Noninvasive Vocal Biomarker is Associated With Severe Acute Respiratory Syndrome Coronavirus 2 Infection.

OBJECTIVE: To investigate the association of voice analysis with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. PATIENTS AND METHODS: A vocal biomarker, a unitless scalar with a value between 0 and 1, was developed based on 434 voice samples. The biomarker training was followed by a prospective, multicenter, observational study. All subjects were tested for SARS-CoV-2, had their voice recorded to a smartphone application, and gave their informed consent to participate in the study. The association of SARS-CoV-2 infection with the vocal biomarker was evaluated. RESULTS: The final study population included 80 subjects with a median age of 29 [range, 23 to 36] years, of whom 68% were men. Forty patients were positive for SARS-CoV-2. Infected patients were 12 times more likely to report at least one symptom (odds ratio, 11.8; P<.001). The vocal biomarker was significantly higher among infected patients (OR, 0.11; 95% CI, 0.06 to 0.17 vs OR, 0.19; 95% CI, 0.12 to 0.3; P=.001). The area under the receiver operating characteristic curve evaluating the association of the vocal biomarker with SARS-CoV-2 status was 72%. With a biomarker threshold of 0.115, the results translated to a sensitivity and specificity of 85% (95% CI, 70% to 94%) and 53% (95% CI, 36% to 69%), respectively. When added to a self-reported symptom classifier, the area under the curve significantly improved from 0.775 to 0.85. CONCLUSION: Voice analysis is associated with SARS-CoV-2 status and holds the potential to improve the accuracy of self-reported symptom-based screening tools. This pilot study suggests a possible role for vocal biomarkers in screening for SARS-CoV-2-infected subjects.

Modeling the sensitivity dependence of silicon-photonics-based ultrasound detectors.

With recent advances in optical technology, interferometric sensing has grown into a highly versatile approach for ultrasound detection, with many interferometric detectors relying on optical waveguides to achieve high levels of sensitivity and miniaturization. In this Letter, we establish a practical model for assessing the sensitivity of silicon-photonics waveguides to acoustic waves. The analysis is performed for different polarizations, waveguide dimensions, and acoustic wave types. Our model was validated experimentally in the acoustic frequency band of 1-13 MHz by measuring the sensitivities of the two polarization modes in a silicon strip waveguide. Both the experimental results and theoretical prediction show that the transverse-magnetic polarization achieves a higher sensitivity and suppression of surface acoustic waves compared to the transverse-electric polarization for the geometries studied.

Is serum lactate necessary in patients with normal anion gap and serum bicarbonate?

INTRODUCTION: There has been an increase in patients having serum lactate drawn in emergency situations. The objective of this study was to determine whether or not it was necessary to obtain a lactate level in patients with a normal serum bicarbonate level and anion gap. METHODS: This is a retrospective chart review evaluation of 304 patients who had serum lactate and electrolytes measured in an emergency setting in one academic medical center. RESULTS: In 66 patients who had elevated serum lactate (>2.2mmol/L), 45 (68%) patients had normal serum bicarbonate (SB) (greater than 21 mmol/L). Normal anion gap (AG) (normal range <16 mEq/l) was found in 51 of the 66 patients (77%). CONCLUSION: We found that among patients with elevated serum lactate, 77% had a normal anion gap and 68% had normal serum bicarbonate. We conclude serum lactate should be drawn based on clinical suspicion of anaerobic tissue metabolism independent of serum bicarbonate or anion gap values.

Exact modeling of cylindrical metal-dielectric multilayers beyond the effective medium approximation.

We present a semi-analytical method for accurate modeling of wave propagation in cylindrically symmetric subwavelength metal-dielectric multilayers. Utilizing a cylindrical transfer matrix method, we compute the amplitude transfer function of cylindrical hyperlens, simulate the exact field distribution and propagation for a given source and compare it to that in effective hyperbolic medium. We investigate the conditions under which the effective medium theory (EMT) is valid and show that in cylindrical configuration, a new degree of freedom is present in the applicability of the EMT-the ratio between the inner radius of the structure and the unit cell size.

Cushing's reflex in a rare case of adult medulloblastoma.

BACKGROUND: Medulloblastoma is a primitive neuro-ectodermal tumor. It is common in childhood, but rarely seen at adult age, comprising only 1% of primary brain tumors. METHODS: We treated a 31-year-old man presented to the emergency department (ED) with a chief complaint of nausea and vomiting for one week duration. Immediate frozen section revealed a grade IV medulloblastoma. During the hospital course, the patient was given craniospinal irradiation with chemotherapy. RESULTS: The patient was eventually discharged from the hospital to an assisted living facility after an uneventful 15-day course with the aid of social work. CONCLUSIONS: Despite intracranial tumors generally being slow growing masses, this patient demonstrates how quickly one can decompensate, and how important it is to recognize these clinical signs and symptoms of an intracranial lesion. Although these symptoms (i.e. Cushing response) are extremely rare, the ED physician should be aware and appreciate their clinical significance.

Cushing's reflex in a rare case of adult medulloblastoma / 世界急诊医学杂志（英文）

BACKGROUND:Medulloblastoma is a primitive neuro-ectodermal tumor. It is common in childhood, but rarely seen at adult age, comprising only 1％ of primary brain tumors. METHODS:We treated a 31-year-old man presented to the emergency department (ED) with a chief complaint of nausea and vomiting for one week duration. Immediate frozen section revealed a grade IV medulloblastoma. During the hospital course, the patient was given craniospinal irradiation with chemotherapy. RESULTS:The patient was eventually discharged from the hospital to an assisted living facility after an uneventful 15-day course with the aid of social work. CONCLUSIONS:Despite intracranial tumors generally being slow growing masses, this patient demonstrates how quickly one can decompensate, and how important it is to recognize these clinical signs and symptoms of an intracranial lesion. Although these symptoms (i.e. Cushing response) are extremely rare, the ED physician should be aware and appreciate their clinical significance.

Nonlinear hyperlens.

The performance of an optical hyperlens made of metal-dielectric layers can be improved by incorporating self-focusing nonlinearity in the dielectric layers. Using a modified beam propagation method in cylindrical coordinates, we show increased bandwidth and better propagation length, which can improve the spatial and temporal resolution of the device.