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Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

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At least 19 records

Linear Mixed-Effects Models for Human-in-the-Loop Tracking Experiment Data

Linear mixed-effects models provide several benefits over more traditional statistical inference tests that are particularly useful for most human-in-the-loop tracking experiment data. However, surprisingly, mixed models are virtually not used for the analysis of tracking experiment data. This paper uses of linear mixed-effects models to analyze combined tracking data from two previous human-in-the-loop roll tracking experiments that compared control behavior metrics collected in both a research aircraft and a motion-base simulator. In the experiments, pilots' behavior under 10 different motion configurations with varying motion filter gains and break frequencies was evaluated and compared to that in the real aircraft. The linear mixed-effects model analysis on the combined dataset confirmed the main statistical outcomes of the individual experiments. The main benefits of mixed models for this type of data were demonstrated by successfully combining data from two experiments that used different experimental conditions and of which one had an additional apparatus and the other a missing participant. Finally, the mixed-model analysis was able to explicitly test for scientifically relevant statistical differences in the dependent measures between the aircraft and simulator, as well as both experiments.

manual control↗

HighDimMixedModels.jl: Robust high-dimensional mixed-effects models across omics data

High-dimensional mixed-effects models are an increasingly important form of regression in which the number of covariates rivals or exceeds the number of samples, which are collected in groups or clusters. The penalized likelihood approach to fitting these models relies on a coordinate descent algorithm that lacks guarantees of convergence to a global optimum. Here, we empirically study the behavior of this algorithm on simulated and real examples of three types of data that are common in modern biology: transcriptome, genome-wide association, and microbiome data. Our simulations provide new insights into the algorithm’s behavior in these settings, and, comparing the performance of two popular penalties, we demonstrate that the smoothly clipped absolute deviation (SCAD) penalty consistently outperforms the least absolute shrinkage and selection operator (LASSO) penalty in terms of both variable selection and estimation accuracy across omics data. To empower researchers in biology and other fields to fit models with the SCAD penalty, we implement the algorithm in a Julia package, HighDimMixedModels.jl .

Gorstein, Evan↗

Evaluation of partial volume correction and analysis of longitudinal [ 18 F]GTP1 tau PET imaging in Alzheimer's disease using linear mixed-effects models

Purpose: We evaluated the impact of partial volume correction (PVC) methods on the quantification of longitudinal [ 18 F]GTP1 tau positron-emission tomography (PET) in Alzheimer's disease and the suitability of describing the tau pathology burden temporal trajectories using linear mixed-effects models (LMEM). Methods: We applied van Cittert iterative deconvolution (VC), 2-compartment, and 3-compartment, and the geometric transfer matrix plus region-based voxelwise methods to data acquired in an Alzheimer's disease natural history study over 18 months at a single imaging site. We determined the optimal PVC method by comparing the standardized uptake value ratio change (%ΔSUVR) between diagnostic and tau burden–level groups and the longitudinal repeatability derived from the LMEM. The performance of LMEM analysis for calculating %ΔSUVR was evaluated in a natural history study and in a multisite clinical trial of semorinemab in prodromal to mild Alzheimer's disease by comparing results to traditional per-visit estimates. Results: The VC, 2-compartment, and 3-compartment PVC methods had similar performance, whereas region-based voxelwise overcorrected regions with a higher tau burden. The lowest within-subject variability and acceptable group separation scores were observed without PVC. The LMEM-derived %ΔSUVR values were similar to the per-visit estimates with lower variability. Conclusion: The results indicate that the tested PVC methods do not offer a clear advantage or improvement over non-PVC images for the quantification of longitudinal [ 18 F]GTP1 PET data. LMEM offers a robust framework for the longitudinal tau PET quantification with low longitudinal test–retest variability. Clinical trial registration: NCT02640092 and NCT03289143.

60 APPLIED LIFE SCIENCES↗

Estimating basis functions in massive fields under the spatial mixed effects model

Abstract Spatial prediction is commonly achieved under the assumption of a Gaussian random field by obtaining maximum likelihood estimates of parameters, and then using the kriging equations to arrive at predicted values. For massive datasets, fixed rank kriging using the expectation–maximization algorithm for estimation has been proposed as an alternative to the usual but computationally prohibitive kriging method. The method reduces computation cost of estimation by redefining the spatial process as a linear combination of basis functions and spatial random effects. A disadvantage of this method is that it imposes constraints on the relationship between the observed locations and the knots. We develop an alternative method that utilizes the spatial mixed effects model, but allows for additional flexibility by estimating the range of the spatial dependence between the observations and the knots via an alternating expectation conditional maximization algorithm. Experiments show that our methodology improves estimation without sacrificing prediction accuracy while also minimizing the additional computational burden of extra parameter estimation. The methodology is applied to a temperature dataset archived by the United States National Climate Data Center, with improved results over previous methodology.

Pazdernik, Karl↗

Mixed Effect Modeling of Dose and Linear Energy Transfer Correlations With Brain Image Changes After Intensity Modulated Proton Therapy for Skull Base Head and Neck Cancer

Intensity modulated proton therapy (IMPT) could yield high linear energy transfer (LET) in critical structures and increased biological effect. For head and neck cancers at the skull base this could potentially result in radiation-associated brain image change (RAIC). The purpose of the current study was to investigate voxel-wise dose and LET correlations with RAIC after IMPT.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Daily Kilometer-Scale MODIS Satellite Maps of PM2.5 Describe Wintertime Episodes

The San Joaquin Valley (SJV) suffers from severe health-endangering episodes of PM2.5 aerosol loadings in wintertime; episodes last approximately 5 days and differ in geographical distribution and composition. PM2.5 stations are scattered; consequently the use of remote sensing to map variable regional patterns of these varying respirable aerosol concentrations is desirable. High-precision AOT retrievals can capture column particulate loading. However,PM2.5 mapping is challenging due to several reasons: particularly thin mixed layers (ML) and thus relatively low aerosol optical thickness (AOT) close to current measurement limits, variable and a typical composition of the aerosols, and complex surface bidirectional reflectance. However, the West does present some advantages in analysis. Air basins are isolated from long-distance transport, and experience predominant strong meteorological subsidence. Thus these Western basin regions have fewer problematic cases of overriding aerosol layers detached from the surface. To counter such local overriding, Chu et al. have described an approach for the Eastern US, and He et al have described a synoptic classification approach useful in Shanghai. The Bay Area Air Quality Management District (BAAQMD) expands our experience with the use of AOT, with lower PM2.5 and several isolated sub-basins. We have prepared daily maps of episodes in each region. We present also a sequence of increasingly detailed statistical models, AOT initially appears to contribute little information; however, inclusion of weather information reveals its utility. Lyapustin and Wang's MultiAngle Implementation of Atmospheric Correction (MAIAC) retrieval for AOT provided the most useful operational remote sensing information for these regions. It provides high (1-km) spatial resolution maps and a high percentage of availability. Empirical regression methods have found that random effects regression models (aka mixed effects models, ME) employing AOT provide good estimates of ground PM2.5 concentrations.Here, we attempt to extend these methods and evaluate the usefulness of AOT with greater physical analysis, based on DISCOVER-AQ4 experience.

Chatfield, Robert B.↗

Evaluation of Plasma Phosphorylated Tau217 for Differentiation Between Alzheimer Disease and Frontotemporal Lobar Degeneration Subtypes Among Patients With Corticobasal Syndrome

Plasma phosphorylated tau217 (p-tau217), a biomarker of Alzheimer disease (AD), is of special interest in corticobasal syndrome (CBS) because autopsy studies have revealed AD is the driving neuropathology in up to 40% of cases. This differentiates CBS from other 4-repeat tauopathy (4RT)–associated syndromes, such as progressive supranuclear palsy Richardson syndrome (PSP-RS) and nonfluent primary progressive aphasia (nfvPPA), where underlying frontotemporal lobar degeneration (FTLD) is typically the primary neuropathology. To validate plasma p-tau217 against positron emission tomography (PET) in 4RT-associated syndromes, especially CBS. This multicohort study with 6, 12, and 24-month follow-up recruited adult participants between January 2011 and September 2020 from 8 tertiary care centers in the 4RT Neuroimaging Initiative (4RTNI). All participants with CBS (n = 113), PSP-RS (n = 121), and nfvPPA (n = 39) were included; other diagnoses were excluded due to rarity (n = 29). Individuals with PET-confirmed AD (n = 54) and PET-negative cognitively normal control individuals (n = 59) were evaluated at University of California San Francisco. Operators were blinded to the cohort. Plasma p-tau217, measured by Meso Scale Discovery electrochemiluminescence, was validated against amyloid-β (Aβ) and flortaucipir (FTP) PET. Imaging analyses used voxel-based morphometry and bayesian linear mixed-effects modeling. Clinical biomarker associations were evaluated using longitudinal mixed-effect modeling. Of 386 participants, 199 (52%) were female, and the mean (SD) age was 68 (8) years. Plasma p-tau217 was elevated in patients with CBS with positive Aβ PET results (mean [SD], 0.57 [0.43] pg/mL) or FTP PET (mean [SD], 0.75 [0.30] pg/mL) to concentrations comparable to control individuals with AD (mean [SD], 0.72 [0.37]), whereas PSP-RS and nfvPPA showed no increase relative to control. Within CBS, p-tau217 had excellent diagnostic performance with area under the receiver operating characteristic curve (AUC) for Aβ PET of 0.87 (95% CI, 0.76-0.98; P < .001) and FTP PET of 0.93 (95% CI, 0.83-1.00; P < .001). At baseline, individuals with CBS-AD (n = 12), defined by a PET-validated plasma p-tau217 cutoff 0.25 pg/mL or greater, had increased temporoparietal atrophy at baseline compared to individuals with CBS-FTLD (n = 39), whereas longitudinally, individuals with CBS-FTLD had faster brainstem atrophy rates. Individuals with CBS-FTLD also progressed more rapidly on a modified version of the PSP Rating Scale than those with CBS-AD (mean [SD], 3.5 [0.5] vs 0.8 [0.8] points/year; P = .005). In this cohort study, plasma p-tau217 had excellent diagnostic performance for identifying Aβ or FTP PET positivity within CBS with likely underlying AD pathology. Plasma P-tau217 may be a useful and inexpensive biomarker to select patients for CBS clinical trials.

59 BASIC BIOLOGICAL SCIENCES↗

Single reader between-cases AUC estimator with nested data

The area under the receiver operating characteristic curve (AUC) is widely used in evaluating diagnostic performance for many clinical tasks. It is still challenging to evaluate the reading performance of distinguishing between positive and negative regions of interest (ROIs) in the nested-data problem, where multiple ROIs are nested within the cases. To address this issue, we identify two kinds of AUC estimators, within-cases AUC and between-cases AUC. We focus on the between-cases AUC estimator, since our main research interest is in patient-level diagnostic performance rather than location-level performance (the ability to separate ROIs with and without disease within each patient). Another reason is that as the case number increases, the number of between-cases paired ROIs is much larger than the number of within-cases ROIs. We provide estimators for the variance of the between-cases AUC and for the covariance when there are two readers. We derive and prove the above estimators’ theoretical values based on a simulation model and characterize their behavior using Monte Carlo simulation results. We also provide a real-data example. Moreover, we connect the distribution-based simulation model with the simulation model based on the linear mixed-effect model, which helps better understand the sources of variation in the simulated dataset.

Health Care Sciences & Services↗

A Robust Segmented Mixed Effect Regression Model for Baseline Electricity Consumption Forecasting

Renewable energy production has been surging around the world in recent years. To mitigate the increasing uncertainty and intermittency of the renewable generation, proactive demand response algorithms and programs are proposed and developed to further improve the utilization of load flexibility and increase the efficiency of power system operation. One of the biggest challenges to efficient control and operation of demand response resources is how to forecast the baseline electricity consumption and estimate the load impact from demand response resources accurately. In this paper, we propose a mixed effect segmented regression model and a new robust estimate for forecasting the baseline electricity consumption in Southern California, USA, by combining the ideas of random effect regression model, segmented regression model, and the least trimmed squares estimate. Since the log-likelihood of the considered model is not differentiable at breakpoints, we propose a new backfitting algorithm to estimate the unknown parameters. The estimation performance of the new estimation procedure has been demonstrated with both simulation studies and the real data application for the electric load baseline forecasting in Southern California.

42 ENGINEERING↗

The temporal onset of associations of cortical proteins with cognitive resilience vary during late life

Background: Cortical proteins associated with cognitive resilience have been identified but their temporal onset in older adults is unknown. We present a multistage approach to first identify cortical proteins associated with cognitive resilience and then examine their associated temporal onset. Methods: We used data from a subset of 1088 decedents from two cohort-studies who had selected reaction monitoring proteomics from the dorsolateral prefrontal cortex, and at least 3 cognitive assessments. Cognition was assessed using a composite derived from 19 tests. We first used linear mixed-effects models to identify cortical proteins associated with cognitive resilience. We then used functional mixed-effects models to examine non-linear associations between proteins and cognitive resilience to identify their temporal onset. Results: Mean age at death was 90 years (SD = 6.4); 69 % were female. On average, cognition started to decline at around 15 years before death, with accelerated decline in the last 7 years. We identified 40 proteins associated with cognitive resilience, of which 17 proteins also showed non-linear associations. Non-linear associations indicated that higher levels of 10 proteins were associated with slower cognitive decline between 23 and 4 years before death. In contrast, higher levels of 7 proteins were associated with faster decline only within the last 7 years before death. Conclusions: Cognitive resilience proteins are differentially related to late-life cognitive aging; the onset of proteins that maintain cognition may begin many years before the onset of proteins that hasten cognitive decline. The temporal onset of cognitive resilience proteins may be crucial for timing efficacious interventions.

Zammit, Andrea↗

Maps Suggest Transport and Source Processes of PM2.5 at 1 km x 1 km for the Whole San Joaquin Valley, Winter 2011 (Generalizations from DISCOVER-AQ)

We present interpreted data analysis using MAIAC (Multiangle implementation of Atmospheric Correction) retrievals and appropriate RAPid Update Cycle (RAP) meteorology to map respirable aerosol (PM2.5) for the period January and February, 2011. The San Joaquin Valley is one of the unhealthiest regions in the USA for PM2.5 and related morbidity. The methodology evaluated can be used for the entire moderate-resolution imaging spectrometer (MODIS, VIIRS) data record. Other difficult areas of the West: Riverside, CA, Salt Lake City, UT, and Doa Ana County, NM share similar difficulties and solutions. The maps of boundary layer depth for 1116 hr local time from RAP allows us to interpret aerosol optical thickness as a concentration of particles in a nearly well-mixed box capped by clean air. That mixing is demonstrated by DISCOVER-AQ data and afternoon samples from the airborne measurements, P3B (on-board) and B200 (HSRL2 lidar). This data and the PM2.5 gathered at the deployment sites allowed us to estimate and then evaluate consistency and daily variation of the AOT to PM2.5 relationship. Mixed-effects modeling allowed a refinement of that relation from day to day; RAP mixed layers explained the success of previous mixed-effects modeling. Compositional, size-distribution, and MODIS angle-of-regard effects seem to describe the need for residual daily correction beyond ML depth.We report on an extension method to the entire San Joaquin Valley for all days with MODIS imagery using the permanent PM2.5 stations, evaluated for representativeness. Resulting map movies show distinct sources, particularly Interstate-5 (at approx. 1km x 1km resolution) and the broader Bakersfield area. Accompanying winds suggest transport effects and variable pathways of pollution cleanout. Such estimates should allow morbiditymortality studies. They should be also useful for actual model assimilations, where composition and sources are uncertain. We conclude with a description of new work to extend these insights to similar regions, e.g. interior valleys of California, the Po Valley, the Mediterranean litoral, and the Ganges Plain.This work show generalizable use of remote sensing, a major goal of DISCOVER-AQ, Deriving Information on Surface Conditions from COlumn and VERtically Resolved Observations Relevant to Air Quality.

Chatfield, R.↗

Testing Extensions of Our Quantitative Daily of San Joaquin Wintertime Aerosols Using MAIAC and Meteorology Without Transport/Transformation Assumptions

The Western US and many regions globally present daunting difficulties in understanding and mapping PM2.5 episodes. We evaluate extensions of a method independent of source-description and transport/transformation. These regions suffer frequent few-day episodes due to shallow mixing; low satellite AOT and bright surfaces complicate the description. Nevertheless, we expect residual errors in our maps of less than 8 ug/m^3 in episodes reaching 60-100 ug/m^3; maps which detail pollution from Interstate 5. Our current success is due to use of physically meaningful functions of MODIS-MAIAC-derived AOD, afternoon mixed-layer height, and relative humidity for a basin in which the latter are correlated. A mixed-effects model then describes a daily AOT-to-PM2.5 relationship. (Note: in other published mixed-effects models, AOT contributes minimally. We seek to extend on these to develop useful estimation methods for similar situations. We evaluate existing but more spotty information on size distribution (AERONET, MISR, MAIA, CALIPSO, other remote sensing). We also describe the usefulness of an equivalent mixing depth for water vapor vs meteorological boundary layer height. Each has virtues and limitations. Finally, we begin to evaluate methods for removing the complications due to detached but polluted layers (which don't mix to the surface) using geographical, meteorological, and remotely sensed data.

Chatfield, Robert B.↗

Do Remote Camera Arrangements and Image Capture Settings Improve Individual Identification of Golden Eagles?

Individual identification of animals from camera traps has become an important task in wildlife research, but camera deployment methods often do not facilitate this important undertaking. Identification of individual golden eagles (Aquila chrysaetos) is possible using uniquely marked rectrices, but no studies have explored methods to maximize the rate of individual identification from camera images. Furthermore, our objectives were to assess whether different camera heights (1 m vs. 3 m), image capture settings (one image after a 1-min delay vs. burst of 5 images after a 30 sec delay), and arrangements relative to bait (dorsally vs. ventrally aimed) affected views of rectrices on golden eagles and our ability to identify individuals. We conducted our study from 15 December 2016 to 3 March 2017 on the Savannah River Site, South Carolina. First, we developed a scoring system based on views of rectrices and used a linear mixed-effects model to compare image scores among different camera arrangements and image settings. Next, after identifying individual eagles, we used generalized linear mixed-effects models to compare total individual eagle detections, total days an individual was detected, and probability of obtaining an unknown individual identification among camera arrangements and settings. Overall, we scored a total of 27,499 images, with 8,083 providing views of marked rectrices that allowed identification of 18 individual eagles. Average image scores and proportion of images suitable for individual identification were higher from elevated (3 m) camera arrangements than standard arrangements (1 m) across sites. Regardless of camera height, faster frequency of image capture provided more images that could be used to identify individuals and the most trap days per individual. Researchers and managers should consider deploying elevated cameras traps with faster frequency of image capture to improve data quality and potential for analysis of golden eagle populations and trends across the species’ range.

60 APPLIED LIFE SCIENCES↗

Revised (Mixed-Effects) Estimation for Forest Burning Emissions of Gases and Smoke, Fire/Emission Factor Typology, and Potential Remote Sensing Classification of Types for Ozone and Black-Carbon Simulation

We summarize recent progress (a) in correcting biomass burning emissions factors deduced from airborne sampling of forest fire plumes, (b) in understanding the variability in reactivity of the fresh plumes sampled in ARCTAS (2008), DC3 (2012), and SEAC4RS (2013) airborne missions, and (c) in a consequent search for remotely sensed quantities that help classify forest-fire plumes. Particle properties, chemical speciation, and smoke radiative properties are related and mutually informative, as pictures below suggest (slopes of lines of same color are similar). (a) Mixed-effects (random-effects) statistical modeling provides estimates of both emission factors and a reasonable description of carbon-burned simultaneously. Different fire plumes will have very different contributions to volatile organic carbon reactivity; this may help explain differences of free NOx(both gas- and particle-phase), and also of ozone production, that have been noted for forest-fire plumes in California. Our evaluations check or correct emission factors based on sequential measurements (e.g., the Normalized Ratio Enhancement and similar methods). We stress the dangers of methods relying on emission-ratios to CO. (b) This work confirms and extends many reports of great situational variability in emissions factors. VOCs vary in OH reactivity and NOx-binding. Reasons for variability are not only fuel composition, fuel condition, etc., but are confused somewhat by rapid transformation and mixing of emissions. We use "unmixing" (distinct from mixed-effects) statistics and compare briefly to approaches like neural nets. We focus on one particularly intense fire the notorious Yosemite Rim Fire of 2013. In some samples, NOx activity was not so suppressed by binding into nitrates as in other fires. While our fire-typing is evolving and subject to debate, the carbon-burned delta(CO2+CO) estimates that arise from mixed effects models, free of confusion by background-CO2 variation, should provide a solid base for discussion. (c) We report progress using promising links we find between emissions-related "fire types" and promising features deducible from remote observations of plumes, e.g., single scatter albedo, Angstrom exponent of scattering, Angstrom exponent of absorption, (CO column density)/(aerosol optical depth).

Remote sensing↗

Comparative Analyses of Bioequivalence Assessment Methods for In Vitro Permeation Test Data

ABSTRACT For topical, dermatological drug products, an in vitro option to determine bioequivalence (BE) between test and reference products is recommended. In particular, in vitro permeation test (IVPT) data analysis uses a reference‐scaled approach for two primary endpoints, cumulative penetration amount (AMT) and maximum flux ( J max ), which takes the within donor variability into consideration. In 2022, the Food and Drug Administration (FDA) published a draft IVPT guidance that includes statistical analysis methods for both balanced and unbalanced cases of IVPT study data. This work presents a comprehensive evaluation of various methodologies used to estimate critical parameters essential in assessing BE. Specifically, we investigate the performance of the FDA draft IVPT guidance approach alongside alternative empirical and model‐based methods utilizing mixed‐effects models. Our analyses include both simulated scenarios and real‐world studies. In simulated scenarios, empirical formulas consistently demonstrate robustness in approximating the true model, particularly in effectively addressing treatment–donor interactions. Conversely, the effectiveness of model‐based approaches heavily relies on precise model selection, which significantly influences their results. The research emphasizes the importance of accurate model selection in model‐based BE assessment methodologies. It sheds light on the advantages of empirical formulas, highlighting their reliability compared to model‐based approaches and offers valuable implications for BE assessments. Our findings underscore the significance of robust methodologies and provide essential insights to advance their understanding and application in the assessment of BE, employed in IVPT data analysis.

Leon, Sami↗

Spatial Statistical Data Fusion (SSDF)

As remote sensing for scientific purposes has transitioned from an experimental technology to an operational one, the selection of instruments has become more coordinated, so that the scientific community can exploit complementary measurements. However, tech nological and scientific heterogeneity across devices means that the statistical characteristics of the data they collect are different. The challenge addressed here is how to combine heterogeneous remote sensing data sets in a way that yields optimal statistical estimates of the underlying geophysical field, and provides rigorous uncertainty measures for those estimates. Different remote sensing data sets may have different spatial resolutions, different measurement error biases and variances, and other disparate characteristics. A state-of-the-art spatial statistical model was used to relate the true, but not directly observed, geophysical field to noisy, spatial aggregates observed by remote sensing instruments. The spatial covariances of the true field and the covariances of the true field with the observations were modeled. The observations are spatial averages of the true field values, over pixels, with different measurement noise superimposed. A kriging framework is used to infer optimal (minimum mean squared error and unbiased) estimates of the true field at point locations from pixel-level, noisy observations. A key feature of the spatial statistical model is the spatial mixed effects model that underlies it. The approach models the spatial covariance function of the underlying field using linear combinations of basis functions of fixed size. Approaches based on kriging require the inversion of very large spatial covariance matrices, and this is usually done by making simplifying assumptions about spatial covariance structure that simply do not hold for geophysical variables. In contrast, this method does not require these assumptions, and is also computationally much faster. This method is fundamentally different than other approaches to data fusion for remote sensing data because it is inferential rather than merely descriptive. All approaches combine data in a way that minimizes some specified loss function. Most of these are more or less ad hoc criteria based on what looks good to the eye, or some criteria that relate only to the data at hand.

Braverman, Amy J.↗

Bayesian Statistical Models for Community Annoyance Survey Data

This paper demonstrates the use of two Bayesian statistical models to analyze single-event sonic boom exposure and human annoyance data from community response surveys. Each model is fit to data from a NASA pilot study.Unlike many community noise surveys, this study used a panel sample to collect multiple observations per participant instead of a single observation. Thus, a multilevel (also known as hierarchical or mixed-effects) model is used to account for the within-subject correlation in the panel sample data. This paper describes a multilevel logistic regression model and a multilevel ordinal regression model. The paper also proposes a method for calculating a summary dose-response curve from the multilevel models that represents the population. The two models’ summary dose-response curves are visually similar. However, their estimates differ when calculating the noise dose at a fixed percent highly annoyed.

Musical instruments↗