bluuebunny/crossref_metadata_2025 huggingface dataset:
Acceptable noise level in bilinguals: Consideration of signal and masker effects
Authors: Azcona Gabrielly , Buten Lupe , Shi Lu-Feng
Published: May 2014

This study explores how bilingual listeners’ acceptable noise level (ANL) may be affected by the language of the signal, language of the masker, and talkers in the masker. ANL measures how much a listener tolerates background noise while listening to running speech. It differs from conventional speech recognition tasks in that it does not concern one’s ability to comprehend speech. Hence, ANLs are expected to be relatively free of bilingual background. In this study, the signal (running passages from New York State Department of Motor Vehicles driving manual) was presented in two languages (English versus Spanish). The maskers (Auditec babbles) were manipulated in language (English versus Spanish) and number of talkers (four versus twelve). Additionally, three groups of 12 listeners participated in the study—monolingual English, Spanish-English bilingual, and Russian-English bilingual. A 3×2×2×2 mixed, repeated design was carried out with listener group as the between-subjects factor, and signal and masker language and number factors as the within-subjects factors. Preliminary findings reveal a non-significant effect for all four factors; however, a marginally significant four-way interaction (p = 0.048) invites group wise analysis. Results may help establish new clinical approaches in assessing listeners’ speech perception difficulty in noise, regardless of language background.
Reliable discrimination thresholds in 17 trials
Authors: Stahl Michael , Epstein Michael , Florentine Mary
Published: May 2014

This study explores potential weaknesses of the Zippy Estimation by Sequential Testing (ZEST) psychophysical procedure as a means of acquiring rapid psychoacoustic measurements. Although ZEST is promising for this purpose, previous work used a priori knowledge to make optimal choices for initial assumptions, a best case scenario for ZEST’s performance. Before the ZEST procedure can be employed as a clinical tool, an understanding of how it performs in the absence of a priori information is needed. Specifically, an investigator must choose: (1) the model psychometric function, (2) the starting level, and (3) the number of trials. The present study explores sensitivity to these choices when ZEST is employed in 2AFC, frequency-discrimination tasks. Data for six normal listeners were obtained for a wide range of initial conditions and compared with simulations. These data indicate that even when an inappropriate psychometric function is used, reliable thresholds can be obtained with only 17 trials when the starting level is within a factor of four times the listener’s “true” threshold. These results suggest that ZEST combined with a 2AFC paradigm is a promising candidate for rapid and reliable assessment of listeners' discrimination thresholds. [Work supported by NIH/NIDCD 1R03DC009071.]
Contribution of detailed parts around talker's mouth for audio-visual speech perception
Authors: Sakamoto Shuichi , Hasegawa Gen , Abe Toru , Ohtani Tomoko , Suzuki Yôiti , Kawase Tetsuaki
Published: May 2014

In this study, the relationship between speech intelligibility and effects of the parts around talker's mouth was investigated based on the results of audio-visual speech intelligibility tests. As the stimuli, nonsense tri-syllables speech sounds were combined with three kinds of moving image of the talker's face: original face, circumference of the lips (mouth part extracted from the original face), and masked lips (face without the mouth). The extracted area around the mouth was varied as a parameter in the circumference-of-the-lips conditions. Generated stimuli were presented with speech spectrum noise to the participants. The results showed that intelligibility scores of several phonemes (/h/, /m/, /w/, /b/, /p/) were increased by adding the visual information. Moreover, there was no significant difference between the score of the original-face condition and that of the circumference-of-the-lips condition. Interestingly, significant difference was observed between the score of the audio-only condition and that of the masked-lips-condition. These results imply that not only a mouth but also areas around the mouth without mouth itself provide rich information for speech understanding. Effects of the mouth edges on speech intelligibility are being examined as a next step.
Auditory attention in a dynamic scene: Behavioral and electrophysiological correlates
Authors: Goldberg Hannah R. , Choi Inyong , Varghese Lenny A. , Bharadwaj Hari , Shinn-Cunningham Barbara G.
Published: May 2014

The ability to direct and redirect selective auditory attention varies substantially across individuals with normal hearing thresholds, even when sounds are clearly audible. We hypothesized that these differences can come from both differences in the spectrotemporal fidelity of subcortical sound representations and in the efficacy of cortical attentional networks that modulate neural representations of the auditory scene. Here, subjects were presented with an initial stream from straight ahead and a second stream (from either left or right), each comprised of four monotonized consonant-vowel syllables. Listeners were instructed to report the contents of either the first stream (holding attentional focus) or the second stream (switching attentional focus). Critically, the direction of the second stream informed subjects whether to hold or to switch attention. Pilot results suggest that when the lateral angle of the second stream is small, task performance is linked to subcortical encoding fidelity of suprathreshold sound (as measured using brainstem frequency-following responses obtained separately in the same subjects). Using a paradigm that allows simultaneous collection of behavioral measures, FFRs, and cortical responses, here we test whether differences in top-down attentional control explain subject variability when the second stream’s lateral angle is large and coding fidelity does not limit performance.
Parameter fitting of a lumped parameter middle ear model
Authors: Lemons Charlsie , Meaud Julien
Published: May 2014

Measurements of otoacoustic emissions in the ear canal are affected by the forward and reverse pressure transfer functions and the reverse middle ear impedance. Thus, a comprehensive middle ear model should reflect each of these measurements of middle ear function using a single set of parameters. A middle ear circuit model consisting of a lumped parameter representation of the ossicular chain coupled to a transmission line model of the eardrum was selected (O’Connor and Puria, JASA, 2008). In the original model, the parameters were fit solely to measurements of the magnitude and phase of the stapes velocity relative to the ear canal pressure in the forward direction. In this paper, the model parameters are optimized through a non-linear least square regression method so that the model’s forward pressure transfer function, reverse pressure transfer function, and reverse middle ear impedance agree with experimental data for the human middle ear from 0.1 to 10 kHz. This parameter fitting procedure is repeated using experimental data for the guinea pig and gerbil middle ear. Differences in model parameters between the three species are discussed.
Effects of spectral degradation on attentional modulation of auditory responses to continuous speech
Authors: Kong Ying-Yee , Mullangi Ala , Ding Nai
Published: May 2014

Auditory attention enhances phase-locked responses to the temporal envelope of the attended speech stream in a competing background. This study investigates how cortical responses are affected by spectral degradation and the extent to which low-frequency fine-structure cues facilitate sound segregation. Two competing speech streams were presented diotically to normal-hearing subjects. Each subject was tested with unprocessed speech, vocoder speech (8 to 64 channels), and six-channel high-frequency vocoder + lowpass filtered speech simulating electric-acoustic stimulation (EAS). Ongoing EEG responses were measured in each condition. Cross-correlation between speech envelope and EEG responses was calculated at different time lags. For unprocessed speech, the cross-correlation function showed opposite signs of correlations between the attended and unattended speech, supporting the neural mechanism of suppression of the competing speech stream. This suppression mechanism, however, was only evident for the 32- and 64-channel vocoder conditions, but not for the 8- and 16-channel conditions. This indicates that greater frequency resolution is required for sound segregation. For EAS, the pattern of cortical responses was similar to that of the eight-channel vocoder condition, although speech intelligibility was higher in EAS than vocoder speech. Consistent with previous psychoacoustic evidence, these neural results further argue against the segregation mechanism for EAS benefit.
Transient response of flat-panel distributed mode loudspeakers
Authors: Anderson David , Roessner Stephen , Bocko Mark F.
Published: May 2014

The acoustic impulse response of a loudspeaker must have short rise and decay times to provide accurate reproduction of signals with fast transients, such as human speech. In a flat panel distributed mode loudspeaker (DML), the transverse bending waves that are the primarily source of acoustic radiation, propagate across the panel at finite velocity. Therefore, regions of the panel more distant from the panel driving point(s) radiate sound at later times, which broadens the DML’s acoustic impulse response. Furthermore, bending wave propagation in a rigid panel is dispersive, with a wave velocity that is proportional to the square root of the frequency, which creates additional distortions of signals with fast transients. Mechanical simulations and scanning laser vibrometer measurements of glass panel DML’s clearly illustrate the delayed radiation and dispersion distortion mechanisms. Furthermore, measurements of the acoustic impulse response of DML’s are in agreement with simulations, which provides additional evidence that the identified mechanisms are a major source of audio distortion in DML’s.
Dynamic response of cross-linked random fiber networks
Authors: Babaee Sahab , Shahsavari Ali , Picu Catalin , Bertoldi Katia
Published: May 2014

Systems composed of fibers are ubiquitous in the living and artificial systems, including cartilage, tendon, ligaments, paper, protective clothing, and packaging materials. Given the importance of fiber systems, their static behavior has been extensively studied and it has been shown that network deformation is nonaffine for compliant, low-density networks and affine for stiff, high-density networks. However, little is known about the dynamic response of fibrous systems. In this work, we investigate numerically the propagation of small-amplitude elastic waves in these materials and characterize their dynamic response as a function of network parameters.
Patch nearfield acoustic holography based visualization of spatial distribution of sound quality objective parameters
Authors: Jin Jiangming , Yuan Fang , Lu Huancai
Published: May 2014

Psychoacoustic research reveal that sound pressure level reduction in cabin does not mean improvement of human’s subjective auditory perception. This paper presents Patch Nearfield Acoustics Holography-Sound Quality (Patch NAH-SQ) combined analysis method with the advantages of NAH and SQ. This methodology breaks the limit of measurement aperture of conventional NAH and can visualize of spatial distribution of sound pressure and sound quality objective parameters of entire sound field by using a small number of microphones. From the 3D images of spatial distribution of sound pressure and sound quality objective parameters, the sound sources which most contribute to human’s auditory perception can be located. In this paper, the impact of the choice of parameters such as overlap ratio of Patch holographic surface, SNR, stand-off distance and frequency on reconstruction error of sound pressure and sound quality objective parameters is examined. Finally, the experiment of Patch NAH-SQ methodology proposed is validated in anechoic camber, the results are presented and analyzed.
Infants’ perception of source size in vowel sounds
Authors: Masapollo Matthew , Polka Linda , Vouloumanos Athena , Ménard Lucie
Published: May 2014

Recent research shows that pre-babbling infants can recognize infant-produced vowels as phonetically similar to adult and child vowel productions (Polka et al., submitted), indicating that infants normalize for speaker size information. Yet little is known about whether infants encode information about speaker size in speech sounds and then use this information for source identification. Here, we investigate whether infants preferentially attend to smaller visual objects over larger visual objects when they hear infant speech sounds, and attend to larger visual objects over smaller visual objects when they hear adult speech sounds. We are currently testing 9-month-old infants using an intermodal matching procedure, in which they are presented with isolated vowel sounds synthesized to emulate productions by either adult female or infant speakers, along with side-by-side geometric shapes that differ in size (e.g., a large square and a small square). Preliminary analysis suggests that infants display greater mean proportion-looking times to the congruent shape-voice pairs, but additional data collection is ongoing. The implications of these findings for theories of infant speech perception will be discussed.
Native listeners’ sensitivity to foreign accent in short, slightly accented utterances: Non-native vowels
Authors: Park Hanyong
Published: May 2014

This study investigated whether native listeners can detect a foreign accent in short, slightly accented utterances. To answer this question, we examined 20 native listeners’ sensitivity (d’ values) to a foreign accent in a one-interval discrimination task (i.e., Yes-no design). Six L1 Korean learners of L2 English with high L2 proficiency along with six natives speakers of English produced the test materials consisting of three English vowels /ɑ/, /eI/, and /æ/ by using the delayed repetition technique. The listeners were asked to judge whether the speaker was a native or a non-native speaker of English for each speech sample played. Results indicated that most listeners detected a foreign accent from hearing the vowel stimuli. Furthermore, the listeners detected a foreign accent more often from the /æ/ stimuli than the /ɑ/ or the /eI/ stimuli. In line with previous L2 research, these results demonstrate that certain L2 segments are more difficult to learn than others. These results also suggest that listeners are sensitive to foreign accent and that they do not need much information (e.g., monosyllabic words) to detect a foreign accent, even in proficient L2 learners’ productions.
Perception of second language phoneme masked by first- or second-language speech in 20–60 years old listeners
Authors: Kubo Rieko , Akagi Masato , Akahane-Yamada Reiko
Published: May 2014

In previous research, we conducted a perceptual training on American English /r/-/l/ for Japanese adults in various age groups and found that; although the training improved identification of these phonemes in all age groups, the improvement decreased along the ages. Analyses suggested that perceptual cues of second-language (L2) phoneme perception differ across age groups. This paper investigated the decrease by focusing on perceptual cues. Listening tests were performed to assess intelligibility of Japanese words and English minimal-pairs masked by English or Japanese speech. Theoretically, in case L2 targets have phonologically non-equivalent in listener’s first-language (L1) orthography, L1-relevant cues can be used separating the targets. In case L2 targets have phonologically equivalent in listener’s L1 orthography, L2-relevant acoustic cues should be taken into perceptual cues. Masker having identical language to the perceptual cues may interfere identifying the targets. In the results of English targets which were supposed to be phonologically equivalent in Japanese orthography, young-adult Japanese showed higher effect from English masker than that of Japanese masker; conversely, older-adult Japanese showed higher effect from Japanese masker. The results suggested that young adults more focused on L2-relevant acoustic cues than elderly did. This difference may lead to the decrease in training effect.
Effect of aging on auditory processing: Relationship between speech perception and auditory brainstem responses
Authors: Jin Su-Hyun , So Won
Published: May 2014

The purpose of the study is to evaluate the auditory processing abilities of older (60–75 years old) and younger (18–30 years old) listeners with normal hearing up to 4000 Hz. We are going to measure series of behavioral and physiological responses of these two listener groups. Behavioral measures include listener’s hearing sensitivity, speech recognition in various listening conditions using different types of noise, and temporal resolution processing complex time-varying signals. For a physiological measure, speech-evoked ABRs, neural responses of subcortical auditory nuclei will be recorded. This quick and non-invasive technique allows us to measure neural responses to fast time-varying speech stimuli. We already synthesized speech stimuli, short syllable like /da/, /ba/, /ta/, /pa/ that can be used to evoke the ABR. It is hypothesized that compared to younger group, older listeners might show a loss of temporal precision results in abnormal ABRs such as subcortical timing delays and decreases in response consistency and magnitude. In addition, listeners with abnormal ABRs might show poorer performance in speech recognition in noise as well as reduced temporal resolution processing. That is, there would be significant correlation between behavioral and physiological measures.
Acoustic cue weighting in perception and production of English and Spanish
Authors: Schertz Jessamyn L. , Warner Natasha , Lotto Andrew J.
Published: May 2014

We present data quantifying the use of multiple acoustic dimensions in the perception and production of word-initial stops in Spanish and English in bilinguals and monolinguals, with a focus on the stability of individuals’ cue weighting strategies across languages and modalities. Early Spanish-English bilinguals who use both languages on a regular basis, along with control groups of monolingual Spanish and English speakers, categorized stop-initial CV syllables covarying in Voice Onset Time (VOT), fundamental frequency at vowel onset (f0), first formant onset frequency (F1), and stop closure duration. Individual perceptual cue weights were calculated via logistic regression, and these weights were compared with the same speakers’ use of the corresponding acoustic dimensions in their productions of the stop contrast. Preliminary results suggest that bilingual listeners’ perceptual cue weighting strategies correspond across Spanish and English; that is, individuals who weight a given cue more heavily than average in English also weight that cue heavily in Spanish. However, in line with previous work, correspondences between a given individual's use of the acoustic dimensions across perception and production are more elusive.
The Psychological Contract of Volunteer Youth Sport Coaches
Authors: Harman Alanna , Doherty Alison
Published: May 2014

This study examined the psychological contract of volunteer youth sport coaches to determine the content, variation, and influences to its development. Interviews were conducted with 22 volunteer coaches of team sports, representing different levels of play (recreational, competitive), coaching tenure (novice, experienced), and gender (female, male), who were sampled to account for the potential variation based on these demographic factors. The findings revealed that volunteer coaches possessed both transactional and relational expectations of themselves and their club. Coaches’ most frequently cited expectations of themselves were technical expertise (transactional), and leadership (relational), while their most frequently cited expectations of the club were fundamental resources and club administration (transactional), and coach support (relational). Variation was found by different levels of play (recreational, competitive) and coaching tenure (novice, experienced). The coaches’ psychological contract was shaped predominately by sources external to the club. Implications for managing the psychological contract of volunteer youth sport coaches and directions for future research are discussed.
Effects of Ankle Joint Position and Submaximal Muscle Contraction Intensity on Soleus H-reflex Modulation in Young and Older Adults
Authors: Chen Yung-Sheng , Zhou Shi , Cartwright Colleen
Published: May 2014

This study investigated the effects of ankle joint position and submaximal contraction intensity on soleus (SOL) H-reflex modulation. Twenty young (25.1 ± 4.8 years) and 20 older adults (74.2 ± 5.1 years) performed plantar flexions during 10%, 30% and 50% maximal voluntary contractions (MVC) and at ankle positions of neutral (0°), plantar flexion (20°) and dorsiflexion (–20°) in a sitting position. The SOL H-reflex gain in older adults was relatively lower than that in young adults during 10%, 30% and 50% MVC. The SOL H-reflex gain was significantly affected by the intensity of plantar flexion in the respective ankle joint position in both age groups. The latency of H-reflex was prolonged in older adults and was ankle joint dependent in young adults. Young adults demonstrated a shorter duration of the H-reflex response than that of older adults. The results indicated that there were age-related changes in the SOL H-reflex during the ankle plantar flexors activities.
Inter- and Intrafoot Coordination When Standing on Balance Boards
Authors: Wang Zheng , Molenaar Peter C. M. , Newell Karl M.
Published: May 2014

The experiment was set up to investigate the inter- and intrafoot coordination dynamics of postural control on balance boards. A frequency domain principal component analysis (PCA) was applied on 4 center of pressure (COP) time series collected from two force platforms to reveal their contributions to postural stability. The orientation of support played a more significant role than its width in channeling the foot coordination dynamics. When the support was oriented along the AP-challenging direction, the 4 COPs revealed a parallel contribution to the 1st principal component (PC1) indicating an interdependence of the foot coordination in both directions. When the support was positioned along the ML-challenging direction, the COPs in the AP direction showed larger weightings to PC1 implying an interfoot coordination. These findings provide evidence that COP coordination operates in adaptive ways to sustain postural stability in light of changing support constraints to standing.
The Long-Awaited Marriage of Cancer Genomics and Immunotherapy Bears Fruit
Authors: Maus Marcela V.
Published: May 2014

A cholangiocarcinoma patient responded to adoptive T cell therapy specific to a mutation identified by whole-exome sequencing.
Losing Brain
Authors: Nishijima Daniel K.
Published: May 2014

A study of college football players shows that more years of active play are associated with smaller volumes of the hippocampus, a brain region underlying cognition and learning.
Bioluminescence Resonance Energy Transfer System for Measuring Dynamic Protein-Protein Interactions in Bacteria
Authors: Cui Boyu , Wang Yao , Song Yunhong , Wang Tietao , Li Changfu , Wei Yahong , Luo Zhao-Qing , Shen Xihui
Published: May 2014

Protein-protein interactions are important for virtually every biological process, and a number of elegant approaches have been designed to detect and evaluate such interactions. However, few of these methods allow the detection of dynamic and real-time protein-protein interactions in bacteria. Here we describe a bioluminescence resonance energy transfer (BRET) system based on the bacterial luciferase LuxAB. We found that enhanced yellow fluorescent protein (eYFP) accepts the emission from LuxAB and emits yellow fluorescence. Importantly, BRET occurred when LuxAB and eYFP were fused, respectively, to the interacting protein pair FlgM and FliA. Furthermore, we observed sirolimus (i.e., rapamycin)-inducible interactions between FRB and FKBP12 and a dose-dependent abolishment of such interactions by FK506, the ligand of FKBP12. Using this system, we showed that osmotic stress or low pH efficiently induced multimerization of the regulatory protein OmpR and that the multimerization induced by low pH can be reversed by a neutralizing agent, further indicating the usefulness of this system in the measurement of dynamic interactions. This method can be adapted to analyze dynamic protein-protein interactions and the importance of such interactions in bacterial processes such as development and pathogenicity.

IMPORTANCE
Real-time measurement of protein-protein interactions in prokaryotes is highly desirable for determining the roles of protein complex in the development or virulence of bacteria, but methods that allow such measurement are not available. Here we describe the development of a bioluminescence resonance energy transfer (BRET) technology that meets this need. The use of endogenous excitation light in this strategy circumvents the requirement for the sophisticated instrument demanded by standard fluorescence resonance energy transfer (FRET). Furthermore, because the LuxAB substrate decanal is membrane permeable, the assay can be performed without lysing the bacterial cells, thus allowing the detection of protein-protein interactions in live bacterial cells. This BRET system added another useful tool to address important questions in microbiological studies.
Pathogenic Influenza Viruses and Coronaviruses Utilize Similar and Contrasting Approaches To Control Interferon-Stimulated Gene Responses
Authors: Menachery Vineet D. , Eisfeld Amie J. , Schäfer Alexandra , Josset Laurence , Sims Amy C. , Proll Sean , Fan Shufang , Li Chengjun , Neumann Gabriele , Tilton Susan C. , Chang Jean , Gralinski Lisa E. , Long Casey , Green Richard , Williams Christopher M. , Weiss Jeffrey , Matzke Melissa M. , Webb-Robertson Bobbie-Jo , Schepmoes Athena A. , Shukla Anil K. , Metz Thomas O. , Smith Richard D. , Waters Katrina M. , Katze Michael G. , Kawaoka Yoshihiro , Baric Ralph S.
Published: May 2014

The broad range and diversity of interferon-stimulated genes (ISGs) function to induce an antiviral state within the host, impeding viral pathogenesis. While successful respiratory viruses overcome individual ISG effectors, analysis of the global ISG response and subsequent viral antagonism has yet to be examined. Employing models of the human airway, transcriptomics and proteomics datasets were used to compare ISG response patterns following highly pathogenic H5N1 avian influenza (HPAI) A virus, 2009 pandemic H1N1, severe acute respiratory syndrome coronavirus (SARS-CoV), and Middle East respiratory syndrome CoV (MERS-CoV) infection. The results illustrated distinct approaches utilized by each virus to antagonize the global ISG response. In addition, the data revealed that highly virulent HPAI virus and MERS-CoV induce repressive histone modifications, which downregulate expression of ISG subsets. Notably, influenza A virus NS1 appears to play a central role in this histone-mediated downregulation in highly pathogenic influenza strains. Together, the work demonstrates the existence of unique and common viral strategies for controlling the global ISG response and provides a novel avenue for viral antagonism via altered histone modifications.

IMPORTANCE
This work combines systems biology and experimental validation to identify and confirm strategies used by viruses to control the immune response. Using a novel screening approach, specific comparison between highly pathogenic influenza viruses and coronaviruses revealed similarities and differences in strategies to control the interferon and innate immune response. These findings were subsequently confirmed and explored, revealing both a common pathway of antagonism via type I interferon (IFN) delay as well as a novel avenue for control by altered histone modification. Together, the data highlight how comparative systems biology analysis can be combined with experimental validation to derive novel insights into viral pathogenesis.
Splenic artery pseudoaneurysm due to acute pancreatitis in a 6-year-old boy with acute lymphoblastic leukaemia treated with l-aspariginase
Authors: Larsen Cæcilie Crawley , Laursen Christian B , Dalby Kasper , Graumann Ole
Published: May 2014

Acute pancreatitis is a rare phenomenon in children but its incidence seems to be increasing. In children, it is generally caused due to systemic illness, biliary disease, trauma, idiopathy and side effects of medicines likel-aspariginase. Acute pancreatitis is difficult to diagnose in children since the clinical presentation is highly variable. Complications such as pseudocysts have been reported at rates as high as 25%. Severe cases of pseudocysts may be further complicated by a possible lethal splenic artery pseudoaneurysm. In this case report, we present a rare case of splenic artery pseudoaneurysm due to acute pancreatitis in a 6-year-old boy with acute lymphoblastic leukaemia treated withl-aspariginase. He presented with fever, irritability and pain in his left groin region.
Pregnancy presenting as hyperthyroidism with negative urine pregnancy test
Authors: Jindal Rita , Deepak Desh , Ghosh Gopal Chandra , Gupta Mamta
Published: May 2014

A 22-year-old lactating mother presented with symptoms of uneasiness, palpitation, tachycardia and exophthalmos. She had an abdominal lump suggestive of 26 weeks uterine size but her urine pregnancy test was negative. Her thyroid profile was suggestive of hyperthyroidism. Gynaecological and ultrasonographic findings revealed a hydatidiform mole. She had a low β-human chorionic gonadotropin level that surprisingly increased after suction and evacuation. The paradoxical findings that appeared as erroneous laboratory results could be explained by the ‘high-dose hook effect’ after a review of literature. One week after the evacuation, the patient's thyroid profile and symptoms resolved completely without any treatment for hyperthyroidism.
Mistaken identity: endometrial or rectal cancer?
Authors: Wou Constance , Chaston Nicola , Doughan Samer
Published: May 2014

A 59-year-old woman with a previous history of endometrial and breast cancer was referred to the colorectal rapid access clinic with abdominal cramps, per rectal bleeding and diarrhoea. CT, MRI and flexible sigmoidoscopy confirmed a rectal tumour and due to its appearance, it was thought to be a primary rectal malignancy. The patient underwent an anterior resection and end colostomy. Histology confirmed a metastatic endometrial adenocarcinoma, which is an unusual site for endometrial metastasis. Her postoperative recovery has been unremarkable and the patient has subsequently been discharged from the general surgical team.
Two cases of acute myelitis with idiopathic hypereosinophilic syndrome
Authors: Tohge Rie , Warabi Yoko , Takahashi Makio , Nagao Masahiro
Published: May 2014

Idiopathic hypereosinophilic syndrome (IHES) is characterised by persistent eosinophilia and organ damage after ruling out other causes. IHES is clinically and pathologically heterogeneous, and several disease mechanisms have been described. Although neurological involvement with IHES is extremely rare, we report the first cases of acute myelitis with IHES, which are confirmed using MRI, fulfil the diagnostic criteria of IHES and pathologically reveal eosinophilic tissue infiltration in the liver and skin. Patient 1 had longitudinally extensive transverse myelitis, which developed in the absence of steroid therapy. Patient 2 developed acute myelitis with two short lesions during a 3 mg/day corticosteroid treatment. Both cases had eosinophilia (>1500/mm3) at the onset of myelitis. These findings suggest that earlier treatment and a sufficient dose of corticosteroids may prevent the lesional expansion in acute myelitis. Steroid therapy should be initiated early before organ involvement, because permanent neuronal damage with a larger lesion becomes more critical.
Teaching general practitioners and doctors-in-training to discuss advance care planning: evaluation of a brief multimodality education programme
Authors: Detering Karen , Silvester William , Corke Charlie , Milnes Sharyn , Fullam Rachael , Lewis Virginia , Renton Jodie
Published: May 2014

Objective

To develop and evaluate an interactive advance care planning (ACP) educational programme for general practitioners and doctors-in-training.

Design

Development of training materials was overseen by a committee; informed by literature and previous teaching experience. The evaluation assessed participant confidence, knowledge and attitude toward ACP before and after training.

Setting

Training provided to metropolitan and rural settings in Victoria, Australia.

Participants

148 doctors participated in training. The majority were aged at least 40 years with more than 10 years work experience; 63% had not trained in Australia.

Intervention

The programme included prereading, a DVD, interactive patient e-simulation workshop and a training manual. All educational materials followed an evidence-based stepwise approach to ACP: Introducing the topic, exploring concepts, introducing solutions and summarising the conversation.

Main outcome measures

The primary outcome was the change in doctors’ self-reported confidence to undertake ACP conversations. Secondary measures included pretest/post-test scores in patient ACP e-simulation, change in ACP knowledge and attitude, and satisfaction with programme materials.

Results

69 participants completed the preworkshop and postworkshop evaluation. Following education, there was a significant change in self-reported confidence in six of eight items (p=0.008 –0.08). There was a significant improvement (p<0.001) in median scores on the e-simulation (pre 7/80, post 60/80). There were no significant differences observed in ACP knowledge following training, and most participants were supportive of patient autonomy and ACP pretraining. Educational materials were rated highly.

Conclusions

A short multimodal interactive education programme improves doctors’ confidence with ACP and performance on an ACP patient e-simulation.
Does palliative care education matter to medical students? The experience of attending an undergraduate course in palliative care
Authors: Centeno Carlos , Ballesteros Montse , Carrasco José Miguel , Arantzamendi María
Published: May 2014

Background

Palliative care (PC) education has become a priority in many European countries where PC is quickly developing. There remains, however, a lack of information on acceptability and medical students’ experiences in PC education. This kind of information is important because it could encourage universities to adapt their curricula appropriately to the demographic and societal necessity.

Objective

To explore medical students’ reactions to an optional PC course using their reflective written comments.

Methods

316 medical students at the University of Navarra, over a period of 4 years, wrote evaluative comments regarding their experience and what they perceived as the course's contribution to their education. With these comments, a qualitative thematic analysis was carried out.

Results

With a response ratio of 90%, five main themes were identified: (1) The course helped medical students to become and act as doctors, (2) The benefits of having a holistic view of the patient and taking the family into account, (3) PC opens up a new a field of knowledge, (4) The course makes students think and reflect on their personal development and encourages them to deepen humanistic aspects of their practice, (5) The practical aspect is essential in PC learning. In addition, significantly, students used vigorous and positive expressions when writing about their experiences.

Discussion

The subject of PC turns out to be very important to students, who almost unanimously evaluated their experience positively and highlighted the benefits of attending a PC course. Students especially reported being surprised by the humane and holistic features of the course, and they found that what they learned in the course is applicable to all patients and prepares them to work better as doctors. Participants recommend the course for all undergraduate students as a core component of the curricula.
Optical coherence tomography of the intracranial vasculature and Wingspan stent in a patient
Authors: Given Curtis Alden , Ramsey Christian Norman , Attizzani Guilherme Ferragut , Jones Michael R , Brooks William H , Bezerra Hiram G , Costa Marco A
Published: May 2014

A 67-year-old man with medically refractory vertebrobasilar insufficiency and short segment occlusions of the intracranial vertebral arteries was treated with angioplasty and stent placement. Fifteen hours after the procedure the patient developed symptoms of posterior fossa ischemia and repeat angiography showed thrombus formation within the stent which was treated with thrombolytic and aggressive antiplatelet therapy. Angiography revealed lysis of the clot, but concerns regarding the mechanism of the thrombotic phenomenon prompted frequency-domain optical coherence tomography (FDOCT) assessment. FDOCT provided excellent visualization of the stent and vessel wall interactions, as well as excluding residual flow-limiting stenosis, obviating the need for further intervention. The potential utility of FDOCT in the evaluation of intracranial atherosclerotic disease and additional intracranial applications are discussed.
Late onset aneurysm development following radiosurgical obliteration of a cerebellopontine angle meningioma
Authors: Kellner Christopher Paul , McDowell Michael M , Connolly E Sander , Sisti Michael B , Lavine Sean D
Published: May 2014

The development of de novo intracranial aneurysms following stereotactic radiosurgery for intracranial pathology is a rare complication secondary to vascular injury. Typically, these aneurysms develop within the first few years after radiation surgery. We present the first case of an aneurysm developing 10 years after radiosurgery for a cerebellopontine angle meningioma. This case highlights the importance of careful long-term follow-up of patients who undergo radiosurgery for lesions abutting major vessels and/or who suffer post-radiation complications.
ANALYSIS OF FINITE CAPACITY QUEUE WITH NEGATIVE CUSTOMERS AND BUNKER FOR OUSTED CUSTOMERS USING CHEBYSHEV AND GEGENBAUER POLYNOMIALS
Authors: RAZUMCHIK ROSTISLAV V.
Published: May 2014

Consideration is given to the queueing system with incoming Poisson flows of regular and negative customers. Regular customers await service in buffer of finite size r. Each negative customer upon arrival pushes a regular customer out of the queue in buffer (if it is not empty) and moves it to another queue of finite capacity r (bunker). Customers from both queues are served according to exponential distribution with parameter μ, first-come, first-served discipline, but customers in bunker are served with relative priority. Using method based on Chebyshev and Gegenbauer polynomials the algorithm for computation of stationary blocking probabilities and joint probability distribution of the number of customers in buffer and bunker is obtained. Numerical example is provided.
Confinement and Mayer cluster expansions
Authors: Bourgine Jean-Emile
Published: May 2014

In this paper, we study a class of grand-canonical partition functions with a kernel depending on a small parameter ϵ. This class is directly relevant to Nekrasov partition functions of 𝒩 = 2 SUSY gauge theories on the 4d Ω-background, for which ϵ is identified with one of the equivariant deformation parameter. In the Nekrasov–Shatashvili limit ϵ→0, we show that the free energy is given by an on-shell effective action. The equations of motion take the form of a TBA equation. The free energy is identified with the Yang–Yang functional of the corresponding system of Bethe roots. We further study the associated canonical model that takes the form of a generalized matrix model. Confinement of the eigenvalues by the short-range potential is observed. In the limit where this confining potential becomes weak, the collective field theory formulation is recovered. Finally, we discuss the connection with the alternative expression of instanton partition functions as sums over Young tableaux.
Isotopical changes induced by ultrasounds in iron
Authors: Cardone Fabio , Petrucci Andrea , Rosada Alberto
Published: May 2014

As part of a series of experiments based on the application of ultrasound to structural materials and metal alloys, a sample of alpha iron (Ferrite) was subjected to ultrasounds in order to investigate the possible emission of nuclear particles and the possible formation of new isotopes. The sample was subsequently subjected to Instrumental Neutron Activation Analysis (INAA) to highlight the possible transformations that occurred, or the formation of new natural isotopes or the variation of the natural isotopic composition of the material.
Key elements of robustness in binary black hole evolutions using spectral methods
Authors: Szilágyi Béla
Published: May 2014

As a network of advanced-era gravitational wave detectors is nearing its design sensitivity, efficient and accurate waveform modeling becomes more and more relevant. Understanding of the nature of the signal being sought can have an order unity effect on the event rates seen in these instruments. The paper provides a description of key elements of the Spectral Einstein Code (SpEC), with details of our spectral adaptive mesh refinement (AMR) algorithm that has been optimized for binary black hole (BBH) evolutions. We expect that the gravitational waveform catalog produced by our code will have a central importance in both the detection and parameter estimation of gravitational waves in these instruments.
AMP-Activated Protein Kinase: Maintaining Energy Homeostasis at the Cellular and Whole-Body Levels
Authors: Hardie D. Grahame
Published: May 2014

The adenosine monophosphate (AMP)-activated protein kinase (AMPK) signaling pathway arose early during evolution of eukaryotic cells, when it appears to have been involved in the response to glucose starvation and perhaps also in monitoring the output of the newly acquired mitochondria. Due to the advent of hormonal regulation of glucose homeostasis, glucose starvation is a less frequent event for mammalian cells than for single-celled eukaryotes. Nevertheless, the AMPK system has been preserved in mammals where, by monitoring cellular AMP:adenosine triphosphate (ATP) and adenosine diphosphate (ADP):ATP ratios and balancing the rates of catabolism and ATP consumption, it maintains energy homeostasis at a cell-autonomous level. In addition, hormones involved in maintaining energy balance at the whole-body level interact with AMPK in the hypothalamus. AMPK is activated by two widely used clinical drugs, metformin and aspirin, and also by many natural products of plants that are either derived from traditional medicines or are promoted as “nutraceuticals.”
Launching a New Food Product or Dietary Supplement in the United States: Industrial, Regulatory, and Nutritional Considerations
Authors: Finley John Weldon , Finley John Wescott , Ellwood Kathleen , Hoadley James
Published: May 2014

Launching a new food/dietary supplement into the US market can be a confusing process to those unfamiliar with the food industry. Industry capability and product specifications are initial determinants of whether a candidate product can be manufactured in a reproducible manner and whether pilot production can be brought up to the market scale. Regulatory issues determine how a product can be produced and marketed; the primary federal institutions involved in regulations are the US Department of Agriculture, the Food and Drug Administration, and the Federal Trade Commission. A primary distinction is made between food and drugs, and no product may enter the food market if it is in part or whole a drug. Product safety is a major concern, and myriad regulations govern the determination of safety. New foods/dietary supplements are often marketed by health claims or structure/function claims, and there are specific regulations pertaining to claims. Not understanding the regulatory issues involved in developing a new product or failing to comply with associated regulations can have legal and financial repercussions.
On the localization of complex sounds: temporal encoding based on input-slope coincidence detection of envelopes
Authors: Gai Yan , Kotak Vibhakar C. , Sanes Dan H. , Rinzel John
Published: May 2014

Behavioral and neural findings demonstrate that animals can locate low-frequency sounds along the azimuth by detecting microsecond interaural time differences (ITDs). Information about ITDs is also available in the amplitude modulations (i.e., envelope) of high-frequency sounds. Since medial superior olivary (MSO) neurons encode low-frequency ITDs, we asked whether they employ a similar mechanism to process envelope ITDs with high-frequency carriers, and the effectiveness of this mechanism compared with the process of low-frequency sound. We developed a novel hybrid in vitro dynamic-clamp approach, which enabled us to mimic synaptic input to brain-slice neurons in response to virtual sound and to create conditions that cannot be achieved naturally but are useful for testing our hypotheses. For each simulated ear, a virtual sound, computer generated, was used as input to a computational auditory-nerve model. Model spike times were converted into synaptic input for MSO neurons, and ITD tuning curves were derived for several virtual-sound conditions: low-frequency pure tones, high-frequency tones modulated with two types of envelope, and speech sequences. Computational models were used to verify the physiological findings and explain the biophysical mechanism underlying the observed ITD coding. Both recordings and simulations indicate that MSO neurons are sensitive to ITDs carried by spectrotemporally complex virtual sounds, including speech tokens. Our findings strongly suggest that MSO neurons can encode ITDs across a broad-frequency spectrum using an input-slope-based coincidence-detection mechanism. Our data also provide an explanation at the cellular level for human localization performance involving high-frequency sound described by previous investigators.
The neural correlates of learned motor acuity
Authors: Shmuelof Lior , Yang Juemin , Caffo Brian , Mazzoni Pietro , Krakauer John W.
Published: May 2014

We recently defined a component of motor skill learning as “motor acuity,” quantified as a shift in the speed-accuracy trade-off function for a task. These shifts are primarily driven by reductions in movement variability. To determine the neural correlates of improvement in motor acuity, we devised a motor task compatible with magnetic resonance brain imaging that required subjects to make finely controlled wrist movements under visual guidance. Subjects were imaged on day 1 and day 5 while they performed this task and were trained outside the scanner on intervening days 2, 3, and 4. The potential confound of performance changes between days 1 and 5 was avoided by constraining movement time to a fixed duration. After training, subjects showed a marked increase in success rate and a reduction in trial-by-trial variability for the trained task but not for an untrained control task, without changes in mean trajectory. The decrease in variability for the trained task was associated with increased activation in contralateral primary motor and premotor cortical areas and in ipsilateral cerebellum. A global nonlocalizing multivariate analysis confirmed that learning was associated with increased overall brain activation. We suggest that motor acuity is acquired through increases in the number of neurons recruited in contralateral motor cortical areas and in ipsilateral cerebellum, which could reflect increased signal-to-noise ratio in motor output and improved state estimation for feedback corrections, respectively.