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The acute respiratory distress syndrome (ARDS) resulting from coronavirus disease 2019 (COVID-19) is associated with a massive release of inflammatory cytokines and high mortality. Mesenchymal stromal cells (MSCs) have anti-inflammatory properties and have shown activity in treating acute lung injury. Here the authors report a case series of 11 patients with COVID-19-associated ARDS (CARDS) requiring mechanical ventilation who were treated with remestemcel-L, an allogeneic MSC product, under individual patient emergency investigational new drug applications.

Patients were eligible if they were mechanically ventilated for less than 72 h prior to the first infusion. Patients with pre-existing lung disease requiring supplemental oxygen or severe liver or kidney injury were excluded. Each patient received two infusions of remestemcel-L at a dose of 2 million cells/kg per infusion given 48-120 h apart.

Remestemcel-L infusions were well tolerated in all 11 patients. At the end of the 28-day follow-up period, 10 (91%, 95% confidence interval [CI], 59-100%) patients were extubated, nine (82%, 95% CI, 48-97%) patients remained liberated from mechanical ventilation and were discharged from the intensive care unit and two (18%, 95 CI%, 2-52%) patients died. The median time to extubation was 10 days. Eight (73%, 95% CI, 34-100%) patients were discharged from the hospital. C-reactive protein levels significantly declined within 5 days of MSC infusion.

The authors demonstrate in this case series that remestemcel-L infusions to treat moderate to severe CARDS were safe and well tolerated and resulted in improved clinical outcomes.

The authors demonstrate in this case series that remestemcel-L infusions to treat moderate to severe CARDS were safe and well tolerated and resulted in improved clinical outcomes.

We hypothesized that a Chief Resident Service educational model provides safe care for patients compared to that received on standard academic services where rotating residents adopt the practices and preferences of their attending.

We retrospectively identified patients undergoing inguinal hernia repairs from July 2016 through June 2019 and matched Chief's service patients to standard academic service patients 11 on CPT, sex and age. We compared patient characteristics, recurrence rates, outcomes and complications.

Tertiary care center, single institution.

Overall, 77 patients undergoing inguinal hernia repairs (66% open and 34% laparoscopic) on the Chief's service matched successfully to 77 standard academic service patients during the study period.

Age, BMI and ASA were similar between the services, but Chief's service patients were less likely to be current smokers (1.3% vs. 24.7%) and more likely to be former smokers (59.7% vs. 26.0%) than standard academic service patients (p < 0.01). PF-6463922 Patietion, is safe for patients presenting with inguinal hernias. Concerns about patient safety should not be a barrier to maximizing entrustment for the evaluation and operative management of select core general surgery diagnoses and operations.

Providing general surgery chief residents with a supervised opportunity to direct, plan and provide surgical care in clinic and the operating room, as a transition to independent practice following graduation, is safe for patients presenting with inguinal hernias. Concerns about patient safety should not be a barrier to maximizing entrustment for the evaluation and operative management of select core general surgery diagnoses and operations.

The auditory steady-state response (ASSR) amplitudes fall in the presence of contralateral noise. However, whether and to what extent medial olivocochlear (MOC) activity involves in contralateral suppression of ASSR remain unclear. Therefore, we assess the role of MOC activity in contralateral suppression of ASSR.

Mice were treated with strychnine to completely eliminate MOC activity and then measured ASSR amplitudes in the presence of contralateral noise.

The contralateral noise reduces ASSR amplitudes at some stimulus intensity. After treating with the strychnine to eliminate MOC activity, ASSR amplitudes recovered again.

MOC activity participated in contralateral suppression of ASSR.

MOC activity participated in contralateral suppression of ASSR.

The objective of this study was to determine the area in the cricopharyngeus muscle (CPM) where botulinum neurotoxin (BoNT) can be injected safely and effectively by evaluating neural distribution in the CPM.

Eleven specimens of the CPM were gathered from human cadavers. The anatomical relationship between the posterior cricoarytenoid muscle (PCAM) and the CPM was evaluated. Myelinated nerve fibers in the CPM were stained using modified Sihler's method. The CPM was classified into five zones according to the area accessible within the CPM via transcutaneous and transluminal approaches for BoNT injection as follows i) lateral area including upper area (zone 1) and lower area (zone 2); ii) posterolateral area including upper area (zone 3) and lower area (zone 4); and iii) posterior area (zone 5). Neural distribution originating from the pharyngeal plexus and the extralaryngeal branches of recurrent laryngeal nerve (EBRLN) within each classified zone in stained specimens was determined.

Six specimens (12 lateral areas, 12 posterolateral areas, and 6 posterior areas) were suitable for evaluating neural distribution within the CPM. Zone 1 was adjacent to the PCAM the most in all specimens. Nerve endings originating from the EBRLN were observed on four sides of zone 2 (33.3%, 4/12 sides) in three specimens (3/6, 50%). Neural distribution originating from the pharyngeal plexus was found on ten sides (83.3%, 10/12 sides) of zone 3 in five specimens (83.3%, 5/6 specimens) and on nine sides (75.0%, 9/12 sides) of zone 4 in five specimens (83.3%, 5/6 specimens).

The posterolateral area (zone 3 and zone 4) is thought to be the most suitable area for alleviating the spasticity of CPM with a minimum dose of BoNT.

The posterolateral area (zone 3 and zone 4) is thought to be the most suitable area for alleviating the spasticity of CPM with a minimum dose of BoNT.Bioacoustic analysis has been used for a variety of purposes including classifying vocalizations for biodiversity monitoring and understanding mechanisms of cognitive processes. A wide range of statistical methods, including various automated methods, have been used to successfully classify vocalizations based on species, sex, geography, and individual. A comprehensive approach focusing on identifying acoustic features putatively involved in classification is required for the prediction of features necessary for discrimination in the real world. Here, we used several classification techniques, namely discriminant function analyses (DFAs), support vector machines (SVMs), and artificial neural networks (ANNs), for sex-based classification of zebra finch (Taeniopygia guttata) distance calls using acoustic features measured from spectrograms. We found that all three methods (DFAs, SVMs, and ANNs) correctly classified the calls to respective sex-based categories with high accuracy between 92 and 96%. Frequency modulation of ascending frequency, total duration, and end frequency of the distance call were the most predictive features underlying this classification in all of our models. Our results corroborate evidence of the importance of total call duration and frequency modulation in the classification of male and female distance calls. Moreover, we provide a methodological approach for bioacoustic classification problems using multiple statistical analyses.Using the characteristics of low rank for reverberation and sparsity for the target echo in multi-ping detection, the low-rank and sparsity decomposition method can effectively reduce reverberation. However, in the case of highly sparse reverberation or a stationary target, the distinctions in the characteristics between the reverberation and target echo become ambiguous. As a result, the reverberation reduction performance is degraded. To guarantee a meaningful decomposition based on the random orthogonal model and random sparsity model, the identifiability condition (IC) for the decomposition was derived from the perspective of the low-rank matrix and sparse matrix, respectively. According to the IC, sparsity compensation for the low-rank matrix was proposed to address the false alarm probability inflation (FAPI) induced by highly sparse reverberation. In addition, increasing the dimension of the sparse matrix was also proposed to manage the detection probability shrinkage caused by a stationary target. The robust reverberation reduction performance was validated via simulations and field experiments. It is demonstrated that FAPI can be eliminated by increasing the sparse coefficient of the low-rank matrix to 0.30 and a stationary target could be detected with a large ping number, i.e., a high dimension, of the sparse matrix.The International Standards Organization (ISO) published Technical Specification (TS) 15666 in 2003 to facilitate the comparison of results from surveys on noise annoyance. This document recommends including two standardized questions with two standardized response scales in all surveys of long-term noise annoyance. A recently revised version of the TS proposes a weighting procedure for the response data to achieve a better similarity between the results from the two questions. This paper analyses the results from 43 surveys conducted according to the ISO/TS 15666 recommendations. It is shown that the average difference in the response to the two annoyance questions is equivalent to a 6 dB shift in the exposure level. The proposed weighting of the verbal response whereby response category 5 (extremely) is counted in full, and category 4 (very) is weighted by a factor 0.4 creates a greater similarity between the two responses. It is important to use a definition of prevalence of high annoyance which matches the one used for the development of the relevant noise regulations.Four species of grouper (family Epinephlidae), Red Hind (Epinephelus guttatus), Nassau (Epinephelus striatus), Black (Mycteroperca bonaci), and Yellowfin Grouper (Mycteroperca venenosa) share an aggregation site in Little Cayman, Cayman Islands and produce sounds while aggregating. Continuous observation of these aggregations is challenging because traditional diver or ship-based methods are limited in time and space. Passive acoustic localization can overcome this challenge for sound-producing species, allowing observations over long durations and at fine spatial scales. A hydrophone array was deployed in February 2017 over a 9-day period that included Nassau Grouper spawning. Passive acoustic localization was used to find positions of the grouper-produced calls recorded during this time, which enabled the measurement of call source levels and evaluation of spatiotemporal aspects of calling. Yellowfin Grouper had the lowest mean peak-to-peak (PP) call source level, and Nassau Grouper had the highest mean PP call source level (143.7 and 155.2 dB re 1 μPa at 1 m for 70-170 Hz, respectively). During the days that Nassau Grouper spawned, calling peaked after sunset. Similarly, when Red Hind calls were abundant, calls were highest in the afternoon and evening. The measured source levels can be used to estimate communication and detection ranges and implement passive acoustic density estimation for these fishes.