia and in the process of rehabilitation and that the application offers useful tools for voice self-management. Based on the suggestions provided, six improvements were made to the prototype. the prototype Q-Voz Application was developed and evaluated by seven judges and subsequently improved. All evaluators stated they would use the application with their patients undergoing rehabilitation, indicating that the Q-Voz Application for mobile devices can be considered an auxiliary tool for voice speech therapy.

Multi-modal assessment of on-road demand of voice and manual phone calling and voice navigation entry across two embedded vehicle systems.

PubMed

Mehler, Bruce; Kidd, David; Reimer, Bryan; Reagan, Ian; Dobres, Jonathan; McCartt, Anne

2016-03-01

One purpose of integrating voice interfaces into embedded vehicle systems is to reduce drivers' visual and manual distractions with 'infotainment' technologies. However, there is scant research on actual benefits in production vehicles or how different interface designs affect attentional demands. Driving performance, visual engagement, and indices of workload (heart rate, skin conductance, subjective ratings) were assessed in 80 drivers randomly assigned to drive a 2013 Chevrolet Equinox or Volvo XC60. The Chevrolet MyLink system allowed completing tasks with one voice command, while the Volvo Sensus required multiple commands to navigate the menu structure. When calling a phone contact, both voice systems reduced visual demand relative to the visual-manual interfaces, with reductions for drivers in the Equinox being greater. The Equinox 'one-shot' voice command showed advantages during contact calling but had significantly higher error rates than Sensus during destination address entry. For both secondary tasks, neither voice interface entirely eliminated visual demand. Practitioner Summary: The findings reinforce the observation that most, if not all, automotive auditory-vocal interfaces are multi-modal interfaces in which the full range of potential demands (auditory, vocal, visual, manipulative, cognitive, tactile, etc.) need to be considered in developing optimal implementations and evaluating drivers' interaction with the systems. Social Media: In-vehicle voice-interfaces can reduce visual demand but do not eliminate it and all types of demand need to be taken into account in a comprehensive evaluation.

Multi-modal assessment of on-road demand of voice and manual phone calling and voice navigation entry across two embedded vehicle systems

PubMed Central

Mehler, Bruce; Kidd, David; Reimer, Bryan; Reagan, Ian; Dobres, Jonathan; McCartt, Anne

2016-01-01

Abstract One purpose of integrating voice interfaces into embedded vehicle systems is to reduce drivers’ visual and manual distractions with ‘infotainment’ technologies. However, there is scant research on actual benefits in production vehicles or how different interface designs affect attentional demands. Driving performance, visual engagement, and indices of workload (heart rate, skin conductance, subjective ratings) were assessed in 80 drivers randomly assigned to drive a 2013 Chevrolet Equinox or Volvo XC60. The Chevrolet MyLink system allowed completing tasks with one voice command, while the Volvo Sensus required multiple commands to navigate the menu structure. When calling a phone contact, both voice systems reduced visual demand relative to the visual–manual interfaces, with reductions for drivers in the Equinox being greater. The Equinox ‘one-shot’ voice command showed advantages during contact calling but had significantly higher error rates than Sensus during destination address entry. For both secondary tasks, neither voice interface entirely eliminated visual demand. Practitioner Summary: The findings reinforce the observation that most, if not all, automotive auditory–vocal interfaces are multi-modal interfaces in which the full range of potential demands (auditory, vocal, visual, manipulative, cognitive, tactile, etc.) need to be considered in developing optimal implementations and evaluating drivers’ interaction with the systems. Social Media: In-vehicle voice-interfaces can reduce visual demand but do not eliminate it and all types of demand need to be taken into account in a comprehensive evaluation. PMID:26269281

An Exploration of the Interaction between Global Education Policy Orthodoxies and National Education Practices in Cambodia, Illuminated through the Voices of Local Teacher Educators

ERIC Educational Resources Information Center

Courtney, Jane

2017-01-01

This research is based on a multi-disciplinary and multi-levelled analysis of evidence to present the case that education reform needs to be contextualised far more widely than is currently practised. It focuses on the voices of Cambodian local teacher trainers through interviews over a five-year period. Interview data is triangulated against…

Functional connectivity between face-movement and speech-intelligibility areas during auditory-only speech perception.

PubMed

Schall, Sonja; von Kriegstein, Katharina

2014-01-01

It has been proposed that internal simulation of the talking face of visually-known speakers facilitates auditory speech recognition. One prediction of this view is that brain areas involved in auditory-only speech comprehension interact with visual face-movement sensitive areas, even under auditory-only listening conditions. Here, we test this hypothesis using connectivity analyses of functional magnetic resonance imaging (fMRI) data. Participants (17 normal participants, 17 developmental prosopagnosics) first learned six speakers via brief voice-face or voice-occupation training (<2 min/speaker). This was followed by an auditory-only speech recognition task and a control task (voice recognition) involving the learned speakers' voices in the MRI scanner. As hypothesized, we found that, during speech recognition, familiarity with the speaker's face increased the functional connectivity between the face-movement sensitive posterior superior temporal sulcus (STS) and an anterior STS region that supports auditory speech intelligibility. There was no difference between normal participants and prosopagnosics. This was expected because previous findings have shown that both groups use the face-movement sensitive STS to optimize auditory-only speech comprehension. Overall, the present findings indicate that learned visual information is integrated into the analysis of auditory-only speech and that this integration results from the interaction of task-relevant face-movement and auditory speech-sensitive areas.

STCA, TCAS, Airproxes and Collision Risk

NASA Astrophysics Data System (ADS)

Brooker, Peter

2005-09-01

The focus here is on the performance of and interaction between the Traffic Alert and Collision Avoidance System (TCAS) and the controller's short-term conflict alert (STCA) system. The data source used is UK Airprox Board Reports of close encounters between aircraft, and the focus is on commercial air transport aircraft using UK controlled airspace with a radar service. Do the systems work well together? Are controllers surprised when they find out that a pilot has received a TCAS resolution advisory? What do TCAS and STCA events say about collision risk? Generally, the systems seem to work together well. On most occasions, controllers are not surprised by TCAS advisories: either they have detected the problem themselves or STCA has alerted them to it. The statistically expected rate of future mid-air collisions is estimated by extrapolation of Airprox closest encounter distances.

Rett syndrome

MedlinePlus

... and height. Weight gain may improve alertness and social interaction. Medicines may be used to treat seizures. Supplements ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated: ...

Development of Attention Networks and Their Interactions in Childhood

ERIC Educational Resources Information Center

Pozuelos, Joan P.; Paz-Alonso, Pedro M.; Castillo, Alejandro; Fuentes, Luis J.; Rueda, M. Rosario

2014-01-01

In the present study, we investigated developmental trajectories of alerting, orienting, and executive attention networks and their interactions over childhood. Two cross-sectional experiments were conducted with different samples of 6-to 12-year-old children using modified versions of the attention network task (ANT). In Experiment 1 (N = 106),…

A qualitative method for analysing multivoicedness

PubMed Central

Aveling, Emma-Louise; Gillespie, Alex; Cornish, Flora

2015-01-01

‘Multivoicedness’ and the ‘multivoiced Self’ have become important theoretical concepts guiding research. Drawing on the tradition of dialogism, the Self is conceptualised as being constituted by a multiplicity of dynamic, interacting voices. Despite the growth in literature and empirical research, there remains a paucity of established methodological tools for analysing the multivoiced Self using qualitative data. In this article, we set out a systematic, practical ‘how-to’ guide for analysing multivoicedness. Using theoretically derived tools, our three-step method comprises: identifying the voices of I-positions within the Self’s talk (or text), identifying the voices of ‘inner-Others’, and examining the dialogue and relationships between the different voices. We elaborate each step and illustrate our method using examples from a published paper in which data were analysed using this method. We conclude by offering more general principles for the use of the method and discussing potential applications. PMID:26664292

Structure alerts for carcinogenicity, and the Salmonella assay system: a novel insight through the chemical relational databases technology.

PubMed

Benigni, Romualdo; Bossa, Cecilia

2008-01-01

In the past decades, chemical carcinogenicity has been the object of mechanistic studies that have been translated into valuable experimental (e.g., the Salmonella assays system) and theoretical (e.g., compilations of structure alerts for chemical carcinogenicity) models. These findings remain the basis of the science and regulation of mutagens and carcinogens. Recent advances in the organization and treatment of large databases consisting of both biological and chemical information nowadays allows for a much easier and more refined view of data. This paper reviews recent analyses on the predictive performance of various lists of structure alerts, including a new compilation of alerts that combines previous work in an optimized form for computer implementation. The revised compilation is part of the Toxtree 1.50 software (freely available from the European Chemicals Bureau website). The use of structural alerts for the chemical biological profiling of a large database of Salmonella mutagenicity results is also reported. Together with being a repository of the science on the chemical biological interactions at the basis of chemical carcinogenicity, the SAs have a crucial role in practical applications for risk assessment, for: (a) description of sets of chemicals; (b) preliminary hazard characterization; (c) formation of categories for e.g., regulatory purposes; (d) generation of subsets of congeneric chemicals to be analyzed subsequently with QSAR methods; (e) priority setting. An important aspect of SAs as predictive toxicity tools is that they derive directly from mechanistic knowledge. The crucial role of mechanistic knowledge in the process of applying (Q)SAR considerations to risk assessment should be strongly emphasized. Mechanistic knowledge provides a ground for interaction and dialogue between model developers, toxicologists and regulators, and permits the integration of the (Q)SAR results into a wider regulatory framework, where different types of evidence and data concur or complement each other as a basis for making decisions and taking actions.

Geoethical issues involved in Tsunami Warning System concepts and operations

NASA Astrophysics Data System (ADS)

Charalampakis, Marinos; Papadopoulos, Gerassimos A.; Tinti, Stefano

2016-04-01

The main goal of a Tsunami Warning System (TWS) is to mitigate the effect of an incoming tsunami by alerting coastal population early enough to allow people to evacuate safely from inundation zones. Though this representation might seem oversimplified, nonetheless, achieving successfully this goal requires a positive synergy of geoscience, communication, emergency management, technology, education, social sciences, politics. Geoethical issues arise always when there is an interaction between geoscience and society, and TWS is a paradigmatic case where interaction is very strong and is made critical because a) the formulation of the tsunami alert has to be made in a time as short as possible and therefore on uncertain data, and b) any evaluation error (underestimation or overestimation) can lead to serious (and sometimes catastrophic) consequences involving wide areas and a large amount of population. From the geoethical point of view three issues are critical: how to (i) combine forecasts and uncertainties reasonably and usefully, (ii) cope and possibly solve the dilemma whether it is better over-alerting or under-alerting population and (iii) deal with responsibility and liability of geoscientists, TWS operators, emergency operators and coastal population. The discussion will be based on the experience of the Hellenic National Tsunami Warning Center (HL-NTWC, Greece), which operates on 24/7 basis as a special unit of the Institute of Geodynamics, National Observatory of Athens, and acts also as Candidate Tsunami Service Provider (CTSP) in the framework of the North-Eastern Atlantic, the Mediterranean and connected seas Tsunami Warning System (NEAMTWS) of the IOC/UNESCO. Since August 2012, when HL-NTWC was officially declared as operational, 14 tsunami warning messages have been disseminated to a large number of subscribers after strong submarine earthquakes occurring in Greece and elsewhere in the eastern Mediterranean. It is recognized that the alerting process and procedure are quite complex and deserve an open and wide debate, that at the moment seems to be absent from media, scientific community and society, very likely until the next tsunami disaster.

Emotion and attention interactions in social cognition: brain regions involved in processing anger prosody.

PubMed

Sander, David; Grandjean, Didier; Pourtois, Gilles; Schwartz, Sophie; Seghier, Mohamed L; Scherer, Klaus R; Vuilleumier, Patrik

2005-12-01

Multiple levels of processing are thought to be involved in the appraisal of emotionally relevant events, with some processes being engaged relatively independently of attention, whereas other processes may depend on attention and current task goals or context. We conducted an event-related fMRI experiment to examine how processing angry voice prosody, an affectively and socially salient signal, is modulated by voluntary attention. To manipulate attention orthogonally to emotional prosody, we used a dichotic listening paradigm in which meaningless utterances, pronounced with either angry or neutral prosody, were presented simultaneously to both ears on each trial. In two successive blocks, participants selectively attended to either the left or right ear and performed a gender-decision on the voice heard on the target side. Our results revealed a functional dissociation between different brain areas. Whereas the right amygdala and bilateral superior temporal sulcus responded to anger prosody irrespective of whether it was heard from a to-be-attended or to-be-ignored voice, the orbitofrontal cortex and the cuneus in medial occipital cortex showed greater activation to the same emotional stimuli when the angry voice was to-be-attended rather than to-be-ignored. Furthermore, regression analyses revealed a strong correlation between orbitofrontal regions and sensitivity on a behavioral inhibition scale measuring proneness to anxiety reactions. Our results underscore the importance of emotion and attention interactions in social cognition by demonstrating that multiple levels of processing are involved in the appraisal of emotionally relevant cues in voices, and by showing a modulation of some emotional responses by both the current task-demands and individual differences.

National Rules for Drug–Drug Interactions: Are They Appropriate for Tertiary Hospitals?

PubMed Central

2016-01-01

The application of appropriate rules for drug–drug interactions (DDIs) could substantially reduce the number of adverse drug events. However, current implementations of such rules in tertiary hospitals are problematic as physicians are receiving too many alerts, causing high override rates and alert fatigue. We investigated the potential impact of Korean national DDI rules in a drug utilization review program in terms of their severity coverage and the clinical efficiency of how physicians respond to them. Using lists of high-priority DDIs developed with the support of the U.S. government, we evaluated 706 contraindicated DDI pairs released in May 2015. We evaluated clinical log data from one tertiary hospital and prescription data from two other tertiary hospitals. The measured parameters were national DDI rule coverage for high-priority DDIs, alert override rate, and number of prescription pairs. The coverage rates of national DDI rules were 80% and 3.0% at the class and drug levels, respectively. The analysis of the system log data showed an overall override rate of 79.6%. Only 0.3% of all of the alerts (n = 66) were high-priority DDI rules. These showed a lower override rate of 51.5%, which was much lower than for the overall DDI rules. We also found 342 and 80 unmatched high-priority DDI pairs which were absent in national rules in inpatient orders from the other two hospitals. The national DDI rules are not complete in terms of their coverage of severe DDIs. They also lack clinical efficiency in tertiary settings, suggesting improved systematic approaches are needed. PMID:27822925

Temporal signatures of processing voiceness and emotion in sound

PubMed Central

Gunter, Thomas C.

2017-01-01

Abstract This study explored the temporal course of vocal and emotional sound processing. Participants detected rare repetitions in a stimulus stream comprising neutral and surprised non-verbal exclamations and spectrally rotated control sounds. Spectral rotation preserved some acoustic and emotional properties of the vocal originals. Event-related potentials elicited to unrepeated sounds revealed effects of voiceness and emotion. Relative to non-vocal sounds, vocal sounds elicited a larger centro-parietally distributed N1. This effect was followed by greater positivity to vocal relative to non-vocal sounds beginning with the P2 and extending throughout the recording epoch (N4, late positive potential) with larger amplitudes in female than in male listeners. Emotion effects overlapped with the voiceness effects but were smaller and differed topographically. Voiceness and emotion interacted only for the late positive potential, which was greater for vocal-emotional as compared with all other sounds. Taken together, these results point to a multi-stage process in which voiceness and emotionality are represented independently before being integrated in a manner that biases responses to stimuli with socio-emotional relevance. PMID:28338796

Temporal signatures of processing voiceness and emotion in sound.

PubMed

Schirmer, Annett; Gunter, Thomas C

2017-06-01

This study explored the temporal course of vocal and emotional sound processing. Participants detected rare repetitions in a stimulus stream comprising neutral and surprised non-verbal exclamations and spectrally rotated control sounds. Spectral rotation preserved some acoustic and emotional properties of the vocal originals. Event-related potentials elicited to unrepeated sounds revealed effects of voiceness and emotion. Relative to non-vocal sounds, vocal sounds elicited a larger centro-parietally distributed N1. This effect was followed by greater positivity to vocal relative to non-vocal sounds beginning with the P2 and extending throughout the recording epoch (N4, late positive potential) with larger amplitudes in female than in male listeners. Emotion effects overlapped with the voiceness effects but were smaller and differed topographically. Voiceness and emotion interacted only for the late positive potential, which was greater for vocal-emotional as compared with all other sounds. Taken together, these results point to a multi-stage process in which voiceness and emotionality are represented independently before being integrated in a manner that biases responses to stimuli with socio-emotional relevance. © The Author (2017). Published by Oxford University Press.

The development of emotion perception in face and voice during infancy.

PubMed

Grossmann, Tobias

2010-01-01

Interacting with others by reading their emotional expressions is an essential social skill in humans. How this ability develops during infancy and what brain processes underpin infants' perception of emotion in different modalities are the questions dealt with in this paper. Literature review. The first part provides a systematic review of behavioral findings on infants' developing emotion-reading abilities. The second part presents a set of new electrophysiological studies that provide insights into the brain processes underlying infants' developing abilities. Throughout, evidence from unimodal (face or voice) and multimodal (face and voice) processing of emotion is considered. The implications of the reviewed findings for our understanding of developmental models of emotion processing are discussed. The reviewed infant data suggest that (a) early in development, emotion enhances the sensory processing of faces and voices, (b) infants' ability to allocate increased attentional resources to negative emotional information develops earlier in the vocal domain than in the facial domain, and (c) at least by the age of 7 months, infants reliably match and recognize emotional information across face and voice.

Investigating the interaction between the homeostatic and circadian processes of sleep-wake regulation for the prediction of waking neurobehavioural performance

NASA Technical Reports Server (NTRS)

Van Dongen, Hans P A.; Dinges, David F.

2003-01-01

The two-process model of sleep regulation has been applied successfully to describe, predict, and understand sleep-wake regulation in a variety of experimental protocols such as sleep deprivation and forced desynchrony. A non-linear interaction between the homeostatic and circadian processes was reported when the model was applied to describe alertness and performance data obtained during forced desynchrony. This non-linear interaction could also be due to intrinsic non-linearity in the metrics used to measure alertness and performance, however. Distinguishing these possibilities would be of theoretical interest, but could also have important implications for the design and interpretation of experiments placing sleep at different circadian phases or varying the duration of sleep and/or wakefulness. Although to date no resolution to this controversy has been found, here we show that the issue can be addressed with existing data sets. The interaction between the homeostatic and circadian processes of sleep-wake regulation was investigated using neurobehavioural performance data from a laboratory experiment involving total sleep deprivation. The results provided evidence of an actual non-linear interaction between the homeostatic and circadian processes of sleep-wake regulation for the prediction of waking neurobehavioural performance.

Giving Voice to Neurologically Diverse High School Students: A Case Study Exploration of Interactions, Relationships, and Realizations through a Collaborative Drama/Life Skills Performance

ERIC Educational Resources Information Center

Hare, Jill L.

2013-01-01

This is a case study about giving voice to a neurologically diverse (ND) community of high school students in a life skills classroom. It is about their lived experiences while involved in a collaborative drama production with a regular education drama class. The research of this study was driven by the assumptions, beliefs, and philosophy based…

Co-Prescription Trends in a Large Cohort of Subjects Predict Substantial Drug-Drug Interactions

PubMed Central

Sutherland, Jeffrey J.; Daly, Thomas M.; Liu, Xiong; Goldstein, Keith; Johnston, Joseph A.; Ryan, Timothy P.

2015-01-01

Pharmaceutical prescribing and drug-drug interaction data underlie recommendations on drug combinations that should be avoided or closely monitored by prescribers. Because the number of patients taking multiple medications is increasing, a comprehensive view of prescribing patterns in patients is important to better assess real world pharmaceutical response and evaluate the potential for multi-drug interactions. We obtained self-reported prescription data from NHANES surveys between 1999 and 2010, and confirm the previously reported finding of increasing drug use in the elderly. We studied co-prescription drug trends by focusing on the 2009-2010 survey, which contains prescription data on 690 drugs used by 10,537 subjects. We found that medication profiles were unique for individuals aged 65 years or more, with ≥98 unique drug regimens encountered per 100 subjects taking 3 or more medications. When drugs were viewed by therapeutic class, it was found that the most commonly prescribed drugs were not the most commonly co-prescribed drugs for any of the 16 drug classes investigated. We cross-referenced these medication lists with drug interaction data from Drugs.com to evaluate the potential for drug interactions. The number of drug alerts rose proportionally with the number of co-prescribed medications, rising from 3.3 alerts for individuals prescribed 5 medications to 11.7 alerts for individuals prescribed 10 medications. We found 22% of elderly subjects taking both a substrate and inhibitor of a given cytochrome P450 enzyme, and 4% taking multiple inhibitors of the same enzyme simultaneously. By examining drug pairs prescribed in 0.1% of the population or more, we found low agreement between co-prescription rate and co-discussion in the literature. These data show that prescribing trends in treatment could drive a large extent of individual variability in drug response, and that current pairwise approaches to assessing drug-drug interactions may be inadequate for predicting real world outcomes. PMID:25739022

Hazards in Motion: Development of Mobile Geofences for Use in Logging Safety

PubMed Central

Zimbelman, Eloise G.; Keefe, Robert F.; Strand, Eva K.; Kolden, Crystal A.; Wempe, Ann M.

2017-01-01

Logging is one of the most hazardous occupations in the United States. Real-time positioning that uses global navigation satellite system (GNSS) technology paired with radio frequency transmission (GNSS-RF) has the potential to reduce fatal and non-fatal accidents on logging operations through the use of geofences that define safe work areas. Until recently, most geofences have been static boundaries. The aim of this study was to evaluate factors affecting mobile geofence accuracy in order to determine whether virtual safety zones around moving ground workers or equipment are a viable option for improving situational awareness on active timber sales. We evaluated the effects of walking pace, transmission interval, geofence radius, and intersection angle on geofence alert delay using a replicated field experiment. Simulation was then used to validate field results and calculate the proportion of GNSS error bearings resulting in early alerts. The interaction of geofence radius and intersection angle affected safety geofence alert delay in the field experiment. The most inaccurate alerts were negative, representing early warning. The magnitude of this effect was largest at the greatest intersection angles. Simulation analysis supported these field results and also showed that larger GNSS error corresponded to greater variability in alert delay. Increasing intersection angle resulted in a larger proportion of directional GNSS error that triggered incorrect, early warnings. Because the accuracy of geofence alerts varied greatly depending on GNSS error and angle of approach, geofencing for occupational safety is most appropriate for general situational awareness unless real-time correction methods to improve accuracy or higher quality GNSS-RF transponders are used. PMID:28394303

The Acoustic Correlates of Breathy Voice: a Study of Source-Vowel INTERACTION{00}{00}{00}{00}{00}{00}{00} {00}{00}{00}{00}{00}{00}{00}{00}{00}{00}{00}{00}{00}{00} {00}{00}{00}{00}{00}{00}{00}{00}{00}{00}{00}{00}{00}{00} {00}{00}{00}{00}{00}{00}{00}{00}{00}{00}{00}{00}{00}{00}.

NASA Astrophysics Data System (ADS)

Lin, Yeong-Fen Emily

This thesis is the result of an investigation of the source-vowel interaction from the point of view of perception. Major objectives include the identification of the acoustic correlates of breathy voice and the disclosure of the interdependent relationship between the perception of vowel identity and breathiness. Two experiments were conducted to achieve these objectives. In the first experiment, voice samples from one control group and seven patient groups were compared. The control group consisted of five female and five male adults. The ten normals were recruited to perform a sustained vowel phonation task with constant pitch and loudness. The voice samples of seventy patients were retrieved from a hospital data base, with vowels extracted from sentences repeated by patients at their habitual pitch and loudness. The seven patient groups were divided, based on a unique combination of patients' measures on mean flow rate and glottal resistance. Eighteen acoustic variables were treated with a three-way (Gender x Group x Vowel) ANOVA. Parameters showing a significant female-male difference as well as group differences, especially those between the presumed breathy group and the other groups, were identified as relevant to the distinction of breathy voice. As a result, F1-F3 amplitude difference and slope were found to be most effective in distinguishing breathy voice. Other acoustic correlates of breathy voice included F1 bandwidth, RMS-H1 amplitude difference, and F1-F2 amplitude difference and slope. In the second experiment, a formant synthesizer was used to generate vowel stimuli with varying spectral tilt and F1 bandwidth. Thirteen native American English speakers made dissimilarity judgements on paired stimuli in terms of vowel identity and breathiness. Listeners' perceptual vowel spaces were found to be affected by changes in the acoustic correlates of breathy voice. The threshold of detecting a change of vocal quality in the breathiness domain was also found to be vowel-dependent.

An information management system for patients with tuberculosis: usability assessment with end-users.

PubMed

Darby, Jonathan; Black, Jim; Morrison, David; Buising, Kirsty

2012-01-01

Information systems with clinical decision support (CDS) offer great potential to assist the co-ordination of patients with chronic diseases and to improve patient care. Despite this, few have entered routine clinical use. Tuberculosis (TB) is an infection of public health importance. It has complex interactions with many comorbid conditions, requires close supervised care and prolonged treatment for effective cure. These features make it suitable for use with an information management system with CDS features. In close consultation with key stakeholders, a clinical application was developed for the management of TB patients in Victoria. A formal usability assessment using semi-structured case-scenario based exercises was performed. Subjects were 12 individuals closely involved in the care of TB patients, including Infectious Diseases and Respiratory Physicians, and Public Health Nurses. Two researchers conducted the sessions, independently analysed responses and discrepancies compared to the voice record for validity. Despite varied computer experience, responses were positive regarding user interface and content. Data location was not always intuitive, however this improved with familiarity of the program. Decision support was considered valuable, with useful suggestions for expansion of these features. Automated reporting for correspondence and notification to the Health Department were felt worth the initial investment in data entry. An important workflow-based issue regarding dismissal of alerts and several errors were detected. Usability assessment validated many design elements of the system, provided a unique insight into workflow issues faced by users and hopefully will impact on its ultimate clinical utility.

Presidential, But Not Prime Minister, Candidates With Lower Pitched Voices Stand a Better Chance of Winning the Election in Conservative Countries.

PubMed

Banai, Benjamin; Laustsen, Lasse; Banai, Irena Pavela; Bovan, Kosta

2018-01-01

Previous studies have shown that voters rely on sexually dimorphic traits that signal masculinity and dominance when they choose political leaders. For example, voters exert strong preferences for candidates with lower pitched voices because these candidates are perceived as stronger and more competent. Moreover, experimental studies demonstrate that conservative voters, more than liberals, prefer political candidates with traits that signal dominance, probably because conservatives are more likely to perceive the world as a threatening place and to be more attentive to dangerous and threatening contexts. In light of these findings, this study investigates whether country-level ideology influences the relationship between candidate voice pitch and electoral outcomes of real elections. Specifically, we collected voice pitch data for presidential and prime minister candidates, aggregate national ideology for the countries in which the candidates were nominated, and measures of electoral outcomes for 69 elections held across the world. In line with previous studies, we found that candidates with lower pitched voices received more votes and had greater likelihood of winning the elections. Furthermore, regression analysis revealed an interaction between candidate voice pitch, national ideology, and election type (presidential or parliamentary). That is, having a lower pitched voice was a particularly valuable asset for presidential candidates in conservative and right-leaning countries (in comparison to presidential candidates in liberal and left-leaning countries and parliamentary elections). We discuss the practical implications of these findings, and how they relate to existing research on candidates' voices, voting preferences, and democratic elections in general.

Absolute Pitch: Effects of Timbre on Note-Naming Ability

PubMed Central

Vanzella, Patrícia; Schellenberg, E. Glenn

2010-01-01

Background Absolute pitch (AP) is the ability to identify or produce isolated musical tones. It is evident primarily among individuals who started music lessons in early childhood. Because AP requires memory for specific pitches as well as learned associations with verbal labels (i.e., note names), it represents a unique opportunity to study interactions in memory between linguistic and nonlinguistic information. One untested hypothesis is that the pitch of voices may be difficult for AP possessors to identify. A musician's first instrument may also affect performance and extend the sensitive period for acquiring accurate AP. Methods/Principal Findings A large sample of AP possessors was recruited on-line. Participants were required to identity test tones presented in four different timbres: piano, pure tone, natural (sung) voice, and synthesized voice. Note-naming accuracy was better for non-vocal (piano and pure tones) than for vocal (natural and synthesized voices) test tones. This difference could not be attributed solely to vibrato (pitch variation), which was more pronounced in the natural voice than in the synthesized voice. Although starting music lessons by age 7 was associated with enhanced note-naming accuracy, equivalent abilities were evident among listeners who started music lessons on piano at a later age. Conclusions/Significance Because the human voice is inextricably linked to language and meaning, it may be processed automatically by voice-specific mechanisms that interfere with note naming among AP possessors. Lessons on piano or other fixed-pitch instruments appear to enhance AP abilities and to extend the sensitive period for exposure to music in order to develop accurate AP. PMID:21085598

Voice Changes in Real Speaking Situations During a Day, With and Without Vocal Loading: Assessing Call Center Operators.

PubMed

Ben-David, Boaz M; Icht, Michal

2016-03-01

Occupational-related vocal load is an increasing global problem with adverse personal and economic implications. We examined voice changes in real speaking situations during a single day, with and without vocal loading, aiming to identify an objective acoustic index for vocal load over a day. Call center operators (CCOs, n = 27) and age- and gender-matched students (n = 25) were recorded at the beginning and at the end of a day, with (CCOs) and without (students) vocal load. Speaking and reading voice samples were analyzed for fundamental frequency (F0), sound pressure level (SPL), and their variance (F0 coefficient of variation [F0 CV], SPL CV). The impact of lifestyle habits on voice changes was also estimated. The main findings revealed an interaction, with F0 rise at the end of the day for the students but not for the CCOs. We suggest that F0 rise is a typical phenomenon of a day of normal vocal use, whereas vocal loading interferes with this mechanism. In addition, different lifestyle profiles of CCOs and controls were observed, as the CCOs reported higher incidence of dehydrating behaviors (eg, smoking, caffeine). Yet, this profile was not linked with voice changes. In sum, we suggest that F0 rise over a day can potentially serve as an index for typical voice use. Its lack thereof can hint on consequent voice symptoms and complaints. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Risk and protective factors for spasmodic dysphonia: a case-control investigation.

PubMed

Tanner, Kristine; Roy, Nelson; Merrill, Ray M; Kimber, Kamille; Sauder, Cara; Houtz, Daniel R; Doman, Darrin; Smith, Marshall E

2011-01-01

Spasmodic dysphonia (SD) is a chronic, incurable, and often disabling voice disorder of unknown pathogenesis. The purpose of this study was to identify possible endogenous and exogenous risk and protective factors uniquely associated with SD. Prospective, exploratory, case-control investigation. One hundred fifty patients with SD and 150 medical controls (MCs) were interviewed regarding their personal and family histories, environmental exposures, illnesses, injuries, voice use patterns, and general health using a previously vetted and validated epidemiologic questionnaire. Odds ratios and multiple logistic regression analyses (α<0.15) identified several factors that significantly increased the likelihood of having SD. These factors included (1) a personal history of mumps, blepharospasm, tremor, intense occupational and avocational voice use, and a family history of voice disorders; (2) an immediate family history of meningitis, tremor, tics, cancer, and compulsive behaviors; and (3) an extended family history of tremor and cancer. SD is likely multifactorial in etiology, involving both genetic and environmental factors. Viral infections/exposures, along with intense voice use, may trigger the onset of SD in genetically predisposed individuals. Future studies should examine the interaction among genetic and environmental factors to determine the pathogenesis of SD. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Real-Time Mapping alert system; characteristics and capabilities

USGS Publications Warehouse

Torres, L.A.; Lambert, S.C.; Liebermann, T.D.

1995-01-01

The U.S. Geological Survey has an extensive hydrologic network that records and transmits precipitation, stage, discharge, and other water-related data on a real-time basis to an automated data processing system. Data values are recorded on electronic data collection platforms at field sampling sites. These values are transmitted by means of orbiting satellites to receiving ground stations, and by way of telecommunication lines to a U.S. Geological Survey office where they are processed on a computer system. Data that exceed predefined thresholds are identified as alert values. The current alert status at monitoring sites within a state or region is of critical importance during floods, hurricanes, and other extreme hydrologic events. This report describes the characteristics and capabilities of a series of computer programs for real-time mapping of hydrologic data. The software provides interactive graphics display and query of hydrologic information from the network in a real-time, map-based, menu-driven environment.

Next Generation Monitoring: Tier 2 Experience

NASA Astrophysics Data System (ADS)

Fay, R.; Bland, J.; Jones, S.

2017-10-01

Monitoring IT infrastructure is essential for maximizing availability and minimizing disruption by detecting failures and developing issues. The HEP group at Liverpool have recently updated our monitoring infrastructure with the goal of increasing coverage, improving visualization capabilities, and streamlining configuration and maintenance. Here we present a summary of Liverpool’s experience, the monitoring infrastructure, and the tools used to build it. In brief, system checks are configured in Puppet using Hiera, and managed by Sensu, replacing Nagios. Centralised logging is managed with Elasticsearch, together with Logstash and Filebeat. Kibana provides an interface for interactive analysis, including visualization and dashboards. Metric collection is also configured in Puppet, managed by collectd and stored in Graphite, with Grafana providing a visualization and dashboard tool. The Uchiwa dashboard for Sensu provides a web interface for viewing infrastructure status. Alert capabilities are provided via external handlers. A custom alert handler is in development to provide an easily configurable, extensible and maintainable alert facility.

Reading affect in the face and voice: neural correlates of interpreting communicative intent in children and adolescents with autism spectrum disorders.

PubMed

Wang, A Ting; Lee, Susan S; Sigman, Marian; Dapretto, Mirella

2007-06-01

Understanding a speaker's communicative intent in everyday interactions is likely to draw on cues such as facial expression and tone of voice. Prior research has shown that individuals with autism spectrum disorders (ASD) show reduced activity in brain regions that respond selectively to the face and voice. However, there is also evidence that activity in key regions can be increased if task demands allow for explicit processing of emotion. To examine the neural circuitry underlying impairments in interpreting communicative intentions in ASD using irony comprehension as a test case, and to determine whether explicit instructions to attend to facial expression and tone of voice will elicit more normative patterns of brain activity. Eighteen boys with ASD (aged 7-17 years, full-scale IQ >70) and 18 typically developing (TD) boys underwent functional magnetic resonance imaging at the Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles. Blood oxygenation level-dependent brain activity during the presentation of short scenarios involving irony. Behavioral performance (accuracy and response time) was also recorded. Reduced activity in the medial prefrontal cortex and right superior temporal gyrus was observed in children with ASD relative to TD children during the perception of potentially ironic vs control scenarios. Importantly, a significant group x condition interaction in the medial prefrontal cortex showed that activity was modulated by explicit instructions to attend to facial expression and tone of voice only in the ASD group. Finally, medial prefrontal cortex activity was inversely related to symptom severity in children with ASD such that children with greater social impairment showed less activity in this region. Explicit instructions to attend to facial expression and tone of voice can elicit increased activity in the medial prefrontal cortex, part of a network important for understanding the intentions of others, in children with ASD. These findings suggest a strategy for future intervention research.

Potential Drug-Drug Interactions in a Cohort of Elderly, Polymedicated Primary Care Patients on Antithrombotic Treatment.

PubMed

Schneider, Katharina Luise; Kastenmüller, Kathrin; Weckbecker, Klaus; Bleckwenn, Markus; Böhme, Miriam; Stingl, Julia Carolin

2018-06-01

Drug-drug interactions (DDIs) are an important risk factor for adverse drug reactions. Older, polymedicated patients are particularly affected. Although antithrombotics have been detected as high-risk drugs for DDIs, data on older patients exposed to them are scarce. Baseline data of 365 IDrug study outpatients (≥ 60 years, use of an antithrombotic and one or more additional long-term drug) were analyzed regarding potential drug-drug interactions (pDDIs) with a clinical decision support system. Data included prescription and self-medication drugs. The prevalence of having one or more pDDI was 85.2%. The median number of alerts per patient was three (range 0-17). For 58.4% of the patients, potential severe/contraindicated interactions were detected. Antiplatelets and non-steroidal anti-inflammatory drugs (NSAIDs) showed the highest number of average pDDI alert involvements per use (2.9 and 2.2, respectively). For NSAIDs, also the highest average number of severe/contraindicated alert involvements per use (1.2) was observed. 91.8% of all pDDI involvements concerned the 25 most frequently used drug classes. 97.5% of the severe/contraindicated pDDIs were attributed to only nine different potential clinical manifestations. The most common management recommendation for severe/contraindicated pDDIs was to intensify monitoring. Number of drugs was the only detected factor significantly associated with increased number of pDDIs (p < 0.001). The findings indicate a high risk for pDDIs in older, polymedicated patients on antithrombotics. As a consequence of patients' frequently similar drug regimens, the variety of potential clinical manifestations was small. Awareness of these pDDI symptoms and the triggering drugs as well as patients' self-medication use may contribute to increased patient safety.

Voices used by nurses when communicating with patients and relatives in a department of medicine for older people-An ethnographic study.

PubMed

Johnsson, Anette; Boman, Åse; Wagman, Petra; Pennbrant, Sandra

2018-04-01

To describe how nurses communicate with older patients and their relatives in a department of medicine for older people in western Sweden. Communication is an essential tool for nurses when working with older patients and their relatives, but often patients and relatives experience shortcomings in the communication exchanges. They may not receive information or are not treated in a professional way. Good communication can facilitate the development of a positive meeting and improve the patient's health outcome. An ethnographic design informed by the sociocultural perspective was applied. Forty participatory observations were conducted and analysed during the period October 2015-September 2016. The observations covered 135 hours of nurse-patient-relative interaction. Field notes were taken, and 40 informal field conversations with nurses and 40 with patients and relatives were carried out. Semistructured follow-up interviews were conducted with five nurses. In the result, it was found that nurses communicate with four different voices: a medical voice described as being incomplete, task-oriented and with a disease perspective; a nursing voice described as being confirmatory, process-oriented and with a holistic perspective; a pedagogical voice described as being contextualised, comprehension-oriented and with a learning perspective; and a power voice described as being distancing and excluding. The voices can be seen as context-dependent communication approaches. When nurses switch between the voices, this indicates a shift in the orientation or situation. The results indicate that if nurses successfully combine the voices, while limiting the use of the power voice, the communication exchanges can become a more positive experience for all parties involved and a good nurse-patient-relative communication exchange can be achieved. Working for improved communication between nurses, patients and relatives is crucial for establishing a positive nurse-patient-relative relationship, which is a basis for improving patient care and healthcare outcomes. © 2018 John Wiley & Sons Ltd.

American Association of Poison Control Centers

MedlinePlus

... all alerts right left NEW! Check out PoisonHelp.org Now there are two ways to get help ... AAPCC's new interactive online poison information tool, PoisonHelp.org. PoisonHelp.org Make your smartphone even smarter. Text " ...

Using Continuous Voice Recognition Technology as an Input Medium to the Naval Warfare Interactive Simulation System (NWISS).

DTIC Science & Technology

1984-06-01

Co ,u’arataor, Gr 7- / ’ . c ; / , caae.ic >ar. ’ ’# d:.i II ’ ..... .. . . .. .. . ... . , rV ABSTRACT A great d-al of research has been conducted an...9 2. Continuous Voice -%ecoait.ior, ....... 11 B. VERBEX 3000 SPEECH APPLiCATION DEVELOP !ENT SYSTEM! ( SPADS ...13 C . NAVAL IAR FARE INT7EACTI7E S:AIULATIC"N SYSTEM (NWISS) ....... .................. 14 D. PURPOSE .................... 16 1. A Past

Functional Connectivity between Face-Movement and Speech-Intelligibility Areas during Auditory-Only Speech Perception

PubMed Central

Schall, Sonja; von Kriegstein, Katharina

2014-01-01

It has been proposed that internal simulation of the talking face of visually-known speakers facilitates auditory speech recognition. One prediction of this view is that brain areas involved in auditory-only speech comprehension interact with visual face-movement sensitive areas, even under auditory-only listening conditions. Here, we test this hypothesis using connectivity analyses of functional magnetic resonance imaging (fMRI) data. Participants (17 normal participants, 17 developmental prosopagnosics) first learned six speakers via brief voice-face or voice-occupation training (<2 min/speaker). This was followed by an auditory-only speech recognition task and a control task (voice recognition) involving the learned speakers’ voices in the MRI scanner. As hypothesized, we found that, during speech recognition, familiarity with the speaker’s face increased the functional connectivity between the face-movement sensitive posterior superior temporal sulcus (STS) and an anterior STS region that supports auditory speech intelligibility. There was no difference between normal participants and prosopagnosics. This was expected because previous findings have shown that both groups use the face-movement sensitive STS to optimize auditory-only speech comprehension. Overall, the present findings indicate that learned visual information is integrated into the analysis of auditory-only speech and that this integration results from the interaction of task-relevant face-movement and auditory speech-sensitive areas. PMID:24466026

Computer-assisted upper extremity training using interactive biking exercise (iBikE) platform.

PubMed

Jeong, In Cheol; Finkelstein, Joseph

2012-01-01

Upper extremity exercise training has been shown to improve clinical outcomes in different chronic health conditions. Arm-operated bicycles are frequently used to facilitate upper extremity training however effective use of these devices at patient homes is hampered by lack of remote connectivity with clinical rehabilitation team, inability to monitor exercise progress in real time using simple graphical representation, and absence of an alert system which would prevent exertion levels exceeding those approved by the clinical rehabilitation team. We developed an interactive biking exercise (iBikE) platform aimed at addressing these limitations. The platform uses a miniature wireless 3-axis accelerometer mounted on a patient wrist that transmits the cycling acceleration data to a laptop. The laptop screen presents an exercise dashboard to the patient in real time allowing easy graphical visualization of exercise progress and presentation of exercise parameters in relation to prescribed targets. The iBikE platform is programmed to alert the patient when exercise intensity exceeds the levels recommended by the patient care provider. The iBikE platform has been tested in 7 healthy volunteers (age range: 26-50 years) and shown to reliably reflect exercise progress and to generate alerts at pre-setup levels. Implementation of remote connectivity with patient rehabilitation team is warranted for future extension and evaluation efforts.

Emotional voices in context: A neurobiological model of multimodal affective information processing

NASA Astrophysics Data System (ADS)

Brück, Carolin; Kreifelts, Benjamin; Wildgruber, Dirk

2011-12-01

Just as eyes are often considered a gateway to the soul, the human voice offers a window through which we gain access to our fellow human beings' minds - their attitudes, intentions and feelings. Whether in talking or singing, crying or laughing, sighing or screaming, the sheer sound of a voice communicates a wealth of information that, in turn, may serve the observant listener as valuable guidepost in social interaction. But how do human beings extract information from the tone of a voice? In an attempt to answer this question, the present article reviews empirical evidence detailing the cerebral processes that underlie our ability to decode emotional information from vocal signals. The review will focus primarily on two prominent classes of vocal emotion cues: laughter and speech prosody (i.e. the tone of voice while speaking). Following a brief introduction, behavioral as well as neuroimaging data will be summarized that allows to outline cerebral mechanisms associated with the decoding of emotional voice cues, as well as the influence of various context variables (e.g. co-occurring facial and verbal emotional signals, attention focus, person-specific parameters such as gender and personality) on the respective processes. Building on the presented evidence, a cerebral network model will be introduced that proposes a differential contribution of various cortical and subcortical brain structures to the processing of emotional voice signals both in isolation and in context of accompanying (facial and verbal) emotional cues.

Emotional voices in context: a neurobiological model of multimodal affective information processing.

PubMed

Brück, Carolin; Kreifelts, Benjamin; Wildgruber, Dirk

2011-12-01

Just as eyes are often considered a gateway to the soul, the human voice offers a window through which we gain access to our fellow human beings' minds - their attitudes, intentions and feelings. Whether in talking or singing, crying or laughing, sighing or screaming, the sheer sound of a voice communicates a wealth of information that, in turn, may serve the observant listener as valuable guidepost in social interaction. But how do human beings extract information from the tone of a voice? In an attempt to answer this question, the present article reviews empirical evidence detailing the cerebral processes that underlie our ability to decode emotional information from vocal signals. The review will focus primarily on two prominent classes of vocal emotion cues: laughter and speech prosody (i.e. the tone of voice while speaking). Following a brief introduction, behavioral as well as neuroimaging data will be summarized that allows to outline cerebral mechanisms associated with the decoding of emotional voice cues, as well as the influence of various context variables (e.g. co-occurring facial and verbal emotional signals, attention focus, person-specific parameters such as gender and personality) on the respective processes. Building on the presented evidence, a cerebral network model will be introduced that proposes a differential contribution of various cortical and subcortical brain structures to the processing of emotional voice signals both in isolation and in context of accompanying (facial and verbal) emotional cues. Copyright © 2011 Elsevier B.V. All rights reserved.

Did you or I say pretty, rude or brief? An ERP study of the effects of speaker's identity on emotional word processing.

PubMed

Pinheiro, Ana P; Rezaii, Neguine; Nestor, Paul G; Rauber, Andréia; Spencer, Kevin M; Niznikiewicz, Margaret

2016-02-01

During speech comprehension, multiple cues need to be integrated at a millisecond speed, including semantic information, as well as voice identity and affect cues. A processing advantage has been demonstrated for self-related stimuli when compared with non-self stimuli, and for emotional relative to neutral stimuli. However, very few studies investigated self-other speech discrimination and, in particular, how emotional valence and voice identity interactively modulate speech processing. In the present study we probed how the processing of words' semantic valence is modulated by speaker's identity (self vs. non-self voice). Sixteen healthy subjects listened to 420 prerecorded adjectives differing in voice identity (self vs. non-self) and semantic valence (neutral, positive and negative), while electroencephalographic data were recorded. Participants were instructed to decide whether the speech they heard was their own (self-speech condition), someone else's (non-self speech), or if they were unsure. The ERP results demonstrated interactive effects of speaker's identity and emotional valence on both early (N1, P2) and late (Late Positive Potential - LPP) processing stages: compared with non-self speech, self-speech with neutral valence elicited more negative N1 amplitude, self-speech with positive valence elicited more positive P2 amplitude, and self-speech with both positive and negative valence elicited more positive LPP. ERP differences between self and non-self speech occurred in spite of similar accuracy in the recognition of both types of stimuli. Together, these findings suggest that emotion and speaker's identity interact during speech processing, in line with observations of partially dependent processing of speech and speaker information. Copyright © 2016. Published by Elsevier Inc.

Designing of Intelligent Multilingual Patient Reported Outcome System (IMPROS)

PubMed Central

Pourasghar, Faramarz; Partovi, Yeganeh

2015-01-01

Background: By self-reporting outcome procedure the patients themselves record disease symptoms outside medical centers and then report them to medical staff in specific periods of time. One of the self-reporting methods is the application of interactive voice response (IVR), in which some pre-designed questions in the form of voice tracks would be played and then the caller responses the questions by pressing phone’s keypad bottoms. Aim: The present research explains the main framework of such system designing according to IVR technology that is for the first time designed and administered in Iran. Methods: Interactive Voice Response system was composed by two main parts of hardware and software. Hardware section includes one or several digital phone lines, a modem card with voice playing capability and a PC. IVR software on the other hand, acts as an intelligent control center, records call information and controls incoming data. Results: One of the main features of the system is its capability to be administered in common PCs, utilizing simple and cheap modems, high speed to take responses and it’s appropriateness to low literate patients. The system is applicable for monitoring chronic diseases, cancer and also in psychological diseases and can be suitable for taking care of elders and Children who require long term cares. Other features include user-friendly, decrease in direct and indirect costs of disease treatment and enjoying from high level of security to access patients’ profiles. Conclusions: Intelligent multilingual patient reported outcome system (IMPROS) by controlling diseases gives the opportunity to patients to have more participation during treatment and it improves mutual interaction between patient and medical staff. Moreover it increases the quality of medical services, Additional to empowering patients and their followers. PMID:26635441

Acoustic passaggio pedagogy for the male voice.

PubMed

Bozeman, Kenneth Wood

2013-07-01

Awareness of interactions between the lower harmonics of the voice source and the first formant of the vocal tract, and of the passive vowel modifications that accompany them, can assist in working out a smooth transition through the passaggio of the male voice. A stable vocal tract length establishes the general location of all formants, including the higher formants that form the singer's formant cluster. Untrained males instinctively shorten the tube to preserve the strong F1/H2 acoustic coupling of voce aperta, resulting in 'yell' timbre. If tube length and shape are kept stable during pitch ascent, the yell can be avoided by allowing the second harmonic to rise above the first formant, creating the balanced timbre of voce chiusa.

Education and Training Module in Alertness Management

NASA Technical Reports Server (NTRS)

Mallis, M. M.; Brandt, S. L.; Oyung, R. L.; Reduta, D. D.; Rosekind, M. R.

2006-01-01

The education and training module (ETM) in alertness management has now been integrated as part of the training regimen of the Pilot Proficiency Awards Program ("WINGS") of the Federal Aviation Administration. Originated and now maintained current by the Fatigue Countermeasures Group at NASA Ames Research Center, the ETM in Alertness Management is designed to give pilots the benefit of the best and most recent research on the basics of sleep physiology, the causes of fatigue, and strategies for managing alertness during flight operations. The WINGS program is an incentive program that encourages pilots at all licensing levels to participate in recurrent training, upon completion of which distinctive lapel or tie pins (wings) and certificates of completion are awarded. In addition to flight training, all WINGS applicants must attend at least one FAA-sponsored safety seminar, FAA-sanctioned safety seminar, or industry recurrent training program. The Fatigue Countermeasures Group provides an FAA-approved industry recurrent training program through an on-line General Aviation (GA) WINGS ETM in alertness management to satisfy this requirement. Since 1993, the Fatigue Countermeasures Group has translated fatigue and alertness information to operational environments by conducting two-day ETM workshops oriented primarily toward air-carrier operations subject to Part 121 of the Federal Aviation Regulations pertaining to such operations. On the basis of the information presented in the two-day ETM workshops, an ETM was created for GA pilots and was transferred to a Web-based version. To comply with the requirements of the WINGS Program, the original Web-based version has been modified to include hypertext markup language (HTML) content that makes information easily accessible, in-depth testing of alertness-management knowledge, new interactive features, and increased informational resources for GA pilots. Upon successful completion of this training module, a participant receives a computer- screen display of a certificate of completion. The certificate, which includes the pilot s name and an identifying number, can be printed out and submitted, for ground training credit, with the pilot s WINGS application.

A fresh look at runway incursions: onboard surface movement awareness and alerting system based on SVS

NASA Astrophysics Data System (ADS)

Vernaleken, Christoph; Mihalic, Lamir; Güttler, Mathias; Klingauf, Uwe

2006-05-01

Increasing traffic density on the aerodrome surface due to the continuous worldwide growth in the number of flight operations does not only cause capacity and efficiency problems, but also increases the risk of serious incidents and accidents on the airport movement area. Of these, Runway Incursions are the by far most safety-critical. In fact, the worst-ever accident in civil aviation, the collision of two Boeing B747s on Tenerife in 1977 with 583 fatalities, was caused by a Runway Incursion. Therefore, various Runway Safety programs have recently been initiated around the globe, often focusing on ground-based measures such as improved surveillance. However, as a lack of flight crew situational awareness is a key causal factor in many Runway Incursion incidents and accidents, there is a strong need for an onboard solution, which should be capable of interacting cooperatively with ground-based ATM systems, such as A-SMGCS where available. This paper defines the concept of preventive and reactive Runway Incursion avoidance and describes a Surface Movement Awareness & Alerting System (SMAAS) designed to alert the flight crew if they are at risk of infringing a runway. Both the SVS flight deck displays and the corresponding alerting algorithms utilize an ED 99A/RTCA DO-272A compliant aerodrome database, as well as airport operational, traffic and clearance data received via ADS-B or other data links, respectively. The displays provide the crew with enhanced positional, operational, clearance and traffic awareness, and they are used to visualize alerts. A future enhancement of the system will provide intelligent alerting for conflicts caused by surrounding traffic.

Effects of operating practices on commercial driver alertness

DOT National Transportation Integrated Search

1999-09-01

This report summarizes the results of a one-year effort to establish the interaction between operating practices in the trucking industry and driver performance, particularly with respect to safety and fatigue. Principal topics were: Loading and unlo...

Recommendations for selecting drug-drug interactions for clinical decision support.

PubMed

Tilson, Hugh; Hines, Lisa E; McEvoy, Gerald; Weinstein, David M; Hansten, Philip D; Matuszewski, Karl; le Comte, Marianne; Higby-Baker, Stefanie; Hanlon, Joseph T; Pezzullo, Lynn; Vieson, Kathleen; Helwig, Amy L; Huang, Shiew-Mei; Perre, Anthony; Bates, David W; Poikonen, John; Wittie, Michael A; Grizzle, Amy J; Brown, Mary; Malone, Daniel C

2016-04-15

Recommendations for including drug-drug interactions (DDIs) in clinical decision support (CDS) are presented. A conference series was conducted to improve CDS for DDIs. A work group consisting of 20 experts in pharmacology, drug information, and CDS from academia, government agencies, health information vendors, and healthcare organizations was convened to address (1) the process to use for developing and maintaining a standard set of DDIs, (2) the information that should be included in a knowledge base of standard DDIs, (3) whether a list of contraindicated drug pairs can or should be established, and (4) how to more intelligently filter DDI alerts. We recommend a transparent, systematic, and evidence-driven process with graded recommendations by a consensus panel of experts and oversight by a national organization. We outline key DDI information needed to help guide clinician decision-making. We recommend judicious classification of DDIs as contraindicated and more research to identify methods to safely reduce repetitive and less-relevant alerts. An expert panel with a centralized organizer or convener should be established to develop and maintain a standard set of DDIs for CDS in the United States. The process should be evidence driven, transparent, and systematic, with feedback from multiple stakeholders for continuous improvement. The scope of the expert panel's work should be carefully managed to ensure that the process is sustainable. Support for research to improve DDI alerting in the future is also needed. Adoption of these steps may lead to consistent and clinically relevant content for interruptive DDIs, thus reducing alert fatigue and improving patient safety. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Multisensory perception of the six basic emotions is modulated by attentional instruction and unattended modality

PubMed Central

Takagi, Sachiko; Hiramatsu, Saori; Tabei, Ken-ichi; Tanaka, Akihiro

2015-01-01

Previous studies have shown that the perception of facial and vocal affective expressions interacts with each other. Facial expressions usually dominate vocal expressions when we perceive the emotions of face–voice stimuli. In most of these studies, participants were instructed to pay attention to the face or voice. Few studies compared the perceived emotions with and without specific instructions regarding the modality to which attention should be directed. Also, these studies used combinations of the face and voice which expresses two opposing emotions, which limits the generalizability of the findings. The purpose of this study is to examine whether the emotion perception is modulated by instructions to pay attention to the face or voice using the six basic emotions. Also we examine the modality dominance between the face and voice for each emotion category. Before the experiment, we recorded faces and voices which expresses the six basic emotions and orthogonally combined these faces and voices. Consequently, the emotional valence of visual and auditory information was either congruent or incongruent. In the experiment, there were unisensory and multisensory sessions. The multisensory session was divided into three blocks according to whether an instruction was given to pay attention to a given modality (face attention, voice attention, and no instruction). Participants judged whether the speaker expressed happiness, sadness, anger, fear, disgust, or surprise. Our results revealed that instructions to pay attention to one modality and congruency of the emotions between modalities modulated the modality dominance, and the modality dominance is differed for each emotion category. In particular, the modality dominance for anger changed according to each instruction. Analyses also revealed that the modality dominance suggested by the congruency effect can be explained in terms of the facilitation effect and the interference effect. PMID:25698945

Multimodal approaches for emotion recognition: a survey

NASA Astrophysics Data System (ADS)

Sebe, Nicu; Cohen, Ira; Gevers, Theo; Huang, Thomas S.

2004-12-01

Recent technological advances have enabled human users to interact with computers in ways previously unimaginable. Beyond the confines of the keyboard and mouse, new modalities for human-computer interaction such as voice, gesture, and force-feedback are emerging. Despite important advances, one necessary ingredient for natural interaction is still missing-emotions. Emotions play an important role in human-to-human communication and interaction, allowing people to express themselves beyond the verbal domain. The ability to understand human emotions is desirable for the computer in several applications. This paper explores new ways of human-computer interaction that enable the computer to be more aware of the user's emotional and attentional expressions. We present the basic research in the field and the recent advances into the emotion recognition from facial, voice, and physiological signals, where the different modalities are treated independently. We then describe the challenging problem of multimodal emotion recognition and we advocate the use of probabilistic graphical models when fusing the different modalities. We also discuss the difficult issues of obtaining reliable affective data, obtaining ground truth for emotion recognition, and the use of unlabeled data.

Multimodal approaches for emotion recognition: a survey

NASA Astrophysics Data System (ADS)

Sebe, Nicu; Cohen, Ira; Gevers, Theo; Huang, Thomas S.

2005-01-01

Recent technological advances have enabled human users to interact with computers in ways previously unimaginable. Beyond the confines of the keyboard and mouse, new modalities for human-computer interaction such as voice, gesture, and force-feedback are emerging. Despite important advances, one necessary ingredient for natural interaction is still missing-emotions. Emotions play an important role in human-to-human communication and interaction, allowing people to express themselves beyond the verbal domain. The ability to understand human emotions is desirable for the computer in several applications. This paper explores new ways of human-computer interaction that enable the computer to be more aware of the user's emotional and attentional expressions. We present the basic research in the field and the recent advances into the emotion recognition from facial, voice, and physiological signals, where the different modalities are treated independently. We then describe the challenging problem of multimodal emotion recognition and we advocate the use of probabilistic graphical models when fusing the different modalities. We also discuss the difficult issues of obtaining reliable affective data, obtaining ground truth for emotion recognition, and the use of unlabeled data.

Adductor spasmodic dysphonia: Relationships between acoustic indices and perceptual judgments

NASA Astrophysics Data System (ADS)

Cannito, Michael P.; Sapienza, Christine M.; Woodson, Gayle; Murry, Thomas

2003-04-01

This study investigated relationships between acoustical indices of spasmodic dysphonia and perceptual scaling judgments of voice attributes made by expert listeners. Audio-recordings of The Rainbow Passage were obtained from thirty one speakers with spasmodic dysphonia before and after a BOTOX injection of the vocal folds. Six temporal acoustic measures were obtained across 15 words excerpted from each reading sample, including both frequency of occurrence and percent time for (1) aperiodic phonation, (2) phonation breaks, and (3) fundamental frequency shifts. Visual analog scaling judgments were also obtained from six voice experts using an interactive computer interface to quantify four voice attributes (i.e., overall quality, roughness, brokenness, breathiness) in a carefully psychoacoustically controlled environment, using the same reading passages as stimuli. Number and percent aperiodicity and phonation breaks correlated significanly with perceived overall voice quality, roughness, and brokenness before and after the BOTOX injection. Breathiness was correlated with aperidocity only prior to injection, while roughness also correlated with frequency shifts following injection. Factor analysis reduced perceived attributes to two principal components: glottal squeezing and breathiness. The acoustic measures demonstrated a strong regression relationship with perceived glottal squeezing, but no regression relationship with breathiness was observed. Implications for an analysis of pathologic voices will be discussed.

Comparing the demands of destination entry using Google Glass and the Samsung Galaxy S4 during simulated driving.

PubMed

Beckers, Niek; Schreiner, Sam; Bertrand, Pierre; Mehler, Bruce; Reimer, Bryan

2017-01-01

The relative impact of using a Google Glass based voice interface to enter a destination address compared to voice and touch-entry methods using a handheld Samsung Galaxy S4 smartphone was assessed in a driving simulator. Voice entry (Google Glass and Samsung) had lower subjective workload ratings, lower standard deviation of lateral lane position, shorter task durations, faster remote Detection Response Task (DRT) reaction times, lower DRT miss rates, and resulted in less time glancing off-road than the primary visual-manual interaction with the Samsung Touch interface. Comparing voice entry methods, using Google Glass took less time, while glance metrics and reaction time to DRT events responded to were similar. In contrast, DRT miss rate was higher for Google Glass, suggesting that drivers may be under increased distraction levels but for a shorter period of time; whether one or the other equates to an overall safer driving experience is an open question. Copyright © 2016 Elsevier Ltd. All rights reserved.

Numerical simulation of self-sustained oscillation of a voice-producing element based on Navier-Stokes equations and the finite element method.

PubMed

de Vries, Martinus P; Hamburg, Marc C; Schutte, Harm K; Verkerke, Gijsbertus J; Veldman, Arthur E P

2003-04-01

Surgical removal of the larynx results in radically reduced production of voice and speech. To improve voice quality a voice-producing element (VPE) is developed, based on the lip principle, called after the lips of a musician while playing a brass instrument. To optimize the VPE, a numerical model is developed. In this model, the finite element method is used to describe the mechanical behavior of the VPE. The flow is described by two-dimensional incompressible Navier-Stokes equations. The interaction between VPE and airflow is modeled by placing the grid of the VPE model in the grid of the aerodynamical model, and requiring continuity of forces and velocities. By applying and increasing pressure to the numerical model, pulses comparable to glottal volume velocity waveforms are obtained. By variation of geometric parameters their influence can be determined. To validate this numerical model, an in vitro test with a prototype of the VPE is performed. Experimental and numerical results show an acceptable agreement.

Central nervous system control of the laryngeal muscles in humans

PubMed Central

Ludlow, Christy L.

2005-01-01

Laryngeal muscle control may vary for different functions such as: voice for speech communication, emotional expression during laughter and cry, breathing, swallowing, and cough. This review discusses the control of the human laryngeal muscles for some of these different functions. Sensori-motor aspects of laryngeal control have been studied by eliciting various laryngeal reflexes. The role of audition in learning and monitoring ongoing voice production for speech is well known; while the role of somatosensory feedback is less well understood. Reflexive control systems involving central pattern generators may contribute to swallowing, breathing and cough with greater cortical control during volitional tasks such as voice production for speech. Volitional control is much less well understood for each of these functions and likely involves the integration of cortical and subcortical circuits. The new frontier is the study of the central control of the laryngeal musculature for voice, swallowing and breathing and how volitional and reflexive control systems may interact in humans. PMID:15927543

Familiar Person Recognition: Is Autonoetic Consciousness More Likely to Accompany Face Recognition Than Voice Recognition?

NASA Astrophysics Data System (ADS)

Barsics, Catherine; Brédart, Serge

2010-11-01

Autonoetic consciousness is a fundamental property of human memory, enabling us to experience mental time travel, to recollect past events with a feeling of self-involvement, and to project ourselves in the future. Autonoetic consciousness is a characteristic of episodic memory. By contrast, awareness of the past associated with a mere feeling of familiarity or knowing relies on noetic consciousness, depending on semantic memory integrity. Present research was aimed at evaluating whether conscious recollection of episodic memories is more likely to occur following the recognition of a familiar face than following the recognition of a familiar voice. Recall of semantic information (biographical information) was also assessed. Previous studies that investigated the recall of biographical information following person recognition used faces and voices of famous people as stimuli. In this study, the participants were presented with personally familiar people's voices and faces, thus avoiding the presence of identity cues in the spoken extracts and allowing a stricter control of frequency exposure with both types of stimuli (voices and faces). In the present study, the rate of retrieved episodic memories, associated with autonoetic awareness, was significantly higher from familiar faces than familiar voices even though the level of overall recognition was similar for both these stimuli domains. The same pattern was observed regarding semantic information retrieval. These results and their implications for current Interactive Activation and Competition person recognition models are discussed.

Natural asynchronies in audiovisual communication signals regulate neuronal multisensory interactions in voice-sensitive cortex.

PubMed

Perrodin, Catherine; Kayser, Christoph; Logothetis, Nikos K; Petkov, Christopher I

2015-01-06

When social animals communicate, the onset of informative content in one modality varies considerably relative to the other, such as when visual orofacial movements precede a vocalization. These naturally occurring asynchronies do not disrupt intelligibility or perceptual coherence. However, they occur on time scales where they likely affect integrative neuronal activity in ways that have remained unclear, especially for hierarchically downstream regions in which neurons exhibit temporally imprecise but highly selective responses to communication signals. To address this, we exploited naturally occurring face- and voice-onset asynchronies in primate vocalizations. Using these as stimuli we recorded cortical oscillations and neuronal spiking responses from functional MRI (fMRI)-localized voice-sensitive cortex in the anterior temporal lobe of macaques. We show that the onset of the visual face stimulus resets the phase of low-frequency oscillations, and that the face-voice asynchrony affects the prominence of two key types of neuronal multisensory responses: enhancement or suppression. Our findings show a three-way association between temporal delays in audiovisual communication signals, phase-resetting of ongoing oscillations, and the sign of multisensory responses. The results reveal how natural onset asynchronies in cross-sensory inputs regulate network oscillations and neuronal excitability in the voice-sensitive cortex of macaques, a suggested animal model for human voice areas. These findings also advance predictions on the impact of multisensory input on neuronal processes in face areas and other brain regions.

Simultaneous recordings from the primary visual cortex and lateral geniculate nucleus reveal rhythmic interactions and a cortical source for γ-band oscillations.

PubMed

Bastos, Andre M; Briggs, Farran; Alitto, Henry J; Mangun, George R; Usrey, W Martin

2014-05-28

Oscillatory synchronization of neuronal activity has been proposed as a mechanism to modulate effective connectivity between interacting neuronal populations. In the visual system, oscillations in the gamma-frequency range (30-100 Hz) are thought to subserve corticocortical communication. To test whether a similar mechanism might influence subcortical-cortical communication, we recorded local field potential activity from retinotopically aligned regions in the lateral geniculate nucleus (LGN) and primary visual cortex (V1) of alert macaque monkeys viewing stimuli known to produce strong cortical gamma-band oscillations. As predicted, we found robust gamma-band power in V1. In contrast, visual stimulation did not evoke gamma-band activity in the LGN. Interestingly, an analysis of oscillatory phase synchronization of LGN and V1 activity identified synchronization in the alpha (8-14 Hz) and beta (15-30 Hz) frequency bands. Further analysis of directed connectivity revealed that alpha-band interactions mediated corticogeniculate feedback processing, whereas beta-band interactions mediated geniculocortical feedforward processing. These results demonstrate that although the LGN and V1 display functional interactions in the lower frequency bands, gamma-band activity in the alert monkey is largely an emergent property of cortex. Copyright © 2014 the authors 0270-6474/14/347639-06$15.00/0.

Postural control system influences intrinsic alerting state.

PubMed

Barra, Julien; Auclair, Laurent; Charvillat, Agnès; Vidal, Manuel; Pérennou, Dominic

2015-03-01

Numerous studies using dual-task paradigms (postural and cognitive) have shown that postural control requires cognitive resources. However, the influence of postural control on attention components has never been directly addressed. Using the attention network test (ANT), which assesses specifically each of the 3 components of attention-alertness, orientation, and executive control-within a single paradigm, we investigated the effect of postural balance demand on these 3 components. Forty-two participants completed the ANT in 3 postural conditions: (a) supine, a very stable position; (b) sitting on a chair, an intermediate position; and (c) standing with feet lined up heel to toe, a very instable position known as the Romberg position. Our results revealed that the difficulty of postural control does modulate alerting in such a way that it improves with the level of instability of the position. Regarding the orienting and executive control components of attention, performance was not different when participants were standing upright or seated, whereas in the supine position, performance dropped. The strong and specific interaction between postural control and the alerting system suggests that these mechanisms may share parts of the underlying neural circuits. We discuss the possible implication of the locus coeruleus, known to be involved in both postural balance and alerting. Also, our findings concerning orienting and executive control systems suggest that supine posture could have a specific effect on cognitive activities. These effects are discussed in terms of particularities resulting from the supine position. PsycINFO Database Record (c) 2015 APA, all rights reserved.

Forms of Mediation: The Case of Interpreter-Mediated Interactions in Medical Systems

ERIC Educational Resources Information Center

Baraldi, Claudio

2009-01-01

This paper analyses the forms of mediation in interlinguistic interactions performed in Italian healthcare services and in contexts of migration. The literature encourages dialogic transformative mediation, empowering participants' voices and changing cultural presuppositions in social systems. It may be doubtful, however, whether mediation can…

Using the Web to Market Your Schools.

ERIC Educational Resources Information Center

Carr, Nora

2001-01-01

With careful planning and a strategic focus, today's technology can greatly enhance a district's marketing efforts. Websites can offer features such as interactive school assignment (based on home address), ability to check student progress, education portals (24-hour news channels), one-to-one communication, and interactive voice responses. (MLH)

The Army word recognition system

NASA Technical Reports Server (NTRS)

Hadden, David R.; Haratz, David

1977-01-01

The application of speech recognition technology in the Army command and control area is presented. The problems associated with this program are described as well as as its relevance in terms of the man/machine interactions, voice inflexions, and the amount of training needed to interact with and utilize the automated system.

Passive pavement-mounted acoustical linguistic drive alert system and method

DOEpatents

Kisner, Roger A.; Anderson, Richard L.; Carnal, Charles L.; Hylton, James O.; Stevens, Samuel S.

2001-01-01

Systems and methods are described for passive pavement-mounted acoustical alert of the occupants of a vehicle. A method of notifying a vehicle occupant includes providing a driving medium upon which a vehicle is to be driven; and texturing a portion of the driving medium such that the textured portion interacts with the vehicle to produce audible signals, the textured portion pattern such that a linguistic message is encoded into the audible signals. The systems and methods provide advantages because information can be conveyed to the occupants of the vehicle based on the location of the vehicle relative to the textured surface.

Douglas flight deck design philosophy

NASA Technical Reports Server (NTRS)

Oldale, Paul

1990-01-01

The systems experience gained from 17 years of DC-10 operation was used during the design of the MD-11 to automate system operation and reduce crew workload. All functions, from preflight to shutdown at the termination of flight, require little input from the crew. The MD-11 aircraft systems are monitored for proper operation by the Aircraft Systems Controllers (ASC). In most cases, system reconfiguration as a result of a malfunction is automated. Manual input is required for irreversible actions such as engine shutdown, fuel dump, fire agent discharge, or Integrated Drive Generator (IDG) disconnect. During normal operations, when the cockpit is configured for flight, all annunciators on the overhead panel will be extinguished. This Dark Cockpit immediately confirms to the crew that the panels are correctly configured and that no abnormalities are present. Primary systems annunciations are shown in text on the Alert Area of the Engine and Alert Display (EAD). This eliminates the need to scan the overhead. The MD-11 aircraft systems can be manually controlled from the overhead area of the cockpit. The center portion of the overhead panel is composed of the primary aircraft systems panels, which include FUEL, AIR, Electrical (ELEC) and Hydraulic (HYD) systems, which are easily accessible from both flight crew positions. Each Aircraft Systems Controller (ASC) has two automatic channels and a manual mode. All rectangular lights are annunciators. All square lights are combined switches and annunciators called switch/lights. Red switch/lights on the overhead (Level 3 alerts) are for conditions requiring immediate crew action. Amber (Level 2 or Level 1 alerts) indicates a fault or switch out of position requiring awareness or crew interaction. Overhead switches used in normal operating conditions will illuminate blue when in use (Level 0 alerts) such as WING ANTI-ICE - ON. An overhead switch/light with BLACK LETTERING on an amber or red background indicates a system failure and that crew interaction is required. A switch/light with blue or amber lettering and a BLACK BACKGROUND indicates a switch out of normal position and that crew action is necessary only if the system is in manual operation.

Administration of Neuropsychological Tests Using Interactive Voice Response Technology in the Elderly: Validation and Limitations

PubMed Central

Miller, Delyana Ivanova; Talbot, Vincent; Gagnon, Michèle; Messier, Claude

2013-01-01

Interactive voice response (IVR) systems are computer programs, which interact with people to provide a number of services from business to health care. We examined the ability of an IVR system to administer and score a verbal fluency task (fruits) and the digit span forward and backward in 158 community dwelling people aged between 65 and 92 years of age (full scale IQ of 68–134). Only six participants could not complete all tasks mostly due to early technical problems in the study. Participants were also administered the Wechsler Intelligence Scale fourth edition (WAIS-IV) and Wechsler Memory Scale fourth edition subtests. The IVR system correctly recognized 90% of the fruits in the verbal fluency task and 93–95% of the number sequences in the digit span. The IVR system typically underestimated the performance of participants because of voice recognition errors. In the digit span, these errors led to the erroneous discontinuation of the test: however the correlation between IVR scoring and clinical scoring was still high (93–95%). The correlation between the IVR verbal fluency and the WAIS-IV Similarities subtest was 0.31. The correlation between the IVR digit span forward and backward and the in-person administration was 0.46. We discuss how valid and useful IVR systems are for neuropsychological testing in the elderly. PMID:23950755

The use of an automated interactive voice response system to manage medication identification calls to a poison center.

PubMed

Krenzelok, Edward P; Mrvos, Rita

2009-05-01

In 2007, medication identification requests (MIRs) accounted for 26.2% of all calls to U.S. poison centers. MIRs are documented with minimal information, but they still require an inordinate amount of work by specialists in poison information (SPI). An analysis was undertaken to identify options to reduce the impact of MIRs on both human and financial resources. All MIRs (2003-2007) to a certified regional poison information center were analyzed to determine call patterns and staffing. The data were used to justify an efficient and cost-effective solution. MIRs represented 42.3% of the 2007 call volume. Optimal staffing would require hiring an additional four full-time equivalent SPI. An interactive voice response (IVR) system was developed to respond to the MIRs. The IVR was used to develop the Medication Identification System that allowed the diversion of up to 50% of the MIRs, enhancing surge capacity and allowing specialists to address the more emergent poison exposure calls. This technology is an entirely voice-activated response call management system that collects zip code, age, gender and drug data and stores all responses as .csv files for reporting purposes. The query bank includes the 200 most common MIRs, and the system features text-to-voice synthesis that allows easy modification of the drug identification menu. Callers always have the option of engaging a SPI at any time during the IVR call flow. The IVR is an efficient and effective alternative that creates better staff utilization.

Improving visual spatial working memory in younger and older adults: effects of cross-modal cues.

PubMed

Curtis, Ashley F; Turner, Gary R; Park, Norman W; Murtha, Susan J E

2017-11-06

Spatially informative auditory and vibrotactile (cross-modal) cues can facilitate attention but little is known about how similar cues influence visual spatial working memory (WM) across the adult lifespan. We investigated the effects of cues (spatially informative or alerting pre-cues vs. no cues), cue modality (auditory vs. vibrotactile vs. visual), memory array size (four vs. six items), and maintenance delay (900 vs. 1800 ms) on visual spatial location WM recognition accuracy in younger adults (YA) and older adults (OA). We observed a significant interaction between spatially informative pre-cue type, array size, and delay. OA and YA benefitted equally from spatially informative pre-cues, suggesting that attentional orienting prior to WM encoding, regardless of cue modality, is preserved with age.  Contrary to predictions, alerting pre-cues generally impaired performance in both age groups, suggesting that maintaining a vigilant state of arousal by facilitating the alerting attention system does not help visual spatial location WM.

Development of a Human Motor Model for the Evaluation of an Integrated Alerting and Notification Flight Deck System

NASA Technical Reports Server (NTRS)

Daiker, Ron; Schnell, Thomas

2010-01-01

A human motor model was developed on the basis of performance data that was collected in a flight simulator. The motor model is under consideration as one component of a virtual pilot model for the evaluation of NextGen crew alerting and notification systems in flight decks. This model may be used in a digital Monte Carlo simulation to compare flight deck layout design alternatives. The virtual pilot model is being developed as part of a NASA project to evaluate multiple crews alerting and notification flight deck configurations. Model parameters were derived from empirical distributions of pilot data collected in a flight simulator experiment. The goal of this model is to simulate pilot motor performance in the approach-to-landing task. The unique challenges associated with modeling the complex dynamics of humans interacting with the cockpit environment are discussed, along with the current state and future direction of the model.

An innovative multimodal virtual platform for communication with devices in a natural way

NASA Astrophysics Data System (ADS)

Kinkar, Chhayarani R.; Golash, Richa; Upadhyay, Akhilesh R.

2012-03-01

As technology grows people are diverted and are more interested in communicating with machine or computer naturally. This will make machine more compact and portable by avoiding remote, keyboard etc. also it will help them to live in an environment free from electromagnetic waves. This thought has made 'recognition of natural modality in human computer interaction' a most appealing and promising research field. Simultaneously it has been observed that using single mode of interaction limit the complete utilization of commands as well as data flow. In this paper a multimodal platform, where out of many natural modalities like eye gaze, speech, voice, face etc. human gestures are combined with human voice is proposed which will minimize the mean square error. This will loosen the strict environment needed for accurate and robust interaction while using single mode. Gesture complement Speech, gestures are ideal for direct object manipulation and natural language is used for descriptive tasks. Human computer interaction basically requires two broad sections recognition and interpretation. Recognition and interpretation of natural modality in complex binary instruction is a tough task as it integrate real world to virtual environment. The main idea of the paper is to develop a efficient model for data fusion coming from heterogeneous sensors, camera and microphone. Through this paper we have analyzed that the efficiency is increased if heterogeneous data (image & voice) is combined at feature level using artificial intelligence. The long term goal of this paper is to design a robust system for physically not able or having less technical knowledge.

Deliberate real-time mood regulation in adulthood: the importance of age, fixation and attentional functioning.

PubMed

Noh, Soo Rim; Lohani, Monika; Isaacowitz, Derek M

2011-09-01

While previous research has linked executive attention to emotion regulation, the current study investigated the role of attentional alerting (i.e., efficient use of external warning cues) on younger (N=39) and older (N=44) adults' use of gaze to regulate their mood in real time. Participants viewed highly arousing unpleasant images while reporting their mood and were instructed to deliberately manage how they felt and to minimise the effect of those stimuli on their mood. Fixations toward the most negative areas of the images were recorded with eye tracking. We examined whether looking less at the most negative regions, compared to each individual's own tendency, was a beneficial mood regulatory strategy and how it interacted with age and alerting ability. High alerting older adults, who rely more on external cues to guide their attention, experienced a smaller decline in mood over time by activating a less-negative-looking approach (compared to their own average tendency), effectively looking away from the most negative areas of the images. More negative gaze patterns predicted better mood for younger adults, though this effect decreased over time. Alerting did not moderate gaze-mood links in younger adults. Successful mood regulation may thus depend on particular combinations of age, fixation, and attention.

Deliberate Real-time Mood Regulation in Adulthood: The Importance of Age, Fixation and Attentional Functioning

PubMed Central

Noh, Soo Rim; Lohani, Monika; Isaacowitz, Derek M.

2011-01-01

While previous research has linked executive attention to emotion regulation, the current study investigated the role of attentional alerting (i.e., efficient use of external warning cues) on younger (N = 39) and older (N = 44) adults’ use of gaze to regulate their mood in real time. Participants viewed highly arousing unpleasant images while reporting their mood and were instructed to deliberately manage how they felt and to minimize the effect of those stimuli on their mood. Fixations toward the most negative areas of the images were recorded with eye tracking. We examined whether looking less at the most negative regions, compared to each individual’s own tendency, was a beneficial mood regulatory strategy and how it interacted with age and alerting ability. High alerting older adults, who rely more on external cues to guide their attention, experienced a smaller decline in mood over time by activating a less-negative-looking approach (compared to their own average tendency), effectively looking away from the most negative areas of the images. More negative gaze patterns predicted better mood for younger adults, though this effect decreased over time. Alerting did not moderate gaze-mood links in younger adults. Successful mood regulation may thus depend on particular combinations of age, fixation, and attention. PMID:21432641

VoiceThread as a Peer Review and Dissemination Tool for Undergraduate Research

NASA Astrophysics Data System (ADS)

Guertin, L. A.

2012-12-01

VoiceThread has been utilized in an undergraduate research methods course for peer review and final research project dissemination. VoiceThread (http://www.voicethread.com) can be considered a social media tool, as it is a web-based technology with the capacity to enable interactive dialogue. VoiceThread is an application that allows a user to place a media collection online containing images, audio, videos, documents, and/or presentations in an interface that facilitates asynchronous communication. Participants in a VoiceThread can be passive viewers of the online content or engaged commenters via text, audio, video, with slide annotations via a doodle tool. The VoiceThread, which runs across browsers and operating systems, can be public or private for viewing and commenting and can be embedded into any website. Although few university students are aware of the VoiceThread platform (only 10% of the students surveyed by Ng (2012)), the 2009 K-12 edition of The Horizon Report (Johnson et al., 2009) lists VoiceThread as a tool to watch because of the opportunities it provides as a collaborative learning environment. In Fall 2011, eleven students enrolled in an undergraduate research methods course at Penn State Brandywine each conducted their own small-scale research project. Upon conclusion of the projects, students were required to create a poster summarizing their work for peer review. To facilitate the peer review process outside of class, each student-created PowerPoint file was placed in a VoiceThread with private access to only the class members and instructor. Each student was assigned to peer review five different student posters (i.e., VoiceThread images) with the audio and doodle tools to comment on formatting, clarity of content, etc. After the peer reviews were complete, the students were allowed to edit their PowerPoint poster files for a new VoiceThread. In the new VoiceThread, students were required to video record themselves describing their research and taking the viewer through their poster in the VoiceThread. This new VoiceThread with their final presentations was open for public viewing but not public commenting. A formal assessment was not conducted on the student impact of using VoiceThread for peer review and final research presentations. From an instructional standpoint, requiring students to use audio for the peer review commenting seemed to result in lengthier and more detailed reviews, connected with specific poster features when the doodle tool was utilized. By recording themselves as a "talking head" for the final product, students were required to be comfortable and confident with presenting their research, similar to what would be expected at a conference presentation. VoiceThread is currently being tested in general education Earth science courses at Penn State Brandywine as a dissemination tool for classroom-based inquiry projects and recruitment tool for Earth & Mineral Science majors.

Identifying high risk medications causing potential drug-drug interactions in outpatients: A prescription database study based on an online surveillance system.

PubMed

Toivo, T M; Mikkola, J A V; Laine, K; Airaksinen, M

2016-01-01

Drug-drug interactions (DDIs) are a significant cause for adverse drug events (ADEs). DDIs are often predictable and preventable, but their prevention and management require systematic service development. Most DDI studies focus on interaction rates in hospitalized patients. Less is known of DDIs in outpatients, particularly how community pharmacists could contribute to DDI management by applying their surveillance systems for identifying high-risk medications. The study was related to the implementation of the first online DDI surveillance system in Finnish community pharmacies. The goal was to demonstrate how community pharmacies can utilize their prospective surveillance system 1) for identifying high risk medications causing potential DDIs in outpatients, 2) for collaborative service development with local physicians, and 3) for academic risk management research purposes. All DDI alerts given by the online surveillance system were collected during a one-month period in 16 out of 17 University Pharmacy outlets in Finland, covering approximately 10% of the national outpatient prescription volume. The surveillance system was based on the FASS database, which categorizes DDIs into four classes (A-D) according to their clinical significance. Potential drug-drug DDIs were analyzed for 276,891 dispensed community pharmacy prescriptions. Potential DDIs were associated with 10.8%, or 31,110 of these prescriptions. Clinically significant interaction alerts categorized as FASS classes D (most severe, should be avoided) and C (clinically significant but controllable) were associated with 0.5% and 7.0% of the prescriptions, respectively. Methotrexate and warfarin had the highest risk of causing potentially serious (class D) interactions. These interaction alerts were most frequently between methotrexate and NSAIDs and warfarin and NSAIDs. In general, NSAIDs were the most commonly interacting drugs in this study. This study demonstrates that community pharmacies can actively contribute to DDI risk management and systematically use their surveillance systems for identifying patients having clinically significant DDIs. The findings also indicate that the majority of potentially serious interactions in outpatients involve a limited number of drugs, particularly NSAIDs, warfarin and methotrexate. Further research should focus on community pharmacists' involvement in DDI risk management in collaboration with local health care providers. Copyright © 2015 Elsevier Inc. All rights reserved.

Feasibility of automated speech sample collection with stuttering children using interactive voice response (IVR) technology.

PubMed

Vogel, Adam P; Block, Susan; Kefalianos, Elaina; Onslow, Mark; Eadie, Patricia; Barth, Ben; Conway, Laura; Mundt, James C; Reilly, Sheena

2015-04-01

To investigate the feasibility of adopting automated interactive voice response (IVR) technology for remotely capturing standardized speech samples from stuttering children. Participants were 10 6-year-old stuttering children. Their parents called a toll-free number from their homes and were prompted to elicit speech from their children using a standard protocol involving conversation, picture description and games. The automated IVR system was implemented using an off-the-shelf telephony software program and delivered by a standard desktop computer. The software infrastructure utilizes voice over internet protocol. Speech samples were automatically recorded during the calls. Video recordings were simultaneously acquired in the home at the time of the call to evaluate the fidelity of the telephone collected samples. Key outcome measures included syllables spoken, percentage of syllables stuttered and an overall rating of stuttering severity using a 10-point scale. Data revealed a high level of relative reliability in terms of intra-class correlation between the video and telephone acquired samples on all outcome measures during the conversation task. Findings were less consistent for speech samples during picture description and games. Results suggest that IVR technology can be used successfully to automate remote capture of child speech samples.

Real-time interactive speech technology at Threshold Technology, Incorporated

NASA Technical Reports Server (NTRS)

Herscher, Marvin B.

1977-01-01

Basic real-time isolated-word recognition techniques are reviewed. Industrial applications of voice technology are described in chronological order of their development. Future research efforts are also discussed.

How do you say 'hello'? Personality impressions from brief novel voices.

PubMed

McAleer, Phil; Todorov, Alexander; Belin, Pascal

2014-01-01

On hearing a novel voice, listeners readily form personality impressions of that speaker. Accurate or not, these impressions are known to affect subsequent interactions; yet the underlying psychological and acoustical bases remain poorly understood. Furthermore, hitherto studies have focussed on extended speech as opposed to analysing the instantaneous impressions we obtain from first experience. In this paper, through a mass online rating experiment, 320 participants rated 64 sub-second vocal utterances of the word 'hello' on one of 10 personality traits. We show that: (1) personality judgements of brief utterances from unfamiliar speakers are consistent across listeners; (2) a two-dimensional 'social voice space' with axes mapping Valence (Trust, Likeability) and Dominance, each driven by differing combinations of vocal acoustics, adequately summarises ratings in both male and female voices; and (3) a positive combination of Valence and Dominance results in increased perceived male vocal Attractiveness, whereas perceived female vocal Attractiveness is largely controlled by increasing Valence. Results are discussed in relation to the rapid evaluation of personality and, in turn, the intent of others, as being driven by survival mechanisms via approach or avoidance behaviours. These findings provide empirical bases for predicting personality impressions from acoustical analyses of short utterances and for generating desired personality impressions in artificial voices.

Instrumental and perceptual evaluations of two related singers.

PubMed

Buder, Eugene H; Wolf, Teresa

2003-06-01

The primary goal of this study was to characterize a performer's singing and speaking voice. One woman was not admitted to a premier choral group, but her sister, who was comparable in physical characteristics and background, was admitted and provided a valuable control subject. The perceptual judgment of a vocal coach who conducted the group's auditions was decisive in discriminating these 2 singers. The singer not admitted to the group described a history of voice pathology, lacked a functional head register, and spoke with a voice characterized by hoarseness. Multiple listener judgments and acoustic and aerodynamic evaluations of both singers provided a more systematic basis for determining: 1) the phonatory basis for this judgment; 2) whether similar judgments would be made by groups of vocal coaches and speech-language pathologists; and 3) whether the type of tasks (e.g., sung vs. spoken) would influence these judgments. Statistically significant differences were observed between the ratings of vocal health provided by two different groups of listeners. Significant interactions were also observed as a function of the types of voice samples heard by these listeners. Instrumental analyses provided evidence that, in comparison to her sister, the rejected singer had a compromised vocal range, glottal insufficiencies as assessed aerodynamically and electroglottographically, and impaired acoustic quality, especially in her speaking voice.

Middle Years Science Teachers Voice Their First Experiences with Interactive Whiteboard Technology

ERIC Educational Resources Information Center

Gadbois, Shannon A.; Haverstock, Nicole

2012-01-01

Among new technologies, interactive whiteboards (IWBs) particularly seem to engage students and offer entertainment value that may make them highly beneficial for learning. This study examined 10 Grade 6 teachers' initial experiences and uses of IWBs for teaching science. Through interviews, classroom visits, and field notes, the outcomes…

Frontal brain activation in premature infants' response to auditory stimuli in neonatal intensive care unit.

PubMed

Saito, Yuri; Fukuhara, Rie; Aoyama, Shiori; Toshima, Tamotsu

2009-07-01

The present study was focusing on the very few contacts with the mother's voice that NICU infants have in the womb as well as after birth, we examined whether they can discriminate between their mothers' utterances and those of female nurses in terms of the emotional bonding that is facilitated by prosodic utterances. Twenty-six premature infants were included in this study, and their cerebral blood flows were measured by near-infrared spectroscopy. They were exposed to auditory stimuli in the form of utterances made by their mothers and female nurses. A two (stimulus: mother and nurse) x two (recording site: right frontal area and left frontal area) analysis of variance (ANOVA) for these relative oxy-Hb values was conducted. The ANOVA showed a significant interaction between stimulus and recording site. The mother's and the nurse's voices were activated in the same way in the left frontal area, but showed different reactions in the right frontal area. We presume that the nurse's voice might become associated with pain and stress for premature infants. Our results showed that the premature infants reacted differently to the different voice stimuli. Therefore, we presume that both mothers' and nurses' voices represent positive stimuli for premature infants because both activate the frontal brain. Accordingly, we cannot explain our results only in terms of the state-dependent marker for infantile individual differences, but must also address the stressful trigger of nurses' voices for NICU infants.

Show and Tell: Video Modeling and Instruction Without Feedback Improves Performance but Is Not Sufficient for Retention of a Complex Voice Motor Skill.

PubMed

Look, Clarisse; McCabe, Patricia; Heard, Robert; Madill, Catherine J

2018-02-02

Modeling and instruction are frequent components of both traditional and technology-assisted voice therapy. This study investigated the value of video modeling and instruction in the early acquisition and short-term retention of a complex voice task without external feedback. Thirty participants were randomized to two conditions and trained to produce a vocal siren over 40 trials. One group received a model and verbal instructions, the other group received a model only. Sirens were analyzed for phonation time, vocal intensity, cepstral peak prominence, peak-to-peak time, and root-mean-square error at five time points. The model and instruction group showed significant improvement on more outcome measures than the model-only group. There was an interaction effect for vocal intensity, which showed that instructions facilitated greater improvement when they were first introduced. However, neither group reproduced the model's siren performance across all parameters or retained the skill 1 day later. Providing verbal instruction with a model appears more beneficial than providing a model only in the prepractice phase of acquiring a complex voice skill. Improved performance was observed; however, the higher level of performance was not retained after 40 trials in both conditions. Other prepractice variables may need to be considered. Findings have implications for traditional and technology-assisted voice therapy. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Natural asynchronies in audiovisual communication signals regulate neuronal multisensory interactions in voice-sensitive cortex

PubMed Central

Perrodin, Catherine; Kayser, Christoph; Logothetis, Nikos K.; Petkov, Christopher I.

2015-01-01

When social animals communicate, the onset of informative content in one modality varies considerably relative to the other, such as when visual orofacial movements precede a vocalization. These naturally occurring asynchronies do not disrupt intelligibility or perceptual coherence. However, they occur on time scales where they likely affect integrative neuronal activity in ways that have remained unclear, especially for hierarchically downstream regions in which neurons exhibit temporally imprecise but highly selective responses to communication signals. To address this, we exploited naturally occurring face- and voice-onset asynchronies in primate vocalizations. Using these as stimuli we recorded cortical oscillations and neuronal spiking responses from functional MRI (fMRI)-localized voice-sensitive cortex in the anterior temporal lobe of macaques. We show that the onset of the visual face stimulus resets the phase of low-frequency oscillations, and that the face–voice asynchrony affects the prominence of two key types of neuronal multisensory responses: enhancement or suppression. Our findings show a three-way association between temporal delays in audiovisual communication signals, phase-resetting of ongoing oscillations, and the sign of multisensory responses. The results reveal how natural onset asynchronies in cross-sensory inputs regulate network oscillations and neuronal excitability in the voice-sensitive cortex of macaques, a suggested animal model for human voice areas. These findings also advance predictions on the impact of multisensory input on neuronal processes in face areas and other brain regions. PMID:25535356

GPS: Shaping Student Success One Conversation at a Time

ERIC Educational Resources Information Center

Star, Mikhael; Collette, Lanita

2010-01-01

Increasing instructor-student interactions and improving support personnel interventions with students positively affects their academic performance, retention, and graduation rates. This article discusses the Grade Performance Status (GPS) which is Northern Arizona University's new online, academic early alert tool for increasing instructor…

The French Infectious Diseases Society's readiness and response to epidemic or biological risk-the current situation following the Middle East respiratory syndrome coronavirus and Ebola virus disease alerts.

PubMed

Coignard-Biehler, H; Rapp, C; Chapplain, J M; Hoen, B; Che, D; Berthelot, P; Cazenave-Roblot, F; Rabaud, C; Brouqui, P; Leport, C

2018-03-01

In 2012, the French Infectious Diseases Society (French acronym SPILF) initiated the "Coordination of epidemic and biological risk" (SPILF-COREB - Emergences [SCE]) group to support the readiness and response of healthcare workers (HCWs) to new alerts. To present the SCE group, its functioning, and the main support it provided for frontline HCWs. A multidisciplinary group of heads of infectious disease departments from reference hospitals was created to build a network of clinical expertise for care, training, and research in the field of epidemic and biological risk (EBR). The network developed a set of standardized operational procedures (SOPs) to guide interventions to manage EBR-suspect patients. A working group created the SOP aimed at frontline HCWs taking care of patients. Priority was given to the development of a generic procedure, which was then adapted according to the current alert. Five key steps were identified and hierarchized: detecting, protecting, caring for, alerting, and referring the EBR patient. The interaction between clinicians and those responsible for the protection of the community was crucial. The SOPs validated by the SPILF and its affiliates were disseminated to a wide range of key stakeholders through various media including workshops and the SPILF's website. SPILF can easily adapt and timely mobilize the EBR expertise in case of an alert. The present work suggests that sharing and discussing this experience, initiated at the European level, can generate a new collective expertise and needs to be further developed and strengthened. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Speed of recovery and side-effect profile of sevoflurane sedation compared with midazolam.

PubMed

Ibrahim, A E; Ghoneim, M M; Kharasch, E D; Epstein, R H; Groudine, S B; Ebert, T J; Binstock, W B; Philip, B K

2001-01-01

Sedation for surgical procedures performed with regional or local anesthesia has usually been achieved with intravenous medications, whereas the use of volatile anesthetics has been limited. The use of sevoflurane for sedation has been suggested because of its characteristics of nonpungency, rapid induction, and quick elimination. The purpose of this investigation was to assess the quality, recovery, and side effects of sevoflurane sedation compared with midazolam. One hundred seventy-three patients undergoing surgery with local or regional anesthesia were enrolled in a multicenter, open-label, randomized investigation comparing sedation with sevoflurane versus midazolam. Sedation level was titrated to an Observer's Assessment of Alertness--Sedation score of 3 (responds slowly to voice). Recovery was assessed objectively by Observer's Assessment of Alertness--Sedation, Digit Symbol Substitution Test (DSST), and memory scores, and subjectively by visual analog scales. Significantly more patients in the sevoflurane group had to be converted to general anesthesia because of excessive movement (18 sevoflurane and 2 midazolam; P = 0.043). Of remaining patients, 141 were assessable for efficacy and recovery data (93 sevoflurane and 48 midazolam). Sevoflurane and midazolam produced dose-related sedation. Sevoflurane patients had higher DSST and memory scores during recovery. Seventy-six percent (sevoflurane) compared with 35% (midazolam) returned to baseline DSST at 30 min postoperatively (P < 0.05). More frequent excitement-disinhibition was observed with sevoflurane (15 [16%] vs. midazolam; P = 0.008). Sevoflurane for sedation produces faster recovery of cognitive function as measured by DSST and memory scores compared with midazolam. However, sevoflurane for sedation is complicated by a high incidence of intraoperative excitement.

Providing accurate near real-time fire alerts for Protected Areas through NASA FIRMS: Opportunities and Challenges

NASA Astrophysics Data System (ADS)

Ilavajhala, S.; Davies, D.; Schmaltz, J. E.; Wong, M.; Murphy, K. J.

2013-12-01

The NASA Fire Information for Resource Management System (FIRMS) is at the forefront of providing global near real-time (NRT) MODIS thermal anomalies / hotspot location data to end-users . FIRMS serves the data via an interactive Web GIS named Web Fire Mapper, downloads of NRT active fire, archive data downloads for MODIS hotspots dating back to 1999 and a hotspot email alert system The FIRMS Email Alerts system has been successfully alerting users of fires in their area of interest in near real-time and/or via daily and weekly email summaries, with an option to receive MODIS hotspot data as a text file (CSV) attachment. Currently, there are more than 7000 email alert subscriptions from more than 100 countries. Specifically, the email alerts system is designed to generate and send an email alert for any region or area on the globe, with a special focus on providing alerts for protected areas worldwide. For many protected areas, email alerts are particularly useful for early fire detection, monitoring on going fires, as well as allocating resources to protect wildlife and natural resources of particular value. For protected areas, FIRMS uses the World Database on Protected Areas (WDPA) supplied by United Nations Environment Program - World Conservation Monitoring Centre (UNEP-WCMC). Maintaining the most up-to-date, accurate boundary geometry for the protected areas for the email alerts is a challenge as the WDPA is continuously updated due to changing boundaries, merging or delisting of certain protected areas. Because of this dynamic nature of the protected areas database, the FIRMS protected areas database is frequently out-of-date with the most current version of WDPA database. To maintain the most up-to-date boundary information for protected areas and to be in compliance with the WDPA terms and conditions, FIRMS needs to constantly update its database of protected areas. Currently, FIRMS strives to keep its database up to date by downloading the most recent WDPA database at regular intervals, processing it, and ingesting it into the FIRMS spatial database. However, due to the large size of database, the process to download, process and ingest the database is quite time consuming. The FIRMS team is currently working on developing a method to update the protected areas database via web at regular intervals or on-demand. Using such a solution, FIRMS will be able access the most up-to-date extents of any protected area and the corresponding spatial geometries in real time. As such, FIRMS can utilize such a service to access the protected areas and their associated geometries to keep users' protected area boundaries in sync with those of the most recent WDPA database, and thus serve a more accurate email alert to the users. Furthermore, any client accessing the WDPA protected areas database could potentially use the solution of real-time access to the protected areas database. This talk primarily focuses on the challenges for FIRMS in sending accurate email alerts for protected areas, along with the solution the FIRMS team is developing. This talk also introduces the FIRMS fire information system and its components, with a special emphasis on the FIRMS email alerts system.

A theoretical study of F0-F1 interaction with application to resonant speaking and singing voice.

PubMed

Titze, Ingo R

2004-09-01

An interactive source-filter system, consisting of a three-mass body-cover model of the vocal folds and a wave reflection model of the vocal tract, was used to test the dependence of vocal fold vibration on the vocal tract. The degree of interaction is governed by the epilarynx tube, which raises the vocal tract impedance to match the impedance of the glottis. The key component of the impedance is inertive reactance. Whenever there is inertive reactance, the vocal tract assists the vocal folds in vibration. The amplitude of vibration and the glottal flow can more than double, and the oral radiated power can increase up to 10 dB. As F0 approaches F1, the first formant frequency, the interactive source-filter system loses its advantage (because inertive reactance changes to compliant reactance) and the noninteractive system produces greater vocal output. Thus, from a voice training and control standpoint, there may be reasons to operate the system in either interactive and noninteractive modes. The harmonics 2F0 and 3F0 can also benefit from being positioned slightly below F1.

New perspective on psychosocial distress in patients with dysphonia: The moderating role of perceived control

PubMed Central

Meredith, Liza; Peterson, Carol B.; Frazier, Patricia A.

2015-01-01

Objectives Although an association between psychosocial distress (depression, anxiety, somatization, and perceived stress) and voice disorders has been observed, little is known about the relationship between distress and patient-reported voice handicap. Further, the psychological mechanisms underlying this relationship are poorly understood. Perceived control plays an important role in distress associated with other medical disorders. The objectives of this study were to 1) characterize the relationship between distress and patient-reported voice handicap and 2) examine the role of perceived control in this relationship. Study Design Cross-sectional study in tertiary care academic voice clinic. Methods Distress, perceived stress, voice handicap, and perceived control were measured using established assessment scales. Association was measured with Pearson’s correlation coefficient; moderation was assessed using multiple hierarchical regression. Results 533 patients enrolled. 34% met criteria for clinically significant distress (i.e., depression, anxiety, and/or somatization). A weak association (r=0.13, p=0.003) was observed between severity of psychosocial distress and vocal handicap. Present perceived control was inversely associated with distress (r=−0.41, p<0.0001), stress (r=−0.30, p<0.0001), and voice handicap (r=−0.30, p<0.0001). The relationship between voice handicap and psychosocial distress was moderated by perceived control (b for interaction term −0.15, p<0.001); greater vocal handicap was associated with greater distress in patients with low perceived control. Conclusions Severity of distress and vocal handicap were positively related, and the relation between them was moderated by perceived control. Vocal handicap was more related to distress among those with low perceived control; targeting this potential mechanism may facilitate new approaches for improved care. PMID:25795347

Processing voiceless vowels in Japanese: Effects of language-specific phonological knowledge

NASA Astrophysics Data System (ADS)

Ogasawara, Naomi

2005-04-01

There has been little research on processing allophonic variation in the field of psycholinguistics. This study focuses on processing the voiced/voiceless allophonic alternation of high vowels in Japanese. Three perception experiments were conducted to explore how listeners parse out vowels with the voicing alternation from other segments in the speech stream and how the different voicing statuses of the vowel affect listeners' word recognition process. The results from the three experiments show that listeners use phonological knowledge of their native language for phoneme processing and for word recognition. However, interactions of the phonological and acoustic effects are observed to be different in each process. The facilitatory phonological effect and the inhibitory acoustic effect cancel out one another in phoneme processing; while in word recognition, the facilitatory phonological effect overrides the inhibitory acoustic effect.

MIT-NASA/KSC space life science experiments - A telescience testbed

NASA Technical Reports Server (NTRS)

Oman, Charles M.; Lichtenberg, Byron K.; Fiser, Richard L.; Vordermark, Deborah S.

1990-01-01

Experiments performed at MIT to better define Space Station information system telescience requirements for effective remote coaching of astronauts by principal investigators (PI) on the ground are described. The experiments were conducted via satellite video, data, and voice links to surrogate crewmembers working in a laboratory at NASA's Kennedy Space Center. Teams of two PIs and two crewmembers performed two different space life sciences experiments. During 19 three-hour interactive sessions, a variety of test conditions were explored. Since bit rate limits are necessarily imposed on Space Station video experiments surveillance video was varied down to 50 Kb/s and the effectiveness of PI controlled frame rate, resolution, grey scale, and color decimation was investigated. It is concluded that remote coaching by voice works and that dedicated crew-PI voice loops would be of great value on the Space Station.

Disentangling the attention network test: behavioral, event related potentials, and neural source analyses

PubMed Central

Galvao-Carmona, Alejandro; González-Rosa, Javier J.; Hidalgo-Muñoz, Antonio R.; Páramo, Dolores; Benítez, María L.; Izquierdo, Guillermo; Vázquez-Marrufo, Manuel

2014-01-01

Background: The study of the attentional system remains a challenge for current neuroscience. The “Attention Network Test” (ANT) was designed to study simultaneously three different attentional networks (alerting, orienting, and executive) based in subtraction of different experimental conditions. However, some studies recommend caution with these calculations due to the interactions between the attentional networks. In particular, it is highly relevant that several interpretations about attentional impairment have arisen from these calculations in diverse pathologies. Event related potentials (ERPs) and neural source analysis can be applied to disentangle the relationships between these attentional networks not specifically shown by behavioral measures. Results: This study shows that there is a basic level of alerting (tonic alerting) in the no cue (NC) condition, represented by a slow negative trend in the ERP trace prior to the onset of the target stimuli. A progressive increase in the CNV amplitude related to the amount of information provided by the cue conditions is also shown. Neural source analysis reveals specific modulations of the CNV related to a task-related expectancy presented in the NC condition; a late modulation triggered by the central cue (CC) condition and probably representing a generic motor preparation; and an early and late modulation for spatial cue (SC) condition suggesting specific motor and sensory preactivation. Finally, the first component in the information processing of the target stimuli modulated by the interaction between orienting network and the executive system can be represented by N1. Conclusions: The ANT is useful as a paradigm to study specific attentional mechanisms and their interactions. However, calculation of network effects is based in subtractions with non-comparable experimental conditions, as evidenced by the present data, which can induce misinterpretations in the study of the attentional capacity in human subjects. PMID:25352800

What can vortices tell us about vocal fold vibration and voice production.

PubMed

Khosla, Sid; Murugappan, Shanmugam; Gutmark, Ephraim

2008-06-01

Much clinical research on laryngeal airflow has assumed that airflow is unidirectional. This review will summarize what additional knowledge can be obtained about vocal fold vibration and voice production by studying rotational motion, or vortices, in laryngeal airflow. Recent work suggests two types of vortices that may strongly contribute to voice quality. The first kind forms just above the vocal folds during glottal closing, and is formed by flow separation in the glottis; these flow separation vortices significantly contribute to rapid closing of the glottis, and hence, to producing loudness and high frequency harmonics in the acoustic spectrum. The second is a group of highly three-dimensional and coherent supraglottal vortices, which can produce sound by interaction with structures in the vocal tract. Present work is also described that suggests that certain laryngeal pathologies, such as asymmetric vocal fold tension, will significantly modify both types of vortices, with adverse impact on sound production: decreased rate of glottal closure, increased broadband noise, and a decreased signal to noise ratio. Recent research supports the hypothesis that glottal airflow contains certain vortical structures that significantly contribute to voice quality.

IBM techexplorer and MathML: Interactive Multimodal Scientific Documents

NASA Astrophysics Data System (ADS)

Diaz, Angel

2001-06-01

The World Wide Web provides a standard publishing platform for disseminating scientific and technical articles, books, journals, courseware, or even homework on the internet; however, the transition from paper to web-based interactive content has brought new opportunities for creating interactive content. Students, scientists, and engineers are now faced with the task of rendering the 2D presentational structure of mathematics, harnessing the wealth of scientific and technical software, and creating truly accessible scientific portals across international boundaries and markets. The recent emergence of World Wide Web Consortium (W3C) standards such as the Mathematical Markup Language (MathML), Language (XSL), and Aural CSS (ACSS) provide a foundation whereby mathematics can be displayed, enlivened, computed, and audio formatted. With interoperability ensured by standards, software applications can be easily brought together to create extensible and interactive scientific content. In this presentation we will provide an overview of the IBM techexplorer Hypermedia Browser, a web browser plug-in and ActiveX control aimed at bringing interactive mathematics to the masses across platforms and applications. We will demonstrate "live" mathematics where documents that contain MathML expressions can be edited and computed right inside your favorite web browser. This demonstration will be generalized as we show how MathML can be used to enliven even PowerPoint presentations. Finally, we will close the loop by demonstrating a novel approach to spoken mathematics based on MathML, DOM, XSL, ACSS, techexplorer, and IBM ViaVoice. By making use of techexplorer as the glue that binds the rendered content to the web browser, the back-end computation software, the Java applets that augment the exposition, and voice-rendering systems such as ViaVoice, authors can indeed create truly extensible and interactive scientific content. For more information see: [http://www.software.ibm.com/techexplorer] [http://www.alphaworks.ibm.com] [http://www.w3.org

Observations on coyote-mule deer interactions at Rocky Flats, Colorado

DOE Office of Scientific and Technical Information (OSTI.GOV)

Alldredge, A.W.; Arthur, W.J. III

1980-01-01

Observations of interactions between coyotes (Canis latrans) and mule deer (Odocoileus hemionus) in N-central Colorado indicated that, upon discovering a coyote close to a herd, mule deer would become alert, bunch together and either flee or pursue the coyote. Two observations of coyotes attacking deer indicated that the rump was the probable point of attack and in one case the deer began a defense using its front hooves.

Oyster Fisheries App

NASA Technical Reports Server (NTRS)

Perez Guerrero, Geraldo A.; Armstrong, Duane; Underwood, Lauren

2015-01-01

This project is creating a cloud-enabled, HTML 5 web application to help oyster fishermen and state agencies apply Earth science to improve the management of this important natural and economic resource. The Oyster Fisheries app gathers and analyzes environmental and water quality information, and alerts fishermen and resources managers about problems in oyster fishing waters. An intuitive interface based on Google Maps displays the geospatial information and provides familiar interactive controls to the users. Alerts can be tailored to notify users when conditions in specific leases or public fishing areas require attention. The app is hosted on the Amazon Web Services cloud. It is being developed and tested using some of the latest web development tools such as web components and Polymer.

Evaluating the use of cell phone messaging for community Ebola syndromic surveillance in high risked settings in Southern Sierra Leone.

PubMed

Jia, Kangbai; Mohamed, Koroma

2015-09-01

Most underdeveloped countries do not meet core disease outbreak surveillance because of the lack of human resources, laboratory and infrastructural facilities. The use of cell phone technology for disease outbreak syndromic surveillance is a new phenomenon in Sierra Leone despite its successes in other developing countries like Sri Lanka. In this study we set to evaluate the effectiveness of using cell phone technology for Ebola hemorrhagic fever syndromic surveillance in a high risked community in Sierra Leone. This study evaluated the effectiveness of using cell phone messaging (text and calls) for community Ebola hemorrhagic fever syndromic surveillance in high risked community in southern Sierra Leone. All cell phone syndromic surveillance data used for this study was reported as cell phone alert messages-texts and voice calls; by the Moyamba District Health Management Team for both Ebola hemorrhagic fever suspect and mortalities. We conducted a longitudinal data analysis of the monthly cumulative confirmed Ebola hemorrhagic fever cases and mortalities collected by both the traditional sentinel and community cell phone syndromic surveillance from August 2014 to October 2014. A total of 129 and 49 Ebola hemorrhagic fever suspect and confirmed cases respectively were recorded using the community Ebola syndromic surveillance cell phone alert system by the Moyamba District Health Management Team in October 2014. The average number of Ebola hemorrhagic fever suspects and confirmed cases for October 2014 were 4.16 (Std.dev 3.76) and 1.58 (Std.dev 1.43) respectively. Thirty-four percent (n=76) of the community Ebola syndromic surveillance cell phone alerts that were followed-up within 24 hours reported Ebola hemorrhagic fever suspect cases while 65.92% (n=147) reported mortality. Our study suggests some form of underreporting by the traditional sentinel Ebola hemorrhagic fever disease surveillance system in Moyamba District southern Sierra Leone for August-September 2014. Cell phone messaging technology can be effectively use as a tool for community epidemic surveillance from peripheral health care facilities to higher levels.

New Perspective on Psychosocial Distress in Patients with Dysphonia: The Moderating Role of Perceived Control.

PubMed

Misono, Stephanie; Meredith, Liza; Peterson, Carol B; Frazier, Patricia A

2016-03-01

Although an association between psychosocial distress (depression, anxiety, somatization, and perceived stress) and voice disorders has been observed, little is known about the relationship between distress and patient-reported voice handicap. Furthermore, the psychological mechanisms underlying this relationship are poorly understood. Perceived control plays an important role in distress associated with other medical disorders. The objectives of this study were to (1) characterize the relationship between distress and patient-reported voice handicap and (2) examine the role of perceived control in this relationship. This is a cross-sectional study in a tertiary care academic voice clinic. Distress, perceived stress, voice handicap, and perceived control were measured using established assessment scales. Association was measured with Pearson correlation coefficients; moderation was assessed using multiple hierarchical regression. A total of 533 patients enrolled. Thirty-four percent of the patients met criteria for clinically significant distress (ie, depression, anxiety, and/or somatization). A weak association (r = 0.13; P = 0.003) was observed between severity of psychosocial distress and vocal handicap. Present perceived control was inversely associated with distress (r = -0.41; P < 0.0001), stress (r = -0.30; P < 0.0001), and voice handicap (r = -0.30; P < 0.0001). The relationship between voice handicap and psychosocial distress was moderated by perceived control (b for interaction term, -0.15; P < 0.001); greater vocal handicap was associated with greater distress in patients with low perceived control. Severity of distress and vocal handicap were positively related, and the relation between them was moderated by perceived control. Vocal handicap was more related to distress among those with low perceived control; targeting this potential mechanism may facilitate new approaches for improved care. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Voice, (inter-)subjectivity, and real time recurrent interaction

PubMed Central

Cummins, Fred

2014-01-01

Received approaches to a unified phenomenon called “language” are firmly committed to a Cartesian view of distinct unobservable minds. Questioning this commitment leads us to recognize that the boundaries conventionally separating the linguistic from the non-linguistic can appear arbitrary, omitting much that is regularly present during vocal communication. The thesis is put forward that uttering, or voicing, is a much older phenomenon than the formal structures studied by the linguist, and that the voice has found elaborations and codifications in other domains too, such as in systems of ritual and rite. Voice, it is suggested, necessarily gives rise to a temporally bound subjectivity, whether it is in inner speech (Descartes' “cogito”), in conversation, or in the synchronized utterances of collective speech found in prayer, protest, and sports arenas world wide. The notion of a fleeting subjective pole tied to dynamically entwined participants who exert reciprocal influence upon each other in real time provides an insightful way to understand notions of common ground, or socially shared cognition. It suggests that the remarkable capacity to construct a shared world that is so characteristic of Homo sapiens may be grounded in this ability to become dynamically entangled as seen, e.g., in the centrality of joint attention in human interaction. Empirical evidence of dynamic entanglement in joint speaking is found in behavioral and neuroimaging studies. A convergent theoretical vocabulary is now available in the concept of participatory sense-making, leading to the development of a rich scientific agenda liberated from a stifling metaphysics that obscures, rather than illuminates, the means by which we come to inhabit a shared world. PMID:25101028

Organizational uncertainty and stress among teachers in Hong Kong: work characteristics and organizational justice.

PubMed

Hassard, Juliet; Teoh, Kevin; Cox, Tom

2017-10-01

A growing literature now exists examining the relationship between organizational justice and employees' experience of stress. Despite the growth in this field of enquiry, there remain continued gaps in knowledge. In particular, the contribution of perceptions of justice to employees' stress within an organizational context of uncertainty and change, and in relation to the new and emerging concept of procedural-voice justice. The aim of the current study was to examine the main, interaction and additive effects of work characteristics and organizational justice perceptions to employees' experience of stress (as measured by their feelings of helplessness and perceived coping) during an acknowledged period of organizational uncertainty. Questionnaires were distributed among teachers in seven public primary schools in Hong Kong that were under threat of closure (n = 212). Work characteristics were measured using the demand-control-support model. Hierarchical regression analyses observed perceptions of job demands and procedural-voice justice to predict both teachers' feelings of helplessness and perceived coping ability. Furthermore, teacher's perceived coping was predicted by job control and a significant interaction between procedural-voice justice and distributive justice. The addition of organizational justice variables did account for unique variance, but only in relation to the measure of perceived coping. The study concludes that in addition to 'traditional' work characteristics, health promotion strategies should also address perceptions of organizational justice during times of organizational uncertainty; and, in particular, the value and importance of enhancing employee's perceived 'voice' in influencing and shaping justice-related decisions. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Exploring interpersonal behavior and team sensemaking during health information technology implementation.

PubMed

Kitzmiller, Rebecca R; McDaniel, Reuben R; Johnson, Constance M; Lind, E Allan; Anderson, Ruth A

2013-01-01

We examine how interpersonal behavior and social interaction influence team sensemaking and subsequent team actions during a hospital-based health information technology (HIT) implementation project. Over the course of 18 months, we directly observed the interpersonal interactions of HIT implementation teams using a sensemaking lens. We identified three voice-promoting strategies enacted by team leaders that fostered team member voice and sensemaking; communicating a vision; connecting goals to team member values; and seeking team member input. However, infrequent leader expressions of anger quickly undermined team sensemaking, halting dialog essential to problem solving. By seeking team member opinions, team leaders overcame the negative effects of anger. Leaders must enact voice-promoting behaviors and use them throughout a team's engagement. Further, training teams in how to use conflict to achieve greater innovation may improve sensemaking essential to project risk mitigation. Health care work processes are complex; teams involved in implementing improvements must be prepared to deal with conflicting, contentious issues, which will arise during change. Therefore, team conflict training may be essential to sustaining sensemaking. Future research should seek to identify team interactions that foster sensemaking, especially when topics are difficult or unwelcome, then determine the association between staff sensemaking and the impact on HIT implementation outcomes. We are among the first to focus on project teams tasked with HIT implementation. This research extends our understanding of how leaders' behaviors might facilitate or impeded speaking up among project teams in health care settings.

Fluid-Structure Interactions as Flow Propagates Tangentially Over a Flexible Plate with Application to Voiced Speech Production

NASA Astrophysics Data System (ADS)

Westervelt, Andrea; Erath, Byron

2013-11-01

Voiced speech is produced by fluid-structure interactions that drive vocal fold motion. Viscous flow features influence the pressure in the gap between the vocal folds (i.e. glottis), thereby altering vocal fold dynamics and the sound that is produced. During the closing phases of the phonatory cycle, vortices form as a result of flow separation as air passes through the divergent glottis. It is hypothesized that the reduced pressure within a vortex core will alter the pressure distribution along the vocal fold surface, thereby aiding in vocal fold closure. The objective of this study is to determine the impact of intraglottal vortices on the fluid-structure interactions of voiced speech by investigating how the dynamics of a flexible plate are influenced by a vortex ring passing tangentially over it. A flexible plate, which models the medial vocal fold surface, is placed in a water-filled tank and positioned parallel to the exit of a vortex generator. The physical parameters of plate stiffness and vortex circulation are scaled with physiological values. As vortices propagate over the plate, particle image velocimetry measurements are captured to analyze the energy exchange between the fluid and flexible plate. The investigations are performed over a range of vortex formation numbers, and lateral displacements of the plate from the centerline of the vortex trajectory. Observations show plate oscillations with displacements directly correlated with the vortex core location.

An mHealth Monitoring System for Traditional Birth Attendant-led Antenatal Risk Assessment in Rural Guatemala

PubMed Central

Stroux, Lisa; Martinez, Boris; Ixen, Enma Coyote; King, Nora; Hall-Clifford, Rachel; Rohloff, Peter; Clifford, Gari D.

2016-01-01

Limited funding for medical technology, low levels of education and poor infrastructure for delivering and maintaining technology severely limit medical decision support in low- and middle-income countries. Perinatal and maternal mortality is of particular concern with millions dying every year from potentially treatable conditions. Guatemala has one of the worst maternal mortality ratios, the highest incidence of intrauterine growth restriction (IUGR), and one of the lowest gross national incomes per capita within Latin America. To address the lack of decision support in rural Guatemala, a smartphone-based system is proposed including peripheral sensors, such as a handheld Doppler for the identification of fetal compromise. Designed for use by illiterate birth attendants, the system uses pictograms, audio guidance, local and cloud processing, SMS alerts and voice calling. The initial prototype was evaluated on 22 women in highland Guatemala. Results were fed back into the refinement of the system, currently undergoing RCT evaluation. PMID:27696915

An mHealth monitoring system for traditional birth attendant-led antenatal risk assessment in rural Guatemala.

PubMed

Stroux, Lisa; Martinez, Boris; Coyote Ixen, Enma; King, Nora; Hall-Clifford, Rachel; Rohloff, Peter; Clifford, Gari D

Limited funding for medical technology, low levels of education and poor infrastructure for delivering and maintaining technology severely limit medical decision support in low- and middle-income countries. Perinatal and maternal mortality is of particular concern with millions dying every year from potentially treatable conditions. Guatemala has one of the worst maternal mortality ratios, the highest incidence of intra-uterine growth restriction (IUGR), and one of the lowest gross national incomes per capita within Latin America. To address the lack of decision support in rural Guatemala, a smartphone-based system is proposed including peripheral sensors, such as a handheld Doppler for the identification of foetal compromise. Designed for use by illiterate birth attendants, the system uses pictograms, audio guidance, local and cloud processing, SMS alerts and voice calling. The initial prototype was evaluated on 22 women in highland Guatemala. Results were fed back into the refinement of the system, currently undergoing RCT evaluation.

Occupational voice demands and their impact on the call-centre industry.

PubMed

Hazlett, D E; Duffy, O M; Moorhead, S A

2009-04-20

Within the last decade there has been a growth in the call-centre industry in the UK, with a growing awareness of the voice as an important tool for successful communication. Occupational voice problems such as occupational dysphonia, in a business which relies on healthy, effective voice as the primary professional communication tool, may threaten working ability and occupational health and safety of workers. While previous studies of telephone call-agents have reported a range of voice symptoms and functional vocal health problems, there have been no studies investigating the use and impact of vocal performance in the communication industry within the UK. This study aims to address a significant gap in the evidence-base of occupational health and safety research. The objectives of the study are: 1. to investigate the work context and vocal communication demands for call-agents; 2. to evaluate call-agents' vocal health, awareness and performance; and 3. to identify key risks and training needs for employees and employers within call-centres. This is an occupational epidemiological study, which plans to recruit call-centres throughout the UK and Ireland. Data collection will consist of three components: 1. interviews with managers from each participating call-centre to assess their communication and training needs; 2. an online biopsychosocial questionnaire will be administered to investigate the work environment and vocal demands of call-agents; and 3. voice acoustic measurements of a random sample of participants using the Multi-dimensional Voice Program (MDVP). Qualitative content analysis from the interviews will identify underlying themes and issues. A multivariate analysis approach will be adopted using Structural Equation Modelling (SEM), to develop voice measurement models in determining the construct validity of potential factors contributing to occupational dysphonia. Quantitative data will be analysed using SPSS version 15. Ethical approval is granted for this study from the School of Communication, University of Ulster. The results from this study will provide the missing element of voice-based evidence, by appraising the interactional dimensions of vocal health and communicative performance. This information will be used to inform training for call-agents and to contribute to health policies within the workplace, in order to enhance vocal health.

Fostering Students' Science Inquiry through App Affordances of Multimodality, Collaboration, Interactivity, and Connectivity

ERIC Educational Resources Information Center

Beach, Richard; O'Brien, David

2015-01-01

This study examined 6th graders' use of the VoiceThread app as part of a science inquiry project on photosynthesis and carbon dioxide emissions in terms of their ability to engage in causal reasoning and their use of the affordances of multimodality, collaboration, interactivity, and connectivity. Students employed multimodal production using…

E-Learning. Trends and Issues Alert.

ERIC Educational Resources Information Center

Imel, Susan

Electronic learning, also known as e-learning, is generally defined as instruction and learning experiences that are delivered via electronic technology such as the Internet, audiotape and videotape, satellite broadcast, interactive television, and CD-ROM. Web-based learning, computer-based learning, and virtual classrooms are some of the…

Development and Feasibility of an Interactive Smartphone App for Early Assessment and Management of Symptoms Following Pancreaticoduodenectomy.

PubMed

Gustavell, Tina; Langius-Eklöf, Ann; Wengström, Yvonne; Segersvärd, Ralf; Sundberg, Kay

2018-03-27

Patients who have undergone pancreaticoduodenectomy because of pancreatic cancer experience distressing symptoms and unmet supportive care needs after discharge. To meet these needs, we have developed a mobile health app (Interaktor) for daily assessment of symptoms and access to self-care advice that includes a risk assessment model for alerts with real-time interactions with professionals. The study aim was to develop and test a version of the Interaktor app adapted for patients who have undergone pancreaticoduodenectomy. The app was developed and tested for feasibility in 6 patients during 4 weeks. One nurse monitored and responded to alerts. Logged data from the app were collected, and all participants were interviewed about their experiences. Adherence to reporting daily was 84%. Alerts were generated in 41% of the reports. The patients felt reassured and cared for and received support for symptom management. The app was easy to use, had relevant content, and had few technical problems, although suggestions for improvement were given. The daily reporting of symptoms and having access to a nurse in real time in the case of an alarming symptom seem to enhance symptom management and render a feeling of security in patients. Some modifications of the app are needed before use in a larger sample. Daily reporting of symptoms after pancreaticoduodenectomy enhances symptom management, self-care, and participation without being a burden to patients, indicating that mobile health can be used in clinical practice by patients with poor prognosis who experience severe symptoms.

Effects of vocal training and phonatory task on voice onset time.

PubMed

McCrea, Christopher R; Morris, Richard J

2007-01-01

The purpose of this study was to examine the temporal-acoustic differences between trained singers and nonsingers during speech and singing tasks. Thirty male participants were separated into two groups of 15 according to level of vocal training (ie, trained or untrained). The participants spoke and sang carrier phrases containing English voiced and voiceless bilabial stops, and voice onset time (VOT) was measured for the stop consonant productions. Mixed analyses of variance revealed a significant main effect between speech and singing for /p/ and /b/, with VOT durations longer during speech than singing for /p/, and the opposite true for /b/. Furthermore, a significant phonatory task by vocal training interaction was observed for /p/ productions. The results indicated that the type of phonatory task influences VOT and that these influences are most obvious in trained singers secondary to the articulatory and phonatory adjustments learned during vocal training.

Irregular vocal fold dynamics incited by asymmetric fluid loading in a model of recurrent laryngeal nerve paralysis

NASA Astrophysics Data System (ADS)

Sommer, David; Erath, Byron D.; Zanartu, Matias; Peterson, Sean D.

2011-11-01

Voiced speech is produced by dynamic fluid-structure interactions in the larynx. Traditionally, reduced order models of speech have relied upon simplified inviscid flow solvers to prescribe the fluid loadings that drive vocal fold motion, neglecting viscous flow effects that occur naturally in voiced speech. Viscous phenomena, such as skewing of the intraglottal jet, have the most pronounced effect on voiced speech in cases of vocal fold paralysis where one vocal fold loses some, or all, muscular control. The impact of asymmetric intraglottal flow in pathological speech is captured in a reduced order two-mass model of speech by coupling a boundary-layer estimation of the asymmetric pressures with asymmetric tissue parameters that are representative of recurrent laryngeal nerve paralysis. Nonlinear analysis identifies the emergence of irregular and chaotic vocal fold dynamics at values representative of pathological speech conditions.

Differences in botulinum toxin dosing between patients with adductor spasmodic dysphonia and essential voice tremor.

PubMed

Orbelo, Diana M; Duffy, Joseph R; Hughes Borst, Becky J; Ekbom, Dale; Maragos, Nicolas E

2014-01-01

To explore possible dose differences in average botulinum toxin (BTX) given to patients with adductor spasmodic dysphonia (ADSD) compared with patients with essential voice tremor (EVT). A retrospective study compared the average BTX dose injected in equal doses to the thyroarytenoid (TA) muscles of 51 patients with ADSD with 52 patients with EVT. Those with ADSD received significantly higher total doses (6.80 ± 2.79 units) compared with those with EVT (5.02 ± 1.65 units). Dose at time of first injection, age at time of first injection, gender, year of first injection, and average time between injections were included in multivariate analysis but did not interact with total average dose findings. Patients with ADSD may need relatively higher doses of BTX injections to bilateral TA muscles compared with patients with EVT. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

In vitro experimental investigation of voice production

PubMed Central

Horáčcek, Jaromír; Brücker, Christoph; Becker, Stefan

2012-01-01

The process of human phonation involves a complex interaction between the physical domains of structural dynamics, fluid flow, and acoustic sound production and radiation. Given the high degree of nonlinearity of these processes, even small anatomical or physiological disturbances can significantly affect the voice signal. In the worst cases, patients can lose their voice and hence the normal mode of speech communication. To improve medical therapies and surgical techniques it is very important to understand better the physics of the human phonation process. Due to the limited experimental access to the human larynx, alternative strategies, including artificial vocal folds, have been developed. The following review gives an overview of experimental investigations of artificial vocal folds within the last 30 years. The models are sorted into three groups: static models, externally driven models, and self-oscillating models. The focus is on the different models of the human vocal folds and on the ways in which they have been applied. PMID:23181007

Translational Systems Biology and Voice Pathophysiology

PubMed Central

Li, Nicole Y. K.; Abbott, Katherine Verdolini; Rosen, Clark; An, Gary; Hebda, Patricia A.; Vodovotz, Yoram

2011-01-01

Objectives/Hypothesis Personalized medicine has been called upon to tailor healthcare to an individual's needs. Evidence-based medicine (EBM) has advocated using randomized clinical trials with large populations to evaluate treatment effects. However, due to large variations across patients, the results are likely not to apply to an individual patient. We suggest that a complementary, systems biology approach using computational modeling may help tackle biological complexity in order to improve ultimate patient care. The purpose of the article is: 1) to review the pros and cons of EBM, and 2) to discuss the alternative systems biology method and present its utility in clinical voice research. Study Design Tutorial Methods Literature review and discussion. Results We propose that translational systems biology can address many of the limitations of EBM pertinent to voice and other health care domains, and thus complement current health research models. In particular, recent work using mathematical modeling suggests that systems biology has the ability to quantify the highly complex biologic processes underlying voice pathophysiology. Recent data support the premise that this approach can be applied specifically in the case of phonotrauma and surgically induced vocal fold trauma, and may have particular power to address personalized medicine. Conclusions We propose that evidence around vocal health and disease be expanded beyond a population-based method to consider more fully issues of complexity and systems interactions, especially in implementing personalized medicine in voice care and beyond. PMID:20025041

Human voice perception.

PubMed

Latinus, Marianne; Belin, Pascal

2011-02-22

We are all voice experts. First and foremost, we can produce and understand speech, and this makes us a unique species. But in addition to speech perception, we routinely extract from voices a wealth of socially-relevant information in what constitutes a more primitive, and probably more universal, non-linguistic mode of communication. Consider the following example: you are sitting in a plane, and you can hear a conversation in a foreign language in the row behind you. You do not see the speakers' faces, and you cannot understand the speech content because you do not know the language. Yet, an amazing amount of information is available to you. You can evaluate the physical characteristics of the different protagonists, including their gender, approximate age and size, and associate an identity to the different voices. You can form a good idea of the different speaker's mood and affective state, as well as more subtle cues as the perceived attractiveness or dominance of the protagonists. In brief, you can form a fairly detailed picture of the type of social interaction unfolding, which a brief glance backwards can on the occasion help refine - sometimes surprisingly so. What are the acoustical cues that carry these different types of vocal information? How does our brain process and analyse this information? Here we briefly review an emerging field and the main tools used in voice perception research. Copyright © 2011 Elsevier Ltd. All rights reserved.

Optical and X-ray early follow-up of ANTARES neutrino alerts

NASA Astrophysics Data System (ADS)

Adrián-Martínez, S.; Ageron, M.; Albert, A.; Samarai, I. Al; André, M.; Anton, G.; Ardid, M.; Aubert, J.-J.; Baret, B.; Barrios-Martí, J.; Basa, S.; Bertin, V.; Biagi, S.; Bogazzi, C.; Bormuth, R.; Bou-Cabo, M.; Bouwhuis, M. C.; Bruijn, R.; Brunner, J.; Busto, J.; Capone, A.; Caramete, L.; Carr, J.; Chiarusi, T.; Circella, M.; Coniglione, R.; Costantini, H.; Coyle, P.; Creusot, A.; Dekeyser, I.; Deschamps, A.; De Bonis, G.; Distefano, C.; Donzaud, C.; Dornic, D.; Drouhin, D.; Dumas, A.; Eberl, T.; Elsässer, D.; Enzenhöfer, A.; Fehn, K.; Felis, I.; Fermani, P.; Folger, F.; Fusco, L. A.; Galatà, S.; Gay, P.; Geißelsöder, S.; Geyer, K.; Giordano, V.; Gleixner, A.; Gracia-Ruiz, R.; Graf, K.; van Haren, H.; Heijboer, A. J.; Hello, Y.; Hernández-Rey, J. J.; Herrero, A.; Hößl, J.; Hofestädt, J.; Hugon, C.; James, C. W.; de Jong, M.; Kadler, M.; Kalekin, O.; Katz, U.; Kießling, D.; Kooijman, P.; Kouchner, A.; Kreykenbohm, I.; Kulikovskiy, V.; Lahmann, R.; Lambard, G.; Lattuada, D.; Lefèvre, D.; Leonora, E.; Loucatos, S.; Mangano, S.; Marcelin, M.; Margiotta, A.; Martínez-Mora, J. A.; Martini, S.; Mathieu, A.; Michael, T.; Migliozzi, P.; Moussa, A.; Mueller, C.; Neff, M.; Nezri, E.; Păvălaš, G. E.; Pellegrino, C.; Perrina, C.; Piattelli, P.; Popa, V.; Pradier, T.; Racca, C.; Riccobene, G.; Richter, R.; Roensch, K.; Rostovtsev, A.; Saldaña, M.; Samtleben, D. F. E.; Sanguineti, M.; Sapienza, P.; Schmid, J.; Schnabel, J.; Schulte, S.; Schüssler, F.; Seitz, T.; Sieger, C.; Spurio, M.; Steijger, J. J. M.; Stolarczyk, Th.; Sánchez-Losa, A.; Taiuti, M.; Tamburini, C.; Trovato, A.; Tselengidou, M.; Tönnis, C.; Turpin, D.; Vallage, B.; Vallée, C.; Van Elewyck, V.; Vecchi, M.; Visser, E.; Vivolo, D.; Wagner, S.; Wilms, J.; Zornoza, J. D.; Zúñiga, J.; Klotz, A.; Boer, M.; Le Van Suu, A.; Akerlof, C.; Zheng, W.; Evans, P.; Gehrels, N.; Kennea, J.; Osborne, J. P.; Coward, D. M.

2016-02-01

High-energy neutrinos could be produced in the interaction of charged cosmic rays with matter or radiation surrounding astrophysical sources. Even with the recent detection of extraterrestrial high-energy neutrinos by the IceCube experiment, no astrophysical neutrino source has yet been discovered. Transient sources, such as gamma-ray bursts, core-collapse supernovae, or active galactic nuclei are promising candidates. Multi-messenger programs offer a unique opportunity to detect these transient sources. By combining the information provided by the ANTARES neutrino telescope with information coming from other observatories, the probability of detecting a source is enhanced, allowing the possibility of identifying a neutrino progenitor from a single detected event. A method based on optical and X-ray follow-ups of high-energy neutrino alerts has been developed within the ANTARES collaboration. This method does not require any assumptions on the relation between neutrino and photon spectra other than time-correlation. This program, denoted as TAToO, triggers a network of robotic optical telescopes (TAROT and ROTSE) and the Swift-XRT with a delay of only a few seconds after a neutrino detection, and is therefore well-suited to search for fast transient sources. To identify an optical or X-ray counterpart to a neutrino signal, the images provided by the follow-up observations are analysed with dedicated pipelines. A total of 42 alerts with optical and 7 alerts with X-ray images taken with a maximum delay of 24 hours after the neutrino trigger have been analysed. No optical or X-ray counterparts associated to the neutrino triggers have been found, and upper limits on transient source magnitudes have been derived. The probability to reject the gamma-ray burst origin hypothesis has been computed for each alert.

Optical and X-ray early follow-up of ANTARES neutrino alerts

DOE Office of Scientific and Technical Information (OSTI.GOV)

Adrián-Martínez, S.; Ardid, M.; Ageron, M.

High-energy neutrinos could be produced in the interaction of charged cosmic rays with matter or radiation surrounding astrophysical sources. Even with the recent detection of extraterrestrial high-energy neutrinos by the IceCube experiment, no astrophysical neutrino source has yet been discovered. Transient sources, such as gamma-ray bursts, core-collapse supernovae, or active galactic nuclei are promising candidates. Multi-messenger programs offer a unique opportunity to detect these transient sources. By combining the information provided by the ANTARES neutrino telescope with information coming from other observatories, the probability of detecting a source is enhanced, allowing the possibility of identifying a neutrino progenitor from amore » single detected event. A method based on optical and X-ray follow-ups of high-energy neutrino alerts has been developed within the ANTARES collaboration. This method does not require any assumptions on the relation between neutrino and photon spectra other than time-correlation. This program, denoted as TAToO, triggers a network of robotic optical telescopes (TAROT and ROTSE) and the Swift-XRT with a delay of only a few seconds after a neutrino detection, and is therefore well-suited to search for fast transient sources. To identify an optical or X-ray counterpart to a neutrino signal, the images provided by the follow-up observations are analysed with dedicated pipelines. A total of 42 alerts with optical and 7 alerts with X-ray images taken with a maximum delay of 24 hours after the neutrino trigger have been analysed. No optical or X-ray counterparts associated to the neutrino triggers have been found, and upper limits on transient source magnitudes have been derived. The probability to reject the gamma-ray burst origin hypothesis has been computed for each alert.« less

The Effect of a Computerized Teaching Assistant on Student Interaction, Student Satisfaction, and Retention Rates of Students in a Distance Course

ERIC Educational Resources Information Center

Reindl-Johnson, Cheryl

2004-01-01

The purpose of this study was to investigate the effect of a computerized teaching assistant (CTA) on student interaction, student satisfaction, and retention rates of students in a distance course. The CTA is humanoid and speaks in a human voice from recorded sound clips, to give the student the feeling that he/she is interacting with a person,…

Advanced alerting features: displaying new relevant data and retracting alerts.

PubMed Central

Kuperman, G. J.; Hiltz, F. L.; Teich, J. M.

1997-01-01

We added two advanced features to our automated alerting system. The first feature identifies and displays, at the time an alert is reviewed, relevant data filed between the login time of a specimen leading to an alerting result and the time the alert is reviewed. Relevant data is defined as data of the same kind as generated the alert. The other feature retracts alerts when the alerting value is edited and no longer satisfies the alerting criteria. We evaluated the two features for a 14-week period (new relevant data) and a 6-week period (retraction). Of a total of 1104 alerts in the 14-week evaluation, 286 (25.9%) had new relevant data displayed at alert review time. Of the 286, 75.2% were due to additions of comments to the original piece of alerting data; 24.1% were due to new or pending laboratory results of the same type that generated the alert. Two alerts (out of 490) were retracted in a 6 week period. We conclude that in our system, new clinically relevant data is often added between the time of specimen login and the time that an alerting result from that specimen is reviewed. Retractions occur rarely but are important to detect and communicate. PMID:9357625

Proactive authenticated notifications for health practitioners: two way human computer interaction through phone.

PubMed

Majeed, Raphael W; Stöhr, Mark R; Röhrig, Rainer

2012-01-01

Notifications and alerts play an important role in clinical daily routine. Rising prevalence of clinical decision support systems and electronic health records also result in increasing demands on notification systems. Failure adequately to communicate a critical value is a potential cause of adverse events. Critical laboratory values and changing vital data depend on timely notifications of medical staff. Vital monitors and medical devices rely on acoustic signals for alerting which are prone to "alert fatigue" and require medical staff to be present within audible range. Personal computers are unsuitable to display time critical notification messages, since the targeted medical staff are not always operating or watching the computer. On the other hand, mobile phones and smart devices enjoy increasing popularity. Previous notification systems sending text messages to mobile phones depend on asynchronous confirmations. By utilizing an automated telephony server, we provide a method to deliver notifications quickly and independently of the recipients' whereabouts while allowing immediate feedback and confirmations. Evaluation results suggest the feasibility of the proposed notification system for real-time notifications.

User's guide to SSARRMENU

USGS Publications Warehouse

Mastin, M.C.; Le, Thanh

2001-01-01

The U.S. Geological Survey, in cooperation with Pierce County Department of Public Works, Washington, has developed an operational tool called the Puyallup Flood-Alert System to alert users of impending floods in the Puyallup River Basin. The system acquires and incorporates meteorological and hydrological data into the Streamflow Synthesis and Reservoir Regulation (SSARR) hydrologic flow-routing model to simulate floods in the Puyallup River Basin. SSARRMENU is the user-interactive graphical interface between the user, the input and output data, and the SSARR model. In a companion cooperative project with Pierce County, the SSARR model for the Puyallup River Basin was calibrated and validated. The calibrated model is accessed through SSARRMENU, which has been specifically programed for the Puyallup River and the needs of Pierce County. SSARRMENU automates the retrieval of data from ADAPS (Automated DAta Processing System, the U.S. Geological Survey?s real-time hydrologic database), formats the data for use with SSARR, initiates SSARR model runs, displays alerts for impending floods, and provides utilities to display the simulated and observed data. An on-screen map of the basin and a series of menu items provide the user wi

The perception of complex pitch in cochlear implants: A comparison of monopolar and tripolar stimulation.

PubMed

Fielden, Claire A; Kluk, Karolina; Boyle, Patrick J; McKay, Colette M

2015-10-01

Cochlear implant listeners typically perform poorly in tasks of complex pitch perception (e.g., musical pitch and voice pitch). One explanation is that wide current spread during implant activation creates channel interactions that may interfere with perception of temporal fundamental frequency information contained in the amplitude modulations within channels. Current focusing using a tripolar mode of stimulation has been proposed as a way of reducing channel interactions, minimising spread of excitation and potentially improving place and temporal pitch cues. The present study evaluated the effect of mode in a group of cochlear implant listeners on a pitch ranking task using male and female singing voices separated by either a half or a quarter octave. Results were variable across participants, but on average, pitch ranking was at chance level when the pitches were a quarter octave apart and improved when the difference was a half octave. No advantage was observed for tripolar over monopolar mode at either pitch interval, suggesting that previously published psychophysical advantages for focused modes may not translate into improvements in complex pitch ranking. Evaluation of the spectral centroid of the stimulation pattern, plus a lack of significant difference between male and female voices, suggested that participants may have had difficulty in accessing temporal pitch cues in either mode.

Nurses using futuristic technology in today's healthcare setting.

PubMed

Wolf, Debra M; Kapadia, Amar; Kintzel, Jessie; Anton, Bonnie B

2009-01-01

Human computer interaction (HCI) equates nurses using voice assisted technology within a clinical setting to document patient care real time, retrieve patient information from care plans, and complete routine tasks. This is a reality currently utilized by clinicians today in acute and long term care settings. Voice assisted documentation provides hands & eyes free accurate documentation while enabling effective communication and task management. The speech technology increases the accuracy of documentation, while interfacing directly into the electronic health record (EHR). Using technology consisting of a light weight headset and small fist size wireless computer, verbal responses to easy to follow cues are converted into a database systems allowing staff to obtain individualized care status reports on demand. To further assist staff in their daily process, this innovative technology allows staff to send and receive pages as needed. This paper will discuss how leading edge and award winning technology is being integrated within the United States. Collaborative efforts between clinicians and analyst will be discussed reflecting the interactive design and build functionality. Features such as the system's voice responses and directed cues will be shared and how easily data can be documented, viewed and retrieved. Outcome data will be presented on how the technology impacted organization's quality outcomes, financial reimbursement, and employee's level of satisfaction.

Technologic Distractions (Part 1): Summary of Approaches to Manage Alert Quantity With Intent to Reduce Alert Fatigue and Suggestions for Alert Fatigue Metrics.

PubMed

Kane-Gill, Sandra L; O'Connor, Michael F; Rothschild, Jeffrey M; Selby, Nicholas M; McLean, Barbara; Bonafide, Christopher P; Cvach, Maria M; Hu, Xiao; Konkani, Avinash; Pelter, Michele M; Winters, Bradford D

2017-09-01

To provide ICU clinicians with evidence-based guidance on tested interventions that reduce or prevent alert fatigue within clinical decision support systems. Systematic review of PubMed, Embase, SCOPUS, and CINAHL for relevant literature from 1966 to February 2017. Focus on critically ill patients and included evaluations in other patient care settings, as well. Identified interventions designed to reduce or prevent alert fatigue within clinical decision support systems. Study selection was based on one primary key question to identify effective interventions that attempted to reduce alert fatigue and three secondary key questions that covered the negative effects of alert fatigue, potential unintended consequences of efforts to reduce alert fatigue, and ideal alert quantity. Data were abstracted by two reviewers independently using a standardized abstraction tool. Surveys, meeting abstracts, "gray" literature, studies not available in English, and studies with non-original data were excluded. For the primary key question, articles were excluded if they did not provide a comparator as key question 1 was designed as a problem, intervention, comparison, and outcome question. We anticipated that reduction in alert fatigue, including the concept of desensitization may not be directly measured and thus considered interventions that reduced alert quantity as a surrogate marker for alert fatigue. Twenty-six articles met the inclusion criteria. Approaches for managing alert fatigue in the ICU are provided as a result of reviewing tested interventions that reduced alert quantity with the anticipated effect of reducing fatigue. Suggested alert management strategies include prioritizing alerts, developing sophisticated alerts, customizing commercially available alerts, and including end user opinion in alert selection. Alert fatigue itself is studied less frequently, as an outcome, and there is a need for more precise evaluation. Standardized metrics for alert fatigue is needed to advance the field. Suggestions for standardized metrics are provided in this document.

Contrast Sensitivity in Army Aviator Candidates: Cycloplegia Effects and Population Norms

DTIC Science & Technology

1988-09-01

administration; this effect is highly significant statistically (F=169.41, df=l,104, p<.0001). The interaction of cycloplegia and spatial frequency is not...and universal acceptance. Deficits observed in visual acuity immediately alert the practitioner to the presence of an ametropia or other

A framework for evaluating the appropriateness of clinical decision support alerts and responses

PubMed Central

Waitman, Lemuel R; Lewis, Julia B; Wright, Julie A; Choma, David P; Miller, Randolph A; Peterson, Josh F

2011-01-01

Objective Alerting systems, a type of clinical decision support, are increasingly prevalent in healthcare, yet few studies have concurrently measured the appropriateness of alerts with provider responses to alerts. Recent reports of suboptimal alert system design and implementation highlight the need for better evaluation to inform future designs. The authors present a comprehensive framework for evaluating the clinical appropriateness of synchronous, interruptive medication safety alerts. Methods Through literature review and iterative testing, metrics were developed that describe successes, justifiable overrides, provider non-adherence, and unintended adverse consequences of clinical decision support alerts. The framework was validated by applying it to a medication alerting system for patients with acute kidney injury (AKI). Results Through expert review, the framework assesses each alert episode for appropriateness of the alert display and the necessity and urgency of a clinical response. Primary outcomes of the framework include the false positive alert rate, alert override rate, provider non-adherence rate, and rate of provider response appropriateness. Application of the framework to evaluate an existing AKI medication alerting system provided a more complete understanding of the process outcomes measured in the AKI medication alerting system. The authors confirmed that previous alerts and provider responses were most often appropriate. Conclusion The new evaluation model offers a potentially effective method for assessing the clinical appropriateness of synchronous interruptive medication alerts prior to evaluating patient outcomes in a comparative trial. More work can determine the generalizability of the framework for use in other settings and other alert types. PMID:21849334

To Hybrid or Not to Hybrid, that Is the Question! Incorporating VoiceThread Technology into a Traditional Communication Course

ERIC Educational Resources Information Center

Pecot-Hebert, Lisa

2012-01-01

A hybrid course, which combines the face-to-face interactions of a traditional course with the flexibility of an online course, provides an alternative option for educating students in a new media environment. While educators often interact with their students through various electronic learning management systems that are set up within the…

Focusing on Culture-Related Episodes in a Teletandem Interaction between a Brazilian and an American Student

ERIC Educational Resources Information Center

Zakir, Maisa A.; Funo, Ludmila B. A.; Telles, João A.

2016-01-01

Teletandem is a telecollaborative learning context that involves pairs of native (or competent) speakers of different languages interacting through voice, text and webcam image. Using Skype, each participant plays the role of learner for half an hour, speaking and practising the language of his/her partner. This paper focuses on a teletandem…

"Big Loud Voice. You Have Important Things to Say": The Nature of Student Initiations during One Teacher's Interactive Read-Alouds

ERIC Educational Resources Information Center

Maloch, Beth; Beutel, Denise Duncan

2010-01-01

This qualitative study explored the nature of student initiations during interactive read alouds of fiction and non-fiction texts in a second grade, urban classroom. Data sources--including expanded field notes, video/audiotape records and transcripts, and teacher interviews--were analyzed inductively, utilizing the constant comparative method and…

Discussion boards: boring no more!

PubMed

Adelman, Deborah S; Nogueras, Debra J

2013-01-01

Creating discussion boards (DBs) that capture student imaginations and contain meaningful interactions can be a difficult process. Traditional DBs use a question-and-answer format that often is boring for both the student and instructor. The authors present creative approaches to DBs that result in lively debates and student-to-student and student-to-faculty interactions, including role playing, blogging, wikis, and the use of voice.

Web 2.0, Pedagogical Support for Reflexive and Emotional Social Interaction among Swedish Students

ERIC Educational Resources Information Center

Augustsson, Gunnar

2010-01-01

Collaborative social interaction when using Web 2.0 in terms of VoiceThread is investigated in a case study of a Swedish university course in social psychology. The case study method was chosen because of the desire not to manipulate the students' behaviour, and data was collected in parallel with course implementation. Two particular…

Former Auctioneer Finds Voice After Aphasia

MedlinePlus

... And, people in trials also benefit from the social interaction. They become part of our group and we try to create an enjoyable, welcoming, and supportive environment." Now, five years ... social situations and continue normal activities. Limit your conversation ...

Considerations in the Use of Interactive Voice Recording for the Temporal Assessment of Suicidal Ideation and Alcohol Use.

PubMed

Bishop, Todd M; Maisto, Stephen A; Britton, Peter C; Pigeon, Wilfred R

2016-09-01

A greater understanding of the temporal variation of suicidal ideation and suicidal behavior is needed to inform more effective prevention efforts. Interactive voice recording (IVR) allows for the study of temporal relationships that cannot be captured with most traditional methodologies. To examine the feasibility of implementing IVR for the assessment of suicidal ideation. Participants (n = 4) receiving a brief intervention based on dialectical behavior therapy were asked to respond to three phone-based surveys each day over 6 weeks that assessed suicidal ideation and alcohol consumption. Participants completed 77.7% of daily assessments, reported that calls were not burdensome, and indicated that calls were sometimes helpful in interrupting suicidal ideation. The preliminary data reported here provide optimism for the use of IVR and other forms of ecological momentary assessment in the exploration of the antecedents of suicidal behavior.

The GuideView System for Interactive, Structured, Multi-modal Delivery of Clinical Guidelines

NASA Technical Reports Server (NTRS)

Iyengar, Sriram; Florez-Arango, Jose; Garcia, Carlos Andres

2009-01-01

GuideView is a computerized clinical guideline system which delivers clinical guidelines in an easy-to-understand and easy-to-use package. It may potentially enhance the quality of medical care or allow non-medical personnel to provide acceptable levels of care in situations where physicians or nurses may not be available. Such a system can be very valuable during space flight missions when a physician is not readily available, or perhaps the designated medical personnel is unable to provide care. Complex clinical guidelines are broken into simple steps. At each step clinical information is presented in multiple modes, including voice,audio, text, pictures, and video. Users can respond via mouse clicks or via voice navigation. GuideView can also interact with medical sensors using wireless or wired connections. The system's interface is illustrated and the results of a usability study are presented.

Designing a spoken dialogue interface to an intelligent cognitive assistant for people with dementia.

PubMed

Wolters, Maria Klara; Kelly, Fiona; Kilgour, Jonathan

2016-12-01

Intelligent cognitive assistants support people who need help performing everyday tasks by detecting when problems occur and providing tailored and context-sensitive assistance. Spoken dialogue interfaces allow users to interact with intelligent cognitive assistants while focusing on the task at hand. In order to establish requirements for voice interfaces to intelligent cognitive assistants, we conducted three focus groups with people with dementia, carers, and older people without a diagnosis of dementia. Analysis of the focus group data showed that voice and interaction style should be chosen based on the preferences of the user, not those of the carer. For people with dementia, the intelligent cognitive assistant should act like a patient, encouraging guide, while for older people without dementia, assistance should be to the point and not patronising. The intelligent cognitive assistant should be able to adapt to cognitive decline. © The Author(s) 2015.

Comparison of methods of alert acknowledgement by critical care clinicians in the ICU setting

PubMed Central

Harrison, Andrew M.; Thongprayoon, Charat; Aakre, Christopher A.; Jeng, Jack Y.; Dziadzko, Mikhail A.; Gajic, Ognjen; Pickering, Brian W.

2017-01-01

Background Electronic Health Record (EHR)-based sepsis alert systems have failed to demonstrate improvements in clinically meaningful endpoints. However, the effect of implementation barriers on the success of new sepsis alert systems is rarely explored. Objective To test the hypothesis time to severe sepsis alert acknowledgement by critical care clinicians in the ICU setting would be reduced using an EHR-based alert acknowledgement system compared to a text paging-based system. Study Design In one arm of this simulation study, real alerts for patients in the medical ICU were delivered to critical care clinicians through the EHR. In the other arm, simulated alerts were delivered through text paging. The primary outcome was time to alert acknowledgement. The secondary outcomes were a structured, mixed quantitative/qualitative survey and informal group interview. Results The alert acknowledgement rate from the severe sepsis alert system was 3% (N = 148) and 51% (N = 156) from simulated severe sepsis alerts through traditional text paging. Time to alert acknowledgement from the severe sepsis alert system was median 274 min (N = 5) and median 2 min (N = 80) from text paging. The response rate from the EHR-based alert system was insufficient to compare primary measures. However, secondary measures revealed important barriers. Conclusion Alert fatigue, interruption, human error, and information overload are barriers to alert and simulation studies in the ICU setting. PMID:28316887

Comparison of methods of alert acknowledgement by critical care clinicians in the ICU setting.

PubMed

Harrison, Andrew M; Thongprayoon, Charat; Aakre, Christopher A; Jeng, Jack Y; Dziadzko, Mikhail A; Gajic, Ognjen; Pickering, Brian W; Herasevich, Vitaly

2017-01-01

Electronic Health Record (EHR)-based sepsis alert systems have failed to demonstrate improvements in clinically meaningful endpoints. However, the effect of implementation barriers on the success of new sepsis alert systems is rarely explored. To test the hypothesis time to severe sepsis alert acknowledgement by critical care clinicians in the ICU setting would be reduced using an EHR-based alert acknowledgement system compared to a text paging-based system. In one arm of this simulation study, real alerts for patients in the medical ICU were delivered to critical care clinicians through the EHR. In the other arm, simulated alerts were delivered through text paging. The primary outcome was time to alert acknowledgement. The secondary outcomes were a structured, mixed quantitative/qualitative survey and informal group interview. The alert acknowledgement rate from the severe sepsis alert system was 3% ( N  = 148) and 51% ( N  = 156) from simulated severe sepsis alerts through traditional text paging. Time to alert acknowledgement from the severe sepsis alert system was median 274 min ( N  = 5) and median 2 min ( N  = 80) from text paging. The response rate from the EHR-based alert system was insufficient to compare primary measures. However, secondary measures revealed important barriers. Alert fatigue, interruption, human error, and information overload are barriers to alert and simulation studies in the ICU setting.

Functional selectivity for face processing in the temporal voice area of early deaf individuals

PubMed Central

van Ackeren, Markus J.; Rabini, Giuseppe; Zonca, Joshua; Foa, Valentina; Baruffaldi, Francesca; Rezk, Mohamed; Pavani, Francesco; Rossion, Bruno; Collignon, Olivier

2017-01-01

Brain systems supporting face and voice processing both contribute to the extraction of important information for social interaction (e.g., person identity). How does the brain reorganize when one of these channels is absent? Here, we explore this question by combining behavioral and multimodal neuroimaging measures (magneto-encephalography and functional imaging) in a group of early deaf humans. We show enhanced selective neural response for faces and for individual face coding in a specific region of the auditory cortex that is typically specialized for voice perception in hearing individuals. In this region, selectivity to face signals emerges early in the visual processing hierarchy, shortly after typical face-selective responses in the ventral visual pathway. Functional and effective connectivity analyses suggest reorganization in long-range connections from early visual areas to the face-selective temporal area in individuals with early and profound deafness. Altogether, these observations demonstrate that regions that typically specialize for voice processing in the hearing brain preferentially reorganize for face processing in born-deaf people. Our results support the idea that cross-modal plasticity in the case of early sensory deprivation relates to the original functional specialization of the reorganized brain regions. PMID:28652333

Interference effects of vocalization on dual task performance

NASA Astrophysics Data System (ADS)

Owens, J. M.; Goodman, L. S.; Pianka, M. J.

1984-09-01

Voice command and control systems have been proposed as a potential means of off-loading the typically overburdened visual information processing system. However, prior to introducing novel human-machine interfacing technologies in high workload environments, consideration must be given to the integration of the new technologists within existing task structures to ensure that no new sources of workload or interference are systematically introduced. This study examined the use of voice interactive systems technology in the joint performance of two cognitive information processing tasks requiring continuous memory and choice reaction wherein a basis for intertask interference might be expected. Stimuli for the continuous memory task were presented aurally and either voice or keyboard responding was required in the choice reaction task. Performance was significantly degraded in each task when voice responding was required in the choice reaction time task. Performance degradation was evident in higher error scores for both the choice reaction and continuous memory tasks. Performance decrements observed under conditions of high intertask stimulus similarity were not statistically significant. The results signal the need to consider further the task requirements for verbal short-term memory when applying speech technology in multitask environments.

Physicians’ response to computerised alerts for psychotropic drugs in older persons: a multilevel analysis of the associated alert, patient and physician characteristics

PubMed Central

Tamblyn, Robyn; Reidel, Kristen; Patel, Vaishali

2012-01-01

Objective Computerised drug alerts are expected to reduce patients’ risk of adverse drug events. However, physicians over-ride most drug alerts, because they believe that the benefit exceeds the risk. The purpose of this study was to determine the drug alert, patient and physician characteristics associated with the: (1) occurrence of psychotropic drug alerts for elderly patients and the (2) response to these alerts by their primary care physicians. Setting Primary care, Quebec, Canada. Design Prospective cohort study. Participants Sixty-one physicians using an electronic prescribing and drug alert decision-support system in their practice, and 3413 elderly patients using psychotropic drugs. Primary and secondary measures Psychotropic drug class, alert severity, patient risk for fall injuries and physician experience, practice volume and computer use were evaluated in relationship to the likelihood of having: (1) a psychotropic drug alert, (2) the prescription revised in response to an alert. Cluster-adjusted alternating logistic regression was used to assess multilevel predictors of alert occurrence and response. Results In total 13 080 psychotropic drug alerts were generated in 8931 visits. Alerts were more likely to be generated for male patients at higher risk of fall-related injury and for physicians who established the highest alert threshold. In 9.9% of alerts seen, the prescription was revised. The highest revision rate was for antipsychotic alerts (22.6%). Physicians were more likely to revise prescriptions for severe alerts (OR 2.03; 95%CI 1.39 to 2.98), if patients had cognitive impairment (OR 1.95; 95%CI 1.13 to 3.36), and if they made more visits to their physician (OR 1.05 per 5 visits; 95%CI 1 to 1.09). Conclusions Physicians view and respond to a small proportion of alerts, mainly for higher-risk patients. To reduce the risk of psychotropic drug-related fall injuries, a new generation of evidence-based drug alerts should be developed. PMID:23024254

Optimizing the real-time ground level enhancement alert system based on neutron monitor measurements: Introducing GLE Alert Plus

NASA Astrophysics Data System (ADS)

Souvatzoglou, G.; Papaioannou, A.; Mavromichalaki, H.; Dimitroulakos, J.; Sarlanis, C.

2014-11-01

Whenever a significant intensity increase is being recorded by at least three neutron monitor stations in real-time mode, a ground level enhancement (GLE) event is marked and an automated alert is issued. Although, the physical concept of the algorithm is solid and has efficiently worked in a number of cases, the availability of real-time data is still an open issue and makes timely GLE alerts quite challenging. In this work we present the optimization of the GLE alert that has been set into operation since 2006 at the Athens Neutron Monitor Station. This upgrade has led to GLE Alert Plus, which is currently based upon the Neutron Monitor Database (NMDB). We have determined the critical values per station allowing us to issue reliable GLE alerts close to the initiation of the event while at the same time we keep the false alert rate at low levels. Furthermore, we have managed to treat the problem of data availability, introducing the Go-Back-N algorithm. A total of 13 GLE events have been marked from January 2000 to December 2012. GLE Alert Plus issued an alert for 12 events. These alert times are compared to the alert times of GOES Space Weather Prediction Center and Solar Energetic Particle forecaster of the University of Málaga (UMASEP). In all cases GLE Alert Plus precedes the GOES alert by ≈8-52 min. The comparison with UMASEP demonstrated a remarkably good agreement. Real-time GLE alerts by GLE Alert Plus may be retrieved by http://cosray.phys.uoa.gr/gle_alert_plus.html, http://www.nmdb.eu, and http://swe.ssa.esa.int/web/guest/space-radiation. An automated GLE alert email notification system is also available to interested users.

Evaluation of health alerts from an early illness warning system in independent living.

PubMed

Rantz, Marilyn J; Scott, Susan D; Miller, Steven J; Skubic, Marjorie; Phillips, Lorraine; Alexander, Greg; Koopman, Richelle J; Musterman, Katy; Back, Jessica

2013-06-01

Passive sensor networks were deployed in independent living apartments to monitor older adults in their home environments to detect signs of impending illness and alert clinicians so they can intervene and prevent or delay significant changes in health or functional status. A retrospective qualitative deductive content analysis was undertaken to refine health alerts to improve clinical relevance to clinicians as they use alerts in their normal workflow of routine care delivery to older adults. Clinicians completed written free-text boxes to describe actions taken (or not) as a result of each alert; they also rated the clinical significance (relevance) of each health alert on a scale of 1 to 5. Two samples of the clinician's written responses to the health alerts were analyzed after alert algorithms had been adjusted based on results of a pilot study using health alerts to enhance clinical decision-making. In the first sample, a total of 663 comments were generated by seven clinicians in response to 385 unique alerts; there are more comments than alerts because more than one clinician rated the same alert. The second sample had a total of 142 comments produced by three clinicians in response to 88 distinct alerts. The overall clinical relevance of the alerts, as judged by the content of the qualitative comments by clinicians for each alert, improved from 33.3% of the alerts in the first sample classified as clinically relevant to 43.2% in the second. The goal is to produce clinically relevant alerts that clinicians find useful in daily practice. The evaluation methods used are described to assist others as they consider building and iteratively refining health alerts to enhance clinical decision making.

[Quantitative Prediction of Drug-Drug Interaction Caused by CYP Inhibition and Induction from In Vivo Data and Its Application in Daily Clinical Practices-Proposal for the Pharmacokinetic Interaction Significance Classification System (PISCS)].

PubMed

Ohno, Yoshiyuki

2018-01-01

　Drug-drug interactions (DDIs) can affect the clearance of various drugs from the body; however, these effects are difficult to sufficiently evaluate in clinical studies. This article outlines our approach to improving methods for evaluating and providing drug information relative to the effects of DDIs. In a previous study, total exposure changes to many substrate drugs of CYP caused by the co-administration of inhibitor or inducer drugs were successfully predicted using in vivo data. There are two parameters for the prediction: the contribution ratio of the enzyme to oral clearance for substrates (CR), and either the inhibition ratio for inhibitors (IR) or the increase in clearance of substrates produced by induction (IC). To apply these predictions in daily pharmacotherapy, the clinical significance of any pharmacokinetic changes must be carefully evaluated. We constructed a pharmacokinetic interaction significance classification system (PISCS) in which the clinical significance of DDIs was considered in a systematic manner, according to pharmacokinetic changes. The PISCS suggests that many current 'alert' classifications are potentially inappropriate, especially for drug combinations in which pharmacokinetics have not yet been evaluated. It is expected that PISCS would contribute to constructing a reliable system to alert pharmacists, physicians and consumers of a broad range of pharmacokinetic DDIs in order to more safely manage daily clinical practices.

An IDS Alerts Aggregation Algorithm Based on Rough Set Theory

NASA Astrophysics Data System (ADS)

Zhang, Ru; Guo, Tao; Liu, Jianyi

2018-03-01

Within a system in which has been deployed several IDS, a great number of alerts can be triggered by a single security event, making real alerts harder to be found. To deal with redundant alerts, we propose a scheme based on rough set theory. In combination with basic concepts in rough set theory, the importance of attributes in alerts was calculated firstly. With the result of attributes importance, we could compute the similarity of two alerts, which will be compared with a pre-defined threshold to determine whether these two alerts can be aggregated or not. Also, time interval should be taken into consideration. Allowed time interval for different types of alerts is computed individually, since different types of alerts may have different time gap between two alerts. In the end of this paper, we apply proposed scheme on DAPRA98 dataset and the results of experiment show that our scheme can efficiently reduce the redundancy of alerts so that administrators of security system could avoid wasting time on useless alerts.

Bias in child maltreatment self-reports using Interactive Voice Response

PubMed Central

Kepple, Nancy J.; Freisthler, Bridget; Johnson-Motoyama, Michelle

2014-01-01

Few methods estimate the prevalence of child maltreatment in the general population due to concerns about socially desirable responding and mandated reporting laws. Innovative methods, such as Interactive Voice Response (IVR), may obtain better estimates that address these concerns. This study examined the utility of Interactive Voice Response (IVR) for child maltreatment behaviors by assessing differences between respondents who completed and did not complete a survey using IVR technology. A mixed-mode telephone survey was conducted in English and Spanish in 50 cities in California during 2009. Caregivers (n = 3,023) self-reported abusive and neglectful parenting behaviors for a focal child under the age of 13 using Computer-Assisted Telephone Interviewing and IVR. We used Hierarchical Generalized Linear Models to compare survey completion by caregivers nested within cities for the full sample and age-specific ranges. For demographic characteristics, caregivers born in the United States were more likely to complete the survey when controlling for covariates. Parenting stress, provision of physical needs, and provision of supervisory needs were not associated with survey completion in the full multivariate model. For caregivers of children 0 to 4 years (n = 838), those reporting they could often or always hear their child from another room had a higher likelihood of survey completion. The findings suggest IVR could prove to be useful for future surveys that aim to estimate abusive and/or neglectful parenting behaviors given the limited bias observed for demographic characteristics and problematic parenting behaviors. Further research should expand upon its utility to advance estimation rates. PMID:24819534

Managing the Alert Process at NewYork-Presbyterian Hospital

PubMed Central

Kuperman, Gilad J; Diamente, Rosanna; Khatu, Vrinda; Chan-Kraushar, Terri; Stetson, Pete; Boyer, Aurelia; Cooper, Mary

2005-01-01

Clinical decision support can improve the quality of care, but requires substantial knowledge management activities. At NewYork-Presbyterian Hospital in New York City, we have implemented a formal alert management process whereby only hospital committees and departments can request alerts. An explicit requestor, who will help resolve the details of the alert logic and the alert message must be identified. Alerts must be requested in writing using a structured alert request form. Alert requests are reviewed by the Alert Committee and then forwarded to the Information Systems department for a software development estimate. The model required that clinical committees and departments become more actively involved in the development of alerts than had previously been necessary. In the 12 months following implementation, 10 alert requests were received. The model has been well received. A lot of the knowledge engineering work has been distributed and burden has been removed from scarce medical informatics resources. PMID:16779073

Three input concepts for flight crew interaction with information presented on a large-screen electronic cockpit display

NASA Technical Reports Server (NTRS)

Jones, Denise R.

1990-01-01

A piloted simulation study was conducted comparing three different input methods for interfacing to a large-screen, multiwindow, whole-flight-deck display for management of transport aircraft systems. The thumball concept utilized a miniature trackball embedded in a conventional side-arm controller. The touch screen concept provided data entry through a capacitive touch screen. The voice concept utilized a speech recognition system with input through a head-worn microphone. No single input concept emerged as the most desirable method of interacting with the display. Subjective results, however, indicate that the voice concept was the most preferred method of data entry and had the most potential for future applications. The objective results indicate that, overall, the touch screen concept was the most effective input method. There was also significant differences between the time required to perform specific tasks and the input concept employed, with each concept providing better performance relative to a specific task. These results suggest that a system combining all three input concepts might provide the most effective method of interaction.

Nonverbal behavior of vendors in customer-vendor interaction.

PubMed

Amsbary, J H; Powell, L

2007-04-01

Two research questions were posed on the homophily theory of customer-vendor interactions: (a) do vendors show any nonverbal preference for Euro-American or African-American customers?; (b) do vendors demonstrate any nonverbal preference for customers with which they share racial homophily? The results supported the homophily theory for Euro-American customers in that there were significant interaction effects by race in facial expression (F = 5.33, p < .05), amount of speaking (F = 6.76, p < .01), tone of voice (F = 7.62, p < .01), and touching (F = 4.57, p < .05). Vendor behavior varied when the customer was Euro-American, with Euro-American vendors smiling more frequently (M = 4.05) than African-American vendors (M = 3.69), speaking more frequently (M = 3.57) than African-American vendors (M = 3.09), using a more friendly tone of voice (M = 3.59, and engaging in more touching behaviors (M = 1.81) than African-American vendors (M = 1.48). There was no significant difference in the behavior of Euro-American and African-American vendors when the customer was African-American.

Optimizing drug-dose alerts using commercial software throughout an integrated health care system.

PubMed

Saiyed, Salim M; Greco, Peter J; Fernandes, Glenn; Kaelber, David C

2017-11-01

All default electronic health record and drug reference database vendor drug-dose alerting recommendations (single dose, daily dose, dose frequency, and dose duration) were silently turned on in inpatient, outpatient, and emergency department areas for pediatric-only and nonpediatric-only populations. Drug-dose alerts were evaluated during a 3-month period. Drug-dose alerts fired on 12% of orders (104 098/834 911). System-level and drug-specific strategies to decrease drug-dose alerts were analyzed. System-level strategies included: (1) turning off all minimum drug-dosing alerts, (2) turning off all incomplete information drug-dosing alerts, (3) increasing the maximum single-dose drug-dose alert threshold to 125%, (4) increasing the daily dose maximum drug-dose alert threshold to 125%, and (5) increasing the dose frequency drug-dose alert threshold to more than 2 doses per day above initial threshold. Drug-specific strategies included changing drug-specific maximum single and maximum daily drug-dose alerting parameters for the top 22 drug categories by alert frequency. System-level approaches decreased alerting to 5% (46 988/834 911) and drug-specific approaches decreased alerts to 3% (25 455/834 911). Drug-dose alerts varied between care settings and patient populations. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Vital signs and other observations used to detect deterioration in pregnant women: an analysis of vital sign charts in consultant-led UK maternity units.

PubMed

Smith, G B; Isaacs, R; Andrews, L; Wee, M Y K; van Teijlingen, E; Bick, D E; Hundley, V

2017-05-01

Obstetric early warning systems are recommended for monitoring hospitalised pregnant and postnatal women. We decided to compare: (i) vital sign values used to define physiological normality; (ii) symptoms and signs used to escalate care; (iii) type of chart used; and (iv) presence of explicit instructions for escalating care. One-hundred-and-twenty obstetric early warning charts and escalation protocols were obtained from consultant-led maternity units in the UK and Channel Islands. These data were extracted: values used to determine normality for each maternal vital sign; chart colour-coding; instructions following early warning system triggering; other criteria used as triggers. There was considerable variation in the charts, warning systems and escalation protocols. Of 120 charts, 89.2% used colour; 69.2% used colour-coded escalation systems. Forty-one (34.2%) systems required the calculation of weighted scores. Seventy-five discrete combinations of 'normal' vital sign ranges were found, the most common being: heart rate=50-99beats/min; respiratory rate=11-20breaths/min; blood pressure, systolic=100-149mmHg, diastolic ≤89mmHg; SpO 2 =95-100%; temperature=36.0-37.9°C; and Alert-Voice-Pain-Unresponsive assessment=Alert. Most charts (90.8%) provided instructions about who to contact following triggering, but only 41.7% gave instructions about subsequent observation frequency. The wide range of 'normal' vital sign values in different systems suggests a lack of equity in the processes for detecting deterioration and escalating care in hospitalised pregnant and postnatal women. Agreement regarding 'normal' vital sign ranges is urgently required and would assist the development of a standardised obstetric early warning system and chart. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Effects of Rate of Deviation and Musical Context on Intonation Perception in Homophonic Four-Part Chorales.

NASA Astrophysics Data System (ADS)

Bell, Michael Stephen

Sixty-four trained musicians listened to four -bar excerpts of selected chorales by J. S. Bach, which were presented both in four-part texture (harmonic context) and as a single voice part (melodic context). These digitally synthesized examples were created by combining the first twelve partials, and all voice parts had the same generic timbre. A within-subjects design was used, so subjects heard each example in both contexts. Included in the thirty -two excerpts for each subject were four soprano, four alto, four tenor, and four bass parts as the target voices. The intonation of the target voice was varied such that the voice stayed in tune or changed by a half cent, two cents, or eight cents per second (a cent is 1/100 of a half step). Although direction of the deviation (sharp or flat) was not a significant factor in intonation perception, main effects for context (melodic vs. harmonic) and rate of deviation were highly significant, as was the interaction between rate of deviation and context. Specifically, selections that stayed in tune or changed only by half cents were not perceived differently; for larger deviations, the error was detected earlier and the intonation was judged to be worse in the harmonic contexts compared to the melodic contexts. Additionally, the direction of the error was correctly identified in the melodic context more often than the hamonic context only for the examples that mistuned at a rate of eight cents per second. Correct identification of the voice part that went out of tune in the four-part textures depended only on rate of deviation: the in tune excerpts (no voice going out of tune) and the eight cent deviations were correctly identified most often, the two cent deviations were next, and the half cent deviation excerpts were the least accurately identified.

Contributions of speech science to the technology of man-machine voice interactions

NASA Technical Reports Server (NTRS)

Lea, Wayne A.

1977-01-01

Research in speech understanding was reviewed. Plans which include prosodics research, phonological rules for speech understanding systems, and continued interdisciplinary phonetics research are discussed. Improved acoustic phonetic analysis capabilities in speech recognizers are suggested.

Humans and Their Impact on Cyber Agility

DTIC Science & Technology

2012-06-01

clearly). - Range of media across which these interactions occur (e.g. voice, email, video conferencing and whiteboards) - Collaborations (working...abilities that they need to accomplish the task at hand Combat Assessment Battle Damage Assessment ( BDA ) + Munitions Effectiveness Assessment (MEA), a

Prescription order risk factors for pediatric dosing alerts.

PubMed

Stultz, J S; Porter, K; Nahata, M C

2015-02-01

To determine dosing alert rates based on prescription order characteristics and identify prescription order risk factors for the occurrence of dosing alerts. A retrospective analysis of inpatient medication orders and dosing alerts occurring during October 2011 and January, April, and July 2012 at a pediatric institution. Prescription orders and alerts were categorized by: medication class, patient age, route of administration, and month of the year. There were 228,259 orders during the studied period, with 11,072 alerted orders (4.9%). The most frequently alerted medication class was the non-analgesic central nervous system agent class (14% of alerts). Age, route, medication class, and month all independently affected dosing alert rates. The alert rate was highest for immunosuppressive agents (54%), neonates (6.7%), and orders for rectal administration (9.5%). The alert rate was higher in adult patients receiving their care at a pediatric institution (5.7%) compared to children (4.7%), but after multivariate analysis, pediatric orders had higher odds for an alert (OR 1.1, 95% CI 1.05-1.16). Mercaptopurine had the highest alert rate when categorized by active ingredient (73.9%). Albuterol 2.5mg/mL continuous aerosol and heparin 1000 units in 0.9% sodium chloride injection solution were the unique medications with the highest alert rates (100.0% and 97.7%, respectively). Certain types of prescription orders have a higher risk for causing dosing alerts than others. Patient age, medication class, route of administration, and the month of year can affect dosing alert rates. Design and customization efforts should focus on these medications and prescription order characteristics that increase the risk for dosing alerts. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Evaluation of Antimicrobial Stewardship-Related Alerts Using a Clinical Decision Support System.

PubMed

Ghamrawi, Riane J; Kantorovich, Alexander; Bauer, Seth R; Pallotta, Andrea M; Sekeres, Jennifer K; Gordon, Steven M; Neuner, Elizabeth A

2017-11-01

Background: Information technology, including clinical decision support systems (CDSS), have an increasingly important and growing role in identifying opportunities for antimicrobial stewardship-related interventions. Objective: The aim of this study was to describe and compare types and outcomes of CDSS-built antimicrobial stewardship alerts. Methods: Fifteen alerts were evaluated in the initial antimicrobial stewardship program (ASP) review. Preimplementation, alerts were reviewed retrospectively. Postimplementation, alerts were reviewed in real-time. Data collection included total number of actionable alerts, recommendation acceptance rates, and time spent on each alert. Time to de-escalation to narrower spectrum agents was collected. Results: In total, 749 alerts were evaluated. Overall, 306 (41%) alerts were actionable (173 preimplementation, 133 postimplementation). Rates of actionable alerts were similar for custom-built and prebuilt alert types (39% [53 of 135] vs 41% [253 of 614], P = .68]. In the postimplementation group, an intervention was attempted in 97% of actionable alerts and 70% of interventions were accepted. The median time spent per alert was 7 minutes (interquartile range [IQR], 5-13 minutes; 15 [12-17] minutes for actionable alerts vs 6 [5-7] minutes for nonactionable alerts, P < .001). In cases where the antimicrobial was eventually de-escalated, the median time to de-escalation was 28.8 hours (95% confidence interval [CI], 10.0-69.1 hours) preimplementation vs 4.7 hours (95% CI, 2.4-22.1 hours) postimplementation, P < .001. Conclusions: CDSS have played an important role in ASPs to help identify opportunities to optimize antimicrobial use through prebuilt and custom-built alerts. As ASP roles continue to expand, focusing time on customizing institution specific alerts will be of vital importance to help redistribute time needed to manage other ASP tasks and opportunities.

Provider management strategies of abnormal test result alerts: a cognitive task analysis.

PubMed

Hysong, Sylvia J; Sawhney, Mona K; Wilson, Lindsay; Sittig, Dean F; Espadas, Donna; Davis, Traber; Singh, Hardeep

2010-01-01

Electronic medical records (EMRs) facilitate abnormal test result communication through "alert" notifications. The aim was to evaluate how primary care providers (PCPs) manage alerts related to critical diagnostic test results on their EMR screens, and compare alert-management strategies of providers with high versus low rates of timely follow-up of results. 28 PCPs from a large, tertiary care Veterans Affairs Medical Center (VAMC) were purposively sampled according to their rates of timely follow-up of alerts, determined in a previous study. Using techniques from cognitive task analysis, participants were interviewed about how and when they manage alerts, focusing on four alert-management features to filter, sort and reduce unnecessary alerts on their EMR screens. Provider knowledge of alert-management features ranged between 4% and 75%. Almost half (46%) of providers did not use any of these features, and none used more than two. Providers with higher versus lower rates of timely follow-up used the four features similarly, except one (customizing alert notifications). Providers with low rates of timely follow-up tended to manually scan the alert list and process alerts heuristically using their clinical judgment. Additionally, 46% of providers used at least one workaround strategy to manage alerts. Considerable heterogeneity exists in provider use of alert-management strategies; specific strategies may be associated with lower rates of timely follow-up. Standardization of alert-management strategies including improving provider knowledge of appropriate tools in the EMR to manage alerts could reduce the lack of timely follow-up of abnormal diagnostic test results.

Group-Level Analysis on Multiplayer Game Collaboration: How Do the Individuals Shape the Group Interaction?

ERIC Educational Resources Information Center

Bluemink, Johanna; Hamalainen, Raija; Manninen, Tony; Jarvela, Sanna

2010-01-01

In this study, the aim was to examine how small-group collaboration is shaped by individuals interacting in a virtual multiplayer game. The data were collected from a design experiment in which six randomly divided groups of four university students played a voice-enhanced game lasting about 1 h. The "eScape" game was a social action adventure…

Reading Fluency through Alternative Text: Rereading with an Interact Sing-to-Read Program Embedded within a Middle School Music Classroom

ERIC Educational Resources Information Center

Biggs, Marie C.; Watkins, Nancy A.

2008-01-01

Singing exaggerates the language of reading. The students find their voices in the rhythm and bounce of language by using music as an alternative technological approach to reading. A concurrent mixed methods study was conducted to investigate the use of an interactive sing-to-read program Tune Into Reading (Electronic Learning Products, 2006)…

Bigdata Oriented Multimedia Mobile Health Applications.

PubMed

Lv, Zhihan; Chirivella, Javier; Gagliardo, Pablo

2016-05-01

In this paper, two mHealth applications are introduced, which can be employed as the terminals of bigdata based health service to collect information for electronic medical records (EMRs). The first one is a hybrid system for improving the user experience in the hyperbaric oxygen chamber by 3D stereoscopic virtual reality glasses and immersive perception. Several HMDs have been tested and compared. The second application is a voice interactive serious game as a likely solution for providing assistive rehabilitation tool for therapists. The recorder of the voice of patients could be analysed to evaluate the long-time rehabilitation results and further to predict the rehabilitation process.

Somatic/Embodied Learning and Adult Education. Trends and Issues Alert.

ERIC Educational Resources Information Center

Kerka, Sandra

A somatic approach to education implies education that trusts individuals to learn from and listen to the information they are receiving from the interaction of self with the environment. Somatic or embodied knowing is experiential knowledge that involves senses, perceptions, and mind-body action and reaction. Western culture has been dominated by…

Communicative interactions between visually impaired mothers and their sighted children: analysis of gaze, facial expressions, voice and physical contacts.

PubMed

Chiesa, S; Galati, D; Schmidt, S

2015-11-01

Social and emotional development of infants and young children is largely based on the communicative interaction with their mother, or principal caretaker (Trevarthen ). The main modalities implied in this early communication are voice, facial expressions and gaze (Stern ). This study aims at analysing early mother-child interactions in the case of visually impaired mothers who do not have access to their children's gaze and facial expressions. Spontaneous play interactions between seven visually impaired mothers and their sighted children aged between 6 months and 3 years were filmed. These dyads were compared with a control group of sighted mothers and children analysing four modalities of communication and interaction regulation: gaze, physical contacts, verbal productions and facial expressions. The visually impaired mothers' facial expressions differed from the ones of sighted mothers mainly with respect to forehead movements, leading to an impoverishment of conveyed meaning. Regarding the other communicative modalities, results suggest that visually impaired mothers and their children use compensatory strategies to guaranty harmonic interaction despite the mother's impairment: whereas gaze results the main factor of interaction regulation in sighted dyads, physical contacts and verbal productions assume a prevalent role in dyads with visually impaired mothers. Moreover, visually impaired mother's children seem to be able to differentiate between their mother and sighted interaction partners, adapting differential modes of communication. The results of this study show that, in spite of the obvious differences in the modes of communication, visual impairment does not prevent a harmonious interaction with the child. © 2015 John Wiley & Sons Ltd.

Nurses' response to parents' 'speaking-up' efforts to ensure their hospitalized child's safety: an attribution theory perspective.

PubMed

Bsharat, Sondos; Drach-Zahavy, Anat

2017-09-01

To understand how attribution processes (control and stability), which the nurse attributes to parental involvement in maintaining child safety, determine the nurse's response to a safety alert. Participation of parents in maintaining their child's safety is shown to reduce the incidence of and risk of clinical errors. Unless nurses respond appropriately to parents' safety alerts, this potential source of support could diminish. A 2 (controllability: high vs. low) × 2 (consistency: high vs. low) factorial design. Data were collected during the period 2013-2014 in paediatric wards. Four variants of scenarios were created corresponding to the different combinations of these variables. A total of 126 nurses read a scenario and completed self-report questionnaires measuring their response to the parent's safety alert. Additional data were collected about the manipulation check, safety norms in the ward and demographic variables. Data were analysed using analysis of variance. Results showed a main effect of stability and a significant two-way interaction effect of stability and controllability, on a nurse's tendency to help the parent and fix the safety problem. Furthermore, safety norms were significantly related to nurses' response. These findings contribute to the understanding of antecedents that affect nurses' responses to parents' speaking-up initiatives: whether nurses will reject or heed the alert. Theoretical and practical implications for promoting parents' engagement in their safety are discussed. © 2017 John Wiley & Sons Ltd.

Computerized pharmacy surveillance and alert system for drug-related problems.

PubMed

Ferrández, O; Urbina, O; Grau, S; Mateu-de-Antonio, J; Marin-Casino, M; Portabella, J; Mojal, S; Riu, M; Salas, E

2017-04-01

Because of the impact of drug-related problems (DRPs) on morbidity and mortality, there is a need for computerized strategies to increase drug safety. The detection and identification of the causes of potential DRPs can be facilitated by the incorporation of a pharmacy warning system (PWS) in the computerized prescriber order entry (CPOE) and its application in the routine validation of inpatient drug therapy. A limited number of studies have evaluated a clinical decision support system to monitor drug treatment. Most of these applications have utilized a small range of drugs with alerts and/or types of alert. The objective of this study was to describe the implementation of a PWS integrated in the electronic medical record (EMR). The PWS was developed in 2003-2004. Pharmacological information to generate drug alerts was entered on demographic data, drug dosage, laboratory tests related to the prescribed drug and drug combinations (interactions, duplications and necessary combinations). The PWS was applied in the prescription reviews conducted in patients admitted to the hospital in 2012. Information on 83% of the drugs included in the pharmacopeia was introduced into the PWS, allowing detection of 2808 potential DRPs, representing 79·1% of all potential DRPs detected during the study period. Twenty per cent of PWS DRPs were clinically relevant, requiring pharmacist intervention. The PWS detected most potential DRPs, thus increasing inpatient safety. The detection ability of the PWS was higher than that reported for other tools described in the literature. © 2017 John Wiley & Sons Ltd.

Visualization techniques for computer network defense

NASA Astrophysics Data System (ADS)

Beaver, Justin M.; Steed, Chad A.; Patton, Robert M.; Cui, Xiaohui; Schultz, Matthew

2011-06-01

Effective visual analysis of computer network defense (CND) information is challenging due to the volume and complexity of both the raw and analyzed network data. A typical CND is comprised of multiple niche intrusion detection tools, each of which performs network data analysis and produces a unique alerting output. The state-of-the-practice in the situational awareness of CND data is the prevalent use of custom-developed scripts by Information Technology (IT) professionals to retrieve, organize, and understand potential threat events. We propose a new visual analytics framework, called the Oak Ridge Cyber Analytics (ORCA) system, for CND data that allows an operator to interact with all detection tool outputs simultaneously. Aggregated alert events are presented in multiple coordinated views with timeline, cluster, and swarm model analysis displays. These displays are complemented with both supervised and semi-supervised machine learning classifiers. The intent of the visual analytics framework is to improve CND situational awareness, to enable an analyst to quickly navigate and analyze thousands of detected events, and to combine sophisticated data analysis techniques with interactive visualization such that patterns of anomalous activities may be more easily identified and investigated.

Effect of gender on communication of health information to older adults.

PubMed

Dearborn, Jennifer L; Panzer, Victoria P; Burleson, Joseph A; Hornung, Frederick E; Waite, Harrison; Into, Frances H

2006-04-01

To examine the effect of gender on three key elements of communication with elderly individuals: effectiveness of the communication, perceived relevance to the individual, and effect of gender-stereotyped content. Survey. University of Connecticut Health Center. Thirty-three subjects (17 female); aged 69 to 91 (mean+/-standard deviation 82+/-5.4). Older adults listened to 16 brief narratives randomized in order and by the sex of the speaker (Narrator Voice). Effectiveness was measured according to ability to identify key features (Risks), and subjects were asked to rate the relevance (Plausibility). Number of Risks detected and determinations of plausibility were analyzed according to Subject Gender and Narrator Voice. Narratives were written for either sex or included male or female bias (Neutral or Stereotyped). Female subjects identified a significantly higher number of Risks across all narratives (P=.01). Subjects perceived a significantly higher number of Risks with a female Narrator Voice (P=.03). A significant Voice-by-Stereotype interaction was present for female-stereotyped narratives (P=.009). In narratives rated as Plausible, subjects detected more Risks (P=.02). Subject Gender influenced communication effectiveness. A female speaker resulted in identification of more Risks for subjects of both sexes, particularly for Stereotyped narratives. There was no significant effect of matching Subject Gender and Narrator Voice. This study suggests that the sex of the speaker influences the effectiveness of communication with older adults. These findings should motivate future research into the means by which medical providers can improve communication with their patients.

The NAS Alert System: A look at the first eight years

USGS Publications Warehouse

Fuller, Pamela L.; Neilson, Matt; Huge, Dane H.

2013-01-01

The U.S. Geological Survey's Nonindigenous Aquatic Species (NAS) database program (http://nas.er.usgs.gov) tracks the distribution of introduced aquatic organisms across the United States. Awareness of, and timely response to, novel species introductions by those involved in nonindigenous aquatic species management and research requires a framework for rapid dissemination of occurrence data as it is incorporated into the NAS database. In May 2004, the NAS program developed an alert system to notify registered users of new introductions as part of a national early detection/rapid response system. This article summarizes information on system users and dispatched alerts from the system's inception through the end of 2011. The NAS alert system has registered over 1,700 users, with approximately 800 current subscribers. A total of 1,189 alerts had been transmitted through 2011. More alerts were sent for Florida (134 alerts) than for any other state. Fishes comprise the largest taxonomic group of alerts (440), with mollusks, plants, and crustaceans each containing over 100 alerts. Most alerts were for organisms that were intentionally released (414 alerts), with shipping, escape from captivity, and hitchhiking also representing major vectors. To explore the archive of sent alerts and to register, the search and signup page for the alert system can be found online at http://nas.er.usgs.gov/AlertSystem/default.aspx.

Provider acceptance of an automated electronic alert for acute kidney injury

PubMed Central

Oh, Janice; Bia, Joshua R.; Ubaid-Ullah, Muhamad; Testani, Jeffrey M.; Wilson, Francis Perry

2016-01-01

Background Clinical decision support systems, including electronic alerts, ideally provide immediate and relevant patient-specific information to improve clinical decision-making. Despite the growing capabilities of such alerts in conjunction with an expanding electronic medical record, there is a paucity of information regarding their perceived usefulness. We surveyed healthcare providers' opinions concerning the practicality and efficacy of a specific text-based automated electronic alert for acute kidney injury (AKI) in a single hospital during a randomized trial of AKI alerts. Methods Providers who had received at least one electronic AKI alert in the previous 6 months, as part of a separate randomized controlled trial (clinicaltrials.gov #01862419), were asked to complete a survey concerning their opinions about this specific AKI alert system. Individual approval of the alert system was defined by a provider's desire to continue receiving the alert after termination of the trial. Results A total of 98 individuals completed the survey, including 62 physicians, 27 pharmacists and 7 non-physician providers. Sixty-nine percent of responders approved the alert, with no significant difference among the various professions (P = 0.28). Alert approval was strongly correlated with the belief that the alerts improved patient care (P < 0.0001), and negatively correlated with the belief that alerts did not provide novel information (P = 0.0001). With each additional 30 days of trial duration, odds of approval decreased by 20% (3–35%) (P = 0.02). Conclusions The alert system was generally well received, although approval waned with time. Approval was correlated with the belief that this type of alert improved patient care. These findings suggest that perceived efficacy is critical to the success of future alert trials. PMID:27478598

Making electronic prescribing alerts more effective: scenario-based experimental study in junior doctors

PubMed Central

Shah, Priya; Wyatt, Jeremy C; Makubate, Boikanyo; Cross, Frank W

2011-01-01

Objective Expert authorities recommend clinical decision support systems to reduce prescribing error rates, yet large numbers of insignificant on-screen alerts presented in modal dialog boxes persistently interrupt clinicians, limiting the effectiveness of these systems. This study compared the impact of modal and non-modal electronic (e-) prescribing alerts on prescribing error rates, to help inform the design of clinical decision support systems. Design A randomized study of 24 junior doctors each performing 30 simulated prescribing tasks in random order with a prototype e-prescribing system. Using a within-participant design, doctors were randomized to be shown one of three types of e-prescribing alert (modal, non-modal, no alert) during each prescribing task. Measurements The main outcome measure was prescribing error rate. Structured interviews were performed to elicit participants' preferences for the prescribing alerts and their views on clinical decision support systems. Results Participants exposed to modal alerts were 11.6 times less likely to make a prescribing error than those not shown an alert (OR 11.56, 95% CI 6.00 to 22.26). Those shown a non-modal alert were 3.2 times less likely to make a prescribing error (OR 3.18, 95% CI 1.91 to 5.30) than those not shown an alert. The error rate with non-modal alerts was 3.6 times higher than with modal alerts (95% CI 1.88 to 7.04). Conclusions Both kinds of e-prescribing alerts significantly reduced prescribing error rates, but modal alerts were over three times more effective than non-modal alerts. This study provides new evidence about the relative effects of modal and non-modal alerts on prescribing outcomes. PMID:21836158

Provider management strategies of abnormal test result alerts: a cognitive task analysis

PubMed Central

Sawhney, Mona K; Wilson, Lindsay; Sittig, Dean F; Espadas, Donna; Davis, Traber; Singh, Hardeep

2010-01-01

Objective Electronic medical records (EMRs) facilitate abnormal test result communication through “alert” notifications. The aim was to evaluate how primary care providers (PCPs) manage alerts related to critical diagnostic test results on their EMR screens, and compare alert-management strategies of providers with high versus low rates of timely follow-up of results. Design 28 PCPs from a large, tertiary care Veterans Affairs Medical Center (VAMC) were purposively sampled according to their rates of timely follow-up of alerts, determined in a previous study. Using techniques from cognitive task analysis, participants were interviewed about how and when they manage alerts, focusing on four alert-management features to filter, sort and reduce unnecessary alerts on their EMR screens. Results Provider knowledge of alert-management features ranged between 4% and 75%. Almost half (46%) of providers did not use any of these features, and none used more than two. Providers with higher versus lower rates of timely follow-up used the four features similarly, except one (customizing alert notifications). Providers with low rates of timely follow-up tended to manually scan the alert list and process alerts heuristically using their clinical judgment. Additionally, 46% of providers used at least one workaround strategy to manage alerts. Conclusion Considerable heterogeneity exists in provider use of alert-management strategies; specific strategies may be associated with lower rates of timely follow-up. Standardization of alert-management strategies including improving provider knowledge of appropriate tools in the EMR to manage alerts could reduce the lack of timely follow-up of abnormal diagnostic test results. PMID:20064805

Perceptual integration of faces and voices depends on the interaction of emotional content and spatial frequency.

PubMed

Kokinous, Jenny; Tavano, Alessandro; Kotz, Sonja A; Schröger, Erich

2017-02-01

The role of spatial frequencies (SF) is highly debated in emotion perception, but previous work suggests the importance of low SFs for detecting emotion in faces. Furthermore, emotion perception essentially relies on the rapid integration of multimodal information from faces and voices. We used EEG to test the functional relevance of SFs in the integration of emotional and non-emotional audiovisual stimuli. While viewing dynamic face-voice pairs, participants were asked to identify auditory interjections, and the electroencephalogram (EEG) was recorded. Audiovisual integration was measured as auditory facilitation, indexed by the extent of the auditory N1 amplitude suppression in audiovisual compared to an auditory only condition. We found an interaction of SF filtering and emotion in the auditory response suppression. For neutral faces, larger N1 suppression ensued in the unfiltered and high SF conditions as compared to the low SF condition. Angry face perception led to a larger N1 suppression in the low SF condition. While the results for the neural faces indicate that perceptual quality in terms of SF content plays a major role in audiovisual integration, the results for angry faces suggest that early multisensory integration of emotional information favors low SF neural processing pathways, overruling the predictive value of the visual signal per se. Copyright © 2016 Elsevier B.V. All rights reserved.

T’ain’t what you say, it’s the way that you say it – left insula and inferior frontal cortex work in interaction with superior temporal regions to control the performance of vocal impersonations

PubMed Central

McGettigan, Carolyn; Eisner, Frank; Agnew, Zarinah K; Manly, Tom; Wisbey, Duncan; Scott, Sophie K

2014-01-01

Historically, the study of human identity perception has focused on faces, but the voice is also central to our expressions and experiences of identity (P. Belin, Fecteau, & Bedard, 2004). Our voices are highly flexible and dynamic; talkers speak differently depending on their health, emotional state, and the social setting, as well as extrinsic factors such as background noise. However, to date, there have been no studies of the neural correlates of identity modulation in speech production. In the current fMRI experiment, we measured the neural activity supporting controlled voice change in adult participants performing spoken impressions. We reveal that deliberate modulation of vocal identity recruits the left anterior insula and inferior frontal gyrus, supporting the planning of novel articulations. Bilateral sites in posterior superior temporal/inferior parietal cortex and a region in right mid/anterior superior temporal sulcus showed greater responses during the emulation of specific vocal identities than for impressions of generic accents. Using functional connectivity analyses, we describe roles for these three sites in their interactions with the brain regions supporting speech planning and production. Our findings mark a significant step toward understanding the neural control of vocal identity, with wider implications for the cognitive control of voluntary motor acts. PMID:23691984

Fluid Dynamics of Human Phonation and Speech

NASA Astrophysics Data System (ADS)

Mittal, Rajat; Erath, Byron D.; Plesniak, Michael W.

2013-01-01

This article presents a review of the fluid dynamics, flow-structure interactions, and acoustics associated with human phonation and speech. Our voice is produced through the process of phonation in the larynx, and an improved understanding of the underlying physics of this process is essential to advancing the treatment of voice disorders. Insights into the physics of phonation and speech can also contribute to improved vocal training and the development of new speech compression and synthesis schemes. This article introduces the key biomechanical features of the laryngeal physiology, reviews the basic principles of voice production, and summarizes the progress made over the past half-century in understanding the flow physics of phonation and speech. Laryngeal pathologies, which significantly enhance the complexity of phonatory dynamics, are discussed. After a thorough examination of the state of the art in computational modeling and experimental investigations of phonatory biomechanics, we present a synopsis of the pacing issues in this arena and an outlook for research in this fascinating subject.

The Linked Dual Representation model of vocal perception and production

PubMed Central

Hutchins, Sean; Moreno, Sylvain

2013-01-01

The voice is one of the most important media for communication, yet there is a wide range of abilities in both the perception and production of the voice. In this article, we review this range of abilities, focusing on pitch accuracy as a particularly informative case, and look at the factors underlying these abilities. Several classes of models have been posited describing the relationship between vocal perception and production, and we review the evidence for and against each class of model. We look at how the voice is different from other musical instruments and review evidence about both the association and the dissociation between vocal perception and production abilities. Finally, we introduce the Linked Dual Representation (LDR) model, a new approach which can account for the broad patterns in prior findings, including trends in the data which might seem to be countervailing. We discuss how this model interacts with higher-order cognition and examine its predictions about several aspects of vocal perception and production. PMID:24204360

Influence of the ventricular folds on a voice source with specified vocal fold motion1

PubMed Central

McGowan, Richard S.; Howe, Michael S.

2010-01-01

The unsteady drag on the vocal folds is the major source of sound during voiced speech. The drag force is caused by vortex shedding from the vocal folds. The influence of the ventricular folds (i.e., the “false” vocal folds that protrude into the vocal tract a short distance downstream of the glottis) on the drag and the voice source are examined in this paper by means of a theoretical model involving vortex sheets in a two-dimensional geometry. The effect of the ventricular folds on the output acoustic pressure is found to be small when the movement of the vocal folds is prescribed. It is argued that the effect remains small when fluid-structure interactions account for vocal fold movement. These conclusions can be justified mathematically when the characteristic time scale for change in the velocity of the glottal jet is large compared to the time it takes for a vortex disturbance to be convected through the vocal fold and ventricular fold region. PMID:20329852

Determinants of structural choice in visually situated sentence production.

PubMed

Myachykov, Andriy; Garrod, Simon; Scheepers, Christoph

2012-11-01

Three experiments investigated how perceptual, structural, and lexical cues affect structural choices during English transitive sentence production. Participants described transitive events under combinations of visual cueing of attention (toward either agent or patient) and structural priming with and without semantic match between the notional verb in the prime and the target event. Speakers had a stronger preference for passive-voice sentences (1) when their attention was directed to the patient, (2) upon reading a passive-voice prime, and (3) when the verb in the prime matched the target event. The verb-match effect was the by-product of an interaction between visual cueing and verb match: the increase in the proportion of passive-voice responses with matching verbs was limited to the agent-cued condition. Persistence of visual cueing effects in the presence of both structural and lexical cues suggests a strong coupling between referent-directed visual attention and Subject assignment in a spoken sentence. Copyright © 2012 Elsevier B.V. All rights reserved.

Impaired conflict resolution and vigilance in euthymic bipolar disorder.

PubMed

Marotta, Andrea; Chiaie, Roberto Delle; Spagna, Alfredo; Bernabei, Laura; Sciarretta, Martina; Roca, Javier; Biondi, Massimo; Casagrande, Maria

2015-09-30

Difficulty attending is a common deficit of euthymic bipolar patients. However, it is not known whether this is a global attentional deficit or relates to a specific attentional network. According to the attention network approach, attention is best understood in terms of three functionally and neuroanatomically distinct networks-alerting, orienting, and executive control. In this study, we explored whether and which of the three attentional networks are altered in euthymic Bipolar Disorder (BD). A sample of euthymic BD patients and age-matched healthy controls completed the Attention Network Test for Interactions and Vigilance (ANTI-V) that provided not only a measure of orienting, executive, and alerting networks, but also an independent measure of vigilance (tonic alerting). Compared to healthy controls, BD patients have impaired executive control (greater interference), reduced vigilance (as indexed by a decrease in the d' sensitivity) as well as slower overall reaction times and poorer accuracy. Our results show that deficits in executive attention and sustained attention often persist in BD patients even after complete remission of affective symptoms, thus suggesting that cognitive enhancing treatments programmed to improve these deficits could contribute to improve their functional recovery. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Processes Affecting the Annual Surface Energy Budget at High-Latitude Terrestrial Sites

NASA Astrophysics Data System (ADS)

Persson, P. O. G.; Stone, R. S.; Grachev, A.; Matrosova, L.

2012-04-01

Instrumentation at four Study of Environmental Arctic Change (SEARCH) sites (Barrow, Eureka, Alert, and Tiksi) have been enhanced in the past 6 years, including during the 2007-2008 IPY. Data from these sites are used to investigate the annual cycle of the surface energy budget (SEB), its coupling to atmospheric processes, and for Alert, its interannual variability. The comprehensive data sets are useful for showing interactions between the atmosphere, surface, and soil at high temporal resolution throughout the annual cycle. Processes that govern the SEB variability at each site are identified, and their impacts on the SEB are quantified. For example, mesoscale modulation of the SEB caused by forcing from the local terrain (downslope wind events) and coastlines (sea and land breezes) are significant at Alert and Eureka, with these processes affecting both radiative, turbulent, and ground heat flux terms in the SEB. Sub-seasonal and interannual variations in atmospheric processes and SEB impact soil thermal structures, such as the depth and timing of the summer active layer. These analyses provide an improved understanding of the processes producing changes in surface and soil temperature, linking them through the SEB as affected by atmospheric processes.

The Effects of Ultra-Long-Range Flights on the Alertness and Performance of Aviators

NASA Technical Reports Server (NTRS)

Caldwell, John A.; Mallis, Melissa M.; Colletti, Laura M.; Oyung, Raymond L.; Brandt, Summer L.; Arsintescu, Lucia; DeRoshia, Charlie W.; Reduta-Rojas, Dinah D.; Chapman, Patrick M.

2006-01-01

This investigation assessed the impact of ultra-long-range (ULR) simulator flights, departing either in the morning or late evening, on the alertness and performance of 17 commercial aviators. Immediately prior to and throughout each flight, alertness and performance were assessed via a computerized test of sustained attention, subjective questionnaires, and "hand-flying" tasks. There were fatigue-related effects on the majority of assessments, and the nature of these effects was consistent across the vigilance and self-report measures. However, the operational "hand-flying" manuevers proved insensitive to the impact of fatigue probably due to procedural factors. Regardless, the results of the present study suggest that fatigue associated with prolonged wakefulness in ULR flight operations will interact with flight schedules due to circadian and homeostatic influences. In this study, the pilots departing at night were at a greater initial disadvantage (during cruise) than pilots who departed earlier in the day; whereas those who departed earlier tended to be most impaired towards the end of the flight prior to landing. In real-world operations, airlines should consider the ramifications of flight schedules and what is known about human sleep and circadian rhythms to optimize safety.

The Honors College Experience Reconsidered: Exploring the Student Perspective

ERIC Educational Resources Information Center

Young, James H., III; Story, Lachel; Tarver, Samantha; Weinauer, Ellen; Keeler, Julia; McQuirter, Allison

2016-01-01

Often administrators overlook the student voice in developing strategic plans, mission and vision statements, marketing strategies, student services, and extracurricular programming. Engaging students in these areas may enhance students' cooperation, interactions, responsibility, and expectations. In order to assess honors students' perspectives…

The effect of phasic auditory alerting on visual perception.

PubMed

Petersen, Anders; Petersen, Annemarie Hilkjær; Bundesen, Claus; Vangkilde, Signe; Habekost, Thomas

2017-08-01

Phasic alertness refers to a short-lived change in the preparatory state of the cognitive system following an alerting signal. In the present study, we examined the effect of phasic auditory alerting on distinct perceptual processes, unconfounded by motor components. We combined an alerting/no-alerting design with a pure accuracy-based single-letter recognition task. Computational modeling based on Bundesen's Theory of Visual Attention was used to examine the effect of phasic alertness on visual processing speed and threshold of conscious perception. Results show that phasic auditory alertness affects visual perception by increasing the visual processing speed and lowering the threshold of conscious perception (Experiment 1). By manipulating the intensity of the alerting cue, we further observed a positive relationship between alerting intensity and processing speed, which was not seen for the threshold of conscious perception (Experiment 2). This was replicated in a third experiment, in which pupil size was measured as a physiological marker of alertness. Results revealed that the increase in processing speed was accompanied by an increase in pupil size, substantiating the link between alertness and processing speed (Experiment 3). The implications of these results are discussed in relation to a newly developed mathematical model of the relationship between levels of alertness and the speed with which humans process visual information. Copyright © 2017 Elsevier B.V. All rights reserved.

Preventing dispensing errors by alerting for drug confusions in the pharmacy information system-A survey of users.

PubMed

Campmans, Zizi; van Rhijn, Arianne; Dull, René M; Santen-Reestman, Jacqueline; Taxis, Katja; Borgsteede, Sander D

2018-01-01

Drug confusion is thought to be the most common type of dispensing error. Several strategies can be implemented to reduce the risk of medication errors. One of these are alerts in the pharmacy information system. To evaluate the experiences of pharmacists and pharmacy technicians with alerts for drug name and strength confusion. In May 2017, a cross-sectional survey of pharmacists and pharmacy technicians was performed in community pharmacies in the Netherlands using an online questionnaire. Of the 269 respondents, 86% (n = 230) had noticed the alert for drug name confusion, and 26% (n = 67) for drug strength confusion. Of those 230, 9% (n = 20) had experienced that the alert had prevented dispensing the wrong drug. For drug strength confusion, this proportion was 12% (n = 8). Respondents preferred to have an alert for drug name and strength confusion in the pharmacy information system. 'Alert fatigue' was an important issue, so alerts should only be introduced for frequent confusions or confusions with serious consequences. Pharmacists and pharmacy technicians were positive about having alerts for drug confusions in their pharmacy information system and experienced that alerts contributed to the prevention of dispensing errors. To prevent alert fatigue, it was considered important not to include all possible confusions as a new alert: the potential contribution to the prevention of drug confusion should be weighed against the risk of alert fatigue.

Predicting and influencing voice therapy adherence using social-cognitive factors and mobile video.

PubMed

van Leer, Eva; Connor, Nadine P

2015-05-01

Patient adherence to voice therapy is an established challenge. The purpose of this study was (a) to examine whether adherence to treatment could be predicted from three social-cognitive factors measured at treatment onset: self-efficacy, goal commitment, and the therapeutic alliance, and (b) to test whether the provision of clinician, self-, and peer model mobile treatment videos on MP4 players would influence the same triad of social cognitive factors and the adherence behavior of patients. Forty adults with adducted hyperfunction with and without benign lesions were prospectively randomized to either 4 sessions of voice therapy enhanced by MP4 support or without MP4 support. Adherence between sessions was assessed through self-report. Social cognitive factors and voice outcomes were assessed at the beginning and end of therapy. Utility of MP4 support was assessed via interviews. Self-efficacy and the therapeutic alliance predicted a significant amount of adherence variance. MP4 support significantly increased generalization, self-efficacy for generalization, and the therapeutic alliance. An interaction effect demonstrated that MP4 support was particularly effective for patients who started therapy with poor self-efficacy for generalization. Adherence may be predicted and influenced via social-cognitive means. Mobile technology can extend therapy to extraclinical settings.

A self-teaching image processing and voice-recognition-based, intelligent and interactive system to educate visually impaired children

NASA Astrophysics Data System (ADS)

Iqbal, Asim; Farooq, Umar; Mahmood, Hassan; Asad, Muhammad Usman; Khan, Akrama; Atiq, Hafiz Muhammad

2010-02-01

A self teaching image processing and voice recognition based system is developed to educate visually impaired children, chiefly in their primary education. System comprises of a computer, a vision camera, an ear speaker and a microphone. Camera, attached with the computer system is mounted on the ceiling opposite (on the required angle) to the desk on which the book is placed. Sample images and voices in the form of instructions and commands of English, Urdu alphabets, Numeric Digits, Operators and Shapes are already stored in the database. A blind child first reads the embossed character (object) with the help of fingers than he speaks the answer, name of the character, shape etc into the microphone. With the voice command of a blind child received by the microphone, image is taken by the camera which is processed by MATLAB® program developed with the help of Image Acquisition and Image processing toolbox and generates a response or required set of instructions to child via ear speaker, resulting in self education of a visually impaired child. Speech recognition program is also developed in MATLAB® with the help of Data Acquisition and Signal Processing toolbox which records and process the command of the blind child.

Reducing duplicate testing: a comparison of two clinical decision support tools.

PubMed

Procop, Gary W; Keating, Catherine; Stagno, Paul; Kottke-Marchant, Kandice; Partin, Mary; Tuttle, Robert; Wyllie, Robert

2015-05-01

Unnecessary duplicate laboratory testing is common and costly. Systems-based means to avert unnecessary testing should be investigated and employed. We compared the effectiveness and cost savings associated with two clinical decision support tools to stop duplicate testing. The Hard Stop required telephone contact with the laboratory and justification to have the duplicate test performed, whereas the Smart Alert allowed the provider to bypass the alert at the point of order entry without justification. The Hard Stop alert was significantly more effective than the Smart Alert (92.3% vs 42.6%, respectively; P < .0001). The cost savings realized per alert activation was $16.08/alert for the Hard Stop alert vs $3.52/alert for the Smart Alert. Structural and process changes that require laboratory contact and justification for duplicate testing are more effective than interventions that allow providers to bypass alerts without justification at point of computerized physician order entry. Copyright© by the American Society for Clinical Pathology.

A Multimodal Emotion Detection System during Human-Robot Interaction

PubMed Central

Alonso-Martín, Fernando; Malfaz, María; Sequeira, João; Gorostiza, Javier F.; Salichs, Miguel A.

2013-01-01

In this paper, a multimodal user-emotion detection system for social robots is presented. This system is intended to be used during human–robot interaction, and it is integrated as part of the overall interaction system of the robot: the Robotics Dialog System (RDS). Two modes are used to detect emotions: the voice and face expression analysis. In order to analyze the voice of the user, a new component has been developed: Gender and Emotion Voice Analysis (GEVA), which is written using the Chuck language. For emotion detection in facial expressions, the system, Gender and Emotion Facial Analysis (GEFA), has been also developed. This last system integrates two third-party solutions: Sophisticated High-speed Object Recognition Engine (SHORE) and Computer Expression Recognition Toolbox (CERT). Once these new components (GEVA and GEFA) give their results, a decision rule is applied in order to combine the information given by both of them. The result of this rule, the detected emotion, is integrated into the dialog system through communicative acts. Hence, each communicative act gives, among other things, the detected emotion of the user to the RDS so it can adapt its strategy in order to get a greater satisfaction degree during the human–robot dialog. Each of the new components, GEVA and GEFA, can also be used individually. Moreover, they are integrated with the robotic control platform ROS (Robot Operating System). Several experiments with real users were performed to determine the accuracy of each component and to set the final decision rule. The results obtained from applying this decision rule in these experiments show a high success rate in automatic user emotion recognition, improving the results given by the two information channels (audio and visual) separately. PMID:24240598

The smartphone and the driver's cognitive workload: A comparison of Apple, Google, and Microsoft's intelligent personal assistants.

PubMed

Strayer, David L; Cooper, Joel M; Turrill, Jonna; Coleman, James R; Hopman, Rachel J

2017-06-01

The goal of this research was to examine the impact of voice-based interactions using 3 different intelligent personal assistants (Apple's Siri , Google's Google Now for Android phones, and Microsoft's Cortana ) on the cognitive workload of the driver. In 2 experiments using an instrumented vehicle on suburban roadways, we measured the cognitive workload of drivers when they used the voice-based features of each smartphone to place a call, select music, or send text messages. Cognitive workload was derived from primary task performance through video analysis, secondary-task performance using the Detection Response Task (DRT), and subjective mental workload. We found that workload was significantly higher than that measured in the single-task drive. There were also systematic differences between the smartphones: The Google system placed lower cognitive demands on the driver than the Apple and Microsoft systems, which did not differ. Video analysis revealed that the difference in mental workload between the smartphones was associated with the number of system errors, the time to complete an action, and the complexity and intuitiveness of the devices. Finally, surprisingly high levels of cognitive workload were observed when drivers were interacting with the devices: "on-task" workload measures did not systematically differ from that associated with a mentally demanding Operation Span (OSPAN) task. The analysis also found residual costs associated using each of the smartphones that took a significant time to dissipate. The data suggest that caution is warranted in the use of smartphone voice-based technology in the vehicle because of the high levels of cognitive workload associated with these interactions. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Computer-automated dementia screening using a touch-tone telephone.

PubMed

Mundt, J C; Ferber, K L; Rizzo, M; Greist, J H

2001-11-12

This study investigated the sensitivity and specificity of a computer-automated telephone system to evaluate cognitive impairment in elderly callers to identify signs of early dementia. The Clinical Dementia Rating Scale was used to assess 155 subjects aged 56 to 93 years (n = 74, 27, 42, and 12, with a Clinical Dementia Rating Scale score of 0, 0.5, 1, and 2, respectively). These subjects performed a battery of tests administered by an interactive voice response system using standard Touch-Tone telephones. Seventy-four collateral informants also completed an interactive voice response version of the Symptoms of Dementia Screener. Sixteen cognitively impaired subjects were unable to complete the telephone call. Performances on 6 of 8 tasks were significantly influenced by Clinical Dementia Rating Scale status. The mean (SD) call length was 12 minutes 27 seconds (2 minutes 32 seconds). A subsample (n = 116) was analyzed using machine-learning methods, producing a scoring algorithm that combined performances across 4 tasks. Results indicated a potential sensitivity of 82.0% and specificity of 85.5%. The scoring model generalized to a validation subsample (n = 39), producing 85.0% sensitivity and 78.9% specificity. The kappa agreement between predicted and actual group membership was 0.64 (P<.001). Of the 16 subjects unable to complete the call, 11 provided sufficient information to permit us to classify them as impaired. Standard scoring of the interactive voice response-administered Symptoms of Dementia Screener (completed by informants) produced a screening sensitivity of 63.5% and 100% specificity. A lower criterion found a 90.4% sensitivity, without lowering specificity. Computer-automated telephone screening for early dementia using either informant or direct assessment is feasible. Such systems could provide wide-scale, cost-effective screening, education, and referral services to patients and caregivers.

Mobile Health Devices as Tools for Worldwide Cardiovascular Risk Reduction and Disease Management.

PubMed

Piette, John D; List, Justin; Rana, Gurpreet K; Townsend, Whitney; Striplin, Dana; Heisler, Michele

2015-11-24

We examined evidence on whether mobile health (mHealth) tools, including interactive voice response calls, short message service, or text messaging, and smartphones, can improve lifestyle behaviors and management related to cardiovascular diseases throughout the world. We conducted a state-of-the-art review and literature synthesis of peer-reviewed and gray literature published since 2004. The review prioritized randomized trials and studies focused on cardiovascular diseases and risk factors, but included other reports when they represented the best available evidence. The search emphasized reports on the potential benefits of mHealth interventions implemented in low- and middle-income countries. Interactive voice response and short message service interventions can improve cardiovascular preventive care in developed countries by addressing risk factors including weight, smoking, and physical activity. Interactive voice response and short message service-based interventions for cardiovascular disease management also have shown benefits with respect to hypertension management, hospital readmissions, and diabetic glycemic control. Multimodal interventions including Web-based communication with clinicians and mHealth-enabled clinical monitoring with feedback also have shown benefits. The evidence regarding the potential benefits of interventions using smartphones and social media is still developing. Studies of mHealth interventions have been conducted in >30 low- and middle-income countries, and evidence to date suggests that programs are feasible and may improve medication adherence and disease outcomes. Emerging evidence suggests that mHealth interventions may improve cardiovascular-related lifestyle behaviors and disease management. Next-generation mHealth programs developed worldwide should be based on evidence-based behavioral theories and incorporate advances in artificial intelligence for adapting systems automatically to patients' unique and changing needs. © 2015 American Heart Association, Inc.

Commercial Mobile Alert Service (CMAS) Alerting Pipeline Taxonomy

DTIC Science & Technology

2012-03-01

for the consumer at the mo- ment but will soon become a commoditized, basic requirement. For example, as the baby boomers grow older, mobile services...Commercial Mobile Alert Service (CMAS) Alerting Pipeline Taxonomy The WEA Project Team March 2012 SPECIAL REPORT CMU/SEI-2012-TR-019 CERT...report presents a taxonomy developed for the Commercial Mobile Alert Service (CMAS). The CMAS Alerting Pipeline Taxonomy is a hierarchical classification

Wireless Emergency Alerts (WEA) Cybersecurity Risk Management Strategy for Alert Originators

DTIC Science & Technology

2014-03-01

formerly known as the Commercial Mobile Alert Service ( CMAS ) RDT&E program, is a collaborative partnership that includes the cellular industry, the...Examples illustrate a STRIDE analysis of the generic mission 1 The CMAS Alerting Pipeline Taxonomy describes in detail a hierarchical classification...SEI-2013-SR-018 | 1 1 Introduction The Wireless Emergency Alerts (WEA) service, formerly known as the Commercial Mobile Alert Service ( CMAS ), is a

Reduction in alert fatigue in an assisted electronic prescribing system, through the Lean Six Sigma methodology.

PubMed

Cuéllar Monreal, Mª Jesús; Reig Aguado, Jorge; Font Noguera, Isabel; Poveda Andrés, José Luis

2017-01-01

To reduce the alert fatigue in our Assisted Electronic Prescribing System (AEPS), through the Lean Six Sigma (LSS) methodology. An observational (transversal) and retrospective study, in a general hospital with 850 beds and AEPS. The LSS methodology was followed in order to evaluate the alert fatigue situation in the AEPS system, to implement improvements, and to assess outcomes. The alerts generated during two trimesters studied (before and after the intervention) were analyzed. In order to measure the qualitative indicators, the most frequent alert types were analyzed, as well as the molecules responsible for over 50% of each type of alert. The action by the prescriber was analyzed in a sample of 496 prescriptions that generated such alerts. For each type of alert and molecule, there was a prioritization of the improvements to be implemented according to the alert generated and its quality. A second survey evaluated the pharmacist action for the alerts most highly valued by physicians. The problem, the objective, the work team and the project schedule were defined. A survey was designed in order to understand the opinion of the client about the alert system in the program. Based on the surveys collected (n = 136), the critical characteristics and the quanti/qualitative indicators were defined. Sixty (60) fields in the alert system were modified, corresponding to 32 molecules, and this led to a 28% reduction in the total number of alerts. Regarding quality indicators, false po sitive results were reduced by 25% (p < 0.05), 100% of those alerts ignored with justification were sustained, and there were no significant differences in user adherence to the system. The project improvements and outcomes were reviewed by the work team. LSS methodology has demonstrated being a valid tool for the quantitative and qualitative improvement of the alert system in an Assisted Electronic Prescription Program, thus reducing alert fatigue. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Integrating clinical decision support systems for pharmacogenomic testing into clinical routine - a scoping review of designs of user-system interactions in recent system development.

PubMed

Hinderer, Marc; Boeker, Martin; Wagner, Sebastian A; Lablans, Martin; Newe, Stephanie; Hülsemann, Jan L; Neumaier, Michael; Binder, Harald; Renz, Harald; Acker, Till; Prokosch, Hans-Ulrich; Sedlmayr, Martin

2017-06-06

Pharmacogenomic clinical decision support systems (CDSS) have the potential to help overcome some of the barriers for translating pharmacogenomic knowledge into clinical routine. Before developing a prototype it is crucial for developers to know which pharmacogenomic CDSS features and user-system interactions have yet been developed, implemented and tested in previous pharmacogenomic CDSS efforts and if they have been successfully applied. We address this issue by providing an overview of the designs of user-system interactions of recently developed pharmacogenomic CDSS. We searched PubMed for pharmacogenomic CDSS published between January 1, 2012 and November 15, 2016. Thirty-two out of 118 identified articles were summarized and included in the final analysis. We then compared the designs of user-system interactions of the 20 pharmacogenomic CDSS we had identified. Alerts are the most widespread tools for physician-system interactions, but need to be implemented carefully to prevent alert fatigue and avoid liabilities. Pharmacogenomic test results and override reasons stored in the local EHR might help communicate pharmacogenomic information to other internal care providers. Integrating patients into user-system interactions through patient letters and online portals might be crucial for transferring pharmacogenomic data to external health care providers. Inbox messages inform physicians about new pharmacogenomic test results and enable them to request pharmacogenomic consultations. Search engines enable physicians to compare medical treatment options based on a patient's genotype. Within the last 5 years, several pharmacogenomic CDSS have been developed. However, most of the included articles are solely describing prototypes of pharmacogenomic CDSS rather than evaluating them. To support the development of prototypes further evaluation efforts will be necessary. In the future, pharmacogenomic CDSS will likely include prediction models to identify patients who are suitable for preemptive genotyping.

76 FR 80780 - Review of the Emergency Alert System

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-27

... Emergency Alert System AGENCY: Federal Communications Commission. ACTION: Final rule. SUMMARY: In this document, the Commission amends its rules governing the Emergency Alert System (EAS) rules to extend the deadline for EAS Participants to be able to receive Common Alerting Protocol (CAP)- formatted EAS alerts to...

What Do Context Aware Electronic Alerts from Virtual Learning Environments Tell Us about User Time & Location?

ERIC Educational Resources Information Center

Crane, Laura; Benachour, Phillip

2013-01-01

The paper describes the analysis of user location and time stamp information automatically logged when students receive and interact with electronic updates from the University's virtual learning environment. The electronic updates are sent to students' mobile devices using RSS feeds. The mobile reception of such information can be received in…

What We Learned from a Tomato: Partnering with a Content Expert Plants New Ideas for Instruction

ERIC Educational Resources Information Center

Ermeling, Bradley A.

2014-01-01

The interactions described in this article represent an example of teachers expanding horizons of instructional plans as a direct result of outside expert contributions. After alerting teachers to oversimplified claims about the benefits of lycopene, the research fellow presented the team with a wider range of instructional options to consider…

An Investigation of Interval Management Displays

NASA Technical Reports Server (NTRS)

Swieringa, Kurt A.; Wilson, Sara R.; Shay, Rick

2015-01-01

NASA's first Air Traffic Management (ATM) Technology Demonstration (ATD-1) was created to transition the most mature ATM technologies from the laboratory to the National Airspace System. One selected technology is Interval Management (IM), which uses onboard aircraft automation to compute speeds that help the flight crew achieve and maintain precise spacing behind a preceding aircraft. Since ATD-1 focuses on a near-term environment, the ATD-1 flight demonstration prototype requires radio voice communication to issue an IM clearance. Retrofit IM displays will enable pilots to both enter information into the IM avionics and monitor IM operation. These displays could consist of an interface to enter data from an IM clearance and also an auxiliary display that presents critical information in the primary field-of-view. A human-in-the-loop experiment was conducted to examine usability and acceptability of retrofit IM displays, which flight crews found acceptable. Results also indicate the need for salient alerting when new speeds are generated and the desire to have a primary field of view display available that can display text and graphic trend indicators.

Nanotechnology enabled sensors and wireless sensing networks

NASA Astrophysics Data System (ADS)

Tsui, Ray; Zhang, Ruth; Mastroianni, Sal; Díaz Aguilar, Alvaro; Forzani, Erica; Tao, Nongjian

2009-05-01

The capabilities of future mobile communication devices will extend beyond merely transmitting and receiving voice, data, and video information. For example, first responders such as firefighters and emergency workers will wear environmentally- aware devices that will warn them of combustible and toxic gases as well as communicate that information wirelessly to the Command and Control Center. Similar sensor systems could alert warfighters of the presence of explosives or biological weapons. These systems can function either in the form of an individual stand-alone detector or part of a wireless sensor network. Novel sensors whose functionality is enhanced via nanotechnology will play a key role in realizing such systems. Such sensors are important because of their high sensitivity, low power consumption, and small size. This talk will provide an overview of some of the advances made in sensors through the use of nanotechnology, including those that make use of carbon nanotubes and nanoparticles. Their applicability in mobile sensing and wireless sensor networks for use in national security and public safety will be described. Other technical challenges associated with the development of such systems and networks will also be discussed.

75 FR 26196 - Publication of OIG Updated Special Fraud Alert on Telemarketing by Durable Medical Equipment...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-11

... Special Fraud Alert on Telemarketing by Durable Medical Equipment Suppliers AGENCY: Office of Inspector... Special Fraud Alert. Specifically, the Updated Special Fraud Alert addressed the statutory provision...) 205-0007. SUPPLEMENTARY INFORMATION: In our publication of the OIG Updated Special Fraud Alert on...

Contributors to Frequent Telehealth Alerts Including False Alerts for Patients with Heart Failure: A Mixed Methods Exploration

PubMed Central

Radhakrishna, K.; Bowles, K.; Zettek-Sumner, A.

2013-01-01

Summary Background Telehealth data overload through high alert generation is a significant barrier to sustained adoption of telehealth for managing HF patients. Objective To explore the factors contributing to frequent telehealth alerts including false alerts for Medicare heart failure (HF) patients admitted to a home health agency. Materials and Methods A mixed methods design that combined quantitative correlation analysis of patient characteristic data with number of telehealth alerts and qualitative analysis of telehealth and visiting nurses’ notes on follow-up actions to patients’ telehealth alerts was employed. All the quantitative and qualitative data was collected through retrospective review of electronic records of the home heath agency. Results Subjects in the study had a mean age of 83 (SD = 7.6); 56% were female. Patient co-morbidities (p<0.05) of renal disorders, anxiety, and cardiac arrhythmias emerged as predictors of telehealth alerts through quantitative analysis (n = 168) using multiple regression. Inappropriate telehealth measurement technique by patients (54%) and home healthcare system inefficiencies (37%) contributed to most telehealth false alerts in the purposive qualitative sub-sample (n = 35) of patients with high telehealth alerts. Conclusion Encouraging patient engagement with the telehealth process, fostering a collaborative approach among all the clinicians involved with the telehealth intervention, tailoring telehealth alert thresholds to patient characteristics along with establishing patient-centered telehealth outcome goals may allow meaningful generation of telehealth alerts. Reducing avoidable telehealth alerts could vastly improve the efficiency and sustainability of telehealth programs for HF management. PMID:24454576

Preventing dispensing errors by alerting for drug confusions in the pharmacy information system—A survey of users

PubMed Central

Campmans, Zizi; van Rhijn, Arianne; Dull, René M.; Santen-Reestman, Jacqueline; Taxis, Katja

2018-01-01

Introduction Drug confusion is thought to be the most common type of dispensing error. Several strategies can be implemented to reduce the risk of medication errors. One of these are alerts in the pharmacy information system. Objective To evaluate the experiences of pharmacists and pharmacy technicians with alerts for drug name and strength confusion. Methods In May 2017, a cross-sectional survey of pharmacists and pharmacy technicians was performed in community pharmacies in the Netherlands using an online questionnaire. Results Of the 269 respondents, 86% (n = 230) had noticed the alert for drug name confusion, and 26% (n = 67) for drug strength confusion. Of those 230, 9% (n = 20) had experienced that the alert had prevented dispensing the wrong drug. For drug strength confusion, this proportion was 12% (n = 8). Respondents preferred to have an alert for drug name and strength confusion in the pharmacy information system. ‘Alert fatigue’ was an important issue, so alerts should only be introduced for frequent confusions or confusions with serious consequences. Conclusion Pharmacists and pharmacy technicians were positive about having alerts for drug confusions in their pharmacy information system and experienced that alerts contributed to the prevention of dispensing errors. To prevent alert fatigue, it was considered important not to include all possible confusions as a new alert: the potential contribution to the prevention of drug confusion should be weighed against the risk of alert fatigue. PMID:29813099

Primary Care Providers' Opening of Time-Sensitive Alerts Sent to Commercial Electronic Health Record InBaskets.

PubMed

Cutrona, Sarah L; Fouayzi, Hassan; Burns, Laura; Sadasivam, Rajani S; Mazor, Kathleen M; Gurwitz, Jerry H; Garber, Lawrence; Sundaresan, Devi; Houston, Thomas K; Field, Terry S

2017-11-01

Time-sensitive alerts are among the many types of clinical notifications delivered to physicians' secure InBaskets within commercial electronic health records (EHRs). A delayed alert review can impact patient safety and compromise care. To characterize factors associated with opening of non-interruptive time-sensitive alerts delivered into primary care provider (PCP) InBaskets. We analyzed data for 799 automated alerts. Alerts highlighted actionable medication concerns for older patients post-hospital discharge (2010-2011). These were study-generated alerts sent 3 days post-discharge to InBaskets for 75 PCPs across a multisite healthcare system, and represent a subset of all urgent InBasket notifications. Using EHR access and audit logs to track alert opening, we performed bivariate and multivariate analyses calculating associations between patient characteristics, provider characteristics, contextual factors at the time of alert delivery (number of InBasket notifications, weekday), and alert opening within 24 h. At the time of alert delivery, the PCPs had a median of 69 InBasket notifications and had received a median of 379.8 notifications (IQR 295.0, 492.0) over the prior 7 days. Of the 799 alerts, 47.1% were opened within 24 h. Patients with longer hospital stays (>4 days) were marginally more likely to have alerts opened (OR 1.48 [95% CI 1.00-2.19]). Alerts delivered to PCPs whose InBaskets had a higher number of notifications at the time of alert delivery were significantly less likely to be opened within 24 h (top quartile >157 notifications: OR 0.34 [95% CI 0.18-0.61]; reference bottom quartile ≤42). Alerts delivered on Saturdays were also less likely to be opened within 24 h (OR 0.18 [CI 0.08-0.39]). The number of total InBasket notifications and weekend delivery may impact the opening of time-sensitive EHR alerts. Further study is needed to support safe and effective approaches to care team management of InBasket notifications.

75 FR 64732 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-20

... customer satisfaction surveys. These surveys provide the public with ongoing opportunity to express their... the public. Customers are defined as any individual or group seeking health or public health... customer satisfaction surveys. The Interactive Voice Response Survey--offered in English and Spanish and...

Phonologically-Based Biomarkers for Major Depressive Disorder

DTIC Science & Technology

2011-04-26

COVERED (From - To) 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d...measures of depression severity and treatment response collected via interactive voice response (IVR) technology." Journal of Neurolinguistics 20(1

Research on realization scheme of interactive voice response (IVR) system

NASA Astrophysics Data System (ADS)

Jin, Xin; Zhu, Guangxi

2003-12-01

In this paper, a novel interactive voice response (IVR) system is proposed, which is apparently different from the traditional. Using software operation and network control, the IVR system is presented which only depends on software in the server in which the system lies and the hardware in network terminals on user side, such as gateway (GW), personal gateway (PG), PC and so on. The system transmits the audio using real time protocol (RTP) protocol via internet to the network terminals and controls flow using finite state machine (FSM) stimulated by H.245 massages sent from user side and the system control factors. Being compared with other existing schemes, this IVR system results in several advantages, such as greatly saving the system cost, fully utilizing the existing network resources and enhancing the flexibility. The system is capable to be put in any service server anywhere in the Internet and even fits for the wireless applications based on packet switched communication. The IVR system has been put into reality and passed the system test.

A scoping review to explore the suitability of interactive voice response to conduct automated performance measurement of the patient's experience in primary care.

PubMed

Falconi, Michael; Johnston, Sharon; Hogg, William

2016-05-01

Practice-based performance measurement is fundamental for improvement and accountability in primary care. Traditional performance measurement of the patient's experience is often too costly and cumbersome for most practices. This scoping review explores the literature on the use of interactive voice response (IVR) telephone surveys to identify lessons for its use for collecting data on patient-reported outcome measures at the primary care practice level. The literature suggests IVR could potentially increase the capacity to reach more representative patient samples and those traditionally most difficult to engage. There is potential for long-term cost effectiveness and significant decrease of the burden on practices involved in collecting patient survey data. Challenges such as low response rates, mode effects, high initial set-up costs and maintenance fees, are also reported and require careful attention. This review suggests IVR may be a feasible alternative to traditional patient data collection methods, which should be further explored.

Laughter catches attention!

PubMed

Pinheiro, Ana P; Barros, Carla; Dias, Marcelo; Kotz, Sonja A

2017-12-01

In social interactions, emotionally salient and sudden changes in vocal expressions attract attention. However, only a few studies examined how emotion and attention interact in voice processing. We investigated neutral, happy (laughs) and angry (growls) vocalizations in a modified oddball task. Participants silently counted the targets in each block and rated the valence and arousal of the vocalizations. A combined event-related potential and time-frequency analysis focused on the P3 and pre-stimulus alpha power to capture attention effects in response to unexpected events. Whereas an early differentiation between emotionally salient and neutral vocalizations was reflected in the P3a response, the P3b was selectively enhanced for happy voices. The P3b modulation was predicted by pre-stimulus frontal alpha desynchronization, and by the perceived pleasantness of the targets. These findings indicate that vocal emotions may be differently processed based on task relevance and valence. Increased anticipation and attention to positive vocal cues (laughter) may reflect their high social relevance. Copyright © 2017 Elsevier B.V. All rights reserved.

Evaluating Alerting and Guidance Performance of a UAS Detect-And-Avoid System

NASA Technical Reports Server (NTRS)

Lee, Seung Man; Park, Chunki; Thipphavong, David P.; Isaacson, Douglas R.; Santiago, Confesor

2016-01-01

A key challenge to the routine, safe operation of unmanned aircraft systems (UAS) is the development of detect-and-avoid (DAA) systems to aid the UAS pilot in remaining "well clear" of nearby aircraft. The goal of this study is to investigate the effect of alerting criteria and pilot response delay on the safety and performance of UAS DAA systems in the context of routine civil UAS operations in the National Airspace System (NAS). A NAS-wide fast-time simulation study was conducted to assess UAS DAA system performance with a large number of encounters and a broad set of DAA alerting and guidance system parameters. Three attributes of the DAA system were controlled as independent variables in the study to conduct trade-off analyses: UAS trajectory prediction method (dead-reckoning vs. intent-based), alerting time threshold (related to predicted time to LoWC), and alerting distance threshold (related to predicted Horizontal Miss Distance, or HMD). A set of metrics, such as the percentage of true positive, false positive, and missed alerts, based on signal detection theory and analysis methods utilizing the Receiver Operating Characteristic (ROC) curves were proposed to evaluate the safety and performance of DAA alerting and guidance systems and aid development of DAA system performance standards. The effect of pilot response delay on the performance of DAA systems was evaluated using a DAA alerting and guidance model and a pilot model developed to support this study. A total of 18 fast-time simulations were conducted with nine different DAA alerting threshold settings and two different trajectory prediction methods, using recorded radar traffic from current Visual Flight Rules (VFR) operations, and supplemented with DAA-equipped UAS traffic based on mission profiles modeling future UAS operations. Results indicate DAA alerting distance threshold has a greater effect on DAA system performance than DAA alerting time threshold or ownship trajectory prediction method. Further analysis on the alert lead time (time in advance of predicted loss of well clear at which a DAA alert is first issued) indicated a strong positive correlation between alert lead time and DAA system performance (i.e. the ability of the UAS pilot to maneuver the unmanned aircraft to remain well clear). While bigger distance thresholds had beneficial effects on alert lead time and missed alert rate, it also generated a higher rate of false alerts. In the design and development of DAA alerting and guidance systems, therefore, the positive and negative effects of false alerts and missed alerts should be carefully considered to achieve acceptable alerting system performance by balancing false and missed alerts. The results and methodology presented in this study are expected to help stakeholders, policymakers and standards committees define the appropriate setting of DAA system parameter thresholds for UAS that ensure safety while minimizing operational impacts to the NAS and equipage requirements for its users before DAA operational performance standards can be finalized.

Amygdala and auditory cortex exhibit distinct sensitivity to relevant acoustic features of auditory emotions.

PubMed

Pannese, Alessia; Grandjean, Didier; Frühholz, Sascha

2016-12-01

Discriminating between auditory signals of different affective value is critical to successful social interaction. It is commonly held that acoustic decoding of such signals occurs in the auditory system, whereas affective decoding occurs in the amygdala. However, given that the amygdala receives direct subcortical projections that bypass the auditory cortex, it is possible that some acoustic decoding occurs in the amygdala as well, when the acoustic features are relevant for affective discrimination. We tested this hypothesis by combining functional neuroimaging with the neurophysiological phenomena of repetition suppression (RS) and repetition enhancement (RE) in human listeners. Our results show that both amygdala and auditory cortex responded differentially to physical voice features, suggesting that the amygdala and auditory cortex decode the affective quality of the voice not only by processing the emotional content from previously processed acoustic features, but also by processing the acoustic features themselves, when these are relevant to the identification of the voice's affective value. Specifically, we found that the auditory cortex is sensitive to spectral high-frequency voice cues when discriminating vocal anger from vocal fear and joy, whereas the amygdala is sensitive to vocal pitch when discriminating between negative vocal emotions (i.e., anger and fear). Vocal pitch is an instantaneously recognized voice feature, which is potentially transferred to the amygdala by direct subcortical projections. These results together provide evidence that, besides the auditory cortex, the amygdala too processes acoustic information, when this is relevant to the discrimination of auditory emotions. Copyright © 2016 Elsevier Ltd. All rights reserved.

When the Eyes No Longer Lead: Familiarity and Length Effects on Eye-Voice Span

PubMed Central

Silva, Susana; Reis, Alexandra; Casaca, Luís; Petersson, Karl M.; Faísca, Luís

2016-01-01

During oral reading, the eyes tend to be ahead of the voice (eye-voice span, EVS). It has been hypothesized that the extent to which this happens depends on the automaticity of reading processes, namely on the speed of print-to-sound conversion. We tested whether EVS is affected by another automaticity component – immunity from interference. To that end, we manipulated word familiarity (high-frequency, low-frequency, and pseudowords, PW) and word length as proxies of immunity from interference, and we used linear mixed effects models to measure the effects of both variables on the time interval at which readers do parallel processing by gazing at word N + 1 while not having articulated word N yet (offset EVS). Parallel processing was enhanced by automaticity, as shown by familiarity × length interactions on offset EVS, and it was impeded by lack of automaticity, as shown by the transformation of offset EVS into voice-eye span (voice ahead of the offset of the eyes) in PWs. The relation between parallel processing and automaticity was strengthened by the fact that offset EVS predicted reading velocity. Our findings contribute to understand how the offset EVS, an index that is obtained in oral reading, may tap into different components of automaticity that underlie reading ability, oral or silent. In addition, we compared the duration of the offset EVS with the average reference duration of stages in word production, and we saw that the offset EVS may accommodate for more than the articulatory programming stage of word N. PMID:27853446

Computerized Dose Range Checking Using Hard and Soft Stop Alerts Reduces Prescribing Errors in a Pediatric Intensive Care Unit.

PubMed

Balasuriya, Lilanthi; Vyles, David; Bakerman, Paul; Holton, Vanessa; Vaidya, Vinay; Garcia-Filion, Pamela; Westdorp, Joan; Sanchez, Christine; Kurz, Rhonda

2017-09-01

An enhanced dose range checking (DRC) system was developed to evaluate prescription error rates in the pediatric intensive care unit and the pediatric cardiovascular intensive care unit. An enhanced DRC system incorporating "soft" and "hard" alerts was designed and implemented. Practitioner responses to alerts for patients admitted to the pediatric intensive care unit and the pediatric cardiovascular intensive care unit were retrospectively reviewed. Alert rates increased from 0.3% to 3.4% after "go-live" (P < 0.001). Before go-live, all alerts were soft alerts. In the period after go-live, 68% of alerts were soft alerts and 32% were hard alerts. Before go-live, providers reduced doses only 1 time for every 10 dose alerts. After implementation of the enhanced computerized physician order entry system, the practitioners responded to soft alerts by reducing doses to more appropriate levels in 24.7% of orders (70/283), compared with 10% (3/30) before go-live (P = 0.0701). The practitioners deleted orders in 9.5% of cases (27/283) after implementation of the enhanced DRC system, as compared with no cancelled orders before go-live (P = 0.0774). Medication orders that triggered a soft alert were submitted unmodified in 65.7% (186/283) as compared with 90% (27/30) of orders before go-live (P = 0.0067). After go-live, 28.7% of hard alerts resulted in a reduced dose, 64% resulted in a cancelled order, and 7.4% were submitted as written. Before go-live, alerts were often clinically irrelevant. After go-live, there was a statistically significant decrease in orders that were submitted unmodified and an increase in the number of orders that were reduced or cancelled.

Hemochromatosis

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16 CFR 613.1 - Duration of active duty alerts.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Duration of active duty alerts. 613.1 Section 613.1 Commercial Practices FEDERAL TRADE COMMISSION THE FAIR CREDIT REPORTING ACT DURATION OF ACTIVE DUTY ALERTS § 613.1 Duration of active duty alerts. The duration of an active duty alert shall be...

16 CFR 613.1 - Duration of active duty alerts.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Duration of active duty alerts. 613.1 Section 613.1 Commercial Practices FEDERAL TRADE COMMISSION THE FAIR CREDIT REPORTING ACT DURATION OF ACTIVE DUTY ALERTS § 613.1 Duration of active duty alerts. The duration of an active duty alert shall be...

16 CFR 613.1 - Duration of active duty alerts.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Duration of active duty alerts. 613.1 Section 613.1 Commercial Practices FEDERAL TRADE COMMISSION THE FAIR CREDIT REPORTING ACT DURATION OF ACTIVE DUTY ALERTS § 613.1 Duration of active duty alerts. The duration of an active duty alert shall be...

47 CFR 80.277 - Ship Security Alert System (SSAS).

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Ship Security Alert System (SSAS). 80.277... Security Alert System (SSAS). (a) Vessels equipped with a Ship Security Alert System pursuant to the Safety..., “RTCM Standard 11020.0—Ship Security Alert Systems (SSAS) using the Cospas-Sarsat System,” Version 1.0...

Does one hour of bright or short-wavelength filtered tablet screenlight have a meaningful effect on adolescents' pre-bedtime alertness, sleep, and daytime functioning?

PubMed

Heath, Melanie; Sutherland, Cate; Bartel, Kate; Gradisar, Michael; Williamson, Paul; Lovato, Nicole; Micic, Gorica

2014-05-01

Electronic media use is prevalent among adolescent populations, as is the frequency of sleeplessness. One mechanism proposed for technology affecting adolescents' sleep is the alerting effects from bright screens. Two explanations are provided. First, screens emit significant amounts of short-wavelength light (i.e. blue), which produces acute alertness and alters sleep timing. Second, later chronotypes are hypothesised to be hypersensitive to evening light. This study analysed the pre-sleep alertness (GO/NOGO task speed, accuracy; subjective sleepiness), sleep (sleep diary, polysomnography), and morning functioning of 16 healthy adolescents (M = 17.4 ± 1.9 yrs, 56% f) who used a bright tablet screen (80 lux), dim screen (1 lux) and a filtered short-wavelength screen (f.lux; 50 lux) for 1 hr before their usual bedtime in a within-subjects protocol. Chronotype was analysed as a continuous between-subjects factor; however, no significant interactions occurred. Significant effects occurred between bright and dim screens for GO/NOGO speed and accuracy. However, the magnitude of these differences was small (e.g. GO/NOGO speed = 23 ms, accuracy = 13%), suggesting minimal clinical significance. No significant effects were found for sleep onset latency, slow-rolling eye movements, or the number of SWS and REM minutes in the first two sleep cycles. Future independent studies are needed to test short (1 hr) vs longer (>2 hrs) screen usage to provide evidence for safe-to-harmful levels of screenlight exposure before adolescents' usual bedtime.

Evaluation of the attention network test using vibrotactile stimulations.

PubMed

Salzer, Yael; Oron-Gilad, Tal; Henik, Avishai

2015-06-01

We report a vibrotactile version of the attention network test (ANT)-the tactile ANT (T-ANT). It has been questioned whether attentional components are modality specific or not. The T-ANT explores alertness, orienting, cognitive control, and their relationships, similar to its visual counterpart, in the tactile modality. The unique features of the T-ANT are in utilizing stimuli on a single plane-the torso-and replacing the original imperative flanker task with a tactile Simon task. Subjects wore a waist belt mounted with two vibrotactile stimulators situated on the back and positioned to the right and left of the spinal column. They responded by pressing keys with their right or left hand in reaction to the type of vibrotactile stimulation (pulsed/continuous signal). On a single trial, an alerting tone was followed by a short tactile (informative/noninformative) peripheral cue and an imperative tactile Simon task target. The T-ANT was compared with a variant of the ANT in which the flanker task was replaced with a visual Simon task. Experimental data showed effects of orienting over control only when the peripheral cues were informative. In contrast to the visual task, interactions between alertness and control or alertness and orienting were not found in the tactile task. A possible rationale for these results is discussed. The T-ANT allows examination of attentional processes among patients with tactile attentional deficits and patients with eyesight deficits who cannot take part in visual tasks. Technological advancement would enable implementation of the T-ANT in brain-imaging studies.

Framework to Define Structure and Boundaries of Complex Health Intervention Systems: The ALERT Project

PubMed Central

Boriani, Elena; Esposito, Roberto; Frazzoli, Chiara; Fantke, Peter; Hald, Tine; Rüegg, Simon R.

2017-01-01

Health intervention systems are complex and subject to multiple variables in different phases of implementation. This constitutes a concrete challenge for the application of translational science in real life. Complex systems as health-oriented interventions call for interdisciplinary approaches with carefully defined system boundaries. Exploring individual components of such systems from different viewpoints gives a wide overview and helps to understand the elements and the relationships that drive actions and consequences within the system. In this study, we present an application and assessment of a framework with focus on systems and system boundaries of interdisciplinary projects. As an example on how to apply our framework, we analyzed ALERT [an integrated sensors and biosensors’ system (BEST) aimed at monitoring the quality, health, and traceability of the chain of the bovine milk], a multidisciplinary and interdisciplinary project based on the application of measurable biomarkers at strategic points of the milk chain for improved food security (including safety), human, and ecosystem health (1). In fact, the European food safety framework calls for science-based support to the primary producers’ mandate for legal, scientific, and ethical responsibility in food supply. Because of its multidisciplinary and interdisciplinary approach involving human, animal, and ecosystem health, ALERT can be considered as a One Health project. Within the ALERT context, we identified the need to take into account the main actors, interactions, and relationships of stakeholders to depict a simplified skeleton of the system. The framework can provide elements to highlight how and where to improve the project development when project evaluations are required. PMID:28804707

Design and Evaluation of an Electronic Override Mechanism for Medication Alerts to Facilitate Communication Between Prescribers and Pharmacists.

PubMed

Russ, Alissa L; Chen, Siying; Melton, Brittany L; Saleem, Jason J; Weiner, Michael; Spina, Jeffrey R; Daggy, Joanne K; Zillich, Alan J

2015-07-01

Computerized medication alerts can often be bypassed by entering an override rationale, but prescribers' override reasons are frequently ambiguous to pharmacists who review orders. To develop and evaluate a new override mechanism for adverse reaction and drug-drug interaction alerts. We hypothesized that the new mechanism would improve usability for prescribers and increase the clinical appropriateness of override reasons. A counterbalanced, crossover study was conducted with 20 prescribers in a simulated prescribing environment. We modified the override mechanism timing, navigation, and text entry. Instead of free-text entry, the new mechanism presented prescribers with a predefined set of override reasons. We assessed usability (learnability, perceived efficiency, and usability errors) and used a priori criteria to evaluate the clinical appropriateness of override reasons entered. Prescribers rated the new mechanism as more efficient (Wilcoxon signed-rank test, P = 0.032). When first using the new design, 5 prescribers had difficulty finding the new mechanism, and 3 interpreted the navigation to mean that the alert could not be overridden. The number of appropriate override reasons significantly increased with the new mechanism compared with the original mechanism (median change of 3.0; interquartile range = 3.0; P < 0.0001). When prescribers were given a menu-based choice for override reasons, clinical appropriateness of these reasons significantly improved. Further enhancements are necessary, but this study is an important first step toward a more standardized menu of override choices. Findings may be used to improve communication through e-prescribing systems between prescribers and pharmacists. © The Author(s) 2015.

Framework to Define Structure and Boundaries of Complex Health Intervention Systems: The ALERT Project.

PubMed

Boriani, Elena; Esposito, Roberto; Frazzoli, Chiara; Fantke, Peter; Hald, Tine; Rüegg, Simon R

2017-01-01

Health intervention systems are complex and subject to multiple variables in different phases of implementation. This constitutes a concrete challenge for the application of translational science in real life. Complex systems as health-oriented interventions call for interdisciplinary approaches with carefully defined system boundaries. Exploring individual components of such systems from different viewpoints gives a wide overview and helps to understand the elements and the relationships that drive actions and consequences within the system. In this study, we present an application and assessment of a framework with focus on systems and system boundaries of interdisciplinary projects. As an example on how to apply our framework, we analyzed ALERT [an integrated sensors and biosensors' system (BEST) aimed at monitoring the quality, health, and traceability of the chain of the bovine milk], a multidisciplinary and interdisciplinary project based on the application of measurable biomarkers at strategic points of the milk chain for improved food security (including safety), human, and ecosystem health (1). In fact, the European food safety framework calls for science-based support to the primary producers' mandate for legal, scientific, and ethical responsibility in food supply. Because of its multidisciplinary and interdisciplinary approach involving human, animal, and ecosystem health, ALERT can be considered as a One Health project. Within the ALERT context, we identified the need to take into account the main actors, interactions, and relationships of stakeholders to depict a simplified skeleton of the system. The framework can provide elements to highlight how and where to improve the project development when project evaluations are required.

Lung Transplant

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Chest MRI

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Cardiac Rehabilitation

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Cardiac MRI

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Oxygen Therapy

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Detecting alerts, notifying the physician, and offering action items: a comprehensive alerting system.

PubMed Central

Kuperman, G. J.; Teich, J. M.; Bates, D. W.; Hiltz, F. L.; Hurley, J. M.; Lee, R. Y.; Paterno, M. D.

1996-01-01

We developed and evaluated a system to automatically identify serious clinical conditions in inpatients. The system notifies the patient's covering physician via his pager that an alert is present and offers potential therapies for the patient's condition (action items) at the time he views the alert information. Over a 6 month period, physicians responded to 1214 (70.2%) of 1730 alerts for which they were paged; they responded to 1002 (82.5% of the 1214) in less than 15 minutes. They said they would take action in 71.5% of the alerts, and they placed an order directly from the alert display screen in 39.4%. Further study is needed to determine if this alerting system improves processes or outcomes of care. PMID:8947756

Revealing the functional neuroanatomy of intrinsic alertness using fMRI: methodological peculiarities.

PubMed

Clemens, Benjamin; Zvyagintsev, Mikhail; Sack, Alexander T; Sack, Alexander; Heinecke, Armin; Willmes, Klaus; Sturm, Walter

2011-01-01

Clinical observations and neuroimaging data revealed a right-hemisphere fronto-parietal-thalamic-brainstem network for intrinsic alertness, and additional left fronto-parietal activity during phasic alertness. The primary objective of this fMRI study was to map the functional neuroanatomy of intrinsic alertness as precisely as possible in healthy participants, using a novel assessment paradigm already employed in clinical settings. Both the paradigm and the experimental design were optimized to specifically assess intrinsic alertness, while at the same time controlling for sensory-motor processing. The present results suggest that the processing of intrinsic alertness is accompanied by increased activity within the brainstem, thalamus, anterior cingulate gyrus, right insula, and right parietal cortex. Additionally, we found increased activation in the left hemisphere around the middle frontal gyrus (BA 9), the insula, the supplementary motor area, and the cerebellum. Our results further suggest that rather minute aspects of the experimental design may induce aspects of phasic alertness, which in turn might lead to additional brain activation in left-frontal areas not normally involved in intrinsic alertness. Accordingly, left BA 9 activation may be related to co-activation of the phasic alertness network due to the switch between rest and task conditions functioning as an external warning cue triggering the phasic alertness network. Furthermore, activation of the intrinsic alertness network during fixation blocks due to enhanced expectancy shortly before the switch to the task block might, when subtracted from the task block, lead to diminished activation in the typical right hemisphere intrinsic alertness network. Thus, we cautiously suggest that--as a methodological artifact--left frontal activations might show up due to phasic alertness involvement and intrinsic alertness activations might be weakened due to contrasting with fixation blocks, when assessing the functional neuroanatomy of intrinsic alertness with a block design in fMRI studies.

Revealing the Functional Neuroanatomy of Intrinsic Alertness Using fMRI: Methodological Peculiarities

PubMed Central

Clemens, Benjamin; Zvyagintsev, Mikhail; Sack, Alexander; Heinecke, Armin; Willmes, Klaus; Sturm, Walter

2011-01-01

Clinical observations and neuroimaging data revealed a right-hemisphere fronto-parietal-thalamic-brainstem network for intrinsic alertness, and additional left fronto-parietal activity during phasic alertness. The primary objective of this fMRI study was to map the functional neuroanatomy of intrinsic alertness as precisely as possible in healthy participants, using a novel assessment paradigm already employed in clinical settings. Both the paradigm and the experimental design were optimized to specifically assess intrinsic alertness, while at the same time controlling for sensory-motor processing. The present results suggest that the processing of intrinsic alertness is accompanied by increased activity within the brainstem, thalamus, anterior cingulate gyrus, right insula, and right parietal cortex. Additionally, we found increased activation in the left hemisphere around the middle frontal gyrus (BA 9), the insula, the supplementary motor area, and the cerebellum. Our results further suggest that rather minute aspects of the experimental design may induce aspects of phasic alertness, which in turn might lead to additional brain activation in left-frontal areas not normally involved in intrinsic alertness. Accordingly, left BA 9 activation may be related to co-activation of the phasic alertness network due to the switch between rest and task conditions functioning as an external warning cue triggering the phasic alertness network. Furthermore, activation of the intrinsic alertness network during fixation blocks due to enhanced expectancy shortly before the switch to the task block might, when subtracted from the task block, lead to diminished activation in the typical right hemisphere intrinsic alertness network. Thus, we cautiously suggest that – as a methodological artifact – left frontal activations might show up due to phasic alertness involvement and intrinsic alertness activations might be weakened due to contrasting with fixation blocks, when assessing the functional neuroanatomy of intrinsic alertness with a block design in fMRI studies. PMID:21984928

ToxAlerts: a Web server of structural alerts for toxic chemicals and compounds with potential adverse reactions.

PubMed

Sushko, Iurii; Salmina, Elena; Potemkin, Vladimir A; Poda, Gennadiy; Tetko, Igor V

2012-08-27

The article presents a Web-based platform for collecting and storing toxicological structural alerts from literature and for virtual screening of chemical libraries to flag potentially toxic chemicals and compounds that can cause adverse side effects. An alert is uniquely identified by a SMARTS template, a toxicological endpoint, and a publication where the alert was described. Additionally, the system allows storing complementary information such as name, comments, and mechanism of action, as well as other data. Most importantly, the platform can be easily used for fast virtual screening of large chemical datasets, focused libraries, or newly designed compounds against the toxicological alerts, providing a detailed profile of the chemicals grouped by structural alerts and endpoints. Such a facility can be used for decision making regarding whether a compound should be tested experimentally, validated with available QSAR models, or eliminated from consideration altogether. The alert-based screening can also be helpful for an easier interpretation of more complex QSAR models. The system is publicly accessible and tightly integrated with the Online Chemical Modeling Environment (OCHEM, http://ochem.eu). The system is open and expandable: any registered OCHEM user can introduce new alerts, browse, edit alerts introduced by other users, and virtually screen his/her data sets against all or selected alerts. The user sets being passed through the structural alerts can be used at OCHEM for other typical tasks: exporting in a wide variety of formats, development of QSAR models, additional filtering by other criteria, etc. The database already contains almost 600 structural alerts for such endpoints as mutagenicity, carcinogenicity, skin sensitization, compounds that undergo metabolic activation, and compounds that form reactive metabolites and, thus, can cause adverse reactions. The ToxAlerts platform is accessible on the Web at http://ochem.eu/alerts, and it is constantly growing.

ToxAlerts: A Web Server of Structural Alerts for Toxic Chemicals and Compounds with Potential Adverse Reactions

PubMed Central

2012-01-01

The article presents a Web-based platform for collecting and storing toxicological structural alerts from literature and for virtual screening of chemical libraries to flag potentially toxic chemicals and compounds that can cause adverse side effects. An alert is uniquely identified by a SMARTS template, a toxicological endpoint, and a publication where the alert was described. Additionally, the system allows storing complementary information such as name, comments, and mechanism of action, as well as other data. Most importantly, the platform can be easily used for fast virtual screening of large chemical datasets, focused libraries, or newly designed compounds against the toxicological alerts, providing a detailed profile of the chemicals grouped by structural alerts and endpoints. Such a facility can be used for decision making regarding whether a compound should be tested experimentally, validated with available QSAR models, or eliminated from consideration altogether. The alert-based screening can also be helpful for an easier interpretation of more complex QSAR models. The system is publicly accessible and tightly integrated with the Online Chemical Modeling Environment (OCHEM, http://ochem.eu). The system is open and expandable: any registered OCHEM user can introduce new alerts, browse, edit alerts introduced by other users, and virtually screen his/her data sets against all or selected alerts. The user sets being passed through the structural alerts can be used at OCHEM for other typical tasks: exporting in a wide variety of formats, development of QSAR models, additional filtering by other criteria, etc. The database already contains almost 600 structural alerts for such endpoints as mutagenicity, carcinogenicity, skin sensitization, compounds that undergo metabolic activation, and compounds that form reactive metabolites and, thus, can cause adverse reactions. The ToxAlerts platform is accessible on the Web at http://ochem.eu/alerts, and it is constantly growing. PMID:22876798

Alert status of nuclear weapons

NASA Astrophysics Data System (ADS)

Kristensen, Hans M.

2017-11-01

Nuclear Alert Forces. Four nuclear-armed states deploy nuclear warheads on alert, ready to be used on relatively short notice: United States, Russia, France and Britain. Combined, the four countries deploy an estimated 1,869 nuclear alert warheads. Russia and the United States deploy 1,749 alert warheads combined, or 94% of all alert warheads. Despite some debate about possible need to increase readiness of nuclear forces (China, Pakistan), the five other nuclear-armed states (China, Pakistan, India, Israel and North Korea) are thought to store their warheads separate from launchers under normal circumstances. The overall number of alert warheads has remained relatively stable during the past five years.

Geo-targeted Weather Alerts Coming to Millions of Mobile Devices

NASA Astrophysics Data System (ADS)

Gerber, M.

2011-12-01

The Personal Localized Alert Network (PLAN), aka Commercial Mobile Alert System (CMAS), is readying for roll out and will be broadcasting emergency public alerts to millions of cell phones by the middle of 2012. Learn how the National Weather Serivce (NWS) is supplying PLAN with geo-referenced weather alert information in the industry standard Common Alerting Protocol (CAP) format and how you can access this same information for integration with mobile devices, other consumer electronics, and decision support systems. Information will also be provided on the NWS' new collaborative venue that encourages wide participation in the evolution and use of NWS CAP alerts in a variety of applications.

Automated External Defibrillator

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Thrombocythemia and Thrombocytosis

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von Willebrand Disease

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Chest X-Ray

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What Is Cardiomyopathy?

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Long QT Syndrome

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Percutaneous Coronary Intervention

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What is Hemophilia?

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Thrombotic Thrombocytopenic Purpura

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What Is Anemia?

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Cardiac CT Scan

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Coronary Calcium Scan

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Patent Ductus Arteriosus

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What is Bronchoscopy?

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Regulatory alerts for dietary supplements in Canada and the United States, 2005-13.

PubMed

Abe, Andrew M; Hein, Darren J; Gregory, Philip J

2015-06-01

Dietary supplement regulatory alerts published by the Food and Drug Administration (FDA) and Health Canada were evaluated and characterized. FDA MedWatch and Health Canada websites were reviewed to identify regulatory alerts regarding dietary supplements from January 1, 2005, through December 31, 2013. Alerts were analyzed to identify product characteristics that may be predictive of product quality issues and potential patient harm. A total of 1560 dietary supplement-related regulatory alerts were identified. Of those, 1287 (83%) were identified through Health Canada, and 273 (18%) were identified through FDA MedWatch. The country of origin of dietary supplements associated with regulatory alerts was not provided in most regulatory alerts; however, when their origin was provided, the United States was the most common. Dietary supplements intended for sexual enhancement were the subject of 33% of all regulatory alerts identified. Products purchased online were the most likely to be associated with a regulatory alert. Dietary supplements intended for sexual enhancement, weight loss, and bodybuilding or athletic performance appeared to pose the greatest risk for patient harm due to product contamination with a pharmaceutical such as a phosphodiesterase-5 inhibitor or sibutramine. Analysis of Canadian and U.S. regulatory alerts concerning dietary supplements revealed that more than 80% of the composite alerts were issued by Health Canada. The most common intended uses of supplements for which alerts were issued were sexual enhancement, weight loss, and bodybuilding or athletic performance. The most common reason for alerts was the presence of a pharmaceutical contaminant. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Mouth and Voice: A Relationship between Visual and Auditory Preference in the Human Superior Temporal Sulcus

PubMed Central

2017-01-01

Cortex in and around the human posterior superior temporal sulcus (pSTS) is known to be critical for speech perception. The pSTS responds to both the visual modality (especially biological motion) and the auditory modality (especially human voices). Using fMRI in single subjects with no spatial smoothing, we show that visual and auditory selectivity are linked. Regions of the pSTS were identified that preferred visually presented moving mouths (presented in isolation or as part of a whole face) or moving eyes. Mouth-preferring regions responded strongly to voices and showed a significant preference for vocal compared with nonvocal sounds. In contrast, eye-preferring regions did not respond to either vocal or nonvocal sounds. The converse was also true: regions of the pSTS that showed a significant response to speech or preferred vocal to nonvocal sounds responded more strongly to visually presented mouths than eyes. These findings can be explained by environmental statistics. In natural environments, humans see visual mouth movements at the same time as they hear voices, while there is no auditory accompaniment to visual eye movements. The strength of a voxel's preference for visual mouth movements was strongly correlated with the magnitude of its auditory speech response and its preference for vocal sounds, suggesting that visual and auditory speech features are coded together in small populations of neurons within the pSTS. SIGNIFICANCE STATEMENT Humans interacting face to face make use of auditory cues from the talker's voice and visual cues from the talker's mouth to understand speech. The human posterior superior temporal sulcus (pSTS), a brain region known to be important for speech perception, is complex, with some regions responding to specific visual stimuli and others to specific auditory stimuli. Using BOLD fMRI, we show that the natural statistics of human speech, in which voices co-occur with mouth movements, are reflected in the neural architecture of the pSTS. Different pSTS regions prefer visually presented faces containing either a moving mouth or moving eyes, but only mouth-preferring regions respond strongly to voices. PMID:28179553

Mouth and Voice: A Relationship between Visual and Auditory Preference in the Human Superior Temporal Sulcus.

PubMed

Zhu, Lin L; Beauchamp, Michael S

2017-03-08

Cortex in and around the human posterior superior temporal sulcus (pSTS) is known to be critical for speech perception. The pSTS responds to both the visual modality (especially biological motion) and the auditory modality (especially human voices). Using fMRI in single subjects with no spatial smoothing, we show that visual and auditory selectivity are linked. Regions of the pSTS were identified that preferred visually presented moving mouths (presented in isolation or as part of a whole face) or moving eyes. Mouth-preferring regions responded strongly to voices and showed a significant preference for vocal compared with nonvocal sounds. In contrast, eye-preferring regions did not respond to either vocal or nonvocal sounds. The converse was also true: regions of the pSTS that showed a significant response to speech or preferred vocal to nonvocal sounds responded more strongly to visually presented mouths than eyes. These findings can be explained by environmental statistics. In natural environments, humans see visual mouth movements at the same time as they hear voices, while there is no auditory accompaniment to visual eye movements. The strength of a voxel's preference for visual mouth movements was strongly correlated with the magnitude of its auditory speech response and its preference for vocal sounds, suggesting that visual and auditory speech features are coded together in small populations of neurons within the pSTS. SIGNIFICANCE STATEMENT Humans interacting face to face make use of auditory cues from the talker's voice and visual cues from the talker's mouth to understand speech. The human posterior superior temporal sulcus (pSTS), a brain region known to be important for speech perception, is complex, with some regions responding to specific visual stimuli and others to specific auditory stimuli. Using BOLD fMRI, we show that the natural statistics of human speech, in which voices co-occur with mouth movements, are reflected in the neural architecture of the pSTS. Different pSTS regions prefer visually presented faces containing either a moving mouth or moving eyes, but only mouth-preferring regions respond strongly to voices. Copyright © 2017 the authors 0270-6474/17/372697-12$15.00/0.

Comparison of three commercial knowledge bases for detection of drug-drug interactions in clinical decision support.

PubMed

Fung, Kin Wah; Kapusnik-Uner, Joan; Cunningham, Jean; Higby-Baker, Stefanie; Bodenreider, Olivier

2017-07-01

To compare 3 commercial knowledge bases (KBs) used for detection and avoidance of potential drug-drug interactions (DDIs) in clinical practice. Drugs in the DDI tables from First DataBank (FDB), Micromedex, and Multum were mapped to RxNorm. The KBs were compared at the clinical drug, ingredient, and DDI rule levels. The KBs were evaluated against a reference list of highly significant DDIs from the Office of the National Coordinator for Health Information Technology (ONC). The KBs and the ONC list were applied to a prescription data set to simulate their use in clinical decision support. The KBs contained 1.6 million (FDB), 4.5 million (Micromedex), and 4.8 million (Multum) clinical drug pairs. Altogether, there were 8.6 million unique pairs, of which 79% were found only in 1 KB and 5% in all 3 KBs. However, there was generally more agreement than disagreement in the severity rankings, especially in the contraindicated category. The KBs covered 99.8-99.9% of the alerts of the ONC list and would have generated 25 (FDB), 145 (Micromedex), and 84 (Multum) alerts per 1000 prescriptions. The commercial KBs differ considerably in size and quantity of alerts generated. There is less variability in severity ranking of DDIs than suggested by previous studies. All KBs provide very good coverage of the ONC list. More work is needed to standardize the editorial policies and evidence for inclusion of DDIs to reduce variation among knowledge sources and improve relevance. Some DDIs considered contraindicated in all 3 KBs might be possible candidates to add to the ONC list. Published by Oxford University Press on behalf of the American Medical Informatics Association 2017. This work is written by US Government employees and is in the public domain in the United States.