Silent Conditions Research Articles

The Effect of Noise and Reverberation on Spatial Perception in Sequential Bilateral Cochlear Implant Users

Abstract Background Spatial orientation is an executive function which includes vital activities and auditory organization according to daily bodily movements, directionality, and environmental information. It is directly linked to the vision and hearing and used throughout life, building complex relationships with these systems, based on learning. Purpose Our purpose in our study is to try to see the effects of noise and reverberation on the users by comparing the localization and auditory performances of the cochlear implant (CI) user individuals in a silent, noisy environment and reverberation. Research Design All subjects were subjected to immitancemetric/audiological tests, language development test (TIFALDI, Receptive/Expressive Language Test score 7 years and above), localization determination in noise, and localization determination test in reverberation. Study sample: In our study, 18 female and 16 male bilateral CI users with profound sensorineural hearing loss were included. The age range of subjects was 8 years 4 months and 10 years 11 months. Data Collection and Analysis Data from subjects were collected prospectively. Data analysis was analyzed with SPSS 21 program. Results It was observed that the subjects did not have difficulty in determining the direction in silent condition, but they had a significant difficulty in localizing the 135-, 225-, and 315-degree angles especially when the noise was signal-to-noise ratio (SNR) –10 dB and the reverberation was 06 and 09 second (p ≤ 0.005). Subjects' performances were significantly altered in sequential implanted users both when the SNR was changed and in the presence of reverberation (p < 0.05). Conclusion As a result of our study, it is thought that individuals with hearing loss will experience intense difficulties, especially in noisy and reverberant environments such as schools, and using assistive listening devices in these environmental conditions will contribute positively to their academic development.

Influence of musical training on temporal productions when using fast and slow counting paces.

The aim of the study was to assess the ability to maintain a steady pace during a counting task, aloud or silently, when a fast (28 counts every 900 ms) or slow (18 counts every 1,400 ms) pace is adopted (target = 25,200 ms), and to test whether ability is the same for musician and nonmusicians. The study analyzes the mean and variability of 30 temporal productions. The results show more variability (a larger coefficient of variation: standard deviation/mean production) in the condition where the pace is slow, a finding consistent with previous reports with this task. This finding applies here in both the aloud and silent counting conditions and, most importantly, applies to both musicians and nonmusicians. The results also indicate that there is no significant difference for the absolute error (|mean production - target duration|). In brief, the capacity to keep variability low when maintaining a pace seems to gain benefit from musical training, and this training difference does not depend on counting aloud versus silently and is not restricted to brief intervals.

Diaphragmatic Palsy Due to a Paraneoplastic Autoimmune Syndrome Revealed by Checkpoint Inhibitors

Background and Clinical Significance: Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment but may underlie diverse and potentially life-threatening immune-related adverse events (irAEs). They may cause various conditions leading to respiratory failure, including myasthenic syndromes and myositis. However, diaphragmatic paralysis (DP) has rarely been reported. To describe patients with diaphragmatic paralysis in a pharmacovigilance registry, we searched the prospective REISAMIC registry at the Gustave Roussy Cancer Center (Villejuif, France) for cases of diaphragmatic palsy (DP) occurring from September 2014 to December 2021. Case Presentation: We identified three patients, in whom DP was confirmed by diaphragmatic ultrasonography, pulmonary function tests, and/or diaphragmatic electroneuromyogram. Diaphragmatic palsy was life-threatening in all patients, as it caused respiratory failure requiring mechanical ventilation. In all cases, a pre-existing subclinical paraneoplastic syndrome was detected. Onconeural antibodies (anti-titin and anti-VGCC) were detected in these patients before and after the initiation of ICI therapy, suggesting a mixed paraneoplastic syndrome with features overlapping those of myasthenic syndrome (myasthenia gravis in one patient and Lambert–Eaton syndrome in another) and myositis. Conclusions: Diaphragmatic palsy is a severe irAE potentially resulting from different mechanisms, including myositis and neuromuscular junction involvement (myasthenia gravis, Lambert–Eaton). Antineuronal antibodies associated with such conditions were already present in our patients prior to immunotherapy initiation, suggesting ICIs could trigger flare-ups of pre-existing silent paraneoplastic autoimmune conditions.

„Mal in Ruhe lesen“: Wirkungen von Lärm auf das Lesen – Ergebnisse einer Laborstudie mit Beschäftigten

“Reading in peace”: Effects of noise on reading – results from a laboratory study with employees Background: It is a regular day-to-day requirement in many occupations to retrieve information from written material by reading. Therefore, a proofreading task was applied as one of two tasks in this study, in which the effects of different realistic sounds on cognitive performance were investigated. Method: Seventy participants worked on a self-developed reading task, once in a silent condition and once in a condition with one of three background sounds. The sounds, which were kindly provided for this study by other institutions, were recordings from a checkout at a fashion retailer, a multi-space office and a construction site. Thus, the sample for this study consisted of three sound groups. In addition, all participants gave subjective assessments referring to the processing of the tasks with respect to four different aspects. Results: For the entire group, the analysis showed the tendency of a lower number of correctly finished items in the sound condition than in the silent condition. The results were different in the separate sound groups. The subjective assessments showed higher experienced effort and disturbance as well as lower self-assessed concentration in the sound condition than in the silent condition. Conclusions: Adverse effects of background sounds on reading performance were detectable, and they were different in the three sound groups. However, clearer effects were identified for the subjective assessments, i.e., when persons were questioned about their impressions. This underlines the importance of asking people affected by noise, in order to get an insight how the interfering effects are experienced. More detailed survey tools would be required to find out more about the sound characteristics which are responsible for particular effects. Keywords: noise – cognitive performance – proofreading – subjective assessments – workplace

Study on the impact of aging on the brain activity patterns in auditory speech comprehension dual-route regions

Objective: To elucidate the patterns of neural activity alterations associated with auditory speech comprehension across the lifespan and the impact of varying listening environments on these dynamics. Methods: Functional near-infrared spectroscopy (fNIRS) was employed to measure the concentration of oxygenated hemoglobin in the brains of 93 adults aged from 20 to 70 with normal hearing. These participants were recruited from Beijing Tongren Hospital, affiliated with Capital Medical University, between March 2021 and February 2023. Brain activity was recorded as subjects passively listened to sentences in both silent and noise conditions with varying signal-to-noise ratios (SNR). The alterations in brain activity were analyzed to delineate the age-related trends under different auditory conditions. Statistical analysis was performed using SPSS 22.0 software. Results: The bilateral primary auditory cortex, superior temporal gyrus, and Wernicke's area, critical for sound signal discrimination and perception, exhibited enhanced activity post-stimulus presentation. Broca's area, pivotal for speech production, demonstrated an initial decrease in activity followed by an increment after stimulus onset. The ventral middle temporal gyrus and dorsal postcentral gyrus showed augmented activity in later time windows. Furthermore, it was observed that in quiet conditions and at low noise levels (SNR=10 dB), auditory cortical activity diminished with age. With increasing noise levels (SNR=5 dB), compensatory brain regions (right ventral middle temporal gyrus and dorsal postcentral gyrus) showed enhanced activity with advancing age. As noise intensity further escalated (SNR=0, SNR=-5 dB), not only did auditory cortical activity decline, but also the activity in regions associated with semantic processing and motor functions reduced with age. Conclusion: During auditory speech comprehension, dual-pathway brain regions exhibit distinct activity patterns. With heightened noise exposure, an increasing number of brain regions are influenced by aging, manifesting as a general decline in activity in most dual-pathway regions, alongside a selective augmentation in some compensatory regions on the right hemisphere.

Lunch melodies: Investigating the impact of music on emotions, hunger, liking, and psychophysiology while viewing a lunch meal

Sensory cues like music can influence our behaviour towards food. In the present study, the effect of music on hunger, fullness, desire to eat and liking of foods, while viewing real lunch food items, was investigated. To this end, emotions and physiological measures were obtained to understand the changes in hunger, fullness, desire to eat and liking. The study aimed to examine changes in hunger, fullness, desire to eat, and liking when viewing a lunch meal under silent and varying music conditions. Additionally, the study explored the potential role of emotions to explain these changes. A crossover experimental design was employed using 50 participants (17 males and 33 females) who observed lunch food items during a silent condition (control), or while listening to either liked or disliked music. The findings demonstrate the cross-modal influence of music on hunger and food liking ratings when viewing food. Hunger ratings were higher and more negative emotions were evoked while viewing lunch food items and listening to disliked music. In contrast, in the silent and liked music conditions, which elicited more positive emotions, there were increased ratings of healthy and unhealthy food pleasantness, overall food liking, and food satisfaction. Electrophysiological measures of heart rate (HR) and skin conductance (SC) were obtained while listening to music and viewing a lunch meal. Viewing food items while listening to disliked music evoked negative emotions and significantly increased SC compared to liked music or silent conditions. Viewing the food items under the silent condition evoked positive emotions and significantly increased HR compared to listening to liked and disliked music. This study showed that the participants’ emotions, hunger level, liking, and electrophysiological responses when viewing food are influenced by music that varied with liking. Results from this study may assist in enhancing dining experiences, as well as influencing food choices and satisfaction with meals.

A comprehensive investigation of morphological features responsible for cerebral aneurysm rupture using machine learning

Cerebral aneurysms are a silent yet prevalent condition that affects a significant global population. Their development can be attributed to various factors, presentations, and treatment approaches. The importance of selecting the appropriate treatment becomes evident upon diagnosis, as the severity of the disease guides the course of action. Cerebral aneurysms are particularly vulnerable in the circle of Willis and pose a significant concern due to the potential for rupture, which can lead to irreversible consequences, including fatality. The primary objective of this study is to predict the rupture status of cerebral aneurysms. To achieve this, we leverage a comprehensive dataset that incorporates clinical and morphological data extracted from 3D real geometries of previous patients. The aim of this research is to provide valuable insights that can help make informed decisions during the treatment process and potentially save the lives of future patients. Diagnosing and predicting aneurysm rupture based solely on brain scans is a significant challenge with limited reliability, even for experienced physicians. However, by employing statistical methods and machine learning techniques, we can assist physicians in making more confident predictions regarding rupture likelihood and selecting appropriate treatment strategies. To achieve this, we used 5 classification machine learning algorithms and trained them on a substantial database comprising 708 cerebral aneurysms. The dataset comprised 3 clinical features and 35 morphological parameters, including 8 novel morphological features introduced for the first time in this study. Our models demonstrated exceptional performance in predicting cerebral aneurysm rupture, with accuracy ranging from 0.76 to 0.82 and precision score from 0.79 to 0.83 for the test dataset. As the data are sensitive and the condition is critical, recall is prioritized as the more crucial parameter over accuracy and precision, and our models achieved outstanding recall score ranging from 0.85 to 0.92. Overall, the best model was Support Vector Machin with an accuracy and precision of 0.82, recall of 0.92 for the testing dataset and the area under curve of 0.84. The ellipticity index, size ratio, and shape irregularity are pivotal features in predicting aneurysm rupture, respectively, contributing significantly to our understanding of this complex condition. Among the multitude of parameters under investigation, these are particularly important. In this study, the ideal roundness parameter was introduced as a novel consideration and ranked fifth among all 38 parameters. Neck circumference and outlet numbers from the new parameters were also deemed significant contributors.

Electroencephalographic Classification Reveals Atypical Speech Motor Planning in Stuttering Adults.

This study explores speech motor planning in adults who stutter (AWS) and adults who do not stutter (ANS) by applying machine learning algorithms to electroencephalographic (EEG) signals. In this study, we developed a technique to holistically examine neural activity differences in speaking and silent reading conditions across the entire cortical surface. This approach allows us to test the hypothesis that AWS will exhibit lower separability of the speech motor planning condition. We used the silent reading condition as a control condition to isolate speech motor planning activity. We classified EEG signals from AWS and ANS individuals into speaking and silent reading categories using kernel support vector machines. We used relative complexities of the learned classifiers to compare speech motor planning discernibility for both classes. AWS group classifiers require a more complex decision boundary to separate speech motor planning and silent reading classes. These findings indicate that the EEG signals associated with speech motor planning are less discernible in AWS, which may result from altered neuronal dynamics in AWS. Our results support the hypothesis that AWS exhibit lower inherent separability of the silent reading and speech motor planning conditions. Further investigation may identify and compare the features leveraged for speech motor classification in AWS and ANS. These observations may have clinical value for developing novel speech therapies or assistive devices for AWS.

Non-Invasive Detection of Early-Stage Fatty Liver Disease via an On-Skin Impedance Sensor and Attention-Based Deep Learning.

Early-stage nonalcoholic fatty liver disease (NAFLD) is a silent condition, with most cases going undiagnosed, potentially progressing to liver cirrhosis and cancer. A non-invasive and cost-effective detection method for early-stage NAFLD detection is a public health priority but challenging. In this study, an adhesive, soft on-skin sensor with low electrode-skin contact impedance for early-stage NAFLD detection is fabricated. A method is developed to synthesize platinum nanoparticles and reduced graphene quantum dots onto the on-skin sensor to reduce electrode-skin contact impedance by increasing double-layer capacitance, thereby enhancing detection accuracy. Furthermore, an attention-based deep learning algorithm is introduced to differentiate impedance signals associated with early-stage NAFLD in high-fat-diet-fed low-density lipoprotein receptor knockout (Ldlr-/-) mice compared to healthy controls. The integration of an adhesive, soft on-skin sensor with low electrode-skin contact impedance and the attention-based deep learning algorithm significantly enhances the detection accuracy for early-stage NAFLD, achieving a rate above 97.5% with an area under the receiver operating characteristic curve (AUC) of 1.0. The findings present a non-invasive approach for early-stage NAFLD detection and display a strategy for improved early detection through on-skin electronics and deep learning.

Association between elevated fibrosis-4 index of liver fibrosis and risk of hemorrhagic stroke.

Cirrhosis is associated with an increased risk of hemorrhagic stroke. Liver fibrosis, typically a silent condition, is antecedent to cirrhosis. The objective of this study was to test the hypothesis that elevated Fibrosis-4 (FIB-4) index, indicating a high probability of liver fibrosis, is associated with an increased risk of hemorrhagic stroke. We performed a cohort analysis of the prospective United Kingdom Biobank cohort study. Participants 40-69 years old were enrolled between 2007 and 2010 and had available follow-up data until March 1, 2018. We excluded participants with prevalent hemorrhagic stroke or thrombocytopenia. High probability of liver fibrosis was defined as having a value >2.67 of the validated FIB-4 index. The primary outcome was hemorrhagic stroke (intracerebral or subarachnoid hemorrhage), defined based on hospitalization and death registry data. Secondary outcomes were intracerebral and subarachnoid hemorrhage, separately. We used Cox proportional hazards models to evaluate the association of FIB-4 index >2.67 with hemorrhagic stroke while adjusting for potential confounders including hypertension, alcohol use, and antithrombotic use. Among 452,994 participants (mean age, 57 years; 54% women), approximately 2% had FIB-4 index >2.67, and 1241 developed hemorrhagic stroke. In adjusted models, FIB-4 index >2.67 was associated with an increased risk of hemorrhagic stroke (HR, 2.0; 95% CI, 1.6-2.6). Results were similar for intracerebral hemorrhage (HR, 2.0; 95% CI, 1.5-2.7) and subarachnoid hemorrhage (HR, 2.2; 95% CI, 1.5-3.5) individually. Elevated FIB-4 index was associated with an increased risk of hemorrhagic stroke.

#837 Information needs and emotional impact when receiving a diagnosis of chronic kidney disease: insights from DISCOVER CKD

Abstract Background and Aims Chronic kidney disease (CKD) is often a silent condition, with symptoms typically not appearing until a large proportion of kidney function has been lost. Therapeutic interventions, e.g., disease-modifying medications, blood pressure and diabetes control, and lifestyle changes, can delay CKD progression, particularly if instigated early. However, psychological distress can reduce adherence to interventions. It is important patients are adequately informed about their diagnosis to improve adherence and reduce the impact of distress. Multinational, real-world data on patient experiences with CKD, particularly about clinical management, treatment patterns and quality of life, are limited. This DISCOVER CKD sub-study aimed to capture the emotions elicited by patients at CKD diagnosis and their perceptions of the information received. Method DISCOVER CKD (NCT04034992) is a multinational cohort study that aims tocharacterise the epidemiology of CKD and describe patient characteristics, CKD progression, clinical outcomes, the patient journey, practice patterns, and clinical management. The current analysis includes a subset of patients from the USA, UK, Japan, and Spain, who participated in 1-2-1 telephone interviews about their CKD experience, including their disease journey and interactions with the healthcare system. Interview topics in DISCOVER CKD were informed by a pilot study that utilised data from PatientsLikeMe, an online network for patients to share personal stories and health data. Qualitative interviews, conducted in the local language by trained interviewers, January–June 2023, lasted ∼60–90 minutes. Transcribed interviews were translated into English for coding (MAXQDA Plus 2022 v22.3.0) and analysis. The study received research ethics board approval and all participants provided written informed consent. Results 103 patients (mean age 63.1 years; 42.7% female; 51.5% with type 2 diabetes) were interviewed. Most had CKD stage 3A (22.3%) or 3B (28.2%); 26.2% had stage 4 or 5 no dialysis and 9.7% were stage 4 (n = 1) or 5 on dialysis. Average time since diagnosis was 9.5 years. Over one-third (38.8%; n = 40/103) of participants did not recall any specific symptoms or signs of CKD prior to diagnosis. Of the pre-diagnosis symptoms reported, the most common was fatigue (21.4%; n = 22/103), then high blood pressure (15.5%; n = 16/103) and swelling (11.7%; n = 12/103). With respect to patient experiences, 55.2% (n = 32/58) said they did not feel sufficient information about CKD was provided at diagnosis and 59.2% (n = 45/76) said no information about their CKD stage was shared. Participants felt overwhelmed and confused about the diagnostic process and struggled to understand the information provided to them, including information about kidney function and symptoms. To supplement their understanding, participants reported using additional sources of information, including the internet (52.9%; n = 36/68), other healthcare professionals (HCPs) (19.1%; n = 13/68), books/printed information (11.8%; n = 8/68) and patient support groups (8.8%; n = 6/68). The most common emotions experienced at the time of diagnosis were worry and fear (28.2%; n = 29/103), then shock/surprise (25.2%; n = 26/103) (Figure). For those reporting no reaction (27.2%; n = 28/103), many stated the condition had no discernible effect on their daily lives. Reasons for fear or worry were related to the potential for disease progression. Conclusion Many patients expressed dissatisfaction with the information they received at their CKD diagnosis. This suggests that HCPs could dedicate more time to explaining the diagnosis, the characteristics and severity of CKD, likelihood of progression, and the benefits of self-management and adherence to intervention. This could be particularly important for those without symptoms at the time of diagnosis, and patients who rely on HCPs as their primary source of information. Patients should be asked what information they want to receive and be directed to trusted sources. The diagnostic process was a highly emotional experience for many patients and counselling or psychological therapy should be considered.

Test conditions impact measures of visual, perceptual, and cognitive performance

Traditionally, visual, perceptual, and cognitive (VPC) testing is performed in well-lit, silent rooms, whilst seated, and with little incentive. Whilst this is a well-controlled setting, it may lack key features of ecological validity and therefore generalisations to real-world environments and tasks may be erroneous. In the present study, 60 participants completed tests of processing speed, divided attention, and selective attention under varying conditions of light, auditory demands, movement demands, and incentive. The results found that processing speed was significantly better in the incentive condition compared to the non-incentive condition; and in the seated and standing conditions compared to the stepping condition. Divided attention and selective attention were significantly worse in the silent condition compared to the music conditions. No significant differences were found between light and dark conditions. These findings demonstrate that performance on the VPC tests is affected by auditory conditions, movement conditions, and incentives, but not light conditions.

Ageing, osteoporosis and intellectual disability; risks differ, and diagnosis can be missed

AbstractBackgroundPeople with intellectual disability often present atypically for various health conditions, making it challenging to identify concerns, particularly when communication challenges are also considered. Additionally, they may face barriers to healthcare access, resulting in many conditions going unnoticed. Health screening inequities are also evident in this population, and osteoporosis, a silent condition often only diagnosed postfracture, requires screening; however, if this does not happen, it may result in unnecessary fracture. Therefore the aim of this study is to identify predictors of osteoporosis in older adults with intellectual disability and examine potential inequity in the diagnosis of the condition.MethodsThe study used data from the Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing (IDS‐TILDA). Bone quality was measured using quantitative ultrasound (QUS). Logistic regression was performed to identify significant predictors of poor bone quality, including chronic health conditions, dietary intake, medication use and activity levels.ResultsOut of 575 participants who completed QUS, osteoporosis prevalence was objectively measured at 41%, with a further 33.2% measured within the osteopenic range, but less than 2 in 10 had a doctor's diagnosis of osteoporosis. Reported Dual‐Energy X‐ray Absorptiometry screening uptake was low at 18.2%. Three major predictor variables of osteoporosis and osteopenia were found significant: difficulty walking 100 yards, taking antiepileptic drugs medicines and taking proton pump inhibitors. The model achieved an overall classification accuracy of 70.8% for osteopenia and 72.5% for identifying osteoporosis.ConclusionThe study highlights the different risk factors in people with intellectual disability, the potential for missed diagnoses and the likelihood there is inadequate screening. There is an urgent need for robust risk assessment and reasonable adjustments to ensure equitable screening and targeted preventive strategies. Clinicians must consider specific concerns for this population to avoid missed diagnoses and reduce the adverse effects of osteoporosis/osteopenia, such as an increased risk of fragility fractures.

Neural correlates of inhibitory control in the context of infant cry and paternal postpartum mental health

BackgroundInhibitory control, a form of self-regulation, may support sensitive parenting, but has been understudied in new fathers despite their pronounced risk for stress and mental health challenges. MethodsThis study probed the neural correlates of inhibitory control and its associations to first-time fathers' postpartum mental health, focusing on depressive symptoms, state anxiety, and perceived stress. Six months after their child’s birth, 38 fathers self-reported on their mood, anxiety, and stress, and performed a Go/No-Go fMRI task while listening to three sets of sounds (infant cry, pink noise, and silence). ResultsFathers’ behavioral inhibition accuracy was consistent across the sound conditions, but their patterns of neural activation varied. Compared to the pink noise condition, fathers showed heightened engagement in prefrontal regulatory regions when self-regulating during the infant cry and silent conditions. When examining correct trials only, results in visual motor area and primary somatosensory cortex emerged only for infant cry and not for pink noise and silence. Moreover, fathers reporting higher levels of postpartum depression, state anxiety, and perceived stress showed greater activation in prefrontal regions when inhibiting during infant cry or silence. ConclusionThis study is the first to underscore the complex interplay between the neural mechanisms related to inhibitory control and postpartum mental health and stress across varied auditory context, laying the groundwork for future research.

Behavioural plasticity compensates for adaptive loss of cricket song.

Behavioural flexibility might help animals cope with costs of genetic variants under selection, promoting genetic adaptation. However, it has proven challenging to experimentally link behavioural flexibility to the predicted compensation of population-level fitness. We tested this prediction using the field cricket Teleogryllus oceanicus. In Hawaiian populations, a mutation silences males and protects against eavesdropping parasitoids. To examine how the loss of this critical acoustic communication signal impacts offspring production and mate location, we developed a high-resolution, individual-based tracking system for low-light, naturalistic conditions. Offspring production did not differ significantly in replicate silent versus singing populations, and fitness compensation in silent conditions was associated with significantly increased locomotion in both sexes. Our results provide evidence that flexible behaviour can promote genetic adaptation via compensation in reproductive output and suggest that rapid evolution of animal communication systems may be less constrained than previously appreciated.

Diabetic retinopathy: Knowledge, awareness, and practices in primary-care centers in the Kingdom of Bahrain.

With the growing incidence of diabetic-related complications such as retinopathy and the well-understood role of screening and telemedicine around the world in preventing and managing this potentially blinding disease, there comes the importance of awareness toward this silent eye condition. Awareness ideally should be raised both from the patients' and physicians' perspectives. This study aims to assess the awareness of primary care physicians (PCPs) towards diabetic retinopathy (DR) and its management. A survey considering professional background, knowledge, and practices was distributed electronically to all PCPs in the Kingdom of Bahrain and analyzed using SPSS Vs 21. A total of 83 physicians completed the survey; 81.9% were female and 96.4% were Bahraini. More than 60% of them accurately knew screening guidelines for type 1 and 2 DR. Of the total, 72.5% would refer patients to the ophthalmologist even if asymptomatic, and 97.6% correctly stated that a dilated eye exam is the method of choice most efficient for assessing DR. Nearly 60% knew about the current treatment modalities for DR and 91.3% knew about the presence of a national screening program in the Kingdom. The overall knowledge of DR was good with some potential gaps in information about screening. PCPs could benefit from regular refresher courses for more precise practices on screening and referral of retinopathy.

Magnesium and magnesium alloy dissolution by high intensity focused ultrasound: erosion/cavitation vs. Wave propagation

The dissolution of metals, influenced by mechanical and chemical factors, plays a crucial role in various applications. Ultrasonic irradiation has been explored for its ability to enhance dissolution rates and modify surface characteristics. In this study, we investigate the dissolution of magnesium (Mg) and magnesium alloys under high-intensity focused ultrasound (HIFU) conditions with frequency sweeping (wobbling). Our findings reveal distinct effects of cavitation and acoustic streaming on the dissolution process. For pure magnesium, ultrasonic treatment significantly increases dissolution rates compared to silent conditions. Negative frequency sweeps result in the highest dissolution rates, linked to increased cavitation activity, while positive sweeps reduce dissolution rates but maintain acoustic streaming effects. The removal of surface oxides is accelerated in all sonication conditions. Macro- and micro-roughness patterns on the surface correspond to the wobbling frequency range, with wavelengths matching the average ultrasonic frequency. However, dissolution is not uniform across the sample, and preferential attack occurs at the focal point during negative frequency sweeps. In contrast, magnesium alloys exhibit lower dissolution rates than pure Mg. The alloy's mechanical properties make it less susceptible to cavitation erosion but more sensitive to acoustic streaming-induced dissolution. Grain boundaries are preferentially attacked, revealing differences between ductile pure Mg and the harder, more cavitation-resistant, alloy. This study highlights the complex interplay between cavitation and acoustic streaming in the dissolution of magnesium and its alloys under HIFU conditions, shedding light on the limits and potential applications of this technique, particularly in microstructure analysis.

Cirrhotic cardiomyopathy: a subject that's always topical.

Cirrhosis is the final stage in the development of hepatic fibrosis in chronic liver disease. It is associated with major hemodynamic disturbances defining the hyperdynamic circulation and may be complicated by specific cardiac involvement or cirrhotic cardiomyopathy which is a silent clinical condition that typically remains asymptomatic until the late stages of liver disease. Recently, new criteria defining CC, based on modern concepts and knowledge of heart failure, have been proposed. Despite knowledge of the main mechanisms behind this entity, there is no specific treatment available for cirrhotic cardiomyopathy. The management approach for symptomatic cardiomyopathy in cirrhotic patients is similar to that for left ventricular failure in non-cirrhotic individuals.

Influence of monaural auditory stimulation combined with music on brain activity.

Recently, the increasing attention to mental states and psychophysical health has fueled the research into methods that can aid in relaxation and recovery. Traditional methods like meditation and sauna, while effective, have their limitations; thus, the need for more accessible and convenient alternatives. Our innovative approach combines monaural beats with music, attempting to replicate the relaxing effects of a sauna in the auditory domain. In comparison to normal music and silent condition, the power of the theta active band significantly increased when listening to our modified music. Furthermore, after listening to modified music, there was a significant increase in mismatch negativity (MMN) amplitude in the oddball task. Additionally, participants' subjective responses to a questionnaire indicated significant changes in body relaxation and other metrics after listening to the processed music. This state is considered similar to the "totonou" state, which manifests in physical and mental feelings of relaxation, pleasure, and mental clarity in the sauna. Thus, the present research proposes a convenient method for achieving relaxation, opening an avenue for individuals to customize their "totonou" music based on personal preferences.

Overcoming passivation through improved mass transport in dense ionic fluids.

Deep Eutectic Solvents (DESs) have recently been shown to be part of a dense ionic fluid continuum between ionic liquids and concentrated aqueous brines. Charge transport was shown to be governed by fluidity, with no discontinuity between molar conductivity and fluidity irrespective of cation, charge density or ionic radius. By adjusting the activity of water and chloride ions, mass transport, speciation and reactivity can be altered. It has been shown that while brines provide a high chloride content at a lower viscosity than DESs, unlike DESs, brines are unable to prevent metal passivation due to their high water content. This results in the possibility to impart a level of selectivity towards metal dissolution (or passivation) when processing mixed metal materials. Forced convection can be used to avoid the issue of slow mass transport in viscous media, and the use of jets or targeted ultrasound are effective methods for overcoming this issue. High-powered ultrasound was applied to copper, cobalt, and aluminium electrodes undergoing anodic dissolution, and linear sweep voltammetry showed a linear current-voltage response at potentials anodic of the oxidation potential under sonication, with total charge passed being 5 to 134 times greater than under silent conditions. Application of ultrasound to silver and nickel electrodes displayed an initial linear current-voltage response, but the increased water content of the brines resulted in passivation. Mass transport throughout the bulk solution is governed by the forced convection imparted by the ultrasound and ionic species must only migrate across the electrical double layer. It is shown that the anodic dissolution of a range of metals classically expected to passivate, e.g. aluminium, can be significantly accelerated under insonation conditions.