The relationship between red cell distribution width (RDW) and hypertension remains a contentious topic, with a lack of large-scale studies focusing on the adults in the United States. This study aimed to investigate the association between RDW and hypertension among US adults from 1999 to 2018. METHODS: Data were derived from the National Health and Nutrition Examination Survey (NHANES) 1999-2018. RDW values were obtained from the Laboratory Data's Complete Blood Count with 5-part Differential-Whole Blood module. Hypertension data were obtained through hypertension questionnaires and blood pressure measurements. Multivariable weighted logistic regression analyses were conducted to assess the association between RDW and hypertension, followed by subgroup and smooth curve analyses. RESULTS: Compared to the non-hypertensive group, the hypertensive group exhibited higher RDW values (13.33±1.38 vs. 12.95±1.27, P <0.001). After adjusting for covariates, weighted multivariable logistic regression analysis revealed a positive correlation between RDW and hypertension prevalence (OR: 1.17, 95% CI 1.13, 1.21, P <0.001). When RDW was included as a categorical variable, participants in the fourth quartile had the highest risk of hypertension (OR: 1.86, 95% CI 1.70, 2.03, P <0.001). Subgroup analysis showed that, except for age, BMI and weak/failing kidneys, gender, race, education level, smoking, alcohol use, congestive heart failure, and stroke did not significantly influence this correlation (all P-values for interaction >0.05).Smooth curve fitting analysis revealed a reverse J-shaped relationship between RDW and hypertension prevalence, with an inflection point at 12.93%. CONCLUSION: We first explored the relationship between RDW and hypertension among US adults and discovered a reverse J-shaped association, providing further insights into the relationship between blood cell counts and hypertension and offering a new foundation for hypertension prevention and control.
Erythrocyte Indices , Hypertension , Nutrition Surveys , Humans , Hypertension/epidemiology , Hypertension/blood , Male , Female , Middle Aged , Adult , United States/epidemiology , Risk Factors , Prevalence , Aged , Blood Pressure , Cross-Sectional Studies , Logistic Models
Introduction: To investigate the prognostic value of the consistency between the residual quantitative flow ratio (QFR) and postpercutaneous coronary intervention (PCI) QFR in patients undergoing revascularization. Methods: This was a single-center, retrospective, observational study. All enrolled patients were divided into five groups according to the ΔQFR (defined as the value of the post-PCI QFR minus the residual QFR): (1) Overanticipated group; (2) Slightly overanticipated group; (3) Consistent group; (4) Slightly underanticipated group; and (5) Underanticipated group. The primary outcome was the 5-year target vessel failure (TVF). Results: A total of 1373 patients were included in the final analysis. The pre-PCI QFR and post-PCI QFR were significantly different among the five groups. TVF within 5 years occurred in 189 patients in all the groups. The incidence of TVF was significantly greater in the underanticipated group than in the consistent group (P = 0.008), whereas no significant differences were found when comparing the underanticipated group with the other three groups. Restricted cubic spline regression analysis showed that the risk of TVF was nonlinearly related to the ΔQFR. A multivariate Cox regression model revealed that a ΔQFR≤ -0.1 was an independent risk factor for TVF. Conclusions: The consistency between the residual QFR and post-PCI QFR may be associated with the long-term prognosis of patients. Patients whose post-PCI QFR is significantly lower than the residual QFR may be at greater risk of TVF. An aggressive PCI strategy for lesions is anticipated to have less functional benefit and may not result in a better clinical outcome.
The gut microbiota undergoes substantial changes in COVID-19 patients; yet, the utility of these alterations as prognostic biomarkers at the time of hospital admission, and its correlation with immunological and hematological parameters, remains unclear. The objective of this study is to investigate the gut microbiota's dynamic change in critically ill patients with COVID-19 and evaluate its predictive capability for clinical outcomes alongside immunological and hematological parameters. In this study, anal swabs were consecutively collected from 192 COVID-19 patients (583 samples) upon hospital admission for metagenome sequencing. Simultaneously, blood samples were obtained to measure the concentrations of 27 cytokines and chemokines, along with hematological and biochemical indicators. Our findings indicate a significant correlation between the composition and dynamics of gut microbiota with disease severity and mortality in COVID-19 patients. Recovered patients exhibited a higher abundance of Veillonella and denser interactions among gut commensal bacteria compared to deceased patients. Furthermore, the abundance of gut commensal bacteria exhibited a negative correlation with the concentration of proinflammatory cytokines and organ damage markers. The gut microbiota upon admission showed moderate prognostic prediction ability with an AUC of 0.78, which was less effective compared to predictions based on immunological and hematological parameters (AUC 0.80 and 0.88, respectively). Noteworthy, the integration of these three datasets yielded a higher predictive accuracy (AUC 0.93). Our findings suggest the gut microbiota as an informative biomarker for COVID-19 prognosis, augmenting existing immune and hematological indicators.
AIMS/HYPOTHESIS: cGAS (cyclic GMP-AMP synthase) has been implicated in various cellular processes, but its role in ß-cell proliferation and diabetes is not fully understood. This study investigates the impact of cGAS on ß-cell proliferation, particularly in the context of diabetes. METHODS: Utilizing mouse models, including cGAS and STING (stimulator of interferon genes) knockout mice, we explored the role of cGAS in ß-cell function. This involved ß-cell-specific cGAS knockout (cGASßKO) mice, created by breeding cGAS floxed mice with transgenic mice expressing Cre recombinase under the insulin II promoter. We analyzed cGAS expression in diabetic mouse models, evaluated the effects of cGAS deficiency on glucose tolerance, and investigated the molecular mechanisms underlying these effects through RNA sequencing. RESULTS: cGAS expression is upregulated in the islets of diabetic mice and by high glucose treatment in MIN6 cells. Both global cGAS deficiency and ß-cell-specific cGAS knockout mice lead to improved glucose tolerance by promoting ß-cell mass. Interestingly, STING knockout did not affect pancreatic ß-cell mass, suggesting a STING-independent mechanism for cGAS's role in ß-cells. Further analyses revealed that cGAS- but not STING-deficiency leads to reduced expression of CEBPß, a known suppressor of ß-cell proliferation, concurrently with increased ß-cell proliferation. Moreover, overexpression of CEBPß reverses the upregulation of Cyclin D1 and D2 induced by cGAS deficiency, thereby regulating ß-cell proliferation. These results confirm that cGAS regulation of ß-cell proliferation via a CEBPß-dependent but STING-independent mechanism. CONCLUSIONS/INTERPRETATION: Our findings highlight the pivotal role of cGAS in promoting ß-cell proliferation and maintaining glucose homeostasis, potentially by regulating CEBPß expression in a STING-independent manner. This study uncovers the significance of cGAS in controlling ß-cell mass and identifies a potential therapeutic target for enhancing ß-cell proliferation in the treatment of diabetes.
Background: While serum uric acid (SUA) is known as a cardiovascular disease risk factor and is associated with increased cardiovascular mortality, the relationship between SUA and cardiovascular adaptability under exercise stress remains unclear. Aims: This study aims to elucidate the relationship between SUA levels and cardiovascular fitness, particularly as manifested during cardiopulmonary exercise testing. Methods: Utilizing data from the National Health and Nutrition Examination Survey (NHANES) 1999-2004, this study included 5765 participants aged 12-49 years. Heart rate recovery (HRR) during cardiopulmonary exercise testing was measured as an indicator of cardiovascular fitness. Multivariate linear regression analysis was used to explore the association between SUA levels and heart rate recovery at 1 min (HRR1) and 2 min (HRR2) post-exercise. Results: After adjusting for potential confounders, an inverse relationship was found between SUA levels and both HRR1 and HRR2. Multivariate adjusted smoothing spline plots demonstrated a decrease in HRR1 and HRR2 with increasing SUA levels. This negative correlation was observed across nearly all subgroups. Conclusions: Elevated SUA levels are indicative of poorer cardiovascular adaptability in the adult US population.
Diffraction sets a natural limit for the spatial resolution of acoustic wave fields, hindering the generation and recording of object details and manipulation of sound at subwavelength scales. We propose to overcome this physical limit by utilizing nonlinear acoustics. Our findings indicate that, contrary to the commonly utilized cumulative nonlinear effect, it is in fact the local nonlinear effect that is crucial in achieving subdiffraction control of acoustic waves. We theoretically and experimentally demonstrate a deep subwavelength spatial resolution up to λ/38 in the far field at a distance 4.4 times the Rayleigh distance. This Letter represents a new avenue towards deep subdiffraction control of sound, and may have far-reaching impacts on various applications such as acoustic holograms, imaging, communication, and sound zone control.
Understanding the sound power characteristics of parametric array loudspeakers (PALs) poses a unique challenge due to the nonlinear process involved. This work addresses this issue by employing the spherical convolution directivity model to obtain the far field intensity, which is then used to calculate the sound power radiated by a PAL. The results reveal that the audio sound power is approximately proportional to the square of the audio frequency and the aperture size, while inversely proportional to the ultrasound frequency. Additionally, the conversion efficiency from ultrasound to audio sound is found to be generally below 0.15% for typical configurations.
AIMS: We aimed to investigate the impact of percutaneous coronary intervention (PCI) and diabetes mellitus (DM) on short- and long-term prognosis in patients with coronary artery disease using three-vessel quantitative flow ratio (3 V-QFR) assessment. METHODS: A retrospective analysis of 2440 vessels in 1181 patients who underwent PCI was performed. The patients were categorized according to the presence or absence of DM and the median 3 V-QFR. The primary outcome was the occurrence of major adverse cardiac events (MACE), defined as a combination of cardiovascular death, myocardial infarction, and ischemia-driven revascularization, over a 5-year period. RESULTS: The pre-PCI and post-PCI 3 V-QFR values for the entire population were 2.37 (2.04-2.56) and 2.94 (2.82-3.00), respectively. Landmark analysis showed that the incidence of MACE was comparable among all groups within the first year (log-rank p = 0.088). Over the course of 2 years, the incidence of MACE was higher in both groups with a post-PCI 3 V-QFR < 2.94 (log-rank p < 0.001). However, from 2 to 5 years, patients with DM had higher rates of MACE (log-rank p = 0.013). CONCLUSIONS: In the short term, a low post-PCI 3 V-QFR is a predictor of high risk for MACE. However, in the long term, DM emerges as the dominant risk factor.
Coronary Artery Disease , Diabetes Mellitus , Percutaneous Coronary Intervention , Humans , Percutaneous Coronary Intervention/adverse effects , Retrospective Studies , Treatment Outcome , Coronary Artery Disease/surgery , Coronary Artery Disease/etiology , Diabetes Mellitus/etiology , Prognosis , Risk Factors , Coronary Angiography
Introduction: Change in the composition of intestinal microbiota is associated with metabolic disorders such as gestational diabetes mellitus (GDM). Methods: To understand how the microbiota impacts the development of gestational diabetes mellitus, we profiled the intestinal microbiome of 54 pregnant women, including 27 GDM subjects, by employing 16S rRNA gene sequencing. Additionally, we conducted targeted metabolomics assays to validate the identified pathways with overrepresented metabolites. Results: We evaluated the patterns of changing abundances of operational taxonomic units (OTU) between GDM and the healthy counterparts over three timepoints. Based on the significant OTUs, we inferred 132 significantly altered metabolic pathways in GDM. And identified two overrepresented metabolites of pregnancy hormone, butyrate and mevalonate, as potential intermediary metabolites of intestinal microbiota in GDM. Finally, we validated the impacts of the intestinal microbiota on GDM by demonstrating consistent changes of the serum levels of progesterone, estradiol, butyrate, and mevalonate in an independent cohort. Discussion: Our findings confirm that alterations in the microbiota play a role in the development of GDM by impacting the metabolism of pregnancy hormones. This provides a novel perspective on the pathogenesis of GDM and introduces potential biomarkers that can be used for early diagnosis and prevention of the disease.
The prediction of reverberant sound fields generated by a directional source is of great interest because practical sound sources are not omnidirectional, especially at high frequencies. For an arbitrary directional source described by cylindrical and spherical harmonics, this paper developed a modal expansion method for calculating the reverberant sound field generated by such a source in both two-dimensional and three-dimensional rectangular enclosures with finite impedance walls. The key is to express the modal source density using the cylindrical or spherical harmonic expansion coefficients of the directional source. A method based on the fast Fourier transform is proposed to enable the fast computation of the summation of enclosure modes when walls are lightly damped or rigid. This makes it possible to obtain accurate reverberant sound fields even in a large room and/or at high frequencies with a relatively low computational load. Numerical results with several typical directional sources are presented. The efficiency and the accuracy of the proposed method are validated by the comparison to the results obtained using the finite element method.
BACKGROUND: Obesity and its associated complications have a negative impact on human health. Metabolic and bariatric surgery (MBS) ameliorates a series of clinical manifestations associated with obesity. However, the overall efficacy of MBS on COVID-19 outcomes remains unclear. OBJECTIVES: The objective of this article is to analyze the relationship between MBS and COVID-19 outcomes. SETTING: A meta-analysis. METHODS: The PubMed, Embase, Web of Science, and Cochrane Library databases were searched to retrieve the related articles from inception to December 2022. All original articles reporting MBS-confirmed SARS-CoV-2 infection were included. Outcomes including hospital admission, mortality, intensive care unit (ICU) admission, mechanical ventilation utilization, hemodialysis during admission, and hospital stay were selected. Meta-analysis with fixed or random-effect models was used and reported in terms of odds ratios (ORs) or weighted mean differences (WMDs) along with their 95% confidence intervals (CIs). Heterogeneity was assessed with the I2 test. Study quality was assessed using the Newcastle-Ottawa Scale. RESULTS: A total of 10 clinical trials involving the investigation of 150,848 patients undergoing MBS interventions were included. Patients who underwent MBS had a lower risk of hospital admission (OR: .47, 95% CI: .34-.66, I2 = 0%), mortality (OR: .43, 95% CI: .28-.65, I2 = 63.6%), ICU admission (OR: .41, 95% CI: .21-.77, I2 = 0%), and mechanical ventilation (OR: .51, 95% CI: .35-.75, I2 = 56.2%) than those who did not undergo surgery, but MBS did not affect hemodialysis risk or COVID-19 infection rate. In addition, the length of hospital stay for patients with COVID-19 after MBS was significantly reduced (WMD: -1.81, 95% CI: -3.11-.52, I2 = 82.7%). CONCLUSIONS: Our findings indicate that MBS is shown to improve COVID-19 outcomes, including hospital admission, mortality, ICU admission, mechanical ventilation, and hospital stay. Patients with obesity who have undergone MBS infected with COVID-19 will have better clinical outcomes than those without MBS.
Bariatric Surgery , COVID-19 , Humans , SARS-CoV-2 , Intensive Care Units , Obesity/complications , Obesity/surgery , Respiration, Artificial
Background: The overall evidence base of anti-inflammatory therapies in patients with type 2 diabetes mellitus (T2DM) has not been systematically evaluated. The purpose of this study was to assess the effects of anti-inflammatory therapies on glycemic control in patients with T2DM. Methods: PubMed, Embase, Web of Science, and Cochrane Library were searched up to 21 September 2022 for randomized controlled trials (RCTs) with anti-inflammatory therapies targeting the proinflammatory cytokines, cytokine receptors, and inflammation-associated nuclear transcription factors in the pathogenic processes of diabetes, such as interleukin-1ß (IL-1ß), interleukin-1ß receptor (IL-1ßR), tumor necrosis factor-α (TNF-α), and nuclear factor-κB (NF-κB). We synthesized data using mean difference (MD) and 95% confidence interval (CI). Heterogeneity between studies was assessed by I2 tests. Sensitivity and subgroup analyses were also conducted. Results: We included 16 RCTs comprising 3729 subjects in the meta-analyses. Anti-inflammatory therapies can significantly reduce the level of fasting plasma glucose (FPG) (MD = - 10.04; 95% CI: -17.69, - 2.40; P = 0.01), glycated haemoglobin (HbA1c) (MD = - 0.37; 95% CI: - 0.51, - 0.23; P < 0.00001), and C-reactive protein (CRP) (MD = - 1.05; 95% CI: - 1.50, - 0.60; P < 0.00001) compared with control, and therapies targeting IL-1ß in combination with TNF-α have better effects on T2DM than targeting IL-1ß or TNF-α alone. Subgroup analyses suggested that patients with short duration of T2DM may benefit more from anti-inflammatory therapies. Conclusion: Our meta-analyses indicate that anti-inflammatory therapies targeting the pathogenic processes of diabetes can significantly reduce the level of FPG, HbA1c, and CRP in patients with T2DM.
Diabetes Mellitus, Type 2 , Tumor Necrosis Factor-alpha , Humans , Anti-Inflammatory Agents/therapeutic use , C-Reactive Protein/analysis , Diabetes Mellitus, Type 2/drug therapy , Glycated Hemoglobin , Glycemic Control , Interleukin-1beta , Tumor Necrosis Factor-alpha/therapeutic use
The far field directivity is a straightforward indicator to describe the radiation pattern of the audio sound generated by a parametric array loudspeaker (pal), but its accurate and computationally efficient prediction is still challenging at present. This paper derives two-dimensional (2D), three-dimensional (3D), and 3D axisymmetric convolution models for calculating the far field directivity based on the quasilinear solution of Westervelt equation. The obtained expressions are expressed as linear and spherical convolutions of the ultrasound directivity and Westervelt directivity for 2D and 3D models, respectively. To improve prediction accuracy, the obtained expression is multiplied by an effective directivity resulted from the aperture factor of audio sound. The calculated directivities are compared against the exact solution obtained using the cylindrical and spherical wave expansions for 2D and 3D models, respectively. Numerical results with piston, apodized, and steerable profiles in both 2D and 3D models show that the proposed modified convolution model agrees well with the exact solution. It is also found that sidelobes appear in the audio sound directivity at large aperture sizes and high audio frequencies due to the aperture factor of audio sound, which can be predicted with the proposed method with a relatively low computational expenditure.
A steerable parametric array loudspeaker (PAL) aims to steer a highly directional audio beam without the need to mechanically rotate the source. The Gaussian beam expansion (GBE) method is often used to model PALs because it is a computationally efficient approach, however the method relies on a paraxial approximation that can result in significant inaccuracies at large steering angles. To address this limitation, a steerable non-paraxial GBE is proposed in this article, where the mainlobe of the steered ultrasonic beam is included in the calculation by rotating the coordinate system. A non-paraxial approximation is then used to improve the accuracy of the method when integrating the virtual audio sources. The numerical results obtained using the proposed method are compared against those using the conventional GBE, as well as an exact solution. For a typical configuration, it is shown that for a conventional GBE the prediction error can be more than 30 dB at large angles, whereas the proposed method reduces this to less than 1 dB. The advantage of the proposed method is more significant at large steering angles, low audio frequencies, and those locations outside of the paraxial region. This improvement in performance is achieved with a computational cost that remains the same as the conventional GBE.
Corynebacterium striatum has recently received increasing attention due to its multiple antimicrobial resistances and its role as an invasive infection/outbreak agent. Recently, whole-genome sequencing (WGS)-based core genome multilocus sequence typing (cgMLST) has been used in epidemiological studies of specific human pathogens. However, this method has not been reported in studies of C. striatum. In this work, we aim to propose a cgMLST scheme for C. striatum. All publicly available C. striatum genomes, 30 C. striatum strains isolated from the same hospital, and 1 epidemiologically unrelated outgroup C. striatum strain were used to establish a cgMLST scheme targeting 1,795 genes (hereinafter referred to as 1,795-cgMLST). The genotyping results of cgMLST showed good congruence with core genome-based single-nucleotide polymorphism typing in terms of tree topology. In addition, the cgMLST provided a greater discrimination than the MLST method based on 6 housekeeping genes (gyrA, gyrB, hsp65, rpoB, secA1, and sodA). We established a clonal group (CG) threshold based on 104 allelic differences; a total of 56 CGs were identified from among 263 C. striatum strains. We also defined an outbreak threshold based on seven allelic differences that is capable of identifying closely related isolates that could give clues on hospital transmission. According to the results of analysis of drug-resistant genes and virulence genes, we identified CG4, CG5, CG26, CG28, and CG55 as potentially hypervirulent and multidrug-resistant CGs of C. striatum. This study provides valuable genomic epidemiological data on the diversity, resistance, and virulence profiles of this potentially pathogenic microorganism. IMPORTANCE Recently, WGS of many human and animal pathogens has been successfully used to investigate microbial outbreaks. The cgMLST schema are powerful genotyping tools that can be used to investigate potential epidemics and provide classification of the strains precise and reliable. In this study, we proposed the development of a cgMLST typing scheme for C. striatum, and then we evaluated this scheme for its applicability to hospital transmission investigations. This report describes the first cgMLST schema for C. striatum. The analysis of hospital transmission of C. striatum based on cgMLST methods has important clinical epidemiological significance for improving nosocomial infection monitoring of C. striatum and in-depth understanding of its nosocomial transmission routes.
Disease Outbreaks , Genome, Bacterial , Animals , Humans , Multilocus Sequence Typing/methods , Molecular Epidemiology/methods
A steerable parametric array loudspeaker (PAL) can electronically steer highly directional audio beams in the desired direction. The challenge of modelling a steerable PAL is to obtain the audio sound pressure in both near and far fields with a low computational load. To address this issue, an extension of the spherical wave expansion is proposed in this paper. The steerable velocity profile on the radiation surface is expanded as Zernike polynomials which are an orthogonal and form a complete set over a unit circle. An expression for the radiated audio sound is then obtained using a superposition of Zernike modes. Compared to the existing methods, the proposed expansion is computationally efficient and provides a rigorous transformation of the quasilinear solution of the Westervelt equation without paraxial approximations. The proposed expansion is further extended to accommodate local effects by using an algebraic correction to the Westervelt equation. Numerical results for steering single and dual beams are presented and discussed. It is shown that the single beam can be steered in the desired direction in both near and far fields. However, dual beams cannot be well separated in the near field, which cannot be predicted by the existing far field models.
Aims: Coronavirus disease 2019 (COVID-19) is caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and within a few months of the first outbreak, it was declared a global pandemic by the WHO. The lethal virus SARS-CoV-2 is transmitted through respiratory droplets and enters host cells through angiotensin-converting enzyme 2 (ACE-2) receptors. ACE-2 receptors are highly expressed in many tissues, including testes. Therefore, the objective of this study was to summarize the available literature regarding the correlation between sex hormone levels and COVID-19. Methods: The PubMed, Web of Science, Embase, and Cochrane Library databases were reviewed systematically through August 2022 for studies comparing sex hormone levels between different patient groups: COVID-19 versus no COVID-19, more severe versus less severe COVID-19, and non-survivors versus survivors. Various types of clinical research reporting sex hormone levels, including free testosterone (FT), luteinizing hormone (LH), follicle-stimulating hormone (FSH), 17ß-oestradiol (E2), the oestradiol-to-testosterone ratio (E2/T), prolactin (PRL), and sex hormone-binding globulin (SHBG), were included. Random- or fixed-effects models were used to calculate weighted mean differences (WMDs) and 95% confidence intervals (CIs). Heterogeneity among the studies was assessed by the I2 index, and data analyses were performed using meta-analysis with Stata version 12.0. Results: Twenty-two articles that included 3369 patients were ultimately included in the meta-analysis. According to analysis of the included studies, patients with COVID-19 had significantly low T/LH, FSH/LH, and SHBG levels and high levels of LH, and E2/T, but their levels of FT, FSH, PRL, E2, and progesterone were not affected. Publication bias was not found according to funnel plots and Egger's regression and Begg's rank correlation tests. Conclusion: Low T/LH, FSH/LH, and SHBG serum levels and high LH, and E2/T levels may increase the risk of COVID-19. Additionally, the greater is the clinical severity of COVID-19, the higher is the probability of increases in LH, and E2/T serum levels and decreases in T/LH, FSH/LH, and SHBG levels. COVID-19 may have unfavourable effects on gonadal functions, which should be taken seriously by clinicians. Routine monitoring of sex hormone levels might help clinicians to evaluate disease severity in patients with COVID-19.
COVID-19 , Male , Humans , COVID-19/epidemiology , SARS-CoV-2 , Luteinizing Hormone , Follicle Stimulating Hormone , Gonadal Steroid Hormones , Testosterone , Estradiol , Prolactin
This work investigates the scattering by a rigid sphere of audio sound generated by a parametric array loudspeaker (pal). A computationally efficient method utilizing a spherical harmonic expansion is developed to calculate the quasilinear solution of audio sound fields based on both Kuznetsov and Westervelt equations. The accuracy of using the Westervelt equation is examined, and the rigid sphere scattering effects are simulated with the proposed method. It is found the results obtained using the Westervelt equation are inaccurate near the sphere at low frequencies. Contrary to conventional loudspeakers, the directivity of the audio sound generated by a pal severely deteriorates behind a sphere, as the ultrasounds maintaining the directivity of the audio sound are almost completely blocked by the sphere. Instead, the ultrasounds are reflected and generate audio sound on the front side of the sphere. It means that a listener in front of the pal will hear the audio sound scattered back after introducing the sphere as if it is reflected by the sphere. The experiment results are also presented to validate the numerical results.
This paper investigates the feasibility of remotely generating a quiet zone in an acoustic free field using multiple parametric array loudspeakers (PALs). A primary sound field is simulated using point monopoles located randomly in a two-dimensional plane, or three-dimensional (3D) space, whereas the secondary sound field is generated by multiple PALs uniformly distributed around the circumference of a circle sitting on the same plane as the primary sources, or on the surface of a sphere for 3D space. A quiet zone size is defined as the diameter of the maximal circular zone within which the noise reduction is greater than 10 dB. The size of this quiet zone is found to be proportional to 0.19λN for N secondary sources with a wavelength λ when the primary and secondary sources are in the same plane, whereas it is found to be 0.55λN1/2 for the 3D case. The size of the quiet zones generated by PALs is similar to that observed with traditional omnidirectional loudspeakers; however, the effects of using PALs on the sound field outside the target zone is much smaller due to their sharp radiation directivity and slow decay rate along the propagation distance. Experimental results are also presented to validate these numerical simulations.
AIMS/INTRODUCTION: There are mixed opinions on the influence of diabetes on the prognosis of patients receiving percutaneous coronary intervention (PCI). Therefore, in this study, the quantitative flow ratio (QFR), an emerging technology of functional evaluation, was used to explore the impact of diabetes on coronary physiology in patients who underwent PCI. MATERIALS AND METHODS: Patients who underwent successful PCI and a 1-year angiographic follow up were retrospectively screened and analyzed by the QFR. Based on the presence or absence of diabetes, 677 enrolled patients (794 vessels) were classified into a diabetes group (211 patients, 261 vessels) and a non-diabetes group (466 patients, 533 vessels). The results of QFR analysis and clinical outcomes were compared between the two groups. RESULTS: The two groups reached a similar level of post-PCI QFR (0.95 ± 0.09 vs 0.96 ± 0.06, P = 0.292). However, at the 1-year follow up, the QFR was lower (0.93 ± 0.11 vs 0.96 ± 0.07, P < 0.001), and the degree of QFR decline was more obvious (-0.024 ± 0.090 vs -0.008 ± 0.070, P = 0.023) in the diabetes group. Additionally, diabetes was independently associated with functional restenosis (odds ratio 2.164, 95% confidence interval 1.210-3.870, P = 0.009) and target vessel failure (odds ratio 2.654, 95% confidence interval 1.405-5.012, P = 0.003). CONCLUSION: As evaluated by the QFR, patients with diabetes received less coronary physiological benefit from PCI, which was consistent with their clinical outcomes.
Coronary Artery Disease , Diabetes Mellitus , Fractional Flow Reserve, Myocardial , Percutaneous Coronary Intervention , Coronary Angiography , Coronary Artery Disease/surgery , Coronary Vessels , Humans , Retrospective Studies
