Spontaneous Conversion Research Articles

Intramolecular hydrogen-atom tunneling in matrix-isolated heterocyclic compounds: 2-thiouracil and its analogues.

Hydrogen-atom tunneling leading to spontaneous tautomeric conversion in monomeric heterocyclic molecules without intramolecular hydrogen bonds has been experimentally detected for the first time. For monomers of 2-thiouracil, 6-aza-2-thiouracil and 1-methyl-2-thiouracil isolated in low-temperature matrices, higher-energy thiol forms were generated upon UV (λ = 305 nm) excitation of the most stable thione tautomers. When the matrices were subsequently kept in the dark and at low temperature, hydrogen-atom tunneling occurred, leading to the thiol → thione conversion. During this process, the photoproduced thiol form spontaneously converted into the lowest energy thione tautomer.

Dancing your Aliyah passage: An Anthropological Inquiry into the Acclimatisation and Integration of Turkish Jewish Immigrants in Israel

ABSTRACT Anthropologists and sociologists explore dance as a political and cultural performance to express beliefs, ideologies and social ideas. This article examines the impact of Israeli folk dance on the socialisation and integration, of Jewish newcomers (Olim) from Turkey into contemporary Israeli society. Based on in-depth interviews, questionnaires, and spontaneous conversations, as well as auto-ethnographic writings, the article clarifies how, by dancing Israeli folk dance, and particularly through participation in the Israeli folk dance troupe, Olim manage diverse social interactions and cultural negotiations within Israeli society, construct their national identity and shed light on tensions and changes regarding homeland, immigration, and Jewish peoplehood. It argues that Israeli folk dance is an important channel in their process of Israelization. On the one hand, it connects them to Israeli culture and strengthens their Jewish pride; on the other, it clarifies the distinction between life in the diaspora and life in an ethno-national space, expressing otherness while encouraging them to bring their own traditions to an Israeli stage.

PROTOCOLS FOR COLLECTING CONVERSATIONAL LANGUAGE IN PERSONS WITH DEMENTIA

Abstract We describe first-of-its-kind protocols for collecting spontaneous conversations in persons with dementia living in a community through conversation elicitation tools twice a month over six months. We also describe the preliminary feasibility of the protocol deployment in the first enrolled participants over the first month of data collection. Participants were recruited from the University of Washington ADRC registry. The audio was captured using RODE wireless microphone system. Four conversational elicitation techniques were used: 1) reminiscence using personal photographs; 2) reminiscence using generic historical images; 3) picture description test from neurocognitive batteries; 4) open-ended questions about daily activities. Health measures included Cornell Scale for Depression in Dementia (CSDD), Clinical Dementia Rating (CDR), and Clinical Frailty Scale (CFS). Four male and two female participants (average age 75) were recruited. Average health measures at baseline were CDR = 2, suggesting moderate dementia; CSDD=7, suggesting depressive symptoms, CFS=5, suggesting mild frailty. At baseline, the tasks’ average conversation time in seconds was as follows: daily activities =528; personal reminiscence=443; historical reminiscence =227; picture description =192. The corresponding average times for the subsequent home visits were 917; 518; 474, and 280 at visit 1 and 525; 767; 629, and 311 at visit 2. We established the feasibility of collecting conversational speech in this population. Participants seemed more interested in conversations focused on daily activities and personal pictures than general topics. There was an increase in the duration of conversations over time, which might be related to participants’ greater familiarity with the study protocol and data collectors.

Prediction of fluorescence quantum yields using the extended thawed Gaussian approximation

Spontaneous emission and internal conversion rates are calculated within harmonic approximations and compared to the results obtained within the semi-classical extended thawed Gaussian approximation (ETGA). This is the first application of the ETGA in the calculation of internal conversion and emission rates for real molecular systems, namely, formaldehyde, fluorobenzene, azulene, and a dicyano-squaraine dye. The viability of the models as black-box tools for prediction of spontaneous emission and internal conversion rates is assessed. All calculations were done using a consistent protocol in order to investigate how different methods perform without previous experimental knowledge using density functional theory (DFT) and time-dependent DFT (TD-DFT) with B3LYP, PBE0, ωB97XD, and CAM-B3LYP functionals. Contrasting the results with experimental data shows that there are further improvements required before theoretical predictions of emission and internal conversion rates can be used as reliable indicators for the photo-luminescence properties of molecules. We find that the ETGA performs rather similar to the vertical harmonical model. Including anharmonicities in the calculation of internal conversion rates has a moderate effect on the quantitative results in the studied systems. The emission rates are fairly stable with respect to computational parameters, but the internal conversion rate reveals itself to be highly dependent on the choice of the spectral line shape function, particularly the width of the Lorentzian function, associated with homogeneous broadening.

Versatile copulas and their stance-marking uses in conversational Odia, an Indo-Aryan language

Recent typological studies have identified some major functions associated with copulas, including tense-aspect-mood (TAM) and agreement (AGR) marking. In this paper, using conversational data from Odia, an Indo-Aryan language, we examine the speaker stance functions in copula constructions. More specifically, in addition to focus marking as a highlighting strategy, we show how copulas help to anchor the speaker’s subjective (attitudinal and affective) and intersubjective (socio-interactional) stance. Our analysis reveals that these (inter)subjective stances can be realized epistemically through the tense-mood marking functions of the copula, socio-interactionally through its agreement marking functions, and emphatically through its focus marking functions. The findings from this study contribute to our understanding of the relationship between copulas and stance-taking/stance-marking in spontaneous conversations in Indo-Aryan languages, and potentially other languages as well.

Speaking partners’ talk in transitions between symbols in conversations that use speech-output technologies

Aided conversations differ from spoken ones in their transitions between turns and symbols because seeking and choosing symbols takes more time than speaking words naturally. This study adopted the concepts and principles of conversation analysis (CA) to analyze the transitions between symbols during the construction of aided turns. The data was from the spontaneous conversations at home between mothers and four males (sons) who used speech-output technologies. The analyses compared the durations of transitions between turns and symbols and frequency of mothers’ talk during the transitions. The mothers most often remained silent during the symbol-transitions, but when they talked, their speech was inspired by the current context and was not coincidental. When the mothers spoke during the symbol-transitions, their sons either continued or paused constructing their turn. Despite the effect on the progress of conversations, the participants did not orient to these expanded aided turns as challenging. The expansions manifested (a) in parallel (b) side by side with the aided turn, and (c) as a part of the ongoing aided turn. Analyzing the structural characteristics of aided conversations deepens our understanding of theoretical concepts, offers strategies to guide aided communicators and their partners, and helps to develop augmentative and alternative communication technologies that promote interactive communication.

Dying 2 Talk: Generating a More Compassion Community for Young People

People in the Global North often have a problem talking about — and processing — the inevitability of death. This can be because death and care of the dying has been professionalised, with encounters of death within our families and communities no longer being ‘normal and routine’ (Kellehear 2005). Young people are particularly excluded from these conversations, with implications for future mental health and wellbeing (Ainsley-Green 2017). Working in Wolverhampton and Bradford, the Dying 2 Talk (D2T) project aimed to build young people’s future resilience around this challenging topic. We recruited over 20 young people as project ambassadors to co-produce resources that would encourage talk about death, dying and bereavement. The resources were used as the basis of ‘Festivals of the Dead’ which were taken to schools to engage wider audiences of young people (aged 11 +). The project aimed to use alternative ‘ways in’ to open discussion, beginning with archaeology, and ultimately using gaming, dance, creative writing and other creative outputs to facilitate discussion, encourage compassionate relationships and build resilience. The resources succeeded in engaging young people from ages 11–19 years, facilitating a comfortable and supportive environment for these vital conversations. Project evaluations and observations revealed that the Festivals, and the activities co-created by the young ambassadors helped to facilitate spontaneous conversations about death, dying and bereavement amongst young people by providing a comfortable and supportive environment. The project was funded by the Arts and Humanities Research Council (AH/V008609/1), building on a pilot project funded by the Higher Education Innovation Fund at the University of Bradford.

Self‐Charged Dual‐Photoelectrode Vanadium–Iron Energy Storage Battery

AbstractThe efficient utilization of solar energy in battery systems has emerged as a crucial strategy for promoting green and sustainable development. In this study, an innovative dual‐photoelectrode vanadium–iron energy storage battery (Titanium dioxide (TiO2) or Bismuth vanadate (BiVO4) as photoanodes, polythiophene (pTTh) as photocathode, and VO2+/Fe3+ as redox couples.) is proposed, which can autonomously charge under sunlight. The dual‐photoelectrode structure enables the efficient harnessing of solar energy. All processes are spontaneous and do not require external power sources. It is noteworthy that the vanadium–iron energy storage battery demonstrates excellent stability and remarkably low cost. The results show that the combinations of TiO2‐pTTh and BiVO4‐pTTh as photoelectrodes achieve spontaneous conversion rates of 29.17% and 25.46% for VO2+ and 25.6% and 23% for Fe3+ after 4 h of light charging. This study offers a promising solution for the development of large‐scale, low‐cost solar energy storage batteries.

Conversion to Sinus Rhythm in Refractory Atrial Fibrillation Patients after Atrioventricular Node Ablation with Conduction System Pacing.

"Ablate and pace" strategy is a reasonable treatment option in refractory atrial fibrillation (AF) when sinus rhythm (SR) cannot be achieved with catheter ablation or pharmacological therapy. Atrioventricular node ablation (AVNA) combined with conduction system pacing (CSP), with left bundle branch pacing (LBBP) or His bundle pacing (HBP), is gaining recognition since it offers the most physiological activation of the left ventricle. However, the incidence of conversion to SR after AVNA with CSP is not known. The purpose of the investigation was to determine the incidence of spontaneous conversion to SR and its predicting factors in patients undergoing CSP and AVNA. Consecutive refractory symptomatic AF patients undergoing AVNA with CSP at our institution between June 2018 and December 2022 were retrospectively analyzed. Twelve lead electrocardiogram (ECG) recordings were analyzed at each outpatient follow-up visit. Echocardiographic and clinical parameters were assessed at baseline and six months after the implantation. Sixty-eight patients (male 42.6%, age 71 8 years, left ventricular ejection fraction 40 15%) were included. Thirty-seven patients (54.4%) received HBP and 31 (45.6%) LBBP. During follow-up, spontaneous conversion to SR was registered in 6 patients (8.8%); 3 in the HBP group and 3 in the LBBP group. Baseline characteristics of patients who converted to SR did not differ from non-sinus rhythm (NSR) patients except for left atrial volume index (LAVI), which was significantly smaller in the SR group (45 mL/ (41-51) vs. 60 mL/ (52-75); p = 0.002). Multiple regression model confirmed an inverse association between LAVI and conversion to SR even after considering other clinically relevant covariates (odds ratio 1.273, p = 0.028). At follow-up, LAVI did not change in any group (SR: p = 0.345; NSR: p = 0.508). Improvement in New York Heart Association (NYHA) class was comparable in both groups. Spontaneous conversion to SR after AVNA combined with CSP is not uncommon, especially in patients with smaller left atria. Further studies are warranted to clarify which patients should be considered for initial dual-chamber device implantation to provide atrio-ventricular synchrony in case of SR restoration.

‘Should we laugh?’ Acoustic features of (in)voluntary laughters in spontaneous conversations

Laughter is one of the most common non-verbal features; however, contrary to the previous assumptions, it may also act as signals of bonding, affection, emotional regulation agreement or empathy (Scott et al. Trends Cogn Sci 18:618–620, 2014). Although previous research agrees that laughter does not form a uniform group in many respects, different types of laughter have been defined differently by individual research. Due to the various definitions of laughter, as well as their different methodologies, the results of the previous examinations were often contradictory. The analysed laughs were often recorded in controlled, artificial situations; however, less is known about laughs from social conversations. Thus, the aim of the present study is to examine the acoustic realisation, as well as the automatic classification of laughter that appear in human interactions according to whether listeners consider them to be voluntary or involuntary. The study consists of three parts using a multi-method approach. Firstly, in the perception task, participants had to decide whether the given laughter seemed to be rather involuntary or voluntary. In the second part of the experiment, those sound samples of laughter were analysed that were considered to be voluntary or involuntary by at least 66.6% of listeners. In the third part, all the sound samples were grouped into the two categories by an automatic classifier. The results showed that listeners were able to distinguish laughter extracted from spontaneous conversation into two different types, as well as the distinction was possible on the basis of the automatic classification. In addition, there were significant differences in acoustic parameters between the two groups of laughter. The results of the research showed that, although the distinction between voluntary and involuntary laughter categories appears based on the analysis of everyday, spontaneous conversations in terms of the perception and acoustic features, there is often an overlap in the acoustic features of voluntary and involuntary laughter. The results will enrich our previous knowledge of laughter and help to describe and explore the diversity of non-verbal vocalisations.

High-output moisture-enabled electricity generator for fully self-powered wearable physical and biochemical monitoring

Spontaneous conversion of environmental moisture energy to high-output electricity can help meet the massive electricity demand of wearable electronics. However, low power density and inefficient energy harvesting are the main challenges to power electronics currently. Herein, we developed a flexible moisture-enabled electricity generation (MEG) membrane with high output power. The asymmetrical structure of the moisture-enabled flexible units is composed of a bilayer of polyanion and polycation. The single device produced a sustained voltage of 0.8 V and can be customized by an aligned stacking strategy for scale integration on demand. Enhanced by increasing the diffusion speed of carriers with the metal-air reaction, the output power reached 286.5 μW/cm2, which is enough for long-term wearable health monitoring. Meanwhile, to solve the power supply challenge of the wearables, a fully self-powered system with an energy harvester, a power management module, and a wireless and wearable sensing module was developed. Biochemical indicators and body motion were detected and monitored by the sensor array, demonstrating the promising application in wearable health management, including harvesting energy from giant moisture and powering wearable electronics.

Spontaneous Cultural Conversion Rate of Mycobacterium avium Complex Pulmonary Disease Based on BACES Severity.

Only a few clinical factors can aid in predicting spontaneous culture conversion (SCC) in patients with Mycobacterium avium complex-pulmonary disease (MAC-PD). In this study, we aimed to evaluate whether the rate of SCC varies according to the severity of the disease in MAC-PD patients. We retrospectively classified 373 MAC-PD patients who had undergone watchful waiting without antibiotics based on the severity assessment using the 'body mass index (BMI), age, cavity, erythrocyte sedimentation rate (ESR), and sex (BACES)' criteria. We evaluated the rate of SCC in MAC-PD patients based on BACES severity and analyzed the relevant factors. Results: Of 373 patients, 153 (41%) achieved SCC without antibiotics during a median follow-up of 48.1 months. There was a trend toward a higher SCC rate in patients with lower BACES severity: 48% (87/183), 37% (58/157), and 24% (8/33) in the mild, moderate, and severe BACES groups, respectively. In addition, a favorable outcome, defined as maintaining SCC or having two consecutive negative sputum cultures until the last follow-up date, was also more common in patients with lower BACES severities of 53% (97/183), 34% (54/157), and 18% (6/33) in the mild, moderate, and severe BACES groups, respectively. In multivariate analysis, moderate BACES (hazard ratio [HR] = 0.63; 95% confidence interval [CI] 0.44-0.91; p = 0.013) and severe BACES (HR 0.37; 95% CI 0.16-0.90; p = 0.028) had a significantly negative impact on favorable outcomes compared to mild BACES. Lower BACES severity may be associated with SCC in MAC-PD patients.

Pilot Results for ECoLoGiC-Tx: A New Conversation-Level Intervention Improving Language in People With Moderate to Severe Aphasia.

This study reports pilot data for a novel intervention, ECoLoGiC-Tx, delivered to four people with moderate to severe aphasia. ECoLoGiC-Tx addresses language and communication in unstructured, participant-led conversation. The speech-language pathologist (SLP) uses a framework to choose turns that facilitate a social interaction. When communication breakdown occurs, the SLP implements a least-to-most hierarchy to maximize the people with aphasia's (PWA's) independence in self-repair. ECoLoGiC-Tx draws its theoretical underpinnings from conversation analysis and theories of rehabilitation, including principles of complexity, neuroplasticity, and learning. Four PWA attended 60-min sessions twice weekly for 10 weeks. Assessment occurred at pretreatment, posttreatment, and 6-week maintenance. Outcomes included established discourse measures for conversation and monologue, tests of language and functional communication, and patient-/family-reported outcome measures (P/FROMs). Discourse samples were collected three times per assessment. Interrater reliability and fidelity for assessment and treatment procedures are reported. Participants presented with Broca's aphasia (one moderate, one severe) or conduction aphasia (one moderate, one severe). Each demonstrated improvements in discourse, test batteries, and P/FROMs. They all demonstrated reduced aphasia severity measured by the Western Aphasia Battery-Revised at posttreatment or maintenance. Change in conversation and monologue was robust for three participants, but was mixed for one person (P1: moderate Broca's aphasia). P/FROMs indicated improvement at posttreatment and maintenance for all participants. Most treatment gains were maintained at 6-week follow-up. This study provides promising results for ECoLoGiC-Tx to improve language function of people with chronic moderate to severe aphasia. Generalization occurred to tests, functional communication, spontaneous conversation, and structured monologue tasks.

Comparison of clinical outcomes of Ibutilide-guided cardioversion and direct current synchronized cardioversion after radiofrequency ablation of persistent atrial fibrillation.

Ibutilide has already been used for cardioversion of persistent atrial fibrillation (PsAF) after radiofrequency catheter ablation (RFCA). The purpose of this study was to determine the effect of Ibutilide-guided cardioversion on clinical outcomes after individualized ablation of PsAF. From October 2020 to September 2021, consecutive patients with PsAF accepted for RFCA were prospectively enrolled. After individualized ablation including pulmonary vein isolation plus left atrial roof line ablation and personalized linear ablation based on left atrial low-voltage zones, patients were divided into the spontaneous conversion (SCV) group, direct current synchronized cardioversion (DCC) group and Ibutilide group according to different cardioversion types during ablation. The rates of freedom from atrial tachyarrhythmia (ATT) among the three groups were evaluated after follow-up. In this study, 110 patients were enrolled, including 12 patients with SCV, 50 patients receiving DCC and 48 patients receiving Ibutilide cardioversion after individualized ablation. Among the three groups, the SCV group had shorter AF duration {12 months [interquartile range (IQR) 12-16], P = 0.042} and smaller left atrial diameter (LAD) [35 mm (IQR: 33-42), P = 0.023]. A 12-month freedom from ATT rate was 83.3% in SCV group, 69.4% in DCC group, and 79.2% in Ibutilide group, respectively (Log-rank, P = 0.745). During the follow-up [17 months (IQR: 15-19)], the rate of freedom from ATT of SCV group (83.3%), and Ibutilide group (72.9%) were both higher than that of DCC group (53.1%, P = 0.042). Moreover, Kaplan-Meier analysis showed a significantly higher sinus rhythm (SR) maintenance in Ibutilide group than in DCC group (Log-rank, P = 0.041). After adjusting for risk factors of AF recurrence, the hazard ratio for AF recurrence of the DCC group with reference to the Ibutilide group was 4.10 [95% confidence interval (CI) (1.87-8.98), P < 0.001]. Furthermore, subgroup analysis showed that freedom from ATT rate in effective Ibutilide subgroup was significantly higher than noneffective Ibutilide subgroup (Log-rank, P < 0.001). For the treatment of the patients with PsAF, Ibutilide-guided cardioversion after individualized RFCA may be benefit for maintenance of SR compared to conventional DCC, especially for the patients who are effective for administration of Ibutilide.

The Acquisition of Strategies to Express Plurality in Hearing Second Language Learners of Sign Language of the Netherlands

AbstractThis study reports on strategies to indicate plural referents in hearing learners of Sign Language of the Netherlands. This is the first explorative study that focuses on L2 expressions of plurality in a sign language. Using data from two datasets, I examined when learners start to express plural and which strategies they apply, and I noted typical learner characteristics. The first study examined spontaneous conversations of three learners, during the first 18 months of their learning. The second study analyzed elicited data from 11 learners during their first year of learning. The data reveal that learners are able to express plural referents in early stages, using strategies that are familiar to them (quantifiers) as well as strategies that do not occur in their mother tongue (reduplication of the noun, use of spatial devices). The early emergence might be explained by the salient nature of the devices and the resemblance with gestural portrayals.

FRI569 A Therapeutic Dilemma: Spontaneous Oscillating Graves' Disease And Hypothyroidism

Abstract Disclosure: D. Suravajjala: None. J. Case: None. S. Kolli: None. V. Eranki: None. Spontaneous recurrent conversions between hyperthyroidism and hypothyroidism in Graves’ disease (GD) is very rare. We present a case of GD with spontaneous oscillation since diagnosis. From our review, less than 10 cases have been reported in the literature with alternating hyper and hypothyroidism. The patient is a 68-year-old female diagnosed with GD 4 years back with TSH &amp;lt;0.01 (0.4 - 4.5 uIU/mL) and TSI 25.70 (0.00-0.5 IU/L). She denied viral illness, radiation exposure, Lithium or Amiodarone use. Ultrasound thyroid was consistent with GD. Thyroid uptake scan was also consistent with GD. Eventually, Methimazole (MMI) 10 mg daily was initiated. About five months after MMI treatment, she was found to be hypothyroid with TSH 9.030 (0.4-4.5 uIU/mL) and FT4 0.99 (0.9-2.2 ng/dl) which led to discontinuation of MMI. 2 months later, she was clinically hyperthyroid with TSH 0.026, FT4 2.93 (0.9-2.2 ng/dl), TSI 9.59 (0-0.55 IU/L). MMI 5 mg daily was resumed, and as she preferred medical management, other treatment options for GD were not considered. Six months after low dose MMI, patient again reverted to hypothyroidism with TSH 21.420, FT4 0.82. MMI 5 mg was changed to every other day. After 8 months, she was found to be clinically and biochemically hypothyroid with TSH 147, FT4 0.41 (0.9-2.2 ng/dl), TSI 7.98 (0-0.55 IU/L). With the suspicion that she had burnt out GD, she was started on Levothyroxine (LT4) 100 mcg daily. Two months after LT4 initiation, she became clinically hyperthyroid with TSH 0.010 (0.4-4.5 uIU/mL) and FT4 1.91 (0.9-2.2 ng/dl). When trial of LT4 dose reduction failed to alleviate patient hyperthyroid symptoms, it was discontinued and MMI was resumed at 2.5 mg qd. Within 3 months she reverted to hypothyroidism. HAMA interference was as well ruled out. Although the patient's thyroid function ranged spontaneously from hyperthyroidism to hypothyroidism, she was still reluctant for definitive treatment options for GD, including RAI ablation and total thyroidectomy. As GD patients may have definitive treatment early, spontaneous conversion between hyperthyroidism and hypothyroidism is usually not seen in GD and most episodes usually occur several years after discontinuation of antithyroid drugs. It is known that both TSH receptor stimulating antibodies (TSAb) and TSH receptor blocking antibodies (TBAb) can be produced at the same time. The presence of hyper or hypothyroidism may depend on the equilibrium between stimulating and blocking antibodies. Switching of TSH receptor antibodies between stimulation and blockage is uncommon. Diagnosis demands careful clinical and biochemical assessments. Alternatively, the case may be easily mistaken for excessive thyroid suppression or replacement. This condition is difficult to manage, and definitive treatment options could be considered with I-131 ablation, thyroidectomy, or pharmacological treatment (block and replace). Presentation: Friday, June 16, 2023

Reduced vowel space in video conferences via Zoom: Evidence from read speecha).

This exploratory study compared vowel space area (VSA) in face-to-face situations and video conference situations using the software Zoom. Twenty native German participants read word lists recorded before and after spontaneous conversation. The overall VSA in Zoom was reduced significantly by 11.9%, with a more reduced VSA before and less reduction after the spontaneous conversation. Of nine peripheral vowels in German, /aː iː yː/ showed a significantly reduced Euclidean distance to the centroid of the vowel space. The observed hypoarticulation is discussed in light of the experimental setup, situational differences, and less involvement in Zoom than in face-to-face situations.

Perceived Conversation Quality in Spontaneous Interactions

The quality of daily spontaneous conversations is of importance towards both our well-being as well as the development of interactive social agents. Prior research directly studying the quality of social conversations has operationalized it in narrow terms, associating greater quality to less small talk. Other works taking a broader perspective of interaction experience have indirectly studied quality through one of the several overlapping constructs such as rapport or engagement, in isolation. In this work we bridge this gap by proposing a holistic conceptualization of conversation quality, building upon the collaborative attributes of cooperative conversation floors. Taking a multilevel perspective of conversation, we develop and validate two instruments for perceived conversation quality (PCQ) at the individual and group levels. Specifically, we motivate capturing external raters' gestalt impressions of participant experiences from thin slices of behavior, and collect annotations of PCQ on the publicly available MatchNMingle dataset of in-the-wild mingling conversations. Finally, we present an analysis of behavioral features that are predictive of PCQ. We find that for the conversations in MatchNMingle, raters tend to associate smaller group sizes, equitable speaking turns with fewer interruptions, and time taken for synchronous bodily coordination with higher PCQ.

Multiple bacterial culture positivity reflects the severity and prognosis as bronchiectasis in Mycobacterium avium complex pulmonary disease

BackgroundBacterial coinfections are observed in 19–66% of patients with Mycobacterium avium complex pulmonary disease (MAC-PD) during the entire duration of the disease. The impact of bacterial coinfection at diagnosis on the clinical course of MAC-PD has not been reported. MethodsAmong 558 patients diagnosed with MAC-PD between January 2016 and December 2020, 218 patients who underwent sputum culture tests twice or more within one year before and after diagnosis were included. We compared the patient characteristics and disease courses between the patients who had the same bacterial species detected twice or more (bacterial culture positive group: BCP group) and those who never had bacteria cultured (bacterial culture negative group: BCN group). ResultsWe included 70 patients in the BCP group and 74 in the BCN group. The radiological findings showed that BCP at diagnosis correlated with a high modified Reiff score. During the median follow-up period of 42 months, the patients in the BCP group were more likely to accomplish spontaneous sputum conversion of MAC. The treatment initiation rate for MAC-PD in the BCP group was lower than that in the BCN group (41.4% vs. 67.6%, P = 0.003). In contrast, the time to the first bronchiectasis exacerbation in the BCP group was shorter than that in the BCN group, and the frequency of bronchiectasis exacerbations was higher in the BCP group. ConclusionsPatients with BCP at diagnosis are less likely to initiate treatment for MAC-PD and more likely to develop bronchiectasis exacerbation.

Predictors and timeline of spontaneous conversion to normal sinus rhythm: A single center retrospective cohort study of patients with symptomatic atrial fibrillation

IntroductionAnnual healthcare expenditures associated with atrial fibrillation (AF) in the United States (US) continue to grow as more symptomatic patients present to emergency departments (ED). Predictors of spontaneous conversion to normal sinus rhythm (ScNSR) remain poorly understood, as well as the timeline of ScNSR remains unclear. We sought to 1) to assess the association of key demographics, anthropometric, and clinical factors to ScNSR and 2) to evaluate the timeline of ScNSR, and 3) determine clinical predictors of ScNSR. MethodsThis single center, retrospective cohort study analyzed patients aged ≥18 years with symptomatic AF as diagnosed and evaluated through the ED of a rural tertiary care center in West Virginia from September 2015 to December 2018. ResultsOur cohort consisted of 375 AF patients (mean age 65 years, 54% male). A total of 177 patients attained ScNSR either in the ED or after hospital admission with a mean conversion time of 14.7 h (±12). Onset of symptoms <24 hrs has strong positive association to ScNSR 3.97 (95% CI: 2.24–7.05; p < 0.0001). Male gender 0.55 (95% CI: 0.35–0.85; p = 0.007) and hypertension 0.48 (95% CI: 0.31–0.76; p = 0.002), showed a strong negative association to ScNSR. Of the patients that converted spontaneously (177), the majority, 136 (76.8%) achieved ScNSR within 24 h of ED triage without use of electrical or chemical cardioversion. ConclusionMost patients with AF in the ED converted spontaneously to sinus rhythm within the first 24 h which underscores the importance of earlier watchful waiting over interventions to achieve normal sinus rhythm (NSR).