Langerhans cell histiocytosis of spine: a comparative study of clinical, imaging features, and diagnosis in children, adolescents, and adults

Eosinophilic granuloma (EG) of the spine is rare, especially in adults. There had been few large and long-term studies reported in the literature. The management goals of this disease in adults are preservation of neurologic function, relief of pain and reconstruction of spinal stability. However, there are still controversies over appropriate management modality of eosinophilic granuloma. Clinical manifestations, radiographic presentations, therapeutic outcomes and follow-up findings of 30 adults who were histiologically diagnosed with spinal eosinophilic granuloma, including 28 patients who received surgical treatment at our institutions from 1985 to 2008 were reviewed retrospectively. There were 25 males and five females with a mean age of 34.5 years (range, 18–71 years). The post-operative follow-up period ranged from 2 to 22.4 years (mean, 8.3 years). Neurologic deficits developed in 21 patients, apparent kyphosis developed in four cases. In contrast to the classic feature of vertebra plana in children, we found that more severe lesions often led to asymmetric collapse in adult patients and only three patients presented with vertebra plana. Thirty-three vertebral lesions distributed throughout the spine column. Twenty-one lesions were in cervical spine, seven in the thoracic spine and five in the lumbar spine. Twenty-eight adult patients underwent surgical resection with or without chemotherapy or radiotherapy, and four (13.3%) patients had recurrence after surgery. No patient in our series died. The onset of spinal EG is insidious and mainly presents as osteolytic destruction. There is a particular high prevalence of lesions in the cervical spine and more severe lesions often led to asymmetric collapse. As the skeleton of adults is well-developed and the epiphysis has stopped growing, individualized management including surgical intervention should be considered in adult patients with spinal EG who present with neurological damage and spinal instability.

Eosinophilic granuloma of spine in adults: a report of 30 cases and outcome

Speech emotion recognition (SER) plays a vital role in improving the interactions between humans and machines by inferring human emotion and affective states from speech signals. Whereas recent works primarily focus on mining spatiotemporal information from hand-crafted features, we explore how to model the temporal patterns of speech emotions from dynamic temporal scales. Towards that goal, we introduce a novel temporal emotional modeling approach for SER, termed Temporal-aware bI-direction Multi-scale Network (TIM-Net), which learns multi-scale contextual affective representations from various time scales. Specifically, TIM-Net first employs temporal-aware blocks to learn temporal affective representation, then integrates complementary information from the past and the future to enrich contextual representations, and finally fuses multiple time scale features for better adaptation to the emotional variation. Extensive experimental results on six benchmark SER datasets demonstrate the superior performance of TIM-Net, gaining 2.34% and 2.61% improvements of the average UAR and WAR over the second-best on each corpus. The source code is available at https://github.com/Jiaxin-Ye/TIM-Net_SER. 

Temporal Modeling Matters: A Novel Temporal Emotional Modeling Approach for Speech Emotion Recognition

Langerhans cell histiocytosis (LCH), formerly known as histiocytosis X, is a rare disorder (approximately 1:1,500,000 inhabitants) characterized by clonal proliferation and excess accumulation of pathologic Langerhans cells causing local or systemic effects. The exact etiology of LCH is still unknown. LCH could affect patients of any age, although most present when they are children. The most frequent sites of the bony lesions are the skull, femur, mandible, pelvis and spine. A variety of treatment modalities has been reported, but there was no evidence suggesting that any one treatment was more advantageous than another. We present an adult with LCH of the atlas. A 26-year-old young man presented with a 2-month history of neck pain and stiffness. CT revealed osteolytic lesion in the left lateral mass of atlas with compression fracture. Histopathological diagnosis was Langerhans cell histiocytosis by percutaneous needle biopsy under CT guidance. The patient underwent conservative treatment, including Halo-vest immobilization and radiotherapy. At 7-year follow-up, the patient was asymptomatic except for mild motion restriction of the neck. CT revealed a significant reconstruction of the C1 lateral mass.

/pdf/langerhans-cell-histiocytosis-of-the-atlas-in-an-adult-41pbpt1i6h.pdf

Langerhans cell histiocytosis of the atlas in an adult

Previous multilingual text-to-speech (TTS) approaches have considered leveraging monolingual speaker data to enable cross-lingual speech synthesis. However, such data-efficient approaches have ignored synthesizing emotional aspects of speech due to the challenges of cross-speaker cross-lingual emotion transfer - the heavy entanglement of speaker timbre, emotion, and language factors in the speech signal will make a system produce cross-lingual synthetic speech with an undesired foreign accent and weak emotion expressiveness. This paper proposes the Multilingual Emotional TTS (METTS) model to mitigate these problems, realizing both cross-speaker and cross-lingual emotion transfer. Specifically, METTS takes DelightfulTTS as the backbone model and proposes the following designs. First, to alleviate the foreign accent problem, METTS introduces multi-scale emotion modeling to disentangle speech prosody into coarse-grained and fine-grained scales, producing language-agnostic and language-specific emotion representations, respectively. Second, as a pre-processing step, formant shift-based information perturbation is applied to the reference signal for better disentanglement of speaker timbre in the speech. Third, a vector quantization-based emotion matcher is designed for reference selection, leading to decent naturalness and emotion diversity in cross-lingual synthetic speech. Experiments demonstrate the good design of METTS.

pdf/metts-multilingual-emotional-text-to-speech-by-cross-speaker-22ga209wl3.pdf

METTS: Multilingual Emotional Text-to-Speech by Cross-Speaker and Cross-Lingual Emotion Transfer

/pdf/gm-tcnet-gated-multi-scale-temporal-convolutional-network-15rat17s.pdf

GM-TCNet: Gated Multi-scale Temporal Convolutional Network using Emotion Causality for Speech Emotion Recognition

The objectives of this paper were to look into the possible incidence of obvious soft tissue extension from Langerhans' cell histiocytosis (LCH) of the spine in children and to evaluate the effects of chemotherapy for those patients. Eighteen patients with histopathological diagnosis of LCH were reviewed and nine with obvious paravertebral soft tissue extension were included in this study. Soft tissue extension was involved in the spinal canal and/or around the vertebral body in eight cases and posterior involvement was prevalent in one case. Eight patients experienced neurological symptoms. All received chemotherapy and one had surgical treatment. The mean follow-up time was 30.3 months. Soft tissue extension disappeared completely in all patients. No clinical evidence of disease was observed at the most recent follow-up. The incidence of LCH of the spine in children with obvious soft tissue extension was up to 50%. Chemotherapy is safe and effective, and surgical decompression was probably not necessary for most patients.

Langerhans' cell histiocytosis of the spine in children with soft tissue extension and chemotherapy.

TWACapsNet: a capsule network with two-way attention mechanism for speech emotion recognition

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GM-TCNet: Gated Multi-scale Temporal Convolutional Network using Emotion Causality for Speech Emotion Recognition

Langerhans' cell histiocytosis of the spine in children with soft tissue extension and chemotherapy.

TWACapsNet: a capsule network with two-way attention mechanism for speech emotion recognition