bluuebunny/crossref_metadata_2025 huggingface dataset:
Monsoonal MCS Initiation, Rainfall, and Diurnal Gravity Waves over the Bay of Bengal: Observation and a Linear Model
Authors: Peng Chin-Hsuan , Chen Xingchao
Published: June 2024

Previous observational studies have indicated that mesoscale convective systems (MCSs) contribute the majority of precipitation over the Bay of Bengal (BoB) during the summer monsoon season, yet their initiation and propagation remain incompletely understood. To fill this knowledge gap, we conducted a comprehensive study using a combination of 20-yr satellite observations, MCS tracking, reanalysis data, and a theoretical linear model. Satellite observations reveal clear diurnal propagation signals of MCS initiation frequency and rainfall from the west coast of the BoB toward the central BoB, with the MCS rainfall propagating slightly slower than the MCS initiation frequency. Global reanalysis data indicate a strong association between the offshore-propagating MCS initiation frequency/rainfall and diurnal low-level wind perturbations, implying the potential role of gravity waves. To verify the hypothesis, we developed a 2D linear model that can be driven by realistic meteorological fields from reanalysis. The linear model realistically reproduces the characteristics of offshore-propagating diurnal wind perturbations. The wind perturbations, as well as the offshore propagation signals of MCS initiation frequency and rainfall, are associated with diurnal gravity waves emitted from the coastal regions, which in turn are caused by the diurnal land–sea thermal contrast. The ambient wind speed and vertical wind shear play crucial roles in modulating the timing, propagation, and amplitude of diurnal gravity waves. Using the linear model and satellite observations, we further show that the stronger monsoonal flows lead to faster offshore propagation of diurnal gravity waves, which subsequently control the offshore propagation signals of MCS initiation and rainfall.

Significance Statement

Rainfall over the Bay of Bengal (BoB) is primarily contributed by large and organized rainfall systems in the summer monsoon season. During this season, these systems are commonly observed over the east coast of India around midnight, the western BoB in the morning, and the central BoB in the afternoon. This eastward rainfall propagation is confirmed by observations, reanalysis data, and a theoretical model to have a strong association with atmospheric diurnal gravity waves. These waves are caused by land–sea thermal contrast and can trigger rainfall systems over the offshore regions. We also found that the diurnal gravity waves, as well as their triggered rainfall systems, can be greatly modulated by the large-scale monsoonal flows. All the above findings improve our understanding of diurnal rainfall cycle over the BoB and may contribute to the future improvement of rainfall forecast over the region.
Near-Term Mediterranean Summer Temperature Climate Projections: A Comparison of Constraining Methods
Authors: Cos Pep , Marcos-Matamoros Raül , Donat Markus , Mahmood Rashed , Doblas-Reyes Francisco J.
Published: June 2024

There are several methods to constrain multimodel projections of future climate. This study assesses the quality of four constraining methods in representing the near-term summer temperature projections of the Mediterranean region. Three are based on phasing in ocean surface temperature variations based on observations or decadal predictions, and the method is based on the measuring performance and independence of the individual simulations. The comparison has been carried out with a new framework inspired by the forecast quality assessment of decadal predictions. The framework led to quality estimates of the constrained projection approaches obtained by producing 20-yr temperature estimates every year from 1970 to 2000 and computing quality metrics against observational references. The evaluation results show some differences between constraining approaches. The improvement or deterioration against quality measures of the full, unconstrained, phase 6 of the Coupled Model Intercomparison Project (CMIP6) ensemble shows strong spatial heterogeneity. From the analysis of the selection approaches it is found that the constraints based on sea surface temperature (SST) fields are affected not only by the variability but also by the warming trend. The weighting method generally shows small quality differences with respect to the full CMIP6 ensemble. Despite caveats of the different methods, there is potential to improve the near-term climate projections as some significant quality enhancements were found in some approaches according to the evaluation metrics used. This study suggests a good understanding of the constraining methods, and their forecast quality is required before using them to take informed decisions. Our study opens the door to optimizing these methods for the Mediterranean climate and highlights the need for evaluating the constraints through retrospective assessments against observational references.
Reorganization of Snowfall beneath Cloud Top within the Comma Head Region of Two Extreme U.S. East Coast Winter Cyclones
Authors: Janiszeski Andrew , Rauber Robert M. , Jewett Brian F. , Zaremba Troy J.
Published: June 2024

This paper examines ice particle reorganization by three-dimensional horizontal kinematic flows within the comma head regions of two U.S. East Coast winter storms and the effect of reorganization on particle concentrations within snowbands in each storm. In these simplified experiments, the kinematic flows are from the initialization of the HRRR model. Ice particles falling through the comma head were started from either 9-, 8-, or 7-km altitude, spaced every 200 m, and were transported north or northwest, arriving within the north or northwest half of the primary snowband in each storm. The greatest particle concentration enhancement within each band was a factor of 2.32–3.84 for the 16–17 December 2020 storm and 1.76–2.32 for the 29–30 January 2022 storm. Trajectory analyses for particles originating at 4 km on the southeast side of the comma head beneath the dry slot showed that this region supplied particles to the south side of the band with particle enhancements of factor of 1.36–2.08 for the 16–17 December 2020 storm and 1.04–2.16 for the 29–30 January 2022 storm. Snowfall within the bands had two source regions: 1) on the north/northwestern side, from ice particles falling from the comma head, and 2) on the southeastern side, from particles forming at or below 4-km altitude and transported northwestward by low-level flow off the Atlantic. While the findings give information on the source of particles in the bands, they do not definitively determine the cause of precipitation banding since other factors, such as large-scale ascent and embedded convection, also contribute to snow growth.

Significance Statement

Wintertime storms along the east coast of North America can produce heavy snowfall, high winds, coastal flooding, and cold temperatures, resulting in major economic impacts within the northeast U.S. urban corridor. The heaviest snowfall typically occurs within snowbands, elongated narrow regions identifiable by high reflectivity on radar. This paper examines the potential sources of the ice particles contributing to the snowbands and how the flow fields throughout the storm can contribute to enhanced particle concentrations within the bands.
Rigid Polyurethane Foam as an Energy Absorbing Core for Composite Components Manufactured by Resin Transfer Moulding (RTM) Fart I: Determination of Properties
Authors: Carruthers J.J. , Robinson A.M.
Published: June 2024

Foam constitutive models allow the effects of changes in parmeter such as density to be predicted and can be used to generat input data for non-linear finite element models. This paper considers three approaches to the constitutive modelling of rigid polyurethane foams: (i) an empirically based shape function approach, (ii) an approach based on a consideration of the mechanics involved in the deformation of a unit cell and (iii) the construction of representative mechanical analogue models. Each approach considered in term of its accuracy, general applicability and ease of use. It is found that the three methods vary primarily in their reliance on experimentaI data and that this directly influences their levels of accuracy. The choice of approach is therefore largely dictated by the availability of appropriate test data.
Scale-up of Transformation of Negative Poisson's Ratio foam: Slabs
Authors: Loureiro M.A. , Lakes R.S.
Published: June 2024

This paper presents an experimental study performed on the scale-up of processing of negative Poisson 's ratio foam. These materials become thinner under compression and fatter under tension, opposite to ordinary materials. The transformation process consists of triaxial compression combined with heat treatment. Transformed foam cells have a concave or "re-entrant" shape. Scaleup is achieved by use of a modified mould assembled around the foam slab and longer processing times. Foam with a distribution of cell sizes was transformed in small block and large slab forms. These blocks and slabs exhibited a negative Poisson's ratio.
Structures and Mechanical Properties of Microcellular Foamed Polyvinyl Chloride
Authors: Matuana Laurent M. , Park Chul B. , Balatinecz John J.
Published: June 2024

In this paper, microcellular foamed polyvinyl chloride (PVC) with unique cell morphology and mechanical properties is characterised. Microcellular foamed structures were produced in PVC by first saturating the polymer with C02 under high pressure followed by rapidly decreasing the solubility of C02 in the samples. The void fraction of the microcellular foamed PVC was controlled by tailoring the foaming temperature and foaming time. Tensile and impact tests were performed on the foamed PVC to investigate the dependence of these properties on the void fraction of foamed specimens. The notched Izod impact strength of microcellular foamed PVC increased as the void fraction increased. When the void fraction was 80%, the notched Izod impact strength of foamed PVC was four times as high as that of the unfoamed PVC. However, the tensile strength and modulus decreased as the void fraction increased. Experimental results indicate that the relative density of microcellular foamed PVC should be determined in consideration of the material saving, weight reduction, enhanced impact strength and reduced tensile strength and modulus to optimise performance of the foamed materials.
Development of HFC Blowing Agents. Part II: Expanded Polystyrene Insulating Boards
Authors: Albouy Arnaud , Roux Jean-Denis , Mouton Denis , Wu Jinhuang
Published: June 2024

The development of HFCs as blowing agents for rigid polyurethane foams has previously been reported11’. In this second paper, it will be seen that the Montreal Protocol and its subsequent reviews have also presented a challenge for the extruded expanded polystyrene (XPS) foam industry. CFC-12 has long been the main blowing agent in that application due to its unique properties such as non-flammability, non-toxicity, low thermal conductivity and good processability.

In developed countries, the rapid phase-out of CFC-12 was made possible due to the availability of HCFCs. HCFC-142b, pure or in blends with HCFC-22 or ethyl chloride, has now become the reference blowing agent for XPS insulating boards world wide owing to its superior properties.

This paper will discuss the current situation by providing some information about properties commonly found in laminated boards. A theoretical model is used to simulate their long term behaviour, especially thermal insulation. Using this theoretical model and available data, it is possible to gain an insight into foam performance that can be achieved by zero ozone depletion potential substitutes such as HFCs and carbon dioxide. HFC-134a appears to be the leading candidate particularly when the thermal insulation is needed.
Diagnosis of post-thrombotic syndrome: International union of phlebology (UIP) survey of medical specialists
Authors: Xu Nuo , Siriwardene Manisha , Naidu Nikita , Connor David E , Davies Alun H , Gloviczki Peter , Meissner Mark H , Parsi Kurosh
Published: June 2024

Objective

To review the current approaches to the diagnosis of Post-Thrombotic Syndrome (PTS) and to evaluate the potential need for a diagnostic tool.

Method

Medical specialists were invited to participate in an online survey of their current approaches to the diagnosis and management of PTS, including the use of scoring systems, diagnostic imaging techniques and the extent the practitioner reviews the patient’s venous history.

Results

502 participants completed the survey. Over 80% obtained imaging reports to confirm a history of deep vein thrombosis (DVT). 72% of participants always obtained an up-to-date duplex ultrasound for PTS diagnosis. Over 50% did not use a scoring system for either PTS diagnosis or management. 65% of the participants agreed that a new system for PTS diagnosis should be devised.

Conclusion

Heterogeneity was observed in methods of diagnosing PTS by medical practitioners with frequent use of medical imaging studies and moderate use of scoring systems. Development of a new diagnostic tool for PTS should be considered for future studies.
Esketamine combined with a mindfulness-based intervention for individuals with alcohol problems
Authors: Gent Emily M , Bryan Joshua W , Cleary Maisy A , Clarke Tegan I , Holmwood Harry D , Nassereddine Rania O , Salway Chris , Depla Simon , Statton Sarah , Krecké Joy , Morgan Celia JA
Published: June 2024

Background:

Alcohol use disorder (AUD) is a major public health issue, posing harmful consequences for individuals and society. Recent advances in addiction research have highlighted the therapeutic potential of ketamine-assisted therapy for AUD. However, the exact mechanisms underlying its effectiveness remain unknown.

Aims:

This double-blind, pilot study aimed to investigate esketamine combined with mindfulness-based intervention (MBI) to examine whether esketamine enhances engagement in MBI for individuals with alcohol misuse problems and whether enhanced engagement has any impact on alcohol-related outcomes.

Methods:

In all, 28 individuals with alcohol problems were randomly assigned to receive sublingual esketamine hydrochloride (AWKN002: 115.1 mg) or vitamin C (placebo) in an oral thin film and took part in 2 weeks of daily MBI. Participants were assessed on various self-report measures, including mindfulness, engagement in MBI (physical and psychological), alcohol cravings and consumption.

Results:

Esketamine enhanced psychological engagement with a daily MBI, compared to placebo, and led to transient decreases in alcohol cravings. Esketamine also resulted in significantly greater mystical experiences and dissociative states compared to placebo.

Conclusions:

The findings suggest that esketamine may improve treatment outcomes when combined with mindfulness-based therapies through its ability to increase engagement with meditative practice.
Applications of hybrid SMC and FLC for augmentation of MPPT method in a wind-PV-battery configuration
Authors: Menzri Fatima , Boutabba Tarek , Benlaloui Idriss , Bawayan Haneen , Mosaad Mohmed I , Mahmoud Mohamed Metwally
Published: June 2024

Green energy sources (GESs) in electrical systems have become widely included in electrical networks for their significant subnational impacts on the economy and the environment. Regrettably, the power generating capacity of these GESs is significantly influenced by environmental circumstances, such as temperature and sun irradiation for PV systems and wind speed for WT systems. Environmental changes impact the power capacity of the electrical system since the maximum amount of power that can be generated will only be achieved by implementing control measures. This research aims to enhance the efficiency of a standalone renewable power system by optimizing the energy output from GESs using the MPPT technique, considering the impact of climate fluctuations. The standalone hybrid GESs combines PV and WT technologies with a BSS. For the PV and WT, a combinatorial MPPT technique is proposed to modify the control settings for this system optimally. This method is based on the SMC and FLC. The FLC plays a role in achieving the MPPT target by utilizing membership functions designed to handle uncertainties caused by shifting environmental conditions. Whereas for the BSS, an energy management plan is developed to optimize the performance of the HRES. The system under study outfitted with the MPPT technology, functions in tandem with a BSS. In case of failure or insufficient power generation from primary sources, a DC/DC bidirectional converter is employed to adjust the charging and discharging of the BSS, ensuring a stable supply of DC power. The system’s response in different climates is examined, and the proposed combination controller’s intended effectiveness is confirmed using MATLAB\Simulink. The investigated structure can achieve approximately 99.213% efficacy with the support of the proposed SMC-FLC method, which is 19.874% greater than the widely used P&O method.
Eastern Churches in the Face of Fratricidal War during Russia's Invasion of Ukraine
Authors: Wawer Robert
Published: June 2024

Eastern Churches in Russia and Ukraine are facing the fratricidal war caused by Russia's invasion of Ukraine. These Churches maintain closeness in faith and liturgy. The similarities of these Churches’ teachings on war are juxtaposed with actual manifestations of their hierarchs’ hostility. The analysis will be carried out from the perspective of the Roman Catholic Church, which is in close unity with the Eastern Churches and understands the context of faith but is not a party to the conflict, which makes it easier to remain objective in examining the phenomenon of fratricide. The first part of the article analyses the doctrinal and historical context. It helps to isolate the factors influencing the existence of enmity between doctrinally close Churches. The second part presents the biblical inspiration of Cain and Abel's story in a search for new ways to counteract this phenomenon.
Post-operative Ultrashort Bowel Syndrome in a Term Neonate: One-year Follow-up
Authors: Shankar Kaushaki , Kukreja Bhavya , Wardhan Harsh , Saneja Vipul , Agrawal Vishnu Dutta
Published: June 2024

Ultrashort bowel syndrome occurs when the length of the small bowel is below 10–25 cm, or 10% of that expected for age. It is a rare occurrence in neonates; however, when it occurs, it results in high morbidity and mortality. Surviving newborns face a significant detriment in growth and development due to malabsorption of nutrients. A multidisciplinary approach with aggressive parenteral nutrition is the mainstay of management. Our case presented at 20 days of life, with malrotation and midgut volvulus resulting in post-surgical ultrashort bowel syndrome. In spite of being left with only 20 cm of short bowel, the infant survived on conservative management and is thriving well; the infant has been off parenteral nutrition completely since 11 months of age.
Mesoscale modeling of dynamic compressive behavior of microcapsule-based self-healing concrete under impact loading
Authors: Zhou Xiaoqing , Lu Qianmei , Tang Jiafan , Wang Xianfeng
Published: June 2024

Microcapsule-based self-healing concrete (MSC) has been widely studied, with a focus on static behavior and self-healing effectiveness. However, the dynamic mechanical properties of MSC have rarely been studied. This study presents a mesoscale numerical investigation of the dynamic compressive behavior of MSC under impact loading. In mesoscale, MSC is regarded as a four-phase composite material mainly composed of coarse aggregates, interface transition zones, cement mortar, and microcapsules. A pseudo 3D numerical model is constructed by combining a slice of a detailed mesoscale model with a homogenous 3D model. The mesoscale MSC slice models with different mass fractions of microcapsules (0%, 2%, 5%, and 8%) are constructed. Different coarse aggregate shapes (i.e., circles, ellipses, and polygons) are considered. The uniaxial dynamic compressive behaviors of MSC materials under loads of different strain rates are numerically simulated and compared with those from split Hopkinson pressure bar tests previously done by the authors. The comparison results show that the present mesoscale model can accurately predict the compressive strength and failure mode of MSC. The effects of the microcapsules ratio and strain rate on the dynamic strength are studied. Results show that the MSC compressive strength decreases with the increase in microcapsules and increases with the increase in strain rate. The dynamic increase factor (DIF) of the specimen is jointly contributed by the material DIF, inertial constraints, and heterogeneity. Different aggregate shapes have little effect on the simulation results of MSC behavior. The obtained dynamic mechanical properties of MSC may assist in designing MSC to resist collisions or explosions.
Apples inside orange peels: Exploring the use of functional equivalents for comparing curriculum processes across contexts
Authors: Caves Katherine M , Rageth Ladina , Renold Ursula
Published: June 2024

Comparative education research is complicated by the difficulty of identifying comparable units across contexts. This paper considers the advantages and limitations of a functional equivalence approach to comparative education. The functional equivalence approach allows us to meaningfully compare the operations that serve each function in the full curriculum value chain of design, application, and updating. We use a theory-based list of common processes in each phase to develop a survey for experts from nine countries, then code their responses to derive ten key common functions. The functional equivalence approach allows us to aggregate some operations that serve the same functions, so our set of functional equivalents is slightly shorter than the theory-based list of processes. In comparing across contexts, we find easily identifiable functional equivalents, functional equivalents that manifest through very different operations, functional equivalents carried out by a wide variety of actors and institutions, similar operations that are not functionally equivalent, and functional equivalents that are not consistently present in all contexts. The functional equivalence approach helps identify comparable operations despite contextual diversity.
A reproducible method for evaluating the degree and direction of overstuffing of the humeral head component in anatomic total shoulder arthroplasty
Authors: Panther Eric J , Hao Kevin A , Patrick Matthew R , King Joseph J , Wright Thomas W , Struk Aimee M , Wright Jonathan O , Schoch Bradley S
Published: June 2024

Background

Improper sizing of the humeral head component in anatomic total shoulder arthroplasty (ATSA) can overstuff the joint, potentially compromising outcomes. The purpose of this study was to validate a novel method of evaluating glenohumeral joint overstuffing in which superoinferior and mediolateral overstuffing can be evaluated independently relative to the native humeral anatomy.

Methods

We identified 25 patients who underwent ATSA and the best Grashey radiograph taken within 1 year of follow-up was assessed using our proposed technique. First, a circle overlaying the implanted humeral head was made. Then, Iannotti's Perfect Circle (IPC) was drawn as originally described. Measurements of superior and medial overstuffing were made using our proposed axes. Inter-rater reliability was assessed by computing interclass correlation coefficients (ICC) using a one-way model. Measurements were summarized as the mean and range, with positive values denoting overstuffing.

Results

The inter-rater reliability for all measurements was excellent (ICC > 0.9). Compared to our method, the IPC method would have missed 77% of overstuffed cases.

Conclusion

We present a reproducible method to assess glenohumeral joint overstuffing in ATSA. This technique addresses limitations of other methods that underestimate overstuffing. Further study is needed to establish a clinically significant value of overstuffing based on the proposed method.
Association of Patient-Surgeon and Patient–Physical Therapist Relationships With Return to Sports After ACL Reconstruction: The Untested Dimension in Outcome Assessments
Authors: Moussa Mohamad K. , Lefèvre Nicolas , Valentin Eugénie , Khalaf Zeinab , Meyer Alain , Grimaud Olivier , Bohu Yoann , Gerometta Antoinne , Khiami Frederic , Hardy Alexandre
Published: June 2024

Background:

The Quality of Patient-Surgeon Relationship (QPASREL) is an 11-item questionnaire developed and validated to assess the relationship between practitioners and patients on recovery and return to work after surgery.

Purpose:

To evaluate the association of patient-surgeon relationship (PSR) and patient-physical therapist relationship (PPR), as measured by QPASREL, with a patient's return to sports (RTS) after anterior cruciate ligament reconstruction (ACLR).

Study Design:

Case-control study; Level of evidence, 3.

Methods:

This study targeted patients who underwent primary ACLR at a specialized sports surgery referral center between January and May 2021. Patients who had revision surgery, multiligamentous knee injury, and sedentary status were excluded from the study. Patients were grouped based on ability to RTS at the preinjury level 1 year postoperatively (RTS group and no-RTS group). The primary outcome was rate of RTS at 1 year postoperatively, and the primary dependent variables were the quality of PSR and PPR as measured by QPASREL scores at 6-month intervals. Secondary outcomes were the correlation and discriminative capacity of the QPASREL compared with the Anterior Cruciate Ligament–Return to Sport After Injury (ACL-RSI) scores (collected at 6-month intervals).

Results:

The study included 243 patients. Patients in the RTS group exhibited a higher mean PPR QPASREL score (36.6 ± 5.1) compared with no-RTS patients (34.8 ± 5.2; P = .01) as well as a higher mean PSR score (35.7 ± 5.1) compared with no-RTS patients (33.8 ± 5.9; P = .01). Multivariate analysis showed that every 5-point increase in the QPASREL scores for PPR and PSR resulted in a 39% (odds ratio [OR] = 1.39; P = 0.014) and 35% (OR = 1.35, P = 0.021) increased odds of RTS, respectively. A weak yet positive correlation was found between QPASREL and ACL-RSI. The predictive capacity of the QPASREL (area under the curve [AUC] = 0.60 for PPR and 0.61 for PSR), although significant, was less powerful compared with that of the ACL-RSI (AUC = 0.73).

Conclusion:

The quality of the PPR and PSR, as measured by QPASREL scores, demonstrated a significant association with RTS rates at 1 year after ACLR. A weak yet positive correlation was found between QPASREL and ACL-RSI.
Where Are the English Learners and Students With Disabilities in Gifted Education?
Authors: Peters Scott J. , Johnson Angela
Published: June 2024

Prior research documented disproportional representation across racial, ethnic, and socioeconomic lines within the population of students identified as gifted and talented (GT). Less research has focused on what predicts improved representation for English learners (ELs) or students with disabilities (SwDs), or how state GT policies facilitate such representation. This paper attempted to fill that void by analyzing data from the Civil Rights Data Collection and Stanford Education Data Archive along with original coding of state GT policies. We found that while ELs and SwDs are disproportionately underrepresented within the population of students identified as gifted, state mandates for schools to offer GT, requirements for formal gifted education plans, and regular audits for compliance were correlated with higher rates of GT service availability and greater representation among ELs and SwDs. We further describe the characteristics of the top 5% of schools with the highest GT representation for ELs and SwDs.
The spatial repercussions of Russia’s war in Ukraine: Region(alism)s, borders, insecurities
Authors: Makarychev Andrey , Dufy Caroline
Published: June 2024

Russia’s war on Ukraine has generated a new chain of insecurities in Europe: energy and food crises, new migration flows from Ukraine, Belarus and Russia, military threats sharpened by Russia’s invasion are triggering a spatial and territorial reshuffling of Europe’s Eastern flank. In this context, regional dynamics within and across the Eastern frontiers of Europe have undergone a succession of path-breaking transformations ranging from overt support to the Ukrainian war effort to decoupling from the Russian economy and an unprecedented boost to expanding the European Union’s security architecture. However, one of the most important effects of the war is the growing gap between two regional models which might be dubbed normative (Europeanization within the EU- and NATO-led European normative space) and post-colonial (exemplified by different Russia-centric projects within the post-Soviet space). The original contribution of this special issue is to address the conceptual connections between security, borders and national identity to discuss the evolving European landscape. While we do not explore the military side of the war, we focus on the nexus of (in)security and bordering practices to capture how a combination of geopolitical changes, economic dynamics and human dimensions of war has created new borders and reshaped existing ones.
Satisfied? Examining Focus of Attention in Self-Directed Practice
Authors: Parsons John E.
Published: June 2024

In a series of three video-recorded assignments over a 6-week period, undergraduate music education students ( N = 16) enrolled in an instrumental methods course described aloud what they were thinking about as they practiced a three-note melody on a secondary brass instrument. Later, I completed a content analysis of the students’ practice verbalizations (PVs) captured in their assignment videos. Brass primary students ( n = 3) described thinking about predominantly external components of performance (the effects their physical actions produced). Non-brass primary students ( n = 13) described thinking about internal (parts of the body) and external components in relatively equal proportion, often focusing their attention on paired action-outcome (i.e., internal–external) relationships. After the final assignment, non-brass students reported higher levels of satisfaction with their progress than the brass primary students and expressed confidence in their ability to guide their own practice independently and effectively toward the accomplishment of meaningful goals.
How I treat bleeding in hereditary hemorrhagic telangiectasia
Authors: Al-Samkari Hanny
Published: June 2024

Hereditary hemorrhagic telangiectasia (HHT; Osler-Weber-Rendu disease) affects 1 in 5000 persons, making it the second most common inherited bleeding disorder worldwide. Telangiectatic bleeding, primarily causing recurrent epistaxis and chronic gastrointestinal bleeding, is the most common and most important manifestation of this multisystem vascular disorder. HHT-associated bleeding results in substantial psychosocial morbidity and iron deficiency anemia that may be severe. Although there remain no regulatory agency–approved therapies for HHT, multiple large studies, including randomized controlled trials, have demonstrated the safety and efficacy of antifibrinolytics for mild-to-moderate bleeding manifestations and systemic antiangiogenic drugs including pomalidomide and bevacizumab for moderate-to-severe bleeding. This has led to a recent paradigm shift away from repetitive temporizing procedural management toward effective systemic medical therapeutics to treat bleeding in HHT. In this article, 4 patient cases are used to illustrate the most common and most challenging presentations of HHT-associated bleeding that hematologists are likely to encounter in daily practice. Built on a framework of published data and supported by extensive clinical experience, guidance is given for modern evidence–based approaches to antifibrinolytic therapy, antiangiogenic therapy, and iron deficiency anemia management across the HHT disease severity spectrum.
Efficacy of intramedullary bridge fixation for midshaft clavicle fractures: a retrospective analysis of a novel technique
Authors: Ma Tianyong , Su Huan , Lu Yihong , Chen Junping , Tan Weiyuan , Lei Fang , Wang Dewei
Published: June 2024

Background

The aim of this study was to explore the efficacy of a novel intramedullary fixation technique using the ortho-bridge system (OBS) for midshaft clavicle fractures.

Methods

A total of 63 patients were included in this study: 35 underwent plate internal fixation (LP group) and 28 underwent OBS intramedullary fixation (OBS group). Surgical time, intraoperative blood loss, incision length, fracture healing time, removal of the internal fixation agent, visual analog scale (VAS) score for shoulder pain, Constant–Murley shoulder score and complication occurrence were compared between the two groups.

Results

Preoperative general data, such as sex, age and fracture type, were not significantly different between the two groups (P > 0.05). However, the OBS group exhibited better outcomes than the LP group exhibited in terms of surgical time, intraoperative blood loss and total incision length (P < 0.05). Additionally, the OBS group exhibited a significantly shorter fracture healing time and internal-fixation removal time than the LP group exhibited (P < 0.05). The VAS scores on postoperative day 1, week 1, month 1 and month 3 were lower in the OBS group than in the LP group (P < 0.05). Furthermore, the Constant–Murley shoulder scores at 1, 3, and 6 months postoperatively were higher in the OBS group than in the LP group (P < 0.05), with no significant difference at 1 year after surgery (P > 0.05). None of the patients in the OBS group experienced scarring of the surgical incision, and 6 patients in the LP group experienced scarring of the surgical incision. Finally, the complication incidence in the OBS group was lower than that in the LP group.

Conclusion

For midshaft clavicle fractures, OBS intramedullary fixation is better than locking-plate internal fixation because it led to less trauma, a faster recovery, better efficacy, and better esthetic outcomes and comfort. Therefore, this technique may have potential as a novel treatment for midshaft clavicle fractures.

Level of evidence: III, retrospective observational study.
Transcriptomic analysis reveals the regulatory mechanisms of messenger RNA (mRNA) and long non-coding RNA (lncRNA) in response to waterlogging stress in rye (Secale cereale L.)
Authors: Bimpong Daniel , Zhao Lili , Ran Mingyang , Zhao Xize , Wu Cuicui , Li Ziqun , Wang Xue , Cheng Ling , Fang Zhengwu , Hu Zanmin , Fan Chengming , Gyebi-Nimako Bernard , Luo Yirou , Wang Shuping , Zhang Yingxin
Published: June 2024

Background

Waterlogging stress (WS) negatively impacts crop growth and productivity, making it important to understand crop resistance processes and discover useful WS resistance genes. In this study, rye cultivars and wild rye species were subjected to 12-day WS treatment, and the cultivar Secale cereale L. Imperil showed higher tolerance. Whole transcriptome sequencing was performed on this cultivar to identify differentially expressed (DE) messenger RNAs (DE-mRNAs) and long non-coding RNAs (DE-lncRNAs) involved in WS response.

Results

Among the 6 species, Secale cereale L. Imperil showed higher tolerance than wild rye species against WS. The cultivar effectively mitigated oxidative stress, and regulated hydrogen peroxide and superoxide anion. A total of 728 DE-mRNAs and 60 DE-lncRNAs were discovered. Among these, 318 DE-mRNAs and 32 DE-lncRNAs were upregulated, and 410 DE-mRNAs and 28 DE-lncRNAs were downregulated. GO enrichment analysis discovered metabolic processes, cellular processes, and single-organism processes as enriched biological processes (BP). For cellular components (CC), the enriched terms were membrane, membrane part, cell, and cell part. Enriched molecular functions (MF) terms were catalytic activity, binding, and transporter activity. LncRNA and mRNA regulatory processes were mainly related to MAPK signaling pathway-plant, plant hormone signal transduction, phenylpropanoid biosynthesis, anthocyanin biosynthesis, glutathione metabolism, ubiquitin-mediated proteolysis, ABC transporter, Cytochrome b6/f complex, secondary metabolite biosynthesis, and carotenoid biosynthesis pathways. The signalling of ethylene-related pathways was not mainly dependent on AP2/ERF and WRKY transcription factors (TF), but on other factors. Photosynthetic activity was active, and carotenoid levels increased in rye under WS. Sphingolipids, the cytochrome b6/f complex, and glutamate are involved in rye WS response. Sucrose transportation was not significantly inhibited, and sucrose breakdown occurs in rye under WS.

Conclusions

This study investigated the expression levels and regulatory functions of mRNAs and lncRNAs in 12-day waterlogged rye seedlings. The findings shed light on the genes that play a significant role in rye ability to withstand WS. The findings from this study will serve as a foundation for further investigations into the mRNA and lncRNA WS responses in rye.
Genome-wide identification, molecular evolution and expression analysis of the B-box gene family in mung bean (Vigna radiata L.)
Authors: Yin Lili , Wu Ruigang , An Ruilan , Feng Yaxin , Qiu Yaqi , Zhang Meiling
Published: June 2024

Background

Mung bean (Vigna radiata L.) is an important warm-season grain legume. Adaptation to extreme environmental conditions, supported by evolution, makes mung bean a rich gene pool for stress tolerance traits. The exploration of resistance genes will provide important genetic resources and a theoretical basis for strengthening mung bean breeding. B-box (BBX) proteins play a major role in developmental processes and stress responses. However, the identification and analysis of the mung bean BBX gene family are still lacking.

Results

In this study, 23 VrBBX genes were identified through comprehensive bioinformatics analysis and named based on their physical locations on chromosomes. All the VrBBXs were divided into five groups based on their phylogenetic relationships, the number of B-box they contained and whether there was an additional CONSTANS, CO-like and TOC1 (CCT) domain. Homology and collinearity analysis indicated that the BBX genes in mung bean and other species had undergone a relatively conservative evolution. Gene duplication analysis showed that only chromosomal segmental duplication contributed to the expansion of VrBBX genes and that most of the duplicated gene pairs experienced purifying selection pressure during evolution. Gene structure and motif analysis revealed that VrBBX genes clustered in the same group shared similar structural characteristics. An analysis of cis-acting elements indicated that elements related to stress and hormone responses were prevalent in the promoters of most VrBBXs. The RNA-seq data analysis and qRT-PCR of nine VrBBX genes demonstrated that VrBBX genes may play a role in response to environmental stress. Moreover, VrBBX5, VrBBX10 and VrBBX12 are important candidate genes for plant stress response.

Conclusions

In this study, we systematically analyzed the genomic characteristics and expression patterns of the BBX gene family under ABA, PEG and NaCl treatments. The results will help us better understand the complexity of the BBX gene family and provide valuable information for future functional characteristics of specific genes in this family.
Chlamydia psittaci detected at a live poultry wholesale market in central China
Authors: Zhang Rusheng , Fu Huiyuan , Luo Can , Huang Zheng , Pei Ruiqing , Di Yu , Zhu Caiying , Peng Jiayi , Hu Huiqi , Chen Shan , Chen Jingfang , Chen Lamei , Xu Mingzhong , Yang Xuewen , Yang Rengui
Published: June 2024

Background

We investigated the presence of Chlamydia psittaci in poultry and the environment in live poultry wholesale markets in Changsha during 2021–2022 and conducted a phylogenetic analysis to understand its distribution in this market.

Methods

In total, 483 samples were analyzed using real-time polymerase chain reaction and 17 C. psittaci-positive samples using high-throughput sequencing, BLAST similarity, and phylogenetic analysis.

Results

Twenty-two out of 483 poultry and environmental samples were positive for C. psittaci (overall positivity rate: 4.55%) with no difference in positivity rates over 12 months. Chlamydia psittaci was detected at 11 sampling points (overall positivity rate: 27.5%), including chicken, duck, and pigeon/chicken/duck/goose shops, with pigeon shops having the highest positivity rate (46.67%). The highest positivity rates were found in sewage (12.5%), poultry fecal (7.43%), cage swab (6.59%), avian pharyngeal/cloacal swab (3.33%), and air (2.29%) samples. The ompA sequences were identified in two strains of C. psittaci, which were determined to bear genotype B using phylogenetic analysis. Thus, during monitoring, C. psittaci genotype B was detected in the poultry and environmental samples from the poultry wholesale market in Changsha.

Conclusions

To address the potential zoonotic threat, C. psittaci monitoring programs in live poultry markets should be enhanced.
Nomogram for the preoperative prediction of Ki-67 expression and prognosis in stage IA lung adenocarcinoma based on clinical and multi-slice spiral computed tomography features
Authors: Li Zhengteng , Liu Hongmei , Wang Min , Wang Xiankai , Pan Dongmei , Ma Aidong , Chen Yang
Published: June 2024

Objective

This study developed and validated a nomogram utilizing clinical and multi-slice spiral computed tomography (MSCT) features for the preoperative prediction of Ki-67 expression in stage IA lung adenocarcinoma. Additionally, we assessed the predictive accuracy of Ki-67 expression levels, as determined by our model, in estimating the prognosis of stage IA lung adenocarcinoma.

Materials and methods

We retrospectively analyzed data from 395 patients with pathologically confirmed stage IA lung adenocarcinoma. A total of 322 patients were divided into training and internal validation groups at a 6:4 ratio, whereas the remaining 73 patients composed the external validation group. According to the pathological results, the patients were classified into high and low Ki-67 labeling index (LI) groups. Clinical and CT features were subjected to statistical analysis. The training group was used to construct a predictive model through logistic regression and to formulate a nomogram. The nomogram’s predictive ability and goodness-of-fit were assessed. Internal and external validations were performed, and clinical utility was evaluated. Finally, the recurrence-free survival (RFS) rates were compared.

Results

In the training group, sex, age, tumor density type, tumor-lung interface, lobulation, spiculation, pleural indentation, and maximum nodule diameter differed significantly between patients with high and low Ki-67 LI. Multivariate logistic regression analysis revealed that sex, tumor density, and maximum nodule diameter were significantly associated with high Ki-67 expression in stage IA lung adenocarcinoma. The calibration curves closely resembled the standard curves, indicating the excellent discrimination and accuracy of the model. Decision curve analysis revealed favorable clinical utility. Patients with a nomogram-predicted high Ki-67 LI exhibited worse RFS.

Conclusion

The nomogram utilizing clinical and CT features for the preoperative prediction of Ki-67 expression in stage IA lung adenocarcinoma demonstrated excellent performance, clinical utility, and prognostic significance, suggesting that this nomogram is a noninvasive personalized approach for the preoperative prediction of Ki-67 expression.
Risk factors for neonatal hypoxic ischemic encephalopathy and therapeutic hypothermia: a matched case-control study
Authors: Roto Suoma , Nupponen Irmeli , Kalliala Ilkka , Kaijomaa Marja
Published: June 2024

Background

Peripartum asphyxia is one of the main causes of neonatal morbidity and mortality. In moderate and severe cases of asphyxia, a condition called hypoxic-ischemic encephalopathy (HIE) and associated permanent neurological morbidities may follow. Due to the multifactorial etiology of asphyxia, it may be difficult prevent, but in term neonates, therapeutic cooling can be used to prevent or reduce permanent brain damage. The aim of this study was to assess the significance of different antenatal and delivery related risk factors for moderate and severe HIE and the need for therapeutic hypothermia.

Methods

We conducted a retrospective matched case-control study in Helsinki University area hospitals during 2013–2017. Newborn singletons with moderate or severe HIE and the need for therapeutic hypothermia were included. They were identified from the hospital database using ICD-codes P91.00, P91.01 and P91.02. For every newborn with the need for therapeutic hypothermia the consecutive term singleton newborn matched by gender, fetal presentation, delivery hospital, and the mode of delivery was selected as a control. Odds ratios (OR) between obstetric and delivery risk factors and the development of HIE were calculated.

Results

Eighty-eight cases with matched controls met the inclusion criteria during the study period. Maternal and infant characteristics among cases and controls were similar, but smoking was more common among cases (aOR 1.46, CI 1.14–1.64, p = 0.003). The incidence of preeclampsia, diabetes and intrauterine growth restriction in groups was equal. Induction of labour (aOR 3.08, CI 1.18–8.05, p = 0.02) and obstetric emergencies (aOR 3.51, CI 1.28–9.60, p = 0.015) were more common in the case group. No difference was detected in the duration of the second stage of labour or the delivery analgesia.

Conclusions

Smoking, induction of labour and any obstetric emergency, especially shoulder dystocia, increase the risk for HIE and need for therapeutic hypothermia. The decisions upon induction of labour need to be carefully weighed, since maternal smoking and obstetric emergencies can hardly be controlled by the clinician.
Analysis of surgically induced astigmatism of the anterior, posterior, and total cornea after implantable collamer lens implantation: a comparative study between temporal and superior clear corneal incisions
Authors: Wan Ting , Chen Huaicheng , Wu Shirou , Jin Hongying
Published: June 2024

Background

To comparatively analyze the surgically induced astigmatism (SIA) of the anterior, posterior, and total corneas of eyes undertaking implantable collamer lens (ICL) implantation with temporal or superior corneal incisions.

Methods

One hundred and nine eyes of 109 patients who received ICL implantation were recruited: 40 eyes had temporal incisions and 69 eyes had superior incisions. Total corneal refractive power (TCRP); simulated keratometry of the anterior (Sim-KAnt) and posterior (Sim-KPost) corneal curvature; and astigmatism of the anterior (CAAnt), posterior (CAPost), and total (CATCRP) cornea were recorded through a Pentacam preoperatively and 3 months postoperatively. The SIA of the anterior, posterior, and total cornea were also compared between the two groups.

Results

There were no significant intergroup differences for TCRP, Sim-KAnt, Sim-KPost, CAAnt, CAPost, or CATCRP, preoperatively. However, values of CAAnt, CAPost, and CATCRP with temporal incision were significantly higher than those parameters with superior incision postoperatively. All of the SIA of the anterior, posterior, and total cornea were significantly lower for temporal incision than those with a superior incision (p < 0.001, p = 0.006 and p = 0.001 respectively). Meanwhile, the superior incisions created against-the-rule (ATR) astigmatism, and temporal incisions always induce with-the-rule (WTR) astigmatism in total cornea.

Conclusions

A superior incision may be suitable for correcting WTR astigmatism, while a temporal incision for correcting ATR astigmatism when using a non-toric ICL. Meanwhile, temporal incision could be a better choice with little preoperative astigmatism or that preoperative astigmatism would be corrected with toric ICLs.

Trial registration

Registration number: ChiCTR2100051739. Prospectively registered: 01 October 2021.