The Past Has Ears (PHE): XR Explorations of Acoustic Spaces as Cultural Heritage

Hearing is one of our most pervasive senses. There is no equivalent to closing our eyes, or averting our gaze, for the ears. When we think about great architectural achievements in European history, such as ancient amphitheatres or Gothic cathedrals, their importance is strongly tied to their acoustic environment. The acoustics of a heritage site is an intangible consequence of the space's tangible construction and furnishings. Inspired by the project's namesake (Phe, for the constellation Phoenix), and the relatively recent res at Cathedrale de Notre Dame de Paris and Teatro La Fenice opera hall, the PHE project focuses on virtual reconstruction of heritage sites, bringing them back from the ashes. In addressing the intangible acoustic heritage of architectural sites, three main objectives have been identied for this research project: Documentation, Modelling, and Presentation. In parallel, three heritage sites are participating as case studies: Tindari Theatre (IT), Notre-Dame de Paris Cathedral (FR), and The Houses of Parliament (UK). The acoustics of a space is immersive, spatial, and due to the nature of auditory perception egocentric, in contrast to visual perception of an object, which can be observed from outside". Consequently, presentation methods for communicating acoustic heritage must represent the spatially immersive and listener-centric nature of acoustics. PHE will lead development of a museum grade hardware/software prototype for the presentation of immersive audio experiences adaptable to multiple platforms, from on-site immersive speaker installations, to mobile XR via smartphone applications

Clinical pharmacy services for tuberculosis management:a systematic review

Objective: This study aims to systematically review the content and potential effects of clinical pharmacy services in tuberculosis (TB) care management.Methods: Searches were performed in PubMed, Embase, Cochrane, Scopus, and Web of Science databases following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Study characteristics and outcomes were extracted, and clinical pharmacy service components were characterized using the Descriptive Elements of Pharmacist Intervention Characterization Tool.Results: Twenty articles were included for full-text assessment, of which 10 fulfilled inclusion criteria, comprising 1,168 patients (N = 39 to 258 per study). These articles included five prospective cohort studies, two case–control studies, two quasi-experimental studies, and one cross-sectional study. Intervention foci within clinical pharmacy services were medication adherence (50%), medication safety (40%), education to patients/caregivers regarding needs/beliefs (30%), optimizing medication/therapy effectiveness (30%), emphasizing HRQoL (10%), and drug selections (10%). The three most frequently applied interventions were drug information/patient counseling (80%), adverse drug reaction monitoring (50%), and drug use evaluation (20%). Based on the World Health Organization (WHO) outcome classification, treatment success ranged from 72% to 93%, with higher cure outcomes (53%–86%) than treatment completion (7%–19%). Other outcomes, including isoniazid metabolites, medication counts, sputum conversion, adherence/compliance, knowledge, and quality of life, were better in the intervention group than those in comparator groups, and/or they improved over time. Risk of bias analysis indicated that the included studies were not comparable to a randomized clinical trial.Conclusion: Clinical pharmacy services as single or composite interventions potentially improve TB outcomes, but its evidence is still inconsistent and limited due to the lack of randomized controlled studies using the WHO outcome classification.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=199028, identifier CRD42020199028.</p

Hooge's Constant of Carbon Nanotube Field Effect Transistors

The 1/f noise in individual semiconducting carbon nanotubes (s-CNT) in a field effect transistor configuration has been measured in ultra-high vacuum and following exposure to air. The amplitude of the normalized current spectral noise density is independent of source-drain current, indicating the noise is due to mobility rather than number fluctuations. Hooge's constant for s-CNT is found to be 9.3 plus minus 0.4x10^-3. The magnitude of the 1/f noise is substantially degreased by exposing the devices to air

Biomarker Discovery In Chronic Obstructive Pulmonary Disease (COPD) Using Epithelial Lining Fluid:A Proteomic Approach

RATIONALE Chronic Obstructive Pulmonary Disease (COPD) is the third most frequent disease worldwide with increasing mortality. Cigarette smoking is the principle risk factor and 15-20% of smokers develop COPD. Epithelial Lining Fluid (ELF) covers the internal part of the airways and can be collected during bronchoscopy. ELF appears to be well-suited for proteomic analysis, since it contains a higher concentration of proteins (150-300 μg /mL) than other lung fluids and can be obtained from different locations of the lungs. No comprehensive proteomic analysis of human ELF has been performed to date, which makes ELF a highly interesting fluid for biomarker discovery in COPD. AIM To discover proteins that change in abundance in ELF from COPD patients versus healthy controls using a quantitative proteomics approach. METHODS The ELF proteome from COPD patients and healthy controls was studied by 1D polyacrylamide gel electrophoresis in the presence of SDS followed by in-gel tryptic digestion to establish the methodology and assess the feasibility of such an approach. Approximately 40 gel slices were obtained from each lane of the gel (corresponding to one patient). Digested samples were analyzed by nanoChip-LC-MS/MS using an ion trap. We performed a quantitative pilot study of ELF from 4 COPD patients and 4 healthy controls (table 1) to test for statistically significant differences in protein levels. ELF samples were digested by trypsin, labeled with stable isotope-containing reagents (iTRAQ®, 8-plex) and processed by strong cation-exchange chromatography followed by nanoLC-MS/MS. In order to validate the results, a second quantitative analysis of an independent sample set (4 COPD vs 4 healthy) using the same methodological approach was done. RESULTS The 1D electrophoretic approach resulted in more than 300 identified proteins. Most of the identified proteins were present in both COPD and healthy samples, although some proteins were only identified either in healthy control or in COPD samples. The quantitative studies showed that a number of proteins was significantly different between ELF of COPD patients and controls, including 4 up-regulated proteins in common in both studies. CONCLUSIONS This is the first study in ELF of COPD patients and healthy controls in which such a large number of proteins has been identified. The obtained results show the feasibility of this proteomic approach and the possibility to discover proteins that are differentially expressed in ELF of COPD patients and controls. We are currently validating these proteins further by western blot and immunohistochemistry

Resonant decay of flat directions

We study preheating, i.e., non-perturbative resonant decay, of flat direction fields, concentrating on MSSM flat directions and the right handed sneutrino. The difference between inflaton preheating and flaton preheating, is that the potential is more constraint in the latter case. The effects of a complex driving field, quartic couplings in the potential, and the presence of a thermal bath are important and cannot be neglected. Preheating of MSSM flat directions is typically delayed due to out-of-phase oscillations of the real and imaginary components and may be preceded by perturbative decay or $Q$-ball formation. Particle production due to the violation of adiabaticity is expected to be inefficient due to back reaction effects. For a small initial sneutrino VEV, $\lesssim m_N/h$ with $m_N$ the mass of the right handed sneutrino and $h$ a yakawa coupling, there are tachyonic instabilities. The $D$-term quartic couplings do not generate an effective mass for the tachyonic modes, making it an efficient decay channel. It is unclear how thermal scattering affects the resonance.Comment: 20 pages, 4 figure

Cost-minimisation analysis of a treat-and-extend regimen with anti-VEGFs in patients with neovascular age-related macular degeneration

PURPOSE: Although intraocular anti-vascular endothelial growth factors (anti-VEGFs) are effective as treatment of neovascular age-related macular degeneration (nAMD), the (economic) burden on the healthcare system is considerable. A treat-and-extend (T&E) regimen is associated with a lower number of injections without compromising the effectiveness and can therefore help optimise nAMD treatment. This study investigates the per-patient costs associated with nAMD treatment, when using aflibercept, bevacizumab, or ranibizumab with a T&E regimen. METHODS: In this cost-minimisation model, the per-patient costs in the Netherlands were modelled using a healthcare payers’ perspective over a 3-year time horizon with the assumption that efficacy of treatments is similar. Additionally, the break-even price of the different anti-VEGFs was calculated relative to the cheapest option and injection frequency. RESULTS: The injection frequency varied from 14.2 for aflibercept to 27.4 for bevacizumab in 3 years. Nonetheless, bevacizumab remains the cheapest treatment option (€14,215), followed by aflibercept (€18,202) and ranibizumab (€31,048). The medication covers the majority of the per-patient costs for aflibercept and ranibizumab, while administration covers the majority of the per-patient costs for bevacizumab. The break-even prices of aflibercept and ranibizumab are respectively €507 and €60.58 per injection. Brolucizumab was included in the scenario analysis and was more expensive than aflibercept (€20,446). Brolucizumab should reduce to 13.8 injections over 3 years to be as costly as aflibercept. CONCLUSION: Bevacizumab is the cheapest anti-VEGF treatment. The list prices of all anti-VEGFs should reduce to be as costly as bevacizumab. Aflibercept is the second-choice treatment and so far brolucizumab is not

Lower leukotriene C4 levels in bronchoalveolar lavage fluid of asthmatic subjects after 2.5 years of inhaled corticosteroid therapy

Long-term treatment with inhaled corticosteroids has been shown to result in improvement of symptoms and lung function in subjects with asthma. Arachidonic acid (AA) metabolites are thought to play a role in the pathophysiology of asthma. It was assessed whether differences could be found in bronchoalveolar lavage (BAL) AA metabolite levels between subjects with asthma who were treated for 2.5 years with inhaled bronchodilators alone or in combination with inhaled corticosteroids. Prostaglandin (PG)D2, PGF2α, 6-keto-PGF1α, thromboxane B2, leukotriene (LT)C4 and LTB4 levels and cell numbers were assessed in BAL fluid from 22 non-smoking asthmatic subjects. They were participating in a randomized, double-blind multicentre drug trial over a period of 2.5 years. Results of the group treated with inhaled corticosteroids (CS+: beclomethasone 200 μg four times daily) were compared with the other group (CS−) which was treated with either ipratropium bromide (40 μg four times daily) or placebo. BAL LTC4 levels of asthmatic subjects were significantly lower after 2.5 years inhaled corticosteroid therapy (CS+, 9(1–17) pg/ml vs. CS−, 16(6-53) pg/ml; p = 0.01). The same trend was observed for the PGD2 levels. The results suggest that inhaled corticosteroids may exert their beneficial effect on lung function via a mechanism in which inhibition of LTC4 synthesis in the airways is involved

Exploring patient satisfaction after operative and nonoperative treatment for midshaft clavicle fractures:a focus group analysis

Background: There is no consensus on the optimal treatment for displaced midshaft clavicle fractures. Several studies indicate superior patient satisfaction in favour of operative reconstruction. It is unknown what drives superior satisfaction in this treatment group. The aim of this study was to explore patient satisfaction and identify contributors to patient satisfaction after operative and nonoperative treatment for displaced midshaft clavicle fractures in adults using a focus group approach. Methods: Four face-to-face and two web-based focus groups were hosted. A total of 24 participants who were treated nonoperatively (n = 14) or operatively (n = 10) agreed to participate. Participants were selected using purposive sampling, ensuring variation in gender, age, treatment complications and outcomes. A question script was developed to systematically explore patient expectations, attitudes and satisfaction with different dimensions of care. All focus groups were voice-recorded and transcribed at verbatim. Thematic analysis was conducted on all face-to-face and web-based transcripts. Results: The main emerging themes across treatment groups were; need for more information, functional recovery, speed of recovery and patient-doctor interaction. There was no difference in themes observed between operative and nonoperative focus groups. The lack of information was the most important complaint in dissatisfied patients. Conclusion: Our study shows that informing patients about their injury, treatment options and expectations for recovery is paramount for overall patient satisfaction after treatment for a displaced midshaft clavicle fracture. Level of evidence: Level III, focus group study. </p