Do we know the strength of the chorioamnion? A critical review and analysis

The chorioamnion is the membrane that surrounds the fetus during gestation. Normally, it must remain intact for the duration of pregnancy, 37-42 weeks, and only rupture during or just before labour and delivery of the fetus. In a significant number (3%) of all births, this does not happen, and membranes rupture before term, resulting in preterm birth and significant perinatal morbidity. It is known that the material properties of chorioamnion may play a major role in mechanical rupture; a number of studies have been undertaken to characterise the physical nature of chorioamnion and examine factors that may predispose to rupture. However, the existing literature is inconsistent in its choice of both physical testing methods and data analysis techniques, motivating the current review. Experimental data from a large number of chorioamnion mechanical studies were collated, and data were converted to standard engineering quantities. The failure strength of the chorioamnion membrane was found consistently to value approximately 0.9 MPa. It is hoped that past and future studies of membrane mechanics can provide insight into the role of chorioamnion in labour and delivery. In addition, biomechanical approaches can help elucidate the potential causes of early rupture, and suggest future protocols or treatments that could both diagnose and prevent its occurrence. © 2009 Elsevier Ireland Ltd.

Continuous F0 in the source-excitation generation for HMM-based TTS: Do we need voiced/unvoiced classification?

Most HMM-based TTS systems use a hard voiced/unvoiced classification to produce a discontinuous F0 signal which is used for the generation of the source-excitation. When a mixed source excitation is used, this decision can be based on two different sources of information: the state-specific MSD-prior of the F0 models, and/or the frame-specific features generated by the aperiodicity model. This paper examines the meaning of these variables in the synthesis process, their interaction, and how they affect the perceived quality of the generated speech The results of several perceptual experiments show that when using mixed excitation, subjects consistently prefer samples with very few or no false unvoiced errors, whereas a reduction in the rate of false voiced errors does not produce any perceptual improvement. This suggests that rather than using any form of hard voiced/unvoiced classification, e.g., the MSD-prior, it is better for synthesis to use a continuous F0 signal and rely on the frame-level soft voiced/unvoiced decision of the aperiodicity model. © 2011 IEEE.

Policy entrepreneurship in the development of public sector strategy: the case of London health reform

The development of health policy is recognized as complex; however, there has been little development of the role of agency in this process. Kingdon developed the concept of policy entrepreneur (PE) within his ‘windows’ model. He argued inter-related ‘policy streams' must coincide for important issues to become addressed. The conjoining of these streams may be aided by a policy entrepreneur. We contribute by clarifying the role of the policy entrepreneur and highlighting the translational processes of key actors in creating and aligning policy windows. We analyse the work in London of Professor Sir Ara Darzi as a policy entrepreneur. An important aspect of Darzi's approach was to align a number of important institutional networks to conjoin related problems. Our findings highlight how a policy entrepreneur not only opens policy windows but also yokes together a network to make policy agendas happen. Our contribution reveals the role of clinical leadership in health reform.