bluuebunny/crossref_metadata_2025 huggingface dataset:
How have thick evaporites affected early seafloor spreading magnetic anomalies in the Central Red Sea?
Authors: Okwokwo Oke I , Mitchell Neil C , Shi Wen , Stewart I C F , Izzeldin A Y
Published: January 2022

The axial region of the Central Red Sea has been shown to be floored by oceanic crust, but this leaves the low amplitudes of off-axis magnetic anomalies to be explained.  Furthermore, if seafloor spreading occurred in the late Miocene, it is unclear how that occurred as widespread evaporites were being deposited then and may have covered the spreading centre. In this study, we derive crustal magnetization for a constant-thickness source layer within the uppermost basement by inverting aeromagnetic anomalies using basement depths derived from seismic reflection and gravity data.  Peak-to-trough variations in magnetization away from the axis are found to be slightly less than half of those of normal oceanic crust, but not greatly diminished, and hence the magnetic anomalies are mostly reduced by the greater depth of basement, which is depressed by isostatic loading by the evaporites (kilometres in thickness in places). There is no relationship between seafloor spreading anomalies and the modern distribution of evaporites mapped out using multibeam sonar data; magnetizations are still significant even where the basement lies several kilometres under the evaporites. This suggests that magnetizations have not been more greatly affected by alteration under the evaporites than typically exposed oceanic crust. A prominent magnetization peak commonly occurs at 60–80 km from the axis on both tectonic plates, coinciding with a basement low suggested previously to mark the transition to continental crust closer to the coasts.  We suggest an initial burst of volcanism occurred at Chron 5 (at ∼10 Ma) to produce this feature. Furthermore, an abrupt change is found at ∼5 Ma from low-frequency anomalies off-axis to high-frequency anomalies towards the present axis. This potentially represents the stage at which buried spreading centres became exposed. In this interpretation, intrusions such as sills at the buried spreading centre led to broad magnetic anomalies, whereas the later exposure of the spreading centre led to a more typical development of crustal magnetization by rapid cooling of extrusives.
A baseline study of macro, meso and micro litter in the Belize River basin, from catchment to coast
Authors: Silburn Briony , Bakir Adil , Binetti Umberto , Russell Josie , Kohler Peter , Preston-Whyte Fiona , Meakins Bryony , van Hoytema Nanne , Andrews Gilbert , Carrias Abel , Maes Thomas
Published: January 2022

The mismanagement of waste and subsequent presence of litter in the environment is an increasingly significant problem. Globally, rivers have been shown to be a major pathway for mismanaged waste. We investigated the distribution of macro, meso and micro litter along the Belize river basin. The North-East Atlantic OSPAR beach litter monitoring protocol was adapted for Belize, taking into account local issues such as mangroves and Sargassum sp. accumulations. On average, 77.3% of litter items consisted of plastic, and the most common items categories were unidentifiable plastic pieces (0–2.5 and 2.5–50 cm), broken glass, and metal bottle caps. The study indicated that there is an increase in the litter load as you move from catchment to coast, with both Plastic Pieces (PP) and Fishing Related (FR) items also increasing in numbers down the system. Additionally, microplastics abundance was determined in riverine sediments and in the riverine fish Cichlasoma synspilum (n = 22). All sediment samples contained microplastics, with a concentration of 200–6500 particles per kg dry sediment. Microplastics were found to be present in 36% of the riverine fish. The data from this study will provide evidence for the formation of Belizean legislation to reduce marine litter.
Smart automotive technology adherence to the law: (de)constructing road rules for autonomous system development, verification and safety
Authors: McLachlan Scott , Neil Martin , Dube Kudakwashe , Bogani Ronny , Fenton Norman , Schaffer Burkhard
Published: January 2022

Driving is an intuitive task that requires skill, constant alertness and vigilance for unexpected events. The driving task also requires long concentration spans, focusing on the entire task for prolonged periods, and sophisticated negotiation skills with other road users including wild animals. Modern motor vehicles include an array of smart assistive and autonomous driving systems capable of subsuming some, most, or in limited cases, all of the driving task. Building these smart automotive systems requires software developers with highly technical software engineering skills, and now a lawyer’s in-depth knowledge of traffic legislation as well. This article presents an approach for deconstructing the complicated legalese of traffic law and representing its requirements and flow. Our approach (de)constructs road rules in legal terminology and specifies them in ‘structured English logic’ that is expressed as ‘Boolean logic’ for automation and ‘Lawmaps’ for visualization. We demonstrate an example using these tools leading to the construction and validation of a ‘Bayesian Network model’. We strongly believe these tools to be approachable by programmers and the general public, useful in development of Artificial Intelligence to underpin motor vehicle smart systems, and in validation to ensure these systems are considerate of the law when making decisions.
APOBEC3C S188I Polymorphism Enhances Context-Specific Editing of Hepatitis B Virus Genome
Authors: Khalfi Pierre , Suspène Rodolphe , Caval Vincent , Thiers Valérie , Beauclair Guillaume , Marchio Agnès , Bekondi Claudine , Amougou Atsama Marie , Camengo-Police Serge Magloire , Noah Noah Dominique , Njouom Richard , Blanc Hervé , Vallet Thomas , Vignuzzi Marco , Pineau Pascal , Vartanian Jean Pierre
Published: January 2022

Single-nucleotide polymorphism in APOBEC3C (resulting in a serine to isoleucine in position 188) is present in approximately 10% of African populations and greatly enhances restriction against human immunodeficiency virus-1 and simian immunodeficiency virus by improving dimerization and DNA processivity of the enzyme. In this study, we demonstrated in culture and in infected patients that hepatitis B virus (HBV) could be edited by APOBEC3CS188I. Using next-generation sequencing, we demonstrated that APOBEC3CS188I led to enhanced editing activity in 5ʹTpCpA→5ʹTpTpA context. This constitutes a new hallmark of this enzyme, which could be used to determine its impact on HBV or nuclear DNA.
The ‘beautiful enigma’
Authors: Levi D’Ancona Modena Luisa
Published: January 2022

Through an analysis of the art collection and patronage of Margherita Traube Mengarini (1856–1912), a German scientist and woman activist of Jewish origin in Rome, this article explores the dynamics of German–Jewish art collectors’ networks active in Italy from the 1880s to the early 1910s, with a particular focus on women. The collection assembled by Margherita and her husband Guglielmo Mengarini included both antique pieces – discovered during the excavations for the couple’s houses in Rome and in Anzio – and paintings of the family, commissioned from contemporary artists. The article discusses the Traube Mengarini collection in context, by focusing on the artists, collectors and intellectuals in their salon, and by comparing both their collection and networks with those of other Jews of German origin in Rome, both men and women.
Obstetrical and Perinatal Outcomes in Female Survivors of Childhood and Adolescent Cancer: A Population-Based Cohort Study
Authors: Zgardau Alina , Ray Joel G , Baxter Nancy N , Nagamuthu Chenthila , Park Alison L , Gupta Sumit , Nathan Paul C
Published: January 2022

Background

The likelihood of pregnancy and risk of obstetrical or perinatal complications is inadequately documented in female survivors of pediatric cancer.

Methods

We assembled a population-based cohort of female survivors of cancer diagnosed at age 21 years and younger in Ontario, Canada, between 1985 and 2012. Survivors were matched 1:5 to women without prior cancer. Multivariable Cox proportional hazards and modified Poisson models assessed the likelihood of a recognized pregnancy and perinatal and maternal complications.

Results

A total of 4062 survivors were matched to 20 308 comparisons. Median (interquartile range) age was 11 (4-15) years at cancer diagnosis and 25 (19-31) years at follow-up. By age 30 years, the cumulative incidence of achieving a recognized pregnancy was 22.3% (95% confidence interval [CI] = 20.7% to 23.9%) among survivors vs 26.6% (95% CI = 25.6% to 27.3%) among comparisons (hazard ratio = 0.80, 95% CI = 0.75 to 0.86). A lower likelihood of pregnancy was associated with a brain tumor, alkylator chemotherapy, cranial radiation, and hematopoietic stem cell transplantation. Pregnant survivors were as likely as cancer-free women to carry a pregnancy >20 weeks (relative risk [RR] = 1.01, 95% CI = 0.98 to 1.04). Survivors had a higher relative risk of severe maternal morbidity (RR = 2.31, 95% CI = 1.59 to 3.37), cardiac morbidity (RR = 4.18, 95% CI = 1.89 to 9.24), and preterm birth (RR = 1.57, 95% CI = 1.29 to 1.92). Preterm birth was more likely in survivors treated with hematopoietic stem cell transplantation (allogenic: RR = 8.37, 95% CI = 4.83 to 14.48; autologous: RR = 3.72, 95% CI = 1.66 to 8.35).

Conclusions

Survivors of childhood or adolescent cancer are less likely to achieve a pregnancy and, once pregnant, are at higher risk for severe maternal morbidity and preterm birth.
The PDF perspective on the tracer-matter connection: Lagrangian bias and non-Poissonian shot noise
Authors: Friedrich Oliver , Halder Anik , Boyle Aoife , Uhlemann Cora , Britt Dylan , Codis Sandrine , Gruen Daniel , Hahn ChangHoon
Published: January 2022

We study the connection of matter density and its tracers from the probability density function (PDF) perspective. One aspect of this connection is the conditional expectation value 〈δtracer|δm〉 when averaging both tracer and matter density over some scale. We present a new way to incorporate a Lagrangian bias expansion of this expectation value into standard frameworks for modelling the PDF of density fluctuations and counts-in-cells statistics. Using N-body simulations and mock galaxy catalogues we confirm the accuracy of this expansion and compare it to the more commonly used Eulerian parametrization. For haloes hosting typical luminous red galaxies, the Lagrangian model provides a significantly better description of 〈δtracer|δm〉 at second order in perturbations. A second aspect of the matter-tracer connection is shot-noise, i.e. the scatter of tracer density around 〈δtracer|δm〉. It is well known that this noise can be significantly non-Poissonian and we validate the performance of a more general, two-parameter shot-noise model for different tracers and simulations. Both parts of our analysis are meant to pave the way for forthcoming applications to survey data.
Deriving ages and horizontal branch properties of integrated stellar populations
Authors: Cabrera-Ziri Ivan , Conroy Charlie
Published: January 2022

A major source of uncertainty in the age determination of old (∼10 Gyr) integrated stellar populations is the presence of hot horizontal branch (HB) stars. Here, we describe a simple approach to tackle this problem, and show the performance of this technique that simultaneously models the age, abundances, and HB properties of integrated stellar populations. For this, we compare the results found during the fits of the integrated spectra of a sample of stellar population benchmarks, against the values obtained from the analysis of their resolved colour–magnitude diagrams (CMDs). We find that the ages derived from our spectral fits for most (26/32) of our targets are within 0.1 dex to their CMDs values. Similarly, for the majority of the targets in our sample we are able to recover successfully the flux contribution from hot HB stars (within ∼0.15 dex for 18/24 targets) and their mean temperature (14/24 targets within $\sim 30 {{\ \rm per\ cent}}$). Finally, we present a diagnostic that can be used to detect spurious solutions in age, that will help identify the few cases when this method fails. These results open a new window for the detailed study of globular clusters beyond the Local Group.
Binary companions triggering fragmentation in self-gravitating discs
Authors: Cadman James , Hall Cassandra , Fontanive Clémence , Rice Ken
Published: January 2022

Observations of systems hosting close-in (<1 au) giant planets and brown dwarfs (M ≳ 7 MJup) find an excess of binary-star companions, indicating that stellar multiplicity may play an important role in their formation. There is now increasing evidence that some of these objects may have formed via fragmentation in gravitationally unstable discs. We present a suite of 3D smoothed particle hydrodynamics simulations of binary-star systems with circumprimary self-gravitating discs, which include a realistic approximation to radiation transport, and extensively explore the companion’s orbital parameter space for configurations that may trigger fragmentation. We identify a ‘sweet spot’ where intermediate separation binary companions (100 au ≲ a ≲ 400 au) can cause a marginally stable disc to fragment. The exact range of ideal binary separations is a function of the companion’s eccentricity, inclination, and mass. Heating is balanced by efficient cooling, and fragmentation occurs inside a spiral mode driven by the companion. Short separation, disc-penetrating binary encounters (a ≲ 100 au) are prohibitive to fragmentation, as mass stripping and disc heating quench any instability. This is also true of binary companions with high orbital eccentricities (e ≳ 0.75). Wide separation companions (a ≳ 500 au) have little effect on the disc properties for the set-up parameters considered here. The sweet spot found is consistent with the range of binary separations that display an excess of close-in giant planets and brown dwarfs. Hence, we suggest that fragmentation triggered by a binary companion may contribute to the formation of these substellar objects.
The launching of cosmic ray-driven outflows
Authors: Huang Xiaoshan , Davis Shane W
Published: January 2022

Cosmic rays (CRs) are thought to be an important feedback mechanism in star-forming galaxies. They can provide an important source of pressure support and possibly drive outflows. We perform multidimensional CR magnetohydrodynamic simulations including transport by streaming and diffusion to investigate wind launching from an initially hydrostatic atmosphere by CRs. We estimate a characteristic Eddington limit on the CR flux for which the CR force exceeds gravity and compare it to simulated systems. Scaling our results to conditions in star-forming galaxies, we find that CRs are likely to contribute to driving outflows for a broad range of star formation environments. We quantify the momentum and energy transfer between CRs and gas, along with the associated mass outflow rates under different assumptions about the relative importance of streaming and diffusion for transport. In simulations with streaming, we observe the growth and saturation of the CR acoustic instability, but the CRs and gas remain well coupled, with CR momentum transferred efficiently to the gas even when this instability is present. Higher CR fluxes transfer more energy to the gas and drive stronger outflows. When streaming is present, most of the transferred energy takes the form of Alfvén wave heating of the gas, raising its pressure and internal energy, with a lower fractional contribution to the kinetic energy of the outflow. We also consider runs with radiative cooling, which modifies gas temperature and pressure profiles but does not seem to have a large impact on the mass outflow for super-Eddington CR fluxes.
The diversity of core–halo structure in the fuzzy dark matter model
Authors: Chan Hei Yin Jowett , Ferreira Elisa G M , May Simon , Hayashi Kohei , Chiba Masashi
Published: January 2022

In the fuzzy dark matter (FDM) model, gravitationally collapsed objects always consist of a solitonic core located within a virialized halo. Although various numerical simulations have confirmed that the collapsed structure can be described by a cored Navarro–Frenk–White-like density profile, there is still disagreement about the relation between the core mass and the halo mass. To fully understand this relation, we have assembled a large sample of cored haloes based on both idealized soliton mergers and cosmological simulations with various box sizes. We find that there exists a sizeable dispersion in the core–halo mass relation that increases with halo mass, indicating that the FDM model allows cores and haloes to coexist in diverse configurations. We provide a new empirical equation for a core–halo mass relation with uncertainties that can encompass all previously found relations in the dispersion, and emphasize that any observational constraints on the particle mass m using a tight one-to-one core–halo mass relation should suffer from an additional uncertainty of the order of 50  per cent for halo masses ${\gtrsim} 10^9 \, [8\times 10^{-23} \, \mathrm{eV}/(mc^2)]^{3/2} \, \mathrm{M}_\odot$. We suggest that tidal stripping may be one of the effects contributing to the scatter in the relation.
CosmoPower: emulating cosmological power spectra for accelerated Bayesian inference from next-generation surveys
Authors: Spurio Mancini Alessio , Piras Davide , Alsing Justin , Joachimi Benjamin , Hobson Michael P
Published: January 2022

We present CosmoPower, a suite of neural cosmological power spectrum emulators providing orders-of-magnitude acceleration for parameter estimation from two-point statistics analyses of Large-Scale Structure (LSS) and Cosmic Microwave Background (CMB) surveys. The emulators replace the computation of matter and CMB power spectra from Boltzmann codes; thus, they do not need to be re-trained for different choices of astrophysical nuisance parameters or redshift distributions. The matter power spectrum emulation error is less than $0.4{{\ \rm per\ cent}}$ in the wavenumber range $k \in [10^{-5}, 10] \, \mathrm{Mpc}^{-1}$ for redshift z ∈ [0, 5]. CosmoPower emulates CMB temperature, polarization, and lensing potential power spectra in the 5-σ region of parameter space around the Planck best-fitting values with an error ${\lesssim}10{{\ \rm per\ cent}}$ of the expected shot noise for the forthcoming Simons Observatory. CosmoPower is showcased on a joint cosmic shear and galaxy clustering analysis from the Kilo-Degree Survey, as well as on a Stage IV Euclid-like simulated cosmic shear analysis. For the CMB case, CosmoPower is tested on a Planck 2018 CMB temperature and polarization analysis. The emulators always recover the fiducial cosmological constraints with differences in the posteriors smaller than sampling noise, while providing a speed-up factor up to O(104) to the complete inference pipeline. This acceleration allows posterior distributions to be recovered in just a few seconds, as we demonstrate in the Planck likelihood case. CosmoPower is written entirely in python, can be interfaced with all commonly used cosmological samplers, and is publicly available at: https://github.com/alessiospuriomancini/cosmopower.
An accurate comprehensive approach to substructure: III. Masses and formation times of the host haloes
Authors: Salvador-Solé Eduard , Manrique Alberto , Canales David , Botella Ignacio
Published: January 2022

With this paper, we complete a comprehensive study of substructure in dark matter haloes. In Paper I, we derived the radial distribution and mass function (MF) of accreted subhaloes (scaled to the radius and mass of the host halo) and showed that they are essentially universal. This is not the case, however, for those of stripped subhaloes, which depend on halo mass and assembly history. In Paper II, we derived these latter properties in the simplest case of purely accreting haloes. Here, we extend the study to ordinary haloes having suffered major mergers. After showing that all the properties of substructure are encoded in the mean truncated-to-original subhalo mass ratio profile, we demonstrate that the dependence of the subhalo MF on halo mass arises from their mass-dependent concentration, while the shape of the subhalo radial distribution depends on the time of the last major merger of the host halo. In this sense, the latter property is a better probe of halo formation time than the former. Unfortunately, this is not the case for the radial distribution of satellites as this profile is essentially disconnected from subhalo stripping and the properties of accreted subhaloes are independent of the halo formation time.
A new measurement of the Hubble constant using fast radio bursts
Authors: Hagstotz Steffen , Reischke Robert , Lilow Robert
Published: January 2022

Fast radio bursts (FRBs) are very short and bright transients visible over extragalactic distances. The radio pulse undergoes dispersion caused by free electrons, along the line of sight, most of which are associated with the large-scale structure (LSS). The total dispersion measure therefore increases with the line of sight and provides a distance estimate to the source. We present the first measurement of the Hubble constant using the dispersion measure – redshift relation of FRBs with identified host counterpart and corresponding redshift information. A sample of nine currently available FRBs yields a constraint of $H_0 = 62.3 \pm 9.1 \, \rm {km} \, \rm {s}^{-1}\, \rm {Mpc}^{-1}$, accounting for uncertainty stemming from the LSS, host halo, and Milky Way contributions to the observed dispersion measure. We discuss possible biases arising from highly dispersed signals, and break the degeneracy between the expansion rate and the mean free electron abundance with a prior on the physical baryon density. The main current limitation is statistical, and we estimate that a few hundred events with corresponding redshifts are sufficient for a per cent measurement of H0. This is a number well within reach of ongoing FRB searches. We perform a forecast using a realistic mock sample to demonstrate that a high-precision measurement of the expansion rate is possible without relying on other cosmological probes. FRBs can therefore arbitrate the current tension between early and late-time measurements of H0 in the near future.
To be or not to be a black hole: detailed binary population models as a sanity check
Authors: Stevance H F , Parsons S G , Eldridge J J
Published: January 2022

We use the self-consistent stellar populations in the Binary Population And Spectral Synthesis (BPASS) models to assess whether NGC 1850-BH1 is a black hole (BH). Using search criteria based on reported physical properties in the literature, we purposefully search for suitable systems with a BH (or compact object) companion: we do not find any. Good matches to the observations are found in models where the bright component is a stripped star and the companion is natively (meaning we did not impose this in our search) 1–2.3 mag fainter than the primary in the optical bands. This alone can explain the lack of detection of the companion in the MUSE spectra without the need to invoke rapid rotation, although the conservative mass transfer exhibited by these particular models is likely to lead to rapidly rotating companions that could further smear their spectroscopic signatures. We advise that future claims of unseen BHs in binary systems would benefit from exploring detailed binary evolution models of stellar populations as a sanity check.
Waves of sumoylation support transcription dynamics during adipocyte differentiation
Authors: Zhao Xu , Hendriks Ivo A , Le Gras Stéphanie , Ye Tao , Ramos-Alonso Lucía , Nguéa P Aurélie , Lien Guro Flor , Ghasemi Fatemeh , Klungland Arne , Jost Bernard , Enserink Jorrit M , Nielsen Michael L , Chymkowitch Pierre
Published: January 2022

Tight control of gene expression networks required for adipose tissue formation and plasticity is essential for adaptation to energy needs and environmental cues. However, the mechanisms that orchestrate the global and dramatic transcriptional changes leading to adipocyte differentiation remain to be fully unraveled. We investigated the regulation of nascent transcription by the sumoylation pathway during adipocyte differentiation using SLAMseq and ChIPseq. We discovered that the sumoylation pathway has a dual function in differentiation; it supports the initial downregulation of pre-adipocyte-specific genes, while it promotes the establishment of the mature adipocyte transcriptional program. By characterizing endogenous sumoylome dynamics in differentiating adipocytes by mass spectrometry, we found that sumoylation of specific transcription factors like PPARγ/RXR and their co-factors are associated with the transcription of adipogenic genes. Finally, using RXR as a model, we found that sumoylation may regulate adipogenic transcription by supporting the chromatin occurrence of transcription factors. Our data demonstrate that the sumoylation pathway supports the rewiring of transcriptional networks required for formation of functional adipocytes. This study also provides the scientists in the field of cellular differentiation and development with an in-depth resource of the dynamics of the SUMO-chromatin landscape, SUMO-regulated transcription and endogenous sumoylation sites during adipocyte differentiation.
The Changing Concepts of the Constitution
Authors: Schwartz Alex
Published: January 2022

There have been several important formal changes to the United Kingdom’s constitution over the past few decades, including devolution to Northern Ireland, Scotland, and Wales; the incorporation of the European Convention on Human Rights in domestic law; and the creation of a new Supreme Court. This article is about the informal semantic changes that may have accompanied these formal changes. It focuses on several central concepts: parliamentary sovereignty, the rule of law, the separation of powers, devolution, and human rights. Using a recently developed machine learning method to analyse a massive corpus of parliamentary debate, the article gauges the extent to which these concepts have become more (or less) related to the meaning of the UK’s constitution in parliamentary discourse. Ultimately, the analysis supports some important theoretical expectations about the changing nature of the constitution, including the claim that parliamentary sovereignty is now a less significant concept for the meaning of the constitution than it once was.
Ribociclib Improves Overall Survival in HR+/HER2– Metastatic Breast Cancer Across Common Genomic and Clinical Subtypes
Authors: Jacobson Anne
Published: January 2022

In updated biomarker and clinical subgroup analyses from the phase III MONALEESA trials, ribociclib demonstrated consistent improvements in overall survival when added to endocrine therapy in patients with HR-positive/HER2-negative advanced breast cancer.
Pyrotinib Improves Survival in Previously Treated HER2-Positive Metastatic Breast Cancer
Authors: Jacobson Anne
Published: January 2022

In the phase III PHOEBE trial, treatment with pyrotinib plus capecitabine significantly improved overall survival compared with lapatinib plus capecitabine in patients with previously treated HER2-positive metastatic breast cancer.
Timing of Evidence-Based Nonsurgical Interventions as Part of Multimodal Treatment Guidelines for the Management of Cervical Radiculopathy: A Delphi Study
Authors: Thoomes Erik , Thoomes-de Graaf Marloes , Cleland Joshua A , Gallina Alessio , Falla Deborah
Published: January 2022

Objective

Conservative management of cervical radiculopathy (CR) is a first treatment option because the risk–benefit ratio for surgery is less favorable. Systematic reviews and clinical practice guidelines reporting on the effectiveness of nonsurgical management have not considered the timing of management. The aim of this study was to establish consensus on effective nonsurgical treatment modalities at different stages (ie, acute, subacute, or chronic) of CR using the Delphi method approach.

Methods

Through an iterative multistage process, experts within the field rated their agreement with a list of proposed treatment modalities according to the stage of CR and could suggest missing treatment modalities. Agreement was measured using a 5-point Likert scale. Descriptive statistics were used to measure agreement (median, interquartile ranges, and percentage of agreement). Consensus criteria were defined a priori for each round. Consensus for Round 3 was based on ≥2 of the following: a median Likert scale value of ≥4, interquartile range value of ≤1, and/or a percentage of agreement ≥70%.

Results

Data analysis produced a consensus list of effective treatment modalities in different stages of recovery.

Conclusion

According to experts, the focus of multimodal management in the acute stage should consist of patient education and spinal manipulative therapy, specific (foraminal opening) exercises, and sustained pain-relieving positions. In the subacute stage, increasing individualized physical activity including supervised motor control, specific exercises, and/or neurodynamic mobilization could be added. In the chronic stage, focus should shift to include general aerobic exercise as well as focused strength training. Postural education and vocational ergonomic assessment should also be considered.

Impact

Multimodal conservative management of individuals with CR should take the stage of the condition into consideration. The focus of therapeutic interventions should shift from passive pain-relieving intervention in the acute stage to increasingly more individualized physical activity and self-management in the chronic stage.
DETERMINATION OF THE NEUTRON CONTAMINATION DURING BRAIN RADIOTHERAPY USING A MODERATED-BORON TRIFLUORIDE DETECTOR AND THE MCNP MONTE CARLO CODE
Authors: Elmtalab Soheil , Shanei Ahmad , Choopan Dastjerdi Mohammad Hossein , Brkić Hrvoje , Abedi Iraj , Amouheidari Alireza
Published: January 2022

This study aimed to determine the neutron dose equivalent to the thyroid gland and eye lens in brain tumor radiation therapy with 15- and 18-MV three-dimensional conformal methods (3D-CRT). A Monte Carlo simulation was performed using the Monte Carlo N-particle transport code to calculate neutron fluence and ambient dose equivalent (H*(10)). Afterward, these parameters were measured using a model NRD roentgen equivalent in man (REM) neutron detector (Thermo Electron Corporation, USA) equipped with Eberline’s ASP-2e rate meter. Finally, the organ neutron dose equivalent was obtained by applying depth corrections to the measured ambient dose equivalent at the distance of the organ center from the central beam axis. The ratio of the out-of-field photon dose equivalent, measured previously, to the neutron dose equivalent in the eye lens was high due to its proximity to the radiation field. In contrast, this ratio remained unexpectedly high in the thyroid gland that is far from the central beam axis (about 15 cm). The calculated neutron parameters agreed with the measurements. The present study findings indicate that external field photon dose is the main source of thyroid gland biological effects in radiotherapy of brain tumors. In addition, it is appropriate to apply the model NRD REM neutron detector for measuring neutron contamination from high-energy linear accelerators inside and outside the treatment field.
Decomposition of socioeconomic inequalities in arboviral diseases in Brazil and Colombia (2007–2017)
Authors: Carabali Mabel , Harper Sam , Lima Neto Antonio S , dos Santos de Sousa Geziel , Caprara Andrea , Restrepo Berta Nelly , Kaufman Jay S
Published: January 2022

Background

We used surveillance data from Brazil and Colombia during 2007–2017 to assess the presence of socioeconomic inequalities on dengue, chikungunya and Zika at the neighborhood level in two Latin American cities.

Methods

To quantify the inequality, we estimated and decomposed the relative concentration index of inequality (RCI) accounting for the spatiotemporal distribution of the diseases.

Results

There were 281 426 arboviral cases notified in Fortaleza, Brazil, and 40 889 in Medellin, Colombia. The RCI indicated greater concentration of dengue cases among people living in low socioeconomic settings in both sites. The RCIs for chikungunya in Fortaleza covered the line of equality during their introduction in 2014, while the RCIs for Zika and chikungunya in Medellin indicated the presence of a small inequality. The RCI decomposition showed that year of notification and age were the main contributors to this inequality. In Medellin, the RCI decomposition showed that age and access to waste management accounted for 75.5%, 72.2% and 54.5% of the overall inequality towards the poor for dengue, chikungunya and Zika, respectively.

Conclusions

Our study presents estimates of the socioeconomic inequality of arboviruses and its decomposition in two Latin American cities. We corroborate the concentration of arboviral diseases in low socioeconomic neighborhoods and identify that year of occurrence, age, presence of healthcare facilities and waste management are key determinants of the heterogenous distribution of endemic arboviruses across the socioeconomic spectrum.
A Critical Analysis of Lateral Versus Central Endpoint in Distal Tibia Nailing: Does It Affect Alignment?
Authors: Brodke Dane J. , Upfill-Brown Alexander , Devana Sai K. , Eichenlaub Emily K. , Mahoney Jonathan M. , Orbach Mattan R. , Bucklen Brandon S. , Kelley Benjamin V. , Mayer Erik N. , Shi Brendan Y. , Lee Christopher
Published: January 2022

Objectives:

To evaluate the effect of a traditional “center-center” end point for distal tibia nailing in comparison with a lateral-of-center end point on fracture malalignment in a cadaver model.

Methods:

Nine matched pairs of human cadaveric lower-extremity specimens were used to model the effect of nail end point on fracture alignment in extra-articular distal tibia fractures. After simulation of the fracture through a standardized osteotomy, 1 member of each pair was fixed with an intramedullary nail using a “center-center” end point, whereas a lateral-of-center end point was used for the other member of the pair. Specimens were stripped of soft tissue, and digital calipers were used to measure fracture translation and gap medially, laterally, anteriorly, and posteriorly. Coronal plane angulation at each fracture was measured on the final mortise image.

Results:

The average coronal angulation was 7.0 degrees of valgus (with a SD of 4.1) in central-end point specimens versus 0.2 degrees of valgus (SD = 1.5) in lateral-end point specimens (P < 0.001). Lateral-end point specimens also demonstrated significantly less fracture gap medially (mean 0.2 vs. 3.1 mm for central-end point specimens, P < 0.001), anteriorly (mean 0.1 vs. 1.3 mm, P = 0.003), and posteriorly (mean 0.3 vs. 2.2 mm, P = 0.003). Lateral-end point specimens also showed less lateral translation (mean 0.6 vs. 1.6 mm, P = 0.006).

Conclusions:

Lateral-of-center nail end points may help surgeons restore native alignment in extra-articular distal tibia fractures and avoid valgus malalignment.
Effect of a Multimodal Analgesic Protocol on Short-Term and Long-Term Opioid Use After Orthopaedic Trauma
Authors: Oyler Douglas R. , Slade Emily , Slavova Svetla , Matuszewski Paul E. , Lei Feitong , Herndon Brooke , Johnson Shannon , Moghadamian Eric S.
Published: January 2022

Objective:

To determine whether the use of a multimodal analgesic protocol reduced short-term and long-term opioid use in patients hospitalized after orthopaedic trauma.

Design:

Retrospective pre–post intervention study.

Setting:

Regional, academic, Level 1 trauma center in Central Kentucky.

Patients/Participants:

Patients were hospitalized after orthopaedic injury before (n = 393) and after (n = 378) the implementation of a multimodal analgesic protocol.

Intervention:

The intervention involved a multimodal analgesic protocol consisting of acetaminophen, ibuprofen/ketorolac, gabapentinoids, skeletal muscle relaxants, and standardized doses of opioids plus standardized pain management education before hospital discharge.

Main Outcome Measurements:

End points included discharge opioid prescription, days' supply and daily morphine milligram equivalent (MME), and long-term opioid use after hospitalization. Opioid use in the 90 days before and after hospitalization was assessed using state prescription drug monitoring program data.

Results:

Discharge opioid prescription rates were similar in the intervention and control cohorts [79.9% vs. 78.4%, odds ratio (OR) 1.30 (0.83–2.03), P = 0.256]. Patients in the intervention cohort received a shorter days' supply [5.7 ± 4.1 days vs. 8.1 ± 6.2 days, rate ratio 0.70 (0.65–0.76), P < 0.001] and lower average daily MME [34.8 ± 24.9 MME vs. 51.5 ± 44.0 MME, rate ratio 0.68 (0.62–0.75), P < 0.001]. The incidence of long-term opioid use was also significantly lower in the intervention cohort [7.7% vs. 12.0%, OR 0.53 (0.28–0.98), P = 0.044].

Conclusions:

Implementation of a multimodal analgesic protocol was associated with reductions in both short-term and long-term opioid use, including long-term opioid therapy, after orthopaedic trauma.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Occurrence of Diastasis of the Rectus Abdominis Muscles in Patients with Medial Pectus Excavatum
Authors: Anger Jaime , de Campos Jose Ribas M.
Published: January 2022

Background:

Since 1994, we have used soft silicone blocks sculpted intraoperatively to correct pectus excavatum in male patients. This technique involves a horizontal access incision in the region of the lower edge of the sternum. During the dissection to expose the sternum, we observed a constant diastasis of the rectus abdominis muscle and changes of the anatomy at its superior insertion. There is no report on this association.

Methods:

Male patients with untreated medial pectus excavatum with indication for silicone block correction were enrolled. Age, weight, height, and the presence of other associated conditions were noted. Ultrasound examination was performed. During the surgery, the width of the linea alba was evaluated and the anatomical positioning of the insertion of rectus abdominis muscle was noted.

Results:

From 2017 to 2019, 10 patients were submitted to surgery. The mean age was 27 years. All patients presented diastasis at the preoperative physical examination. Imaging examination reports showed diastasis of the rectus abdominis muscle: seven partial epigastric separations and three total separations, two of which were associated with umbilical hernia. The intraoperative findings showed the line alba with a minimum of 23 mm and a maximum of 45 mm width at 4 cm from the xiphoid process edge. The muscle borders presented a curved lateral deviation up to the insertion in the costal arches with a distance ranging from 35 mm to 60 mm.

Conclusions:

This study confirms the anatomical alterations of the superior portion of the rectus abdominis muscle. The authors discuss the surgical consequences and suggest that the semiology of rectus abdominis muscle is an important preoperative action in pectus excavatum patients.
Ready for Anything
Authors: Burton Candace W. , Carey Shannon , Draughon Moret Jessica E.
Published: January 2022

Although numerous training options exist for sexual assault nurse examiner certification, most focus on specific certification-related content rather than on creating a holistic preparation for sexual assault nurse examiner (SANE) practice. Holistic preparation may be preferable for SANE trainees who are early in their nursing careers or who have practiced in limited clinical environments. This article describes a holistic training approach implemented at a SANE training site funded by the Advanced Nursing Education initiative of the Health Resources and Services Administration. Training covers hands-on pelvic and anal examinations, community education, underserved communities, self-care, and other topics that support newly trained SANEs in establishing and maintaining practice. This content has prepared trainees for a wide variety of patient encounters as well as for engaging with the community. With this approach, our trainees have the opportunity to enhance their ability to provide SANE care and to provide additional resources within their primary practice environments.
Functional Reach and Gait Speed Improvement in A Matter of Balance Participants
Authors: Hood Jessica , Sharrah Mark L.
Published: January 2022

BACKGROUND:

Falls among older adults are the most common cause of hospital admissions. A Matter of Balance may reduce these falls by improving balance, flexibility, gait speed, and agility.

OBJECTIVE:

The study aimed to measure functional reach and gait speed among adults older than 65 years following A Matter of Balance. It was hypothesized that functional reach scores would increase and gait speed scores would decrease.

METHODS:

This was an interventional study with the primary outcomes of functional reach (measured by the Functional Reach test) and gait speed (measured by the Timed Up and Go test). A one-tailed paired t test was used to compare pre- and postprogram functional reach mean differences. A one-tailed Wilcoxon signed-rank test was used for comparing median differences of pre- and postprogram gait speed. Characteristics of participants who improved scores were compared with those who did not improve, using two-tailed independent-samples t tests and two-tailed Pearson's χ2. Effect sizes were computed for tests significant beyond p < .05.

RESULTS:

Mean functional reach increased by 0.6 inches (SD = 2.21, p = .002; d = 0.2). Median gait speed decreased by 1.25 s (interquartile range = 2.39, p < .001; r = .76). Improvement was not attributable to differences of age, sex, health status, preexisting conditions, or delivery site.

CONCLUSIONS:

Following A Matter of Balance, functional reach and gait speed improved. Adults older than 65 years should be encouraged to participate in the program, as it may reduce their fall risk.
Identification of Delayed Traumatic Diaphragmatic Injury: A Concise Review
Authors: Bartzak Patricia J.
Published: January 2022

OBJECTIVE:

To provide a concise review of the literature on both the difficulty and subtly of identifying a traumatic diaphragmatic hernia in the delayed phase of injury.

DATA SOURCES:

Source data were obtained from PubMed and Open Access Journals.

STUDY SELECTION:

Studies addressing traumatic diaphragmatic injury in the delayed phase of diaphragmatic injury. PubMed was searched using the MeSH term “delayed diaphragmatic rupture.”

DATA EXTRACTION:

Relevant studies were reviewed and included on the basis of the preponderance of diaphragmatic injury cases that presented in the delayed phase. The following aspects of each study were identified, abstracted, and analyzed: study population, study design, methods, results, and relevant implications for practice. A few case studies were included to illustrate the importance of a careful medical history and patient evaluation necessary to identify a delayed diaphragmatic hernia presentation.

DATA SYNTHESIS:

Diaphragmatic herniation can occur days and weeks to decades after the initial trauma as a small diaphragmatic tear can evolve into a larger one over time. Follow-up after the acute phase is essential to assess for occult diaphragmatic injury and potential herniation. Meticulous patient history and evaluation are important considerations when the patient presents after the acute phase of injury with vague respiratory or abdominal complaints. During the triage phase of care, trauma nurses have an important role in assessing trauma history.

CONCLUSIONS:

The available evidence suggests that diaphragmatic injury should be on the differential list during and after trauma presentation for both providers and trauma nurses. Other critical injuries may portend a possible diaphragmatic injury. Diaphragmatic injury, though relatively rare, has high morbidity and mortality.
Educational Needs of U.S. Emergency Nurses Related to Forensic Nursing Processes
Authors: Wolf Lisa Adams , Perhats Cydne , Delao Altair
Published: January 2022

BACKGROUND:

Forensic nursing is a specialty deployed in patient care areas, including emergency departments, intensive care units, labor and delivery suites, and psychiatric units treating persons who have suffered trauma from a violent or criminal act. The recognition of violence-related injuries in patients presenting to health care facilities is critical to an appropriate care trajectory. These patients require specialized resources beyond the treatment of physical injuries to include psychosocial and legal care that supports patient recovery and pursuit of criminal justice.

OBJECTIVE:

The purpose of this study is to obtain a broad view of current forensic knowledge and training for emergency nurses working in U.S. emergency departments and to identify gaps in nursing skills and practice such that appropriate education can be developed for this nursing specialty.

METHODS:

The study was conducted using a quantitative exploratory, descriptive approach via an emailed cross-sectional survey sent to a convenience sample of U.S. emergency nurses.

RESULTS:

A total of 43,775 emails were sent out to members of the Emergency Nurses Association. Of that group, 2,493 recipients opened the email, and 1,824 completed the survey, resulting in a total response rate of 4% and a 73% response rate from those who opened the email. Few respondents self-reported competence in the care of patients who experienced child abuse (13.1%), elder abuse (12.4%), interpersonal violence (17.6%), sexual assault (19.2%), human trafficking (7.4%), developmental challenges (7.2%), strangulation (12.5%), or who were suspected of committing a violent crime (11.4%).

CONCLUSIONS:

There is a compelling need to expand forensic education to advance knowledge and skill acquisition in emergency nursing practice and provide staff with additional resources that support a holistic trauma-informed approach to patient care.
Validation of the Trauma and Injury Severity Score for Prediction of Mortality in a Greek Trauma Population
Authors: Filippatos Georgios , Tsironi Maria , Zyga Sofia , Andriopoulos Panagiotis
Published: January 2022

BACKGROUND:

Although the Trauma and Injury Severity Score (TRISS) has been extensively used for mortality risk adjustment in trauma, its applicability in contemporary trauma populations is increasingly questioned.

OBJECTIVE:

The study aimed to evaluate the predictive performance of the TRISS in its original and revised version and compare these with a recalibrated version, including current data from a Greek trauma population.

METHODS:

This is a retrospective cohort study of admitted trauma patients conducted in two tertiary Greek hospitals from January 2016 to December 2018. The model algorithm was calculated based on the Major Trauma Outcome Study coefficients (TRISSMTOS), the National Trauma Data Bank coefficients (TRISSNTDB), and reweighted coefficients of logistic regression obtained from a Greek trauma dataset (TRISSGrTD). The primary endpoint was inhospital mortality. Models' prediction was performed using discrimination and calibration statistics.

RESULTS:

A total of 8,988 trauma patients were included, of whom 854 died (9.5%). The TRISSMTOS displayed excellent discrimination with an area under the curve (AUC) of 0.912 (95% CI 0.902–0.923) and comparable with TRISSNTDB (AUC = 0.908, 95% CI 0.897–0.919, p = .1195). Calibration of both models was poor (Hosmer–Lemeshow test p < .001), tending to underestimate the probability of mortality across almost all risk groups. The TRISSGrTD resulted in statistically significant improvement in discrimination (AUC = 0.927, 95% CI 0.918–0.936, p < .0001) and acceptable calibration (Hosmer–Lemeshow test p = .113).

CONCLUSION:

In this cohort of Greek trauma patients, the performance of the original TRISS was suboptimal, and there was no evidence that it has benefited from its latest revision. By contrast, a strong case exists for supporting a locally recalibrated version to render the TRISS applicable for mortality prediction and performance benchmarking.