bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of glaucoma on executive function and visual search
Authors: Lee Samantha Sze‐Yee , Wood Joanne M , Black Alexander A
Published: March 2020

Purpose

Executive function and visual search are linked to a number of activities of daily living including driving and mobility. Using a computerised version of the Trail Making Test B (TMT‐B), we compared the executive function and visual search ability of older adults with glaucoma to age‐similar controls and identified which visual function tests best predict TMT‐B performance. Novel low‐contrast and shifting‐target variations of the test were incorporated to explore the effects of different levels of test complexity.

Methods

Thirty‐one older adults with mild to moderate glaucoma (mean age = 71.2 years [SD 6.9]; better‐eye mean deviation [MD]: median = −1.9 dB [IQR = −1.2 to 0.4], worse‐eye MD: median = −11.1 dB [IQR = −14.0 to −7.7]) and 24 age‐similar controls (mean age = 71.9 years [SD 6.6]) with normal vision participated. The groups were matched in age, sex, and cognitive status (mini‐mental state examination [MMSE]). Participants underwent measurements of visual acuity, contrast sensitivity (CS), visual fields, and visual processing speeds using the useful field‐of‐view (UFoV). Participants then completed four variations of a computerised TMT‐B test, with different levels of complexity based on target contrast (high/low‐contrast) and shifts in target position (fixed/shifting locations). Linear mixed‐effect models were used to explore the effects of group, target contrast and shift on TMT‐B completion time.

Results

The glaucoma group took 17.3s longer than controls to complete the TMT‐B (P = 0.028). All participants took 6.5s longer to complete the low‐ compared to the high‐contrast tests (P = 0.012), and 10.6s longer for the shifting TMT‐B compared to the fixed version (P < 0.001). There was no interaction effect between group, contrast, or target shift on completion time. Across all tests and participant groups, longer completion time was associated with slower UFoV processing speeds (divided attention: P = 0.003; selective attention: P = 0.006). Poorer CS was associated with longer completion times for the low (P = 0.007), but not the high‐contrast tests.

Conclusions

Our findings suggest that older adults with mild to moderate glaucoma have poorer visual search ability and executive function relative to controls. However, decreasing target contrast or shifting target position did not exacerbate the effects of glaucomatous visual impairment on performance. The UFoV was a strong predictor of TMT‐B performance.
Ferrous sulfate oral solution in young children with iron deficiency anemia: An open‐label trial of efficacy, safety, and acceptability
Authors: Pachuta Węgier Lidia , Kubiak Maciej , Liebert Agata , Clavel Thierry , Montagne Agnès , Stennevin Aline , Roye Sandrine , Boudribila Asmaa
Published: March 2020

Background

This study evaluated the efficacy, safety, and acceptability of a new ferrous sulfate oral solution (Tardyferon® 20 mg/mL) in young children with mild or moderate iron deficiency anemia (IDA).

Methods

This was a multicenter, national, single‐arm, open‐label study. Children aged 6–53 months presenting with mild or moderate IDA (i.e., blood hemoglobin (Hb) ranging from 7.0 to 10.9 g/dL and serum ferritin <12 ng/mL) were eligible for inclusion. The ferrous sulfate heptahydrate solution (2 mg/kg/day) was administered orally for 3 months. If normalization of either Hb or ferritin was not achieved at month 3 the treatment was continued for another 3 months.

Results

Of the 100 children screened, 21 aged 6–17 months were included and received the study treatment, and 19 were analyzed for hematologic outcomes at month 3. Only one patient continued treatment for the additional 3 months. At month 3, mean ± SD Hb and ferritin levels were 12.0 ± 0.7 g/dL and 31.5 ± 19.4 ng/mL, respectively. Hemoglobin and ferritin levels were normalized in 95% (18/19) and 84% (16/19) of the patients, respectively. Treatment compliance and levels of satisfaction of both the parents and the investigators were high. Overall, 33.3% of patients (7/21) experienced at least one adverse event. Only one patient (4.8%) experienced a drug‐related adverse event (upper abdominal pain).

Conclusions

A 2 mg/kg daily dose of the new oral ferrous sulfate heptahydrate solution provides substantial therapeutic benefit with high levels of tolerability in young children who have mild or moderate IDA.
Rethinking contextual ambidexterity through parallel structures
Authors: Lô Amadou , Fatien Diochon Pauline
Published: March 2020

This paper offers an alternative perspective on achieving contextual ambidexterity in organizations. Building on a collaborative research project within Renault’s Innovation Department, we identified that the corporate Fab Lab acted as a parallel structure in support of contextual ambidexterity. These findings provide three main contributions. First, we locate a source of contextual ambidexterity outside of the traditional business unit. In doing so, we challenge the dominant focus on managers, and show that, despite non‐supportive contexts, employees can demonstrate ambidextrous skills through individual autonomous initiatives and bootlegging behaviors. Second, we delineate four key functions and related features – spatial, technical, methodological, and cultural – of parallel structures that nurture contextual ambidexterity. Finally, we recommend that the facilitation of a parallel structure should combine both flexibility and stability.
Soil reconstruction after mining fails to restore soil function in an Australian arid woodland
Authors: Duncan Corrine , Good Megan K. , Sluiter Ian , Cook Simon , Schultz Nick L.
Published: March 2020

The biogeochemical properties of soils drive ecosystem function and vegetation dynamics, and hence soil restoration after mining should aim to reinstate the soil properties and hydrological dynamics of remnant ecosystems. The aim of this study is to assess soil structure in two vegetation types in an arid ecosystem, and to understand how these soil properties compare to a reconstructed soil profile after mining. In an arid ecosystem in southeast Australia, soil samples were collected at five depths (to 105 cm) from remnant woodland and shrubland sites, and sites either disturbed or totally reconstructed after mining. We assessed soil physico‐chemical properties and microbial activity. Soils in the remnant arid ecosystem had coarse‐textured topsoils that overlay clay horizons, which allows water to infiltrate and avoid evaporation, but also slows drainage to deeper horizons. Conversely, reconstructed soils had high sand content at subsoil horizons and high bulk density and compaction at surface layers (0–20 cm). Reconstructed soils had topsoils with higher pH and electrical conductivity. The reconstructed soils did not show increased microbial activity with time since restoration. Overall, the reconstructed soil horizons were not organized in a way that allowed rainfall infiltration and water storage, as is imperative to arid‐zone ecosystem function. Future restoration efforts in arid ecosystems should focus on increasing sand content of soils near the surface, to reduce evaporative water loss and improve soil quality and plant health.
Micromechanisms of Cortical Bone Failure Under Different Loading Conditions
Authors: Sharma N. K. , Sharma Swati , Rathi Apoorv , Kumar Abhinav , Saini Karan Vir , Sarker M. D. , Naghieh Saman , Ning Liqun , Chen Xiongbiao
Published: March 2020

Bone being a hierarchical composite material has a structure varying from macro- to nanoscale. The arrangement of the components of bone material and the bonding between fibers and matrix gives rise to its unique material properties. In this study, the micromechanisms of cortical bone failure were examined under different loading conditions using scanning electron microscopy. The experimental tests were conducted in longitudinal and transverse directions of bone diaphysis under tensile as well as compressive loading. The results show that bone material has maximum stiffness under longitudinal tensile loading, while the strength is higher under transverse compressive loading. A reverse trend of compressive mechanical properties of bone is observed for longitudinal and transverse loading as compared to trends reported in the previous studies. Therefore, micromechanisms of cortical bone failure were analyzed for different loading conditions to reveal such type of behavior of cortical bone and to correlate bone microstructure with mechanical response of bone.
Characterizing Strain Rate-Dependent Mechanical Properties for Bovine Cortical Bones
Authors: Lei Jianyin , Li Lintao , Wang Zhihua , Zhu Feng
Published: March 2020

Comprehensive knowledge of strain rate-dependent viscoelastic properties of bony materials is necessary to understand the mechanisms of bone fracture under impact loading conditions (e.g., falls, traffic accidents, and military environments). Although the mechanical properties of bones have been studied for several decades, the high strain rate data and corresponding material parameters of the rate-dependent constitutive models are still limited. In this study, split Hopkinson pressure bar technique was used to test bovine cortical bones, to obtain the rate-dependent stress–strain curves in two directions (along and perpendicular to the bone fibers). A constitutive relationship comprising two terms was then applied to identify the material constants with strain rate effect and viscoelastic properties. In this model, the linear elasticity was combined with nonlinear viscoelasticity components to describe the overall nonlinear strain rate dependence. The presented data give strong experimental evidence and basis for further development of numerical biomechanical models to simulate human cortical bone fracture.
Drag Reduction by Polymers in Saline Nutrient Solutions
Authors: Silva Renata T. , Campos Aloysio A. S. , Soares Edson J. , Santos Leonardo dos , Siqueira Renato N.
Published: March 2020

Drag reduction (DR) by polymers has several industrial applications, and it has also shown to produce beneficial effects on blood circulation and may represent a way to treat cardiovascular disorders. Concerning medical applications, there are basically two types of studies using drag reducing polymers (DRP), i.e., in vitro and in vivo. Although blood may be used in the in vitro studies, there are several limitations, such as incompatibility of Rh and possibility of denaturing blood proteins. Thus, biomedical researchers commonly use an artificial plasma-like saline nutrient solution (SNS), which contains ions, nutrients, a buffer to maintain pH levels and a supply of oxygen to the tissue. The behavior of the DRP in water is well reported in the literature, but the SNS components can interact with the polymers, changing their capacity to reduce drag. This study investigates the behavior of three different polymers, i.e., polyacrylamide (PAM), polyethylene oxide (PEO), and xanthan gum (XG), when applied as DRP to a commonly used SNS. For the conditions evaluated, the SNS composition does not change significantly PAM and PEO behavior, showing that they can be satisfactorily diluted in this solvent without loss of efficiency as drag reducers. However, it modifies XG conformation, drastically reducing its efficiency. The experiments with tail arterial beds suggest that PAM is efficient to reduce the perfusion pressure, but PEO and XG do not seem to be good reducers under the experimental conditions that have been analyzed, possibly due to the interaction of the drag reducers with the flow, with the solvent components and with the tissues that were kept alive during the experiments. Although PEO did not present a good performance as DRP for the conditions evaluated in the perfusion tests, its performance can be improved in other organs where the turbulence levels, or instabilities, are higher, as suggested by the rheometer tests.
Noncontact Planar Stage Based on Near-Field Acoustic Transportation
Authors: Yang Yang , Chen Keyu , Guo Ping
Published: March 2020

Acoustic radiation force in the near-field of a vibrating source can be utilized to lift and transport objects, which provides a noncontact driving technology in addition to maglev. This paper presents a novel design of a self-levitated planar stage based on near-field acoustic transportation. A closed-loop system is proposed to design a capacitance surface encoder to provide direct two-dimensional (2D) position feedback. A dynamic model based on the Reynolds equation is established to study its driving mechanism. A prototype including the levitation stage, encoder, and controller is implemented to demonstrate the potential of arbitrary trajectory tracking in two-dimensional space.
Effect of Air Plasma Sprayed Flash Bond Coatings on Furnace Cycle Lifetime of Disks and Rods
Authors: Pint Bruce A. , Lance Michael J. , Haynes J. Allen , Gildersleeve Edward J. , Sampath Sanjay
Published: March 2020

Air plasma sprayed (APS) flash coatings on high velocity oxygen fuel (HVOF) bond coatings are well known to extend the lifetime of thermal barrier coatings (TBCs). Recent work compared flash coatings of NiCoCrAlY and NiCoCrAlYHfSi applied to both rods and disk substrates of alloy 247. For rod specimens, 100 h cycles were used at 1100 °C in wet air. Both flash coatings significantly improved the lifetime compared to HVOF-only and vacuum plasma spray (VPS)-only MCrAlY bond coatings with no statistical difference between the two flash coatings. For disk specimens tested in 1 h cycles at 1100 °C in wet air, the NiCoCrAlY flash coating significantly outperformed an HVOF-only NiCoCrAlYHfSi bond coating and a NiCoCrAlYHfSi flash coating. The flash coatings formed a mixed oxide-metal zone that appeared to inhibit crack formation and therefore extend lifetime. In addition to the flash coating increasing the bond coating roughness, the underlying HVOF layer acted as a source of Al for this intermixed zone and prevented the oxide from penetrating deeper into the bond coating. The lower Y+Hf content in the Y-only flash coating appeared to minimize oxidation in the flash layer, thereby increasing the benefit compared to a NiCoCrAlYHfSi flash coating.
An Experimental Research on the Effects of Negative Valve Overlap on Performance and Operating Range in a Homogeneous Charge Compression Ignition Engine With RON40 and RON60 Fuels
Authors: Polat Seyfi , Solmaz Hamit , Uyumaz Ahmet , Calam Alper , Yılmaz Emre , Serdar Yucesu H.
Published: March 2020

In this study, the effects of negative valve overlap (NVO) on homogenous charge compression ignition (HCCI) combustion and engine performance were experimentally investigated. A four stroke, single cylinder, port injection HCCI engine was operated at −16 deg crank angle (CA), −8 deg CA, and +8 deg CA valve overlap values and different lambda values and engine speeds at wide open throttle. RON40 and RON60 were used as test fuels in view of combustion and performance characteristics in HCCI mode. The variations of indicated mean effective pressure (IMEP), residual gas, CA50, indicated thermal efficiency (ITE), indicated specific fuel consumption (ISFC), maximum pressure rise rate (MPRR) and ringing intensity (RI) were observed on HCCI combustion. The results showed that NVO caused to trap residual gases in the combustion chamber. Hot residual gases showed heating and dilution effect on HCCI combustion. Combustion was retarded with the presence of residual gas at −16 deg CA NVO. Test results showed that higher imep and maximum in-cylinder pressure were obtained with RON60 according to RON40. As expected, CA50 was obtained later with RON60 compared to RON40 due to more resistance of auto-ignition. RON60 residual gas prevented the rapid and sudden combustion due to higher heat capacity of charge mixture. RI decreased with the usage of RON60 compared to RON40. Significant decrease was seen on RI with RON60 especially at lower lambda values. It was seen that HCCI combustion can be controlled with NVO and operating range of HCCI engines can be extended.
Resonant sputtered neutral mass spectrometry using multiple reflections of laser to counterbalance Doppler broadening
Authors: Zhao Yue , Ohmori Yuzuka , Miyashita Yuta , Morita Masato , Sakamoto Tetsuo , Kato Kotaro , Sonnenschein Volker , Tomita Hideki , Kawai Toshihide , Okumura Takeo , Satou Yukihiko , Miyabe Masabumi , Wakaida Ikuo
Published: March 2020

Resonant laser sputtered neutral mass spectrometry can greatly enhance the ionization efficiency of specific neutral sputtered atoms through resonant excitation using tunable laser(s). However, the laser beam cannot irradiate the entire volume where sputtered particles are moving, because the laser beam is focused. In contrast, for an extremely low concentration of target elements, it is necessary to increase the laser irradiation efficiency. Irradiation efficiency depends on both spatial coverage and resonance wavelength matching. The former can be increased by increasing the laser path length within the sputtered neutral plume. The latter depends on the relationship between the laser spectral linewidth and the Doppler broadening width caused by the velocity of sputtered neutral particles. The authors have developed a new method to improve the ionization probability of neutral particles by reflecting the laser using mirrors to increase the ionization efficiency based on the concept mentioned above.
Greenhouse Gas Footprints for Physicists
Authors: Binder P.-M. , Foreman-Bunting Kelsey D. , Whitney Zoë A. , Leach Allison M. , Dukes Elizabeth S. , Galloway James N.
Published: March 2020

Our aim in this paper is to describe an opportunity for physics students and faculty to learn about an environmental issue of much current interest: the quantification, or footprint analysis, of carbon dioxide (CO2) and reactive nitrogen emissions. These can originate from human activities such as energy use, food consumption, and transportation, and are among the greenhouse gases (GHG) that contribute to global warming and rising sea levels. Moreover, nitrogen compounds also have effects on the chemistry and biology of the environment. Analyzing both of these footprints together captures multiple environmental impacts from the local to the global levels and can suggest mitigation strategies. We focus on the experiences of interdisciplinary teams, which included physics students and faculty, and that used the leading greenhouse gas analysis platform SIMAP (Sustainability Indicator Management and Analysis Platform).
The Effect of a Tangential Frictional Force on Rotating Disks: An Experimental Approach
Authors: Gomes Mário S. M. N. F. , da Silva Pedro Pereira , Silva Manuela Ramos , Martín-Ramos Pablo
Published: March 2020

This paper describes an experiment with two touching rotating disks, whose movement is followed by video analysis. Within the disks’ movements, there are intervals with sliding and intervals without sliding, that is, intervals with frictional forces between the touching surfaces and intervals without it. This system configuration allows for measurement of the changeable magnitudes and directions of frictional forces (much more difficult to set up with translational motion). This activity may be used to combat studentś misconceptions of “frictional force always opposes the motion” and “between the same two bodies, one gets the same frictional force,” commonly found in the classroom, or just to reinforce the rotational dynamics relationships.
An Undergraduate Demonstration of Gravitational Time Dilation
Authors: Patterson Brian , Serna Mario , Gearba M. Alina , Olesen Robert , O’Shea Patrick , Schiller Jonathan , Emanuel David , Sell Jerry F. , Burns M. Shane , Leveille Michael D. , Dominguez Armand R. , Gebhard Brian B. , Huestis Samuel E. , Steele Jeffrey
Published: March 2020

According to Einstein’s general theory of relativity, a clock runs more slowly if it is close to a large gravitating object. This principle was highlighted in the movie “Interstellar,” in which the main character spends several hours on a planet orbiting a massive black hole, and returns to find that his young daughter has become an elderly woman. In the movie, one hour on the planet equates to seven years on Earth. The same effect can be measured on a much smaller scale by changing locations within Earth’s gravitational field. Using atomic clocks, we have compared the ticking of time at Colorado College (elevation 1845 m above sea level), at the United States Air Force Academy (elevation 2165 m), and near the summit of Pikes Peak (elevation 4288 m). Our results confirm that clocks do indeed tick more quickly at higher altitudes, in accordance with Einstein’s theory. This work was carried out as a collaboration of physics majors and faculty at Colorado College (CC) and the United States Air Force Academy (USAFA). The experimental technique is straightforward and our results can be reproduced by other students and teachers, given access to an atomic clock and reasonably large changes in elevation. Indeed, a similar endeavor has been reported by amateur clock enthusiasts.
A Thin Film Interference Laboratory Experiment for Introductory Physics
Authors: Drake Dereth J. , Epperson Christiana G. , Burks Savanna L.
Published: March 2020

Introductory physics laboratory experiments have typically been employed to reinforce classroom instruction instead of teaching students experimental design. Recent research has shown that lab experiments that focus on experimental practices are more effective at teaching students physics concepts. The experiment described in this paper has been developed to teach students the basics of experimental design by exploring the physics of thin film interference and spectroscopy in order to answer the following question: “What is the thickness of the oxide layer of anodized niobium?”
The motion of a conical pendulum in a rotating frame: The study of the paths, determination of oscillation periods, and the Bravais pendulum
Authors: Giacometti José A.
Published: March 2020

In this paper, Newton's equations are solved to describe the motion of a conical pendulum in a rotating frame for the right- and left-hand conical oscillations. If the pendulum is started with the initial angular velocity (±ω0−Ωz), with ω0 being the frequency of pendulum oscillation and Ωz the angular velocity of the rotating frame around the z-axis, the paths are shown to be circular, which would apparently indicate that the Coriolis force becomes non-effective in the rotating frame. This paper explains why the paths in the rotating frame are circular, and the difference between the periods for the right- and left-handed rotations is calculated analytically. It is also shown that in an inertial frame, the conical pendulum follows an elliptical path. As the Bravais pendulum is a conical pendulum oscillating at Earth's surface, its motion is also discussed.
Geodesy on surfaces of revolution: A wormhole application
Authors: Resca Lorenzo Gallerani , Mecholsky Nicholas A.
Published: March 2020

We outline a general procedure to derive first-order differential equations obeyed by geodesic orbits over two-dimensional (2D) surfaces of revolution immersed or embedded in ordinary three-dimensional (3D) Euclidean space. We illustrate that procedure with an application to a wormhole model introduced by Morris and Thorne (MT), which provides a prototypical case of a “splittable space-time” geometry. We obtain analytical solutions for geodesic orbits expressed in terms of elliptic integrals and functions, which are qualitatively similar to, but even more fundamental than, those that we previously reported for Flamm's paraboloid of Schwarzschild geometry. Two kinds of geodesics correspondingly emerge. Regular geodesics have turning points larger than the “throat” radius. Thus, they remain confined to one half of the MT wormhole. Singular geodesics funnel through the throat and connect both halves of the MT wormhole, perhaps providing a possibility of “rapid inter-stellar travel.” We provide numerical illustrations of both kinds of geodesic orbits on the MT wormhole.
Oldest fossil of modern birds is a ‘turducken’
Authors: Vogel Gretchen
Published: March 2020

Ancestral bird skull looks like a duck from the back and a chicken from the front.
Top neuroscientist leaving Mexican university
Authors: Gutiérrez Inés , Pérez Ortega Rodrigo
Published: March 2020

Alleged incidents of sexual harassment by Ranulfo Romo Trujillo began years ago.
Sick time
Authors: Cohen Jon
Published: March 2020

Dozens of diseases wax and wane with the seasons. Will COVID-19?
cFLIP
L
protects macrophages from LPS-induced pyroptosis via inhibition of complex II formation
Authors: Muendlein Hayley I. , Jetton David , Connolly Wilson M. , Eidell Keith P. , Magri Zoie , Smirnova Irina , Poltorak Alexander
Published: March 2020

Macrophages cFLIP out

Pathogens have evolved to survive within hosts in part by interfering with host signaling cascades.
Yersinia
bacteria use the effector protein YopJ to thwart MAP kinase signaling downstream of Toll-like receptor activation. In response to YopJ, host cells can release interleukin-1β and initiate pyroptosis by inhibition of the kinase TAK1 and subsequent caspase-8–directed cleavage of gasdermin D, a protein that forms cell membrane pores. Muendlein
et al.
report that cFLIP, a major antiapoptotic regulator, plays a central role in this process. Knockdowns of the long but not short cFLIP isoform in macrophages removes the requirement for TAK1 inhibition. Rather, deficiency of the long isoform fuels caspase-8 activation, mitochondrial complex II formation, pyroptosis, and interleukin-1β secretion in response to lipopolysaccharide alone, underscoring its importance for cell death and inflammation.

Science
, this issue p.
1379
Insights into human genetic variation and population history from 929 diverse genomes
Authors: Bergström Anders , McCarthy Shane A. , Hui Ruoyun , Almarri Mohamed A. , Ayub Qasim , Danecek Petr , Chen Yuan , Felkel Sabine , Hallast Pille , Kamm Jack , Blanché Hélène , Deleuze Jean-François , Cann Howard , Mallick Swapan , Reich David , Sandhu Manjinder S. , Skoglund Pontus , Scally Aylwyn , Xue Yali , Durbin Richard , Tyler-Smith Chris
Published: March 2020

Genomes from around the globe

Genomic sequencing of diverse human populations to understand overall genetic diversity has lagged behind in-depth examination of specific populations. To add to our understanding of human genetic diversity, Bergström
et al.
generated whole-genome sequences surveying individuals in the Human Genome Diversity Project, which is a panel of global populations that has been instrumental in understanding the history of human populations. The authors' study adds data about African, Oceanian, and Amerindian populations and indicates that diversity tends to result from differences at the single-nucleotide level rather than copy number variation. An analysis of archaic sequences in modern populations identifies ancestral genetic variation in African populations that likely predates modern humans and has been lost in most non-African populations.

Science
, this issue p.
eaay5012
An artificial impact on the asteroid (162173) Ryugu formed a crater in the gravity-dominated regime
Authors: Arakawa M. , Saiki T. , Wada K. , Ogawa K. , Kadono T. , Shirai K. , Sawada H. , Ishibashi K. , Honda R. , Sakatani N. , Iijima Y. , Okamoto C. , Yano H. , Takagi Y. , Hayakawa M. , Michel P. , Jutzi M. , Shimaki Y. , Kimura S. , Mimasu Y. , Toda T. , Imamura H. , Nakazawa S. , Hayakawa H. , Sugita S. , Morota T. , Kameda S. , Tatsumi E. , Cho Y. , Yoshioka K. , Yokota Y. , Matsuoka M. , Yamada M. , Kouyama T. , Honda C. , Tsuda Y. , Watanabe S. , Yoshikawa M. , Tanaka S. , Terui F. , Kikuchi S. , Yamaguchi T. , Ogawa N. , Ono G. , Yoshikawa K. , Takahashi T. , Takei Y. , Fujii A. , Takeuchi H. , Yamamoto Y. , Okada T. , Hirose C. , Hosoda S. , Mori O. , Shimada T. , Soldini S. , Tsukizaki R. , Iwata T. , Ozaki M. , Abe M. , Namiki N. , Kitazato K. , Tachibana S. , Ikeda H. , Hirata N. , Hirata N. , Noguchi R. , Miura A.
Published: March 2020

Blowing a crater in asteroid Ryugu

The Hayabusa2 spacecraft was designed to collect samples from the nearby asteroid (162173) Ryugu and return them to Earth for laboratory analysis. Arakawa
et al.
describe how the spacecraft's Small Carry-on Impactor was fired into the asteroid's surface, producing an artificial impact crater. Analysis of the resulting plume of ejecta, recorded by a remote camera, sets an upper limit on the strength of the rubble-pile surface. The crater has a semicircular shape, probably due to a large boulder buried close to the impact location. The crater exposed material from Ryugu's subsurface, which has not been subjected to space weathering, that is suitable for collection by Hayabusa2.

Science
, this issue p.
67
The uncertain future of the Antarctic Ice Sheet
Authors: Pattyn Frank , Morlighem Mathieu
Published: March 2020

The Antarctic Ice Sheet is losing mass at an accelerating pace, and ice loss will likely continue over the coming decades and centuries. Some regions of the ice sheet may reach a tipping point, potentially leading to rates of sea level rise at least an order of magnitude larger than those observed now, owing to strong positive feedbacks in the ice-climate system. How fast and how much Antarctica will contribute to sea level remains uncertain, but multimeter sea level rise is likely for a mean global temperature increase of around 2°C above preindustrial levels on multicentennial time scales, or sooner for unmitigated scenarios.
Evolving epidemiology of poliovirus serotype 2 following withdrawal of the serotype 2 oral poliovirus vaccine
Authors: Macklin G. R. , O’Reilly K. M. , Grassly N. C. , Edmunds W. J. , Mach O. , Santhana Gopala Krishnan R. , Voorman A. , Vertefeuille J. F. , Abdelwahab J. , Gumede N. , Goel A. , Sosler S. , Sever J. , Bandyopadhyay A. S. , Pallansch M. A. , Nandy R. , Mkanda P. , Diop O. M. , Sutter R. W.
Published: March 2020

A public health catch-22

In 2016, the serotype 2 component of the oral poliovirus vaccine given to children was withdrawn. This measure was taken to prevent vaccine-associated disease outbreaks caused by mutation in the live attenuated vaccine. Children around the world now have poor immunity to serotype 2 poliovirus because the inactivated vaccine is far less effective and a new oral vaccine is not yet ready. Using a statistical model, Macklin
et al.
discovered that most current outbreaks of polio in several countries across Asia and sub-Saharan Africa are likely associated with the serotype 2 vaccine strain (see the Perspective by Donlan and Petri). To block transmission when poliovirus outbreaks occur requires deployment of the only tool in the box: the existing live attenuated serotype 2 oral vaccine, which increases the risk of vaccine-derived disease.

Science
, this issue p.
401
; see also p.
362
Updated Approaches against SARS-CoV-2
Authors: Li Haiou , Zhou Yunjiao , Zhang Meng , Wang Haizhou , Zhao Qiu , Liu Jing
Published: March 2020

Novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lies behind the ongoing outbreak of coronavirus disease 2019 (COVID-19). There is a growing understanding of SARS-CoV-2 in virology, epidemiology, and clinical management strategies. However, no anti-SARS-CoV-2 drug or vaccine has been officially approved due to the absence of adequate evidence. Scientists are racing to develop a treatment for COVID-19. Recent studies have revealed many attractive therapeutic options, even if some of them remain to be further confirmed in rigorous preclinical models and clinical trials.
Late Ottawan orogenic collapse of the Adirondacks in the Grenville province of New York State (USA): Integrated petrologic, geochronologic, and structural analysis of the Diana Complex in the southern Carthage-Colton mylonite zone
Authors: Baird Graham B.
Published: March 2020

Crustal-scale shear zones can be highly important but complicated orogenic structures, therefore they must be studied in detail along their entire length. The Carthage-Colton mylonite zone (CCMZ) is one such shear zone in the northwestern Adirondacks of northern New York State (USA), part of the Mesoproterozoic Grenville province. The southern CCMZ is contained within the Diana Complex, and geochemistry and U-Pb zircon geochronology demonstrate that the Diana Complex is expansive and collectively crystallized at 1164.3 ± 6.2 Ma.

Major ductile structures within the CCMZ and Diana Complex include a northwest-dipping penetrative regional mylonitic foliation with north-trending lineation that bisects a conjugate set of mesoscale ductile shear zones. These ductile structures formed from the same 1060–1050 Ma pure shear transitioning to a top-to-the-SSE shearing event at ∼700 °C. Other important structures include a ductile fault and breccia zones. The ductile fault formed immediately following the major ductile structures, while the breccia zones may have formed at ca. 945 Ma in greenschist facies conditions.

Two models can explain the studied structures and other regional observations. Model 1 postulates that the CCMZ is an Ottawan orogeny (1090–1035 Ma) thrust, which was later reactivated locally as a tectonic collapse structure. Model 2, the preferred model, postulates that the CCMZ initially formed as a subhorizontal mid-crustal mylonite zone during collapse of the Ottawan orogen. With continued collapse, a metamorphic core complex formed and the CCMZ was rotated into is current orientation and overprinted with other structures.
Pyoderma gangrenosum of the breast 17 years after breast cancer treatment
Authors: Pellegrino Samantha Ann , Cham Alvin , Pitcher Meron
Published: March 2020

We present a case of pyoderma gangrenosum (PG) affecting the breast of a 74-year-old woman, with a history of breast cancer treated with breast conserving surgery and adjuvant radiotherapy 17 years prior. She presented to the hospital with worsening breast ulceration, after a punch biopsy was performed at the site. She had surrounding cellulitis and concurrent infection to that breast which required antibiotics. The ulceration persisted even after treatment, and incisional biopsies of the area of ulceration confirmed the diagnosis of PG. Her condition was managed effectively with the use of immunosuppressive therapy, and she continued to display a good clinical response 2 months post discharge from the hospital.
Regional metastatic paraganglioma of the bladder: a rare cause of myocardial infarction, reversible cardiomyopathy and an intracardiac thrombus
Authors: Kazakova Vera , Kadamkulam Syriac Arun , Perepletchikov Aleksandr , Sweeney Ann T
Published: March 2020

Sympathetic paragangliomas are rare neuroendocrine tumours that arise from chromaffin cells and secrete catecholamines. On rare occasions, patients with sympathetic paragangliomas can present with symptoms of congestive heart failure. The optimal treatment is surgical to remove all disease and thereby improve survival as well as restore cardiac function. We report a case of a patient with a regional metastatic bladder paraganglioma and a succinate dehydrogenase complex subunit B gene mutation presenting with cardiomyopathy who had significant improvement in his cardiac function with surgical resection despite further progression of metastatic disease. During his 4-year follow-up period, the patient remains free from heart-failure signs and symptoms.
Iris and its relevance to angle closure disease: a review
Authors: Soh Zhi Da , Thakur Sahil , Majithia Shivani , Nongpiur Monisha Esther , Cheng Ching-Yu
Published: March 2020

Glaucoma is a leading cause of irreversible visual impairment, and primary angle closure glaucoma (PACG) affects Asians disproportionately. Whereas advances in ocular imaging have identified several anatomical risk factors, our ability to predict PACG still requires considerable improvement. The iris plays a crucial role in the pathophysiology of angle closure disease, either through a mechanical or vascular mechanism. Irises of closed-angle eyes inhibit vastly different structural constituents as compared with those of open-angle eyes, thereby effecting variations in biomechanical properties and iris fluid conductivity. The clinical consequences include a smaller change in iris volume on pupil dilation in closed-angle eyes, thereby bringing the iris and trabecular meshwork closer in apposition. In this review, we summarise the potential role of the iris in the pathogenesis of angle closure disease.
Effects of the low carbohydrate, high fat diet on glycemic control and body weight in patients with type 2 diabetes: experience from a community-based cohort
Authors: Ahmed Shabina Roohi , Bellamkonda Sridevi , Zilbermint Mihail , Wang Jiangxia , Kalyani Rita Rastogi
Published: March 2020

Objective

The optimal diet to improve glycemia in patients with type 2 diabetes remains unclear. Low carbohydrate, high fat (LCHF) diets can improve glycemic control, but have not been investigated in real-world settings.

Research design and methods

We investigated effects of the LCHF diet compared with usual care in a community-based cohort of patients with type 2 diabetes by performing a retrospective study of 49 patients who followed the LCHF diet for ≥3 months, and compared glycemic outcomes with age-matched and body mass index (BMI)-matched controls who received usual care (n=75). The primary outcome was change in A1C from baseline to the end of follow-up.

Results

Compared with the usual care group, the LCHF group showed a significantly greater reduction in A1C (−1.29% (95% CI −1.75 to −0.82; p<0.001)) and body weight (−12.8 kg (95% CI −14.7 to −10.8; p<0.001) at the end of follow-up after adjusting for age, sex, baseline A1C, BMI, baseline insulin dose. Of the patients initially taking insulin therapy in the LCHF group, 100% discontinued it or had a reduction in dose, compared with 23.1% in the usual care group (p<0.001). The LCHF group also had significantly greater reduction in fasting plasma glucose (−43.5 vs −8.5 mg/mL; p=0.03) compared with usual care.

Conclusions

In a community-based cohort of type 2 diabetes, the LCHF diet was associated with superior A1C reduction, greater weight loss and significantly more patients discontinuing or reducing antihyperglycemic therapies suggesting that the LCHF diet may be a metabolically favorable option in the dietary management of type 2 diabetes.
Strategies to identify individuals with monogenic diabetes: results of an economic evaluation
Authors: Peters Jaime L , Anderson Rob , Shields Beverley , King Sophie , Hudson Michelle , Shepherd Maggie , McDonald Timothy James , Pearson Ewan , Hattersley Andrew , Hyde Chris
Published: March 2020

Objectives

To evaluate and compare the lifetime costs associated with strategies to identify individuals with monogenic diabetes and change their treatment to more appropriate therapy.

Design

A decision analytical model from the perspective of the National Health Service (NHS) in England and Wales was developed and analysed. The model was informed by the literature, routinely collected data and a clinical study conducted in parallel with the modelling.

Setting

Secondary care in the UK.

Participants

Simulations based on characteristics of patients diagnosed with diabetes <30 years old.

Interventions

Four test-treatment strategies to identify individuals with monogenic diabetes in a prevalent cohort of diabetics diagnosed under the age of 30 years were modelled: clinician-based genetic test referral, targeted genetic testing based on clinical prediction models, targeted genetic testing based on biomarkers, and blanket genetic testing. The results of the test-treatment strategies were compared with a strategy of no genetic testing.

Primary and secondary outcome measures

Discounted lifetime costs, proportion of cases of monogenic diabetes identified.

Results

Based on current evidence, strategies using clinical characteristics or biomarkers were estimated to save approximately £100–£200 per person with diabetes over a lifetime compared with no testing. Sensitivity analyses indicated that the prevalence of monogenic diabetes, the uptake of testing, and the frequency of home blood glucose monitoring had the largest impact on the results (ranging from savings of £400–£50 per person), but did not change the overall findings. The model is limited by many model inputs being based on very few individuals, and some long-term data informed by clinical opinion.

Conclusions

Costs to the NHS could be saved with targeted genetic testing based on clinical characteristics or biomarkers. More research should focus on the economic case for the use of such strategies closer to the time of diabetes diagnosis.

Trial registration number

NCT01238380.
Missed posterior shoulder fracture dislocations: a new protocol from a London major trauma centre
Authors: Magnussen Alex Peter , Watura Christopher , Torr Nicola , Walker Miny , Amiras Dimitri , Griffiths Dylan
Published: March 2020

Background

A high incidence of missed posterior shoulder dislocations is widely recognised in the literature. Concern was raised by the upper limb multidisciplinary team at a London major trauma centre that these missed injuries were causing serious consequences due to the need for surgical intervention and poor functional outcome.

Objective

To identify factors contributing to missed diagnosis and propose solutions.

Methods

A local quality improvement report was performed investigating time from admission to diagnosis of simple posterior dislocations and fracture dislocations over a 5-year period. Factors contributing to a delayed diagnosis were analysed.

Results

The findings supported current evidence: a posterior shoulder dislocation was more often missed if there was concurrent fracture of the proximal humerus. Anteroposterior and scapular Y view radiographs were not always diagnostic for dislocation. Axial views were more reliable in assessment of the congruency of the joint and were associated with early diagnosis and appropriate treatment of the injury.

Discussion

As a result of these findings a new protocol was produced by the orthopaedic and radiology departments and distributed to our emergency department practitioners and radiography team. The protocol included routine axial or modified trauma axial view radiographs for all patients attending the emergency department with a shoulder injury, low clinical suspicion for dislocation and a low threshold for CT scan. Reaudit and ongoing data collection have shown significant increase in axial view radiographs and improved diagnosis.
Antibiotic prescribing in neonatal sepsis: an Australian nationwide survey
Authors: McMullan Brendan , Cooper Celia , Spotswood Naomi , James Rodney , Jones Cheryl , Konecny Pamela , Blyth Christopher , Karen Thursky
Published: March 2020

Objective

To evaluate quality and variation in antibiotic prescribing for neonatal sepsis.

Design

We analysed prescribing in hospitalised neonates using the National Antimicrobial Prescribing Survey in Australian neonates from 1 January 2014 to 31 December 2018.

Setting

Data from antibiotic point prevalence surveys performed in hospitals, ranging from rural hospitals to tertiary paediatric and maternity hospitals within Australia.

Patients

Admitted neonates <28 days of age from participating hospitals.

Main outcome measures

Variation and appropriateness in prescribing for neonatal sepsis and variation in dosing for gentamicin and benzylpenicillin across hospitals.

Results

A total of 415 prescriptions among 214 neonates from 39 different hospitals were included. The majority of prescriptions (342, 82.4%) were for neonates <7 days of age. The most commonly prescribed antibiotics were gentamicin and benzylpenicillin, with 323 (77.8%) prescriptions. Dosing variability was substantial, with doses ranging from 2 to 8 mg/kg for gentamicin (median 5 mg/kg, IQR 4–5) and from 45 to 72 mg/kg for benzylpenicillin (median 60 mg/kg, IQR 50–60), although only 13 (3.2%) and 19 (4.6%) prescriptions were locally assessed as inappropriate or non-compliant with guidelines, respectively. At time of audit, 22% of antibiotics had been given for more than 48 hours and 9% more than 72 hours, although microbiologically confirmed infection was documented in only nine (4.2%) neonates.

Conclusions

Prescribing for neonatal sepsis was dominated by use of benzylpenicillin and gentamicin with substantial variation in dosing. A small minority had culture-confirmed infection. Efforts to standardise antibiotic dosing and duration for suspected neonatal sepsis are recommended.
Asthma control is associated with economic outcomes, work productivity and health-related quality of life in patients with asthma
Authors: Lee Lulu K , Ramakrishnan Karthik , Safioti Guilherme , Ariely Rinat , Schatz Michael
Published: March 2020

Background

The objective of this analysis was to examine the association between asthma control (based on Asthma Control Test (ACT) responses) and healthcare resource utilisation (HRU), work productivity and health-related quality of life (HRQoL) among a nationwide sample of US adults with a self-reported diagnosis of asthma and without comorbid chronic obstructive pulmonary disease.

Methods

Data were obtained from the 2015 and 2016 self-administered, internet-based National Health and Wellness Surveys. Patients were grouped by ACT score (≤15: poorly controlled; 16–19: partly controlled; 20–25: well-controlled asthma). Study outcomes included HRU (patient-reported healthcare provider visits, emergency department visits and hospitalisations during the previous 6 months); work productivity, measured using the Work Productivity and Activity Impairment-General Health Scale; HRU-associated costs and work productivity loss and HRQoL, measured using EuroQoL-5 Dimensions-5 Levels (EQ-5D-5L) and the Short Form Health Survey-36V.2 (SF-36V.2). Incremental differences in outcomes between groups were assessed using generalised linear models adjusted for covariates.

Results

Of 7820 eligible adults, 17.4% had poorly controlled, 20.1% partly controlled and 62.5% well-controlled asthma. Well-controlled asthma was associated with significantly lower HRU (p<0.001) and lower mean direct costs ($6012 vs $8554 and $15 262, respectively; p<0.001); well-controlled asthma was also associated with significantly lower mean scores for work absenteeism, work presenteeism, overall work impairment and activity impairment (all p<0.001), and lower mean indirect costs ($6353 vs $10 448 and $14 764, respectively; p<0.001). Clinically meaningful differences favouring well-controlled asthma were seen for all HRQoL measures, with statistically significantly higher adjusted mean EQ-5D-5L index and SF-6D Health Utilities Index scores (derived from SF-36V.2) for patients with well-controlled asthma compared with partly controlled or poorly controlled asthma (p<0.001).

Conclusions

The study demonstrates a clear relationship between asthma control and its impact on HRU, costs, work productivity and HRQoL. This will allow for better identification and management of patients with poorly controlled asthma.