Search Results (29)

Background/Objectives: The Motor Speech Hierarchy (MSH) Probe Words (PWs) have yet to be validated as effective in discriminating between children with impaired and children with typically developing speech motor control. This preliminary study first examined the effectiveness of the mandibular control subtest of the MSH-PWs in distinguishing between typically developing (TD) and speech sound-disordered (SSD) children aged between 3 years 0 months and 3 years 6 months. Secondly, we compared automatically derived kinematic measures of jaw range and control with MSH-PW consensus scoring to assist in identifying deficits in mandibular control. Methods: Forty-one children with TD speech and 13 with SSD produced the 10 words of the mandibular stage of the MSH-PWs. A consensus team of speech pathologists observed video recordings of the words to score motor speech control and phonetic accuracy, as detailed in the MSH-PW scoring criteria. Specific measures of jaw and lip movements during speech were also extracted to derive the objective measurements, with agreement between the perceptual and objective measures of jaw range and jaw control evaluated. Results: A significant difference between TD and SSD groups was found for jaw range (p = 0.006), voicing transitions (p = 0.004) and total mandibular scores (p = 0.015). SSD and TD group discrimination was significant (at alpha = 0.01) with a balanced classification accuracy of 0.79. Initial analysis indicates objective kinematic measures using facial tracking show good agreement with perceptual judgements of jaw range and jaw control. Conclusions: The preliminary data indicate the MSH-PWs can discriminate TD speech from SSD at the level of mandibular control and can be used by clinicians to assess motor speech control. Further investigation of objective measures to support perceptual scoring is indicated. Full article

For the Norman kings of Sicily and the ecclesiastical authorities who ruled their dioceses, Byzantine art served as both a symbol of luxury and a model of prestige. Similarly to the mosaics of Palermo, Monreale, and Cefalú, as well as textiles and goldsmithing, the manuscripts preserved in the National Library of Madrid stand as prime examples of the fascination that the dignitaries of the Kingdom of Sicily had for Byzantine esthetics. Among these manuscripts, the Sacramentary of Messina (Madrid, BNE Ms. 52) is perhaps the most striking. This Latin sacramentary, comprising 303 folios, features illuminated initials, a calendar with depictions of classical topics, such as the Spinario and a compelling depiction of August inspired by the Byzantine Koimesis, the months and zodiac, and two full-page illustrations depicting the Virgin Glykophilousa, the Crucifixion, and the Deesis. This study has a dual focus. First, it aims to analyze the iconographic peculiarities of the monthly images in this Latin calendar. Second, it seeks to provide new insights into the manuscript’s patronage and its place of origin. In this context, one of the most striking and significant aspects of the sacramentary’s iconography is the prominent role of the Virgin, a theme that will also be examined in this study. Archbishop Richard Palmer emerges as the leading candidate to have been the driving force in the patronage of the manuscript to the Royal scriptoria of Palermo. Full article

Background: Uric acid (UA), a metabolite of purine and fructose metabolism, is linked to inflammation and metabolic disorders, including gout and cardiovascular disease. Its pro-inflammatory effects are largely driven by the activation of the nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome, leading to increased cytokine production. Beta-hydroxybutyrate (BHB), a ketone produced during fasting or carbohydrate restriction, has been shown to reduce inflammation. This study explores the role of BHB in mitigating the inflammatory and metabolic effects of elevated uric acid levels. Methods: We utilized a murine muscle cell culture treated with UA and BHB. Results: Muscle cells treated with UA had increased production of pro-inflammatory cytokines and reduced cell viability. Co-treatment with BHB reversed these effects, improving cell survival and reducing cytokine levels. Additionally, uric acid impaired mitochondrial function and increased oxidative stress, which were mitigated by BHB. Furthermore, uric acid disrupted insulin signaling, but BHB co-treatment restored insulin sensitivity. Conclusions: These findings suggest that BHB holds therapeutic potential by counteracting the inflammatory and metabolic disruptions caused by elevated uric acid, making it a promising target for conditions such as hyperuricemia and metabolic syndrome. Full article

Speech Sound Disorders (SSDs) are prevalent communication problems in children that pose significant barriers to academic success and social participation. Accurate diagnosis is key to mitigating life-long impacts. We are developing a novel software solution—the Speech Movement and Acoustic Analysis Tracking (SMAAT) system to facilitate rapid and objective assessment of motor speech control issues underlying SSD. This study evaluates the feasibility of using automatically extracted three-dimensional (3D) facial measurements from single two-dimensional (2D) front-facing video cameras for classifying speech movements. Videos were recorded of 51 adults and 77 children between 3 and 4 years of age (all typically developed for age) saying 20 words from the mandibular and labial-facial levels of the Motor-Speech Hierarchy Probe Wordlist (MSH-PW). Measurements around the jaw and lips were automatically extracted from the 2D video frames using a state-of-the-art facial mesh detection and tracking algorithm, and each individual measurement was tested in a Leave-One-Out Cross-Validation (LOOCV) framework for its word classification performance. Statistics were evaluated at the $\alpha =0.05$ significance level and several measurements were found to exhibit significant classification performance in both the adult and child cohorts. Importantly, measurements of depth indirectly inferred from the 2D video frames were among those found to be significant. The significant measurements were shown to match expectations of facial movements across the 20 words, demonstrating their potential applicability in supporting clinical evaluations of speech production. Full article

This paper presents a capacity planning framework for a microgrid based on renewable energy sources and supported by a hybrid battery energy storage system which is composed of three different battery types, including lithium-ion (Li-ion), lead acid (LA), and second-life Li-ion batteries for supplying electric vehicle (EV) charging stations. The objective of this framework is to determine the optimal size for the wind generation systems, PV generation systems, and hybrid battery energy storage systems (HBESS) with the least cost. The framework is formulated as a mixed integer linear programming (MILP) problem, which incorporates constraints for battery ageing and the amount of unmet load for each year. The system uncertainties are managed by conducting the studies for various scenarios, generated and reduced by generative adversarial networks (GAN) and the k-means clustering algorithm for wind speed, global horizontal irradiation, and EV charging load. The studies are conducted for three levels of unmet load, and the outputs are compared for these reliability levels. The results indicate that the cost of hybrid energy storage is lower than individual battery technologies (21% compared to Li-ion, 4.6% compared to LA, and 6% compared to second-life Li-ion batteries). Additionally, by using HBESS, the capacity fade of LA batteries is decreased (for the unmet load levels of 0, 1%, 5%, 4.2%, 6.1%, and 9.7%, respectively), and the replacement of the system is deferred proportional to the degradation reduction. Full article

Nuclear power plants (NPPs) require continuous monitoring of various systems, structures, and components to ensure safe and efficient operations. The critical safety testing of new fuel compositions and the analysis of the effects of power transients on core temperatures can be achieved through modeling and simulations. They capture the dynamics of the physical phenomenon associated with failure modes and facilitate the creation of digital twins (DTs). Accurate reconstruction of fields of interest (e.g., temperature, pressure, velocity) from sensor measurements is crucial to establish a two-way communication between physical experiments and models. Sensor placement is highly constrained in most nuclear subsystems due to challenging operating conditions and inherent spatial limitations. This study develops optimized data-driven sensor placements for full-field reconstruction within reactor and steam generator subsystems of NPPs. Optimized constrained sensors reconstruct field of interest within a tri-structural isotropic (TRISO) fuel irradiation experiment, a lumped parameter model of a nuclear fuel test rod and a steam generator. The optimization procedure leverages reduced-order models of flow physics to provide a highly accurate full-field reconstruction of responses of interest, noise-induced uncertainty quantification and physically feasible sensor locations. Accurate sensor-based reconstructions establish a foundation for the digital twinning of subsystems, culminating in a comprehensive DT aggregate of an NPP. Full article

Water resource managers require accurate estimates of the 7-day, 10-year low flow (7Q10) of streams for many reasons, including protecting aquatic species, designing wastewater treatment plants, and calculating municipal water availability. StreamStats, a publicly available web application developed by the United States Geologic Survey that is commonly used by resource managers for estimating the 7Q10 in states where it is available, utilizes state-by-state, locally calibrated regression equations for estimation. This paper expands StreamStats’ methodology and improves 7Q10 estimation by developing a more regionally applicable and generalized methodology for 7Q10 estimation. In addition to classical methodologies, namely multiple linear regression (MLR) and multiple linear regression in log space (LTLR), three promising machine learning algorithms, random forest (RF) decision trees, neural networks (NN), and generalized additive models (GAM), are tested to determine if more advanced statistical methods offer improved estimation. For illustrative purposes, this methodology is applied to and verified for the full range of unimpaired, gaged basins in both the northeast and mid-Atlantic hydrologic regions of the United States (with basin sizes ranging from 2–1419 mi²) using leave-one-out cross-validation (LOOCV). Pearson’s correlation coefficient (R²), root mean square error (RMSE), Kling–Gupta Efficiency (KGE), and Nash–Sutcliffe Efficiency (NSE) are used to evaluate the performance of each method. Results suggest that each method provides varying results based on basin size, with RF displaying the smallest average RMSE (5.85) across all ranges of basin sizes. Full article

Novel biomarkers for tumour burden and bone disease are required to guide clinical management of plasma cell dyscrasias. Recently, bone turnover markers (BTMs) and Diffusion-Weighted Magnetic Resonance Imaging (DW-MRI) have been explored, although their role in the prospective assessment of multiple myeloma (MM) and monoclonal gammopathy of undetermined significance (MGUS) is unclear. Here, we conducted a pilot observational cohort feasibility study combining serum BTMs and DW-MRI in addition to standard clinical assessment. Fifty-five patients were recruited (14 MGUS, 15 smouldering MM, 14 new MM and 12 relapsed MM) and had DW-MRI and serum biomarkers (P1NP, CTX-1, ALP, DKK1, sclerostin, RANKL:OPG and BCMA) measured at baseline and 6-month follow-up. Serum sclerostin positively correlated with bone mineral density (r = 0.40−0.54). At baseline, serum BCMA correlated with serum paraprotein (r = 0.42) and serum DKK1 correlated with serum free light chains (r = 0.67); the longitudinal change in both biomarkers differed between International Myeloma Working Group (IMWG)-defined responders and non-responders. Myeloma Response Assessment and Diagnosis System (MY-RADS) scoring of serial DW-MRI correlated with conventional IMWG response criteria for measuring longitudinal changes in tumour burden. Overall, our pilot study suggests candidate radiological and serum biomarkers of tumour burden and bone loss in MM/MGUS, which warrant further exploration in larger cohorts to validate the findings and to better understand their clinical utility. Full article

Neurodevelopmental regression (NDR) is an enigmatic event associated with autism spectrum disorder (ASD) during which a child loses previously acquired skills and develops ASD symptoms. In some, a trigger which precedes the NDR event, such as a fever, can be identified, but in many cases no trigger is obvious. We hypothesize that air pollution (PM_2.5) may trigger NDR, especially in those children without an identified trigger. Average daily PM_2.5, ozone, precipitation and maximum temperature (T_max) were derived from Environmental Protection Agency models and National Oceanic and Atmospheric Administration monitors based on zip-code information from 83 ASD participants during the six-weeks following the onset month of an NDR event and a reference period defined as one year before and one year after the event. Seasonally adjusted logistic regression (LR) and linear mixed models (LMM) compared cases (with a history of NDR) and matched controls (without a history of NDR). LR models found that the risk of NDR was related to higher PM_2.5 during 3 to 6 weeks of the NDR event period, particularly in those without a trigger. Overall, both models converged on NDR being related to a higher PM_2.5 and lower T_max both during the NDR event period as well as the reference period, particularly in those without a known trigger. This temporal pattern suggests that environmental triggers, particularly PM_2.5, could be related to NDR, especially in those without an identifiable trigger. Further studies to determine the underlying biological mechanism of this observation could help better understand NDR and provide opportunities to prevent NDR. Full article

Uterine transplantation is becoming an increasingly realistic therapeutic for uterine infertility. Surgical training on large animal models such as sheep is a prerequisite for establishing a program in humans. The objective of our study was to analyze the predictive factors for successful vascular anastomoses. We performed 40 autotransplants that involved end-to-side anastomoses from the uterine to the external iliac vessels. We analyzed vessel results in terms of success or failure; a total of 78.7% of arterial and 82.9% of venous anastomoses were successful in the immediate postoperative period. In multivariate analysis, independent factors associated with immediate successful vein anastomoses were as follows: a short warm ischemia time (<2 h, OR = 0.05; 95% CI [0.003–0.88], p = 0.04), the absence of any anastomotic complications (OR = 0.06; 95% CI [0.003–0.099], p = 0.049), and their realization by a vascular surgeon (OR = 29.3; 95% CI [1.17–731.9], p = 0.04). Secondly, we showed that an increase in lactate levels greater than 2.72 mmol/L, six hours after reperfusion was predictive of failure, with a sensibility of 85.7% and a specificity of 75.0%. In order to perfect the management of vascular anastomoses by a vascular surgeon, training on animal models and in microsurgery are mandatory in establishing a uterine transplantation program in humans. Full article

The increasing demand for palliative care in New Zealand presents a potential threat to the quality of service delivery. One strategy to overcome this is through the implementation of valid and reliable patient-reported outcome measures. This mixed-methods study aimed to (1) implement measurement-based palliative care (MBPC) in a community palliative care service in Auckland, New Zealand; (2) evaluate the clinical utility of MBPC perceived by clinicians; (3) describe patient characteristics as measured by the Integrated Palliative Care Outcome Scale (IPOS), the Australasian Modified Karnofsky Performance Scale (AKPS), and Phase of Illness (POI); and (4) evaluate the internal consistency of the IPOS. Participants were over 18 years of age from a community outpatient palliative care service. In a phased approach to implementation, healthcare staff were educated on each instrument used for patient assessment. Uptake and internal consistency were evaluated through descriptive statistics. An interpretive descriptive methodology was used to explore the clinical utility of MBPC through semi-structured interviews with seven clinical staff members. Individual patient assessments (n = 1507) were undertaken predominantly on admission, with decreasing frequency as patients advanced through to the terminal phase of their care. Mean total IPOS scores were 17.97 (SD = 10.39, α = 0.78). The POI showed that 65% of patients were in the stable phase, 20% were in the unstable phase, 9% were in the deteriorating phase, and 2% were in the terminal phase. Clinicians reported that MBPC facilitated holistic and comprehensive assessments, as well as the development of a common interdisciplinary language. Clinicians expressed discomfort using the psychosocial and spiritual items. Measurement-based palliative care was only partially implemented but it was valued by staff and perceived to increase the quality of service delivery. Future research should determine the optimal timing of assessments, cultural responsivity for Māori and Pacific patients, and the role of MBPC in decision support for clinicians. Full article

Mice with transgenic expression of human SOD1^G93A are a widely used model of ALS, with a caudal–rostral progression of motor impairment. Previous studies have quantified the progression of motoneuron (MN) degeneration based on size, even though alpha (α-) and gamma (γ-) MNs overlap in size. Therefore, using molecular markers and synaptic inputs, we quantified the survival of α-MNs and γ-MNs at the lumbar and cervical spinal segments of 3- and 4-month SOD1^G93A mice, to investigate whether there is a caudal–rostral progression of MN death. By 3 months, in the cervical and lumbar spinal cord, there was α-MN degeneration with complete γ-MN sparing. At 3 months, the cervical spinal cord had more α-MNs per ventral horn than the lumbar spinal cord in SOD1^G93A mice. A similar spatial trend of degeneration was observed in the corticospinal tract, which remained intact in the cervical spinal cord at 3- and 4- months of age. These findings agree with the corticofugal synaptopathy model that α-MNs and CST of the lumbar spinal cord are more susceptible to degeneration in SOD1^G93A mice. Hence, there is a spatial and temporal caudal–rostral progression of α-MN and CST degeneration in SOD1^G93A mice. Full article

Older people living in care homes are at high risk of poor health outcomes and mortality if they contract COVID-19 or other infectious diseases. Measures used to protect residents include social distancing and isolation, although implementation is challenging. This review aimed to assess the social distancing and isolation strategies used by care homes to prevent and control the transmission of COVID-19 and other infectious diseases. Seven electronic databases were searched: Medline, CINAHL, Embase, PsycINFO, HMIC, Social Care Online, and Web of Science Core Collection. Grey literature was searched using MedRxiv, PDQ-Evidence, NICE Evidence Search, LTCCovid19.org and TRIP. Extracted data were synthesised using narrative synthesis and tabulation. 103 papers were included (10 empirical studies, seven literature reviews, and 86 policy documents). Strategies used to prevent and control the transmission of COVID-19 and other infectious diseases included social distancing and isolation of residents and staff, zoning and cohorting of residents, restriction of resident movement/activities, restriction of visitors and restriction of staff working patterns. This review demonstrates a lack of empirical evidence and the limited nature of policy documentation around social distancing and isolation measures in care homes. Evaluative research on these interventions is needed urgently, focusing on the well-being of all residents, particularly those with hearing, vision or cognitive impairments. Full article

Silver (Ag) nanoparticles were successfully prepared by using the in-liquid pulsed plasma technique. This method is based on a low voltage, pulsed spark discharge in a dielectric liquid. We explore the effect of the protecting ligands, specifically Cetyl Trimethylammonium Bromide (CTAB), Polyvinylpyrrolidone (PVP), and Sodium n-Dodecyl Sulphate (SDS), used as surfactant materials to prevent nanoparticle aggregation. The X-Ray Diffraction (XRD) patterns of the samples confirm the face-centered cubic crystalline structure of Ag nanoparticles with the presence of Ag₂O skin. Scanning Transmission Electron Microscopy (STEM) reveals that spherically shaped Ag nanoparticles with a diameter of 2.2 ± 0.8 nm were synthesised in aqueous solution with PVP surfactant. Similarly, silver nanoparticles with a peak diameter of 1.9 ± 0.4 nm were obtained with SDS surfactant. A broad size distribution was found in the case of CTAB surfactant. Full article

For every three people on the planet, there are approximately two Tonnes (Te) of plastic waste. We show that carbon recovery from polystyrene (PS) plastic is enhanced by the coaddition of solvents to grow carbon nanotubes (CNTs) by liquid injection chemical vapour deposition. Polystyrene was loaded up to 4 wt% in toluene and heated to 780 °C in the presence of a ferrocene catalyst and a hydrogen/argon carrier gas at a 1:19 ratio. High resolution transmission electron microscopy (HRTEM), scanning electron microscopy (SEM), thermogravimetric analysis (TGA) and Raman spectroscopy were used to identify multiwalled carbon nanotubes (MWCNTs). The PS addition in the range from 0 to 4 wt% showed improved quality and CNT homogeneity; Raman “Graphitic/Defective” (G/D) values increased from 1.9 to 2.3; mean CNT diameters increased from 43.0 to 49.2 nm; and maximum CNT yield increased from 11.37% to 14.31%. Since both the CNT diameters and the percentage yield increased following the addition of polystyrene, we conclude that carbon from PS contributes to the carbon within the MWCNTs. The electrical contact resistance of acid-washed Bucky papers produced from each loading ranged from 2.2 to 4.4 Ohm, with no direct correlation to PS loading. Due to this narrow range, materials with different loadings were mixed to create the six wires of an Ethernet cable and tested using iPerf3; the cable achieved up- and down- link speeds of ~99.5 Mbps, i.e., comparable to Cu wire with the same dimensions (~99.5 Mbps). The lifecycle assessment (LCA) of CNT wire production was compared to copper wire production for a use case in a Boeing 747-400 over the lifespan of the aircraft. Due to their lightweight nature, the CNT wires decreased the CO₂ footprint by 21 kTonnes (kTe) over the aircraft’s lifespan. Full article