bluuebunny/crossref_metadata_2025 huggingface dataset:
Establishment and Finite Element Analysis of a Three‐dimensional Dynamic Model of Upper Cervical Spine Instability
Authors: Wang Xiao‐dong , Feng Min‐shan , Hu Yong‐cheng
Published: June 2019

Objectives

To establish a dynamic three‐dimensional (3D) model of upper cervical spine instability and to analyze its biomechanical characteristics.

Methods

A 3D geometrical model was established after CT scanning of the upper cervical spine specimen. The ligament of the specimen was fatigued to establish the upper cervical spine‐instability model. A 100‐N preloaded stress was applied to the upper surface of the occipital bone, and then a 1.5‐Nm moment was applied in the occipital‐sagittal direction to simulate upper cervical spine flexion and extension. Subsequently, the 3D dynamic model was established based on trajectory data that were measured using a motion‐capture system. The stress on the main ligament and the relative motion angle of the joint were analyzed.

Results

The shape of the model grid was regular and the total number of its units was 627 000. After finite‐element analysis was conducted, results of the ligament stress and relative movement angle were obtained. After the upper cervical spine instability, the pressure of the alar ligament during the upper cervical spine extension was increased from 2.85 to 8.12 MPa. The pressure of the flavum ligament was increased during the upper‐cervical spine flexion, from 0.90 to 1.21 MPa. The pressure of the odontoid ligament was reduced during the upper cervical spine flexion and extension, from 10.46 to 6.67 MPa and 25.66 to 16.35 MPa, respectively. The pressure of the anterior longitudinal ligament and cruciate ligament was increased to a certain degree during upper cervical spine flexion and extension. The pressure of the anterior longitudinal ligament was increased during flexion and extension, from 7.70 to 10.10 MPa and 10.45 to 13.75 MPa, respectively. The pressure of the cruciate ligament was increased during flexion and extension, from 2.29 to 4.34 MPa and 2.32 to 4.40 MPa, respectively. In addition, after upper cervical spine instability, the articular‐surface relative‐movement angle of the atlanto‐occipital joint and atlanto‐axial joint had also changed. During upper cervical spine flexion, the angle of the atlanto‐occipital joint was increased from 3.49° to 5.51°, and the angle of the atlanto‐axial joint was increased from 8.84° to 13.70°. During upper cervical spine extension, the angle of the atlanto‐occipital joint was increased from 11.16° to 12.96°, and the angle of the atlanto‐axial joint was increased from 14.20° to 17.20°. Therefore, the movement angle of the atlanto‐axial joint was most obvious after induction of instability.

Conclusion

The 3D dynamic finite‐element model of the upper cervical spine can be used to analyze and summarize the relationship between the change of ligament stress and the degree of instability in cervical instability. Frequent or prolonged flexion activities are more likely to lead to instability of the upper cervical spine.
Midterm Clinical Outcome of Combined Posterior Cruciate Ligament Reconstruction and Posterolateral Corner Surgery Using Second‐Look Arthroscopic “Lateral Gutter Drive‐Through” Test as an Adjunctive Evaluation
Authors: Li Yue , Hong Lei , Wang Xue‐song , Zhang Hui , Li Xu , Zheng Tong , Feng Hua
Published: June 2019

Objectives

The arthroscopic “lateral gutter drive‐through” (LGDT) sign is reported to diagnose popliteus tendon (PT) injury with high sensitivity and specificity. However, no study has provided a postoperative evaluation of combined posterior cruciate ligament (PCL) and posterolateral corner (PLC) injuries using the LGDT test.

Methods

From January 2012 to January 2015, a total of 80 consecutive patients who underwent combined PCL reconstruction and PLC surgeries were identified. Fifty eligible patients were included in this study for evaluation with subjective scoring systems, physical examinations, posterior and varus stress radiographs, and second‐look arthroscopic surgeries during hardware removal operation.

Results

Forty‐nine patients were available for a mean of 31.5 ± 9.3 months follow‐up (range, 24.0–81.0 months). In terms of PLC injury pattern, there were 27 type A, 10 type B, and 12 type C patients, with 21 acute cases and 28 chronic cases. At the final follow‐up, subjective scores were all significantly improved. The side‐to‐side difference (SSD) of posterior tibial translation (PTT) improved from 18.4 ± 9.2 mm (range, 12.9–25.6 mm) to 5.2 ± 5.0 mm (range, −5.0−18.5 mm, P < 0.001), and the SSD of tibial external rotation by dial test (ER) decreased from 18.0° ± 14.4° (range, 13.0°–22.0°) to 1.2° ± 7.5° (range, −9.0°–22.0°, P < 0.001). In patients with type C injury, the SSD of the lateral opening decreased from 14.2 ± 6.6 mm (range, 22–10.2 mm) to 0.9 ± 3.1 mm (range, −4.4‐6 mm, P < 0.001). In a comparison between patients with positive and negative LGDT signs, the LGDT‐negative patients had significant superiority in subjective scores, SSD of PTT, and SSD of ER. The sensitivity and specificity of the LGDT test in detecting postoperative posterolateral rotational instability (PLRI) were calculated as 100% and 88.4%, respectively.

Conclusions

In the series of surgically treated patients with PCL and PLC injury: (i) patients had improved subjective and objective clinical outcome after combined PCL reconstruction and PLC surgery at a minimum of 24‐months follow‐up; and (ii) second arthroscopic LGDT sign testing had high sensitivity and specificity in detecting postoperative PLRI, and a positive LGDT sign was related with inferior subjective and objective results.
Clinical efficacy of a combined acceptance and commitment therapy, dialectical behavioural therapy, and functional analytic psychotherapy intervention in patients with borderline personality disorder
Authors: Reyes‐Ortega Michel A. , Miranda Edgar M. , Fresán Ana , Vargas Angélica N. , Barragán Sandra C. , Robles García Rebeca , Arango Iván
Published: June 2019

Objective

Borderline personality disorder (BPD) consists of a persistent pattern of instability in affective regulation, impulse control, interpersonal relationships, and self‐image. Although certain forms of psychotherapy are effective, their effects are small to moderate. One of the strategies that have been proposed to improve interventions involves integrating the therapeutic elements of different psychotherapy modalities from a contextual behavioural perspective (ACT, DBT, and FAP).

Methods

Patients (n = 65) attending the BPD Clinic of the Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz in Mexico City who agreed to participate in the study were assigned to an ACT group (n = 22), a DBT group (n = 20), or a combined ACT + DBT + FAP therapy group (n = 23). Patients were assessed at baseline and after therapeutic trial on measures of BPD symptom severity, emotion dysregulation, experiential avoidance, attachment, control over experiences, and awareness of stimuli.

Results

ANOVA analyses showed no differences between the three therapeutic groups in baseline measures. Results of the MANOVA model showed significant differences in most dependent measures over time but not between therapeutic groups.

Conclusions

Three modalities of brief, contextual behavioural therapy proved to be useful in decreasing BPD symptom severity and emotional dysregulation, as well as negative interpersonal attachment. These changes were related to the reduction of experiential avoidance and the acquisition of mindfulness skills in all treatment groups, which may explain why no differences between the three different intervention modalities were observed.

Practitioner points

Brief adaptations of acceptance and commitment therapy and dialectical behavioural therapy are effective interventions for BPD patients, in combined or isolated modalities, and with or without the inclusion of functional analytic psychotherapy.

The reduction of experiential avoidance and the acquisition of mindfulness skills are related with the diminution of BPD symptoms severity, including emotional dysregulation and negative interpersonal attachment.
End‐of‐life care in the pediatric intensive care unit: Survey in Japan
Authors: Seino Yusuke , Kurosawa Hiroshi , Shiima Yuko , Niitsu Takehiro
Published: June 2019

Background

End‐of‐life (EOL) care is an important topic in critical care medicine, but EOL discussions with families can be difficult and stressful for intensivists. The aim of this study was to clarify the current practices and barriers facing pediatric intensive care unit (PICU) EOL care and to identify the requisites for excellent PICU EOL care in Japan.

Methods

A survey was conducted in 29 facilities across Japan in 2016. The questionnaire consisted of 19 multiple‐choice questions and one open‐ended question.

Results

Twenty‐seven facilities responded to the survey. Only 19% had educational programs on EOL care for fellows or residents. Although 21 hospitals (78%) had a multidisciplinary palliative care team, only eight of these teams were involved in EOL care in PICUs. Mental health care for health‐care providers provided by a psychiatrist was rare (4%). The free comments were categorized as individual, team, environment, legal/ethics, or culture. Commonly raised individual issues included “lack of experience and knowledge about EOL care”, “fear of making the decision to end care”, and “reluctance to be involved in EOL care because of its complex process”. Team issues included “insufficient frequency of conferences” and “non‐multidisciplinary approach”. Legal and ethics issues were “lack of legal support” and “fear of lawsuits”.

Conclusions

This study is the first to investigate the current conditions and barriers in PICU EOL care in Japan. Most of the facilities involved were not satisfied with current practices. A need was identified for relevant educational programs, as well as the importance of multidisciplinary and legal support.
Effects of feedback delay and agency on feedback‐locked beta and theta power during reinforcement learning
Authors: Weismüller Benjamin , Kullmann Janna , Hoenen Matthias , Bellebaum Christian
Published: June 2019

Feedback‐based learning initiated by dopamine (DA) cell firing is crucial for adaptive behavior. The nature and context of feedback can vary, however, affecting how feedback is processed. For example, the feedback‐related negativity (FRN) in the ERP in humans, which has been linked to the DA system, is reduced for delayed feedback and for observational compared to active learning. Recent research suggested that oscillations in the theta and beta band over the medio‐frontal cortex reflect distinct feedback processing mechanisms. In this study, we hypothesized that the power in both frequency bands is affected by feedback delay and agency. We thus investigated effects of feedback delay (1 s vs. 7 s) on induced theta and beta band power and the FRN in a probabilistic feedback learning task in two participant groups, one learning actively and one by observation. For theta and beta, a larger power difference between negative and positive feedback for immediate than delayed feedback was found, driven by positive feedback for beta and by negative feedback for theta, while no differential modulation by agency was seen for theta or beta power following positive and negative feedback. These results indicate that feedback‐locked beta and theta both reflect neural processes that are specific for the integration of feedback and recently preceding events, possibly linked to cognitive control and memory. With respect to the FRN amplitude, we could replicate previous findings of both delay and agency modulations, suggesting that the neural processes underlying feedback‐locked ERPs and theta and beta power modulations differ.
Balancing nature and economic interests in the European Union: On the concept of mitigation under the Habitats Directive
Authors: Squintani Lorenzo
Published: June 2019

The Habitats Directive and, more specifically, its provisions on site protection have been the subject of several judgments by the Court of Justice of the European Union. These judgments have progressively clarified the balance between nature conservation interests and economic ones. Following a recent judgment of the Court about the managing of nitrogen deposition in Natura 2000 sites, this contribution highlights the known and unknown aspects of this legal field. It underlines in particular the importance of further clarification of the standards to pursue a programmatic approach in nature conservation and to evaluate science‐based evidence in court.
A review of approaches for analysing obstructive sleep apnoea‐related patterns in pulse oximetry data
Authors: Terrill Philip I.
Published: June 2019

Overnight pulse oximetry allows the relatively non‐invasive estimation of peripheral blood haemoglobin oxygen saturations (SpO2), and forms part of the typical polysomnogram (PSG) for investigation of obstructive sleep apnoea (OSA). While the raw SpO2 signal can provide detailed information about OSA‐related pathophysiology, this information is typically summarized with simple statistics such as the oxygen desaturation index (ODI, number of desaturations per hour). As such, this study reviews the technical methods for quantifying OSA‐related patterns in oximetry data. The technical methods described in literature can be broadly grouped into four categories: (i) Describing the detailed characteristics of desaturations events; (ii) Time series statistics; (iii) Analysis of power spectral distribution (i.e. frequency domain analysis); and (d) Non‐linear analysis. These are described and illustrated with examples of oximetry traces. The utilization of these techniques is then described in two applications. First, the application of detailed oximetry analysis allows the accurate automated classification of PSG‐defined OSA. Second, quantifications which better characterize the severity of desaturation events are better predictors of OSA‐related epidemiological outcomes than standard clinical metrics. Finally, methodological considerations and further applications and opportunities are considered.
China in Laos: Enclave spaces and the transformation of borders in the Mekong Region
Authors: Laungaramsri Pinkaew
Published: June 2019

Where China Meets Southeast Asia: Social and Cultural Change in the Border Regionsedited by Grant Evanset al., is among the few works that take borderlands between China and mainland Southeast Asia seriously. A major contribution of this collection of border studies is its attempt to understand how border experiences and the process of bordering have changed since the early 1990s. Various Chinese–local interactions are explored in this book, with an emphasis on complex local responses to border transformations and diverse forms of mobility and network building. This article further examines the role of China and the Lao state, and the new wave of Chinese movement at the border. In establishing an economic integration that spills across the region, the penetration of Chinese power has been effective. The consequent retreat of the Lao state at the border has not only put an end to the old frontier but turned various borderlands into an estranged space of neoliberal enclave.
Surface Modification of Teflonated Carbon Fabric by Ultrasound-Assisted Radiation Induced Grafting Copolymerization
Authors: Zubair Nur Afifah , Nasef Mohamed Mahmoud , Ming Ting Teo , Abouzari-Lotf Ebrahim , Abdullah Ezzat Chan
Published: June 2019

A simple and effective modification method was carried out to improve the surface properties of teflon-impregnated carbon fabric (TICF) by radiation induced grafting (RIG) of glycidyl methacrylate (GMA). The grafting reaction was carried out using an ultrasound-assisted technique in comparison with a conventional grafting technique. The degree of grafting was investigated at various reaction times for both systems. The grafting efficiency for ultrasonic-aided technique reached 85% compared to 53% in conventional grafting technique. This significant improvement is probably due to the emergence of monomers diffusion on the grafting sites caused by ultrasonically assisted grafting reaction. Scanning electron microscopy (SEM) and Fourier transform infrared (FTIR) spectroscopy have provided evidences for incorporation of poly(GMA) grafts. The grafting under ultrasonic condition was proven to be more efficient and economical as indicated by the increase in DG and reduction in the homopolymer contamination accompanied by homogenous grafting and smoother surfaces in TICF.
Energy Efficiency Study, Comparing, Commercial Grade Propane/Butane Blend; Refrigerant Grade Propane and Chlorodifluoromethane (CHClF2), Investigated in a Psychrometric Chamber
Authors: Zakaria Z. , Veerasamy D. , Koh J. H.
Published: June 2019

The current use of hydrochlorofluorocarbons (HCFCs) and hydrofluorocarbons (HFCs) as refrigerants will be phaseout and phasedown. Hydrocarbon (HC) refrigerants were introduced as potential replacements. These refrigerant grade hydrocarbons namely propane (R 290) and isobutane (R 600a) were on sale at premium prices. As Malaysia has capabilities to produce LPG, a study was conducted to find out the suitability of commercial liquefied petroleum gas (LPG) to be used as refrigerant. This study compares the efficiencies and cooling capacities of commercial grade LPG to refrigerant grade propane (C3H8) and chlorodifluoromethane (CHClF2) (R 22) in a split unit air conditioner installed in a psychrometric chamber. Results of experiments indicated that the commercial blends in the ratio of 80% propane and 20% butane provided the highest efficiency, but had the lowest cooling capacities; in contrast, the imported refrigerant grade propane despite value being purer, was not reflected in term of its efficiency; recorded the lowest. CHClF2 provided the highest efficiency and cooling capacity. LPG has the potential to replace R22 in split air conditioners despite losing 10 % in cooling capacities but instead gained 2.6% in energy efficiencies.
Nilai-Nilai Islam Dalam Pelaksanaan Sistem Pengurusan Kualiti ISO 9000: Kajian Kes Di Institusi Pengajian Tinggi Malaysia (Islamic Values in Quality Management System ISO 9000 Implementation: A Case Study in Malaysia Higher Education Institution)
Authors: Basir Siti Arni , Ismail Sharifah Hayaati Syed , Azmi Ilhaamie Abdul Ghani , Mohamed Hasan Albanna , Kamaruzzaman Syahrul Nizam
Published: June 2019

The ISO 9000 Quality Management System is widely implemented in various sectors in Malaysia, including in the higher education sector. The main objective of implementing ISO 9000 in Higher Education Institutions (HEIs) is to improve the quality related to administrative as well as academic matters. Implementation of ISO 9000 emphasizes on key clauses namely quality management system, risk management, resource management, product realization, analysis and continuous improvement. All these clauses emphasize on technical aspects. Therefore, the value aspect should also be emphasized that the practice of ISO 9000 can be implemented in a balanced way. The objective of this article is to examine Islamic values in the implementation of ISO 9000 in Malaysian HEI. This qualitative study uses a public HEI located in the Klang Valley as a case study. Semi-structural interview is used as a data collection method. The data were analyzed using thematic analysis method. The research findings show that there are five Islamic values practiced in the implementation of ISO 9000 namely Shura, Itqan, discipline, responsibility and Istiqamah. All of these Islamic values help in implementing ISO 9000 effectively in Malaysian HEI.
Synergity of Health Services to the Interaction of Healthy Life Behavior of Rural Communities in South Sulawesi
Authors: M. Kes Darwis,
Published: June 2019

Types of qualitative research through the phenomenological approach, the results showed that health services in the area is not optimal, it is seen that health care is still dominated by Puskesmas, while for diseases Conducted by referring to hospitals that have a better scale and handling, this is because Puskesmas has limited service in terms of facilities, medical personnel, drugs etc., other than that the community is increasingly The day, the more economic access would require better service so that many people choose treatment in the city that has better facilities.
Application of a Novel Rotordynamic Identification Method for Annular Seals With Arbitrary Elliptical Orbits and Eccentricities
Authors: Zhang Wanfu , Gu Qianlei , Yang Jiangang , Li Chun
Published: June 2019

The identification method using infinitesimal theory is proposed to predict rotordynamic coefficients of annular gas seals. The transient solution combined with moving grid method was unitized to obtain the fluid reaction force at a specific position under different whirling frequencies. The infinitesimal method is then applied to obtain the rotordynamic coefficients, which agrees well with published experimental results for both labyrinth seals and eccentric smooth annular seals. Particularly, the stability parameter of the effective damping coefficient can be solved precisely. Results show that the whirling frequency has little influence on direct damping coefficient, effective damping coefficient, and cross-coupled stiffness coefficient for the labyrinth seal. And the effective damping coefficients decrease as the eccentricity ratio increases. A higher eccentricity ratio tends to destabilize the seal system, especially at a low whirling frequency. Results also show that the fluid velocity in the maximum clearance in the seal leakage path is less than that in the minimum clearance. The inertial effect dominates the flow field. Then it results in higher pressure appearing in maximum clearances. The pressure difference aggravates the eccentricity of rotor and results in static instabilities of the seal system.
Thermal Analysis of Cold Plate for Direct Liquid Cooling of High Performance Servers
Authors: Ramakrishnan Bharath , Hadad Yaser , Alkharabsheh Sami , Chiarot Paul R. , Sammakia Bahgat
Published: June 2019

Data center energy usage keeps growing every year and will continue to increase with rising demand for ecommerce, scientific research, social networking, and use of streaming video services. The miniaturization of microelectronic devices and an increasing demand for clock speed result in high heat flux systems. By adopting direct liquid cooling, the high heat flux and high power demands can be met, while the reliability of the electronic devices is greatly improved. Cold plates which are mounted directly on to the chips facilitate a lower thermal resistance path originating from the chip to the incoming coolant. An attempt was made in the current study to characterize a commercially available cold plate which uses warm water in carrying the heat away from the chip. A mock package mimicking a processor chip with an effective heat transfer area of 6.45 cm2 was developed for this study using a copper block heater arrangement. The thermo-hydraulic performance of the cold plates was investigated by conducting experiments at varying chip power, coolant flow rates, and coolant temperature. The pressure drop (ΔP) and the temperature rise (ΔT) across the cold plates were measured, and the results were presented as flow resistance and thermal resistance curves. A maximum heat flux of 31 W/cm2 was dissipated at a flow rate of 13 cm3/s. A resistance network model was used to calculate an effective heat transfer coefficient by revealing different elements contributing to the total resistance. The study extended to different coolant temperatures ranging from 25 °C to 45 °C addresses the effect of coolant viscosity on the overall performance of the cold plate, and the results were presented as coefficient of performance (COP) curves. A numerical model developed using 6SigmaET was validated against the experimental findings for the flow and thermal performance with minimal percentage difference.
Experimental Testing of Vibration Mitigation in 3D-Printed Architected Metastructures
Authors: Arretche Ignacio , Matlack Kathryn H.
Published: June 2019

Band gaps in metamaterials and phononic crystals provide a way to engineer vibration mitigation into a material’s geometry. Here, we present a comprehensive experimental characterization of band gaps in lattice-resonator metastructures, which have been previously analyzed with finite element simulations, to better understand this phenomenon in 3D-printed materials. We fabricate the metastructures with a new approach to obtain multimaterial structures using stereolithography. We experimentally characterize the material’s frequency-dependent storage and loss modulus over the band gap frequencies to confirm that the measured band gaps are due to geometry and not due to material properties. Experimental results using both frequency sweep and impulse excitations show that band gaps and attenuation efficiencies strongly depend on the lattice geometry as well as loading direction, and a comparison between axial and bending excitation responses reveals frequency ranges of “fluid-like” and “optical-like” behaviors. Comparison between finite element simulations and experimental results demonstrate the robustness of the metastructure design. While the experiments used here are well established, their combination allows us to gain additional insights into band gaps measurements. Specifically, we show that the coherence function, a common concept in signal processing, is a strong predictor of band gaps in linear materials and that the attenuation efficiency inside the measured band gap can be physically limited by fluid–structure interactions.
Characterization of bubbler performance for low-volatility liquid precursor delivery
Authors: Maslar James E. , Kimes William A. , Sperling Brent A. , Kanjolia Ravindra K.
Published: June 2019

The performance of a bubbler to deliver the low-volatility, liquid cobalt precursor μ2-η2-(tBu-acetylene) dicobalthexacarbonyl (CCTBA) for reduced-pressure chemical vapor deposition and atomic layer deposition processes was characterized. A relatively large process window was investigated by varying carrier gas flow rate, system pressure, and bubbler temperature. For this range of conditions, the CCTBA partial pressure was measured using a custom-designed nondispersive infrared gas analyzer, and the CCTBA flow rates were derived from these partial pressure measurements. The dependence of CCTBA flow rate on these process parameters was modeled to obtain a deeper understanding of the factors influencing bubbler performance. Good agreement between measured and modeled CCTBA flow rates was obtained using a model in which the pressure drop between the bubbler head space and the pressure measurement location was included and in which a constant CCTBA partial pressure in the bubbler head space for a given bubbler temperature was assumed. The dependence of CCTBA head space partial pressure on temperature was parameterized in the form of the August equation, which is commonly used to describe the temperature-dependence of vapor pressure. While this report was focused specifically on CCTBA, the results of this study indicate that this method for estimating the precursor delivery rate from a bubbler should be applicable to other low-volatility, liquid precursors.
The Effect of Carbohydrate Ingestion Following Eccentric Resistance Exercise on AKT/mTOR and ERK Pathways: A Randomized, Double-Blinded, Crossover Study
Authors: Figueiredo Vandre C. , Farnfield Michelle M. , Ross Megan L.R. , Gran Petra , Halson Shona L. , Peake Jonathan M. , Cameron-Smith David , Markworth James F.
Published: June 2019

Purpose: To determine the acute effects of carbohydrate (CHO) ingestion following a bout of maximal eccentric resistance exercise on key anabolic kinases of mammalian target of rapamycin and extracellular signal-regulated kinase (ERK) pathways. The authors’ hypothesis was that the activation of anabolic signaling pathways known to be upregulated by resistance exercise would be further stimulated by the physiological hyperinsulinemia resulting from CHO supplementation. Methods: Ten resistance-trained men were randomized in a crossover, double-blind, placebo (PLA)-controlled manner to ingest either a noncaloric PLA or 3 g/kg of CHO beverage throughout recovery from resistance exercise. Muscle biopsies were collected at rest, immediately after a single bout of intense lower body resistance exercise, and after 3 hr of recovery. Results: CHO ingestion elevated plasma glucose and insulin concentrations throughout recovery compared with PLA ingestion. The ERK pathway (phosphorylation of ERK1/2 [Thr202/Tyr204], RSK [Ser380], and p70S6K [Thr421/Ser424]) was markedly activated immediately after resistance exercise, without any effect of CHO supplementation. The phosphorylation state of AKT (Thr308) was unchanged postexercise in the PLA trial and increased at 3 hr of recovery above resting with ingestion of CHO compared with PLA. Despite stimulating-marked phosphorylation of AKT, CHO ingestion did not enhance resistance exercise–induced phosphorylation of p70S6K (Thr389) and rpS6 (Ser235/236 and Ser240/244). Conclusion: CHO supplementation after resistance exercise and hyperinsulinemia does not influence the ERK pathway nor the mTORC1 target p70S6K and its downstream proteins, despite the increased AKT phosphorylation.
Development of an Athlete Diet Index for Rapid Dietary Assessment of Athletes
Authors: Capling Louise , Gifford Janelle A. , Beck Kathryn L. , Flood Victoria M. , Slater Gary J. , Denyer Gareth S. , O’Connor Helen T.
Published: June 2019

Food-based diet indices provide a practical, rapid, and inexpensive way of evaluating dietary intake. Rather than nutrients, diet indices assess the intake of whole foods and dietary patterns, and compare these with nutrition guidelines. An athlete-specific diet index would offer an efficient and practical way to assess the quality of athletes’ diets, guide nutrition interventions, and focus sport nutrition support. This study describes the development and validation of an Athlete Diet Index (ADI). Item development was informed by a review of existing diet indices, relevant literature, and in-depth focus groups with 20 sports nutritionists (median of 11 years’ professional experience) from four elite athlete sporting institutes. Focus group data were analyzed (NVivo 11 Pro; QSR International Pty. Ltd., 2017, Melbourne, Australia), and key themes were identified to guide the development of athlete-relevant items. A modified Delphi survey in a subgroup of sports nutritionists (n = 9) supported item content validation. Pilot testing with athletes (n = 15) subsequently informed face validity. The final ADI (n = 68 items) was categorized into three sections. Section A (n = 45 items) evaluated usual intake, special diets or intolerances, dietary habits, and culinary skills. Section B (n = 15 items) assessed training load, nutrition supporting training, and sports supplement use. Section C (n = 8 items) captured the demographic details, sporting type, and caliber. All of the athletes reported the ADI as easy (40%) or very easy (60% of participants) to use and rated the tool as relevant (37%) or very relevant (63% of participants) to athletes. Further evaluation of the ADI, including the development of a scoring matrix and validation compared with established dietary methodology, is warranted.
Father-Child Sports Participation and Outdoor Activities: Patterns and Implications for Health and Father-Child Relationships
Authors: Knoester Chris , Randolph Theo
Published: June 2019

Using Fragile Families data (N = 2,581), this study analyzes father’s engagement in sports and outdoor activities with their nine year-old child. It also considers the implications of these interactions for health and father-child relationships. First, the results indicate patterns of relatively high levels of father engagement. Most fathers reported doing sports or outdoor activities with their child once per week or more. Second, the results show socioeconomic, gender, and family structure discrepancies in the likelihood that fathers engage in sports or outdoor activities with their child. Finally, the findings reveal that father-child interactions in sports and outdoor activities are positively associated with reports of health and father-child closeness, for both fathers and children. Thus, it seems that father-child interactions in sports and outdoor activities can serve as purposive forms of leisure that can have positive effects for health and relationships.
Pretty Strong Women: Ingenious Agency, Pink Gloves and Muay Thai
Authors: Davies Sharyn G. , Deckert Antje
Published: June 2019

Women now compete in the Ultimate Fighting Championship for which Muay Thai is a feeder discipline. It is timely to analyze how the tools of this pugilist trade, women’s bodies, are lived and discursively positioned. We explore how bodily attributes (strength and beauty) are positioned vis-a-vis women fighters by drawing on 17 interviews with women Muay Thai fighters. We argue while women are in control of their bodies and proud of their strength, normative narratives of fighting being unfeminine must be combatted. Theoretically, we expand discussion of gender and the body by deploying the ‘pretty imperative’ to examine how women’s quotidian practices open space for other women fighters and by engaging the notion of ingenious agency to reveal women’s strategic efforts for inclusion and acceptance.
“I Feel We are Inclusive Enough”: Examining Swimming Coaches’ Understandings of Inclusion and Disability
Authors: Hammond Andrew , Jeanes Ruth , Penney Dawn , Leahy Deana
Published: June 2019

In this study, semi-structured interviews were conducted with eight Victorian swimming coaches to examine the discourses of disability1 and inclusion that they expressed in relation to their current coaching practices. Analysis specifically pursued links between neoliberalism, ableism, elitism, classification and inclusion in coaching, with the intention of exploring what discourse relations are possible, imaginable and practical within what have been referred to as neoliberal-ableist times. Findings reveal that coaches replicate and reproduce elitist, ableist assumptions about the body and sport. The discussion prompts a consideration of how rationalities and techniques of inclusion are limited under the prevailing political context.
North Korea's HIV epidemic emerges from the shadows
Authors: Stone Richard
Published: June 2019

Nation has long denied the presence of the virus. But new report says it's being spread by drug use and tainted blood.
Plan to use second Ebola vaccine sparks debate
Authors: Kupferschmidt Kai
Published: June 2019

New shots could protect more people, but also create confusion and stretch resources.
AAAS' EPI Center shares the science of election security
Authors: Korte Andrea
Published: June 2019

New program to deliver evidence to policy-makers ahead of 2020 elections
Mechanism of β
2
AR regulation by an intracellular positive allosteric modulator
Authors: Liu Xiangyu , Masoudi Ali , Kahsai Alem W. , Huang Li-Yin , Pani Biswaranjan , Staus Dean P. , Shim Paul J. , Hirata Kunio , Simhal Rishabh K. , Schwalb Allison M. , Rambarat Paula K. , Ahn Seungkirl , Lefkowitz Robert J. , Kobilka Brian
Published: June 2019

Positive reinforcement in a GPCR

Many drug discovery efforts focus on G protein–coupled receptors (GPCRs), a class of receptors that regulate many physiological processes. An exemplar is the β
2
-adrenergic receptor (β
2
AR), which is targeted by both blockers and agonists to treat cardiovascular and respiratory diseases. Most GPCR drugs target the primary (orthosteric) ligand binding site, but binding at allosteric sites can modulate activation. Because such allosteric sites are less conserved, they could possibly be targeted more specifically. Liu
et al.
report the crystal structure of β
2
AR bound to both an orthosteric agonist and a positive allosteric modulator that increases receptor activity. The structure suggests why the modulator compound is selective for β
2
AR over the closely related β
1
AR. Furthermore, the structure reveals that the modulator acts by enhancing orthosteric agonist binding and stabilizing the active conformation of the receptor.

Science
, this issue p.
1283
Elephants that help humans
Giants of the Monsoon Forest: Living and Working with Elephants
Jacob Shell
Norton, 2019. 291 pp.
Authors: Rizzolo Jessica Bell
Published: June 2019

An unlikely interspecies partnership hints at a potential model for conservation
Murray Gell-Mann (1929–2019)
Authors: Ramond Pierre
Published: June 2019

Brilliant particle physicist who discovered quarks
Factors Controlling Floc Formation and Structure in the Cyanobacterium
Synechocystis
sp. Strain PCC 6803
Authors: Conradi Fabian D. , Zhou Rui-Qian , Oeser Sabrina , Schuergers Nils , Wilde Annegret , Mullineaux Conrad W.
Published: June 2019

Some bacteria form flocs, which are multicellular floating assemblages of many thousands of cells. Flocs have been relatively little studied compared to surface-adherent biofilms, but flocculation could play many physiological roles, be a crucial factor in marine carbon burial, and enable more efficient biotechnological cell harvesting. We studied floc formation and architecture in the model cyanobacterium
Synechocystis
sp. strain PCC 6803, using mutants to identify specific cell surface structures required for floc formation. We show that floc formation is regulated by blue and green light perceived by the photoreceptor Cph2. The flocs have a characteristic structure based on strands of linked cells aggregating into dense clusters. Cells within the dense clusters show signs of nutrient stress, pointing to a disadvantage of floc formation.
Transforming Growth Factor β Acts as a Regulatory Molecule for Lipogenic Pathways among Hepatitis C Virus Genotype-Specific Infections
Authors: Patra Tapas , Sasaki Reina , Meyer Keith , Ray Ratna B. , Ray Ranjit
Published: June 2019

Hepatic steatosis is a frequent complication associated with chronic hepatitis C virus (HCV) infection and is a key prognostic indicator for progression to fibrosis and cirrhosis. Several mechanisms are proposed for the development of steatosis, especially with HCV genotype 3a. Our observations suggest that transforming growth factor β (TGF-β) and peroxisome proliferator-activated receptor alpha (PPARα)-associated mechanistic pathways in hepatocytes infected with HCV genotype 2a and 3a differ from those in cells infected with genotype 1a. The results suggest that a targeted therapeutic approach for enhanced PPARα and lipolysis may reduce HCV genotype-associated lipid metabolic disorder in liver disease.
New biostratigraphic evidence of Late Permian to Late Triassic deposits from Central Tibet and their paleogeographic implications
Authors: Wu Gui-chun , Ji Zhan-sheng , Liao Wei-hua , Yao Jian-xin
Published: June 2019

Triassic deposits in the Bangong-Nujiang Suture Zone are important for understanding its tectonic nature and evolutionary history, but have not been systematically studied due to a lack of biostratigraphic data. For a long time, the Upper Triassic Quehala Group featuring clasolite has been regarded as the only rocky unit. In recent years, the silicite-dominated Gajia Formation that bears radiolarian fossils was suggested to represent Ladinian to Carnian deposits. The Upper Permian and Lower Triassic rocks have never been excavated and thus are considered to be absent. This research, however, reveals that fossils aged from the Late Permian to Anisian of the Middle Triassic and Norian of the Late Triassic have been preserved in the central Bangong-Nujiang Suture Zone, which provides evidence of Upper Permian to early Middle Triassic deposits and provides new insights on the Upper Triassic strata as well. A new Triassic strata succession is thus proposed for the Bangong-Nujiang Suture Zone, and it demonstrates great similarities with those from Lhasa to the south and Qiangtang to the north. Therefore, we deduce that the Bangong-Nujiang Suture Zone was under a similar depositional setting as its two adjacent terranes, and it was likely a carbonate platform background because limestones were predominant across the Triassic. The newly acquired biostratigraphic data indicate that Lhasa and Qiangtang could not have been located on two separate continents with disparate sedimentary settings; therefore, the Bangong-Nujiang Suture Zone likely did not represent a large ocean between them. This conclusion is supported by lithostratigraphic and paleomagnetic research, which revealed that Lhasa and Qiangtang were positioned at low to middle latitudes during the Early Triassic. Combining this conclusion with fossil evidence, we suggest that the three main Tibetan terranes were in the same palaeobiogeographic division with South China, at least during the Latest Permian to Early Triassic. The Early Triassic conodont species Pachycladina obliqua is probably a fossil sign of middle to low latitudes in palaeogeography.
Neonatal lung ultrasonography to evaluate need for surfactant or mechanical ventilation: a systematic review and meta-analysis
Authors: Razak Abdul , Faden Maher
Published: June 2019

Context

Lung ultrasonography (LUS) is increasingly used to identify various neonatal respiratory disorders. There is emerging evidence that it can identify infants with significant lung disease who need surfactant treatment or mechanical ventilation.

Objective

To systematically review the accuracy of LUS in determining the need for surfactant treatment or mechanical ventilation in infants with respiratory distress treated with nasal continuous positive airway pressure (NCPAP).

Methods

Database search include EMBASE, Medline, CINAHL and Cochrane central from inception until 17 October 2018. Included is diagnostic accuracy studies reporting LUS evaluating surfactant therapy/mechanical ventilation. Two authors extracted data independently and assessed quality. Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to determine the methodological quality.

Results

Six studies involving 485 infants included in the review. Three studies used LUS score, two used type 1 lung profile, and one used high-risk LUS to evaluate the outcome. The pooled sensitivity and specificity at LUS score cut-off >5–6 was 88% (95% CI 80% to 93%) and 82% (95% CI 74% to 89%), respectively. Infants with LUS score >5–6 were at significantly increased risk of surfactant treatment compared with infants with LUS score <5–6 (relative risk=7.51; 95% CI 4.16 to 13.58; two studies; participants=189; I2=0%). The diagnostic accuracy of type 1 lung profile was better in younger preterm infants (sensitivity 88.9%, specificity 100%) compared with late preterm and term infants (sensitivity 100%, specificity 28%).

Conclusions

LUS, particularly LUS score, can be used accurately to determine the need for surfactant replacement treatment or mechanical ventilation in infants with respiratory distress treated with NCPAP support. The accuracy is better in younger preterm infants compared with late preterm and term infants.

PROSPERO registration number

CRD42018115135.
Primary angiosarcoma of thyroid
Authors: Kondapalli Ananya , Redd Lucas , DeBlanche Lorraine , Oo Yin
Published: June 2019

Mesenchymal origin of primary thyroid angiosarcomas (TAS) is extremely rare and comprises less than 1% of primary thyroid cancer worldwide. While TAS are most commonly occurring in the Alpine region, there are multiple reported cases of TAS in non-Alpine regions. Diagnosis of TAS is commonly made after thyroidectomy as cytologic diagnosis can be challenging due to paucity of cells, presence of necrosis and unawareness of the disease due to rarity. We report a case of primary TAS diagnosed by cytology in a 56-year-old man who presented with a sudden onset of left neck pain, swelling and haemoptysis. He was later noted to have suspicious nodules on both lobes of thyroid on ultrasound. Fine needle aspiration of thyroid nodules showed malignant epithelioid cells. The diagnosis of TAS was made based on positive endothelial markers such as thrombomodulin and CD31, with many pertinent negatives, including negative cytokeratins,thyroid transcription factor (TTF1), thyroglobulin, calcitonin and carcinoembryonic antigen (CEA).
Physical activity trajectories and mortality: population based cohort study
Authors: Mok Alexander , Khaw Kay-Tee , Luben Robert , Wareham Nick , Brage Soren
Published: June 2019

Objective

To assess the prospective associations of baseline and long term trajectories of physical activity on mortality from all causes, cardiovascular disease, and cancer.

Design

Population based cohort study.

Setting

Adults from the general population in the UK.

Participants

14 599 men and women (aged 40 to 79) from the European Prospective Investigation into Cancer and Nutrition-Norfolk cohort, assessed at baseline (1993 to 1997) up to 2004 for lifestyle and other risk factors; then followed to 2016 for mortality (median of 12.5 years of follow-up, after the last exposure assessment).

Main exposure

Physical activity energy expenditure (PAEE) derived from questionnaires, calibrated against combined movement and heart rate monitoring.

Main outcome measures

Mortality from all causes, cardiovascular disease, and cancer. Multivariable proportional hazards regression models were adjusted for age, sex, sociodemographics, and changes in medical history, overall diet quality, body mass index, blood pressure, triglycerides, and cholesterol levels.

Results

During 171 277 person years of follow-up, 3148 deaths occurred. Long term increases in PAEE were inversely associated with mortality, independent of baseline PAEE. For each 1 kJ/kg/day per year increase in PAEE (equivalent to a trajectory of being inactive at baseline and gradually, over five years, meeting the World Health Organization minimum physical activity guidelines of 150 minutes/week of moderate-intensity physical activity), hazard ratios were: 0.76 (95% confidence interval 0.71 to 0.82) for all cause mortality, 0.71 (0.62 to 0.82) for cardiovascular disease mortality, and 0.89 (0.79 to 0.99) for cancer mortality, adjusted for baseline PAEE, and established risk factors. Similar results were observed when analyses were stratified by medical history of cardiovascular disease and cancer. Joint analyses with baseline and trajectories of physical activity show that, compared with consistently inactive individuals, those with increasing physical activity trajectories over time experienced lower risks of mortality from all causes, with hazard ratios of 0.76 (0.65 to 0.88), 0.62 (0.53 to 0.72), and 0.58 (0.43 to 0.78) at low, medium, and high baseline physical activity, respectively. At the population level, meeting and maintaining at least the minimum physical activity recommendations would potentially prevent 46% of deaths associated with physical inactivity.

Conclusions

Middle aged and older adults, including those with cardiovascular disease and cancer, can gain substantial longevity benefits by becoming more physically active, irrespective of past physical activity levels and established risk factors. Considerable population health impacts can be attained with consistent engagement in physical activity during mid to late life.