bluuebunny/crossref_metadata_2025 huggingface dataset:
Structural peculiarities, mineral inclusions, and point defects in yakutites—A variety of impact‐related diamond
Authors: Shiryaev Andrei A. , Pavlushin Anton D. , Pakhnevich Alexei V. , Kovalenko Ekaterina S. , Averin Alexei A. , Ivanova Anna G.
Published: February 2022

An unusual variety of impact‐related diamond from the Popigai impact structure—yakutites—is characterized by complementary methods including optical microscopy, X‐ray diffraction, radiography and tomography, infrared, Raman, and luminescence spectroscopy providing structural information at widely different scales. It is shown that relatively large graphite aggregates may be transformed to diamond with preservation of many morphological features. Spectroscopic and X‐ray diffraction data indicate that the yakutite matrix represents bulk nanocrystalline diamond. For the first time, features of two‐phonon IR absorption spectra of bulk nanocrystalline diamond are interpreted in the framework of phonon dispersion curves. Luminescence spectra of yakutite are dominated by dislocation‐related defects. Optical microscopy supported by X‐ray diffraction reveals the presence of single crystal diamonds with sizes of up to several tens of microns embedded into nanodiamond matrix. The presence of single crystal grains in impact diamond may be explained by chemical vapor deposition–like growth in a transient cavity and/or a seconds‐long compression stage of the impact process due to slow pressure release in a volatile‐rich target. For the first time, protogenetic mineral inclusions in yakutites represented by mixed monoclinic and tetragonal ZrO2 are observed. This implies the presence of baddeleyite in target rocks responsible for yakutite formation.
COVID‐19‐associated pulmonary aspergillosis in ICU patients in a German reference centre: Phenotypic and molecular characterisation of Aspergillus fumigatus isolates
Authors: Kirchhoff Lisa , Braun Lukas Miles , Schmidt Dirk , Dittmer Silke , Dedy Jutta , Herbstreit Frank , Stauf Raphael , Steckel Nina Kristin , Buer Jan , Rath Peter‐Michael , Steinmann Joerg , Verhasselt Hedda Luise
Published: February 2022

Background

COVID‐19‐associated invasive pulmonary aspergillosis (CAPA) is associated with increased mortality. Cases of CAPA caused by azole‐resistant Aspergillus fumigatus strains have been reported.

Objectives

To analyse the twelve‐month CAPA prevalence in a German tertiary care hospital and to characterise clinical A. fumigatus isolates from two German hospitals by antifungal susceptibility testing and microsatellite genotyping.

Patients/Methods.

Retrospective observational study in critically ill adults from intensive care units with COVID‐19 from 17 February 2020 until 16 February 2021 and collection of A. fumigatus isolates from two German centres. EUCAST broth microdilution for four azole compounds and microsatellite PCR with nine markers were performed for each collected isolate (N = 27) and additional for three non‐COVID A. fumigatus isolates.

Results

welve‐month CAPA prevalence was 7.2% (30/414), and the rate of azole‐resistant A. fumigatus isolates from patients with CAPA was 3.7% with detection of one TR34/L98H mutation. The microsatellite analysis revealed no major clustering of the isolates. Sequential isolates mainly showed the same genotype over time.

Conclusions

Our findings demonstrate similar CAPA prevalence to other reports and a low azole‐resistance rate. Genotyping of A. fumigatus showed polyclonal distribution except for sequential isolates.
Relationship between genetic distance based on single nucleotide polymorphism markers and hybrid performance in Robusta coffee (Coffea canephora)
Authors: Akpertey Abraham , Padi Francis Kwame , Meinhardt Lyndel , Zhang Dapeng
Published: February 2022

The choice of parents is a vital first step in any variety development process. This is particularly imperative in tree crops that require minimally 15–20 years to complete a varietal development. The present study was conducted to determine genetic distances (GDs) between parental clones of Robusta coffee hybrids and assess the relationship between GD and hybrid performance. The experimental material consisted of 64 parental clones and 56 hybrids. The hybrids were evaluated over 11 years, planted in a randomized complete block design with six replications. GD among parental clones was determined based on 120 SNP markers. The results revealed a significant correlation (r = 0.351, p < 0.0082) between GD of parental clones and yield performance of their hybrids. Posterior selection of highest GD hybrids revealed an increase in yield gain over general mean with increasing GD between parental clones of hybrids. Furthermore, comparison of inter‐ and intra‐population hybrids classified using Bayesian clustering analysis revealed consistent outcome where inter‐group hybrids outperformed intra‐group hybrids for cumulative yield. These results supported the hypothesis that GD is related to the yield performance of Robusta coffee hybrids and is an efficient predicator of hybrid performance for yield.
Management alters drought‐induced mortality patterns in European beech (Fagus sylvaticaL.) forests
Authors: Meyer P. , Spînu A. P. , Mölder A. , Bauhus J.
Published: February 2022

The high tree mortality during the dry and hot years of 2018–2019 in Europe has triggered concerns on the future of European beech (Fagus sylvaticaL.) forests under climate change and raised questions as to whether forest management may increase tree mortality. We compared long‐term mortality rates of beech between managed and unmanaged stands including the years 2018‐2019 at 11 sites in Hesse, Germany.

We hypothesized that mortality would increase with climate water deficits during the growing season, initial stand density, decreasing dominance of trees, and decreasing intensity of tree removals. Initial stand density, tree removals, the climate water balance and the competitive status of trees were used as predictor variables.

Mean annual natural mortality rates ranged between 0.5% and 2.1%. Even in the drought years, we observed no signs of striking canopy disintegration. The significantly higher mortality (1.6–2.1%) in unmanaged stands during the drought years 2018 and 2019 was largely confined to suppressed trees. There was no significant increase of mortality in managed stands during the drought years, but a shift in mortality towards larger canopy trees.

Our study did not confirm a general influence of management, in the form of tree removals, on mortality rates. Yet, we found that during drought years, management changed the distribution of mortality within the tree community. To analyse the effects of management on mortality rates more comprehensively, a wider gradient in site moisture conditions, including sites drier than in this study, and longer post‐drought periods should be employed.
SediRate‐Fischer plots as a tool to illustrate relative sea‐level and lake‐level changes in subaqueous terrigenous deposits
Authors: Yang Daming , Huang Yongjian , Wang Chengshan
Published: February 2022

For more extensive and efficient sea‐level and lake‐level reconstructions and correlations in siliciclastic systems, this paper presents a new tool called SediRate‐Fischer plot (SR‐Fischer plot). In SR‐Fischer plots, the linear‐corrected sedimentary rate of each terrigenous sedimentary cycle is plotted from the top of the previous cycle to the top of the current cycle. This process is repeated cycle by cycle, constructing curves of cumulative departure from mean sedimentary rate (CDMR). Based on the assumption that relative sea‐level and lake‐level changes may control sedimentary rates of subaqueous terrigenous sediments within basins, the CDMR could change inversely with relative sea or lake level. Thus, this tool could be interpreted as an indicator of relative sea‐level and lake‐level changes in terrigenous successions. SediRate‐Fischer plots can be obtained from either lithological or proxy cycles formed by sea‐level and lake‐level changes in the case of availability of orbitally tuned data. The SR‐Fischer plots constructed based on different materials are compared with other methods in two cases, as follows: first for the lacustrine Mingshui Formation of the Songliao Basin in China; and second for the deep‐marine Arcillas de Gibraleón Formation of the Guadalquivir Basin in Spain. The SR‐Fischer plots of the Mingshui Formation exhibit low and high CDMR values for shallow‐lake intervals and lakeshore intervals, respectively, and vary inversely with the lake‐level curves derived from changes in sedimentary facies. For the Arcillas de Gibraleón Formation, the CDMR values illustrated by the SR‐Fischer plots exhibit opposite variations with sea‐level curves indicated by dinocyst/pollen ratios. The negative Z‐scores derived from runs tests indicate that these SR‐Fischer plots are not randomly stacked and are minimally influenced by different cycle‐splitting strategies. Thus, the results of comparison with other methods and runs tests demonstrate the validity of this method. Nonetheless, the other allogenic inflows (tectonics and climates) may limit interpretations of SR‐Fischer plots.
Exporting costs and multi‐product shipments*
Authors: Gomtsyan David , Tarasov Alexander
Published: February 2022

In this paper, employing transaction‐level data for Russian imports, we explore the role of multi‐product shipments in explaining shipping patterns across countries. In our data, an average shipment includes five different products. We document that firms from higher‐income countries on average include a larger number of different products into a single shipment and have a larger number of shipments per period with a lower average quantity and value. We then propose a mechanism that reconciles both facts. Specifically, multi‐product shipments allow firms to split fixed costs per shipment across many products and, therefore, reduce total shipment costs. As a result, higher‐income countries tend to have lower fixed costs per shipment. Finally, we construct a simple partial equilibrium model that enables us to quantify the potential increases in trade volumes and welfare created by the multi‐product shipment option.
Epidemiological changes, demographic drivers, and global years of life lost from suicide over the period 1990–2019
Authors: Zheng Yan , Molassiotis Alex , Tyrovolas Stefanos , Yip Paul S. F.
Published: February 2022

Objective

To quantify the contributions of epidemiological changes (age‐ and gender‐specific suicide rates) and demographic forces (population growth and aging) to global changes in years of life lost (YLLs) from suicide over the last 30 years.

Method

A decomposition analysis was used to assess the impacts of population growth, population aging, and suicide prevalence on global changes in YLLs from suicide between 1990 and 2019.

Results

From 1990 to 2019, global YLLs from suicide reduced by 2,073,714 years (5.9%), from 35,246,316 years to 33,172,602 years. This was mainly due to the decline in age‐specific suicide rates, which reduced the overall YLLs from suicide by 20,185,691 years (973.4%). However, this decline was offset by the impacts of population growth and population aging, which increased global YLLs from suicide by 14,949,110 years (−720.9%) and 3,442,074 years (−166.0%), respectively. The combined effects of epidemiological and demographic drivers were also reflected in different trends in YLLs from suicide across genders and World Bank income level regions, with particularly notable increases in low‐ income and lower‐middle income countries and the aging population.

Conclusions

With the significant effects of epidemiological and demographic drivers, global and regional YLLs from suicide may be expected to change greatly in the future. Efforts to reduce the burden of suicide require appropriate allocation of resources for suicide‐prevention strategies and further consideration of demographic factors.
Optimized Load-Independent Hyperelastic Microcharacterization of Human Brain White Matter
Authors: Ramzanpour Mohammadreza , Hosseini-Farid Mohammad , Ziejewski Mariusz , Karami Ghodrat
Published: February 2022

A micromechanical methodology combined with genetic algorithm (GA) as a global optimization method is used to find the material properties of axons and extracellular matrix (ECM) in corpus callosum which is a part of human brain white matter. Studies have shown that axons are highly oriented in the ECM which enables us to approximate brain white matter as a unidirectional fibrous composite model. Using the one-term Ogden hyperelastic constitutive equations for the constituents and knowing the mechanical response of corpus callosum, GA optimization procedure is used in conjunction with finite element (FE) micromechanical analysis to find optimal material parameters for axon and ECM in three uniaxial loading scenarios of tension, compression, and simple shear. Moreover, by simultaneous fitting to the three loading modes' responses and applying Nelder–Mead simplex optimization method, best-fit parameters are found. The best-fit parameters can be used to approximate the behavior of axons and ECM in different uniaxial loading conditions with the minimum error and hence, can be interpreted as load-independent parameters. Micromechanical simulations by best-fit parameters show maximum stress increase of 2% and 29% for tension and shear and less than 1% reduction for compression mode compared to the case where optimal parameters are used. The findings and the methodology of this study can be employed for constitutive modeling of axonal fibers and its implementation in human head FE model where load-independent parameters are needed for simulating different loading scenarios.
A buckling-sheet ring oscillator for electronics-free, multimodal locomotion
Authors: Lee Won-Kyu , Preston Daniel J. , Nemitz Markus P. , Nagarkar Amit , MacKeith Arthur K. , Gorissen Benjamin , Vasios Nikolaos , Sanchez Vanessa , Bertoldi Katia , Mahadevan L. , Whitesides George M.
Published: February 2022

Locomotion of soft robots typically relies on control of multiple inflatable actuators by electronic computers and hard valves. Soft pneumatic oscillators can reduce the demand on controllers by generating complex movements required for locomotion from a single, constant input pressure, but either have been constrained to low rates of flow of air or have required complex fabrication processes. Here, we describe a pneumatic oscillator fabricated from flexible, but inextensible, sheets that provides high rates of airflow for practical locomotion by combining three instabilities: out-of-plane buckling of the sheets, kinking of tubing attached to the sheets, and a system-level instability resulting from connection of an odd number of pneumatic inverters made from these sheets in a loop. This device, which we call a “buckling-sheet ring oscillator” (BRO), directly generates movement from its own interaction with its surroundings and consists only of readily available materials assembled in a simple process—specifically, stacking acetate sheets, nylon film, and double-sided tape, and attaching an elastomeric tube. A device incorporating a BRO is capable of both translational and rotational motion over varied terrain (even without a tether) and can climb upward against gravity and downward against the buoyant force encountered under water.
Presence of Mobile Tigecycline Resistance Gene
tet
(X4) in Clinical Klebsiella pneumoniae
Authors: Zhai Weishuai , Tian Yingxin , Lu Mi , Zhang Muchen , Song Huangwei , Fu Yulin , Ma Tengfei , Sun Chengtao , Bai Li , Wang Yang , Liu Dejun , Zhang Ying
Published: February 2022

Tigecycline, the first member of glycylcycline class antibiotic, is often considered one of the effective antibiotics against multidrug-resistant (MDR) infections. However, the emergence and wide distribution of two novel plasmid-mediated tigecycline resistance genes,
tet
(X3) and
tet
(X4), pose a great threat to the clinical use of tigecycline.
Application of Amplicon-Based Targeted NGS Technology for Diagnosis of Drug-Resistant Tuberculosis Using FFPE Specimens
Authors: Song Jing , Du Weili , Liu Zichen , Che Jialu , Li Kun , Che Nanying
Published: February 2022

Amplicon-based targeted NGS technology focuses on a set of gene mutations of known or suspected associations with drug susceptibility in
Mycobacterium tuberculosis
(MTB). This method offers many benefits, such as low sequencing cost, easy customization, high throughput, shorter testing time and not culture dependent.
Sequencing Independent Molecular Typing of Staphylococcus aureus Isolates: Approach for Infection Control and Clonal Characterization
Authors: Dufkova Kristyna , Bezdicek Matej , Cuprova Kristina , Pantuckova Dagmar , Nykrynova Marketa , Brhelova Eva , Kocmanova Iva , Hodova Silvie , Hanslianova Marketa , Juren Tomas , Lipovy Bretislav , Mayer Jiri , Lengerova Martina
Published: February 2022

Rapid and cost-effective molecular typing tools for
Staphylococcus aureus
epidemiological applications such as transmission tracking, source attribution and outbreak investigations are highly desirable. High-resolution melting based methods are effective alternative to those based on sequencing.
Experimental Combination Therapy with Amiodarone and Low-Dose Benznidazole in a Mouse Model of Trypanosoma cruzi Acute Infection
Authors: Barbosa Juliana Magalhães Chaves , Pedra Rezende Yasmin , de Melo Tatiana Galvão , de Oliveira Gabriel , Cascabulho Cynthia Machado , Pereira Evelyn Nunes Goulart da Silva , Daliry Anissa , Salem Kelly Salomão
Published: February 2022

Chagas disease affects approximately 6 to 7 million people worldwide, with cardiomyopathy being the clinical manifestation that most commonly leads to patient death. The etiological treatment of Chagas disease is limited to drugs (benznidazole and nifurtimox) with relatively high toxicity and therapeutic failures.
Differential Growth Rates and
In Vitro
Drug Susceptibility to Currently Used Drugs for Multiple Isolates of Naegleria fowleri
Authors: Russell A. Cassiopeia , Kyle Dennis E.
Published: February 2022

Naegleria fowleri
, also known as the brain-eating amoeba, is ubiquitous in warm freshwater and is an opportunistic pathogen that causes primary amoebic meningoencephalitis. Although few cases are described each year, the disease has a case fatality rate of >97%.
Machine Learning Predicts Biogeochemistry from Microbial Community Structure in a Complex Model System
Authors: Dutta Avishek , Goldman Thomas , Keating Jeffrey , Burke Ellen , Williamson Nicole , Dirmeier Reinhard , Bowman Jeff S.
Published: February 2022

Microbial communities control many biogeochemical processes. Many of these processes are impractical or expensive to measure directly.
Preliminary study of automated oxygen titration at birth for preterm infants
Authors: Ali Sanoj KM , Jayakar Rohan V , Marshall Andrew P , Gale Timothy J , Dargaville Peter A
Published: February 2022

Objective

To study the feasibility of automated titration of oxygen therapy in the delivery room for preterm infants.

Design

Prospective non-randomised study of oxygenation in sequential preterm cohorts in which FiO2was adjusted manually or by an automated control algorithm during the first 10 min of life.

Setting

Delivery rooms of a tertiary level hospital.

Participants

Preterm infants <32 weeks gestation (n=20 per group).

Intervention

Automated oxygen control using a purpose-built device, with SpO2readings input to a proportional-integral-derivative algorithm, and FiO2alterations actuated by a motorised blender. The algorithm was developed via in silico simulation using abstracted oxygenation data from the manual control group. For both groups, the SpO2target was the 25th–75th centile of the Dawson nomogram.

Main outcome measures

Proportion of time in the SpO2target range (25th–75th centile, or above if in room air) and other SpO2ranges; FiO2adjustment frequency; oxygen exposure.

Results

Time in the SpO2target range was similar between groups (manual control: median 60% (IQR 48%–72%); automated control: 70 (60–84)%; p=0.31), whereas time with SpO2>75th centile when receiving oxygen differed (manual: 17 (7.6–26)%; automated: 10 (4.4–13)%; p=0.048). Algorithm-directed FiO2adjustments were frequent during automated control, but no manual adjustments were required in any infant once valid SpO2values were available. Oxygen exposure was greater during automated control, but final FiO2was equivalent.

Conclusion

Automated oxygen titration using a purpose-built algorithm is feasible for delivery room management of preterm infants, and warrants further evaluation.
Pseudorenal failure as a delayed presentation of a traumatic urinary bladder rupture
Authors: Moonen Hanneke Pierre Franciscus Xaverius , Kortleve Michael DH , Mollen Roland MHG , de Jong Gabie
Published: February 2022

The urinary bladder is less susceptible to traumatic injury than other abdominal organs, due to its anatomical location behind the pubic bone. As a result, intraperitoneal urinary bladder ruptures are a rare consequence of blunt abdominal trauma and most often occur in the context of high energy and multitraumas. However, a distended bladder is more vulnerable to burst rupture even from a minor trauma, and in case of an isolated bladder injury, presentation can be delayed. We describe a case in which a patient presented 4 days after a minor blunt trauma, with an acute abdomen and pseudorenal failure as the main clinical signs of urinary ascites due to a significant bladder rupture. As an intraperitoneal bladder rupture is associated with significant morbidity and mortality and should be treated surgically, it should always be considered in patients presenting with anuria, ascites and increased serum creatinine after abdominal trauma.
Naso-Bronchial Rhinosporidiosis
Authors: Nagi Kezevino , Sekar Raghul , Saxena Sunil Kumar , Stephen Norton
Published: February 2022

Rhinosporidiosis is a chronic mucocutaneous granulomatous disease caused byRhinosporidium seeberi, commonly affecting the nose and nasopharynx. Endobronchial involvement is of rare occurrence but can pose challenging problems for diagnosis, surgical excision and anaesthetic management. We report a 40-year-old man with a history of recurrent nasal rhinosporidiosis who presented with unilateral nasal obstruction, cough, shortness of breath and a radiological feature of left lung collapse. Eight years since the last surgery, he presented with a recurrent lesion in the nose with concurrent endobronchial involvement. The patient underwent excision of the nasal and the endobronchial lesion successfully under general anaesthesia without any complication and good symptomatic improvement. The clinical presentation and the management of endobronchial rhinosporidiosis are discussed here. The surgical difficulties faced during the procedure are highlighted.
Differences in progression by surgical specialty: a national cohort study
Authors: Hope Carla , Lund Jonathan , Griffiths Gareth , Humes David
Published: February 2022

The aim of surgical training across the 10 surgical specialties is to produce competent day 1 consultants. Progression through training in the UK is assessed by the Annual Review of Competency Progression (ARCP).

Objective

This study aimed to examine variation in ARCP outcomes within surgical training and identify differences in outcomes between specialties.

Design

A national cohort study using data from the UK Medical Education Database was performed. ARCP outcome was the primary outcome measure. Multilevel ordinal regression analyses were performed, with ARCP outcomes nested within trainees.

Participants

Higher surgical trainees (ST3–ST8) from nine UK surgical specialties were included (vascular surgery was excluded due to insufficient data). All surgical trainees across the UK with an ARCP outcome between 2010 and 2017 were included.

Results

Eight thousand two hundred and twenty trainees with an ARCP outcome awarded between 2010 and 2017 were included, comprising 31 788 ARCP outcomes. There was substantial variation in the proportion of non-standard outcomes recorded across specialties with general surgery trainees having the highest proportion of non-standard outcomes (22.5%) and urology trainees the fewest (12.4%). After adjustment, general surgery trainees were 1.3 times more likely to receive a non-standard ARCP outcome compared with trainees in trauma and orthopaedics (T&O) (OR 1.33, 95% CI 1.21 to 1.45, p=0.001). Urology trainees were 36% less likely to receive a non-standard outcome compared with T&O trainees (OR 0.64, 95% CI 0.54 to 0.75, p<0.001). Female trainees and older age were associated with non-standard outcomes (OR 1.11, 95% CI 1.02 to 1.22, p=0.020; OR 1.04, 95% CI 1.03 to 1.05, p<0.001).

Conclusion

There is wide variation in the training outcome assessments across surgical specialties. General surgery has higher rates of non-standard outcomes compared with other surgical specialties. Across all specialties, female sex and older age were associated with non-standard outcomes.
Reopening strategies, mobility and COVID-19 infections in Europe: panel data analysis
Authors: Franks Jeffrey , Gruss Bertrand , Mulas-Granados Carlos , Patnam Manasa , Weber Sebastian
Published: February 2022

Objectives

Characterise the reopening policies of European countries after the first wave of infections and evaluate how these policies affected economic activity and subsequent infections.

Study design

Using publicly available data, we construct a database of reopening policy announcements by country authorities and develop measures related to the speed and timing of reopening. Using panel data regressions, we then assess how a country’s reopening action subsequently affected its mobility and COVID-19 infections. Samples of 22 European countries used in the study comprise: Austria, Belgium, Czech Republic, Denmark, Finland, France, Germany, Greece, Ireland, Israel, Italy, Netherlands, Norway, Poland, Portugal, Romania, Russia, Spain, Switzerland, Turkey, Ukraine and the UK.

Main outcomes

Mobility index as well as COVID-19 case and death counts.

Results

Reopening policies are associated with a 1.5 percentage point increase in mobility and a 4% increase in subsequent infections after 2 weeks. However, some reopening strategies are associated with lower infection risk. In particular, early and fast reopeners saw 5%–10% increases in infections relative to those that opened later and adopted a gradual approach. The sequencing of sectoral reopenings matters, with infection amplification effects larger for some sectors (like retail and events) than others (like schools).

Conclusions

Findings suggest some merit of gradual and late reopening strategies with a careful sequencing of sectoral openings based on their infection amplification risks.
Three-year results of accelerated transepithelial cross-linking (30 mW/cm2× 3 min) for keratoconus: a prospective study
Authors: Ishii Hitoha , Yoshida Junko , Toyono Tetsuya , Yamagami Satoru , Usui Tomohiko , Miyai Takashi
Published: February 2022

Objective

To assess the long-term efficacy and safety of accelerated transepithelial corneal cross-linking (ATE-CXL) with 30 mW/cm2× 3 min.

Methods and Analysis

Thirty-four eyes of 23 patients with progressive keratoconus (KCN) recruited within a single centre were enrolled in this prospective interventional study. Exclusion criteria included: history of Descemet’s membrane rupture, glaucoma, uveitis, severe dry eye, concurrent corneal infections, and systemic disease that could affect corneal healing. ATE-CXL was performed with 3 min of ultraviolet-A continuous irradiation (30 mW/cm2). Follow-up examinations were scheduled on postoperative day 1; 1 and 2 weeks; 1, 3 and 6 months; and 1, 2 and 3 years. Main outcome measures were maximum corneal power (Kmax), average corneal power (AvgK), steepest corneal power (Ks), central corneal thickness, thinnest corneal thickness, uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BCVA) and endothelial cell density.

Results

Mean Kmax, AvgK, Ks, UCVA, BCVA and endothelial cell density did not significantly change over 3 years. The speed of progression obtained by linear regression analysis on corneal parameters (Kmax, AvgK, Ks) improved after ATE-CXL. All baseline parameters correlated with the postoperative Kmax slope. Two eyes underwent ATE-CXL redo because of continued progression after the primary CXL.

Conclusion

This is the first report of 3-year results of ATE-CXL with 30 mW/cm2× 3 min. ATE-CXL (30 mW/cm2× 3 min) was safe and effective for slowing down KCN progression.

Trial registration number

This study was registered with ID UMIN000009372 in UMIN-Clinical Trials Registry.
Delivery of remote otology care: a UK pilot feasibility study
Authors: Forde Cillian T , Dimitrov Lilia , Doal Suneal , Patel Jay , Clare Dawn , Burslem Michael , Mehta Nishchay , Manjaly Joseph G
Published: February 2022

Introduction

The COVID-19 pandemic has catalysed the need to implement the National Health Service Long-Term Plan to deliver more care in the community and to reduce face-to-face hospital appointments by up to 33%. This study aimed to assess the feasibility of a remote otology service from triage through to delivery.

Methods

New adult otology referrals at a tertiary ear, nose and throat (ENT) hospital aged between 18 and 70 with hearing loss or tinnitus were included. Patients attended an audiology-led community clinic where they underwent a focused history, audiometric testing, and a smartphone-based application and otoscope (Tympa System) was used to capture still and video images of their eardrums. The information was reviewed by ENT clinicians using a remote review platform with a subset of patients subsequently undergoing an in-person review to measure concordance between the two assessments.

Results

58 patients participated. 75% of patients had their pathways shortened by one hospital visit with 65% avoiding any hospital attendances. 24% required an additional face-to-face appointment due to incomplete views of the tympanic membrane or need for additional examinations. Electronic validation by a blinded consultant otologist demonstrated a diagnosis concordance of 95%, and concordance between remote-review and in-person consultations in the 12 patients who agreed to attend for an in-person review was 83.3%. 98% of patients were satisfied with the pathway.

Conclusion

This pilot service is feasible, safe and non-inferior to the traditional outpatient model in the included patient group. There is potential for the development of a community audiology-led service or use for general practioner advice and guidance.
Impact of COVID-19 on paediatric emergency department attendances at four English hospitals
Authors: Aldridge Patrick , Wilson Sarah , Roland Damian , McCann Gerard , Burridge Richard George
Published: February 2022

Paediatric emergency department (PED) attendances reduced worldwide during the COVID-19 pandemic (2020) but anecdotally babies under 30 days (BUD) appeared less affected. We collated monthly PED attendances (16 years and under) across four hospitals (three district general hospitals and a tertiary specialist PED) in England, UK from January 2017 to December 2020. Gross PED attendances dropped by 34% in 2020 (n=98 256) compared to 2019 (n=148 640). However, cumulative BUD attendances dropped by only 6% in 2020 (n=3922) compared to 2019 (n=4162). Monthly site-specific attendances showed marginal variation. PED attendances broadly decreased in 2020 with less of an impact on BUD.
Prognostic accuracy of triage tools for adults with suspected COVID-19 in a prehospital setting: an observational cohort study
Authors: Marincowitz Carl , Sutton Laura , Stone Tony , Pilbery Richard , Campbell Richard , Thomas Benjamin , Turner Janette , Bath Peter A , Bell Fiona , Biggs Katie , Hasan Madina , Hopfgartner Frank , Mazumdar Suvodeep , Petrie Jennifer , Goodacre Steve
Published: February 2022

Background

Tools proposed to triage patient acuity in COVID-19 infection have only been validated in hospital populations. We estimated the accuracy of five risk-stratification tools recommended to predict severe illness and compared accuracy to existing clinical decision making in a prehospital setting.

Methods

An observational cohort study using linked ambulance service data for patients attended by Emergency Medical Service (EMS) crews in the Yorkshire and Humber region of England between 26 March 2020 and 25 June 2020 was conducted to assess performance of the Pandemic Respiratory Infection Emergency System Triage (PRIEST) tool, National Early Warning Score (NEWS2), WHO algorithm, CRB-65 and Pandemic Medical Early Warning Score (PMEWS) in patients with suspected COVID-19 infection. The primary outcome was death or need for organ support.

Results

Of the 7549 patients in our cohort, 17.6% (95% CI 16.8% to 18.5%) experienced the primary outcome. The NEWS2 (National Early Warning Score, version 2), PMEWS, PRIEST tool and WHO algorithm identified patients at risk of adverse outcomes with a high sensitivity (>0.95) and specificity ranging from 0.3 (NEWS2) to 0.41 (PRIEST tool). The high sensitivity of NEWS2 and PMEWS was achieved by using lower thresholds than previously recommended. On index assessment, 65% of patients were transported to hospital and EMS decision to transfer patients achieved a sensitivity of 0.84 (95% CI 0.83 to 0.85) and specificity of 0.39 (95% CI 0.39 to 0.40).

Conclusion

Use of NEWS2, PMEWS, PRIEST tool and WHO algorithm could improve sensitivity of EMS triage of patients with suspected COVID-19 infection. Use of the PRIEST tool would improve sensitivity of triage without increasing the number of patients conveyed to hospital.
Diagnostic approach in adult-onset neurometabolic diseases
Authors: Fernández-Eulate Gorka , Carreau Christophe , Benoist Jean-François , Lamari Foudil , Rucheton Benoit , Shor Natalia , Nadjar Yann
Published: February 2022

Neurometabolic diseases are a group of individually rare but numerous and heterogeneous genetic diseases best known to paediatricians. The more recently reported adult forms may present with phenotypes strikingly different from paediatric ones and may mimic other more common neurological disorders in adults. Furthermore, unlike most neurogenetic diseases, many neurometabolic diseases are treatable, with both conservative and more recent innovative therapeutics. However, the phenotypical complexity of this group of diseases and the growing number of specialised biochemical tools account for a significant diagnostic delay and underdiagnosis. We reviewed all series and case reports of patients with a confirmed neurometabolic disease and a neurological onset after the age of 10 years, with a focus on the 36 treatable ones, and classified these diseases according to their most relevant clinical manifestations. The biochemical diagnostic approach of neurometabolic diseases lays on the use of numerous tests studying a set of metabolites, an enzymatic activity or the function of a given pathway; and therapeutic options aim to restore the enzyme activity or metabolic function, limit the accumulation of toxic substrates or substitute the deficient products. A quick diagnosis of a treatable neurometabolic disease can have a major impact on patients, leading to the stabilisation of the disease and cease of repeated diagnostic investigations, and allowing for familial screening. For the aforementioned, in addition to an exhaustive and clinically meaningful review of these diseases, we propose a simplified diagnostic approach for the neurologist with the aim to help determine when to suspect a neurometabolic disease and how to proceed in a rational manner. We also discuss the place of next-generation sequencing technologies in the diagnostic process, for which deep phenotyping of patients (both clinical and biochemical) is necessary for improving their diagnostic yield.
Clinical practice guideline for the management of paediatric Charcot-Marie-Tooth disease
Authors: Yiu Eppie M , Bray Paula , Baets Jonathan , Baker Steven K , Barisic Nina , de Valle Katy , Estilow Timothy , Farrar Michelle A , Finkel Richard S , Haberlová Jana , Kennedy Rachel A , Moroni Isabella , Nicholson Garth A , Ramchandren Sindhu , Reilly Mary M , Rose Kristy , Shy Michael E , Siskind Carly E , Yum Sabrina W , Menezes Manoj P , Ryan Monique M , Burns Joshua
Published: February 2022

Background and objectives

Charcot-Marie-Tooth disease (CMT) is the most common inherited neuropathy and often presents during childhood. Guidelines for the optimal management of common problems experienced by individuals with CMT do not exist, for either children or adults. We formed the Paediatric CMT Best Practice Guidelines Consortium to develop evidence and consensus-based recommendations for the clinical management of children and adolescents with CMT, with the primary objective of promoting optimal, standardised care globally.

Methods

Development of this clinical practice guideline involved a series of systematic reviews covering 10 clinical questions, modified Delphi methodology involving an international panel of clinicians to generate consensus where evidence did not exist, and application of the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach to evaluate the body of literature and formulate recommendations.

Results

The final guideline includes three evidence-based and 31 consensus-based recommendations. They encompass the management of muscle weakness, balance and mobility impairment, sensory symptoms, muscle cramps, impaired upper limb function, respiratory impairment, maintenance of joint range of motion and non-surgical management of joint deformity. Consensus was not achieved in some management areas, reflecting differences in practice between clinicians and healthcare settings, and highlighting the need for further research.

Conclusions

This clinical practice guideline provides practical and implementable guidance on the management of common clinical problems experienced by children with CMT and advocates for improved access to multidisciplinary care. Successful dissemination and implementation of these recommendations will be critical in ensuring their application across multiple healthcare settings.
Physical observations of the transient evolution of the porosity distribution during internal erosion using spatial time domain reflectometry
Authors: Sufian Adnan , Bittner Tilman , Bore Thierry , Bajodek Mathieu , Scheuermann Alexander
Published: February 2022

A purpose-built permeameter was used to explore the transient evolution of porosity during the mixing process in filtration experiments. The experiments considered upward seepage flow and explored the influence of base and filter particle sizes, along with different hydraulic conditions. The permeameter acted as a coaxial transmission line enabling electromagnetic measurements based on spatial time domain reflectometry, from which the porosity profile was obtained using an inversion technique. Quantitative characteristics of the onset and progression of the mixing process were extracted from a porosity field map. The limiting onset condition was influenced by geometric and hydraulic factors, with the critical flow rate exhibiting a strong dependence on the base particle size, while the critical hydraulic gradient exhibited a stronger dependence on filter particle size. The progression of the mixing process was characterised by both the transport of base particles into the filter layer, as well as the settlement of the filter particles into the base layer due to the reduction of the effective stress at the base–filter interface leading to partial bearing failure. The rate of development of the mixture zone was strongly dependent on the hydraulic loading condition and the base particle size, but the final height of the sample after complete mixing was independent of the hydraulic loading path.
Memory effect of the pp waves with torsion
Authors: Cvetković B. , Simić D.
Published: February 2022

We analyse the motion of test particles in the spacetime of the plane-fronted (pp) waves with torsion in four-dimensions. We conclude that there is a velocity memory effect in the direction of advanced time and along radial direction, while we have rotation of particles in angular direction. The velocity memory effect in the aforementioned directions is severely affected by the value of the tordion mass and probably it is not observable. A very interesting, probably observable effect, steams from the rotation, which is insensitive to the tordion mass.
Azimuthal asymmetries and transverse momentum distributions of charged hadrons in muon-proton deep inelastic scattering
Authors: Moretti Andrea
Published: February 2022

In 2016 and 2017, the COMPASS Collaboration at CERN collected a large sample of DIS events with a longitudinally polarized 160 GeV/[Formula: see text] muon beam scattering off a liquid hydrogen target. Part of the collected data has been analyzed to extract preliminary results for the amplitudes of the modulations in the azimuthal angle of the charged hadrons and for their transverse momentum distributions. These observables give relevant information for the study of the transverse momentum and spin structure of the nucleon. The results, presented here for the first time, have been obtained from part of the data collected in 2016. In the analysis, a new method for the evaluation of the contribution of exclusive diffractive processes has been implemented. The azimuthal asymmetries exhibit strong kinematic dependencies, similar to those observed in COMPASS deuteron measurements. The transverse momentum distributions show smooth exponential trends and are compatible with the previous measurement on deuteron.
Nucleon-pair shell model: Effect of non-collective pairs for odd 123−129Sn
Authors: Li Z. W. , He B. C. , Li L. , Luo Y. A. , Bao L. N. , Pan F. , Draayer J. P.
Published: February 2022

In this paper, odd-mass isotopic chain of [Formula: see text]Sn has been studied within the framework of nucleon-pair shell model (NPSM) with the noncollective pair originating from the alignment of two neutrons in the [Formula: see text]h11/2 orbit included. It was found that NPSM can reproduce the properties of the yrast bands satisfactorily, it is crucial to include the noncollective pair in the NPSM. The band structure can be explained as the backbending or the phase transition from vibrational limit to the rotational limit. The mechanism of the yrast band can be explained as band crossing between the ground state band and the S band constructed from the neutron alignment in the [Formula: see text]h11/2 orbit. Our results also suggest that the mechanism of the band structure of those four Sn isotopes can also be interpreted as the competition and transition between collective and noncollective phase.
WEAR PROPERTIES AND MICROSTRUCTURE OF WC–10Co–4Cr POWDER COATING APPLIED TO CULTIVATOR BLADES VIA HVOF
Authors: DİLAY YUSUF , GÜNEY BEKIR , ÖZKAN ADEM
Published: February 2022

Abrasion of cultivator equipment parts working in the soil causes serious losses if necessary precautions are not taken. The cultivator blades used to plow the soil in agricultural production wear out over time. In order to reduce this wear, the hardness and wear resistance of the material should be increased first. In this study, some of the 30MnB5 cultivator blades were heat-treated and some were coated with HVOF technique. The samples were obtained by plowing the soil at 15-cm working depth and 5.4-km[Formula: see text]h[Formula: see text] forward speed in two fields with different soil moisture contents. As a result of the experiments, abrasion losses and surface deformation of the blade material were observed and the effect of soil moisture on wear was also determined. After the treatment of 49.5[Formula: see text]daa (decare) with soil at 9% moisture content, the heat-treated 30MnB5 sample was worn 5.6 g, and the sample coated with WC–10Co–4Cr was worn 3.2[Formula: see text]g. Abrasions at 14% soil moisture were 6.3 g and 3.6[Formula: see text]g, respectively. It was observed that the coated material was less corroded than the heat-treated material. While the results obtained will contribute to the prevention of economic losses, the release of metals into the soil will also be prevented.
MACHINABILITY INVESTIGATION OF CRYOGENICALLY TREATED HARDENED AISI 4140 ALLOY STEEL USING CBN INSERT UNDER SUSTAINABLE FINISH DRY HARD TURNING
Authors: RAFIGHI MOHAMMAD , ÖZDEMIR MUSTAFA , DAS ANSHUMAN , DAS SUDHANSU RANJAN
Published: February 2022

Cryogenic treatments have been applied to enhance both wear and abrasion resistance for the cutting inserts. Therefore, many investigations focused on the shallow and deep cryogenic treatments in terms of their performance on the machinability criteria. This paper presents a detailed analysis on machinability investigation of cryogenically treated hardened 4140 steel (55 HRC), and sustainability assessment in hard machining on finishing mode carried out at dry cutting regime. A series of machining trials have been performed under varied cutting conditions (feed, depth of cut and speed) following the L9 orthogonal array design experimental layout for analysis of various responses along with cost estimation in hard turning. Moreover, the machining parameters are optimized and mathematically formulated for the minimization of various responses using a multi-objective optimization method. Finally, considering the motivational idea of “Go green–Think green–Act green”, a unique novel approach has been proposed concerning economic evaluation and sustainability assessment in hard turning for safer and cleaner approach of environment friendly manufacturing. According to statistical analysis, feed influenced both surface roughness and cutting force significantly. Because of cryogenic treatment both surface roughness and cutting force diminished. It is noticed that with high speed, low feed, and depth of cut both force and roughness value declined. The tool life of CBN was 44[Formula: see text]min and considering the same, Gilbert’s machining economic model calculated the overall machining cost per part of 80.86 in the machining of hardened AISI 4140 steel. The outcomes clearly established that machining under dry conditions provides environment friendliness, technologically viable, and economically feasible to improve sustainability.
Research on the Dynamic Monitoring System of Intelligent Digital Teaching
Authors: Zhang Huizhong , Meng Fanrong , Wang Gui , Saraswathi E. , Ruby D.
Published: February 2022

Education is one of the areas with a higher impact on digitalization, which takes various forms such as education through digital devices and technology to improve the learning process. Online and tangible computing platforms have become more interested in pursuing active teaching through educational technologies within the curriculum. Some common problems and considerations can be addressed, such as access, capacity, financing, periodic progress measurements, and evaluation results. The productive learning activity can be immediately and constantly monitored by proposing Digital Tangible Intelligent Monitoring systems (DTIMS). The decision tree method’s teaching methodology can efficiently perform this proposed system, which monitors the former challenges. At the same time, the next is resolved by a dynamic evaluation process based on the Internet of Things (IoT). The research is evaluated using the education systems currently adopted. The results highlighted the potential of the proposed model and helped to gain information in digital teaching. The simulation analysis is performed based on accuracy 97.69%, vulnerability 91.09%, and efficiency, proving the proposed framework’s reliability of 85.10%.