bluuebunny/crossref_metadata_2025 huggingface dataset:
US clinicians' perspectives on advance care planning for persons with dementia: A qualitative study
Authors: Tjia Jennifer , D'Arcangelo Noah , Carlston Daniel , Bronzi Olivia , Gazarian Priscilla , Reich Amanda , Porteny Thalia , Gonzales Kristina , Perez Stephen , Weissman Joel S. , Ladin Keren
Published: December 2022

Background

Although advance care planning (ACP) for persons with dementia (PWD) can promote patient‐centered care by aligning future healthcare with patient values, few PWD have documented ACPs for reasons incompletely understood. The objective of this paper is to characterize the perceived value of, barriers to, and successful strategies for completing ACP for PWD as reported by frontline clinicians.

Methods

Qualitative study using semi‐structured interviews (August 2018–December 2019) with clinicians (physicians, nurse practitioners, nurses, social workers) at 11 US health systems. Interviews asked clinicians about their approaches to ACP with PWDs, including how ACP was initiated, what was discussed, how carepartners were involved, how decision‐making was approached, and how decision‐making capacity was assessed.

Results

Of 75 participating generalist and specialty clinicians from across the United States, 61% reported conducting ACP with PWD, of whom 19% conducted ACP as early as possible with PWD. Three themes emerged: value of early ACP preserves PWD's autonomy in cases of differing PWD carepartner values, acute medical crises, and clinician paternalism; barriers to ACP with PWD including the dynamic and subjective assessment of patient decision‐making capacity, inconsistent awareness of cognitive impairment by clinicians, and the need to balance patient and family carepartner involvement; and strategies to support ACP include clarifying clinicians' roles in ACP, standardizing clinicians' approach to PWD and their carepartners, and making time for ACP and decision‐making assessments that allow PWD and carepartner involvement regardless of the patients' capacity.

Conclusions

Clinicians found early ACP for PWD valuable in promoting patient‐centered care among an at‐risk population. In sharing their perspectives on conducting ACP for PWD, clinicians described challenges that are amenable to changes in training, workflow, and material support for clinician time. Clinical practices need sustainable scheduling and financial support models.
Molecular mechanisms underlying the toxicity and detoxification of trace metals and metalloids in plants
Authors: Tang Zhong , Wang Han‐Qing , Chen Jie , Chang Jia‐Dong , Zhao Fang‐Jie
Published: December 2022

Plants take up a wide range of trace metals/metalloids (hereinafter referred to as trace metals) from the soil, some of which are essential but become toxic at high concentrations (e.g., Cu, Zn, Ni, Co), while others are non‐essential and toxic even at relatively low concentrations (e.g., As, Cd, Cr, Pb, and Hg). Soil contamination of trace metals is an increasing problem worldwide due to intensifying human activities. Trace metal contamination can cause toxicity and growth inhibition in plants, as well as accumulation in the edible parts to levels that threatens food safety and human health. Understanding the mechanisms of trace metal toxicity and how plants respond to trace metal stress is important for improving plant growth and food safety in contaminated soils. The accumulation of excess trace metals in plants can cause oxidative stress, genotoxicity, programmed cell death, and disturbance in multiple physiological processes. Plants have evolved various strategies to detoxify trace metals through cell‐wall binding, complexation, vacuolar sequestration, efflux, and translocation. Multiple signal transduction pathways and regulatory responses are involved in plants challenged with trace metal stresses. In this review, we discuss the recent progress in understanding the molecular mechanisms involved in trace metal toxicity, detoxification, and regulation, as well as strategies to enhance plant resistance to trace metal stresses and reduce toxic metal accumulation in food crops.
The clinico‐pathological characterisation of focal cortical dysplasia type IIb genetically defined by MTOR mosaicism
Authors: Wang Yajie , Yu Tao , Blümcke Ingmar , Cai Yanning , Sun Ke , Gao Runshi , Wang Yujiao , Fu Yongjuan , Wang Wei , Wang Yuping , Zhang Guojun , Piao Yueshan
Published: December 2022

Aims

Focal cortical dysplasia (FCD) is a major cause of drug‐resistant paediatric epilepsy and is amenable to successful neurosurgical resection. FCD ILAE Type IIb is the most common FCD subtype, and brain somatic mutations affecting the mTOR pathway play a major pathogenic role. The aim of this study was to comprehensively describe the genotype–phenotype association of 20 patients with histopathologically confirmed FCDIIb using next generation sequencing (NGS) of paired blood–brain samples.

Methods

Clinical and neuropathological data were retrospectively reviewed from the hospital archive. The NGS panel included 11 mTOR‐pathway‐related genes with maximum coverage of 2000×. The detected variants were validated by digital droplet PCR.

Results

Pathogenic MTOR variants were identified in 10 patients (50%). Further comparison with MTOR‐wildtype FCDIIb suggested a profound genotype–phenotype association characterised by (1) a non‐temporal lobe lesion on MRI, (2) a larger lesion volume occupying grey and white matter (3.032 ± 1.859 cm3 vs 1.110 ± 0.856 cm3, p = 0.014), (3) more balloon cells (50.20 ± 14.40 BC/mm2 vs 31.64 ± 30.56 BC/mm2, p = 0.099) and dysmorphic neurons (48.72 ± 19.47DN/mm2 vs 15.28 ± 13.95DN/mm2, p = 0.000) and (4) a positive correlation between VAF and the lesion volume (r = 0.802, p = 0.017).

Conclusions

Our study identified frequent MTOR mutations in the cell‐rich FCDIIb phenotype, clinically characterised by a non‐temporal location and large lesion volume. Comprehensive genotype–phenotype associations will help us further explore and define the broad spectrum of FCD lesions to make more targeted therapies available in the realm of epileptology.
Scheduling with present bias
Authors: Hall Nicholas G. , Liu Zhixin
Published: December 2022

The study of time‐inconsistent decision‐making, in particular present bias, has greatly influenced the field of behavioral economics over the last two decades. Moreover, it has resulted in the design and implementation of widely used incentive schemes for various important applications. However, the effect of present bias on decision‐making for operational problems has been studied less. This work considers the effect of present bias in a simple scheduling system that requires decisions about project timing and sequencing. We design algorithms that enable optimization of revenue less cost under present bias for both naive and sophisticated (i.e., self‐aware) decision‐makers. We describe managerial insights about the relative performance of time‐consistent, naive, and sophisticated decision‐makers, and how to mitigate the effects of present bias. Both theoretical and computational results support these insights.
Populist Citizens in four European Countries: Widespread Dissatisfaction goes with Contradictory but Pro‐democratic Regime Preferences
Authors: Wuttke Alexander , Schimpf Christian , Schoen Harald
Published: December 2022

Are populist citizens a threat to democracy? Some philosophers view populism and democracy as irreconcilable conceptions of governing. Another line of thought describes populism as useful democratic corrective. Drawing on nationally representative surveys from four European countries, this study investigates how European populist citizens think about democracy. Descriptive analyses reveal that populist worldviews only weakly predict how people think about democracy. On average, populist and non‐populist citizens aspire to similar kinds of political systems and both endorse liberal‐democratic institutions. Yet, populists and non‐populists differ in the degree to which they hold inconsistent beliefs. Citizens with populist outlook more frequently express contradictory demands that political institutions cannot possibly deliver. Based on these findings, we conclude that most populist citizens do not pursue an elaborate anti‐democratic conception of governing. Rather, the widespread dissatisfaction among populists may create an indeterminate openness for institutional change that political elites could steer in different directions.
Expression of interleukin‐1β, interleukin‐4, interferon‐γ and tumour necrosis factor α in different tissue in a dinitrochlorobenzene‐induced ear swelling test in mice
Authors: Li Chun‐Lian , Liu Na
Published: December 2022

Objective

To study the expression of interleukin‐1β (IL‐1β), interleukin‐4 (IL‐4), interferon‐γ (IFN‐γ) and tumour necrosis factor α (TNF‐α) in different tissue in a dinitrochlorobenzene (DNCB)‐induced ear swelling test in mice and further evaluate the correlation between the cytokine expression in different tissues and the degree of ear swelling.

Methods

The mice were sensitised with a 0.50% DNCB solution on their back for 3 days. After 7 days, the thickness of their ears was measured and grouped. Different concentrations of the DNCB solution were challenged in the left ear of each group of mice, and the right ear was used as the control. The thickness of both ears was measured every 24 h, and the mice were sacrificed 72 h after the challenge. The expressions of IL‐1β, IL‐4, IFN‐γ and TNF‐α in the mouse serum, lymph node and ear tissue were quantified by enzyme‐linked immunosorbent assay, respectively.

Results

There was a linear positive correlation between the swelling index of the mouse lateral ear and the challenge concentration of DNCB (r = 0.96,p < 0.01). The high expression of IL‐1β and IL‐4 in the lateral ear tissue of the mice was positively correlated with the ear swelling index 48 h after the challenge. The correlation coefficient was 0.78 (p < 0.01). Furthermore, IFN‐γ and TNF‐α had no significant correlation with the ear swelling index 48 h after the challenge.

Conclusion

There is a correlation between the degree of ear swelling in mice and the concentration of DNCB and the expression of IL‐1β and IL‐4 in the lateral ear tissue. There is a sub‐clinical skin sensitivity state in contact allergy.
Hydraulic Couplings for Internal-Combustion-Engine Applications
Authors: Alison N. L. , Olson R. G. , Nelden R. M.
Published: December 2022

This paper deals with hydraulic couplings of the hydro-kinetic type used for the transmission of power from internal-combustion engines in marine, traction, and industrial applications. The units described are of the two-element type, having a one-to-one torque ratio, and although mention is made of certain applications of the hydraulic torque converter, such as the original Föttinger speed transformer, the detail discussion is confined to the two-element transmitter or hydraulic coupling.
Effect of Variations in Atmospheric Conditions on Diesel-Engine Performance
Authors: Doolittle Jesse S.
Published: December 2022

This paper presents the variations obtained in fuel rates and maximum power output of a two-cycle Diesel engine when there were changes in the temperature, pressure, and humidity of the supply air and in the exhaust pressure. The author found the engine to be quite insensitive to any of these changes at light loads. At loads in excess of the load of minimum fuel rate, any changes in intake or exhaust conditions that affected the air supply to the engine measurably changed the fuel rate and maximum power output.
The Combustion-Gas Turbine
Authors: Rettaliata J. T.
Published: December 2022

The numerous obstacles in the path of the development of the modern combustion-gas turbine have been adequately surmounted. Years of metallurgical and aerodynamical research, resulting in better materials and an efficient compressor, are the factors which contributed most to the realization of a commercial gas turbine. Its advantages, when compared with other methods of power production, are manifold. Many new uses to which it can be profitably applied are anticipated when additional experience is obtained.

This paper deals with the development and theory of the gas turbine, as well as the features which make it possess attractive potentialities for certain classes of service.
Relative “Engine Efficiencies” Realizable from Large Modern Steam-Turbine-Generator Units
Authors: Warren G. B. , Knowlton P. H.
Published: December 2022

This paper analyzes the results of tests on more than 100 turbines under station operating conditions. The progress in turbine efficiency made over the last 20 years is shown and the analysis of the test results is carried out in such a way as to permit working out a system for predicting relative turbine performance. This method is given in detail and will permit the prediction of relative turbine performance for large condensing and noncondensing machines over a wide range of conditions.
Turbines for Grand Coulee Dam
Authors: Burnard James J.
Published: December 2022

The Grand Coulee power plant, when fully equipped, will be the largest hydroelectric power plant in existence, containing eighteen 150,000-hp main generating units and three 14,000-hp station-service units, or a total capacity of 2,742,000 hp. The turbines are of the vertical-shaft single-runner Francis type with spiral casing, supplied with water through individual plate-steel penstocks connecting with the upstream face of the Grand Coulee Dam. This paper describes in some detail the mechanical features of the main hydraulic turbines for this plant.
Steam Generation in Steel Mills
Authors: Kerr H. J.
Published: December 2022

The author compares operating results of blast-furnace power plants for the years 1922, 1931, and 1940, at the same time indicating the changes which have occurred since 1931, when F. G. Cutler (1) ably presented the developments for the preceding decade. In the course of the paper, an analysis is given of the factors delaying the use of high steam pressures in steel-mill practice, and the problems to be solved in raising steam temperatures. Numerous blast-furnace boiler installations, typical of the best modern practice, are briefly described and illustrated.
A Study of the Development of Skill During Performance of a Factory Operation
Authors: Barnes Ralph M. , Perkins J. S.
Published: December 2022

While in general the many studies into the nature of skill have been concerned with the total time required to accomplish a given task and the influence on time values of varying conditions pertaining to a specific operation, this paper is primarily devoted to a time study of the elements entering into the performance of an industrial task. The investigation constitutes a pioneer effort to study the effect of practice on a typical factory operation, conducted under laboratory conditions.

The work was undertaken jointly by the Western Electric Company and the University of Iowa. The equipment was made, the tests were run, and the data were compiled in the industrial engineering laboratory at the University of Iowa. The statistical work, tabulation of results, and other activities incidental to the preparation of the final report were handled in the offices of the Western Electric Company.
The Flow of Saturated Water Through Throttling Orifices
Authors: Benjamin M. W. , Miller J. G.
Published: December 2022

In this paper are presented the results of tests to determine the flow characteristics for saturated water and for various mixtures of saturated water and steam through sharp-edged thin-plate orifices. Tests show that the actual flow of saturated water through these orifices is considerably greater than would be expected from theoretical calculation based upon a change of state and that no critical back-pressure condition is evident over the range of initial pressures considered. Primarily, this investigation was intended to determine the feasibility of using throttling orifices alone or in combination with float-operated drainers for regulating the draining of condensate from feedwater heaters. The tests which form the basis of the paper have provided sufficient information to permit the derivation of practical design formulas, which have been used successfully in several instances by the authors’ company. These test data apply only to throttling orifices and should not be used to design orifices for metering purposes. An Appendix to the paper shows the application of the formulas to the design of a single-stage orifice to drain the condensate from a feedwater heater, and to the design of an orifice to be used in series with a float-operated drainer.
Vaporization Inside Horizontal Tubes
Authors: McAdams W. H. , Woods W. K. , Bryan R. L.
Published: December 2022

This paper reports an investigation carried out to determine the changes in the coefficient of heat transfer for the evaporation of a liquid flowing inside a heated horizontal tube. For this research, a semiworks apparatus was constructed, consisting of 48 ft of standard 1-in. copper pipe, provided with 12 individual steam jackets, steam traps, and condensate lines. In the benzene runs, the velocities ranged from 0.26 to 1 fps at the inlet and 80 to 240 fps at the outlet; in the water runs, the corresponding values were 0.27 to 0.85 and 205 to 540 fps. With moderate temperature differences, as the fluid is progressively vaporized, the local over-all coefficient at first increases, goes through a maximum, and then decreases sharply toward values typical of superheating dry vapor. Such “vapor-binding” is attributed to insufficient liquid to wet the wall, small droplets of liquid being carried down the center of the tube, as observed at the entrance to the glass return bend. With high temperature differences, the type of vapor-binding previously observed when boiling liquids outside submerged tubes, where (due to excessive temperature difference) a vapor film insulates the tube wall from the bulk of the liquid, was encountered.
Recommended Code of Procedure for Fatigue Testing of Hot-Wound Helical Compression Springs
Authors: Edgerton C. T.
Published: December 2022

This paper gives the recommended procedure for fatigue testing hot-wound helical compression springs in complete detail, so that any competent research technician, with only an elementary knowledge of spring theory, can successfully carry out a program of fatigue tests on helical springs, with practically no other guidance than the instructions laid down in the Code. This has been proved by actual trial.

The test procedure is planned to develop a complete S-N diagram for each group of variables, instead of merely an endurance limit. In the actual plotting of the S-N diagrams, the Committee has developed a technique based on probability theory, which has been included in the Code recommendations. The type of formula used is assumed. The precision measurements and test methods prescribed in the Code permit the computation of relative stresses in the test springs to a high order of accuracy.

It would seem reasonable to assume that there is a mathematical equation representing the S-N relation, the formulation of which awaits an exact determination of the statistical laws controlling the formation and propagation of fatigue cracks. The Committee feels that a studied guess at the correct form of equation is a constructive move. If results indicate that the guess is approximately correct, the use of such a formula has the important advantage that without it the research consists of a series of successive approximations to the correct value of the endurance limit, a quantity obviously immune to exact measurement. In testing helical springs, this procedure is very tedious and expensive, on account of the slow speeds to which we are limited. On the other hand, if the test data are fitted to a probable S-N diagram, every observation makes a considerable contribution to the correctness of the graph, and only one or two of the runs need be prolonged beyond 1,000,000 cycles of stress.
Electric-Slip Couplings for Use With Diesel Engines
Authors: Andriola A. D.
Published: December 2022

The fact that, in the last 12 months, at least twenty Diesel-driven vessels have been equipped with electromagnetic-slip couplings in this country indicates its value for ship-propulsion purposes. This paper explains the functions of the device as (1) to reduce torque-variation intensity at the reduction gears, and (2) to permit two or more engines to be rapidly coupled and uncoupled to and from the gearing to a common propeller shaft. Elements of the system are described and theoretical principles of the mechanism are analyzed. A brief comparison is given of the electric-slip coupling with the hydraulic system. The paper concludes with mention of additional applications in conjunction with internal-combustion engines.
Flexible Couplings for Internal-Combustion Engines
Authors: Ormondroyd J.
Published: December 2022

Four typical dynamical cases of torsionally flexible “linear” couplings are examined: (1) Instantaneous applications of the maximum engine torque; (2) instantaneous stoppage of the engine or the driven member; (3) dangerous torsional resonance; and (4) tooth chatter in geared drives.
Graphical Methods for Plotting Time-Speed-Distance Curves for Railway Trains
Authors: Lipetz A. I.
Published: December 2022

The paper reviews briefly the interest displayed some years ago in Europe, particularly in Russia, in graphical methods for plotting time-speed-distance curves for railway trains and develops methods devised by the author for plotting such curves. Analytical methods and the graphical method are compared and the results are tabulated, and the author’s methods are applied to data from runs of high-speed trains in this country.
Silica in High-Pressure-Boiler Water
Authors: Farmer Harold
Published: December 2022

The advent of high steam pressure has resulted in many boiler-tube failures in which silica appears to have played a very significant part. Attention is called in this paper to the fact that silica trouble appears to be more prevalent in high-pressure boilers having high rates of heat input. Trouble has occurred irrespective of high or low silica content in the boiler water, although silica scale does not form in all boilers irrespective of the amount present. The author points out the need for more basic knowledge regarding the behavior of silica in boiler water at high pressures and temperatures, as well as the development of satisfactory methods for determining the form in which silica exists in the boiler water.
The Flexible-Sleeve Multiple-Oil-Film Radial Bearing
Authors: Fast Gustave
Published: December 2022

Prof. Osborne Reynolds’ theoretical analysis of Beauchamp Tower’s researches on journal bearings proved the necessity for a convergent wedge-shaped oil film between journal and bearing surfaces in order to create useful load-carrying pressures in the oil film. Michell and Kingsbury working independently applied Reynolds’ theory to the development, notably of thrust bearings, and incidentally of radial bearings, with surfaces divided into tilting pads which created a multiplicity of convergent oil films instead of the single convergent film naturally present in an ordinary plain journal bearing. Later Wallgren brought out another form of pivoted-pad radial bearing, in which the pads rotate with the shaft. The multiple-oil-film radial bearing discussed in this paper accomplishes the foregoing without recourse to the use of pivoted shoes or pads. The flexing of the continuous block-sleeve-bearing member under load provides a multiplicity of wedge-shaped oil-film boundaries which create shearing stresses in the circulating oil and produce useful load-carrying pressures in the oil films. Careful tests have been conducted on the multiple-oil-film radial bearing under different conditions of speed, load, and oil viscosity, in order to determine its operating characteristics. The paper summarizes and discusses these test data.
Novel Equivalent Circuit Model for a Load-Type Bi-Stable Supersonic Fluidic Oscillator
Authors: Xu Sichang , Ryzer Eugene , Rankin Gary W.
Published: December 2022

This paper describes the development and evaluation of a novel equivalent fluid circuit model capable of accurately predicting the performance of a load-type bistable supersonic fluidic oscillator. The model utilizes some aspects of previous models that are available in the literature. It is based on a quasi-steady assumption and includes a special nonlinear element to account for certain aspects of the oscillator switching mechanism in addition to the traditional fluid resistance, capacitance, and inductance. A new technique for modeling a junction in a fluid duct network is also presented. Unlike previous studies which made use of empirical experimental data or analytical assumptions to estimate the fluid element parameter values and form of the nonlinearity, the current method utilizes steady, computational fluid dynamic techniques to evaluate the parameters and nonlinearity which cannot be accurately determined analytically. A simplification of the model is also used to establish the criteria for oscillations to exist. The transient solution of the model equations is then shown to give good quantitative agreement with previous experimental values of the oscillation frequency and amplitude. The model is also capable of predicting certain operational limitations and other trends in the data. Finally, the usefulness and robustness of the model are also demonstrated by showing the ease with which a parameter and design changes can be investigated.
Bi-color atomic beam slower and magnetic field compensation for ultracold gases
Authors: Li Jianing , Lim Kelvin , Das Swarup , Zanon-Willette Thomas , Feng Chen-Hao , Robert Paul , Bertoldi Andrea , Bouyer Philippe , Kwong Chang Chi , Lan Shau-Yu , Wilkowski David
Published: December 2022

Transversely loaded bidimensional-magneto-optical-traps (2D-MOTs) have been recently developed as high flux sources for cold strontium atoms to realize a new generation of compact experimental setups. Here, we discuss on the implementation of a cross-polarized bi-color slower for a strontium atomic beam, improving the 2D-MOT loading and increasing the number of atoms up to ∼109 atoms in the 461 nm MOT. Our slowing scheme addresses simultaneously two excited Zeeman substates of the 88Sr 1S0→ 1P1 transition at 461 nm. We also realized a three-axis active feedback control of the magnetic field down to the microgauss regime. Such a compensation is performed thanks to a network of eight magnetic field probes arranged in a cuboid configuration around the atomic cold sample and a pair of coils in a quasi-Helmholtz configuration along each of three Cartesian directions. Our active feedback is capable of efficiently suppressing most of the magnetically induced position fluctuations of the 689 nm intercombination-line MOT.
Limitations of the independent control of ion flux and energy distribution function in high-density inductively coupled chlorine plasmas
Authors: Levko Dmitry , Upadhyay Rochan R. , Suzuki Kenta , Raja Laxminarayan L.
Published: December 2022

Using a self-consistent plasma model coupled with Maxwell's equations, the limitations of independent control of ion fluxes and their energy distribution functions extracted from the high-density inductively coupled chlorine plasma are studied. Two extreme cases of discharge power are considered: 100 W and 1 kW. We find that in the low-power case, plasma is mainly generated by electromagnetic waves while the radio-frequency biased electrode primarily enables plasma ion extraction. Therefore, the ion fluxes and distribution functions are controlled independently. For the high-power case of 1 kW, the bias electrode significantly contributes to plasma generation but has only a small effect on sheath voltage. As a consequence, independent control of ion fluxes and distribution functions becomes impossible. Namely, the increase in the power driving the radio-frequency electrode leads to the increase in the ion fluxes but has little effect on their energy and angular distributions.
Growth of ultrathin Bi2Se3 films by molecular beam epitaxy
Authors: Nasir Saadia , Smith Walter J. , Beechem Thomas E. , Law Stephanie
Published: December 2022

Bi 2 Se 3 is a widely studied 3D topological insulator having potential applications in optics, electronics, and spintronics. When the thickness of these films decreases to less than approximately 6 nm, the top and bottom surface states couple, resulting in the opening of a small gap at the Dirac point. In the 2D limit, Bi2Se3 may exhibit quantum spin Hall states. However, growing coalesced ultrathin Bi2Se3 films with a controllable thickness and typical triangular domain morphology in the few nanometer range is challenging. Here, we explore the growth of Bi2Se3 films having thicknesses down to 4 nm on sapphire substrates using molecular beam epitaxy that were then characterized with Hall measurements, atomic force microscopy, and Raman imaging. We find that substrate pretreatment—growing and decomposing a few layers of Bi2Se3 before the actual deposition—is critical to obtaining a completely coalesced film. In addition, higher growth rates and lower substrate temperatures led to improvement in surface roughness, in contrast to what is observed for conventional epitaxy. Overall, coalesced ultrathin Bi2Se3 films with lower surface roughness enable thickness-dependent studies across the transition from a 3D-topological insulator to one with gapped surface states in the 2D regime.
The mass spectrum of quarkonium using matrix mechanics
Authors: Belhouari Aissa
Published: December 2022

The matrix method is used to determine the mass spectrum (energy levels) of quarkonium, a composite particle comprising a quark and an anti-quark. This two-body system is similar to the hydrogen atom but at a reduced length scale. The results obtained by solving the Schrödinger equation for this system are in agreement with experimental and theoretical results obtained via other techniques, showing that problems with complicated potentials can be tackled by undergraduates.
High-entropy mechanism to boost ionic conductivity
Authors: Zeng Yan , Ouyang Bin , Liu Jue , Byeon Young-Woon , Cai Zijian , Miara Lincoln J. , Wang Yan , Ceder Gerbrand
Published: December 2022

Advances in solid-state batteries have primarily been driven by the discovery of superionic conducting structural frameworks that function as solid electrolytes. We demonstrate the ability of high-entropy metal cation mixes to improve ionic conductivity in a compound, which leads to less reliance on specific chemistries and enhanced synthesizability. The local distortions introduced into high-entropy materials give rise to an overlapping distribution of site energies for the alkali ions so that they can percolate with low activation energy. Experiments verify that high entropy leads to orders-of-magnitude higher ionic conductivities in lithium (Li)–sodium (Na) superionic conductor (Li-NASICON), sodium NASICON (Na-NASICON), and Li-garnet structures, even at fixed alkali content. We provide insight into selecting the optimal distortion and designing high-entropy superionic conductors across the vast compositional space.
In Science Journals
Authors: Jiang Di , Purnell Beverly A. , Osborne Ian S. , Stern Peter , Yeston Jake , Malo Courtney S. , Ferrarelli Leslie K. , Szuromi Phil , Grocholski Brent , Alderton Gemma , Hines Pamela J. , Lavine Marc S. , Vignieri Sacha , Olingy Claire
Published: December 2022

Highlights from the
Science
family of journals
Moms’ mitochondria may refresh cells in sick kids
Authors: Leslie Mitch
Published: December 2022

Technique is designed to treat mitochondrial disease
A Cross-Sectional Study of SARS-CoV-2 Antibodies and Risk Factors for Seropositivity in Staff in Day Care Facilities and Preschools in Denmark
Authors: Fogh Kamille , Eriksen Alexandra R. R. , Larsen Tine Graakjær , Hasselbalch Rasmus B. , Bundgaard Henning , Scharff Bibi F. S. S. , Nielsen Susanne D. , Jørgensen Charlotte S. , Erikstrup Christian , Østergaard Lars , Ellermann-Eriksen Svend , Andersen Berit , Nielsen Henrik , Johansen Isik S. , Wiese Lothar , Hindhede Lotte , Mikkelsen Susan , Sækmose Susanne G. , Aagaard Bitten , Holm Dorte K. , Harritshøj Lene , Simonsen Lone , Fischer Thea K. , Folke Fredrik , Lippert Freddy , Ostrowski Sisse R. , Benfield Thomas , Mølbak Kåre , Ethelberg Steen , Koch Anders , Vangsted Anne-Marie , Krause Tyra Grove , Fomsgaard Anders , Ullum Henrik , Skov Robert , Iversen Kasper
Published: December 2022

Identifying at-risk groups and evaluating preventive interventions in at-risk groups is imperative for the ongoing pandemic as well as for the control of future epidemics. Although DCS staff have a much higher risk of being infected within their own household than at their workplace, most are fearful of being infected with COVID-19 or bringing COVID-19 to work.
Improving reproducibility of geoscience models with Sciunit
Authors: Ahmad Raza , Choi Young Don , Goodall Jonathan L. , Tarboton David , Nassar* Ayman , Malik Tanu
Published: December 2022

For science to reliably support new discoveries, its results must be reproducible. Assessing reproducibility is a challenge in many fields—including the geosciences—that rely on computational methods to support these discoveries. Reproducibility in these studies is particularly difficult; the researchers conducting studies must agree to openly share research artifacts, provide documentation of underlying hardware and software dependencies, ensure that computational procedures executed by the original researcher are portable and execute in different environments, and, finally, verify if the results produced are consistent. Often these tasks prove to be tedious and challenging for researchers.

Sciunit (https://sciunit.run) is a system for easily containerizing, sharing, and tracking deterministic computational applications across environments. Geoscience applications in the fields of hydrology, solid Earth, and space science have actively used Sciunit to encapsulate, port, and repeat workflows across computational environments. In this chapter, we provide a comprehensive survey of geoscience applications that have used Sciunit to improve sharing and reproducibility. We classify the applications based on their reproducibility requirements and show how Sciunit accommodates relevant interfaces and architectural components to support reproducibility requirements within each application. We aim to provide these applications as a Sciunit compendium of use cases for replicability, benchmarking, and improving the conduct of reproducible science in other fields.
Optogenetic Prosthetization of Retinal Bipolar Cells
Authors: Rotov A. Yu. , Firsov M. L.
Published: December 2022

Although the experience of optogenetic retinal prosthetics
in animal models dates back to more than 16 years, the first results
obtained on humans have only been reported in the last year. Over this
period, the main challenges of prosthetics became clear and the
approaches to their solution were proposed. In this review, we aim
to present the achievements in the field of optogenetic prosthetization
of retinal bipolar cells with a focus mainly on relatively recent
publications. The review addresses the advantages and disadvantages
of bipolar cell prosthetics as compared to the alternative target,
retinal ganglion cells, and provides a comparative analysis of the
effectiveness of ionotropic light-sensitive proteins (channelrhodopsins)
or metabotropic receptors (rhodopsins) as prosthetic tools.
Clinical predictors of bacteraemia in neonates with suspected early-onset sepsis in Malawi: a prospective cohort study
Authors: de Baat Tessa , Lester Rebecca , Ghambi Lugano , Twabi Hussein H , Nielsen Maryke , Gordon Stephen B , van Weissenbruch Mirjam M , Feasey Nicholas A , Dube Queen , Kawaza Kondwani , Iroh Tam Pui-Ying
Published: December 2022

Objectives

We studied neonates with suspected early-onset sepsis (EOS, sepsis developing in the first 72 hours after delivery) in Malawi to (1) describe clinical characteristics and microbiological findings, (2) identify which patient characteristics may be associated with pathogen positivity on blood culture, and (3) describe mortality and its potential determinants.

Design

Prospective observational study (May 2018–June 2019).

Setting

Neonatal ward in Queen Elizabeth Central Hospital, the largest government hospital in Malawi.

Patients

All neonates with suspected EOS in whom a blood culture was obtained.

Results

Out of 4308 neonatal admissions, 1244 (28.9%) had suspected EOS. We included 1149 neonates, of which 109 blood cultures had significant growth (9.5%). The most commonly isolated pathogens wereStaphylococcus aureus,Klebsiella pneumoniae,Enterobacter cloacae,Escherichia coliandAcinetobacter baumanii. Many of the Gram negatives were extended-spectrum beta lactamase-producing Enterobacteriaceae, and these were 40–100% resistant to first-line and second-line antimicrobials. Gestational age (GA) of <32 weeks was associated with pathogen-positive blood cultures (<28 weeks: adjusted OR (AOR) 2.72, 95% CI 1.04 to 7.13; 28–32 weeks: AOR 2.26, 95% CI 1.21 to 4.21; p=0.005). Mortality was 17.6% (202/1149) and associated with low birth weight (<1000 g: AOR 47.57, 95% CI 12.59 to 179.81; 1000–1500 g: AOR 11.31, 95% CI 6.97 to 18.36; 1500–2500 g: AOR 2.20, 95% CI 1.42 to 3.39; p<0.001), low Apgar scores at 5 min (0–3: AOR 18.60, 95% CI 8.81 to 39.27; 4–6: AOR 4.41, 95% CI 2.81 to 6.93; p<0.001), positive maternal venereal disease research laboratory status (AOR 2.53, 95% CI 1.25 to 5.12; p=0.001) and congenital anomalies (AOR 7.37, 95% CI 3.61 to 15.05; p<0.001). Prolonged rupture of membranes was inversely associated with mortality (AOR 0.43, 95% CI 0.19 to 0.98; p 0.007).

Conclusion

In Malawi, EOS was suspected in nearly a third of neonatal admissions and had a high mortality. Ten per cent were culture-confirmed and predicted by low GA. To reduce the impact of suspected neonatal sepsis in least developed countries, improved maternal and antenatal care and development of rapid point of care methods to more accurately guide antimicrobial use could simultaneously improve outcome and reduce antimicrobial resistance.
Intraductal tubulopapillary neoplasm
Authors: Yu Catherine , Lokan Julie , Jackett Louise , Nikfarjam Mehrdad , Mills Christopher
Published: December 2022

A man aged above 70 years old with a medical history of ulcerative colitis presented with unintentional weight loss. A pancreatic mass associated with pancreatic duct dilatation was detected on imaging procedures. Initial investigations including fine needle aspiration and cytology examination were inconclusive. A diagnosis of intraductal tubulopapillary neoplasm (ITPN) was made with histopathology and immunohistochemistry examination on a surgically resected specimen. Two years after surgery, the patient remained well with no radiological evidence of recurrence.

ITPN is a rare pancreatic duct tumour with limited case reports in medical literature. Risk factors are not well established. We report the first case of ITPN occurring in a patient with ulcerative colitis. A typical presentation of this rare tumour is reported to encourage clinicians to consider ITPN in the differential diagnoses of a pancreatic mass.
Surgical management of pneumomediastinum in the COVID-19 patient
Authors: Abou-Abdallah Michel , Dewhurst Samuel , Dunne Henry , Irune Ekpemi
Published: December 2022

As the SARS-CoV-2 virus continues to infect millions of people worldwide, the medical profession is seeing a wide range of short-term and long-term complications of COVID-19. One lesser-known complication is that of pneumomediastinum. This is a rare, but significant, complication defined by the presence of air in the mediastinum with an incidence of 1.2 per 100 000. Described mortality rate is 30%, increasing to 60% in patients with concomitant pneumothoraces. Management of pneumomediastinum is typically conservative, but in cases of extensive subcutaneous emphysema, cardiac or airway compression, life-saving surgical decompression is necessary. We report a case of pneumomediastinum secondary to COVID-19, requiring a surgical approach not described in pneumomediastinum secondary to COVID-19. The case demonstrates the importance of prompt diagnosis and management, as well as the potential for good clinical outcome in selected patients.
Levofloxacin-associated transient mixed sensorimotor lacunar syndrome
Authors: Michelassi Francesco , Bloom Joshua , Su Mark K , Naqvi Imama A
Published: December 2022

Fluoroquinolones are commonly used antimicrobials with multiple known adverse effects, yet overdose events are rarely reported. Here, we report a case of a previously healthy middle-aged woman who unintentionally ingested 7 g of levofloxacin in one dose. Thereafter, she presented to the emergency department with hemiparesis concerning for ischaemic stroke and was administered tissue plasminogen activator. Her brain imaging showed no ischaemic injury and her symptoms resolved within 24 hours; this is consistent with a transient ischaemic attack. Our case highlights potential adverse effects of an acute overdose of levofloxacin that has not previously been well described.
Atypical APC-1 pelvic fracture presenting with pelvic instability: successful management with pubic symphysis fusion
Authors: Wakefield Sophia M , Giannoudis Vasileios , Messori Matteo , Giannoudis Peter V
Published: December 2022

By definition, anteroposterior (AP) compression type 1 (APC-1) injury is a type of pelvic ring injury, which is widely acknowledged as ‘stable’. Unstable forms of this injury are very rare and present a challenge for diagnosis and clinical management. Detailed herein is a man in his early 30s, referred to our institution with a 2-year history of pubic symphysis pain following a road traffic accident. Radiological investigation revealed an unstable APC-1 injury. This was subsequently managed with surgical reconstruction leading to the successful return of the patient to former function and recreational activities.
Effect of a home-based inspiratory muscle training programme on functional capacity in postdischarged patients with long COVID: the InsCOVID trial
Authors: Palau Patricia , Domínguez Eloy , Gonzalez Cruz , Bondía Elvira , Albiach Cristina , Sastre Clara , Martínez Maria Luz , Núñez Julio , López Laura
Published: December 2022

Background

Fatigue and exercise intolerance are the most common symptoms in patients with long COVID.

Aims

This study aimed to evaluate whether a home-based inspiratory muscle training (IMT) programme improves maximal functional capacity in patients’ long COVID after a previous admission due to SARS-CoV-2 pneumonia.

Methods

This study was a single-centre, blinded assessor, randomised controlled trial. Twenty-six patients with long COVID and a previous admission due to SARS-CoV-2 pneumonia were randomly assigned to receive either a 12-week IMT or usual care alone (NCT05279430). The physiotherapist and participants were not blinded. Patients allocated to the IMT arm were instructed to train at home twice daily using a threshold inspiratory muscle trainer and to maintain diaphragmatic breathing during the training session. The usual care arm received no intervention.

The primary endpoint was the change in peak oxygen consumption (peakVO2). Secondary endpoints were changes in quality of life (QoL), ventilatory efficiency and chronotropic response during exercise (evaluated by chronotropic index-CIx- formula). We used linear mixed regression analysis for evaluating changes in primary and secondary endpoints.

Results

The mean age of the sample and time to first visit after discharge were 50.4±12.2 years and 362±105 days, respectively. A total of 11 (42.3%) were female. At baseline, the mean of peakVO2, ventilatory efficiency and CIx were 18.9±5 mL/kg/min, 29.4±5.2 and 0.64±0.19, respectively. The IMT arm improved their peakVO2significantly compared with usual care (+Δ 4.46 mL/kg/min, 95% CI 3.10 to 5.81; p<0.001). Similar positive findings were found when evaluating changes for CIxand some QoL dimensions. We did not find significant changes in ventilatory efficiency.

Conclusion

In long COVID patients with a previous admission due to SARS-CoV-2 pneumonia, IMT was associated with marked improvement in exercise capacity and QoL.

Trial registration number

NCT05279430.
Imaging of intracoronary thrombus
Authors: Whittington Beth , Tzolos Evangelos , Williams Michelle C , Dweck Marc R , Newby David E
Published: December 2022

The identification of intracoronary thrombus and atherothrombosis is central to the diagnosis of acute myocardial infarction, with the differentiation between type 1 and type 2 myocardial infarction being crucial for immediate patient management. Invasive coronary angiography has remained the principal imaging modality used in the investigation of patients with myocardial infarction. More recently developed invasive intravascular imaging approaches, such as angioscopy, intravascular ultrasound and optical coherence tomography, can be used as adjunctive imaging modalities to provide more direct visualisation of coronary atheroma and the causes of myocardial infarction as well as to improve the sensitivity of thrombus detection. However, these invasive approaches have practical and logistic constraints that limit their widespread and routine application. Non-invasive angiographic techniques, such as CT and MRI, have become more widely available and have improved the non-invasive visualisation of coronary artery disease. Although they also have a limited ability to reliably identify intracoronary thrombus, this can be overcome by combining their anatomical and structural characterisation of coronary anatomy with positron emission tomography. Specific radiotracers which bind with high specificity and sensitivity to components of thrombus, such as activated platelets, fibrin and factor XIIIa, hold promise for the non-invasive detection of intracoronary thrombus. The development of these novel non-invasive approaches has the potential to inform clinical decision making and patient management as well as to provide a non-invasive technique to assess the efficacy of novel antithrombotic therapies or interventional strategies. However, these have yet to be realised in routine clinical practice.
Coronary calcium score in the initial evaluation of suspected coronary artery disease
Authors: Pedersen Eva Ringdal , Hovland Siren , Karaji Iman , Berge Christ , Mohamed Ali Abukar , Lekven Ole Christian , Kuiper Kier Jan , Rotevatn Svein , Larsen Terje Hjalmar
Published: December 2022

Objective

We evaluated coronary artery calcium (CAC) scoring as an initial diagnostic tool in outpatients and in patients presenting at the emergency department due to suspected coronary artery disease (CAD).

Methods

10 857 patients underwent CAC scoring and coronary CT angiography (CCTA) at Haukeland University Hospital in Norway during 2013–2020. Based on CCTA, obstructive CAD was defined as at least one coronary stenosis ≥50%. High-risk CAD included obstructive stenoses of the left main stem, the proximal left ascending artery or affecting all three major vascular territories with at least one proximal segment involved.

Results

Median age was 58 years and 49.5% were women. The overall prevalence of CAC=0 was 45.0%. Among those with CAC=0, 1.8% had obstructive CAD and 0.6% had high-risk CAD on CCTA. Overall, the sensitivity, specificity, positive predictive value and negative predictive value (NPV) of CAC=0 for obstructive CAD were 95.3%, 53.4%, 30.0% and 98.2%, respectively. However, among patients <45 years of age, although the NPV was high at 98.9%, the sensitivity of CAC=0 for obstructive CAD was only 82.3%.

Conclusions

In symptomatic patients, CAC=0 correctly ruled out obstructive CAD and high-risk CAD in 98.2% and 99.4% of cases. This large registry-based cross-sectional study supports the incorporation of CAC testing in the early triage of patients with chest pain and as a gatekeeper to further cardiac testing. However, a full CCTA may be needed for safely ruling out obstructive CAD in the youngest patients (<45 years of age).