Patients presenting to the emergency department with a possible barbeque brush bristle ingestion pose many challenges. A detailed history and oral examination is needed and the typical first line investigation involves flexible laryngoscopy for direct visualization of the bristle. Given the high rate of false negatives with laryngoscopy, further imaging may be required in patients with a high suspicion of bristle ingestion Case Reports We report on two cases presenting to the emergency department with pain following ingestion of grilled food. In both cases imaging was required to identify and assist with the removal of the bristle. Why Should an Emergency Physician Be Aware of This? Emergency physicians should have a high index of suspicion for bristle ingestion in patients with acute onset of pain or a foreign body sensation after ingesting grilled meats. Patients may require imaging to identify bristles if physical examination and laryngoscopy is negative.
 Patients presenting to the emergency department with a possible barbeque brush bristle ingestion pose many challenges. A detailed history and oral examination is needed and the typical first line investigation involves flexible laryngoscopy for direct visualization of the bristle. Given the high rate of false negatives with laryngoscopy, further imaging may be required in patients with a high suspicion of bristle ingestion Case Reports We report on two cases presenting to the emergency department with pain following ingestion of grilled food. In both cases imaging was required to identify and assist with the removal of the bristle. Why Should an Emergency Physician Be Aware of This? Emergency physicians should have a high index of suspicion for bristle ingestion in patients with acute onset of pain or a foreign body sensation after ingesting grilled meats. Patients may require imaging to identify bristles if physical examination and laryngoscopy is negative.Increasing ethanol demand and public concerns about environmental protection promote the production of lignocellulosic bioethanol. Compared to that of starch- and sugar-based bioethanol production, the production of lignocellulosic bioethanol is water-intensive. A large amount of water is consumed during pretreatment, detoxification, saccharification, and fermentation. Water is a limited resource, and very high water consumption limits the industrial production of lignocellulosic bioethanol and decreases its environmental feasibility. In this review, we focused on the potential for reducing water consumption during the production of lignocellulosic bioethanol by performing pretreatment and fermentation at high solid loading, omitting water washing after pretreatment, and recycling wastewater by integrating bioethanol production and anaerobic digestion. In addition, the feasibility of these approaches and their research progress were discussed. This comprehensive review is expected to draw attention to water competition between bioethanol production and human use.
  Vocal fatigue (VF) is a primary vocal symptom experienced by professional voice users, such as teachers, whose voice is an occupational tool. The study determines the utilization of the Vocal Fatigue Index (VFI), a 19-item scale in identifying symptoms of VF and its severity in teachers.
 
  Using responses of 695 teachers who completed the VFI, Mokken scaling was conducted on the items to identify the experiences of VF and its associated hierarchical nature of VF symptoms in teachers. Mokken scaling was completed on a total of four groups (a) Total teachers group, (b) No VF group, (c) Low VF group, and (d) High VF group.
 
  Results revealed differences in item hierarchies between total teachers and across the separate groups of VF severity. Item hierarchy for teachers highlighted items from physical discomfort at the mild end of the hierarchy to items from symptom improvement with rest at the severe end of the hierarchy. Items related to avoidance presented as a separate scale for teachers presenting with high VF.
 
  Mokken scaling in teachers provides insight into the underlying complexity of the experience of VF symptoms and reliance on differential behavioral strategies in its management, suggesting the heterogenous nature of latent trait for VF in this specific population.
 Mokken scaling in teachers provides insight into the underlying complexity of the experience of VF symptoms and reliance on differential behavioral strategies in its management, suggesting the heterogenous nature of latent trait for VF in this specific population.
  Selexipag is a selective oral prostacyclin receptor agonist indicated for pulmonary arterial hypertension (PAH) treatment. SelexiPag tHe usErs dRug rEgistry (SPHERE) (NCT03278002) is collecting data from selexipag-treated patients in real-world clinical practice to elucidate and describe the clinical characteristics, outcomes, and dosing/titration regimens of patients treated with selexipag in routine clinical practice.
 
  SPHERE is a United States (US)-based, ongoing, multicenter, prospective observational study (target N = 800). This study enrolls patients who are either newly initiated on selexipag (≤60 days before enrollment) or were previously receiving selexipag with documentation of dose titration at study enrollment. Data collection for the study occurs at routine clinic visits. In this paper, we report on the first 500 patients enrolled.
 
  Median follow-up was 17.8 months; 77.6% of patients completed the planned 18 months follow-up, and 22.4% discontinued early from the study. At diagnosis, 94.8% ofe daily).
 
  Real-world, US-based patients with PAH initiating selexipag typically have WHO FC II/III disease and are at intermediate risk, despite receiving PAH-specific treatment. Selexipag was prescribed as part of a combination regimen in most patients. The study identified no unexpected adverse effects.
 Real-world, US-based patients with PAH initiating selexipag typically have WHO FC II/III disease and are at intermediate risk, despite receiving PAH-specific treatment. Selexipag was prescribed as part of a combination regimen in most patients.  https://www.selleckchem.com/products/mps1-in-6-compound-9-.html  The study identified no unexpected adverse effects.