bluuebunny/crossref_metadata_2025 huggingface dataset:
Facial skin esthetic treatments with plasma radiofrequency ablation
Authors: Baroni Adone
Published: March 2021

Background

The field of esthetic dermatology continues to evolve rapidly, and esthetic procedures for facial skin play a key role in it. During recent years, patients have been demanding more non‐invasive and safe technology characterized by satisfactory results and minimal downtime as compared to traditional surgical procedures. In the panorama of facial skin treatments, many options have different indications and limitations.

Aims

The aim of this study was to report the effectiveness of plasma radiofrequency (PRF) ablation in facial skin esthetic treatments, performed with D.A.S. Medical device (Technolux, Italia).

Methods

Once the dermatologist has diagnosed the unsightly facial skin disorder and ascertained that PRF ablation could be an appropriate approach, contraindications to treatment must be excluded. After the patient has signed the informed consent for treatment, it will be possible to proceed with the PRF ablation sessions. According to the esthetic disorder and the area of the face to be treated, PRF ablation is performed at energy and frequency values chosen depending on the case.

Results

Treatments are generally well tolerated by patients, and excellent esthetic results and no side effects are observed.

Conclusions

Even today, plasma radiofrequency ablation is perhaps one of the most versatile minimal invasive techniques, regarding both for variety of indications as well as effectiveness and fast downtime. Its applications are many, ranging from the removal of unsightly skin lesions, to the correction of scars, treatment of blepharochalasis, periocular, and perioral wrinkles, active acne, that distort the homogeneity and the youthful appearance of the face. PRF ablation has shown to be an effective option demonstrating its value in this field.
Integrating Diversity into Distance Research for Added Rigor, Parsimony, and Relevance
Authors: Kostova Tatiana , Beugelsdijk Sjoerd
Published: March 2021

The management of cross‐national differences is of central concern in international business (IB) and international management (IM). Thus, it is not surprising that the concept of distance which captures such differences has received much attention in this field. Lumineau, Hanisch, and Wurtz, in their Point article, seek to strengthen distance research by challenging one of its key assumptions – country level homogeneity – and advancing an alternative view of country differences based on the notion of diversity. We concur with their critique of the homogeneity assumption and with the general idea of bringing in the concept of diversity. However, our approach to this goal is substantially different. Instead ofreplacingdistance with a diversity‐based conceptualization, as they seem to propose, our emphasis is onintegratingdiversity into current distance research. Moving beyond critique and high‐level conceptualizing, we provide a usable roadmap forincorporatingdiversity into distance research both theoretically and empirically. Specifically, we introduce a new construct of intra‐country diversity that captures the condition of within‐country differences, and then, explain how it can be used to enrich distance models, illustrating our approach with several key IB/IM topics. Empirically, we use available cross‐cultural data to illustrate how to account for different degrees and patterns of intra‐country diversity in distance research. Overall, our approach aims at building on, not negating, existing distance research, increasing its rigor and relevance through the concept of diversity, and helping scholars incorporate diversity into their work by providing concrete guidelines and examples.
Clinical management and knowledge of neonatal hypoglycaemia in Germany: A national survey of midwives and nurses
Authors: Roeper Marcia , Salimi Dafsari Roschan , Hoermann Henrike , Hoehn Thomas , Kummer Sebastian , Meissner Thomas
Published: March 2021

Aim

Despite being a common metabolic condition, the detection and care of neonatal hypoglycaemia in Germany largely depends on the infant's health‐care provider, rather than a national protocol. Therefore, this study aimed to evaluate midwives' and nurses' knowledge and management of neonatal hypoglycaemia and to determine the need for national guidelines.

Methods

An anonymous online survey was developed and completed by 127 perinatal nurses and midwives. Descriptive statistics, Mann–Whitney‐U, χ2 and Fisher's exact tests were used to summarise and analyse the results.

Results

In total, 82% of respondents indicated using guidelines but routine blood glucose screening for neonates at risk for hypoglycaemia was rarely reported (44%). A blood glucose concentration of 2.5 mmol/L (45 mg/dL) was considered the treatment threshold by 52% of the respondents. However, the responses to clinical scenarios showed distinct differences regarding the management of neonatal hypoglycaemia. Finally, 49% of respondents reported insufficient knowledge regarding neonatal hypoglycaemia and 77% indicated that they would advocate the implication of enhanced national guidelines.

Conclusions

There is considerable variation in knowledge about the prevention, screening and management of neonatal hypoglycaemia among nurses and midwives in Germany. Enhanced guidelines and education of health‐care professionals are urgently needed to provide the best possible care to all hypoglycaemic newborns.
Moral distress: A theorized model of influences to facilitate mitigation and resilience
Authors: Guzys Diana
Published: March 2021

Moral distress results from the threat to professional moral integrity and identity. This phenomenon is well documented in nursing literature. Persistent and unresolved moral distress is frequently linked to high nursing staff turnover and shortages. Engagement in a structured hermeneutic critical reflective process facilitated identification of micro, meso, and macro factors influencing the experience of moral distress. Following this process, a theorized model was developed to illustrate interactions between influences contributing to the experience of moral distress in nurses. The model highlights where opportunities lay to take action to avoid or minimize the negative consequences of this phenomenon. Professional resilience is achieved via the conscientious development of professional identity and practice of critical reflection, as components of enculturation of nurses into the profession. Undergraduate and further nurse education activities must focus on developing the necessary attitude, confidence, and skills to address issues in practice which contribute to the experience moral distress to build resilience.
The role of IFT140 in early bone healing of tooth extraction sockets
Authors: Zhou Shuang , Li Gongchen , Zhou Tingting , Zhang Shuai , Xue Hui , Geng Jiangyu , Liu Wenjing , Sun Yao
Published: March 2021

Objectives

Primary cilium is a key organelle of regulating bone development and maintenance. The aim of this study is to investigate whether ciliary intraflagellar transporter protein 140 (IFT140) plays a positive role in extraction socket healing by promoting bone formation.

Materials and Methods

A left maxillary first molar extraction model was established using 6‐week‐old Ift140flox/flox (Ctrl group) and Ift140flox/flox, Osx‐cre (cKO group) mice. The maxillary bone samples from 1, 2, and 3 weeks were postoperatively evaluated by micro‐CT, molecular biology, and histomorphometry analysis. Alveolar bone marrow stromal cells (aBMSCs) from 4‐week‐old mice were cultured in vitro and tested for proliferation and osteogenic ability.

Results

Ciliated cells were predominantly observed in the early socket healing stage with highly expressed ciliary protein IFT140. Compared with the Ctrl group, the healing of extraction sockets in the cKO group was significantly delayed. The proliferation and osteogenic differentiation ability of aBMSCs were reduced in the cKO group.

Conclusion

IFT140 has a facilitating role in the early osteogenesis of extraction socket healing and is involved in regulating the proliferation and osteogenic differentiation of aBMSCs.
Lateral Fracture–Dislocation of the Calcaneus: Case Reports and a Systematic Review
Authors: Zhang Chi , Ye Zhao‐ming , Lin Ping , Miao Xu‐dong
Published: March 2021

Objective

To report a case series of calcaneal fracture–dislocations, which have not been described previously in China, and to provide a systematic review to explore the clinic manifestations, methods for diagnoses, and treatments.

Methods

Between January 2018 and December 2019, 4 patients (4 men; average age, 33.0 ± 16.67 years; range, 15–50 years) were diagnosed with fracture–dislocation of the calcaneus and treated by surgery. We also reviewed published cases and studies of calcaneal fracture–dislocations through the databases of PubMed and Web of Science between January 1977 and December 2019.

Results

Between January 2018 and December 2019, 4 cases were identified as calcaneal fracture–dislocations in our hospital. The main clinical manifestations include hindfoot pain, swelling, and deformity. The diagnoses were confirmed via radiographic examination. Two patients underwent open reduction and internal fixation (ORIF) and two were treated with a minimally invasive approach. Diagnosis had been missed in one patient and, consequently, presented with early signs of post‐traumatic arthritis, which may require extra subtalar arthrodesis in the future. Two patients were diagnosed inaccurately but achieved satisfactory outcomes through open reduction and internal fixation. The average follow‐up period was 9.75 ± 5.19 months. Except for the 1 misdiagnosed patient, the other 3 patients showed functional improvement. Only 23 fracture–dislocations of calcaneus cases were reported in the literature between January 1977 and December 2019. There were 15 Sanders type II fractures (65.22%) and 7 (30.43%) Sanders type III fractures, and there was 1 grade II open calcaneal fracture. Among them, 1 was a medial dislocation and 2 were “joint‐elevation” dislocations; the rest of them (20/23, 86.96%) were lateral dislocations. A total of 11 patients (47.83%) exhibited the double‐density sign, and varus tilt of the talus was revealed on plain radiographs for 9 patients (39.13%). Increased Bohler's angle was evident in lateral X‐ray films for 2 patients (2/23, 8.70%). A total of 21 cases (86.96%) were treated with surgical intervention and achieved satisfactory outcomes. Only 1 patient was treated with external fixation. Another 2 patients were treated conservatively and had poor clinic outcomes.

Conclusion

Calcaneal fracture–dislocation is a rare injury that is challenging to treat. Clinical manifestations such as fibular tendon dislocation, the double‐density sign on profile radiography, and abnormal talar tilt in the distal talofibular joint are important signs that may indicate this rare injury pattern. Timely surgical intervention is essential for satisfactory clinic outcomes. Orthopaedic surgeons should be aware of this uncommon injury to avoid misdiagnosis or inappropriate treatment.
Overweight and exercise‐induced bronchoconstriction – Is there a link?
Authors: Malmberg Maiju , Malmberg L. Pekka , Pelkonen Anna S. , Mäkelä Mika J. , Kotaniemi‐Syrjänen Anne
Published: March 2021

Background

The objective of this study was to evaluate the role of body mass index with regard to exercise performance, exercise‐induced bronchoconstriction (EIB), and respiratory symptoms in 7‐ to 16‐year‐old children.

Methods

A total of 1120 outdoor running exercise challenge test results of 7‐ to 16‐year‐old children were retrospectively reviewed. Lung function was evaluated with spirometry, and exercise performance was assessed by calculating distance per 6 minutes from the running time and distance. Respiratory symptoms in the exercise challenge test were recorded, and body mass index modified for children (ISO‐BMI) was calculated for each child from height, weight, age, and gender according to the national growth references.

Results

Greater ISO‐BMI and overweight were associated with poorer exercise performance (P < .001). In addition, greater ISO‐BMI was independently associated with cough (P = .002) and shortness of breath (P = .012) in the exercise challenge. However, there was no association between ISO‐BMI and EIB or with wheeze during the exercise challenge.

Conclusion

Greater ISO‐BMI may have a role in poorer exercise performance and appearance of respiratory symptoms during exercise, but not in EIB in 7‐ to 16‐year‐old children.
Policy Entrepreneurs in Public Administration: A Social Network Analysis
Authors: Petridou Evangelia , Becker Per , Sparf Jörgen
Published: March 2021

This article examines the role of policy entrepreneurs in promoting change in flood risk mitigation at the local level in Sweden through a comparative study of two Swedish municipalities with different approaches to flood risk governance; as a technical issue or a social issue. The municipality in which flood risk mitigation is addressed as a social issue exhibits a larger size of the network mitigating flood risk, more diverse actors involved, and a more central location of the politicians and senior management. Moreover, the analysis points to the salience of a bureaucratic policy entrepreneur in promoting this shift toward addressing it as a social issue, and shows how they use relational strategies to frame the issue as relating to climate change action. The article operationalizes sociability and credibility, two of the attributes of policy entrepreneurs, and thus, contributes to the theoretical and methodological discussion of policy entrepreneurs in general, and as they pertain to environmental policy in particular.

Related Articles

David, Charles‐Philippe. 2015. “Policy Entrepreneurs and the Reorientation of National Security Policy under the G. W. Bush Administration (2001‐04).” Politics & Policy 43 (1): 163‐195. https://doi.org/10.1111/polp.12106

Shock, David R. 2013. “The Significance of Opposition Entrepreneurs on Local Sales Tax Referendum Outcomes.” Politics & Policy 41 (4): 588‐614. https://doi.org/10.1111/polp.12028

Sidha, Zedekia, Patrick Asingo, and Justine Magutu. 2021. “Street‐Level Bureaucrats as Policy Entrepreneurs: The Nexus between Timing of Traffic Enforcement Activities and Road Safety Policy Outcomes.” Politics & Policy Early View. https://doi.org/10.1111/polp.12386
A note on lung cancer in the COVID‐19 era
Authors: Aujayeb Avinash
Published: March 2021

See related reply
Monodromy in prolate spheroidal harmonics
Authors: Dawson Sean R. , Dullin Holger R. , Nguyen Diana M. H.
Published: March 2021

We show that spheroidal wave functions viewed as the essential part of the joint eigenfunctions of two commuting operators onhave a defect in the joint spectrum that makes a global labeling of the joint eigenfunctions by quantum numbers impossible. To our knowledge, this is the first explicit demonstration that quantum monodromy exists in a class of classically known special functions. Using an analog of the Laplace–Runge–Lenz vector we show that the corresponding classical Liouville integrable system is symplectically equivalent to the C. Neumann system. To prove the existence of this defect, we construct a classical integrable system that is the semiclassical limit of the quantum integrable system of commuting operators. We show that this is a generalized semitoric system with a nondegenerate focus–focus point, such that there is monodromy in the classical and the quantum systems.
Anticoagulation strategies in continuous renal replacement therapy
Authors: Legrand Matthieu , Tolwani Ashita
Published: March 2021

The most common anticoagulant options for continuous renal replacement therapy (CRRT) include unfractionated heparin (UFH), regional citrate anticoagulation (RCA), and no anticoagulation. Less common anticoagulation options include UFH with protamine reversal, low‐molecular weight heparin (LMWH), thrombin antagonists, and platelet inhibiting agents. The choice of anticoagulant for CRRT should be determined by patient characteristics, local expertise, and ease of monitoring. The Kidney Disease Improving Global Outcomes (KDIGO) acute kidney injury guidelines recommend using RCA rather than UFH in patients who do not have contraindications to citrate and are with or without increased risk of bleeding. Monitoring should include evaluation of the anticoagulant effect, circuit life, filter efficacy, and complications.
Evolution from syn‐rift carbonates to early post‐rift deep‐marine intraslope lobes: The role of rift basin physiography on sedimentation patterns
Authors: Privat Aurélia M‐L. J. , Hodgson David M. , Jackson Christopher A‐L. , Schwarz Ernesto , Peakall Jeff
Published: March 2021

The stratigraphic architecture of Early Jurassic strata exposed along a >10 km long transect in the Chachil Graben, an exhumed marine rift depocentre in the Neuquén Basin (Argentina), provides insights into the sedimentological and stratigraphic expression of the syn‐rift to post‐rift transition. A change from syn‐rift intrabasinal carbonate to post‐rift extrabasinal siliciclastic sedimentation is recorded, as well as variations in sediment supply and dispersal patterns across rift‐related topography. The late syn‐rift was marked by a transgression and development of a shallow‐marine carbonate system, including carbonate platform deposits perched on fault‐block highs and periplatform deposits accumulated in fault‐block lows, which overlies continental volcano‐sedimentary syn‐rift deposits. Differential subsidence and basin deepening induced retrogradation of the carbonate system, which was progressively drowned and overlain by organic‐rich calcareous mudstone that draped across rift structures at the onset of the early post‐rift. The first extrabasinal siliciclastic influx led to progradation of an early post‐rift intraslope lobe complex into the graben, which is associated with kilometre‐scale clastic injectites. The depositional architecture, facies distribution and pinch‐out style of intraslope lobes record the effects of an inherited compaction hinge, which acted as an oblique counterslope to sediment gravity flows. The occurrence of combined‐flow bedforms, widespread erosion, and limited facies segregation across lobes bearing different hybrid event bed types, is in sharp contrast to sedimentological characteristics of existing intraslope lobe models. Documentation of the syn‐rift to post‐rift transition stratigraphy permitted identification of changes in thickness and facies resulting from the passive infill of inherited topography with early post‐rift differential compaction. This architecture contrasts markedly with those developed during syn‐rift normal faulting. Furthermore, the influence of local inherited topography on the development of early post‐rift lobes is key to improve subsurface prediction of sandstone distribution and quality during assessment of hydrocarbon reservoirs and carbon storage sites.
Circular Beams Loaded Normal to the Plane of Curvature—2
Authors: Hogan Mervin B.
Published: March 2021

Expressions are presented in this paper for the deflection, angle of slope, and angle of twist of the free end of a circular cantilever beam with a bending moment applied at the free end. Like expressions are also given for the same beam with a twisting moment acting at the free end. The values of the reaction and the angles of slope and twist at the simple support are given for a circular beam built in at one end, simply supported at the other, and loaded as in each of the foregoing cases. Also, equations are included for the three internal reactions, i.e., bending moment, twisting moment, and shear existing at the plane of symmetry of a cantilever arc beam, built in at both ends, with an arbitrarily placed concentrated load acting perpendicular to the plane of the beam, and at its center line. Corresponding expressions for the same element with a uniformly distributed load covering the half of the beam to one side of the axis of symmetry, and an expression for the bending moment at the plane of symmetry of the same beam when its entire length is uniformly loaded, are also stated.
Measurement of the Damping of Engineering Materials During Flexural Vibration at Elevated Temperatures
Authors: Schabtach Carl , Fehr R. O.
Published: March 2021

The method and equipment developed and used by the authors for measuring the damping of materials are described. A tuning-fork specimen is set into vibration by jerking a spreader from the gap between the ends of the tines. The damping is expressed in terms of the logarithmic decrement of the decaying vibration, which is measured and recorded by means of a magnetic oscillograph, amplifiers, and a resistance-type electric strain gage cemented to the specimen. The results include (1) the damping of a number of materials during flexural vibration at approximately 1000 cycles per sec, at maximum bending stresses up to 40,000 psi, and at temperatures up to 1400 F; (2) the variation in modulus of elasticity with temperature, as determined from the specimen vibration frequencies.
The Bending of the Cylindrically Aeolotropic Plate
Authors: Carrier G. F.
Published: March 2021

In this paper, the small-deflection theory, applicable to plates of cylindrically aeolotropic material, is presented, and expressions are obtained for the moments and deflections produced by the following combinations of loading and boundary conditions: The disk clamped along its circumference and loaded by a uniform lateral pressure; the clamped disk loaded by a central concentrated force; the simply supported disk loaded by uniform edge moment; the disk with a rigid core clamped along its circumference and loaded by a central concentrated force; the ring clamped along its outer edge and loaded by a uniform shear distribution along the inner edge; the simply supported disk with an elastic isotropic core loaded by a uniform edge moment; and the disk under the loading given by p = p0 r cos θ. The six symmetrical problems of this group were chosen for evaluation since they and their linear combinations comprise a large part of the total set of such problems. Curves are included showing, for three of the foregoing problems, the effect of the degree of anisotropy on the stresses. The practical application of solutions obtained by the following theory might lie, for example, in design problems involving circular plates which are built up of laminas of radial symmetry with different tangential and radial stiffnesses. The theory could also be applied to the design of circular concrete slabs with different amounts of reinforcing steel in the radial and tangential directions.
Basic Mechanics of the Metal-Cutting Process
Authors: Merchant M. Eugene
Published: March 2021

The author presents a mathematical analysis of the geometry and mechanics of the metal-cutting process, covering two common types of geometry which occur in cutting. This analysis offers a key for the study of engineering problems in the field of metal cutting in terms of such fundamental quantities as strain, rate of shear, friction between chip and tool, shear strength of the metal, work done in shearing the metal and in overcoming friction, etc. The two cases covered are, in essence, that of a straight-edged cutting tool moving relative to the work-piece in a direction perpendicular to its cutting edge, termed “orthogonal cutting,” and that of a similar cutting tool so set that the cutting edge is oblique to the direction of relative motion of tool and work, termed “oblique cutting.” Equations are developed which permit the calculation of such quantities as those just enumerated from readily observable values. The theoretical findings are particularly applicable and significant in the case of present-day high-speed machining operations with sintered-carbide tools.
Studies in Three-Dimensional Photoelasticity Torsional Stresses by Oblique Incidence
Authors: Frocht Max M.
Published: March 2021

In this paper a photoelastic method is described for the study of stresses in cylindrical shafts due to pure torsion. The basic photoelastic equation governing this case is derived. It is shown that the maximum stresses, i.e., the boundary stresses, can be determined from a single stress pattern, and that the two stress components which define the complete stress system in pure torsion at an interior point can be determined from two stress patterns obtained from one section of a shaft into which the pure-torsion system has been frozen, employing to this end the Drucker-Mindlin suggestion of oblique incidence. The method is applied to a circular shaft, and the experimental results are found to be in complete agreement with the theory.
Scaling relations for brittle fracture of entangled polystyrene melts and solutions in elongational flow
Authors: Wagner Manfred H. , Narimissa Esmaeil , Huang Qian
Published: March 2021

The criterion for brittle fracture of entangled polymer liquids [Wagner et al., J. Rheol. 62, 221–223 (2018)] is extended by including the effects of finite chain extensibility and polymer concentration. Crack initiation follows from rupture of primary C–C bonds, when the strain energy of entanglement segments reaches the energy of the covalent bond. Thermal fluctuations will concentrate the strain energy on one C–C bond of entanglement segments, leading to bond scission and rupture of polymer chains followed by crack initiation and fast crack growth. In start-up flows, entanglement segments characterized by long relaxation times, i.e., predominantly those in the middle of the polymer chain, will be the first to reach the critical strain energy and will fracture. Recent experimental data of Huang [Phys. Fluids 31, 083105 (2019)] of fracture of a monodisperse polystyrene melt and of several solutions of monodisperse polystyrenes dissolved in oligomeric styrene are in agreement with the scaling relations for critical Weissenberg number as well as Hencky strain and stress at fracture derived from this fracture criterion and the extended interchain pressure model [Narimissa, Huang, and Wagner, J. Rheol. 64, 95–110 (2020)].
Lava lake rises at dangerous African volcano
Authors: Pease Roland
Published: March 2021

Funding for volcano's lone monitoring station lost as warning signs flash.
Scientists and science are on the ballot
Authors: Mervis Jeffrey
Published: March 2021

Chemistry professor hopes to become first female Ph.D. scientist in Congress.
Evaluation of Specimen Types and Saliva Stabilization Solutions for SARS-CoV-2 Testing
Authors: Griesemer Sara B. , Van Slyke Greta , Ehrbar Dylan , Strle Klemen , Yildirim Tugba , Centurioni Dominick A. , Walsh Anne C. , Chang Andrew K. , Waxman Michael J. , St. George Kirsten
Published: March 2021

Identifying SARS-CoV-2 infections through aggressive diagnostic testing remains critical to tracking and curbing the spread of the COVID-19 pandemic. Collection of nasopharyngeal swabs (NPS), the preferred sample type for SARS-CoV-2 detection, has become difficult due to the dramatic increase in testing and consequent supply strain.
Longitudinal Multi-omics and Microbiome Meta-analysis Identify an Asymptomatic Gingival State That Links Gingivitis, Periodontitis, and Aging
Authors: Huang Shi , He Tao , Yue Feng , Xu Xiujun , Wang Lijiang , Zhu Pengfei , Teng Fei , Sun Zheng , Liu Xiaohui , Jing Gongchao , Su Xiaoquan , Jin Lijian , Liu Jiquan , Xu Jian
Published: March 2021

A significant portion of world population still fails to brush teeth daily. As a result, the majority of the global adult population is afflicted with chronic gingivitis, and if it is left untreated, some of them will eventually suffer from periodontitis.
Anode Surface Bioaugmentation Enhances Deterministic Biofilm Assembly in Microbial Fuel Cells
Authors: Yanuka-Golub Keren , Dubinsky Vadim , Korenblum Elisa , Reshef Leah , Ofek-Lalzar Maya , Rishpon Judith , Gophna Uri
Published: March 2021

Mixed microbial communities play important roles in treating wastewater, in producing renewable energy, and in the bioremediation of pollutants in contaminated environments. While these processes are well known, especially the community structure and biodiversity, how to efficiently and robustly manage microbial community assembly remains unknown.
A Small Molecule Coordinates Symbiotic Behaviors in a Host Organ
Authors: Zink Katherine E. , Ludvik Denise A. , Lazzara Phillip R. , Moore Terry W. , Mandel Mark J. , Sanchez Laura M.
Published: March 2021

The complexity of animal microbiomes presents challenges to defining signaling molecules within the microbial consortium and between the microbes and the host. By focusing on the binary symbiosis between
Vibrio fischeri
and
Euprymna scolopes
, we have combined genetic analysis with direct imaging to define and study small molecules in the intact symbiosis.
Graves’ disease inducing a massive cardiac tamponade
Authors: Fonseca Elisabeth Martinez , Schonhofen Igor , Toralles Maria Pereira , de Carvalho Jozelio Freire
Published: March 2021

A 23-year-old woman was diagnosed with Graves’ disease 5 months ago with decompensated thyroid function, for which she is taking thiamazole and propranolol. She developed progressive respiratory dyspnoea [New York Heart Association (NYHA) class III] and frequent palpitations. On emergency admission, the patient was tachypnoeic, hypotensive (77/54 mm Hg) and tachycardic (120 beats per minute), with an oxygen saturation of 94%. She also presented with cold, swollen and shaky extremities, with extended capillary filling time, and a significant reduction in heart sounds. Echocardiogram showed massive pericardial effusion compatible with cardiac tamponade. Pericardiocentesis was performed, with a drainage of 1420 mL serosanguinolent fluid, with prompt haemodynamic recovery. Analysis of the pericardial fluid showed exudates. A diagnosis of pericardial effusion secondary to Graves’ disease was determined and corticotherapy, lithium carbonate, cholestyramine and phenobarbital were prescribed. An oral iodine-131 was performed and the patient showed reasonable control of the clinical manifestations of hyperthyroidism. After 3 months, the patient showed no symptoms of hyperthyroidism and a new echocardiogram revealed a significant reduction in pericardial effusion.
Targeted rehabilitation may improve patient flow and outcomes: development and implementation of a novel Proactive Rehabilitation Screening (PReS) service
Authors: Wu Jane , Misa Olivia , Shiner Christine T , Faux Steven G
Published: March 2021

Rehabilitation programmes can be delivered to patients receiving acute care (‘in-reach rehabilitation’) and/or those who have completed acute care but experience ongoing functional impairments (‘subacute rehabilitation’). Access to these programmes depends on a rehabilitation assessment, but there are concerns that referrals for this assessment are often triggered too late in the acute care journey. We describe a Proactive Rehabilitation Screening (PReS) process designed to systematically screen patients during an acute hospital admission, and identify early those who are likely to require specialist rehabilitation assessment and intervention. The process is based on review of patient medical records on day 5 after acute hospital admission, or day 3 after transfer from intensive care to an acute hospital ward. Screening involves brief review of documented care needs, pre-existing and new functional disabilities, the need for allied health interventions and non-medical factors delaying discharge. From May 2017 to February 2019, the novel screening process was implemented as part of a service redesign of the rehabilitation consultation service. Four thousand consecutive screens were performed at the study site. Of those ‘ruled in’ by screening as needing a rehabilitation assessment, 86.0% went on to receive inpatient rehabilitation interventions. Of those ‘ruled out’ by screening, 92.1% did not go on to receive a rehabilitation intervention, while 7.9% did receive some form of rehabilitation intervention. Of all patients accepted into a rehabilitation programme (n=516), PReS was able to identify 53.6% (n=282) of them before the acute care teams made a referral (based on traditional criteria). In conclusion, we have designed and implemented a systematic, PReS service in one metropolitan Australian hospital. The process described was found to be time efficient and feasible to implement in an acute hospital setting. Further, it appeared to identify the majority of patients who went on to receive formal inpatient rehabilitation interventions.
Clinical outcome of COVID-19 in patients with adult congenital heart disease
Authors: Schwerzmann Markus , Ruperti-Repilado Francisco Javier , Baumgartner Helmut , Bouma Berto , Bouchardy Judith , Budts Werner , Campens Laurence , Chessa Massimo , del Cerro Marin Maria Jesús , Gabriel Harald , Gallego Pastora , Garcia-Orta Rocio , Gonzalez Ana Elvira , Jensen Annette Schophuus , Ladouceur Magalie , Miranda-Barrio Berta , Morissens Marielle , Pasquet Agnes , Rueda Joaquín , van den Bosch Annemien E , van der Zwaan Heleen Berdina , Tobler Daniel , Greutmann Matthias
Published: March 2021

Aims

Patients with adult congenital heart disease (ACHD) are a potentially vulnerable patient cohort in case of COVID-19. Some cardiac defects may be associated with a poor COVID-19 outcome. Risk estimation in ACHD is currently based on expert opinion. The aim of this study was to collect clinical outcome data and to identify risk factors for a complicated course of COVID-19 in patients with ACHD.

Methods

Twenty-five ACHD centres in nine European countries participated in the study. Consecutive patients with ACHD diagnosed with COVID-19 presenting to one of the participating centres between 27 March and 6 June 2020 were included. A complicated disease course was defined as hospitalisation for COVID-19 requiring non-invasive or invasive ventilation and/or inotropic support, or a fatal outcome.

Results

Of 105 patients with a mean age of 38±13 years (58% women), 13 had a complicated disease course, of whom 5 died. In univariable analysis, age (OR 1.3, 95% CI 1.1 to 1.7, per 5 years), ≥2 comorbidities (OR 7.1, 95% CI 2.1 to 24.5), body mass index of >25 kg/m2 (OR 7.2, 95% CI 1.9 to 28.3) and cyanotic heart disease (OR 13.2, 95% CI 2.5 to 68.4) were associated with a complicated disease course. In a multivariable logistic regression model, cyanotic heart disease was the most important predictor (OR 60.0, 95% CI 7.6 to 474.0).

Conclusions

Among patients with ACHD, general risk factors (age, obesity and multiple comorbidities) are associated with an increased risk of complicated COVID-19 course. Congenital cardiac defects at particularly high risk were cyanotic lesions, including unrepaired cyanotic defects or Eisenmenger syndrome.
Percutaneous transorbital direct puncture to obliterate a cavernous sinus dural arteriovenous fistula
Authors: Cavalcanti Daniel D , Raz Eytan , Shapiro Maksim , Mir Osman , Nossek Erez , Nelson Peter Kim
Published: March 2021

Cavernous sinus dural arteriovenous fistulas (CS-DAVF) can have an indolent course, with insidious onset, but still showing a high likelihood of spontaneous resolution.1 Nevertheless, symptoms in a subset of patients evolve more rapidly, with malignant signs on imaging, warranting intervention.2 We report on a patient in his 40s presenting with redness and proptosis of the right eye, intermittent blurred vision and diplopia. Once ophthalmological examination revealed increased intraocular pressure and imaging showed cortical venous congestion, the decision was made to obliterate a CS-DAVF involving the posteromedial right cavernous sinus.

Multiple arteries including branches of the ascending pharyngeal artery, occipital artery and bilateral meningohypophyseal trunks supplied the fistula. Once transarterial embolization was deemed unsafe and both inferior petrosal sinuses did not grant access to the right cavernous sinus, a direct puncture to the cavernous sinus was performed to successfully coil the involved compartments.3–5 The aid of DynaCT imaging and needle guidance software is emphasized (video 1).

Video 1
How to enhance recruitment of individuals at risk of rheumatoid arthritis into trials aimed at prevention: understanding the barriers and facilitators
Authors: van Boheemen Laurette , ter Wee Marieke M , Seppen Bart , van Schaardenburg Dirkjan
Published: March 2021

Objectives

Several trials to test the efficacy of a pharmacological intervention aimed at primary prevention of rheumatoid arthritis (RA) are ongoing or have recently been completed. A common issue in these trials is the severe difficulty with patient recruitment. In order to enhance recruitment, this qualitative study identified barriers and facilitators of individuals at risk of RA to participate in a prevention trial.

Methods

Individuals at risk of developing RA (ie, arthralgia with anticitrullinated protein antibodies and/or rheumatoid factor without arthritis), who had previously been asked to participate in a prevention trial, participated in focus group discussions (n=18) exploring their facilitators and barriers for trial participation. Thematic analysis identified factors that were important in at-risk individuals’ decision about trial participation.

Results

The prospect of personal benefit, the acknowledgement of one’s symptoms and the desire to contribute to society facilitated trial participation. In contrast, misconception about what it means to be at risk, or about the aim of the prevention trial, negative views on trial medication, and a low perceived urgency to act on the possibility of developing RA versus a high perceived burden of participating in a trial discouraged participation.

Conclusions

To enhance inclusion in trials aimed to prevent RA, the results suggest to use strategies such as optimising education about RA, personal risk, trial aim and trial medication, explicitly addressing misconceptions and concerns, using tools to improve information provision, limiting study burden in trial design and encouraging physicians to mention trial participation.
Molecular characterization of a novel mutation in the E1 flowering gene induced by gamma irradiation in soybean
Authors: Rani Anita , Kumar Vineet , Shukla Shruti , Manjaya J.G.
Published: March 2021

Soybean is a typical short-day (SD) plant. It undergoes reproductive growth only when the day length becomes shorter than a critical length. Fourteen major genes/loci affecting soybean flowering and maturity period have been mapped to date. These are E1 and E7 on chr6, E1La, E1Lb, E6, E8, and J on chr4, E2 on chr10, E3 on chr19, E4 on chr20, E9 on chr6, E10 on chr8, Dt1 on chr19, and GmAGL1 on chr14. The functional allele of all these genes, except E6, E9, J, and GmAGL1, delay flowering, while the non-functional counterpart accelerates flowering and maturity. The contribution of the E1 gene in delaying flowering is highest. Four non-functional/dysfunctional allelic variants of the E1 gene are already known, which accelerates the flowering by 20–25 days and are being used in development of early maturing soybean varieties in many parts of the world. In this study, seeds of the late maturing Indian variety NRC 37 were irradiated with gamma rays to develop an early maturing variety. One early maturing variant was obtained. Molecular characterization of the gene responsible for early flowering proved it to be a non-functional variant of the E1 gene with major deletion.
Theoretical prediction of structural stability, elastic and magnetic properties for Mn2NiGa alloy
Authors: Bai Jing , Wang Jinlong , Shi Shaofeng , Liang Xinzeng , Yang Yiqiao , Yan Haile , Zhao Xiang , Zuo Liang , Zhang Yudong , Esling Claude
Published: March 2021

The parent phase structure of Mn2NiGa has always been controversial in the past decade. The ground state energy of the conventional cubic structure is higher than that of the Hg2CuTi structure, while the widely accepted Hg2CuTi structure for the parent phase does not satisfy with the mechanical stability criteria. In this work, a new configuration was found by the first-principles calculations. Its total energy is lower than that of the Hg2CuTi structure. Moreover, the elastic constants of this new structure can satisfy the criteria of mechanical stability. This suggests that the newly proposed structure is more likely than Hg2CuTi-type for the parent phase of the Mn2NiGa alloys.
Solitons in spin-tensor–momentum-coupled Bose–Einstein condensates
Authors: Liu Yun , Liu Yong-Kai
Published: March 2021

Recently spin-tensor–momentum coupling (STMC) has been proposed to realize in the Bose–Einstein condensate (BEC). Here, we study the bright soliton in spin-1 three components BEC with STMC. The properties of the bright solitons are discussed by the analytical solutions and numerical solutions. In addition, we also study its dynamic evolution and discover the spontaneous motion, which is different from the spin-orbit-coupled solitons.
DYNAMICAL BEHAVIOR OF STOCHASTIC COMPETITION BETWEEN PLASMID-BEARING AND PLASMID-FREE ORGANISMS IN A CHEMOSTAT MODEL
Authors: LIU XIAOJUAN , SUN SHULIN
Published: March 2021

In this paper, a model of stochastic competition between plasmid-bearing and plasmid-free organisms in a chemostat is investigated. First, we show that there is a unique global positive solution for the stochastic system. Second, by employing stochastic Lyapunov functions, Itô formula, strong law of large number and some other important inequalities, stochastic characteristics of the stochastic competition chemostat model are studied such as the stochastic asymptotic behaviors of the system. Finally, some numerical simulations are given.
Terreneuvian bio- and chemostratigraphy of the South Sichuan Region (South China)
Authors: Yang Ben , Steiner Michael
Published: March 2021

Classical sections, such as the Maidiping and Daqiao Mine sections of South Sichuan (China), expose early Cambrian deposits that are crucial for understanding the biological and environmental evolution of Yangtze Craton. These sequences are rich in Terreneuvian small shelly fossils, which can be assigned to assemblages I and III from South China. The
Anabarites trisulcatus
–
Protohertzina anabarica
Assemblage Zone (Assemblage I) is recognized at the lower Maidiping Formation. The second assemblage (
Paragloborilus subglobosus
–
Purella squamulosa
Assemblage Zone) cannot be verified in South Sichuan, although previous reports claimed its existence based on the occurrence of
Paragloborilus subglobosus
. The third assemblage (
Watsonella crosbyi
Assemblage Zone) is confirmed in the upper Maidiping Formation. The abundant bioclasts in this interval indicate abrasions and bioerosions by winnowing or starved sedimentation. Carbon isotope values from the Maidiping section present no negative excursion at the presumed Ediacaran–Cambrian transition. A positive carbon isotope excursion is observed in the Upper Maidiping Formation (Assemblage III) which is correlated to the ZHUCE excursion in the Dahai Member of eastern Yunnan. The shallow-water deposits of South Sichuan can be correlated with the South China, western Mongolia and Siberia successions based on biozonations and carbon isotope trends.

Supplementary material:
Isotope data are available at
https://doi.org/10.6084/m9.figshare.c.5326834

Thematic collection:
This article is part of the Advances in the Cambrian Explosion collection available at:
https://www.lyellcollection.org/cc/advances-cambrian-explosion
Developmental capacity and the early evolution of animals
Authors: Erwin Douglas H.
Published: March 2021

Disentangling the factors underlying the appearance of macroscopic, often skeletonized, bilaterians during the Ediacaran–Cambrian diversification of animals requires carefully parsing the contributions of ecological opportunity, environmental potential and developmental capacity. The early evolution of animals involved the introduction of genomic, developmental, morphologic and behavioural novelties, identified as the individuation of new characters, which led to the construction of new ecological networks (innovation). Here I employ a recently introduced conceptual framework for novelty and individuation that distinguishes between potentiation, novelty, innovation and adaptive adjustments to the Ediacaran–Cambrian Radiation, and focus on the roles of potentiation and novelty in the expansion of developmental capacity. Comparative developmental studies combined with molecular clock estimates and data from the fossil record suggest that developmental capacity, the potential to generate a range of morphologies, may expand rapidly through developmental novelties without leading directly to morphological novelties, or to innovation. The expected patterns from this framework are markedly different from those in adaptive radiation scenarios.

Thematic collection:
This article is part of the Advances in the Cambrian Explosion collection available at:
https://www.lyellcollection.org/cc/advances-cambrian-explosion
A Reusable Characterization of the Memory System Behavior of SPEC2017 and SPEC2006
Authors: Hassan Muhammad , Park Chang Hyun , Black-Schaffer David
Published: March 2021

The SPEC CPU Benchmarks are used extensively for evaluating and comparing improvements to computer systems. This ubiquity makes characterization critical for researchers to understand the bottlenecks the benchmarks do and do not expose and where new designs should and should not be expected to show impact. However, in characterization there is a tradeoff between accuracy and reusability: The more precisely we characterize a benchmark’s performance on a given system, the less usable it is across different micro-architectures and varying memory configurations. For SPEC, most existing characterizations include system-specific effects (e.g., via performance counters) and/or only look at aggregate behavior (e.g., averages over the full application execution). While such approaches simplify characterization, they make it difficult to separate the applications’ intrinsic behavior from the system-specific effects and/or lose the diverse phase-based behaviors.

In this work we focus on characterizing the applications’ intrinsic memory behaviour by isolating them from micro-architectural configuration specifics. We do this by providing a simplified generic system model that evaluates the applications’ memory behavior across multiple cache sizes, with and without prefetching, and over time. The resulting characterization can be reused across a range of systems to understand application behavior and allow us to see how frequently different behaviors occur. We use this approach to compare the SPEC 2006 and 2017 suites, providing insight into their memory system behaviour beyond previous system-specific and/or aggregate results. We demonstrate the ability to use this characterization in different contexts by showing a portion of the SPEC 2017 benchmark suite that could benefit from giga-scale caches, despite aggregate results indicating otherwise.
Statistical Connectomics
Authors: Chung Jaewon , Bridgeford Eric , Arroyo Jesús , Pedigo Benjamin D. , Saad-Eldin Ali , Gopalakrishnan Vivek , Xiang Liang , Priebe Carey E. , Vogelstein Joshua T.
Published: March 2021

The data science of networks is a rapidly developing field with myriad applications. In neuroscience, the brain is commonly modeled as a connectome, a network of nodes connected by edges. While there have been thousands of papers on connectomics, the statistics of networks remains limited and poorly understood. Here, we provide an overview from the perspective of statistical network science of the kinds of models, assumptions, problems, and applications that are theoretically and empirically justified for analysis of connectome data. We hope this review spurs further development and application of statistically grounded methods in connectomics.