bluuebunny/crossref_metadata_2025 huggingface dataset:
Ratcheting Electrophoresis Microchip (REM) for Programmable Transport and Separation of Macromolecules
Authors: Ohara T. , Majumdar A.
Published: November 2021

This paper introduces the concept of a ratcheting electrophoresis microchip (REM), a microfluidic device for electrophoretic separation of macromolecules such as DNA and proteins in aqueous solution using low applied voltages (∼ 1 V). The device consists of several thousands of parallel linear electrodes with a constant pitch of about 10 μm. A spatial saw-tooth like potential distribution generated by the electrode array causes local electrophoretic migration of charged molecules between adjacent electrodes. By cycling the potential distribution in a certain pattern, the spatio-temporal electrophoretic ratchet can be used to separate and manipulate macromolecules at speeds much faster than thermal ratchets or more traditional techniques such as capillary or gel electrophoresis. This paper describes results of two simulations: First, using a simple one-dimensional potential distribution for the ratchet, the basic device function is examined using a probabilistic approach that simulates the interplay between electrophoretic mobility and molecular diffusion. The results suggest that the REM can function as a molecular filter through which only molecules having mobility larger than a threshold can pass. The REM can also be programmed to separate molecules to create a molecular profile, much like conventional electrophoresis. Second, two-dimensional stochastic simulations based on molecular diffusion and transient Debye screening by mobile ions are used to demonstrate the feasibility of the REM. The results suggest that biomolecular separation can indeed be achieved within time and length scales much shorter than capillary and gel electrophoresis.
High-Impulse Digital Microthrusters Using Low-Boiling-Temperature Liquid Propellant With High-Viscosity Fluid Plug
Authors: Kang Tae Goo , Kim Sang Wook , Cho Young-Ho
Published: November 2021

A high-impulse, low-power, digital microthruster has been developed using low-boiling-temperature liquid propellant with high-viscosity fluid plug. The low-boiling-temperature propellant is used for reducing the electrical input power required for blast pressure build-up, while the high-viscosity fluid plug is intended to withhold the propellant pressure for the high-impluse blast. The three-layer microthruster has been fabricated by surface micromachining as well as bulk micromachining in the size of 7mmx13mmx1.5mm. At the continuous operation mode, the maximum output impulse bit of 6.4 × 10−8 N·sec is obtained for the fabricated microthruster using perfluoro normal hexane (FC72) propellant and oil plug.
Zinc Bonding for MEMS Packaging at the Wafer-Level
Authors: Lee Ki Bang , Lin Liwei
Published: November 2021

A new bonding process for MEMS packaging at the wafer-level using electroplated nickel and zinc is demonstrated. Package with the electroplated zinc solder and nickel support for forming the cavity for MEMS has been presented and demonstrated. A set of wafers is bonded at the temperature of 425°C and under the pressure of 1000N/ m2 and examined to estimate the bonding strength of bonded wafer. The bonding strength between zinc and gold is comparable to the fracture of toughness silicon. Bonding mechanism and fabrication process has been discussed.
An Integrated Microfluidic Device for the Continuous Sampling and Analysis of Biological Fluids
Authors: Zahn Jeffrey D. , Deshmukh Ajay A. , Papavasiliou Alexandros P. , Pisano Albert P. , Liepmann Dorian
Published: November 2021

Enzyme based biosensors suffer from loss of activity and sensitivity. One major reason is due to large molecular weight proteins adsorbing on the surface of the sensor. These proteins affect sensor signal stability and disrupt enzyme function. Thus, one fruitful way to minimize the loss of sensor activity is to filter out large molecular weight compounds before they come in contact with the enzyme based biosensor. Further, the removal of free protein from biological solution helps to increase sensor accuracy and lifetime. Therefore, a microdialysis microneedle is introduced that is capable of excluding large MW compounds based on size. These microneedles have been integrated into a planar microfluidic system capable of sampling and analyzing biological solutions. The integrated microfluidic system includes the assembly of microneedles with on-chip flow channels and electronics together with previously designed positive displacement micropumps, microvalves and a planar electro-chemical sensor for biological detection. Multichannel fluidic control for biological sampling, sensor cleansing and recalibration is demonstrated with integrated sensor operation.
A Magnetically Actuated Scanner for Intravascular Ultrasound Imaging
Authors: Chang Carl W. , Budde Thomas , Gatzen Hans H. , Muller Richard S.
Published: November 2021

We have fabricated and tested a magnetically actuated microplatform system for intravascular ultrasound imaging (IVUS). The system consists of a torsional microplatform located above a magnetic drive source. The magnetic source is fabricated on a separate wafer and is made up of a pair of U-shaped permalloy yokes with surrounding coils. Two Ni bars on the ends of the microplatform complete two magnetic circuits that are individually activated to tilt the corresponding side of the microplatform. Experiments show that the microplatform can rotate through a mechanical-scan angle of 14.8°. The initial magnetic source design requires a dc current of 1.48A to achieve this rotation, which can be substantially reduced by replacing the single-turn coils with dual-layer multiturn coils. The magnetically actuated microplatform system could be built at lower cost and provide greater operational flexibility than are available with present-day state-of-the-art IVUS systems.
Water Tunnel Acoustic Measurements Using a Time Reversal Mirror
Authors: Barber Christopher , Lauchle Gerald C. , Capone Dean E.
Published: November 2021

Acoustic time reversal is a process in which acoustic energy received at an array is recorded, time-reversed, and then rebroadcast through the same or a collocated array. The result is that the original signal is “retrofocused” in time and space to the original source location without regard to the propagation paths or characteristics of the complex media between source and receiver. The array used for receive and rebroadcast, together with the data acquisition and processing system, is referred to as a time reversal mirror (TRM). Adaptation of time reversal mirrors to the problem of water tunnel acoustic measurements is examined. A concept demonstration test is planned for the Garfield Thomas Water Tunnel (GTWT) at the Pennsylvania State University Applied Research Laboratory, with the objective of demonstrating improved acoustic measurement capabilities compared to other conventional measurement techniques. An outline of the planned test is presented, as well as results from preliminary water tank testing of the arrays and instrumentation to be used in the GTWT experiment. A mathematical description of the time reversal mirror is developed, and preliminary conclusions regarding expected TRM performance in the water tunnel environment and limitations of the proposed measurement scheme are discussed.
A Sequential Adjoint Variable Method in Design Sensitivity Analysis of NVH Problems
Authors: Kim N. H. , Choi K. K. , Dong J. , Pierre C. , Vlahopoulos N. , Ma Z. D. , Castanier M.
Published: November 2021

A design sensitivity analysis of a sequential structural-acoustic problem is presented. A frequency response analysis is used to obtain the dynamic behavior of an automotive structure, while the boundary element method is used to solve the pressure response of an interior, acoustic domain. For the purposes of design sensitivity analysis, a direct differentiation method and an adjoint variable method are presented. In the adjoint variable method, an adjoint load is obtained from the acoustic boundary element re-analysis, while the adjoint solution is calculated from the structural dynamic re-analysis. The evaluation of pressure sensitivity only involves a numerical integration process for the structural part. The proposed sensitivity results are compared to finite difference sensitivity results with excellent agreement.
Numerical Probabilistic Analysis of Structural/Acoustic Systems
Authors: Allen Michael , Vlahopoulos Nickolas
Published: November 2021

A formulation that accounts for manufacturing variability in the analysis of structural/acoustic systems is presented. The methodology incorporates the concept of fast probability integration with finite element (FEA) and boundary element analysis (BEA) for producing the probabilistic acoustic response of a structural/acoustic system. The advanced mean value method is used for integrating the system probability density function. FEA and BEA are combined for producing the acoustic response that constitutes the performance function. The probabilistic acoustic response is calculated in terms of a cumulative distribution function. The new methodology is used to illustrate the difference between the results from a probabilistic analysis that accounts for manufacturing uncertainty, and an equivalent deterministic simulation through applications. The probabilistic computations are validated by comparison to Monte Carlo simulations. Based on its computational efficiency and its accuracy the new methodology is concluded to be a viable method of calculating numerically the probabilistic response of structural/acoustic systems due to manufacturing variability.
Acoustic Control in a 2D Enclosure Using Two Optimally Designed Helmholtz Resonators
Authors: Driesch Patricia L. , Koopmann Gary H.
Published: November 2021

A virtual design methodology is developed to minimize the noise in enclosures when coupled to optimally designed systems of passive acoustic absorbers (Helmholtz resonators). This methodology utilizes a computationally efficient modeling technique in order to determine the modified response of a system by modal expansion of the unmodified system eigenvectors. A determination of this type (efficient model/reanalysis approach) significantly increases the design possibilities when current optimization techniques are implemented. This novel methodology is experimentally verified for a 30.5 cm by 40.6 cm by 2.5 cm 2D enclosure coupled to two optimally designed Helmholtz resonators. A 4.2 dB experimental reduction of potential energy averaged over the 300—700 Hz band was obtained.
Domain Decomposition Methods With Frequency Band Interpolation for Computational Acoustics
Authors: Thompson Lonny L. , Zhang Limin , Ingel Robert P.
Published: November 2021

Interpolation over frequency (wavenumber) bands with domain decomposition (substructure) methods is used to provide fast solutions to wave problems when large numbers of frequency evaluations are required. Dispersion analysis is used to quantify the accuracy of the frequency interpolation for both generalized Schur complement and regularized FETI-H substructuring methods. Wavenumber-frequency dispersion relations are compared with different numbers of condensed internal nodes, numbers of interpolation points, and frequency band size. Several numerical examples are performed which validate the conclusions made in the dispersion analysis.
Wing Geometry Effect on Blade-Vortex Interaction Response Using BEM
Authors: Wood Trevor H. , Grace Sheryl M.
Published: November 2021

The boundary element method provides a low-order computational model for investigating unsteady wing response. This method is applied here to investigate the effect of fixed wing geometry on the blade-vortex interaction (BVI) problem. The method has been validated using a harmonic Sears gust as well as three-dimensional BVI analytical results for thin, flat, rectangular wings. It is shown that wing taper and twist do not significantly affect the BVI response while sweep greatly reduces it.
Visualization of Sound Transmission Into a Vehicle Passenger Compartment
Authors: Moondra Manmohan S. , Wu Sean F.
Published: November 2021

The paper examines the effectiveness of the Helmholtz equation least-squares (HELS) method (Wu and Yu, J. Acoust. Soc. Am., Vol. 104, 2054–2060, 1998; Wu, J. Acoust. Soc. Am., Vol. 107, 2511–2522, 2000) in visualizing the areas that are prone to noise transmission into a full-size vehicle passenger compartment due to exterior excitations such as the engine and turbulent flow. To simulate sound transmission, harmonic excitations are assumed to act on arbitrarily selected vehicle interior surfaces. The surface acoustic pressures are calculated using the boundary element method (BEM) based Helmholtz integral equation. A fine mesh for the interior cavity is generated so as to yield as accurate as possible the acoustic pressure distributions as benchmark using the BEM codes. The radiated acoustic pressures inside the vehicle compartment are calculated and taken as the input to the HELS formulation. Once the HELS formulation is established, the acoustic pressure anywhere including the vehicle interior surface is reconstructed. The normal component of the surface velocity can be reconstructed in a similar manner. Consequently, the normal component of the time-averaged acoustic intensity and acoustic energy flow inside a vehicle passenger compartment can be visualized. This three-dimensional acoustic image can provide valuable insight into vehicle interior noise reduction. The reconstructed acoustic pressures are compared with the benchmark values evaluated at the same locations. The effect of the measurement locations on the accuracy of reconstruction is investigated.
Human Error Assessment and Decision Making for Fishing Vessels Using Analytical Hierarchy Processing
Authors: Pillay A. , Wang J.
Published: November 2021

An approach to integrate human error assessment and decision-making using the Analytical Hierarchy Processing (AHP) method is proposed. The aim of this approach is to reduce the probability of occurrence and severity of human error during the operational phase of a fishing vessel. It utilises AHP theory to rank the impacts of human error and further integrates the available control options (to minimise these errors) within the analysis. The result obtained from the analysis reflects the most favoured control option that will address all the possible human errors within the system to a satisfactory level. A test case, which considers the shooting operation of a beam trawler, is used to demonstrate the proposed approach. Each step involved in the shooting operation is assessed for its vulnerability to human error with respect to the equipment being operated and this captures the operator-machine interaction. The AHP method integrates the evaluation of solutions to reduce risk levels within the human error assessment and this reduces the complexity of the analysis that is present in traditional methods.
SMEs Oriented Industrial Alliance
Authors: Hongzhao Dong , Ying Chen , Canjun Yang , Jiangyang Huang
Published: November 2021

Small-Medium-enterprises (SMEs) occupy a large proportion in modem global economies. However, most SMEs haven’t enough capacities to obtain valuable information and develop new products, thus resulting in a low flexibility to the market. In the times of intellectual globalization economies, while being in competition with powerful rival such as large corporation group, how the SMEs could find an effective way to survive today and further develop tomorrow, especially in the developing country, is focused on in this paper. Based on industry catalog, Industrial Alliance, a novel approach was put forward in this paper. Owing to commonwealth information platform, Industrial Alliance is able to assemble SMEs with similar product characteristics and market areas to enhance their competitiveness. In this paper, enterprise behavior protocol is proposed concerning forging alliance among SMEs. Moreover, the systematic architecture of Industrial Alliance is mainly depicted in order to image the whole profile of Industrial Alliance, including the essential principle, support application technology coupled with collaboration activities. At last, take the fluid power trade for an example, the practical research experiment of the information system for China fluid power (Including hydraulic and pneumatic products) Industrial Alliance is illustrated.
Modelling and Simulation Used to Understand Learning of New Computer-Based Tools - In Cooperative and Competitive Engineering Context
Authors: Lovén Eva
Published: November 2021

There is a growing belief that computer-based tools can and should be used to improve quality and productivity. But studies show there is a wide gap between theory and practice. Few investments in computerisation resulted in a measured improvement in profit. Companies have difficulties in integrating technology, organization and people especially when initiating and implementing new computer-based tools for engineering design work. Few studies have simulated social behaviour and used the engineers’ language to understand complex social phenomenon. A question raised in this paper is if a competitive context is more productive than a co-operative context when learning new computer-based tools? The paper discusses theoretical more closely what competition and co-operation does to us and presents the results from modelling and simulation of two individuals/groups that learn new tools in cooperative — compared to competitive — engineering context.

When mathematical tools are used, people implicitly assume a great deal of accuracy from the tool. A lot of the criticism when mathematical modelling is used in new areas stem from the fact that the area is to be considered to complex to be analysed with the accuracy expected from mathematical tools. This criticism does not, however, take into account that verbal mental model are nevertheless used which are no more accurate than a mathematical model is. In this paper it is illustrated how learning new tools in co-operative compared to competitive environment is better for productivity. The results show the importance of an external stabilising loop to handle a potentially competitive context and transform it into a co-operative one. Management must handle the looses in a competitive context. Deming supports our results and he wrote that one of the manager’s roles is to understand the benefits of co-operation and the losses from competition between people and between groups. Our simulations show this clearly. Co-operative and competitive systems are defined in mathematical terms. Two kinds of competitive systems are identified; under-critical and over-critical, where the over-critical competitive system is destructive in the sense that it leads to collapse of some of the participants. The presented example shows that simulation can be used to enhance and illuminate the reasoning of organisation and behaviour of groups. Furthermore, it ensures that the reasoning and description is stringent and sharpened because of the fact that it must be translated into mathematical terms. On the other hand it must be emphasised that the result is no more valid than the underlying assumptions, but this is true for all analysis being mathematical or purely verbal.
Quality of Participation Experiences in Special Olympics Sports Programs
Authors: Arbour-Nicitopoulos Kelly P. , Bruno Natasha , Orr Krystn , O’Rourke Roxy , Wright Virginia , Renwick Rebecca , Bobbie Kirsten , Noronha James
Published: November 2021

This cross-sectional study examined experiential elements facilitating quality sport experiences for youth (ages 12–24 years) in Special Olympics, and the associated influences of sport program and sociodemographic characteristics. A total of 451 athletes involved in the 2019 Special Olympics Youth Games completed a survey assessing elements of quality participation (autonomy, belongingness, challenge, engagement, mastery, and meaning). The t tests investigated whether athletes with intellectual and developmental disabilities rated elements differently across Traditional and Unified Sport programs. Regression analyses explored whether sport program and sociodemographic characteristics were predictors of these elements. Youth reported high mean scores across the elements, with no significant differences between athletes with intellectual and developmental disabilities in Traditional or Unified Sport. Athletes with no reported disability rated higher autonomy than those who reported disability (p = .01). Women tended to report greater engagement in sport than men (p = .07). Findings provide theoretical and practical insights into quality sport participation among youth in Special Olympics.
California's stem cell research fund dries up
Authors: Kaiser Jocelyn
Published: November 2021

Researchers hope a planned ballot initiative will renew funding in 2020.
Psychologist aims to study diverse minds, not WEIRDos
Authors: Kupferschmidt Kai
Published: November 2021

Daniel Haun wants his fellow psychologists to study people outside of rich, Western societies.
Certify reproducibility with confidential data
Authors: Pérignon Christophe , Gadouche Kamel , Hurlin Christophe , Silberman Roxane , Debonnel Eric
Published: November 2021

A trusted third party certifies that results reproduce
IFITM proteins inhibit placental syncytiotrophoblast formation and promote fetal demise
Authors: Buchrieser Julian , Degrelle Séverine A. , Couderc Thérèse , Nevers Quentin , Disson Olivier , Manet Caroline , Donahue Daniel A. , Porrot Françoise , Hillion Kenzo-Hugo , Perthame Emeline , Arroyo Marlene V. , Souquere Sylvie , Ruigrok Katinka , Dupressoir Anne , Heidmann Thierry , Montagutelli Xavier , Fournier Thierry , Lecuit Marc , Schwartz Olivier
Published: November 2021

Placenta formation and fetal demise

A critical step of placental development is the fusion of trophoblast cells into a multi-nucleated syncytiotrophoblast layer. Trophoblast fusion is mediated by syncytins, encoded by endogenous retrovirus–derived envelope glycoproteins. Buchrieser
et al.
report that interferon-induced transmembrane (IFITM) proteins inhibit syncytin-mediated syncytiotrophoblast formation, restricting placental development and triggering fetal demise (see the Perspective by Kellam and Weiss). The results provide a molecular explanation for the placental dysfunctions observed in interferon-mediated disorders such as intrauterine growth retardation, TORCH (toxoplasmosis, other, rubella, cytomegalovirus, and herpes) infections, and some forms of preeclampsia.

Science
, this issue p.
176
; see also p.
118
Response to Comment on “Long-term measles-induced immunomodulation increases overall childhood infectious disease mortality”
Authors: Mina Michael J. , Grenfell Bryan T. , Metcalf C. Jessica E.
Published: November 2021

Thakkar and McCarthy suggest that periodicity in measles incidence artifactually drives our estimates of a 2- to 3-year duration of measles “immune-amnesia.” We show that periodicity has a negligible effect relative to the immunological signal we detect, and demonstrate that immune-amnesia is largely undetectable in small populations with large fluctuations in mortality of the type they use for illustration.
The double-edged sword: Harnessing PD-1 blockade in tumor and autoimmunity
Authors: Kuchroo Juhi R. , Hafler David A. , Sharpe Arlene H. , Lucca Liliana E.
Published: November 2021

PD-1 restrains both effector T cells and T
regs
; therefore, PD-1 may be uniquely modulated to enhance tumor rejection while maintaining immune tolerance.
Recruitment of dendritic cell progenitors to foci of influenza A virus infection sustains immunity
Authors: Cabeza-Cabrerizo Mar , Minutti Carlos M. , da Costa Mariana Pereira , Cardoso Ana , Jenkins Robert P. , Kulikauskaite Justina , Buck Michael D. , Piot Cécile , Rogers Neil , Crotta Stefania , Whittaker Lynne , Encabo Hector Huerga , McCauley John W. , Allen Judith E. , Pasparakis Manolis , Wack Andreas , Sahai Erik , Reis e Sousa Caetano
Published: November 2021

Effective T cell–dependent immunity to influenza A virus requires recruitment of cDC progenitors to foci of infection via CCR2.
Imaging dragons in the Old Testament: Were Leviathan and Behemoth Mesozoic monsters?
Authors: Bakker Robert T.
Published: November 2021

For much of the nineteenth century, the majority of respected stratigraphers were serial creationists who read the rocks as recording successive extinctions followed by new creations, a process that generated progress in vertebrate structure. Beginning after World War I, Leviathan and Behemoth were cited by Young Earth Creationists—a minority among anti-Darwinians—as Mesozoic species observed by humans. This view spread rapidly after World War II. However, the anatomy and behavior of these beings, as portrayed in Ugaritic and Hebrew literature, leads to a firmer identification. The Leviathan of Job has powerful jaws armed with great teeth; skull armor renders hooks impotent; body armor of scales set so close together that they repel spears; water is thrashed into foam by twisting death rolls; this is altogether an accurate rendition of the Nile Crocodile. The Behemoth is a young, adult male African Elephant distinguished by grass-eating habits and an enormous, uncontrolled male organ: “tail like a cedar tree.”
The Fritz Zerritsch/Erich Thenius suite of paleontological wall roll-ups and the pageant-of-life-through-time genre of paleontological art
Authors: Rowland Stephen M.
Published: November 2021

Here I rescue from obscurity a mid-twentieth-century sequence of ten paintings representing biotas and ecosystems present in different periods of geologic time. They were used to illustrate a 1955 book titled The History of Life on Earth by University of Vienna paleontologist Erich Thenius. The paintings were also mass produced as classroom teaching aids in the form of wall chart roll-ups. Thenius collaborated with Viennese landscape artist Fritz Zerritsch to produce these scenes from Deep Time. In terms of the selection and arrangement of animals in some of the scenes, Thenius and Zerritsch were probably influenced by well-known paleoartists Rudolph Zallinger and Charles R. Knight. I corresponded with Professor Thenius concerning his collaboration with Zerritsch, and his answers to my questions illuminate some of the choices he made. The Zerritsch/Thenius collection of paleo-scenes is a good example of the pageant-of-life-through-time genre of paleontological art. I use this sequence of prehistoric tableaux to examine artistic conventions within this genre.
Foraminiferal art through the ages
Authors: Lipps Jere H.
Published: November 2021

Foraminifera are single-celled organisms with and without shells (tests). They have an abundant fossil record over the past 545 million years and presence in modern oceans. The art of forams is dominated by hand-drawn scientific illustrations to scanning electron microscopic images done over the past 455 years, providing vital knowledge about shelled forams. From 1665 to 1835, forams were assigned to micro-invertebrates rather than single-celled forms. With more than 75,000 publications and nearly 50,000 described species of forams, illustrations must number more than 200,000. The illustrations include a range from simple line drawings through shaded ink and pencil renderings, sometimes even colored, to photographs and scanning electron micrographs. Forams also appear in other art forms: The Pyramids at Giza in Egypt, hand-sized models, jewelry, flooring, stamps, coins, sculptures, and a Chinese Foraminiferal Sculpture Park. Foraminiferal art, although very abundant in many forms, has not caught the attention of many people outside of foraminiferology.
Supplemental Material: Quantifying metasomatic high-field-strength and rare-earth element transport from alkaline magmas
Authors: Sokół Krzysztof , al. et
Published: November 2021

Petrographic information, parameterization of the Grant model, description of the HFSE tonnage estimation method, and supplemental tables of whole-rock data, standardization, and HFSE volume-tonnage calculations.
Supplemental Material: Water in omphacite fingerprints the thermal history of eclogites
Authors: Jiang Peilin , Yang Xiaozhi , al. et
Published: November 2021

Fourier transform infrared and Raman spectra, electron microprobe data, and resolved band absorbance ratios of samples.
Supplemental Material: Continental Magmatism and Uplift as the Primary Driver for First-Order Oceanic 87Sr/86Sr Variability with Implications for Global Climate and Atmospheric Oxygenation
Authors: Paulsen Timothy S , al. et
Published: November 2021

Table S1: Detrital zircon U-Pb age and trace element ratio global compilation
Severe presentation of non-ossifying fibroma of the femur in osteoglophonic dysplasia
Authors: Kumar Abilash , Chong Yee Tong , Jamil Kamal , Rusli Emilia
Published: November 2021

Osteoglophonic dwarfism, also known as osteoglophonic dysplasia (OD), is an uncommon skeletal dysplasia with an autosomal dominant mode of inheritance, which equally affects boys and girls. OD is saliently featured by craniosynostosis, dysmorphic facial features, impacted mandibular teeth, rhizomelic limb shortening and non-ossifying fibromas habitually at the metaphyseal regions, which usually disappear after skeletal maturity. The long bones in OD are portrayed by this distinguishable ‘hollowed-out’ appearance with metaphyseal cystic defects that have a natural history of spontaneous resolution. We report a case of a rare and unusual presentation of OD in a 23-year-old woman whom has been diagnosed with OD during her early childhood. She presented with a progressively enlarging right thigh swelling associated with pain for the past 1 year. Her right femur plain radiograph revealed diffuse lysis of the whole femur with cortical thinning. MRI revealed multiple bilateral femur benign cystic lesion synonymous with a severe spectrum of OD. She was started on a trial of oral bisphosphonates, which led to a significant improvement in pain.
Perceptions of ASHA workers in the HOPE collaborative care mental health intervention in rural South India: a qualitative analysis
Authors: Bansal Stuti , Srinivasan Krishnamachari , Ekstrand Maria
Published: November 2021

Objective

The main objective of this exploratory study was to investigate the overlooked perspectives and beliefs of Accredited Social Health Activists (ASHA workers) regarding a collaborative care mental health intervention (HOPE:HealthierOptions throughEmpowerment), mental illness and the health of their rural communities.

Design

Semi-structured, one-on-one, qualitative interviews.

Setting

Seven primary health centres (PHCs) in rural Karnataka, India. All PHCs had previously completed the HOPE study.

Participants

15 ASHA workers, selected via purposive sampling. ASHAs are high school-educated village women trained as community health workers. ASHAs were included if they had previously participated in the HOPE intervention, a collaborative-care randomised controlled trial that aimed to integrate mental healthcare into existing primary care systems in rural Karnataka.

Interventions

No interventions were introduced.

Results

ASHA workers mostly had positive interactions with patients, including encouraging them to attend sessions, helping to explain the topics and techniques, and checking on the patients frequently. ASHA workers were able to identify key barriers to treatment and facilitators to treatment. ASHAs claimed that their knowledge about mental illness improved because of the HOPE study, though gaps remained in their understanding of aetiology and treatment. Several expressed interest in receiving additional mental health training. Overall, ASHAs viewed the HOPE study as a necessary and effective intervention, and requested that it expand.

Conclusions

This paper discusses the perspectives of ASHAs who participated in a novel effort to extend the collaborative care model to their own communities. ASHA workers help maintain relationships with patients that encourage participation, and the efforts of ASHAs often aid in mitigating common barriers to treatment. ASHA workers’ beliefs and knowledge regarding mental illness can be changed, and ASHAs can become effective advocates for patients. Future collaborative care interventions would likely benefit from involving ASHA workers in community outreach efforts.
Protocol for a scoping review on rehabilitation among individuals who experience homelessness and traumatic brain injury
Authors: Chan Vincy , Estrella Maria Jennifer , Babineau Jessica , Colantonio Angela
Published: November 2021

Introduction

Rehabilitation is key to improving outcomes and quality of life after traumatic brain injury (TBI). However, individuals experiencing homelessness are rarely represented in research that informs evidence-based rehabilitation guidelines even though TBI is disproportionately prevalent among this population. This protocol is for a scoping review to explore the extent to which rehabilitation, including the types of rehabilitation interventions, is available to, or used by, individuals who experience homelessness and TBI to inform (1) opportunities to integrate rehabilitation for individuals experiencing homelessness and TBI, (2) considerations for existing clinical and practice guidelines for rehabilitation and (3) recommendations for future research.

Methods and analysis

The scoping review will be guided by six stages described in scoping review methodology frameworks. Electronic databases (MEDLINE, Embase and Embase Classic, Cochrane CENTRAL Register of Clinical Trials, CINAHL, APA PsycINFO, Applied Social Sciences Index and Abstracts, and Nursing and Allied Health), reference list of included articles and scoping or systematic reviews identified from the search and grey literature, defined as reports from relevant brain injury, housing and rehabilitation organisations, will be searched. Two reviewers will independently screen all articles based on predetermined inclusion and exclusion criteria. A descriptive numerical summary of data items will be provided and qualitative content analytic techniques will be used to identify and report common themes. Preliminary findings will be shared with stakeholders to seek feedback on the implications of the results.

Ethics and dissemination

Ethics review will not be required, as only publicly available data will be analysed. Findings from the scoping review will be published in a peer-reviewed journal and presented at scientific meetings and to stakeholders, defined as service providers in the housing and TBI sectors; health professionals who provide care for individuals with TBI and/or homelessness; health administrators, decision-makers and policy-makers; researchers; and caregivers or family members of individuals with lived experience of TBI and homelessness.
Malnutrition and contributing factors among newborns delivered at the University of Gondar Hospital, Northwest Ethiopia: a cross-sectional study
Authors: Gonete Almaz Tefera , Alemu Tewodros Getaneh , Mekonnen Eskedar Getie , Takele Wubet Worku
Published: November 2021

Objectives

To estimate the prevalence of various indicators of malnutrition (stunting, wasting, low birth weight, concurrent stunting and wasting, overweight/obesity and double burden malnutrition) among newborns and to investigate factors associated with these nutritional disorders.

Methods

A hospital-based cross-sectional study was conducted from 10 March through to May 2020. A total of 419 newborns were recruited into the study to estimate the prevalence of low birth weight and stunting. After excluding 28 newborns whose length was less than 45 cm, 394 newborn–mother dyads were approached to estimate wasting and overweight/obesity. A systematic random sampling technique was used to select participants. All independent variables were entered into the multivariable logistic regression model and variables that had significant associations were identified based on a p value.

Results

A very small proportion of the newborns 2.5% (0.9% to 4.1%) were concurrently wasted and stunted. The prevalence rates of low birth weight and wasting were 20.8% (16.8% to 24.6%) and 10.9% (7.82% to 14.01%), respectively. The magnitude of overweight/obesity was 12.7% (9.3% to 15.9%) where 2.8% (1.1% to 4.4%) of newborns have the double burden of malnutrition. Having a father with a primary level of education 2.82 (1.19 to 6.65) and being stunted at birth 3.17 (1.6 to 6.0) were variables that were associated with increased odds of low birth weight. The odds of being overweight/obese are significantly higher among newborns born to mothers who are urban dwellers 0.35 (0.12 to 0.99).

Conclusions

The study underscores that malnutrition is a pressing public health concern that demands due emphasis. Fathers’ educational status (low level) and being stunted are associated with a high burden of low birth weight. Mothers’ residency (being urban) is associated with an elevated risk of overweight/obesity among newborns. Thus, improving the health literacy of fathers and preventing stunting at birth are recommended to mitigate low birth weight.
Development and evaluation of guidelines for prevention of retraumatisation in torture survivors during surgical care: protocol for a multistage qualitative study
Authors: Schippert Ana Carla , Grov Ellen Karine , Dahl-Michelsen Tone , Silvola Juha , Sparboe-Nilsen Bente , Danielsen Stein Ove , Aaland Mariann , Bjørnnes Ann Kristin
Published: November 2021

Introduction

Healthcare professionals working in somatic departments are not trained to recognise signs of torture or provide appropriate healthcare to torture survivors, which may result in retraumatisation during surgical treatment.

Methods and analysis

This protocol outlines a four-stage qualitative-method strategy for the development and evaluation of guidelines for prevention of retraumatisation of torture survivors during surgical care. The systematic search for literature review in stages 1 and 2 was conducted in August 2019 and March 2021, respectively, using nine databases. The search strategies employed in stage 1, without imposing any date limits, resulted in the inclusion of eight studies that addressed inadequate healthcare strategies associated with retraumatisation. The clinical guidelines review in stage 2 will include publications from 2000 onwards, which will be appraised using the Appraisal of Guidelines Research and Evaluation Version II instrument. Following multi-institutional recruitment in Norway, stage 3 will explore survivors’ experiences of receiving surgical treatment using indepth interviews (n=8–12), which will be audio-recorded, transcribed verbatim and analysed using the interpretative phenomenological analysis approach. In stage 4a, based on the findings from stages 1, 2 and 3, a set of clinical guidelines for preventing retraumatisation during surgical treatment will be developed. Next, the feasibility and acceptability of the guidelines will be assessed in stage 4b in three interdisciplinary focus group interviews (n=5 per group) and text condensation analyses.

Ethics and dissemination

The Regional (South-East C) Committee for Medical and Health Research Ethics approved the study in May 2021 (#227624). In stages 3 and 4, an informational letter and an informed consent form will be distributed to the participants to sign before the interview. The study results will be disseminated through publications, conference presentations, and national and local public forums to healthcare professionals, service managers, policymakers and refugee-supporting agencies.
Physicians’ clinical experience and its association with healthcare quality: a systematised review
Authors: Ajmi Soffien Chadli , Aase Karina
Published: November 2021

Background and purpose

There is conflicting evidence regarding whether physicians’ clinical experience affects healthcare quality. Knowing whether an association exists and which dimensions of quality might be affected can help healthcare services close quality gaps by tailoring improvement initiatives according to physicians’ clinical experience. Here, we present a systematised review that aims to assess the potential association between physicians’ clinical experience and different dimensions of healthcare quality.

Methods

We conducted a systematised literature review, including the databases MEDLINE, Embase, PsycINFO and PubMed. The search strategy involved combining predefined terms that describe physicians’ clinical experience with terms that describe different dimensions of healthcare quality (ie, safety, clinical effectiveness, patient-centredness, timeliness, efficiency and equity). We included relevant, original research published from June 2004 to November 2020.

Results

Fifty-two studies reporting 63 evaluations of the association between physicians’ clinical experience and healthcare quality were included in the final analysis. Overall, 27 (43%) evaluations found a positive or partially positive association between physicians’ clinical experience and healthcare quality; 22 (35%) found no association; and 14 (22%) evaluations reported a negative or partially negative association. We found a proportional association between physicians’ clinical experience and quality regarding outcome measures that reflect safety, particularly in the surgical fields. For other dimensions of quality, no firm evidence was found.

Conclusion

We found no clear evidence of an association between measures of physicians’ clinical experience and overall healthcare quality. For outcome measures related to safety, we found that physicians’ clinical experience was proportional with safer care, particularly in surgical fields. Our findings support efforts to secure adequate training and supervision for early-career physicians regarding safety outcomes. Further research is needed to reveal the potential subgroups in which gaps in quality due to physicians’ clinical experience might exist.
Results of watchful waiting of unruptured intracranial aneurysms in a Western patient population: a single-center cohort
Authors: Aubertin Mathilde , Jourdaine Clément , Thépenier Cédric , Labeyrie Marc-Antoine , Civelli Vittorio , Saint-Maurice Jean-Pierre , Guédon Alexis , Houdart Emmanuel
Published: November 2021

Background

The natural history of unruptured intracranial aneurysms (UIAs) in Western populations is still debated, especially for those <7 mm. Reporting data of a large single-center cohort managed with watchful waiting is therefore interesting.

Methods

From January 2011 to June 2019, 662 UIAs were followed up by yearly MR angiography. Morphologically stable UIAs were managed conservatively while unstable UIAs were offered treatment. The patients’ clinical and radiological data were analyzed retrospectively.

Results

UIAs were ≤4 mm in 60%, 4.1–7.0 mm in 33%, and >7 mm in 7%. They were located on the anterior circulation in 90% of cases. The mean follow-up duration was 51.32 months for a total of 2831 aneurysm-years. During follow-up, 37 UIAs (5.5%) were treated because of an increase in size, and 8 UIAs were treated because of patient decision. Three aneurysms ruptured during follow-up for an annual risk of rupture of 0.1% (95% CI 0% to 0.24%). No risk factors for rupture were identified. The three ruptured cases made an excellent recovery. During follow-up, annual mortality from unrelated causes was 0.8% (95% CI 0.51% to 1.18%).

Conclusions

This single-center cohort evaluated our watchful waiting policy applied in two-thirds of all incidental UIAs. Morphological change of UIAs during follow-up led to treatment in 5.5% of cases. With such a management paradigm, we found a low rupture rate in these selected UIAs and the mortality was unrelated to aneurysms.
Impact of axial spondyloarthritis on mental health in Europe: results from the EMAS study
Authors: Garrido-Cumbrera Marco , Gálvez-Ruiz David , Delgado-Domínguez Carlos J , Poddubnyy Denis , Navarro-Compán Victoria , Christen Laura , Mahapatra Raj , Makri Souzi , Bundy Christine
Published: November 2021

Objective

To determine the presence of mental disorder risk and associated factors in European patients with axial spondyloarthritis (axSpA).

Methods

Data from 2,166 patients with axSpA in 12 European countries were collected from 2017 to 2018 through the European Map of Axial Spondyloarthritis online survey. Risk of mental disorders was assessed using the 12-item General Health Questionnaire. Possible predictors included age, gender, relationship status, patient organisation membership, job status, educational level, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), functional limitation (0–54) and self-reported depression or anxiety. Bivariate analyses were conducted to determine predictors of risk of mental disorders (Mann-Whitney and χ2) and multivariable analysis identified factors associated with risk of mental disorders.

Results

60.7% of patients reported risk of mental disorders: they were younger (41.7 vs 46.0 years), more likely female (68.2% vs 57.9%), unemployed (7.5% vs 2.7%), on temporary (15.9% vs 5.4%) or permanent sick leave (13.2% vs 8.0%), reported depression (45.2% vs 14.2%) or anxiety (41.3% vs 12.5%), higher disease activity (BASDAI ≥4; 87.6% vs 62.3%) and functional limitation (16.5 vs 10.8). The factors most associated with risk of mental disorders were disease activity (OR=2.80), reported depression (OR=2.42), anxiety (OR=2.39), being unemployed or on sick leave (OR=1.98), functional limitation (OR=1.02) and younger age (OR=0.97).

Conclusions

Compared with the general population, patients with axSpA show disproportionately worse mental health associated mainly with disease activity and employment status. Healthcare professionals should pay close attention to patients with high disease activity and address internally or refer to specialist services, where appropriate to ensure optimal patient outcomes.
A new scoring system for use in capture–recapture studies for bowhead whales photographed with drones
Authors: Koski William R. , Young Brent G.
Published: November 2021

Effective management of animal populations requires knowledge of life history parameters and estimates of population abundance. One method commonly used to estimate abundance is capture–recapture analyses of photographs. Small, relatively inexpensive, rotary-wing drones have become an effective platform for obtaining high-quality aerial photographs of whales. To conduct capture–recapture analyses the animal needs to be defined as marked or unmarked and the photographs must be of high quality. While a system for scoring quality and markedness has previously been developed for bowhead whales (Balaena mysticetus Linnaeus, 1758) ( Rugh et al. 1998 . Rep. int. Whal. Commn. 48: 501–512), a revised scoring system was needed to incorporate increased information in photographs taken by drones. We present a revised scoring system that enlarges two of the previously defined areas of the whale examined for markings and incorporates smaller markings into the definition of marked whales. We scored 30 whales using the previous criteria and the revised criteria developed in this paper. More whales were identified as marked (23%) and mark scores were higher for 30% of the zones scored using the new system. Increasing the number of marked whales during capture–recapture studies increases the precision of estimated parameters and permits us to make those estimates with smaller samples of photographs.
Bottom of spectra and coverings of orbifolds
Authors: Ballmann Werner , Polymerakis Panagiotis
Published: November 2021

We discuss the behavior of the bottom of the spectrum of scalar Schrödinger operators under Riemannian coverings of orbifolds. We apply our results to geometrically finite and to conformally compact orbifolds.