Diffusive benefits of cylinders in front of a Schroeder diffuser

A numerical investigation is performed into the diffusive effects of cylinders positioned in front of a Schroeder diffuser. A regular line of cylinders is shown to offer notable improvements to diffusion from a periodic Schroeder device, provided lateral cylinder spacing is incommensurable with the Schroeder period width. Further investigation considers angular dependence and low frequency results in greater detail, as well as the effects on narrowband and modulated Schroeder devices. An optimization procedure is subsequently performed to investigate the effects of an irregular cylinder arrangement, which provides further diffusive benefits. (C) 2010 Acoustical Society of America

Estrogen Receptor and Signal Transducer and Activator of Transcription 3 Expression in Equine Mammary Tumors.

Equine mammary tumors are uncommon, and relatively sparse histopathologic and molecular data exist. The present study describes the histopathologic features of 7 such tumors, which exhibited infiltrative growth, intermediate to high mitotic rates, and focally extensive necrosis. The tumors exhibited variably strong staining for vimentin and cytokeratin 14, as well as frequently weak cytoplasmic staining for pan-cytokeratin. E-cadherin expression was strong. Interestingly, a subgroup of the tumors exhibited strong nuclear staining for estrogen receptor α. Three of 7 tumors exhibited nuclear expression of the transcription factor STAT3, suggesting that STAT3 was transcriptionally active. Rare to absent nuclear STAT3 expression was observed in carcinomas exhibiting moderate to intense staining for cytokeratin 14. This investigation confirms previous investigators' assertions that equine mammary tumors have a malignant phenotype. A subset of the equine mammary tumors exhibited estrogen receptor α expression, suggesting that these tumors may potentially have similar molecular characteristics to their feline and canine counterparts.This is the author accepted manuscript. The final version is available from Sage via http://dx.doi.org/10.1177/030098581455940

Volumetric diffusers : pseudorandom cylinder arrays on a periodic lattice

Most conventional diffusers take the form of a surface based treatment, and as a result can only operate in hemispherical space. Placing a diffuser in the volume of a room might provide greater efficiency by allowing scattering into the whole space. A periodic cylinder array (or sonic crystal) produces periodicity lobes and uneven scattering. Introducing defects into an array, by removing or varying the size of some of the cylinders, can enhance their diffusing abilities. This paper applies number theoretic concepts to create cylinder arrays that have more even scattering. Predictions using a Boundary Element Method are compared to measurements to verify the model, and suitable metrics are adopted to evaluate performance. Arrangements with good aperiodic autocorrelation properties tend to produce the best results. At low frequency power is controlled by object size and at high frequency diffusion is dominated by lattice spacing and structural similarity. Consequently the operational bandwidth is rather small. By using sparse arrays and varying cylinder sizes, a wider bandwidth can be achieved

Can the workload–injury relationship be moderated by improved strength, speed and repeated-sprint qualities?

Objectives The aim of this study was to investigate potential moderators (i.e. lower body strength, repeated-sprint ability [RSA] and maximal velocity) of injury risk within a team-sport cohort. Design Observational Cohort Study. Methods Forty male amateur hurling players (age: 26.2 ± 4.4 yr, height: 184.2 ± 7.1 cm, mass: 82.6 ± 4.7 kg) were recruited. During a two-year period, workload (session RPE x duration), injury and physical qualities were assessed. Specific physical qualities assessed were a three-repetition maximum Trapbar deadlift, 6 × 35-m repeated-sprint (RSA) and 5-, 10- and 20-m sprint time. All derived workload and physical quality measures were modelled against injury data using regression analysis. Odds ratios (OR) were reported against a reference group. Results Moderate weekly loads between ≥ 1400 AU and ≤ 1900 AU were protective against injury during both the pre-season (OR: 0.44, 95%CI: 0.18–0.66) and in-season periods (OR: 0.59, 95% CI: 0.37–0.82) compared to a low load reference group (≤ 1200 AU). When strength was considered as a moderator of injury risk, stronger athletes were better able to tolerate the given workload at a reduced risk. Stronger athletes were also better able to tolerate larger week-to-week changes ( > 550 AU to 1000 AU) in workload than weaker athletes (OR = 2.54–4.52). Athletes who were slower over 5-m (OR: 3.11, 95% CI: 2.33–3.87), 10-m (OR: 3.45, 95% CI: 2.11–4.13) and 20-m (OR: 3.12, 95% CI: 2.11–4.13) were at increased risk of injury compared to faster athletes. When repeated-sprint total time (RSAt) was considered as a moderator of injury risk at a given workload (≥ 1750 AU), athletes with better RSAt were at reduced risk compared to those with poor RSAt (OR: 5.55, 95%: 3.98–7.94). Conclusions These findings demonstrate that well-developed lower-body strength, RSA and speed are associated with better tolerance to higher workloads and reduced risk of injury in team-sport athletes

Use of whole-genome sequencing to identify clusters of Shigella flexneri associated with sexual transmission in men who have sex with men in England: a validation study using linked behavioural data

Since the 1970s, shigellosis has been reported as a sexually transmissible infection, and in recent years, genomic data have revealed the breadth of Shigella spp. transmission among global networks of men who have sex with men (MSM). In 2015, Public Health England (PHE) introduced routine whole-genome sequencing (WGS) of Shigella spp. to identify transmission clusters. However, limited behavioural information for the cases hampers interpretation. We investigated whether WGS can distinguish between clusters representing sexual transmission in MSM and clusters representing community (non-sexual) transmission to inform infection control. WGS data for Shigella flexneri from August 2015 to July 2017 were aggregated into single linkage clusters based on SNP typing using a range of SNP distances (the standard for Shigella surveillance at PHE is 10 SNPs). Clusters were classified as 'adult male', 'household', 'travel-associated' or 'community' using routine demographic data submitted alongside laboratory cultures. From August 2015 to March 2017, PHE contacted those with shigellosis as part of routine public-health follow-up and collected exposure data on a structured questionnaire, which for the first time included questions about sexual identity and behaviour. The questionnaire data were used to determine whether clusters classified as 'adult male' represented likely sexual transmission between men, thereby validating the use of the SNP clustering tool for informing appropriate public-health responses. Overall, 1006 S. flexneri cases were reported, of which 563 clustered with at least one other case (10-SNP threshold). Linked questionnaire data were available for 106 clustered cases, of which 84.0 % belonged to an 'adult male' cluster. At the 10-SNP threshold, 95.1 % [95 % confidence interval (CI) 88.0-98.1%] of MSM belonged to an 'adult male' cluster, while 73.2 % (95 % CI 49.1-87.5%) of non-MSM belonged to a 'community' or 'travel-associated' cluster. At the 25-SNP threshold, all MSM (95 % CI 96.0-100%) belonged to an 'adult male' cluster and 77.8 % (95 % CI 59.2-89.4%) of non-MSM belonged to a 'community' or 'travel-associated' cluster. Within one phylogenetic clade of S. flexneri, 9 clusters were identified (7 'adult male'; 2 'community') using a 10-SNP threshold, while a single 'adult male' cluster was identified using a 25-SNP threshold. Genotypic markers of azithromycin resistance were detected in 84.5 % (294/348) of 'adult male' cases and 20.9 % (9/43) of cases in other clusters (10-SNP threshold), the latter of which contained gay-identifying men who reported recent same-sex sexual contact. Our study suggests that SNP clustering can be used to identify Shigella clusters representing likely sexual transmission in MSM to inform infection control. Defining clusters requires a flexible approach in terms of genetic relatedness to ensure a clear understanding of underlying transmission networks

Suicidal Behavior and Depression in Smoking Cessation Treatments

BACKGROUND: Two treatments for smoking cessation--varenicline and bupropion--carry Boxed Warnings from the U.S. Food and Drug Administration (FDA) about suicidal/self-injurious behavior and depression. However, some epidemiological studies report an increased risk in smoking or smoking cessation independent of treatment, and differences between drugs are unknown. METHODOLOGY: From the FDA's Adverse Event Reporting System (AERS) database from 1998 through September 2010 we selected domestic, serious case reports for varenicline (n = 9,575), bupropion for smoking cessation (n = 1,751), and nicotine replacement products (n = 1,917). A composite endpoint of suicidal/self-injurious behavior or depression was defined as a case with one or more Preferred Terms in Standardized MedDRA Query (SMQ) for those adverse effects. The main outcome measure was the ratio of reported suicide/self-injury or depression cases for each drug compared to all other serious events for that drug. RESULTS: Overall we identified 3,249 reported cases of suicidal/self-injurious behavior or depression, 2,925 (90%) for varenicline, 229 (7%) for bupropion, and 95 (3%) for nicotine replacement. Compared to nicotine replacement, the disproportionality results (OR (95% CI)) were varenicline 8.4 (6.8-10.4), and bupropion 2.9 (2.3-3.7). The disproportionality persisted after excluding reports indicating concomitant therapy with any of 58 drugs with suicidal behavior warnings or precautions in the prescribing information. An additional antibiotic comparison group showed that adverse event reports of suicidal/self-injurious behavior or depression were otherwise rare in a healthy population receiving short-term drug treatment. CONCLUSIONS: Varenicline shows a substantial, statistically significant increased risk of reported depression and suicidal/self-injurious behavior. Bupropion for smoking cessation had smaller increased risks. The findings for varenicline, combined with other problems with its safety profile, render it unsuitable for first-line use in smoking cessation

Antifungal prophylaxis in chemotherapy-associated neutropenia: a retrospective, observational study

<p>Abstract</p> <p>Background</p> <p>In August 2002, the antifungal prophylaxis algorithm for neutropenic hematology/oncology (NHO) patients at the Medical Center was changed from conventional amphotericin (AMB) to an azole (AZ) based regimen (fluconazole [FLU] in low-risk and voriconazole [VOR] in high-risk patients). The aim of our study was to compare outcomes associated with the two regimens, including breakthrough fungal infection, adverse drug events, and costs.</p> <p>Methods</p> <p>Adult, non-febrile, NHO patients who received prophylactic AMB from 8/01/01-7/30/02 or AZ from 8/01/02-7/30/03 were retrospectively evaluated.</p> <p>Results</p> <p>A total of 370 patients (AMB: n = 181; AZ: n = 216) associated with 580 hospitalizations (AMB: n = 259; AZ: n = 321) were included. The incidence of probable/definite breakthrough Aspergillus infections was similar among regimens (AMB: 1.9% vs AZ: 0.6%; p=0.19). A greater incidence of mild/moderate (24.7% vs. 5.3%; p < 0.0001) and severe renal dysfunction (13.5% vs. 4.4%; p < 0.0012) was observed with AMB. In contrast, patients treated with VOR were found to have an increased rate of severe hepatic toxicity (32.5%) compared with patients treated with either AMB (22.6%) or FLU (21.4%) (p = 0.05). While the AZ period was associated with a >$9,000 increase in mean total costs/hospitalization, the mean acquisition cost associated with AZ was only$947/hospitalization more than AMB.</p> <p>Conclusion</p> <p>While an AZ-based regimen is associated with increased cost, the reduced rate of nephrotoxicity and availability of oral dosage forms, suggests that azoles be used preferentially over AMB. However, an increased rate of severe hepatic toxicity may be associated with VOR.</p

Drivers of Holocene peatland carbon accumulation across a climate gradient in northeastern North America

Peatlands are an important component of the Holocene global carbon (C) cycle and the rate of C sequestration and storage is driven by the balance between net primary productivity and decay. A number of studies now suggest that climate is a key driver of peatland C accumulation at large spatial scales and over long timescales, with warmer conditions associated with higher rates of C accumulation. However, other factors are also likely to play a significant role in determining local carbon accumulation rates and these may modify past, present and future peatland carbon sequestration. Here, we test the importance of climate as a driver of C accumulation, compared with hydrological change, fire, nitrogen content and vegetation type, from records of C accumulation at three sites in northeastern North America, across the N-S climate gradient of raised bog distribution. Radiocarbon age models, bulk density values and %C measurements from each site are used to construct C accumulation histories commencing between 11,200 and 8000cal. years BP. The relationship between C accumulation and environmental variables (past water table depth, fire, peat forming vegetation and nitrogen content) is assessed with linear and multivariate regression analyses. Differences in long-term rates of carbon accumulation between sites support the contention that a warmer climate with longer growing seasons results in faster rates of long-term carbon accumulation. However, mid-late Holocene accumulation rates show divergent trends, decreasing in the north but rising in the south. We hypothesise that sites close to the moisture threshold for raised bog distribution increased their growth rate in response to a cooler climate with lower evapotranspiration in the late Holocene, but net primary productivity declined over the same period in northern areas causing a decrease in C accumulation. There was no clear relationship between C accumulation and hydrological change, vegetation, nitrogen content or fire, but early successional stages of peatland growth had faster rates of C accumulation even though temperatures were probably lower at the time. We conclude that climate is the most important driver of peatland accumulation rates over millennial timescales, but that successional vegetation change is a significant additional influence. Whilst the majority of northern peatlands are likely to increase C accumulation rates under future warmer climates, those at the southern limit of distribution may show reduced rates. However, early succession peatlands that develop under future warming at the northern limits of peatland distribution are likely to have high rates of C accumulation and will compensate for some of the losses elsewhere