bluuebunny/crossref_metadata_2025 huggingface dataset:
Surface Solar Extremes in the Most Irradiated Region on Earth, Altiplano
Authors: Cordero Raúl R. , Feron Sarah , Damiani Alessandro , Sepúlveda Edgardo , Jorquera Jose , Redondas Alberto , Seckmeyer Gunther , Carrasco Jorge , Rowe Penny , Ouyang Zutao
Published: June 2023

Satellites have consistently pointed to the Altiplano of the Atacama Desert as the place on Earth where the world’s highest surface irradiance occurs. This region, near the Tropic of Capricorn, is characterized by its high elevation, prevalent cloudless conditions, and relatively low concentrations of ozone, aerosols, and precipitable water. Aimed at studying the variability of the surface solar irradiance and detecting atmospheric composition changes in the Altiplano, an atmospheric observatory was set up in 2016 at the northwestern border of the Chajnantor Plateau (5,148 m MSL, 22.95°S, 67.78°W, Chile). Here, we report on the first 5 years of measurements at this observatory that establish the Altiplano as the region that receives the highest-known irradiation on Earth and illuminate the unique features of surface solar extremes at high-altitude locations. We found that the global horizontal shortwave (SW) irradiance on the plateau is on average 308 W m−2 (equivalent to an annual irradiation of 2.7 MWh m−2 yr−1, the highest worldwide). We also found that forward scattering by broken clouds often leads to intense bursts of SW irradiance; a record of 2,177 W m−2 was measured, equivalent to the extraterrestrial SW irradiance expected at approximately 0.79 astronomical units (AU) from the Sun. These cloud-driven surface solar extremes occur on the Chajnantor Plateau at a frequency, intensity, and duration not previously seen anywhere in the world, making the site an ideal location for studying the response of photovoltaic (PV) power plants to periods of enhanced SW variability.
Supercell Low-Level Mesocyclones: Origins of Inflow and Vorticity
Authors: Coffer Brice E. , Parker Matthew D. , Peters John M. , Wade Andrew R.
Published: June 2023

The development and intensification of low-level mesocyclones in supercell thunderstorms have often been attributed, at least in part, to augmented streamwise vorticity generated baroclinically in the forward flank of supercells. However, the ambient streamwise vorticity of the environment (often quantified via storm-relative helicity), especially near the ground, is particularly skillful at discriminating between nontornadic and tornadic supercells. This study investigates whether the origins of the inflow air into supercell low-level mesocyclones, both horizontally and vertically, can help explain the dynamical role of environmental versus storm-generated vorticity in the development of low-level mesocyclone rotation. Simulations of supercells, initialized with wind profiles common to supercell environments observed in nature, show that the air bound for the low-level mesocyclone primarily originates from the ambient environment (rather than from along the forward flank) and from very close to the ground, often in the lowest 200–400 m of the atmosphere. Given that the near-ground environmental air comprises the bulk of the inflow into low-level mesocyclones, this likely explains the forecast skill of environmental streamwise vorticity in the lowest few hundred meters of the atmosphere. The low-level mesocyclone does not appear to require much augmentation from the development of additional horizontal vorticity in the forward flank. Instead, the dominant contributor to vertical vorticity within the low-level mesocyclone is from the environmental horizontal vorticity. This study provides further context to the ongoing discussion regarding the development of rotation within supercell low-level mesocyclones.

Significance Statement

Supercell thunderstorms produce the majority of tornadoes, and a defining characteristic of supercells is their rotating updraft, known as the “mesocyclone.” When the mesocyclone is stronger at lower altitudes, the likelihood of tornadoes increases. The purpose of this study is to understand if the rotation of the mesocyclone in supercells is due to horizontal spin present in the ambient environment or whether additional horizontal spin generated by the storm itself primarily drives this rotation. Our results suggest that inflow air into supercells and low-level mesocyclone rotation are mainly due to the properties of the environmental inflow air, especially near the ground. This hopefully provides further context to how our community views the development of low-level mesocyclones in supercells.
Challenges in Numerical Weather Prediction of the 10 August 2020 Midwestern Derecho: Examples from the FV3-LAM
Authors: Gallus William A. , Harrold Michelle A.
Published: June 2023

A severe derecho impacted the Midwestern United States on 10 August 2020, causing over $12 billion (U.S. dollars) in damage, and producing peak winds estimated at 63 m s−1, with the worst impacts in Iowa. The event was not forecast well by operational forecasters, nor even by operational and quasi-operational convection-allowing models. In the present study, nine simulations are performed using the Limited Area Model version of the Finite-Volume-Cubed-Sphere model (FV3-LAM) with three horizontal grid spacings and two physics suites. In addition, when a prototype of the Rapid Refresh Forecast System (RRFS) physics is used, sensitivity tests are performed to examine the impact of using the Grell–Freitas (GF) convective scheme. Several unusual results are obtained. With both the RRFS (not using GF) and Global Forecast System (GFS) physics suites, simulations using relatively coarse 13- and 25-km horizontal grid spacing do a much better job of showing an organized convective system in Iowa during the daylight hours of 10 August than the 3-km grid spacing runs. In addition, the RRFS run with 25-km grid spacing becomes much worse when the GF convective scheme is used. The 3-km RRFS run that does not use the GF scheme develops spurious nocturnal convection the night before the derecho, removing instability and preventing the derecho from being simulated at all. When GF is used, the spurious storms are removed and an excellent forecast is obtained with an intense bowing echo, exceptionally strong cold pool, and roughly 50 m s−1 surface wind gusts.
Transmission of child removal stories Among Norwegian Somalis: An interactionist analysis of ethnic minority parents’ fears of child welfare services
Authors: Handulle Ayan , Vassenden Anders
Published: June 2023

Ethnic minority parents who are fearful of child welfare services (CWS) is an acknowledged social problem, but the existing academic understanding is limited. Interpretations in previous research have tended to highlight people's ‘dispositions’, typically cultural backgrounds, and lack of knowledge, or ‘structures’ like welfare and penal systems. More neglected is how CWS fears can be generated from interactional processes within groups. Building on extensive ethnography with Norwegian Somalis, a marginalized migrant group, we extend the sociological understanding of ethnic minority parents’ CWS fears. Relying on an interactionist theoretical framework, we centre Erving Goffman's interaction ritual (e.g., facework) and stigma, which we combine with Robert Putnam's bonding social capital. From this vantage point, we construct a ‘bottom-up’ theoretical model highlighting transmission of child removal stories in tight-knit social networks. Among Norwegian Somalis, fears emanate from a social process with four interconnected factors: (A) adversities and ‘tribal stigma’; (B) bonding social capital, for coping and self-respect; (C) children as a ‘lifeline’. Together these generate (D) wide diffusion of child removal stories, which perpetuates pervasive CWS fears. This model should productively inform comparative research.
Trauma-Induced Median Arcuate Ligament Syndrome is an Under-Recognized Source of Chronic Abdominal Pain
Authors: Fitzpatrick Suzanna , Dunlap Eleanor , Nagarsheth Khanjan
Published: June 2023

Median arcuate ligament syndrome (MALS) can be a debilitating condition resulting in epigastric pain, nausea, difficulty eating due to postprandial pain, weight loss, and malnutrition in otherwise healthy individuals. The pain is caused by the compression of the celiac artery and neural ganglia by the median arcuate ligament as it attaches from the spine to the diaphragm. Diagnostic imaging, either duplex or angiography, can show the abnormality however, vague symptoms can lead to a missed diagnosis. While MALS is a known anatomical variation in the population, to our knowledge, has not been identified to be caused by trauma. Here, we present 4 patients who developed MALS following abdominal or spinal trauma whom all required surgery to alleviate lifestyle-limiting pain.
Fluorescence-Guided Robotic Segment 8 Superior Liver Resection. Technical Approach to Sectoral Inflow Occlusion
Authors: Touadi Melissa , Younos Ahmed , Geunoun Kawtar , Ross Sharona , Sucandy Iswanto
Published: June 2023

In the past decade, precision hepatectomy which requires the understanding of segmental and subsegmental liver anatomy has gained popularity due to its parenchymal-sparing benefits. The importance of this concept has led liver surgeons to a consensus conference and its guideline in regards to precision anatomy in minimally invasive liver resection, held in Tokyo in 2020. A precise control of the sectoral hepatic artery and portal vein allows for a bloodless liver resection, without the use of Pringle maneuver. In the literature, technical description of the right anterior portal pedicle dissection during minimally invasive robotic liver surgery is limited. In this study, we therefore demonstrate such a technique using fluorescence guidance during robotic segment 8 superior liver resection.
Diagnosis and Management of Constitutional Mismatch Repair Deficiency Syndrome
Authors: Winter Kelly , Tan Martin , Briscoe Eric , Hyde Alan , Daniel Stanley J.
Published: June 2023

Constitutional mismatch repair deficiency (CMMRD) syndrome is a rare autosomal recessive genetic disorder that has little more than 200 total cases reported as of 2020. Whereas a single mutation in genes responsible for mismatch repair causes the autosomal dominant Lynch syndrome (LS), CMMRD is caused by biallelic heterozygous defects: distinct deleterious mutations on each allele for a single gene. As the disease is exceedingly rare and may present via a wide variety of signs, including neurofibromatosis type 1- and Lynch Syndrome-associated malignancies, diagnosis and subsequent surveillance are complex with suggested methods published by the International Replication Repair Deficiency Consortium. We report here the history and management of a patient whose newly diagnosed CMMRD was managed with both curative and prophylactic surgical treatment.
The Political Effects of Witnessing State Atrocities: Evidence from the Nazi Death Marches
Authors: De Juan Alexander , Gläßel Christian , Haass Felix , Scharpf Adam
Published: June 2023

How does witnessing regime atrocities influence the political attitudes of bystanders? We argue that observing regime violence against innocent civilians triggers psychological dissonance between beliefs about the regime and the witnessed moral transgression. As a result, regime support should decrease among bystanders of state atrocities. We analyze original, highly disaggregated archival data from the Nazi death marches at the end of World War II, which confronted ordinary German citizens with the regime’s crimes. We find that locations with higher victim numbers had lower vote shares for right-wing nationalist parties after the war. Supporting our proposed mechanism, we show that (1) this effect was strongest when Nazi crimes were at the center of public discourse and (2) that witnessing Nazi atrocities was associated with individuals’ rejection of Hitler 20 years later. The findings have implications for understanding democratization prospects and people’s nostalgia for fallen autocrats.
Comprehensive inter-fibre failure analysis and failure criteria comparison for composite materials using micromechanical modelling under biaxial loading
Authors: Wan Lei , Ullah Zahur , Yang Dongmin , Falzon Brian G.
Published: June 2023

Inter-fibre failure analysis of carbon fibre-reinforced polymer (CFRP) composites, under biaxial loading conditions, has been a longstanding challenge and is addressed in this study. Biaxial failure analysis of IM7/8552 CFRP unidirectional (UD) composites is conducted under various stress states. Two widely accepted failure criteria, the interactive Tsai-Wu and non-interactive Hashin failure criteria, are comprehensively assessed with finite element-based micromechanical analysis. High-fidelity three-dimensional representative volume elements (RVEs) are subjected to biaxial loadings with imposed periodic boundary conditions. Carbon fibres are assumed to be transversely isotropic and linearly elastic. The Drucker-Prager plastic damage constitutive model and cohesive zone model are utilised to simulate the mechanical response of the matrix and fibre-matrix interface, respectively. Coulomb friction is assumed between the fibres and matrix after interface failure. Two sets of biaxial loading scenarios (i.e. transverse stress dominated and shear stress dominated) with the associated failure modes are selected for the failure analysis and assessment of these failure criteria. A data-driven failure envelope for the composites under biaxial loadings is developed using a univariate cubic spline function. Failure mode transition points are determined under biaxial loadings. It is found that the micromechanics-based numerical model is effective in assessing these two existing criteria.
The Ambiguous Nature of Contextual Dynamics During Drug Addiction Recovery: A Qualitative Study of Personal Narratives
Authors: Bellaert Lore , De Ruysscher Clara , Martinelli Thomas F. , Vander Laenen Freya , Sinclair Deborah L. , Vanderplasschen Wouter
Published: June 2023

The concept of recovery has emerged as a prominent paradigm to understand processes of change in individuals with substance use problems. To date, most studies have focused on personal recovery as the key driving force of recovery journeys, generally individualizing the often-disabling social realities that persons in recovery face. To counterbalance this bias, this paper focuses on the contextual dynamics at stake during recovery processes, based on the lived experiences of 30 persons in drug addiction recovery in Flanders (Belgium). A Lifeline Interview Method was applied to elicit recovery narratives, which were thematically analysed. We found that interpersonal relationships, enabling and disabling places, and socio-economic factors facilitate or impede recovery in meaningful ways. The findings also show how these diverse contextual dimensions are interrelated and ambiguous. Researchers, policymakers, and treatment providers should acknowledge the relational nature of recovery and the invalidating impact of stigma across the three identified contextual levels.
Lymphoma recurrence presenting as vocal cord fixation
Authors: Denne Carter M , Schell Stephen , Steehler Andrew
Published: June 2023

Lymphomas of the larynx are a rare finding. Those with lymphoma of the larynx often present with symptoms such as vocal hoarseness, throat pain, dysphagia, and weight loss. This is a case of a 74-year-old man who presents with new onset of hoarseness and dysphagia. He has a previous history of diffuse large B-cell lymphoma (DLBCL) but was thought to be in remission at the time of presentation. On nasolaryngoscopy, there was a large, right sided, sub-mucosal mass with right vocal cord fixation. Physical exam and computed topography of the neck did not identify any adenopathy. Biopsy confirmed the recurrence of DLBCL isolated to the larynx at the time of diagnosis. The patient was treated with chemotherapy and fully recovered his vocal cord motion with resolution of his hoarseness and dysphagia. Physicians should consider lymphoma in patients presenting with laryngeal complaints especially in patients with a history of lymphoma.
Cardiovascular surgical experiences of IVC tumor and thrombus: Operative strategies Based on 51 consecutive patients
Authors: Rahmanian Mehrzad , Badkoubeh Roya Sattarzadeh , Rasouli Seyed Jaber , Nowroozi Mohammad Reza , Saberi Kianoush , Salehi Mehrdad , Larti Farnoosh , Tajaddini Ali , Fatemian Hossein , Rad Mehrdad Rabiee , Dabaghi Ghazal Ghasempour , Malekhosseini Hamidreza
Published: June 2023

Background

The only beneficial treatment option for the management of inferior vena cava (IVC) tumor thrombus is complete tumor removal. The aim of this study was to report our experience in surgical and clinical outcomes in patients with tumor thrombosis in IVC.

Methods

A retrospective chart review of patients who underwent surgical resection of IVC tumor at our institution over the past 10 years was performed. The patients were identified using a prospectively maintained database.

Results

We identified 51 patients, the mean age was 53.4 ± 16.8 years, and 25.4% were female. They were divided into three groups based on tumor thrombosis level. Twenty patients (39.2%) required sternotomy, and cardiopulmonary bypass (CPB) was used in 19 (37.2%) patients, and 2 (3.9%) cases underwent coronary artery bypass graft. The perioperative complications were severe bleeding (3 patients), pulmonary embolism (2 patients), and duodenal perforation (1 patient). Three (5.8%) in-hospital deaths occurred, and all were due to severe abdominal bleeding. After a mean follow-up time of 46.5 ± 42.0 months, 29 (56.9%) patients were alive. The mean survival time was 75.2 ± 8.4 months. In multivariate analysis, higher age ( p = 0.033) and male gender ( p = 0.033) proved to be independent prognostic factors.

Conclusions

Tumor thrombus extending to the IVC is a rare and challenging event. Although using CPB may be safe and result in long-term survival with acceptable function, excessive bleeding during surgery may limit the use of this method.
Living through the pandemic together: Exploring the associations among couples’ communal orientation, self-disclosure, and thriving
Authors: Denes Amanda , Cornelius Talea , Webber Katrina T. , Guest Chelsea , Ellis Julia A. , Gorin Amy A.
Published: June 2023

The present study tested several pathways detailed in the theory of resilience and relational load (TRRL) in the context of urban couples living together during the COVID-19 pandemic. Fifty cohabitating couples completed a baseline assessment and 7 days of daily diaries. Results indicated that, the more an individual or their partner reported being communally oriented within their relationship at baseline, the greater that individual’s relational thriving each day. Results also revealed that, the more an individual reported being communally oriented, the more they viewed their partner as engaging in self-disclosure each day. Two indirect effects emerged, such that one’s own communal orientation positively predicted their perceptions of their partner’s self-disclosure, which in turn predicted greater individual and relational thriving. These findings and their implications for the TRRL, couples’ communication, and coping with pandemic-related stress are discussed.
Sharpening the “essence” of mobbing: An examination of constructive leadership behaviors and negative employee outcomes
Authors: Glaveli Niki , Galanou Aikaterini , Kolias George
Published: June 2023

Drawing on social exchange and affective events theories, this study investigates the relationship between constructive leader behaviors—those associated with ethical, authentic, transformational, and transactional supervision—and employees’ experiences of withdrawal intentions and behaviors (intentions to leave the organization, absenteeism, job neglect, and organizational silence) by examining the mediating role of downward mobbing (DM). The investigation of the research model of this work relies on data (collected from 335 employees in varied workplace settings) and using structural equation modeling, this paper examines the postulated relationships. Results suggest that ethical, authentic, and transformational leadership are negatively related to employee experiences of withdrawal reactions through employee perceptions of being the victims of DM. Interestingly, transactional leadership is the sole significant predictors of DM. Additionally, it was revealed that exposure to DM triggers revenge type social exchanges through the appearance of psychological withdrawal behaviors: job neglect, organizational silence, as well as intentions to leave the organization. However, absenteeism is not related to mobbing, suggesting that mobbing targets choose to be psychologically rather than physically absent from work.
Minimum 5-Year Clinical Outcomes of Arthroscopically Repaired Massive Rotator Cuff Tears: Effect of Age on Clinical Outcomes
Authors: Dey Hazra Rony-Orijit , Dey Hazra Maria E. , Hanson Jared A. , Rutledge Joan C. , Doan Kent C. , Ganokroj Phob , Horan Marilee P. , Dornan Grant J. , Millett Peter J.
Published: June 2023

Background:

Massive rotator cuff tears (MRCTs) can be challenging to treat, and the efficacy of repair of MRCTs in older patients has been debated.

Purpose:

To report minimum 5-year outcomes after primary arthroscopic rotator cuff repair of MRCT and determine whether age affects outcomes.

Study Design:

Case series; Level of evidence 4.

Methods:

The study included consecutive patients with MRCTs who were treated with arthroscopic rotator cuff repair by a single surgeon between February 2006 and October 2016. MRCTs were defined as ≥2 affected tendons with tendon retraction to the glenoid rim and/or a minimum exposed greater tuberosity of ≥67. Patient-reported outcome (PRO) data collected preoperatively and at a minimum of 5 years included the American Shoulder and Elbow Surgeons (ASES) score; Single Assessment Numeric Evaluation (SANE) score; the shortened version of the Disabilities of the Arm, Shoulder and Hand score (QuickDASH); the 12-Item Short Form Health Survey (SF-12) Physical Component Summary (PCS); and patient satisfaction. Surgical failure was defined as subsequent revision rotator cuff surgery or conversion to reverse total shoulder arthroplasty. Regression analysis was performed to determine whether age had an effect on clinical outcomes.

Results:

A total of 53 shoulders in 51 patients (mean age, 59.7 years; range, 39.6-73.8 years; 34 male, 19 female) met inclusion criteria with a mean follow-up of 8.1 years (range, 5.0-12.1 years). Three shoulders (5.7%) failed at 2.4, 6.0, and 7.1 years. Minimum 5-year follow-up was obtained in 45 of the remaining 50 shoulders (90%). Mean PROs improved as follows: ASES from 58.8 to 96.9 ( P < .001), SANE from 60.5 to 88.5 ( P < .001), QuickDASH from 34.2 to 6.8 ( P < .001), and SF-12 PCS from 41.1 to 52.2 ( P < .001). Patient satisfaction was a median of 10 (on a scale of 1-10). Age was not associated with any PRO measures postoperatively ( P > .05).

Conclusion:

This study demonstrated significantly improved clinical scores, decreased pain, and increased return to activity for patients with MRCT at midterm follow-up (mean, 8.1 years; range, 5.0-12.1 years). In this patient cohort, no association was found between age and clinical outcomes.
Effect of Whole Body Parameters on Knee Joint Biomechanics: Implications for ACL Injury Prevention During Single-Leg Landings
Authors: Sadeqi Sara , Norte Grant E. , Murray Amanda , Erbulut Deniz U. , Goel Vijay K.
Published: June 2023

Background:

Previous studies have examined the effect of whole body (WB) parameters on anterior cruciate ligament (ACL) strain and loads, as well as knee joint kinetics and kinematics. However, articular cartilage damage occurs in relation to ACL failure, and the effect of WB parameters on ACL strain and articular cartilage biomechanics during dynamic tasks is unclear.

Purposes:

(1) To investigate the effect of WB parameters on ACL strain, as well as articular cartilage stress and contact force, during a single-leg cross drop (SLCD) and single-leg drop (SLD). (2) To identify WB parameters predictive of high ACL strain during these tasks.

Study Design:

Descriptive laboratory study.

Methods:

Three-dimensional motion analysis data from 14 physically active men and women were recorded during an SLCD and SLD. OpenSim was used to obtain their kinematics, kinetics, and muscle forces for the WB model. Using these data in kinetically driven finite element simulations of the knee joint produced outputs of ACL strains and articular cartilage stresses and contact forces. Spearman correlation coefficients were used to assess relationships between WB parameters and ACL strain and cartilage biomechanics. Moreover, receiver operating characteristic curve analyses and multivariate binary logistic regressions were used to find the WB parameters that could discriminate high from low ACL strain trials.

Results:

Correlations showed that more lumbar rotation away from the stance limb at peak ACL strain had the strongest overall association (ρ = 0.877) with peak ACL strain. Higher knee anterior shear force (ρ = 0.895) and lower gluteus maximus muscle force (ρ = 0.89) at peak ACL strain demonstrated the strongest associations with peak articular cartilage stress or contact force in ≥1 of the analyzed tasks. The regression model that used muscle forces to predict high ACL strain trials during the dominant limb SLD yielded the highest accuracy (93.5%), sensitivity (0.881), and specificity (0.952) among all regression models.

Conclusion:

WB parameters that were most consistently associated with and predictive of high ACL strain and poor articular cartilage biomechanics during the SLCD and SLD tasks included greater knee abduction angle at initial contact and higher anterior shear force at peak ACL strain, as well as lower gracilis, gluteus maximus, and medial gastrocnemius muscle forces.

Clinical relevance:

Knowledge of which landing postures create a high risk for ACL or cartilage injury may help reduce injuries in athletes by avoiding those postures and practicing the tasks with reduced high-risk motions, as well as by strengthening the muscles that protect the knee during single-leg landings.
Lower Extremity Strains in the US National Football League, 2015-2019
Authors: Herzog Mackenzie M. , Weiss Leigh , Lee Rebecca Y. , Williams Tyler , Ramsden Sam , Sills Allen K. , Mack Christina D.
Published: June 2023

Background:

Lower extremity (LEX) strains, including hamstring, quadriceps, adductor, and calf strains, are among the most common injuries in sports. These injuries lead to high burden, resulting in significant missed participation time.

Purpose:

To describe the incidence of LEX strains in professional American football.

Study Design:

Descriptive epidemiology study.

Methods:

This study included all players who played in ≥1 National Football League (NFL) game or sustained a LEX strain during participation in the 2015-2019 seasons. LEX strain frequency was calculated by setting (game, practice, conditioning), timing in season (offseason, preseason, regular season, postseason), and roster position. Game incidence rates were calculated for season, roster position, and play type. LEX strains were identified in the standardized leaguewide electronic health record (n = 32 teams).

Results:

Across 5 years, 5780 LEX strains were reported among 2769 players (1-year risk, 26.7%; 95% CI, 26.0%-27.3%); 69% (n = 4015) resulted in time loss. Among all LEX strains, 54.7% were hamstring (n = 3163), 24.1% adductor (n = 1393), 12.6% calf (n = 728), 8.3% quadriceps (n = 477), and 0.3% multiple muscle groups (n = 19). Most were reported during preseason practices (n = 1076; 27%) and regular season games (n = 1060; 26%). The 2-week period of training camp practices comprised 19% of all time-loss strains. Among game injuries, preseason games had the highest rate of LEX strain (2.9/10,000 player-plays; 95% CI, 2.6-3.2). Defensive secondary players accounted for the highest proportion of time-loss LEX strains (27%; n = 1082). In games, punt plays had nearly twice the injury rate of kickoff plays (14.9/1000 plays [95% CI, 13.1-17.0] vs 7.5/1000 plays [95% CI, 6.2-8.9], respectively) and >3 times the rate of pass plays (4.3/1000 plays; 95% CI, 4.0-4.7) and run plays (2.6/1000 plays; 95% CI, 2.3-2.9). In aggregate, LEX strains led to an estimated 16,748 participation days missed each year and a median 12 days missed per injury.

Conclusion:

LEX strains affected 1 in 4 NFL players each year, resulting in a high burden of injury in terms of time lost from practice and competition. Safe return to the NFL season during training camp and reduction of injuries during regular season games are key focuses for future injury reduction.
Evaluation of workplace exposure to respirable crystalline silica in road construction industries in Alberta
Authors: Couture Ariel , Charuvil Elizabeth Rose Marie , Lefsrud Lianne , Sattari Fereshteh
Published: June 2023

Occupational exposure to respirable crystalline silica (RCS) is common for several occupations in construction, not only because of its presence in many handling materials but also in processes such as grinding and sawing. This study investigated workplace exposure to RCS as quartz in industries and occupations within road construction in Alberta through the RCS monitoring database provided by the Alberta Roadbuilders and Heavy Construction Association (ARHCA) between 2007 and 2016. Descriptive statistics were calculated for exposure-related variables, and mixed model analysis was performed to determine factors affecting the exposure levels. Results showed that the highest exposed workers were in the sand and gravel industry (GM = 45 μg/m3). For worker occupations, geometric means ranged from 78 μg/m3 for crusher operators to 10 μg/m3 for concrete truck operators. The maximum exposure severity was 33.3 times the occupational exposure limit (OEL) for the sand and gravel and 31 times the OEL for tower operators. The results also showed the effect of seasonal variability on RCS exposure levels. The heterogeneous exposure results indicated significant room for improvement and that controls should focus more on the activity performed than the occupation to lower exposure to RCS levels in industries.
Beyond net-zero: Toward a “One Planet” health system
Authors: Hancock Trevor
Published: June 2023

Climate change has captured much attention, but it is just one part of a much larger set of massive and rapid global ecological changes. While the United Nations has taken to referring to the “triple planetary crisis” of climate change, biodiversity loss, and pollution, even this does not capture the full extent of human impact upon the Earth—and thus upon human well-being. Canada’s ecological footprint is equivalent to five planets worth of biocapacity, and healthcare’s footprint is probably greater. So while health systems need to become low-carbon or net-zero, they need to go further. If healthcare is to stand by its ethical duty to do no harm, it must become a “One Planet” system. In addition to becoming a net-zero system, healthcare must reduce the consumption of material resources, the use of toxic substances, and production of all forms of waste, and protect and restore nature.
Association of Incremental peritoneal dialysis with residual kidney function decline in patients on peritoneal dialysis: The balANZ trial
Authors: Hayat Ashik , Cho Yeoungjee , Hawley Carmel M , Htay Htay , Krishnasamy Rathika , Pascoe Elaine , Teitelbaum Isaac , Varnfield Marliene , Johnson David W
Published: June 2023

Background:

Incremental peritoneal dialysis (PD), defined as less than Full-dose PD prescription, has several possible merits, including better preservation of residual kidney function (RKF), lower peritoneal glucose exposure and reduced risk of peritonitis. The aims of this study were to analyse the association of Incremental and Full-dose PD strategy with RKF and urine volume (UV) decline in patients commencing PD.

Methods:

Incident PD patients who participated in the balANZ randomised controlled trial (RCT) (2004–2010) and had at least one post-baseline RKF and UV measurement was included in this study. Patients receiving <56 L/week and ≥56 L/week of PD fluid at PD commencement were classified as Incremental and Full-dose PD, respectively. An alternative cut-point of 42 L/week was used in a sensitivity analysis. The primary and secondary outcomes were changes in measured RKF and daily UV, respectively.

Results:

The study included 154 patients (mean age 57.9 ± 14.1 years, 44% female, 34% diabetic, mean follow-up 19.5 ± 6.6 months). Incremental and Full-dose PD was commenced by 45 (29.2%) and 109 (70.8%) participants, respectively. RKF declined in the Incremental group from 7.9 ± 3.2 mL/min/1.73 m2 at baseline to 3.2 ± 2.9 mL/min/1.73 m2 at 24 months ( p < 0.001), and in the Full-dose PD group from 7.3 ± 2.7 mL/min/1.73 m2 at baseline to 3.4 ± 2.8 mL/min/1.73 m2 at 24 months ( p < 0.001). There was no difference in the slope of RKF decline between Incremental and Full-dose PD ( p = 0.78). UV declined from 1.81 ± 0.73 L/day at baseline to 0.64 ± 0.63 L/day at 24 months in the Incremental PD group ( p < 0.001) and from 1.38 ± 0.61 L/day to 0.71 ± 0.46 L/day in the Full-dose PD group ( p < 0.001). There was no difference in the slope of UV decline between Incremental and Full-dose PD ( p = 0.18).

Conclusions:

Compared with Full-dose PD start, Incremental PD start is associated with similar declines in RKF and UV.
Finite element based indentation contact analysis of SWCNT nano-composite
Authors: Bhadra Rakesh , Jana Tamonash , Mitra Anirban , Sahoo Prasanta
Published: June 2023

The focus of the present study is to simulate the indentation type contact behaviour of single walled carbon nanotube (SWCNT) based nanocomposite. The contact system consists of a deformable Aluminium matrix, reinforced with a group of SWCNTs, and a conical indenter which is assumed as rigid. Downward and upward displacement is imparted on the conical indenter in order to simulate the loading and unloading phases of the contact. The model has been developed using APDL code on the ANSYS platform. Adequacy and validity of the model has been established by comparison with results from already published papers available in literature and the matching between the two sets of results is found to be excellent. In terms of results, contact forces, contact area, contact pressure and deformation behaviour are extracted from the analysis with varying wall thickness of CNTs. Detailed analysis of the obtained results has been carried out and it is found that sink in and pile up (in one particular scenario) behaviour is exhibited. It is also found that due to high deformation of the tubes at high indentation depth, there is material flow towards the axis of symmetry and creation of small elastic zones in the matrix material.
Adaptive Encoding Speed in Working Memory
Authors: de Jong Joost , van Rijn Hedderik , Akyürek Elkan G.
Published: June 2023

Humans can adapt when complex patterns unfold at a faster or slower pace, for instance when remembering a grocery list that is dictated at an increasingly fast rate. Integrating information over such timescales crucially depends on working memory, but although recent findings have shown that working memory capacity can be flexibly adapted, such adaptations have not yet been demonstrated for encoding speed. In a series of experiments, we found that young adults encoded at a faster rate when they were adapted to overall and recent stimulus duration. Interestingly, our participants were unable to use explicit cues to speed up encoding, even though these cues were objectively more informative than statistical information. Our findings suggest that adaptive tuning of encoding speed in working memory is a fundamental but largely implicit mechanism underlying our ability to keep up with the pace of our surroundings.
Prevalence of colorectal cancer and breast cancer screening according to history of diabetes in 2010–2019
Authors: Liu Zechen , Song Mingyang
Published: June 2023

As cancer is overtaking cardiovascular disease as the leading cause of death among diabetics, improved cancer prevention efforts are needed for individuals with diabetes. In this research letter, we used data from the US National Health Interview Survey to examine the use of screening for two major diabetes-related cancers, colorectal cancer, and breast cancer, in individuals with and without diabetes. We found that individuals with diabetes had slightly higher use of colorectal cancer screening and similar use of breast cancer screening compared to those without diabetes in the US. Besides, despite the increasing use of colorectal cancer and breast cancer screening over the past 10 years, screening uptake remains suboptimal. We believe that these findings provide important data to inform policymaking and cancer prevention efforts.
Cardioprotection and its Translation: A Need for New Paradigms? Or for New Pragmatism? An Opinionated Retro- and Perspective
Authors: Heusch Gerd
Published: June 2023

The dawn of cardioprotection by infarct size reduction originated from the idea to favourably alter the oxygen demand–supply balance of the ischaemic/infarcting myocardium by reducing the contractile determinants of its oxygen consumption. This idea is probably not correct, since the ischaemic/infarcting myocardium does not contract anyway. None of the successful initial preclinical attempts of infarct size reduction translated into clinical practice, except for timely reperfusion which has become and still is the backbone of all clinical infarct therapy up today. The idea of cardioprotection gained momentum again with the recognition of ischaemic conditioning, and a myriad of preclinical studies have identified molecules and mechanisms of such self-defence mechanism. Although there are positive clinical proof-of-concept studies, ischaemic conditioning strategies and drugs related to its signal transduction have not translated into clinical practice. We are currently trying to understand the obstacles to translation from successful preclinical studies on cardioprotection to clinical practice, but are also waiting for an innovative mechanistic breakthrough.
Implementation and evaluation of a shared care model between oncologists and pharmacists for breast cancer patients at a Canadian regional ambulatory cancer centre
Authors: Goh Elaine , Labelle Sylvie , Chan Angela
Published: June 2023

Background

The introduction of CDK 4/6 inhibitors for breast cancer patients has contributed to increased ambulatory patient visits for oncologists. The Medication Assessment by Pharmacist program aims to evaluate the impact of oncology pharmacists performing medication assessment follow-up visits.

Methods

Breast cancer patients on a CDK 4/6 inhibitor deemed suitable by their oncologist for pharmacist assessment could be booked for a pharmacist medication assessment appointment at alternate treatment cycles.

Results

Between February 2019 to November 2021, 29 of 128 patients (22.7%) were selected for 46 total Medication Assessment by Pharmacist visits resulting in 920 min of clinic time savings for physicians. There were similar rates of adhering to provincial protocols for scheduling visits (99% vs. 96%, p  =  0.12) and monitoring investigations (98% vs. 98%, p  =  0.96) between those enrolled in Medication Assessment by Pharmacist or not. Surveys completed by medical oncologists and pharmacists demonstrated that nine of nine oncologists felt Medication Assessment by Pharmacist reduced workload and wanted Medication Assessment by Pharmacist expanded to additional oncology drugs. Pharmacist-completed surveys revealed that nine of nine pharmacists felt Medication Assessment by Pharmacist increased job satisfaction, and allowed further application of clinical skills. All agreed that patients were receptive to meeting with pharmacists. According to survey results, 33% of oncologists versus 100% of pharmacists routinely asked about medication adherence, new medications or supplements.

Conclusion

Integrating pharmacists into a shared care model reduces ambulatory patient visits for oncologists without deviating from provincial protocol guidelines for monitoring and visits for patients on CDK 4/6 inhibitors. Leveraging the medication expertise of pharmacists also increases the frequency of addressing medication adherence and concurrent therapies. Medication Assessment by Pharmacist may be an effective strategy in alleviating projected shortages of oncology providers.
Out-of-plane crashworthiness of hierarchical cellular topology with different wall thicknesses in hierarchies
Authors: Zhang Yuwu , Liu Guoliang , Liu Shu , Li Yugang
Published: June 2023

Hierarchical honeycomb is a topology presenting better weight-efficiency than the conventional honeycomb. However, the existing research are mainly conducted based on an assumption of uniform in-plane wall thickness. Rare studies consider the effect of different wall thicknesses in hierarchies. This paper investigates the out-of-plane crashworthiness of vertex hexagonal-based hierarchical honeycombs with non-uniform wall thickness in distinct hierarchies experimentally and theoretically. The coupons with parent material of 316L steel are obtained using Selective Laser Melting fabricating technique. The experimental results indicate that the first order honeycombs with uniform wall thickness experience a failure mechanism transition from local elastic buckling to local plastic buckling of cell walls at the critical density of 0.0772. A progressive folding wave can be identified when relative density is lower than 0.0386. At any edge length ratio, the plateau crushing stress increases monotonously as the increase of the wall thickness ratio, but not for the half wavelength. Both the half wavelength and maximum plateau crushing stresses are linearly related to relative density. For the first order honeycombs, the effect of edge length ratio is more considerable on the plateau crushing stress than the wall thickness ratio. The second order honeycombs exhibit higher half wavelengths and maximum plateau crushing stresses than the first order honeycombs owing to the more considerable cell wall constraint among the hierarchies. Compared to the hierarchical honeycombs with uniform wall thicknesses at relative densities of 0.005∼0.0386, the non-uniform wall thickness enhances the maximum plateau crushing stress significantly, especially at a low relative density, and the maximum improvements for first order and second order honeycombs are 71.5 and 48.6%, respectively. However, the absolute improvements are similar, averaging approximately 1.18 MPa. This work provides a foundation for developing ultralight hierarchical material candidates applied in passive protection equipment, such as aircrafts and vehicles.
The retina-brain axis and diabetic retinopathy
Authors: Ebrahimi Moein , Thompson Paul , Lauer Andreas K , Sivaprasad Sobha , Perry George
Published: June 2023

Diabetic retinopathy (DR) is a major contributor to permanent vision loss and blindness. Changes in retinal neurons, glia, and microvasculature have been the focus of intensive study in the quest to better understand DR. However, the impact of diabetes on the rest of the visual system has received less attention. There are reports of associations of changes in the visual system with preclinical and clinical manifestations of diabetes. Simultaneous investigation of the retina and the brain may shed light on the mechanisms underlying neurodegeneration in diabetics. Additionally, investigating the links between DR and other neurodegenerative disorders of the brain including Alzheimer's and Parkinson's disease may reveal shared mechanisms for neurodegeneration and potential therapy options.
Evaluation of tribological properties of vegetable oil–based ionanolubricants: An experimental study
Authors: Kumar Gitesh , Garg H C
Published: June 2023

Growing environment concern has forced us for the development of environmentally acceptable lubricants. In this study, tribological properties of sesame oil and castor oil containing imidazolium-based ionic liquid 1-ethyl 3methylimidazolium dicyanamide ([EMIM][DCN]) (IL1), phosphonium-based ionic liquid Trihexyltetradecylphosphonium bis(2,4,4-trimethylpentyl) phosphinate ([P66614][BTMPP]) (IL2) and titanium oxide (TiO2) nanoparticles (NPs) as hybrid additives have been investigated using four-ball tester with ASTM D4172B. Three different concentrations of IL1, IL2 and TiO2 NPs were selected for the formulation of vegetable oil–based ionanolubricants. It was found that castor oil with the addition of 0.03[Formula: see text] of TiO2 NPs and 1.3 vol.% of IL1 shows the lowest specific wear rate amongst all investigated lubricant samples. It is evident from field emission scanning electron microscopy analysis of worn-out surfaces of steel balls that a combination of ball bearing effect and tribofilm formation is responsible for the improved tribological characteristics.
Developing innovation capability in the hotel industry, who and what is important? A mixed methods approach
Authors: Chandran VGR , Ahmed Tariq , Jebli Fedwa , Josiassen Alexander , Lang Eva
Published: June 2023

This study employs a sequential mixed methods design to examine the dynamic roles of leadership, customer orientation, and customer collaboration on the innovation capability and performance of Malaysian hotels. An exploratory qualitative assessment based on semi-structured interviews was conducted to provide a comprehensive understanding of the contextual environment and establish a robust conceptual framework. A confirmatory survey among Malaysian hotel managers allowed for the empirical testing of the hypotheses. The results suggest that customer orientation is a key element that directly promotes hotels’ innovation capabilities. The results further show that the influence of customer collaboration on innovation can be enhanced by a transformational leader. Improvements in innovation capabilities have lasting effects on hotel performance, underscoring their strategic importance in the dynamic hospitality sector. These findings offer important implications for top management and decision-making personnel seeking to leverage innovation as a means of improving performance and gaining a competitive edge.
Black summer on TikTok and ABC news: Shaping cultural identity during an Australian bushfire crisis
Authors: van der Nagel Emily , Hutchinson Jonathon , Abidin Crystal , Kaye Bondy
Published: June 2023

This study investigates the role of two intermediaries, a mainstream media outlet and a popular digital media platform, to shape cultural identity through a case study of the 2019-2020 Australian bushfire crisis (colloquially known as the ‘Black Summer’). Theoretically framed by networked publics, this study explores the vernacular creativity of social media users and mainstream media coverage during the Black Summer bushfire crisis. Findings draw on a thematic analysis of 100 news articles published between September 2019 and January 2020 by the Australian Broadcasting Corporation (ABC) randomly selected from a larger corpus of bushfire coverage ( n = 1269) and 120 TikTok videos posted between November 2019 and January 2021 that included prominent hashtags associated with the bushfires. Findings from news coverage highlight the ways in which the ABC framed the role of social media to connect with wider audiences while preserving their values as a public service media outlet. Findings from TikTok videos illustrate the role of ‘templates’ that encourage user participation and vernacular creativity on the platform. Comparing coverage of the bushfires on the ABC and TikTok revealed a shared set of striking visual elements used to shape cultural identity, communicate information, and make sense of a significant public crisis. This article offers directions for future research to explore the relationships and tensions between digital content creators and journalists and their capacity to create and contest cultural identities and imaginaries.