Speech recognition is a prominent technology, which helps us to develop a Natural language interface through speech for the Human-Robot Interaction (HRI). It allows the computer to take the spoken instructions, interpret it, and generate text from it. In this paper, we propose a phoneme based speech recognition system to control industrial robots. Speech recognition has become one of the popular interfaces when it comes to reducing robot operator’s efforts to control and command the robot. This paper intends to investigate the potential of Linear Predictive coding technique to develop a stable and robust phoneme speech recognition system for robotics applications. Our system is divided into three segments: a microphone array, a voice module, and a 3-DOF robotic arm. To validate our approach, we have performed tests with simple and complex sentences for various robotics activities like manipulating a cube and pick and place tasks. Moreover, we also analyzed the test result to rectify the problems and limitations in our approach. The paper presents all the test results which we have achieved through conducting experiments on our project.

Background: COVID-19 outbreak in Wuhan, China recently. It quickly spread throughout. Objectives: To investigate clinical features and outcomes of pregnant women with COVID-19. Search Strategy: PubMed、Web of Science、EMBASE、MEDLINE were searched from January 1, 2020 to April 16, 2020. Selection Criteria: Case review of pregnant women infected with COVID-19 Data Collection and Analysis: Two reviewers screened 366 literatures and 14 studies included, four reviewers independently extracted the features of the literatures. We used random-effects model to analyze incidence (P) and 95% confidence interval (95%CI). Heterogeneity was assessed using the I2 statistic. Main Results: The meta- analysis included 236 pregnant women with COVID-19. The results were as follows: positive CT findings (71%; 95%CI, 0.49~0.93), cesarean section (65%; 95%CI, 0.42~0.87), fever (51%; 95%CI, 0.35~0.67), lymphopenia (49%; 95%CI, 0.29~0.70), coexisting disorders (33%; 95%CI, 0.21~0.44), cough (31%; 95%CI, 0.23~0.39), fetal distress (29%; 95%CI, 0.08~0.49), preterm labor (23%; 95%CI, 0.14~0.32), severe case or death (12%; 95%CI, 0.03~0.20). The subgroup analysis showed compared with nonpregnant patients, pregnant women with COVID-19 had significantly lower incidences of fever (pregnant women group, 51%; nonpregnant patients group, 91%; P＜0.00001) and cough (pregnant women group, 31%; nonpregnant patients group, 67%; P＜0.0001). Conclusions: The incidence of fever, cough and positive CT findings in pregnant women with COVID-19 is less than that in the general population, preterm labor is the opposite. There is no evidence that COVID-19 can propagate vertically for the time being. Keywords: 2019-nCoV, COVID-19, clinical features, pregnancy outcomes, pregnant women, meta-analysis

Objective: To compare maternal, perinatal and long-term outcome of triplet pregnancies managed expectantly with those reduced to twins Design: A retrospective cohort study Setting: Tertiary medical institutions in South Korea Population: We examined short-term and long-term outcomes in 524 triplet pregnancies with three live fetuses before 14 weeks of gestation that were comprised of expectant management(EM) group (n=213) and embryo reduction(ER) group (n=311) from 2006 to 2017. Methods: The two groups were compared for the following outcomes. Main Outcome Measures: 1) the rates of non-viable pregnancy loss before 23 weeks, 2) the rates of preterm birth before 32 weeks of gestation; 3) the number of survival fetuses; and 4) long term neurodevelopmental outcomes. Results: In the EM group, the risk of preterm delivery (<36, <34, <32, and <28 weeks) was higher compared to the ER group. However, the risk of non-viable pregnancy loss was lower [2(0.9%) vs. 20(6.4%), p=0.008] in EM group, and the rate of cases with at least one alive neonate were higher in EM group than ER group [208(97.7%) vs. 287(92.3), p=0.013]. The survival rate until discharge of neonates were also significantly higher in the EM group than the ER group [607(95.0%) vs. 545(87.6), p=0.001]. The risk of developmental delay or cerebral palsy in survived neonates was not different between the two groups of cases. Conclusions: In triplet pregnancies, EM may improve the chance of fetal survival, without any significant differences in developmental delay and cerebral palsy.

Objective: To compare labor pattern at 4cm and 6 cm cervical dilatation in spontaneous labor in low risk nulliparous women. Design: A prospective observational study. Setting: The study was conducted in a tertiary referral center of India. Population: Study involved 500 low risk nulliparas; singleton term pregnancy; vertex presentation in spontaneous labor; cervical dilatation ≤4cm and no contraindications for vaginal delivery. Methods: Women were randomized into two groups A and B of 250 each, active phase considered at 4cm for group A and 6cm for group B. Labor duration was calculated and average labor curves were drawn. Main Outcome: To study the average labor pattern curve. Results: Mean duration of active phase from 4- 10 cm is 5.12±2.01 hours and from 6-10 cm is 2.79 ± 1.72 hours. 95th percentile values suggest that it took 5-6hours in progression from 4-6 cm and again 5-6 hours from 6-10cm. The minimum labor progression rate can be as low as 0.5cm/hour, still vaginal delivery can be achieved. The slope of labor curve steeps after 6cm, suggesting 6cm as the onset of active phase. Conclusion: Allowing labor to continue for a longer period before 6 cm of cervical dilation may reduce the rate of unnecessary intrapartum intervention and caesarean section for labor dystocia. Large-scale studies further needed for standardization of cutoff values for differentiating normal from abnormal labor. Funding: We received no financial support for the research, authorship, and/or publication of this article. Keywords: labor duration, nulliparous women, labor pattern, active phase of labor

Editorial commentary for “Electrogram Morphology Discriminators in Implantable Cardioverter Defibrillators: a comparative evaluation”.

The pandemic caused by SARS-CoV-2 has affected communities throughout the world. The global nature of health care disparities is exacerbated by COVID-19. Patients in Low-and Middle-Income Countries have limited health care resources and marginal support for the evaluation and treatment of cardiac rhythm disorders. Heart Rhythm Societies and their members need to advocate for increased subsidies and assistance for these patients.

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus (SARS-CoV)-2 infection has become a pandemic cause of viral pneumonia. Elderly patients with chronic comorbidities are susceptible to SARS-CoV-2, and are more likely to have complications that can lead to severe or even fatal consequences. It is important to seek the appropriate effective treatment for these susceptible persons. Here we report a case of elderly COVID-19 patient with hypertension, which was a member of the familial cluster COVID-19 in Enshi City, Hubei Province, China. He successfully survived after removal of tracheal intubation and inhalation of the invasive mechanical ventilation (IMV). This report aims to provide an inspiration for the prevention and treatment of critical COVID-19 cases.

Introduction: The success rate of cavo-tricuspid isthmus (CTI) ablation to treat right common flutter is high, up to 95%, but needs bidirectional block confirmation, requiring 2 or 3 catheters. We describe a new pacing technic using a single catheter to ablate and confirm CTI block with differential PR interval measurements. Methods: We included 61 patients from 5 centers that were referred for CTI ablation. All patients had CTI ablation and the CTI block was confirmed by differential pacing using 2 or 3 catheters. The new method consisted in measuring PR interval on the surface ECG using pacing from the tip of ablation catheter on the lateral side (lateral delay) and septal side (coronary sinus ostium) of the CTI line (difference =delta PR interval) before and after CTI ablation. We analyzed the value of delta PR interval to predict bidirectional CTI block as confirmed by standard methods. Results: Among our patient’s population (63±12 years-old), 39 patients were ablated during sinus rhythm while 22 during common flutter. CTI block was achieved in all patients but one. Then, Lateral delay and delta PR interval increased significantly after validation of CTI block (257±42ms vs 318±50ms and 32±23 vs 96±22ms, p<0.0001, respectively). A cut-off ≥70ms of delta PR interval had a 100% of sensitivity and specificity to predict bidirectional CTI block. Conclusion: A single catheter ablation approach to perform CTI line based on surface ECG PR interval measurement is feasible. After ablation, CTI block

Knowledge of the biomass allometry and partitioning is essential for understanding shrub adaptive strategies to extreme arid environments as well as for estimating organic carbon storage. We studied biomass accumulation, allocation patterns, and allometric models of Salsola passerina shrub in Alxa desert steppe, northwestern (NW) China. We measured above- and below-ground biomass accumulation across different ages (0-50 years) by destructive sampling. The biomass allocation patterns between aboveground biomass (MA), leaves (ML), branches (MB) and roots (MR) were studied by fitting allometric functions for both pooled and age-classed data. Allometric biomass models were developed by regressing on single-input variable of basal diameter (D), crown area (C), height (H), and age (A) alone or on the pairwise variables of above four parameters. Biomass accumulation increased with age, aboveground components represented 86–89% of the total biomass, root to shoot biomass ratios increased with shrub age. Allometry patterns of S. passerina is relatively constant, the growth rate of root was faster than that of aboveground components. Allometric models with two-input variables were obviously better than single variable models. C and D were the best predictors for biomass of S. passerina shrub.

We report the management of an electrical storm in a 68-years-old patient with previous history of coronary artery disease and severe left ventricular systolic disfunction, affected by mild-symptomatic coronavirus disease 2019 (Covid-19) pneumonia. Covid-19 infection triggered a ventricular tachycardia storm requiring urgent catheter ablation procedure, in a patient who had never experienced sustained ventricular arrhythmias before. This case suggests the potential role of Covid-19 infection in precipitating life-threatening ventricular arrhythmias in patients with pre-existing cardiovascular diseases.

Implantable cardioverter-defibrillators (ICDs) are routinely used for primary and secondary prevention of arrhythmia-related deaths in patients with heart failure and reduced left ventricular ejection fraction.Various early and late complications have been well described in the literature during transvenous ICD implantation.This case report describes an unusual site ICD lead implantation.

Title pageTitle : Long VA tachycardia after slow pathway modification for slow-fast atrioventricular nodal reentrant tachycardia : Insights about the mechanism from intriguing electrogram and polarity reversal.Short Title: Mechanism of long VA tachycardia after slow pathway modification.

Reclamation of mined soil improved soil quality and SOC sequestration. A chronosequence study consisting of 8 and 25years old reclaimed mine soils under Azadirachta indica, Gmelina arborea, Dalbergia sissoo and recently dumped soils in Gevra, Chhattisgarh, India was initiated to quantify the quality and quantity of carbon pools. MBC (microbial biomass carbon) showed highest value in case of Azadirachta indica (1468.45 ug C/g soil) followed by Dalbergia sissoo (1338.19 ug C/g soil) and Gmelina arborea (1160.61ug C/g soil) in surface soil after 25years of reclamation. Mean total soil C stock was estimated as 334.72,226.94 and 191.20 Mg C ha-1, under Azadirachta indicia, Dalbergia sissoo and Gmelina arborea plantation respectively. Carbon stock of the soil increased with an increase in year of reclamation. Among the four different pools of organic carbon, the carbon per cent was highest in the non-labile pool of carbon under Azadirachta indica (88.25%). Humic acid C content and C/N ratio had increased under Azadirachta indica, Dalbergia sissoo with an increase in the year of reclamation. FT-IR spectra in the case of Azadirachta indica, Dalbergia sissoo and Gmelina arborea indicated that relative proportions of aromatic groups along the chronosequence have increased. TOC (Total organic carbon) content was highest under Azardichta indica but aromaticity was highest under Gmelina arborea as obtained by E4/E6 and EET: EBZ ratio. These results indicated that different carbon pool and aromaticity of carbon improved with the increase in year of reclamation and significant relationships were present between spectroscopic indices and different soil carbon parameters.

We report implementation of a hierarchical equations of motion (HEOM) module within the open-source Libra software. It includes the standard and scaled HEOM algorithms for computing the dynamics of open quantum systems interacting with a harmonic bath. The module allows computing evolution of the reduced density matrix as well as spectral lineshapes. The truncation, filtering, and “update list” schemes as well as OpenMP parallelization allow for further computational saving. The package is written in a mix of C++ and Python languages, delivering the best compromise between user friendliness and efficiency. The Python layer of the package takes advantage of standard Python libraries, such as h5py which allows efficient storage and retrieval of the generated results. The package can be seamlessly used within Jupyter notebooks; its careful design shall provide the maximal convenience and intuitiveness to its users.

Background: Limited information is available to guide therapy for aortic dilation (AoD) in the absence of genetic syndromes. Our aim was to identify aortic diameters that prompted intervention. Methods: We performed a single center retrospective chart review of patients from birth to 30 years between 2011 and 2017. Advanced imaging [magnetic resonance (MR)/computed tomography (CT)] and echocardiographic diameters at the sinuses of Valsalva (SoV) and ascending aorta (AAo) were reviewed. We identified patients on pharmacotherapy and those who underwent aortic surgery. Results: Data from 47 patients was analyzed (74% male) and included bicuspid aortic valve (BAV, 40%), Marfan syndrome (MFS, 28%), isolated aortic dilation (21%), Turner syndrome (TS, 4%), and Loeys-Dietz syndrome (LDS, 4%). Family history of AoD, aortic dissection, or vascular aneurysm was identified in 40%. Medication was initiated at a median echo diameter of 34 mm at the SoV and 32 mm at the AAo. Patients with genetic conditions (MFS, LDS, TS) were started on medication earlier in the course of SoV dilation by echocardiography. Patients with BAV were started on medication at a larger AAo diameter compared to patients with genetic diagnoses and isolated AoD. Five patients underwent aortic surgery at a median age of 20 years (two patients were < 20 years old at surgery). Conclusion: Patients with genetic conditions were started on medications at an earlier stage of AoD compared to BAV and those with isolated AoD. Over a third of patients had a significant family history of AoD, aortic dissection, or vascular aneurysm.

Aeolian desertification, one of the most serious eco-environmental issues, has strongly hampered the sustainable socio-econmic development in semi-arid regions. However, research on climatic change and its influence on aeolian desertification in such region remains problematic. To combat desertification, it is necessary to identify the causes of aeolian desertification. In the present study, based on the geostatistical approach, the meteorological data were used to characterize the climate variation and its impact on aeolian desertification in the period of 1970-2015. Results demonstrated that the climate tended to become warmer and drier. The linear trend rates of mean temperature for the whole year (WY), winter half year (WHY), and summer half year (SHY) were 0.24 ℃ (10 a)-1, 0.25 ℃ (10 a)-1, and 0.18 ℃ (10 a)-1, respectively. The linear trend rates of mean precipitation in WY, WHY, and SHY were -8.29 mm (10 a)-1, 2.69 mm (10 a)-1, and -8.27 mm (10 a)-1, respectively. The temperature rise in WY, WHY, and SHY resulted in an increasing topsoil evaporation and could trigger aeolian desertification. However, the decrease of precipitation in SHY weakened soil water erosion process, and the increase of precipitation at a rate of 0.26 mm a-1 in WHY improved soil-moisture content. Thus, the analyzed results show that there are relative high sensitivities for climate change, especially in WHY, to ADL expansion or reversal in semi-arid regions.

Whilst soil respiration is often increased in response to litter inputs, the magnitude of the effect and the underlying drivers remains poorly understood. We synthesized 66 recently published papers on forest ecosystems with 2436 observations using a meta-analysis approach to investigate the effect of litter inputs on soil respiration. The results showed that litter inputs had strong positive impacts on soil respiration, labile C availability, and the abundance of soil microorganisms, with less of an effect on soil moisture and temperature. The increase in soil respiration in response to litter inputs showed the following patterns: with coniferous forests (50.7%) > broad-leaved forests (41.3%) > mixed forests (31.9%). The effect also depended on stand age with middle-aged forests (53.3%) > mature forests (50.2%) > young forests (34.5%). Correspondingly, microbial biomass carbon (MBC) and dissolved organic carbon (DOC) were increased by 21.0%-33.6% and 60.3%-87.7%, respectively, in response to normal and doubled litter inputs, whilst soil respiration increased linearly with increases in DOC and MBC. Normal and doubled litter inputs increased total PLFA (Phospholipid Fatty Acid) by 6.6% and 19.7%, respectively, but decreased the fungal/bacterial PLFA ratio by 26.9% and 18.7%, respectively. Increases in soil respiration in response to litter inputs were closely related with total PLFA, fungal PLFA, bacterial PLFA, and fungal/bacterial PLFA ratio. Therefore, in addition to forest type and stand age, labile C availability, and soil microorganisms are also important factors that influence soil respiration in response to litter inputs.

The high genetic diversity of rear-edge refugia has been predicted to result from repeated retreats of species’ ranges to low latitudes during glacial periods in the course of Quaternary climate change. However, a few recent empirical studies of cold tolerant plants revealed an opposite pattern. We investigate whether current populations of the cold-adapted and range-restricted Bupleurum euphorbioides in the Baekdudaegan, South Korea and North Korea, could be interglacial refugia, and document how their rear-edge populations differ genetically from those of typical temperate species. Phylogeographic analysis and ecological niche modeling (ENM) were used. Genetic structure was analyzed using microsatellite markers and chloroplast DNA sequences. The congener B. longiradiatum was included as a typical temperate plant species. Despite having almost identical life history traits, these congeneric species exhibited contrasting patterns of genetic diversity. ENM revealed a wide range expansion along the Korean mountains to northern Far East Russia (Primorsky) during the Last Glacial Maximum, but not during the last interglacial. Thus, we hypothesize that B. euphorbioides retreated to refugia following maximum range contraction during interglacial periods. Unlike populations in the central region, the rear-edge populations were genetically impoverished and uniform, both within populations and in pooled regional populations. The rear-edge has endured at least one past interglacial, contributing to the species’ genetic diversity. We believe that such genetic variation in the cold-adapted B. euphorbioides gives it the necessary adaptations that will enable it to survive an upcoming favorable environment (the next glacial), unless there is artificial environmental change.

Congenital superior vena cava (SVC) stenosis is a very rare anomaly especially in pediatric population. Co-existence with obstructed supracardiac total anomalous pulmonary venous connection (TAPVC) has never been reported. Clinical examination should prompt detailed and focused evaluation for this treatable etiology. SVC stenosis, although causing SVC syndrome, may decrease the severity of pulmonary venous hypertension by limiting the amount of blood in obstructed common chamber. Pericardial patch augmentation can cure SVC stenosis, and may allow for growth potential as well. We describe a case of congenital SVC stenosis in a case of obstructed supra-cardiac TAPVC in a 3 month old infant, managed successfully.

COVID-19 is a novel viral pneumonia with a higher incidence of bilateral pneumonia and pleural effusion. The high pulmonary tropism and contagiousness of the virus SARS-CoV-2 should stimulate new approaches to combat its widespread diffusion. In the development of new pharmacological strategies, the volatility of molecules is argued to add as much value as the desired antiviral and anti-inflammatory effect. Volatile molecules are characterized by a high vapour pressure and are consequently easily exhaled by the lungs. This feature could be exploited from a pharmacological point of view, reaching the site of action in an uncommon way but allowing for drug delivery. In this way, a hypothetical candidate molecule for COVID-19 must have a balance between its lung exhalation characteristics and antiviral and anti-inflammatory pharmacological action. Here, the feasibility, advantages and disadvantages of a therapy based on volatile molecules will be discussed. Known aerosolized antiviral drugs and volatile molecules are briefly reviewed, and a complete evaluation of the latter is provided in view of a possible clinical use.

Aortic insufficiency with recirculation syndrome can be a difficult diagnosis to make in patients with continuous flow left ventricular assist devices as it is generally underestimated by traditional transthoracic echocardiography. Transesophageal echocardiography can also underestimate aortic insufficiency and requires general anesthesia, which can be prohibitive in some cases. This case study demonstrates a novel use of intracardiac echocardiography to evaluate for and troubleshoot complications associated with continuous flow left ventricular assist devices. Intracardiac echocardiography was able to rule out aortic insufficiency in our patient, thereby preventing unnecessary procedures such as a valvular intervention.

Rheumatic mitral stenosis is a leading cause of morbidity in developing countries. Symptomatic patients with mitral valve area>1.5 cm2 comprises a gray zone in management. Exercise stress testing is recommended in these patients with symptoms discordant with the severity of the stenosis. Left atrial strain analysis with speckle tracking imaging emerges as a promising technique for the evaluation of haemodynamics better. The aim of our study is to examine the left atrial and ventricular function both during rest and just after exercise by speckle tracking imaging in patients with mild rheumatic mitral stenosis and ascertain early hemodynamic deterioration. We included 46 patients with mild mitral stenosis (mitral valve area>1.5 cm2) The patients were evaluated with comprehensive 2D and Doppler echocardiography during rest, before the exercise stress test. Left atrial and ventricular peak systolic strain values were calculated by using a software program. Exercise stress test was then performed by using treadmill with standard Bruce protocol. Immediately after the termination of the test, the echocardiographic examination was repeated. Both mean trans-mitral gradient and systolic pulmonary artery pressure values were higher following exercise (p<0.001, p=0.001, respectively). Exercise did not cause a significant chance in left atrial and ventricular peak systolic strain value (p=0.708, p=0.854). A negative significant correlation was found between the mean trans-mitral gradient and peak systolic left atrial strain following exercise. In patients with mitral valve area>1.5 cm2, exercise stress test did not cause a significant change in left atrial and ventricular peak systolic strain.

We report a case of refractory life-threatening warm autoimmune hemolytic anemia (wAIHA) associated with chronic myelomonocytic leukemia (CMML) for which all conventional treatments had failed. The use of eculizumab allowed controlling hemolysis and resulted in transfusion independence. These data support the use of eculizumab in refractory wAIHA.

The renal benefits of glucagon-like peptide-1 receptor agonists (GLP-1 RA) are based mainly on preservation of glomerular filtration and a reduction in macroalbuminuria. In controlled studies dulaglutide has shown good metabolic rate and slows the progression of glomerular filtration rate (GFR) loss. We analyzed, the metabolic control, the renal preservation data based on estimated GFR (eGFR) and the relationship of eGFR changes with baseline values at 36 months (M) follow–up. The results shows: glycated hemoglobin was reduced −1.4% at 12M, (p<0.001), fasting blood glucose showed a significant reduction (−30 mg/dL) at 12M (p=0.005), weight showed a 3.6 kg reduction at 12M (p=0.009). GFR did not show a worsening during follow-up: baseline value was 88.10±26.47 ml/min/1.73m2 and remained stable (83.25±29.27 ml/min/1.73m2; p=0.134) at the end of the study. Based on the 36M follow-up results, dulaglutide was shown to be an effective and nephroprotective drug in diabetic patients.