Search

Laryngeal mucus hydrates and lubricates the deformable tissue of the vocal folds and acts as a boundary layer with the airflow from the lungs. However, the effects of the mucus' viscoelasticity on phonation remain widely unknown and mucus has not yet been established in experimental procedures of voice research. In this study, four synthetic mucus samples were created on the basis of xanthan with focus on physiological frequency-dependent viscoelastic properties, which cover viscosities and elasticities over 2 orders of magnitude. An established ex vivo experimental setup was expanded by a reproducible and controllable application method of synthetic mucus. The application method and the suitability of the synthetic mucus samples were successfully verified by fluorescence evidence on the vocal folds even after oscillation experiments. Subsequently, the impact of mucus viscoelasticity on the oscillatory dynamics of the vocal folds, the subglottal pressure, and acoustic signal was investigated with 24 porcine larynges (2304 datasets). Despite the large differences of viscoelasticity, the phonatory characteristics remained stable with only minor statistically significant differences. Overall, this study increased the level of realism in the experimental setup for replication of the phonatory process enabling further research on pathological mucus and exploration of therapeutic options.

The following case report discusses a person who experienced vision loss after consuming homemade alcoholic beverage for 14 days. A 32-year-old Iranian man with chief complaint of blindness was referred to Loghman-e Hakim hospital. His visual acuity was light perception (LP) and could only describe where the light was coming from. The patient had the history of buying 20-liter homemade alcoholic beverage. He drank it during 14 days with different groups of his friends. The day after he finished the beverage and stopped drinking his vision decreased up to the time which at the end of day 2 he was almost blind. None of his other friends that drank from the same alcohol were showing any visual or other symptoms of methanol poisoning problems. The purchased liquor had a slight amount of methanol that was detoxified by folinic acid in his fellows but accumulated during 2 weeks of constant drinking in patient and due to ethanol being a competitive inhibitor of methanol to alcohol dehydrogenase (ADH) enzyme it didn’t convert to formic acid causing blindness. But by the time his blood ethanol levels became lower he showed symptoms of methanol toxicity.

Introduction: Necrotizing fasciitis (NF) is a critical disease with high morbidity and mortality rates that poses significant challenges in diagnosis and treatment. Prognostic factors for the clinical course of NF remain unclear and are currently under research. This study aims to identify such factors in a large cohort of patients which represents a major comprehensive investigation of prognostic factors for NF. Methods: Retrospective analysis was conducted on necrotizing fasciitis cases from 2003 to 2023 at two German hospitals. Data included demographics, comorbidities, laboratory findings, infection site, causative microorganisms and outcomes. Statistical analysis involved t-tests, chi-square tests, and ROC analysis. Results: A total of 209 patients were included, with a mortality rate of 18%. Patients were categorized into survivors (n = 171) and non-survivors (n = 38). Non-survivors were significantly older (68.9 ± 13.9 years vs. 55.9 ± 14.3 years; p < 0.01) and exhibited a higher prevalence of peripheral vascular diseases, cancer, and heart, liver, or renal insufficiency. Laboratory findings and scoring results also varied significantly between the two groups. The ROC curve analysis identified age as a predictor of mortality, with an optimal cut-off value of 68.5 years (sensitivity: 60.5%, specificity: 81.9%). Higher age was associated with increased mortality risk. Conclusions: The patient’s age stands out as the primary predictive element for mortality in necrotizing fasciitis. Additionally, we advocate for employing the Laboratory and Anamnestic Risk Indicator for Necrotizing Fasciitis (LARINF—score), which holds substantial prognostic significance and is straightforward to calculate. Considering our findings, crafting a clinical algorithm or scoring mechanism to forecast mortality in NF would be a promising target for future research.

The algal–bacterial shortcut nitrogen removal (ABSNR) process can be used to treat high ammonia strength wastewaters without external aeration. However, prior algal–bacterial SNR studies have been conducted under fixed light/dark periods that were not representative of natural light conditions. In this study, laboratory-scale photo-sequencing batch reactors (PSBRs) were used to treat anaerobic digester sidestream under varying light intensities that mimicked summer and winter conditions in Tampa, FL, USA. A dynamic mathematical model was developed for the ABSNR process, which was calibrated and validated using data sets from the laboratory PSBRs. The model elucidated the dynamics of algal and bacterial biomass growth under natural illumination conditions as well as transformation processes for nitrogen species, oxygen, organic and inorganic carbon. A full-scale PSBR with a 1.2 m depth, a 6-day hydraulic retention time (HRT) and a 10-day solids retention time (SRT) was simulated for treatment of anaerobic digester sidestream. The full-scale PSBR could achieve >90% ammonia removal, significantly reducing the nitrogen load to the mainstream wastewater treatment plant (WWTP). The dynamic simulation showed that ABSNR process can help wastewater treatment facilities meet stringent nitrogen removal standards with low energy inputs. HIGHLIGHTS Sidestream wastewater treatment by algal–bacterial shortcut nitrogen removal.; Varying illumination simulated summer/winter outdoor conditions.; Model developed for dynamic PSBR simulation under varying illumination.; Long-term simulation employed for TN removal in a full-scale WWTP.;

Polycystic ovary syndrome (PCOS) is often associated with metabolic abnormalities in the affected patients such as obesity or a dysregulated glucose metabolism/insulin resistance (IR). IR affects the serum levels of several circulating microRNAs; however, studies on the association between IR-related microRNAs and PCOS are scarce. Therefore, we quantified the serum levels of the IR-associated microRNAs miR-93, miR-148a, miR-216a, miR-224 and miR-320a via qPCR in a cohort of 358 infertility patients, of whom 136 were diagnosed with PCOS. In bivariate correlation analyses, the serum levels of miR-93 and miR-216a were inversely associated with dipeptidyl peptidase 4 serum concentrations, and the miR-320a serum levels were significantly downregulated in PCOS patients (p = 0.02, Mann–Whitney U test). Interestingly, in all patients who achieved pregnancy after Assisted Reproductive Technology (ART) cycles, the serum levels of the five IR-associated microRNAs were significantly elevated compared to those of non-pregnant patients. In cell culture experiments, we detected a significant upregulation of miR-320a expression following testosterone stimulation over 24 and 48 h in KGN and COV434 granulosa carcinoma cells. In conclusion, we demonstrated a significantly reduced serum level of the IR-associated miR-320a in our patient cohort. This result once again demonstrates the close relationship between metabolic disorders and the dysregulation of microRNA expression patterns in PCOS.

Background and Objectives: Toxic epidermal necrolysis (TEN) and Stevens–Johnson syndrome (SJS) are rare yet life-threatening dermatologic conditions characterized by severe skin and mucous membrane involvement. Accurate prognostic systems are crucial for clinical management to assess disease severity and predict outcomes. The primary objective of this study was to assess the epidemiological characteristics and clinical outcomes of patients with Stevens–Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap over a 17-year period at a specialized burn center. The secondary objectives were to evaluate the performance of existing prognostic scoring systems (SCORTEN, Re-SCORTEN, and ABCD-10) in predicting mortality and to propose a novel classification tree model to improve mortality prediction. Materials and Methods: A 17-year retrospective study at a burn center included 68 patients with SJS, SJS/TEN overlap, or TEN. Demographic, clinical, laboratory data, and prognostic scores (SCORTEN, Re-SCORTEN, ABCD-10) were collected and analyzed for associations with mortality. A classification tree was created to detect unknown determinants of SJS/TEN mortality. Results: The drug most frequently associated with the occurrence of SJS/TEN was metamizole. The mortality rate was 51%. Affected body surface area, platelet count, and serum blood urea nitrogen differed significantly between survivors and non-survivors. Regarding the scoring systems, only the Re-SCORTEN showed reliable differentiation for these groups. A classification tree model achieved an accuracy of 89% in predicting the mortality risk. In the ROC curve analysis, the AUC values were 0.88 for the classification tree, 0.66 for Re-SCORTEN, 0.61 for SCORTEN, and 0.56 for ABCD-10. Conclusions: This study explores mortality predictors in SJS/TEN via a classification tree model, highlighting potential factors for further investigation. While cautioning against immediate clinical application due to data constraints, the findings underscore the need for larger studies to validate and refine prediction models in this context.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social interaction and communication. While many studies suggest that individuals with ASD struggle with emotion processing, the association between emotion processing and autistic traits in non-clinical populations is still unclear. We examine whether neurotypical adults’ facial emotion recognition and expression imitation are associated with autistic traits. We recruited 32 neurotypical adults; each received two computerized tasks, the Dynamic Emotion Recognition and Expression Imitation, and two standardized measures: the Chinese version AQ and the Twenty-Item Prosopagnosia Index (PI-20). Results for the dynamic emotion recognition showed that happiness has the highest mean accuracy, followed by surprise, sadness, anger, fear, and disgust. For expression imitation, it was easiest to imitate surprise and happiness, followed by disgust, while the accuracy of imitating sadness, anger, and fear was much lower. Importantly, individual AQ scores negatively correlated with emotion recognition accuracy and positively correlated with PI-20. The AQ imagination, communication sub-scores, and PI-20 positively correlated with the expression imitation of surprise. In summary, we found a significant link between recognizing emotional expressions and the level of autistic traits in non-clinical populations, supporting the concept of broader autism phenotype.

Communities of practice have taken a firm foothold in the second language teaching profession due to their promise of enabling participants to self determine their professional development needs and, through peer mentoring, achieve their goals. This article provides a rationale as to why the model is particularly well suited to teacher professional development along with guidelines for establishing and sustaining the community. This process is illustrated via several examples: (1) a large-scale, multinational community of practice established in the Lower Mekong region of Southeast Asia and funded by the U.S. Department of State's Office of English Language Programs; and (2) two teacher-created local outgrowths of this community established in Siem Reap and Phnom Penh, Cambodia.

As teacher educators (TEs), we have a unique and remarkable opportunity to mentor the next generation of teachers. Over the years, our teacher candidates (TCs) have reported a sense of cognitive and affective dissonance while engaging in their culminating master's research requirement as part of a research seminar course. Cognitively, this research study requires knowledge-generation quite different from research they engaged in throughout the program, where they would synthesize and analyze published work in response to a prompt. This knowledge-generation process would often result in challenging previously held assumptions regarding the topic of inquiry through an analysis of authentic data gathered in the field. Many also experience affective dissonance when beliefs about their sense of self as emerging practitioner-researchers are questioned. Some research has examined ways in which to provide deliberate feedback that attunes not only to the TCs' cognitive and affective dimensions but also to where they can be moved in terms of the outer limits of their learning potential. This study examines how the lenses of socio-cultural and constructive-developmental theories can complement TEs in supporting their TCs in navigating the complex task of teacher research and proposes a framework for feedback practice grounded in a person-centered approach that accounts for TC developmental potentialities.

Cyber aggression has become a growing problem in today's society. It offers convenient opportunities to humiliate, bully, or harass others online. Global studies on cyber aggression found that youths who were aggressed online reported feeling depressed, anxious and afraid. They showed poor academic performance, and experienced eating disorders, alcohol, drugs and substance abuse. Therefore the study aimed to investigate the interrelationships between predictive factors namely peer attachment, parental attachment, exposure to the Internet and cyber aggression-victimization among youths. The renowned general aggression model (GAM) was applied to understand the phenomenon. A sample of 430 urban youths aged between 13 and 18 years living within Klang Valley area were randomly selected to participate in the study. Data were gathered through self-report questionnaires and later analyzed using SPSS and AMOS. The results revealed several noteworthy findings; most of respondents made use of the Internet for approximately 7 to 21 hours per day during weekends mainly for surfing social media, followed by entertainment and online games. A relatively significant number of youths were engaged with cyber victimization through written-verbal and online exclusion. Finally, the structural path analysis indicates that Internet exposure is the strongest predictor associated with cyber aggression-victimization. Based on these findings, the implications and recommendations for future investigations with reference to the current theoretical framework and empirical findings on cyber aggression-victimization are thoroughly discussed.

MyShake is a free citizen science and public safety smartphone application that delivers the United States ShakeAlert program's Earthquake Early Warning to the public in the states of California, Oregon, andWashington. Although smartphone notifications have long been a component of the ShakeAlert warning delivery plan, very little data has been published on the efficiency and accuracy of such communication. MyShake records timestamps in its alert processing system, including the time it takes for a phone to receive and acknowledge an alert's delivery. We use data collected for five representative earthquakes-three in urban regions, two rural events-since October 2019 to assess MyShake alert delivery latencies and ground-motion prediction accuracy. For these events, MyShake was capable of efficiently processing and delivering warnings. For the smaller urban events that occur beneath the target population, about half of recipients received a warning before the estimated onset of the S-wave, and up to 90% received an alert prior to experiencing peak shaking. When earthquakes occur further from populated areas, the warning time naturally increases. Smartphone acceleration recordings can also be used to quantify the user experience during earthquakes because they are colocated with people. A review of waveforms collected by MyShake shows a systematic amplification of shaking recorded by smartphones relative to nearby traditional stations. The median amplification calculated using records from all five sample events is a factor of 3.1. Once this correction is applied, MyShake peak accelerations are generally consistent with the distribution of shaking intensities in the U.S. Geological Survey ShakeMap product, whereas also showing some individual sites with substantial amplification and de-amplification. In addition to delivering early warnings, therefore, MyShake provides a waveform observation dataset to densify shaking intensity observations and thereby improve our understanding of earthquake effects and evaluate the accuracy of ShakeAlert's alerting regions.

BackgroundCurrent standard treatment concepts in head and neck squamous cell carcinoma (HNSCC) are based on former studies using 2D and 3D treatment plans. However, modern radiation techniques allow for a more precise and individual dose application. Therefore, in a clearly defined patient population, de-intensified risk-adapted radiation is investigated.MethodsPatients with newly diagnosed HNSCC after surgery (with resection margins ≥1 mm and cM0) with the following tumor stages (TNM 7th Edition) were eligible for the study: oral cavity, oropharynx, or larynx: pT1–3, pN0–pN2b; hypopharynx: pT1–2, pN1. The patients should have either a low risk of local recurrence [≤pT2, resection margin ≥5 mm, no peritumoral lymphangiosis (L0), and no perineural invasion] or contralateral lymph node metastasis (≤3 ipsilateral lymph node metastases, in case of well-lateralized oropharyngeal or oral cavity cancer contralateral cN0, otherwise pN0). Patients were assigned to three different treatment regimes with reduction of the treated volume, radiation dose, or both, according to tumor stage and results of surgery performed. The primary objective was to show an LRR of

ناقشت هذه الدراسة نسبة تأثير طريقة التغذية الراجعة 360 درجة على فعالية الأداء الوظيفي من خلال العدالة التنظيمية كمتغير وسيط، والتي يستخدمها معلمو التربية الإسلامية للصفوف (5 إلى 12) في أربع محافظات: مسقط، جنوب الباطنة، شمال الباطنة، والداخلية. هدفت الدراسة إلى: قياس مدى تطبيق طريقة التغذية الراجعة، وقياس تأثيرها على فعالية الأداء الوظيفي للمعلمين، وعلى العدالة التنظيمية، وتأثير العدالة التنظيمية على فعالية الأداء الوظيفي للمعلمين. اعتمدت الدراسة المنهج الوصفي التحليلي والمنهج الكمي في جمع البيانات وتحليلها. تم اختيار عينة عشوائية بسيطة من (350) معلما ومعلمة من أصل (3885). وتم تطوير ثلاث استبانات مكونة من (63) عبارة موزعة على (3) محاور، وتم التأكد من صلاحيتها وثباتها. وأظهرت النتائج: أن هناك تأثيرا إيجابيا عاليا ومباشرا ذا دلالة إحصائية لطريقة التغذية الراجعة على فعالية الأداء الوظيفي بمقدار (0.577) وحدة. وهناك تأثير إيجابي مرتفع لطريقة التغذية الراجعة على العدالة التنظيمية بقيمة (0.667). وأخيرًا، هناك تأثير إيجابي مرتفع ومباشر ذو دلالة إحصائية لفعالية العدالة التنظيمية على الأداء الوظيفي لمعلمي التربية الإسلامية بقيمة (0.584) وحدة.