bluuebunny/crossref_metadata_2025 huggingface dataset:
Collecting truths: A paradox in two guises
Authors: Updike Eric
Published: May 2021

Two proofs are given which show that if some set of truths fall under finitely many concepts (so‐called ), then they all fall under at least one of them even if we do not know which one. Examples are given in which the result seems paradoxical. The first proof crucially involves Moorean propositions while the second is a reconstruction and generalization of a proof due to Humberstone free from any reference to such propositions. We survey a few solution routes including Tennant‐style restriction strategies. It is concluded that accepting for some set of truths while also denying that any of the involved concepts in isolation capture all of them requires that one of these concepts cannot be closed under conjunction elimination. This is surprising since the paper surveys several applications in which and the latter closure condition seemed jointly satisfiable for concepts of actual philosophical interest.
Study on spore release of Polytrichum commune Hedw. var. commune by synergetic effects of sub‐hygroscopic movement and wind
Authors: Zhang Z. Q. , Min H. X. , Wang Z. H. , Zhang Z. H.
Published: May 2021

The effect of humidity change on spore release of the Nematodontae Polytrichaceae has never been tested experimentally. Similarly, the impact of humidity alterations on structure of the peristome have never been studied.

Polytrichum commune Hedw. var. commune from Guizhou Province, China, was selected as the research object to examine effects of simulated wind in the laboratory. By controlling humidity and wind, the mechanism of spore dispersal was revealed.

When humidity increased, the size of the peristome and epiphragm enlarged significantly (the peristome has no obvious spatial displacement, unlike the hygroscopic movement of Arthrodontae mosses. Thus, we named it ‘sub‐hygroscopic movement’), then recovered to normal size when humidity decreased. When humidity was controlled and wind applied, the scattering of spores gradually decreased as the capsule dried out and finally reached a very low level; when the capsule was wetted or rewetted, the amount of spores released rose and returned to the initial state. Through comparison of moist and dry capsules, only enhanced humidity of the sporophytes led to increases in spore release.

The results show that the dispersal of spores was significantly improved in windy conditions and the sub‐hygroscopic movement of the capsule peristome, which ensure the continuity and effectiveness of P. commune reproduction.
Trade policy and input liberalization: The effect on Egyptian firms’ productivity
Authors: Martínez Zarzoso Inmaculada , Said Mona , Zaki Chahir
Published: May 2021

This paper explores the link between trade liberalization and firms’ performance in Egypt combining macro and micro data. Using the Economic Census of Egypt 2013, we examine the association between tariffs and non‐tariffs measures (NTM) imposed on intermediate input sand total factor productivity (TFP). In a first step TFP is estimated as the residual of a Cobb‐Douglas/Translog production function and in thesecond, TFP is regressed on weighted tariffs and NTM imposed on intermediate inputs. Egyptian input‐output tables are used to construct the weights. Our main findings show a positive and significant association between imported inputs and value‐added and a significantly negative relationship between tariffs and TFP.
Is Sjogren's syndrome a risk factor/contraindication for dental implants? An umbrella review
Authors: Barros Ana Waleska Pessôa , Sales Pedro Henrique da Hora , Carvalho Alessandra de Albuquerque Tavares , Patel Preeyan , Porter Stephen , Leão Jair Carneiro
Published: May 2021

Introduction

There have been concerns that longstanding oral dryness secondary to Sjogren's syndrome may increase the risk of failure of dental implants.

Aims

The aim of the present study was to determine the level of methodological quality of systematic reviews that evaluated the effectiveness of dental implants in patients diagnosed with Sjogren's syndrome.

Methods and results

Databases of PubMed/Medline, LILACS, Science Direct and Dare Cochrane to October 2020 were evaluated. A total of 833 articles were initially identified but following use of appropriate inclusion and exclusion criteria 4 papers were identified for detailed analysis. An eventual study sample comprised 722 implants placed in 189 patients with a 95.22% success rate, the minimum follow‐up time was 45.2 ± 23.8 months and the maximum 125.5 months. The studies were assessed for their methodological quality by the AMSTAR 2 tool, in which 3 had critically low quality and one low quality.

Conclusion

Oral rehabilitation with dental implants in patients with Sjogren's syndrome seems to have a high success rate; however, the low quality of relevant reports highlights the need for primary and secondary studies with better methodological design in order to reduce bias and provide reassurance for this treatment option.
Facing an unexpected reality – oscillating between health and suffering 4–6 years after bariatric surgery
Authors: Lindberg Susan , Wennström Berith , Larsson Anna‐Karin
Published: May 2021

Background

Obesity is a significant public health problem that is on the increase worldwide, and treatment with bariatric surgery is becoming more and more common. This type of surgery has proved to be good for weight reduction and for preventing complications, but few studies have investigated patients’ long‐term experiences of health and suffering.

Aim

To explore people's experiences of health after bariatric surgery. What are their thoughts about their life, body and sexuality?

Methods

This study is based on semi‐structured interviews with eight women and eight men, 4–6 years after bariatric surgery. The data were analysed using qualitative content analysis and resulted in 5 main themes and 14 subthemes.

Results

The new body enabled a healthy life due to better treatment in society, enhanced self‐esteem, the pleasure of purchasing clothes and the courage to become more sexually active. At the same time, the body could be experienced as so unfamiliar that their life was dominated by despondency, a lack of freedom and a feeling of being lost, which made them wish to return to their old body.

Conclusion and implications

The participants received extensive information before as well as follow‐up conversations up to one year after surgery. Nevertheless, they all experienced that changing from life as an obese person to a radically reduced body often meant a confrontation with an unexpected reality that oscillated between health and suffering. This indicates that preparedness for the life changes that bariatric surgery may entail is inadequate and that moving towards health and suffering takes its own time.

Therefore, more time should be allocated to talking about how life is and can become in the long term, which may facilitate a dialogical, person‐centred approach to the setbacks and situations each person needs to manage in order to improve her/his health.
The next generation: Nationalism and violence in the narratives of Serbian students on the break‐up of Yugoslavia
Authors: Jovanović Rodoljub , Bermúdez Ángela
Published: May 2021

Twenty years after the end of the violent break‐up of Yugoslavia, new generations of young people in Serbia are living with its legacies. Despite the socio‐psychological implications of violent conflict in post‐conflict societies being well established in the literature, there are still only a few studies which focus on young Serbians’ meaning‐making in relation to the recent wars. The present study focuses on how a group of young Serbians, born after the violence was over, understands the violent break‐up of Yugoslavia. The article presents the analysis of interviews and group discussions with 31 first‐year university students in Serbia about these events. The goal of the analysis is to determine a) whether participants’ narratives contain identifiable themes of a collective memory of conflict and b) whether participants normalize past violence through narrative. The relationship between the two as well as the relationship between history textbooks and participants’ narratives will be discussed. Finally, the findings are discussed in regard to how participants’ understandings of past violence might shape their political positioning in relation to nationalism.
Protection by whom, for whom? Muslim refugee women facing a contested European identity
Authors: Golesorkhi Lara‐Zuzan
Published: May 2021

The protection of the ‘European way of life’ has come at the expense of protecting the human rights of migrants. This trade‐off has occurred at border crossings and in host countries, and has left third‐country nationals, including Muslim refugee women, in grey areas of protection. How can we explain these limited protections across the EU? I argue that the limited protections of Muslim refugee women can be explained through a combination of the EU’s fragmented non‐discrimination framework and surging nationalist dynamics. By using Germany as my case study and by drawing on ethnographic research, I propose that Muslim refugee women have been securitized through three distinct but connected ‘threat logics’: refugees as threat, Muslims and Islam as threat, and Muslim women as threat. All three threat logics have been employed by nationalist and right‐wing groups to simultaneously target migration and Islam qua Muslim refugee women.
Comparison of the clinical, ultrasound, and CT findings in 13 dogs with gastric neoplasia
Authors: Zuercher Melonie , Vilaplana Grosso Federico , Lejeune Amandine
Published: May 2021

Diagnosis of gastric tumors in dogs is difficult and is often obtained by biopsy following identification of a mass through ultrasound (US) or endoscopy. In human medicine, modalities such as CT and endoscopy are standard of care in the diagnosis and staging of gastric tumors. Although one veterinary study has described CT findings of gastric tumors in dogs using iatrogenic gas dilation, there are no veterinary studies that have directly compared the usefulness of US versus CT in the diagnosis and staging of these tumors. This retrospective, descriptive study evaluated US and CT images from 13 dogs. Gastric tumor diagnoses included leiomyoma (n = 4), adenocarcinoma (n = 3), leiomyosarcoma (n = 3), gastrointestinal stromal tumor (n = 2), and lymphoma (n = 1). Computed tomography was successful in identification of 92% of gastric tumors, while US identified only 69%. Computed tomography identified more locations of lymphadenopathy and correctly identified the location of gastric tumors more frequently than US when compared to the surgical, endoscopic, or necropsy reports. Most features seen on US and CT overlapped between the different tumor types. Lymphoma had a lower mean attenuation in CT than the other gastric tumors and was the only gastric tumor to not have complete loss of the gastric wall layering on US. As expected, adenocarcinoma appeared as gastric wall thickening with regional lymphadenopathy. Findings supported using CT as an ancillary diagnostic test for characterizing and staging gastric tumors in dogs and assisting in the selection of surgical candidates.
Antibiotic‐resistant bacteria and blaNDM‐1 genes in the drinking tap water of a megacity
Authors: Khan Sadia , Mustafa Atif
Published: May 2021

Antibiotic resistance genes (ARGs) in drinking water are a major issue for the world. blaNDM‐1 confers resistance to carbapenem antibiotics, which is one of the cures for fatal bacterial infections. The study aimed to identify coliform and other bacteria with sul‐1, sul‐2 and blaNDM‐1 ARGs in drinking water. Members of the genera Klebsiella, Serratia, Citrobacter, Pseudomonas, Aeromonas, Acinetobacter and Delftia were identified with Chromocult Coliform Agar, polymerase chain reaction (PCR) and gene sequencing. blaNDM‐1 genes were present in 7.8% of isolated bacteria. A weak but significant correlation was observed between coliform and TDS/EC/Hardness/Mg+2/Heterotrophic plate count (HPC). This research is the first study reporting blaNDM‐1 in the drinking water of Karachi. This study indicates the biological contamination along with antibiotic‐resistant bacteria and genes in drinking water. It highlights the need for continuous monitoring and control of emerging contaminants in urban water supply for protection of public health and ecosystems.
What is the “normal” wound bed temperature? A scoping review and new hypothesis
Authors: Gethin Georgina , Ivory John D. , Sezgin Duygu , Muller Hendrik , O'Connor Gerard , Vellinga Akke
Published: May 2021

Wound bed temperature measurement holds the potential to be a safe, easy to use, and low‐cost tool to aid objective wound bed assessment, clinical decision making and improved patient outcomes. However, there is no consensus on the normal range of wound bed temperature in chronic wounds. We conducted a scoping review including any study type, from 2010 to 2020 in which chronic wound bed temperature was reported. Thirteen studies including 477 patients met our criteria. Venous ulcers (VLU) accounted for 46.5% (n = 222) of wounds; diabetic foot ulcers (DFU) for 25.4% (n = 121) with pressure ulcers (PU), mixed arterial venous ulcers (MAVLU) and unknown aetiology accounting for the remainder. The weighted mean of means for wound bed temperature was 31.7°C (n = 395) for all wound types; 31.7°C for VLU; 31.6°C for DFU; 33.3°C for PU; 30.9°C for MAVLU; and 32.0°C for those with unknown aetiology. Based on our review, we hypothesise that normal wound bed temperature is within a range of 30.2–33.0°C.
A Novel Phosphide Derived From Metal-Organic Frameworks as Cost-Effective Electrocatalyst for Oxygen Evolution Reaction
Authors: Yang Yi-Wen , Song Bing-Ye
Published: May 2021

Developing an efficient, green, and low-cost non noble metal catalyst toward oxygen evolution reaction (OER) has been urgent for new generation of sustainable energy technologies. Herein, the Co/Ni metal-organic frameworks (MOFs) derived metal phosphides/carbon matrix composites are successfully produced by the precipitation-carbonization-phosphorization processes. The obtained samples are characterized and analyzed for structural and morphological investigation. Electrochemical tests for OER are performed in the alkaline medium. The positive effects of P, Ni doping in MOFs on the structure and properties of composites have been analyzed. Benefitting from the unique structure of three-dimensional flower-like polyhedron with rich structure and higher porosity, the NiCo-P/NC catalyst exhibits the lowest overpotential of 0.32 V compared with the commercial IrO2 (0.34 V) at 10 mA/cm2, as well as outstanding stability and kinetic mechanism. Besides, the cost of the proposed novel material is calculated to be 4.337 US$/g, which is only 1.57% of that of commercial IrO2 (276 US$/g). The results obtained from the MOF-derived low-cost and high-efficiency OER catalyst would provide a new perspective on application of electrochemical storage and batteries.
Operational Modal Analysis of a Rotating Structure Subject to Random Excitation Using a Tracking Continuously Scanning Laser Doppler Vibrometer via an Improved Demodulation Method
Authors: Lyu L. F. , Zhu W. D.
Published: May 2021

A new operational modal analysis (OMA) method is developed for estimation of modal parameters (MPs) of a rotating structure (RS) subject to random excitation using a nonuniform rotating beam model, an image processing method, and an improved demodulation method. The solution to the governing equation of a nonuniform rotating beam is derived, which can be considered as the response of the beam measured by a continuously scanning laser Doppler vibrometer (CSLDV) system. A recently developed tracking CSLDV system can track and scan the RS. The image processing method determines the angular position of the RS so that the tracking CSLDV system can sweep its laser spot along a time-varying path on it. The improved demodulation method obtains undamped mode shapes (UMSs) of the RS by multiplying its measured response by sinusoids whose frequencies are its damped natural frequencies (DNFs) that are obtained from the fast Fourier transform (FFT) of the measured response. Experimental investigation of the OMA method using the tracking CSLDV system is conducted, and MPs of a rotating fan blade (RFB), including DNFs and UMSs, with different constant speeds and its instantaneous MPs with a nonconstant speed are estimated. Estimated first DNFs and UMSs of the stationary fan blade and RFB are compared with those from the lifting method that was previously developed by the authors.
An equivalent circuit based electro-vibro-acoustic model of a cylindrical transducer array
Authors: Sim Min-Jung , Jeong Weui-Bong , Hong Chinsuk
Published: May 2021

Cylindrical transducer arrays are used in many applications such as SONAR, depth sounding, ultrasound imaging, etc. This study developed the equivalent circuit (EC)-based-model of a cylindrical array with theoretical acoustic coupling. The electro-mechanical-acoustic coupling impedance matrix was first constructed to determine the response of the array. The electrical and mechanical impedances of the individual transducers were obtained by the EC model. The acoustic radiation impedances were obtained by the theoretical model. The cylindrical array is modeled by coupling the EC model and acoustic radiation impedances. The acoustic transfer matrix was then constructed using the theoretical method to determine both the far-field and near-field acoustic responses. The characteristics of the transducer array were represented with the electrical admittance, velocity response as a function of the voltage, transmit voltage response, beam pattern, and normalized pressure curve. To verify the proposed model, the analysis results were successfully compared to those of the fully coupled finite element model. Due to its high accuracy and computational efficiency, the proposed EC-based-model is expected to be useful for the conceptual design stage, which requires frequent design changes.
Electrostatics, conformation, and rheology of unentangled semidilute polyelectrolyte solutions
Authors: Chen Guang , Perazzo Antonio , Stone Howard A.
Published: May 2021

Polyelectrolyte (PE) solutions, which are charged polymers in polar solvents, are ubiquitous and essential to life. Due to the electrostatic interactions among the charged monomers and mobile ions, the dependence of the rheological properties on the polymer concentration of PE solutions differs significantly from that of solutions of uncharged macromolecules. In addition, salt in PE solutions, whether added intentionally or intrinsically present, can affect the properties of the solutions. Here, we analyze the ion distribution near a monomer using the nonlinear Poisson–Boltzmann equation for scenarios with nonoverlapping and overlapping electric double layers. Consequently, by incorporating the electrostatic interactions into the blob model and Zimm–Rouse dynamic model, we obtain different scaling laws for the electrostatic energy per monomer, correlation length, end-to-end distance, relaxation time and viscosity η of semidilute, unentangled PE solutions in consecutive regimes of polymer concentration np, and salt concentration ns, which are summarized in tables. With our theory, we anticipate that the empirical Fuoss law η∝np1/2 is expected for solutions prepared with salt-contaminated PE samples, while η∝np0.68 might be found for those with purer PE samples. A new critical charge fraction φc is defined, where we predict that the peak, which is present in the measurements of the reduced viscosity η/np as a function of np, is only expected for weakly charged PEs φ<φc prepared with pure PE samples. Comparisons with the experimental data as well as the classical scaling theories are provided, and the range of applicability of the theory is discussed.
The Influence of Sitting, Standing, and Stepping Bouts on Cardiometabolic Health Markers in Older Adults
Authors: Verswijveren Simone J.J.M. , Powell Cormac , Chappel Stephanie E. , Ridgers Nicola D. , Carson Brian P. , Dowd Kieran P. , Perry Ivan J. , Kearney Patricia M. , Harrington Janas M. , Donnelly Alan E.
Published: May 2021

Aside from total time spent in physical activity behaviors, how time is accumulated is important for health. This study examined associations between sitting, standing, and stepping bouts, with cardiometabolic health markers in older adults. Participants from the Mitchelstown Cohort Rescreen Study (N = 221) provided cross-sectional data on activity behaviors (assessed via an activPAL3 Micro) and cardiometabolic health. Bouts of ≥10-, ≥30-, and ≥60-min sitting, standing, and stepping were calculated. Linear regression models were fitted to examine the associations between bouts and cardiometabolic health markers. Sitting (≥10, ≥30, and ≥60 min) and standing (≥10 and ≥30 min) bouts were detrimentally associated with body composition measures, lipid markers, and fasting glucose. The effect for time spent in ≥60-min sitting and ≥30-min standing bouts was larger than shorter bouts. Fragmenting sitting with bouts of stepping may be targeted to benefit cardiometabolic health. Further insights for the role of standing need to be elicited.
A Time for Clinical Transformation: Emerging Implications From COVID-19 for Athlete Transition Research and Clinical Practice
Authors: DeFreese J.D. , Walton Samuel R. , Chandran Avinash , Kerr Zachary Y.
Published: May 2021

The COVID-19 pandemic has resulted in changes to the structure of sport and the experiences of athletes. In this commentary, we consider how these changes, including schedule disruptions and the early termination of careers, have contributed to a reconsideration of how athlete transition should be defined, examined, and intervened upon. We outline our rationale for this proposed reconfiguration, including implications for researchers and practitioners working with athletes during the COVID-19 pandemic and beyond. For researchers, we recommend updating the transition definition, reconsidering the measurement of salient transition-related variables, and utilizing study designs/methods that best facilitate this work. For practitioners, we recommend considering the dynamic nature of transition within holistic athlete care, building momentum on mental health destigmatization achieved during the pandemic, athlete transition education, and clinician advocacy for transition-related resources for athletes. Ultimately, we hope this work will spark continued innovations in athlete transition research and practice moving forward.
Striking the Right Balance: Evidence to Inform Combined Physical Activity and Sedentary Behavior Recommendations
Authors: Chastin Sebastien F.M. , McGregor Duncan E. , Biddle Stuart J.H. , Cardon Greet , Chaput Jean-Philippe , Dall Philippa M. , Dempsey Paddy C. , DiPietro Loretta , Ekelund Ulf , Katzmarzyk Peter T. , Leitzmann Michael , Stamatakis Emmanuel , Van der Ploeg Hidde P.
Published: May 2021

Background: Crucial evidence gaps regarding: (1) the joint association of physical activity and sedentary time with health outcomes and (2) the benefits of light-intensity physical activity were identified during the development of recommendations for the World Health Organization Guidelines on physical activity and sedentary behavior (SB). The authors present alternative ways to evidence the relationship between health outcomes and time spent in physical activity and SB and examine how this could be translated into a combined recommendation in future guidelines. Methods: We used compositional data analysis to quantify the dose–response associations between the balance of time spent in physical activity and SB with all-cause mortality. The authors applied this approach using 2005–2006 National Health and Nutrition Examination Survey accelerometer data. Results: Different combinations of time spent in moderate- to vigorous-intensity physical activity, light-intensity physical activity, and SB are associated with similar all-cause mortality risk level. A balance of more than 2.5 minutes of moderate- to vigorous-intensity physical activity per hour of daily sedentary time is associated with the same magnitude of risk reduction for all-cause mortality as obtained by being physically active according to the current recommendations. Conclusion: This method could be applied to provide evidence for more flexible recommendations in the future with options to act on different behaviors depending on individuals’ circumstances and capacity.
Chapter 1: 21st Century Physical Education in the United States: Introduction to the Special Issue
Authors: Ward Phillip , Lawson Hal A. , van der Mars Hans , Mitchell Murray F.
Published: May 2021

In this chapter, we examine the system of physical education with a Janus-like perspective. We focus on examining and learning from the past as we anticipate what society, school systems, and the physical education system might look like in the future. Drawing on futuristic scenarios developed for this special journal issue, we ask a timely, pivotal question. What does all of this mean for the future of the field of physical education, including its school programs, teacher education programs, doctoral programs, and salient public policies? The several chapters in this special issue can be viewed as a response to this question—and with a delimited focus on the unique context of the United States. This chapter is structured to provide an overall context for these other contributions. It includes a discussion of relevant theories provided in this special issue and a representative summary of the other articles. Selectivity is apparent and unavoidable in every article, and it can be viewed variously as a strength or limitation.
How Common Is the Exponential Decay Pattern of Motor Skill Acquisition? A Brief Investigation
Authors: Olivier Geneviève N. , Walter Christopher S. , Paul Serene S. , Dibble Leland E. , Schaefer Sydney Y.
Published: May 2021

Motor performance is classically described as improving nonlinearly with practice, demonstrating rapid improvements early in practice with stabilization later, which is commonly modeled by exponential decay functions. However, retrospective analyses of our previously collected data challenge this theoretical model of motor skill acquisition, suggesting that a majority of individual learners actually demonstrate patterns of motor improvement different from this classical model. A convenience sample of young adults, older adults, and people with Parkinson disease trained on the same functional upper-extremity task. When fitting three-parameter exponential decay functions to individual participant data, the authors found that only 13.3% of young adults, 40.9% of older adults, and 66.7% of adults with Parkinson disease demonstrated this “classical” skill acquisition pattern. Thus, the three-parameter exponential decay pattern may not well-represent individuals’ skill acquisition of complex motor tasks; instead, more individualized analysis methods may be warranted for advancing a theoretical understanding of motor skill acquisition.
Cardiac cell type–specific gene regulatory programs and disease risk association
Authors: Hocker James D. , Poirion Olivier B. , Zhu Fugui , Buchanan Justin , Zhang Kai , Chiou Joshua , Wang Tsui-Min , Zhang Qingquan , Hou Xiaomeng , Li Yang E. , Zhang Yanxiao , Farah Elie N. , Wang Allen , McCulloch Andrew D. , Gaulton Kyle J. , Ren Bing , Chi Neil C. , Preissl Sebastian
Published: May 2021

A human heart cell type–specific cis-regulatory element atlas reveals gene regulatory mechanisms of cardiovascular diseases.
Hierarchy in sensory processing reflected by innervation balance on cortical interneurons
Authors: Ma Guofen , Liu Yanmei , Wang Lizhao , Xiao Zhongyi , Song Kun , Wang Yanjie , Peng Wanling , Liu Xiaotong , Wang Ziyue , Jin Sen , Tao Zi , Li Chengyu T. , Xu Tianle , Xu Fuqiang , Xu Min , Zhang Siyu
Published: May 2021

Hierarchy in sensory processing is reflected by the innervation balance on cortical interneurons in the corticothalamic network.
Assignment of enantiomorphs for the chiral allotrope β-Mn by diffraction methods
Authors: Burkhardt Ulrich , Winkelmann Aimo , Borrmann Horst , Dumitriu Andreea , König Markus , Cios Grzegorz , Grin Yuri
Published: May 2021

Enantiomorph-distribution maps for chiral element and multicomponent structures by Electron Backscatter Diffraction.
Transcription of Cystathionine β-Lyase (MetC) Is Repressed by HeuR in Campylobacter jejuni, and Methionine Biosynthesis Facilitates Colonocyte Invasion
Authors: Kelley Brittni R. , Callahan Sean M. , Johnson Jeremiah G.
Published: May 2021

As the leading cause of bacteria-derived gastroenteritis worldwide,
Campylobacter jejuni
has a significant impact on human health. Investigating colonization factors that allow
C. jejuni
to successfully infect a host furthers our understanding of genes and regulatory elements necessary for virulence.
Marine terrace evolution of windward Barbados
Authors: Speed* Robert C. , Cheng† Hai
Published: May 2021

The geomorphic evolution of southeastern windward Barbados is embodied in the development of a terraced seaward island slope on a tectonically rising scarp. The island slope is wholly erosional and a product of marine and subaerial processes. Modulation of the slope by terraces has occurred fundamentally by marine erosion at eustatic stillstands but includes morphologic additions by limestone deposition. The ongoing phase of morphologic development and island emergence began at or before ca. 700 ka. Emergence has proceeded at an increasing rate northwestward along the island’s southeastern coastline. The terraced island slope is markedly affected by post-terrace denudation.

As many as eight marine terraces are preserved on the windward island slope below the planed surface of the Central Highlands, which is counted as terrace 1. Relics of an upper set of terraces are perched on the face of Second High Cliff, the ancient erosional margin of the oldest limestone capping Barbados. Second High Cliff developed by successive marine incisions over a probably long duration preceding oxygen isotope stage 9. A lower terrace set was excised in stages 9 through 5a in the siliciclastic island foundation or (and) in limestone cover of preceding terraces.

Marine terrace floors extend seaward from an erosional backcliff and shoreline angle to a younger erosional cutoff. The most broadly preserved terrace floors indicate the following systematic succession of seaward profile elements: narrow upper ramp; broad upper flat; lower ramp; and on one, a lower flat. Carbonate cover is chiefly clastic on the upper ramp and flat, and chiefly reefal on the lower ramp. Most shoal-water reefal facies appear to be in fringe reef blankets.

Terrace profile geometries are explained by a simple theory of wave abrasion in proportion to duration of sea level at a shoreline. At stillstands, the wave impact caused large shoreline recession and development of flats, whereas in transgression and regression, rapid sea-level change permitted only minor recession. Corresponding differences in cover facies are explained as functions of duration of breaking waves and seabed stability.

Widespread post-terrace denudation is attributed to floods of upland provenance, local overland flow, and marine flooding. Riverine processes have produced channelization and a high degree of terrace preservation on the interfluves in the steeper, foundation-based northern windward region. This differs markedly from the more diffuse, shallow gullying and stripping of the limestone-covered shallow slopes of the southern region. An intensely stormy spell is suggested between stages 5e and 5c.
Supplemental Material: Mantle source of tephritic porphyry in the Tarim Large Igneous Province constrained from Mg, Zn, Sr, and Nd isotope systematics: Implications for deep carbon cycling
Authors: Kong Weiliang , Zhang Zhaochong , al. et
Published: May 2021

Supplemental figures and tables.
Supplemental Material: The timeline of prolonged accretionary processes in eastern Central Asian Orogenic Belt: Insights from episodic Paleozoic intrusions in central Inner Mongolia, North China
Authors: Yuan Lingling , Zhang Xiaohui , Yang Zhili
Published: May 2021

Mineral chemistry, geochronological, element geochemical and Sr-Nd-Hf-O isotopic data (Tables S1 and S3–S6), zircon CL images (Fig. S1) and data quality control (Table S2) for the Paleozoic intrusions from the Erenhot region of northern Central Inner Mongolia.
Supplemental Material: Tectonic evolution of the central California margin as reflected by detrital zircon composition in the Mount Diablo region
Authors: Gooley Jared T. , al. et
Published: May 2021

Appendix S1: Geologic map data sources; Appendix S2: Sample preparation and analytical methods; Table S1: U-Th-Pb data; Table S2: U-Pb age components.
Fifteen-minute consultation: Clinical pubertal assessment
Authors: Prentice Philippa
Published: May 2021

A pubertal assessment is an important part of the clinical examination of a young person. Clinicians must be empowered to do this confidently and in a sensitive manner. Tanner staging allows an objective measurement of pubertal status, including pubic and axillary hair growth, and breast or genital development. Alongside history, age and growth patterns, pubertal assessment can identify normal, precocious, delayed or arrested puberty and be suggestive of underlying pathology. This article aims to familiarise clinicians with the pubertal assessment, both the examination and interpretation.
Neonatal arterial stroke location is associated with outcome at 2 years: a voxel-based lesion-symptom mapping study
Authors: Núñez Christian , Stephan-Otto Christian , Arca Gemma , Agut Thais , Arnaez Juan , Cordeiro Malaika , Benavente-Fernández Isabel , Boronat Nuria , Lubián-López Simón Pedro , Valverde Eva , Hortigüela Montesclaros , García-Alix Alfredo
Published: May 2021

Objective

In contrast to motor impairments, the association between lesion location and cognitive or language deficits in patients with neonatal arterial ischaemic stroke remains largely unknown. We conducted a voxel-based lesion-symptom mapping cross-sectional study aiming to reveal neonatal arterial stroke location correlates of language, motor and cognitive outcomes at 2 years of age.

Design

Prospective observational multicentre study.

Setting

Six paediatric university hospitals in Spain.

Participants

We included 53 patients who had a neonatal arterial ischaemic stroke with neonatal MRI and who were followed up till 2 years of age.

Main outcome measures

We analysed five dichotomous clinical variables: speech therapy (defined as the need for speech therapy as established by therapists), gross motor function impairment, and the language, motor and cognitive Bayley scales. All the analyses were controlled for total lesion volume.

Results

We found that three of the clinical variables analysed significantly correlated with neonatal stroke location. Speech therapy was associated with lesions located mainly at the left supramarginal gyrus (p=0.007), gross motor function impairment correlated with lesions at the left external capsule (p=0.044) and cognitive impairment was associated with frontal lesions, particularly located at the left inferior and middle frontal gyri (p=0.012).

Conclusions

The identification of these susceptible brain areas will allow for more precise prediction of neurological impairments on the basis of neonatal brain MRI.
Early lung ultrasound affords little to the prediction of bronchopulmonary dysplasia
Authors: Woods Patricia Lee , Stoecklin Benjamin , Woods Amanda , Gill Andrew William
Published: May 2021

Objective

To test the hypothesis that lung ultrasound (LUS) performed in the first week of life would predict bronchopulmonary dysplasia (BPD). Secondary outcomes included the utility of LUS in predicting interim respiratory interventions.

Design

A prospective observational cohort study in preterm infants born <28 weeks’ gestation in the single tertiary statewide neonatal intensive care unit in Western Australia.

Methods

A rigorous protocol for LUS acquisition on day 1, day 3–4, day 7, day 28 and 36 weeks’ postmenstrual age (PMA) was implemented with blinded analysis using a modified, previously validated LUS score. BPD was defined by both recent National Institute of Child Health and Human Development categorical criteria and a continuous physiological variable using a modified Shift test.

Results

Of the 100 infants studies, primary outcome data were available for the 96 infants, surviving to 36 weeks’ PMA. In a univariate logistic regression analysis, LUS on days 3–4 and day 7 accurately predicted BPD (day 3–4 OR (95% CI)=1.54 (1.03 to 2.42), p=0.044; day 7 OR (95% CI)=1.66 (1.07 to 2.70), p=0.031). The predictive value of LUS was insignificant in a multivariate model in which gestational age was the dominant predictor. LUS accurately predicted interim respiratory outcomes including surfactant administration, duration of intubation and extubation to non-invasive support at 48 hours.

Conclusions

LUS in the first week of life predicted BPD. However, LUS offers little additive accuracy to current gestational age-based models.

Trial registration number

ACTRN12617000208303.
Fifteen-minute consultation: Child with an incidental finding of a fatty liver
Authors: Chan Joseph , Gupte Girish
Published: May 2021

The incidental finding of a fatty liver on an abdominal ultrasound scan performed for an unrelated reason in an overweight child is an increasingly common phenomenon in paediatric practice. This article will explain the steps to be taken when receiving such an ultrasound report.
Lower step rate is associated with a higher risk of bone stress injury: a prospective study of collegiate cross country runners
Authors: Kliethermes Stephanie A , Stiffler-Joachim Mikel R , Wille Christa M , Sanfilippo Jennifer L , Zavala Pedro , Heiderscheit Bryan C
Published: May 2021

Objectives

To determine if running biomechanics and bone mineral density (BMD) were independently associated with bone stress injury (BSI) in a cohort of National Collegiate Athletic Association Division I cross country runners.

Methods

This was a prospective, observational study of 54 healthy collegiate cross country runners over three consecutive seasons. Whole body kinematics, ground reaction forces (GRFs) and BMD measures were collected during the preseason over 3 years via motion capture on an instrumented treadmill and total body densitometer scans. All medically diagnosed BSIs up to 12 months following preseason data collection were recorded. Generalised estimating equations were used to identify independent risk factors of BSI.

Results

Univariably, step rate, centre of mass vertical excursion, peak vertical GRF and vertical GRF impulse were associated with BSI incidence. After adjusting for history of BSI and sex in a multivariable model, a higher step rate was independently associated with a decreased risk of BSI. BSI risk decreased by 5% (relative risk (RR): 0.95; 95% CI 0.91 to 0.98) with each one step/min increase in step rate. BMD z-score was not a statistically significant risk predictor in the final multivariable model (RR: 0.93, 95% CI 0.85 to 1.03). No other biomechanical variables were found to be associated with BSI risk.

Conclusion

Low step rate is an important risk factor for BSI among collegiate cross country runners and should be considered when developing comprehensive programmes to mitigate BSI risk in distance runners.
Conceptualising interventions to enhance spread in complex systems: a multisite comprehensive medication review case study
Authors: Lennox Laura , Barber Susan , Stillman Neil , Spitters Sophie , Ward Emily , Marvin Vanessa , Reed Julie E
Published: May 2021

Background

Advancing the description and conceptualisation of interventions in complex systems is necessary to support spread, evaluation, attribution and reproducibility. Improvement teams can provide unique insight into how interventions are operationalised in practice. Capturing this ‘insider knowledge’ has the potential to enhance intervention descriptions.

Objectives

This exploratory study investigated the spread of a comprehensive medication review (CMR) intervention to (1) describe the work required from the improvement team perspective, (2) identify what stays the same and what changes between the different sites and why, and (3) critically appraise the ‘hard core’ and ‘soft periphery’ (HC/SP) construct as a way of conceptualising interventions.

Design

A prospective case study of a CMR initiative across five sites. Data collection included: observations, document analysis and semistructured interviews. A facilitated workshop triangulated findings and measured perceived effort invested in activities. A qualitative database was developed to conduct thematic analysis.

Results

Sites identified 16 intervention components. All were considered essential due to their interdependency. The function of components remained the same, but adaptations were made between and within sites. Components were categorised under four ‘spheres of operation’: Accessibility of evidence base; Process of enactment; Dependent processes and Dependent sociocultural issues. Participants reported most effort was invested on ‘dependent sociocultural issues’. None of the existing HC/SP definitions fit well with the empirical data, with inconsistent classifications of components as HC or SP.

Conclusions

This study advances the conceptualisation of interventions by explicitly considering how evidence-based practices are operationalised in complex systems. We propose a new conceptualisation of ‘interventions-in-systems’ which describes intervention components in relation to their: proximity to the evidence base; component interdependence; component function; component adaptation and effort.
Frailty and quality of life after invasive management for non-ST elevation acute coronary syndrome
Authors: Beska Benjamin , Coakley Daniel , MacGowan Guy , Adams-Hall Jennifer , Wilkinson Chris , Kunadian Vijay
Published: May 2021

Objective

Older patients presenting with non-ST elevation acute coronary syndrome (NSTEACS) require holistic assessment. We carried out a longitudinal cohort study to investigate health-related quality of life (HRQoL) of older, frail adults with NSTEACS undergoing coronary angiography.

Methods

217 consecutive patients aged ≥65 years (mean age 80.9±4.0 years, 60.8% male) with NSTEACS referred for coronary angiography were recruited from two tertiary cardiac centres between November 2012 and December 2015. Frailty was assessed with the Fried Frailty Index; a score of 0 was characterised as robust, 1–2 prefrail and ≥3 frail. The Short Form Survey 36 (SF-36), an HRQoL tool consisting of eight domains spanning physical and mental health, was performed at baseline and 1 year.

Results

186 patients (85.7%) had invasive revascularisation. At baseline, 52 (23.9%) patients were frail and 121 (55.8%) were prefrail, with most SF-36 domains falling below the norm-population mean. Patients with frailty had lower mean scores in all physical SF-36 domains (p≤0.05) compared with those without frailty. Robust patients had temporal improvement in two domains (role physical +5.80 (95% CI 1.31 to 10.3) and role emotional +6.46 (95% CI 1.02 to 11.9)) versus patients with frailty and prefrailty, who had a collective improvement in a greater number of physical and psychological domains at 1 year (2 domains vs 11 domains), notably role physical (prefrail +6.53 (95% CI 3.85 to 9.20) and frail +10.4 (95% CI 6.7814.1)).

Conclusions

Frail older adults with NSTEACS have poor HRQoL. One year following invasive management, there are modest improvements in HRQoL, most marked in frail and prefrail patients, who received a proportionally larger benefit than robust patients.

Trial registration number

NCT01933581.
Comparison of non-myeloablative lymphodepleting preconditioning regimens in patients undergoing adoptive T cell therapy
Authors: Nissani Abraham , Lev-Ari Shaked , Meirson Tomer , Jacoby Elad , Asher Nethanel , Ben-Betzalel Guy , Itzhaki Orit , Shapira-Frommer Ronnie , Schachter Jacob , Markel Gal , Besser Michal J.
Published: May 2021

Background

Adoptive cell therapy with T cells genetically engineered to express a chimeric antigen receptor (CAR-T) or tumor-infiltrating T lymphocytes (TIL) demonstrates impressive clinical results in patients with cancer. Lymphodepleting preconditioning prior to cell infusion is an integral part of all adoptive T cell therapies. However, to date, there is no standardization and no data comparing different non-myeloablative (NMA) regimens.

Methods

In this study, we compared NMA therapies with different doses of cyclophosphamide or total body irradiation (TBI) in combination with fludarabine and evaluated bone marrow suppression and recovery, cytokine serum levels, clinical response and adverse events.

Results

We demonstrate that a cumulative dose of 120 mg/kg cyclophosphamide and 125 mg/m2fludarabine (120Cy/125Flu) and 60Cy/125Flu preconditioning were equally efficient in achieving deep lymphopenia and neutropenia in patients with metastatic melanoma, whereas absolute lymphocyte counts (ALCs) and absolute neutrophil counts were significantly higher following 200 cGyTBI/75Flu-induced NMA. Thrombocytopenia was most profound in 120Cy/125Flu patients. 30Cy/75Flu-induced preconditioning in patients with acute lymphoblastic leukemia resulted in a minor ALC decrease, had no impact on platelet counts and did not yield deep neutropenia. Following cell infusion, 120Cy/125Flu patients with objective tumor response had significantly higher ALC and significant lower inflammatory indexes, such as neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). Receiver-operating characteristics curve analysis 7 days after cell infusion was performed to determine the cut-offs, which distinguish between responding and non-responding patients in the 120Cy/125Flu cohort. NLR≤1.79 and PLR≤32.7 were associated with clinical response and overall survival. Cytokine serum levels did not associate with clinical response in patients with TIL. Patients in the 120Cy/125Flu cohort developed significantly more acute NMA-related adverse events, including thrombocytopenia, febrile neutropenia and cardiotoxicity, and stayed significantly longer in hospital compared with the 60Cy/125Flu and TBI/75Flu cohorts.

Conclusions

Bone marrow depletion and recovery were equally affected by 120Cy/125Flu and 60Cy/125Flu preconditioning; however, toxicity and consequently duration of hospitalization were significantly lower in the 60Cy/125Flu cohort. Patients in the 30Cy/75Flu and TBI/75Flu groups rarely developed NMA-induced adverse events; however, both regimens were not efficient in achieving deep bone marrow suppression. Among the regimens, 60Cy/125Flu preconditioning seems to achieve maximum effect with minimum toxicity.