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On average, in both male and female adults, PVFD is associated with conversion disorder, representing a physical manifestation of underlying psychological difficulty. There also appears to be a subset of PVFD that is not associated with psychopathology. PVFD patients with a previous psychological history are prone to more depressive and anxious symptomatology. Patients with PVFD and a history of asthma or GERD are more likely to excessively complain about physical symptoms. Overall levels of stress are not higher in PVFD patients compared to a general population. However, females report more negative stress, and both males and females may have trouble coping with the amount of stress that they do have. PVFD is more common among women, more prevalent among older individuals, and can be comorbid with asthma, GERD, and previous abuse. These results have implications for treatment- psychotherapy directed for somatoform and conversion disorders may be added to traditional speech therapy for increased efficacy.

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IPVFMD should be considered in patients presenting with respiratory symptoms after irritant exposure. Sensitivity of diagnosis can be improved via a standardized approach consisting of a careful history and physical examination, including laryngoscopy in the presence of triggers. Laryngeal control therapy is a well-tolerated and effective method of managing IPVFMD.

Background Physicians and hospital systems often have relationships with biomedical manufacturers to develop new ideas, products, and further education. Because this relationship can influence medical research and practice, reporting disclosures is necessary to reveal any potential bias and inform consumers. The Sunshine Act was created to develop a new reporting system of these financial relationships called the Open Payments database. Currently, all disclosures submitted with research to scientific meetings are at the discretion of the physician. We hypothesized that financial relationships between authors and medical industry are underreported. Objectives We aimed to describe concordance between physicians’ financial disclosures listed in the abstract book from the 41st Annual Society of Gynecologic Surgeons’ (SGS) Scientific Meeting to physician payments reported to the Center for Medicaid and Medicare Services’ (CMS) Open Payments database for the same year. Study Design Authors and scientific committee members responsible for the content of the 41st SGS Scientific Meeting were identified from the published abstract book; each abstract listed disclosures for each author. Abstract disclosures were compared to transactions recorded on the CMS Open Payments database for concordance. Two authors reviewed each non-disclosed CMS listing to determine relatedness between the company listed on CMS and abstract content. Results Abstracts and disclosures of 335 physicians meeting inclusion criteria were reviewed. 209/335 (62%) physicians had transactions reported in CMS which totaled $1.99 million. 24/335 (7%) physicians listed companies with their abstracts; 5 of those 24 physicians were concordant with CMS. The total amount of all non-disclosed transactions was $1.3 million. Transactions reported in CMS associated with a single physician ranged from $11.72 to $405,903.36. Of the 209 physicians with CMS transactions that were not disclosed, the majority (68%) had at least one company listed in CMS that was determined after review to be related to the subject of their abstract. Conclusion Voluntary disclosure of financial relationships was poor, and the majority of unlisted disclosures in the abstract book were companies related to the scientific content of the abstract. Better transparency is needed by physicians responsible for the content presented at gynecologic scientific meetings.

Opioid prescriptions filled for postoperative pain after hysterectomy substantially increased from 2004 through 2014. Opioid prescription procurement has increased despite a concomitant increase in minimally invasive hysterectomy routes. In light of the current opioid epidemic, physicians must recognize that postoperative prescribing practices may contribute to chronic opioid use. Heightened awareness of opioid prescribing practices following surgery is critically important to decrease risk of development of chronic opioid dependence.

Exploring acoustic and linguistic information embedded in spontaneous speech recordings has proven to be efficient for automatic Alzheimer's dementia detection. Acoustic features can be extracted directly from the audio recordings, however, linguistic features, in fully automatic systems, need to be extracted from transcripts generated by an automatic speech recognition (ASR) system. We explore two state-of-the-art ASR paradigms, Wav2vec2.0 (for transcription and feature extraction) and time delay neural networks (TDNN) on the ADReSSo dataset containing recordings of people describing the Cookie Theft (CT) picture. As no manual transcripts are provided, we train an ASR system using our in-house CT data. We further investigate the use of confidence scores and multiple ASR hypotheses to guide and augment the input for the BERT-based classification. In total, five models are proposed for exploring how to use the audio recordings only for acoustic and linguistic information extraction. The test results on best acoustic-only and best linguisticonly are 74.65% and 84.51% respectively (representing a 15% and 9% relative increase to published baseline results).