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This study establishes competency indicators for digital electronics contestants in skills competitions to examine instructor importance levels as well as to observe the competency indicator performance of the contestants these instructors had trained. Using a purposive sampling method, the digital electronics skill competition "Golden Hand Award" winners and the 65 teachers selected from Taiwan who had trained the competition contestants in 2007-2015, were taken as the subjects for an importance-performance analysis (IPA). Competence was measured using the five indicators of general discipline, professional field, self-management, characteristics, and professional skills; 17 indicator connotations; and 67 indicator items. It was observed that instructors found professional field indicator facets to be the most important for teacher indicator importance levels, and that professional knowledge and abilities were the most important for the professional field. The results showed the most important of the instructors' cognition in dimensions to be specialised field, and the most important of the instructors' cognition in specialised fields to be professional subjects; the best performance of the contestants in dimensions to be professional skills, and the best performance of the contestants in professional skills to be the ability to measure.

In this study, we determined the diagnostic performance of adding ultrasound (US) with/without fine‐needle aspiration cytology (FNAC) to computed tomography (CT)/magnetic resonance imaging (MRI) in evaluating neck lymphadenopathy (LAP) in patients with head and neck cancer treated with irradiation. We included 269 patients who had neck LAP after radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) resulting from cancers of the head and neck region between October 2008 and September 2018. The diagnostic methods consisted of the following: 1) CT/MRI alone, 2) CT/MRI combined with a post-RT US predictive model, and 3) CT/MRI combined with US + FNAC. We compared their diagnostic performance using receiver operating characteristic (ROC) curves. In total, 141 (52%) malignant and 128 (48%) benign LAPs were observed. Regarding the diagnostic accuracy, the area under the ROC curves was highest for the combined CT/MRI and US + FNAC (0.965), followed by the combined CT/MRI and post-RT US predictive model (0.906) and CT/MRI alone (0.836). Our data suggest that the addition of a US examination to CT/MRI resulted in higher diagnostic performance than CT/MRI alone in terms of diagnosing recurrent or persistent nodal disease during the evaluation of LAP in patients with irradiation-treated head and neck cancer.

The prevention of postoperative recurrence after endoscopic sinus surgery (ESS) relies on targeting specific pathological mechanisms according to individuals' immunological profiles. However, essential biomarkers and biological characteristics of difficult-to-treat chronic rhinosinusitis (CRS) patients are not well-defined. The aim of this study was to explore the immunologic profiles of subgroups of CRS patients and determine the specific cytokines responsible for recalcitrant or recurrent CRS with nasal polyposis (rCRSwNP). We used 30 cytokine antibody arrays to determine the key cytokines related to recurrent polypogenesis. Enzyme-linked immunosorbent assay (ELISA) experiments were conducted to assess the levels of these key cytokines in 78 patients. Polymorphonuclear leukocytes (PMNs) isolated from nasal polyps were challenged with specific cytokines to examine the levels of enhanced interleukin (IL)-8 production. Finally, we used immunohistochemistry (IHC) staining to check for the presence and distribution of the biomarkers within nasal polyps. A cytokine antibody array revealed that IL-8, IL-13, IL-15, and IL-20 were significantly higher in the recalcitrant CRSwNP group. Subsequent ELISA screening showed a stepwise increase in tissue IL-8 levels in the CHR, CRSsNP, and CRSwNP groups. PMNs isolated from nine CRSwNP cases all demonstrated enhanced IL-8 production after IL-15 treatment. IHC staining was labeled concurrent IL-8 and IL-15 expression in areas of prominent neutrophil infiltration. Our results suggest that IL-15 within the sinonasal mucosa plays a crucial role in promoting IL-8 secretion by infiltrating PMNs in recalcitrant nasal polyps. In addition, we propose a novel therapeutic strategy targeting the anti-IL-15/IL-8 axis to treat CRS with nasal polyposis. [ABSTRACT FROM AUTHOR]

Purpose: Previous studies have reported that voice therapy via telepractice is useful for patients with nodules and muscle tension dysphonia. Nevertheless, telepractice for elderly patients with voice disorders has not yet been investigated. We conducted this study to examine the hypothesis that voice therapy via telepractice is not inferior to conventional voice therapy. Method: Eighty patients with dysphonia aged more than 55 years participated in this study from September 2016 to June 2018. After screening the inclusion and the exclusion criteria, 69 patients were randomized into telepractice (33 patients) and conventional (36 patients) groups. The outcome measurements included Voice Handicap Index-10, videolaryngostroboscopy, maximum phonation time, auditory-perceptual evaluation, and acoustic analysis. Paired "t" test, Wilcoxon signed-ranks test, and repeated measures analysis of variance were used to examine treatment outcomes. Results: The diagnoses of voice disorders included atrophy (n = 33), unilateral vocal paralysis (n = 13), muscle tension dysphonia (n = 7), nodules (n = 6), and polyps (n = 10). No significant differences were observed in age, sex, and baseline measurements between the two groups. Twenty-five patients in the telepractice group and 24 patients in the control group completed at least four weekly sessions. Significant improvements were observed for all the outcome measures (p < 0.05) in both groups. Improvements in Voice Handicap Index-10 in the telepractice group (24.84 ± 5.49 to 16.80 ± 8.94) were comparable to those in the conventional group (22.17 ± 7.29 to 13.46 ± 9.95, p = 0.764). Other parameters also showed comparable improvements between the two groups without statistically significant differences. Conclusions: This is the first randomized controlled trial comparing telepractice and conventional voice therapy in elderly patients with voice disorders. The results showed that the effectiveness of voice therapy via telepractice was not inferior to that of conventional voice therapy, indicating that telepractice can be used as an alternative to provide voice care for elderly patients with vocal disorders.

Amplitude modulation (AM) is a common phenomenon associated with wind turbine (WT) related noise annoyance. Within the interdisciplinary project Inter-Wind, acoustic, ground motion, and meteorological data are captured to be evaluated with noise reports of residents living near a wind farm in Southern Germany. The recorded data builds a solid data base for the evaluation of AM. The occurrence of AM is detected within acoustic and ground motion data and set in relation to all available data, including WT operational parameters, meteorology, and noise reports. In this study, the origins of detected AM are tones at 57.8 Hz and 133 Hz, related to the generator and drive train, which are amplitude modulated by the blade passing frequency. AM detection was successful both with acoustic as well as ground motion data. A comparison of a method for AM detection developed by the Institute of Acoustics (IOA reference method) with a method specifically developed to detect AM in ground motion data showed that the reference method detected AM three to six times more often than the newly developed method. AM occurred most likely during stable atmospheric conditions, with a positive lapse rate, and was (albeit to a small degree) more likely to be detected when residents reported higher levels of annoyance.

An accurate prediction of the unsteady loads acting on floating offshore wind turbines (FOWTs) under consideration of wave excitation is crucial for a resource-efficient turbine design. Despite a considerable number of simulation studies in this area, it is still not fully understood which unsteady aerodynamic phenomena have a notable influence on the loads acting on a wind turbine rotor in motion. In the present study, investigations are carried out to evaluate the most relevant unsteady aerodynamic phenomena for a wind turbine rotor in surge motion. As a result, inflow conditions are determined for which a significant influence of these phenomena on the rotor loads can be expected. The experimental and numerical investigations are conducted on a two-bladed wind turbine rotor subjected to a tower-top surge motion. A specialised wind tunnel test rig has been developed to measure the aerodynamic torque response of the rotor subjected to surge motions with moderate frequencies. The torque measurements are compared to two free-vortex-wake (FVW) methods, namely a panel method and a lifting-line method. Unsteady contributions that cannot be captured using quasi-steady modelling have not been detected in either the measurements or the simulations in the covered region of motions ranging from a rotor reduced frequency of 0.55 to 1.09 and with motion velocity amplitudes of up to 9 % of the wind speed. The surge motion frequencies were limited to a moderate range (5 to 10 Hz) due to vibrations occurring in the experiments. Therefore, a numerical study with an extended range of motion frequencies using the panel and the lifting-line method was performed. The results from both FVW methods reveal significant unsteady contributions of the surge motions to the torque and thrust response that have not been reported in the recent literature. Furthermore, the results show the presence of the returning wake effect, which is known from helicopter aerodynamics. Additional simulations of the UNAFLOW scale model and the IEA 15 MW rotor demonstrate that the occurrence of the returning wake effect is independent from the turbine but determined by the ratio of 3P and surge motion frequency. In the case of the IEA 15 MW rotor, a notable impact of the returning wake effect was found at surge motion frequencies in the range of typical wave periods. Finally, a comparison with OpenFAST simulations reveals notable differences in the modelling of the unsteady aerodynamic behaviour in comparison to the FVW methods. [ABSTRACT FROM AUTHOR]

Purpose: Previous studies have reported that voice therapy via telepractice is useful for patients with nodules and muscle tension dysphonia. Nevertheless, telepractice for elderly patients with voice disorders has not yet been investigated. We conducted this study to examine the hypothesis that voice therapy via telepractice is not inferior to conventional voice therapy. Method: Eighty patients with dysphonia aged more than 55 years participated in this study from September 2016 to June 2018. After screening the inclusion and the exclusion criteria, 69 patients were randomized into telepractice (33 patients) and conventional (36 patients) groups. The outcome measurements included Voice Handicap Index-10, videolaryngostroboscopy, maximum phonation time, auditory-perceptual evaluation, and acoustic analysis. Paired t test, Wilcoxon signed-ranks test, and repeated measures analysis of variance were used to examine treatment outcomes. Results: The diagnoses of voice disorders included atrophy (n = 33), unilateral vocal paralysis (n = 13), muscle tension dysphonia (n = 7), nodules (n = 6), and polyps (n = 10). No significant differences were observed in age, sex, and baseline measurements between the two groups. Twenty-five patients in the telepractice group and 24 patients in the control group completed at least four weekly sessions. Significant improvements were observed for all the outcome measures (p < .05) in both groups. Improvements in Voice Handicap Index-10 in the telepractice group (24.84 [+ or -] 5.49 to 16.80 [+ or -] 8.94) were comparable to those in the conventional group (22.17 [+ or -] 7.29 to 13.46 [+ or -] 9.95, p = .764). Other parameters also showed comparable improvements between the two groups without statistically significant differences. Conclusions: This is the first randomized controlled trial comparing telepractice and conventional voice therapy in elderly patients with voice disorders. The results showed that the effectiveness of voice therapy via telepractice was not inferior to that of conventional voice therapy, indicating that telepractice can be used as an alternative to provide voice care for elderly patients with vocal disorders., The number of elderly people in the world is increasing rapidly. According to the World Health Organization, the global elderly population (aged more than 65 years) was about 400 million [...]

Inflow wind field measurements from nacelle-based lidar systems offer great potential for different applications including turbine control, load validation, and power performance measurements. On floating wind turbines nacelle-based lidar measurements are affected by the dynamic behavior of the floating foundations. Therefore, the effects on lidar wind speed measurements induced by floater dynamics must be understood. In this work, we investigate the influence of floater motions on wind speed measurements from forward-looking nacelle-based lidar systems mounted on floating offshore wind turbines (FOWTs) and suggest approaches for correcting motion-induced effects. We use an analytical model, employing the guide for the expression of uncertainty in measurements (GUM) methodology and a numerical lidar simulation for the quantification of uncertainties. It is found that the uncertainty of lidar wind speed estimates is mainly caused by the fore--aft motion of the lidar, resulting from the pitch displacement of the floater. Therefore, the uncertainty is heavily dependent on the amplitude and the frequency of the pitch motion. The bias of 10 min mean wind speed estimates is mainly influenced by the mean pitch angle of the floater and the pitch amplitude. We correct motion-induced biases in time-averaged lidar wind speed measurements with a model-based approach, employing the developed analytical model for uncertainty and bias quantification. Testing of the approach with simulated dynamics from two different FOWT concepts shows good results with remaining mean errors below 0.1m s-1 For the correction of motion-induced fluctuation in instantaneous measurements, we use a frequency filter to correct fluctuations caused by floater pitch motions for instantaneous measurements. The correction approach's performance depends on the pitch period and amplitude of the FOWT design. [ABSTRACT FROM AUTHOR]