bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigation on Tripping in Magnetic Generator in Steam-Assisted Gravity Drainage Wells Based on Numerical Simulation
Authors: Chen Yong , Su An Qiao , Zhang Jin Tao , Jia Zong Sheng
Published: October 2020

Magnetic Guidance Technology can meet the precise measurement requirements when drilling steam-assisted gravity drainage (SAGD) oil wells. Magnetic generator is a key part in the Magnetic Guidance Technology. When magnetic generator is tripped into horizontal well, pump pressure and passing capacity of the magnetic source generator in the curved section need to be analyzed. So, a mathematical model of tripping in the magnetic generator is established. If curvature radius, deviation angle, and friction factor are known, the forces acting on the magnetic generator in different positions could be calculated. The finite element (FE) results show that: (1) with depth increasing in the curved section, the equivalent stress on the magnetic generator increases in a fluctuating manner, the contact area, friction drag, and energy loss increase. (2) The greater the hole curvature, the greater tripping in force and the higher pump pressure are needed. The lower friction coefficient is favorable to tripping in the magnetic generator. (3) The friction between the magnetic generator and tubing wall in the horizontal section is much less than that in the curved section. Field applications have shown that the maximum downforce is close to the result of finite element analysis. The research results provide a reasonable reference basis for smooth running of magnetic source generators with different trajectory conditions.
Lattice Discrete Particle Modeling of Size Effect in Slab Scratch Tests
Authors: Han Lin , Pathirage Madura , Akono Ange-Therese , Cusatis Gianluca
Published: October 2020

For a long time, geomechanicians have used scratch tests to characterize the compressive behavior and hardness of rocks. In recent years, this test has regained popularity in the field of mechanics, especially after a series of publications that highlighted the potential capability of the scratch test to determine the fracture properties of quasi-brittle materials. However, the complex failure mechanisms observed experimentally in scratch tests led to scientific debates and, in particular, raised the question of the size effect. This article intends to provide a better understanding of the problem by using numerical tools and fracture mechanics considerations. To narrow the investigation area, this study focuses on slab scratch tests of quasi-brittle materials and adopts two different numerical methods: (i) the lattice discrete particle model (LDPM) that includes constitutive laws for cohesive fracturing, frictional shearing, and nonlinear compressive behavior, and (ii) the meshless method based on Shepard function and partition of unity (MSPU) implementing linear elastic fracture mechanics (LEFM). The numerical results are further analyzed through Bažant’s size effect law (SEL) with an appropriate mixed-mode fracture criterion. Fracture properties are then calculated and compared to the results of typical notched three-point bending tests. The results show that mixed-mode fracture considerations are of paramount importance in analyzing the fracture process and size effect of scratch tests.
Exergaming as a Community Program for Older Adults: The Effects of Social Interaction and Competitive Information
Authors: Li Jinhui , Li Chen , Chia Bing Xun , Chen Xinran , Pham Tan Phat , Theng Yin-Leng
Published: October 2020

This study examined how different types of social interaction and competitive information in exergaming affect older adults’ motivation and attitude toward playing exergames. A 2 (time: pre- vs. posttest) × 3 (social interaction: play alone vs. play with peer vs. play with youth) × 2 (competition: competition informed vs. noncompetition informed) mixed experiment was conducted with 319 Singaporean older adults over 6 weeks through a three-way analysis of variance. Social interaction was found to significantly affect the changes of extrinsic motivation over time, while competitive information affected intrinsic motivation significantly. The results showed significant three-way interaction effects between time, social interaction, and competitive information on older adults’ extrinsic and intrinsic motivations. The changes of attitude over time were not affected by either social interaction or competitive information. The findings contribute to aging research and advance the knowledge of potential factors that promote the effective implementation of exergames for community older adults.
Barriers to Implementation of Physical Activity in Danish Public Schools
Authors: Koch Sofie , Troelsen Jens , Cassar Samuel , Pawlowski Charlotte Skau
Published: October 2020

Purpose: In 2014, the Danish Government introduced a new public school reform, which included implementation of 45 min of daily physical activity (PA) within the academic classroom curriculum. The purpose of the present study was to explore school staff’s perceived barriers to implementation of a national PA policy. Method: A mixed-methods approach using a questionnaire and semistructured interviews was conducted. A total of 198 teachers and 26 school management team members (principals, deputy principals, and leading teachers) from 31 schools completed a questionnaire, and 11 school management team members were interviewed. The socioecological model was used as a theoretical framework to examine the results. Results: A total of 15 different barriers were identified and reflected within all levels of the socioecological model. Facilities, motivation, and time were the most prominent barriers identified. Conclusion: Development and deployment of a national PA policy needs to be done in cooperation with consumers from all levels within the socioecological model to ensure successful implementation.
Effects of Mirror and Metronome Use on Spontaneous Dance Movements
Authors: Brown Derrick D. , Bosga Jurjen , Meulenbroek Ruud G.J.
Published: October 2020

This study investigated effects of mirror and metronome use on spontaneous upper body movements by 10 preprofessional dancers in a motor task in which maximally diverse upper body movement patterns were targeted. Hand and trunk accelerations were digitally recorded utilizing accelerometers and analyzed using polar frequency distributions of the realized acceleration directions and sample entropy of the acceleration time. Acceleration directions were more variably used by the arms than by the torso, particularly so when participants monitored their performance via a mirror. Metronome use hardly affected the predictability of the acceleration time series. The findings underscore the intrinsic limitations that people experience when being asked to move randomly and reveal moderate effects of visual and acoustic constraints on doing so in dance.
Efforts to control monkey brains get a boost
Authors: Servick Kelly
Published: October 2020

With open data project, primate optogenetics confronts stumbling blocks.
AAAS drafts plan to address systemic racism in sciences
Authors: Ham Becky
Published: October 2020

Diversity assessment within the organization's programs among plan's first steps
Multi-omics analyses of radiation survivors identify radioprotective microbes and metabolites
Authors: Guo Hao , Chou Wei-Chun , Lai Yunjia , Liang Kaixin , Tam Jason W. , Brickey W. June , Chen Liang , Montgomery Nathan D. , Li Xin , Bohannon Lauren M. , Sung Anthony D. , Chao Nelson J. , Peled Jonathan U. , Gomes Antonio L. C. , van den Brink Marcel R. M. , French Matthew J. , Macintyre Andrew N. , Sempowski Gregory D. , Tan Xianming , Sartor R. Balfour , Lu Kun , Ting Jenny P. Y.
Published: October 2020

Radioprotective bacteria

A common symptom of radiation treatment for cancer is gastrointestinal disruption. The damage caused can become so severe and debilitating that it interrupts treatment. Guo
et al.
noticed that mice surviving experimental radiation exposure had distinctive taxonomic representation in their gut microbiota. A similar correlation was also observed in a small group of human subjects. Further experiments in mice revealed that some strains of bacteria produced high levels of short-chain fatty acids, which seemed to be dampening inflammatory responses and alleviating the damage caused by reactive oxygen species released by the radiation. A metabolomics analysis also implicated a role for tryptophan metabolic pathways in radiation survivorship.

Science
, this issue p.
eaay9097
Metal-organic magnets with large coercivity and ordering temperatures up to 242°C
Authors: Perlepe Panagiota , Oyarzabal Itziar , Mailman Aaron , Yquel Morgane , Platunov Mikhail , Dovgaliuk Iurii , Rouzières Mathieu , Négrier Philippe , Mondieig Denise , Suturina Elizaveta A. , Dourges Marie-Anne , Bonhommeau Sébastien , Musgrave Rebecca A. , Pedersen Kasper S. , Chernyshov Dmitry , Wilhelm Fabrice , Rogalev Andrei , Mathonière Corine , Clérac Rodolphe
Published: October 2020

Lightening the load

Permanent magnets are generally produced from solid metals or alloys. Less dense compositions involving lighter elements tend to demagnetize well below room temperature or under modest applied external fields. Perlepe
et al.
now report that chemical reduction of a low-density chromium-pyrazine network produces a magnet that remains stable above 200°C and resists demagnetization with 7500-oersted coercivity at room temperature. The straightforward synthetic route to the material shows promise for broad exploration of potential applications.

Science
, this issue p.
587
Denisovan ancestry and population history of early East Asians
Authors: Massilani Diyendo , Skov Laurits , Hajdinjak Mateja , Gunchinsuren Byambaa , Tseveendorj Damdinsuren , Yi Seonbok , Lee Jungeun , Nagel Sarah , Nickel Birgit , Devièse Thibaut , Higham Tom , Meyer Matthias , Kelso Janet , Peter Benjamin M. , Pääbo Svante
Published: October 2020

DNA analyses of an early East Asian

Ancient, anatomically modern humans interbred with the archaic hominins Neanderthals and Denisovans. However, the extent of this interbreeding and how it affects modern populations is not well understood. Massilani
et al.
generated genome-wide data from a 34,000-year-old female individual from the Salkhit Valley in eastern Mongolia and conducted a detailed modeling of her ancestry with regard to other Pleistocene human genomes. They found evidence for Denisovan ancestry in ancient human genomes from at least 6000 years before the Salkhit individual lived and determined that the Denisovan contribution differed from that of another ancient Asian individual, as well as from the ancient Denisovan contribution to extant Australasians. This reference point helps us to understand the early history of our species in Eurasia, especially Eastern Eurasia, for which genomic evidence remains scarce.

Science
, this issue p.
579
Parallel single-shot measurement and coherent control of solid-state spins below the diffraction limit
Authors: Chen Songtao , Raha Mouktik , Phenicie Christopher M. , Ourari Salim , Thompson Jeff D.
Published: October 2020

Addressing the many and the individual

The ability to coherently manipulate the quantum state of atomic defects in solid-state systems is a promising route to developing a platform for quantum technologies. A successful platform requires the interaction of many qubits in close proximity, as well as the ability to address each qubit individually, and, to date, such requirements have run counter to each other. Chen
et al.
devised an optical frequency-domain method with which they were able to simultaneously address many individual rare-earth ion defects (six at this point) with separations all within the diffraction limit of the control light. Because the approach is scalable to tens or hundreds of defects, it provides the prospect of realizing truly large-scale quantum processors.

Science
, this issue p.
592
Surface deformation associated with fractures near the 2019 Ridgecrest earthquake sequence
Authors: Xu Xiaohua , Sandwell David T. , Ward Lauren A. , Milliner Chris W. D. , Smith-Konter Bridget R. , Fang Peng , Bock Yehuda
Published: October 2020

Mapping out backward motion

Most deformation associated with an earthquake is, not surprisingly, in the same direction as the fault rupture. Xu
et al.
used satellite imaging to find areas of deformation associated with the 2019 Ridgecrest earthquake sequence that moved in the opposite direction. These regions moved in this direction because of inelastic deformation, which helped to accommodate the overall fault rupture for the sequence. The observations were possible because of improved radar imaging and are likely more common than previously believed.

Science
, this issue p.
605
The vibrant lives of Neanderthals
Kindred
Rebecca Wragg Sykes
Bloomsbury Sigma, 2020. 400 pp.
Authors: Pomeroy Emma
Published: October 2020

A nuanced portrait of our evolutionary cousins encourages empathy and understanding
Should I stay or should I go?
Authors: McKinney Garrett
Published: October 2020

Pinpointing genetic alleles that influence the timing of salmon migration might aid restoration efforts
In Vitro
Activity of Cefepime-Zidebactam, Ceftazidime-Avibactam, and Other Comparators against Clinical Isolates of
Enterobacterales
, Pseudomonas aeruginosa, and Acinetobacter baumannii: Results from China Antimicrobial Surveillance Network (CHINET) in 2018
Authors: Yang Yang , Guo Yan , Yin Dandan , Zheng Yonggui , Wu Shi , Zhu Demei , Hu Fupin
Published: October 2020

This study evaluated the
in vitro
activity of cefepime-zidebactam in comparison with that of ceftazidime-avibactam and other comparators against clinically significant Gram-negative bacillus isolates. A total of 3,400 nonduplicate Gram-negative clinical isolates were collected from 45 medical centers across China in the CHINET Program in 2018, including
Enterobacterales
(
n
 = 2,228),
Pseudomonas aeruginosa
(
n
 = 657), and
Acinetobacter baumannii
(
n
 = 515).
Detection and Characterization of Swine Origin Influenza A(H1N1) Pandemic 2009 Viruses in Humans following Zoonotic Transmission
Authors: Cook Peter W. , Stark Thomas , Jones Joyce , Kondor Rebecca , Zanders Natosha , Benfer Jeffrey , Scott Samantha , Jang Yunho , Janas-Martindale Alicia , Lindstrom Stephen , Blanton Lenee , Schiltz John , Tell Rachel , Griesser Richard , Shult Peter , Reisdorf Erik , Danz Tonya , Fry Alicia , Barnes John , Vincent Amy , Wentworth David E. , Davis C. Todd
Published: October 2020

Influenza virus infects a wide range of hosts, resulting in illnesses that vary from asymptomatic cases to severe pneumonia and death. Viral transfer can occur between human and nonhuman hosts, resulting in human and nonhuman origin viruses circulating in novel hosts. In this work, we have identified the first case of a swine-origin influenza A(H1N1)pdm09 virus resulting in a human infection. This shows that these viruses not only circulate in swine hosts, but are continuing to evolve and distinguish themselves from previously circulating human-origin influenza viruses. The development of techniques for distinguishing human-origin and swine-origin viruses are necessary for the continued surveillance of influenza viruses. We show that unique genetic signatures can differentiate circulating swine-associated strains from circulating human-associated strains of influenza A(H1N1)pdm09, and these signatures can be used to enhance surveillance of swine-origin influenza.
Intracranial injuries on computed tomography head scans in infants investigated for suspected physical abuse: a retrospective review
Authors: Daley Helen , Smith Hilary , McEvedy Samantha , King Rachel , Andrews Edward , Hawkins Faye , Guppy Nicole , Kiryazova Todorka , Macleod Rebecca , Blake Emma , Harrison Rachael
Published: October 2020

Background

UK national guidelines recommend that investigation of infants (aged <12 months) with suspected physical abuse should always include CT head scans. Such imaging carries small but recognised risks from radiation exposure. Studies report a range of yields for occult intracranial injuries in suspected physical abuse.

Aims

To report the yield of intracranial injuries on CT head scans carried out for suspected physical abuse in infants, compare yields for those presenting with or without signs of head injury and to describe selected clinical and radiological features.

Methods

A retrospective cross-sectional review of case records of infants undergoing skeletal survey for suspected physical abuse in Wessex, England. The main outcome measure was yield of intracranial injuries on CT head scan.

Results

In total, n=363 CT head scans were included (n=275 aged <6 months). The overall yield of intracranial injury was 37 (10%). Among 68 infants presenting with neurological signs or skull fractures, yield was 36 (53%) compared with just 1 (0.34%) of 295 without neurological signs or skull fractures. This one intracranial injury was found to be consistent with an accidental fall. Scalp injury was the only additional clinical feature associated with intracranial injury.

Conclusion

In suspected physical abuse, CT head scans should be carried out in infants who present with neurological signs, skull fractures or scalp injuries. However, in balancing potential risks and benefits, we question the value of performing a CT head scan in every infant investigated for suspected physical abuse.
The relationships between rugby union, and health and well-being: a scoping review
Authors: Griffin Steffan A , Panagodage Perera Nirmala Kanthi , Murray Andrew , Hartley Catherine , Fawkner Samantha G , P T Kemp Simon , Stokes Keith A , Kelly Paul
Published: October 2020

Objective

To scope the relationships between rugby union, and health and well-being.

Design

Scoping review.

Data sources

Published and unpublished reports of any age, identified by searching electronic databases, platforms and reference lists.

Methods

A three-step search strategy identified relevant published primary, secondary studies and grey literature, which were screened usinga prioriinclusion criteria. Data were extracted using a standardised tool, to form (1) a numerical analysis and (2) a thematic summary.

Results and discussion

6658 records were identified, and 198 studies met the inclusion criteria. All forms of rugby union can provide health-enhancing physical activity (PA). ‘Non-contact’ and wheelchair rugby in particular provide a wide range of physical and mental health and well-being benefits. The evidence is either mixed or unclear in relation to ‘contact’ rugby union and its effects on a range of physical health domains. Injury and concussion incidence rates are high for contact rugby union relative to other sports.

Conclusions

A wide range of stakeholders as well as existing and potential participants can use this information to make a more informed decision about participating in and promoting rugby union as a health-enhancing activity. Industry and policy-makers can use this review to inform policies and strategies that look to increase participation rates and use rugby union as a vehicle to contribute positively to population health. Further research understanding rugby union’s contribution to PA as well as to muscle-strengthening and balance is indicated, as well as research examining more health and well-being outcomes across more diverse cohorts.
Advances and challenges on the path toward the SDGs: subnational inequalities in Mexico, 1990–2017
Authors: Gutierrez Juan Pablo , Agudelo-Botero Marcela , Garcia-Saiso Sebastian , Zepeda-Tena Carolina , Davila-Cervantes Claudio Alberto , Gonzalez-Robledo Maria Cecilia , Fullman Nancy , Razo Christian , Hernández-Prado Bernardo , Martínez Gabriel , Barquera Simón , Lozano Rafael
Published: October 2020

Background

The sustainable development goals (SDGs) have generated momentum for global health, aligning efforts from governments and international organisations toward a set of goals that are expected to reflect improvements in life conditions across the globe. Mexico has huge social inequalities that can affect access to quality care and health outcomes. The objective of this study is to analyse inequalities among Mexico’s 32 states on the health-related SDG indicators (HRSDGIs) from 1990 to 2017.

Methods

These analyses rely on the estimation of HRSDGIs as part of the Global Burden of Disease study 2017. We estimated the concentration index for 40+3 HRSDGI stratified by Socio-demographic Index and marginalisation index, and then for indicators where inequalities were identified, we ran decomposition analyses using structural variables such as gross domestic product per capita, poverty and health expenditure.

Findings

Mexico has made progress on most HRSDGIs, but current trends in improvement do not appear to fast enough to meet 2030 targets. Out of 43 HRSDGIs, we identified evidence of inequality between Mexico’s states for 30 indicators; of those, 23 HRSDGIs were unequal distributed affecting states with lower development and seven affecting states with higher development. The decomposition analysis indicates that social determinants of health are major drivers of HRSDGI inequalities in Mexico.

Interpretation

Modifying current trends for HRSDGIs will require subnational-level and national-level policy action, of which should be informed by the latest available data and monitoring on the health-related SDGs. The SDGs’ overarching objective ofleaving no-one behindshould be prioritised not only for individuals but also for communities and other subnational levels.
Using a pharmacist-led mHealth to improve patient’s adherence of antidepressants: patients’ experiences in low resourceful country
Authors: Amir Muhammad , Feroz Zeeshan , Beg Anwar Ejaz , Rickles Nathaniel
Published: October 2020

Depression is considered fourth leading cause of disability and premature death in the world. It is estimated that in developing countries about 25 individuals among hundred suffers from some mental disease in any part of their life. Adherence is a major factor in the success of the treatment of depression. Patients with psychiatric illness are highly affected by non-adherence. 68% of patients with depression discontinue antidepressants within 3 months of therapy initiation, whereas those patients who continue to take their medications, fewer than 33% consistently take the antidepressant as prescribed. Hence, patients with depression can greatly benefit by adherence improving interventions. There is limited evidence of using pharmacist along with mobile health technology for medication adherence in clinical settings. The aim of the study is to develop pharmacist-led mobile application and explore patients’ experience on its utility.
Concussion history is associated with increased lower-extremity injury incidence in Reserve Officers’ Training Corps cadets
Authors: Hunzinger Katherine J , Radzak K N , Costantini K M , Swanik C B , Buckley T A
Published: October 2020

Introduction

Concussions have been associated with an increased risk of lower-extremity musculoskeletal injury (LE-MSI) in athletes and US Army soldiers, creating an added economic, physical and social burden. Yet, there is a paucity of evidence on this relationship among Reserve Officers’ Training Corps (ROTC) cadets, a group which engages in activities with high-injury risk and will subsequently commission as active duty officers. This study aimed to examine the association between concussions and LE-MSI in ROTC cadets.

Methods

125 (83 were male) Army and Air Force ROTC cadets (19.8±2.0 years) from two large state universities’ Army and Air Force ROTC programmes participated in this study. Cadets completed a reliable injury history questionnaire to ascertain the following variables of interest: (1) any concussion history, (2) reported concussions, (3) undiagnosed concussions, and (4) potentially unrecognised concussion history and LE-MSI history (eg, ankle sprain, knee sprain or muscle strain). Data were analysed using a χ2test for association and binary logistic regression to determine ORs.

Results

Cadets with any concussion history (n=42) had a significantly (p=0.035) higher association with LE-MSI (OR 2.47, 95% CI 1.05 to 5.83) than those without. Cadets who had a reported concussion (n=33) had a significantly (p=0.026) higher association with LE-MSI (OR 2.95, 95% CI 1.11 to 7.84) compared to cadets without.

Conclusions

ROTC cadets with a history of diagnosed concussion were more likely to have suffered an LE-MSI than cadets without a concussion history. ROTC cadre should be aware of this relationship and incorporate injury prevention protocols.
Get PrEPPT (pre-exposure prophylaxis and pregnancy termination): an exploration of the values, attitudes and preferences regarding HIV and PrEP among women seeking abortion
Authors: Ralph Jessika Ann , Yeh Chen , Cowett Allison , Hirschhorn Lisa R , Hammond Cassing
Published: October 2020

Introduction

Pre-exposure prophylaxis (PrEP) for the prevention of HIV transmission is under utilised by women in the US. Women seeking abortion have a higher HIV prevalence than women who continue prenatal care and could benefit from HIV risk assessment and PrEP counselling. We assessed the knowledge, attitudes, and preferences of women seeking abortion care regarding their HIV risk and knowledge of PrEP, and identified individual and system barriers to PrEP access.

Methods

We performed a cross sectional descriptive study of English speaking women at a freestanding abortion clinic through an anonymous survey. Participants with indications for PrEP care included those who performed sex work, experienced a recent sexually transmitted infection, or had multiple sexual partners and inconsistent condom use. We performed descriptive statistics on response data; Wilcoxon tests were used to compare continuous variables across groups.

Results

64 (32.3%) participants had indications for PrEP, but only 31 (16.1%) had previous knowledge of PrEP. After the concept was explained, attitudes towards PrEP were generally positive, and 54 participants (27.8%) would consider starting PrEP in the next 6 months. Participants were most interested in receiving PrEP care from their primary care provider rather than from an abortion clinic.

Conclusions

Among women seeking abortion, women vulnerable to HIV infection outnumbered those with PrEP knowledge by 2 to 1. Prior knowledge of PrEP as an HIV prevention method was low, but women found PrEP acceptable. While women reported preferring to receive PrEP from a primary care provider, the abortion clinic visit may also represent an important time for HIV education and risk screening.
Postpartum women’s knowledge and planned use of contraception in Myanmar
Authors: Yu Hnin Hnin , Raynes-Greenow Camille , Nyunt Kyi Kyi , Hnin Htet Santhar , Yee Nan Kin Wutt , Mugo Ngatho Samuel , Black Kirsten I
Published: October 2020

Background

Maternal mortality in Myanmar is one of the highest in the WHO South-East Asian region. Additionally, the country has a high unmet need for contraception and low rates of uptake of long-acting reversible contraceptive methods (LARCs) including intrauterine devices (IUDs) and implants. Engagement with health professionals around the time of a birth is an ideal opportunity for women to access contraception but immediate postpartum provision is not widely offered in Myanmar.

Methods

We undertook a cross-sectional survey of women immediately postpartum at two hospitals in Yangon to investigate their knowledge, and past use of, contraceptive methods and their plans for postpartum contraception including perceptions of implants and IUDs. Four trained obstetrics staff collected data using electronic tablets between January 2017 and January 2018.

Results

Of the 1755 participants, 55.1% had used pills and 42.2% injectables. In contrast, only 0.5% had used an IUD and 0.3% an implant. Few women (4.4%) anticipated starting contraception immediately postpartum and only a minority would consider future use of an implant (36.9%) or an IUD (13.0%). Fear of side effects was the major barrier to future implant and IUD uptake, reported by 64.5% and 62.5%, respectively.

Conclusions

Women in maternity care in Yangon have some awareness of IUDs and implants but many hold misconceptions about their side effects leading to reluctance to use. Reducing the unmet need for contraception and improving maternal outcomes in Myanmar could be achieved by improving education, policy and practice around immediate postpartum contraception provision, with a particular focus on LARC methods.
Haemodynamic determinants of improved aerobic capacity after tricuspid valve surgery in Ebstein anomaly
Authors: Egbe Alexander , Miranda William , Connolly Heidi , Dearani Joseph
Published: October 2020

Background

Although tricuspid valve surgery improves functional capacity in patients with Ebstein anomaly, it is not always associated with improvement in aerobic capacity. The purpose of this study was to identify the determinants of improved aerobic capacity after tricuspid valve surgery in adults with Ebstein anomaly with severe tricuspid regurgitation.

Methods

Retrospective study of patients with severe tricuspid regurgitation due to Ebstein anomaly that had tricuspid valve surgery at Mayo Clinic Rochester (2000–2019) and had preoperative and postoperative cardiopulmonary exercise tests and echocardiograms. The patients were divided into aerobic capacity(+) and aerobic capacity(-) groups depending on whether they had postoperative improvement in %-predicted peak oxygen consumption (VO2).

Results

Of 76 patients with severe tricuspid regurgitation due to Ebstein anomaly, 28 (37%) and 48 (63%) were in aerobic capacity(+) and aerobic capacity(-) groups, respectively. The average improvement in peak VO2 was 2.1±1.4 mL/kg/min and −0.9±0.4 mL/kg/min in the in aerobic capacity(+) and aerobic capacity(-) groups, respectively. Although both groups had similar severity of residual tricuspid regurgitation, the aerobic capacity(+) group had more postoperative improvement in right atrial (RA) function, left atrial (LA) function and left ventricular preload and stroke volume. Of the preoperative variables analysed, RA reservoir strain (relative risk 1.12; 95% CI 1.06 to 1.18); LA reservoir strain (relative risk 1.09; 95% CI 1.04 to 1.14) and LV stroke volume index (OR 1.04; 95% CI 1.01 to 1.07) were predictors of postoperative improvement in peak VO2.

Conclusions

One-third of patients with severe tricuspid regurgitation due to Ebstein anomaly had postoperative improvement in aerobic capacity, and atrial function indices were the best predictors of postoperative improvement in aerobic capacity. These data provide new insight into the haemodynamic determinants of exercise capacity and lay the foundation for further studies to determine whether postoperative improvement in aerobic capacity translates to improved long-term survival, and whether timing of tricuspid valve surgery based on these echocardiographic indices will improve long-term outcomes.
Validity of whole genomes sequencing results in neoplasms in precision medicine
Authors: Echejoh Godwins , Liu Yiwen , Chung-Faye Guy , Charlton Jessica , Moorhead Jane , Clark Barnaby , Davidson Philip , Sarker Debashis , Ross Paul , Ooft Marc Lucas
Published: October 2020

Objective

To compare the whole genomes sequencing (WGS) results in the 100K Genomes project with the results of routine molecular diagnostics in precision medicine.

Materials and methods

We analysed 374 cancers including a high tumour mutational burden (TMB-high) subgroup, defined as >10 non-synonymous single nucleotide variations per megabase. Colon cancers were evaluated for microsatellite instability (MSI), mismatch repair (MMR) genes and NRAS, KRAS and BRAF mutations using routine molecular diagnostics. Fluorescence in-situ hybridisation/immunohistochemistry was used to evaluate the Her2Neu status in breast cancers.

Results

There was high correlation between WGS and routine diagnostic testing results irrespective of TMB status in colon cancers. Her2Neu status was discordant in 3 out of the 5 TMB-high breast cancers (p=0.049). The presence of ductal carcinoma in-situ correlated significantly with discordance (p=0.04). There were 3 (5%) discordant colorectal cases, all in the KRAS gene, 2 of which were from the non-invasive adenomatous component (p=0.0058). Of the 374 cases we identified 24 tumours with a TMB >10; comprising (colorectal carcinomas (CRCs) n=16, breast carcinomas n=5, bladder urothelial cell cancers n=3). Of the 16 TMB-high colorectal adenocarcinomas, 13 had MSI-high status. The same 13 had defective MMR protein expression. TMB-high colorectal cancers had 100% concordant results between WGS and NGS testing for KRAS, BRAF and NRAS (16/16).

Conclusion

The microsatellite and mutational status of colorectal cancers evaluated by WGS seem to correlate well with the routine diagnostic testing if it is ensured that the invasive component is sequenced. Evaluation of WGS results need to be carefully correlated with histomorphology, as tumour heterogeneity/contamination with pre-malignant components needs to be taken into account.
Unequal burdens: assessing the determinants of elevated COVID-19 case and death rates in New York City’s racial/ethnic minority neighbourhoods
Authors: Do D. Phuong , Frank Reanne
Published: October 2020

Background

The disproportionate burden of the COVID-19 pandemic on racial/ethnic minority communities has revealed glaring inequities. However, multivariate empirical studies investigating its determinants are still limited. We document variation in COVID-19 case and death rates across different racial/ethnic neighbourhoods in New York City (NYC), the initial epicentre of the U.S. coronavirus outbreak, and conduct a multivariate ecological analysis investigating how various neighbourhood characteristics might explain any observed disparities.

Methods

Using ZIP-code-level COVID-19 case and death data from the NYC Department of Health, demographic and socioeconomic data from the American Community Survey and health data from the Centers for Disease Control’s 500 Cities Project, we estimated a series of negative binomial regression models to assess the relationship between neighbourhood racial/ethnic composition (majority non-Hispanic White, majority Black, majority Hispanic and Other-type), neighbourhood poverty, affluence, proportion of essential workers, proportion with pre-existing health conditions and neighbourhood COVID-19 case and death rates.

Results

COVID-19 case and death rates for majority Black, Hispanic and Other-type minority communities are between 24% and 110% higher than those in majority White communities. Elevated case rates are completely accounted for by the larger presence of essential workers in minority communities but excess deaths in Black neighbourhoods remain unexplained in the final model.

Conclusions

The unequal COVID-19 case burden borne by NYC’s minority communities is closely tied to their representation among the ranks of essential workers. Higher levels of pre-existing health conditions are not a sufficient explanation for the elevated mortality burden observed in Black communities.
Evaluation of the in Vitro Interaction of Fosfomycin and Meropenem against Metallo-β-Lactamase-Producing Pseudomonas Aeruginosa using Etest and Time-Kill Assay
Authors: Jahan Sanjida , Davis Heather , Ashcraft Deborah S , Pankey George A
Published: October 2020

Pseudomonas aeruginosa is a nosocomial pathogen containing various resistance mechanisms. Among them, metallo-β-lactamase (MBL)-producing Pseudomonas are difficult to treat. Fosfomycin is an older antibiotic that has recently seen increased usage due to its activity against a broad spectrum of multidrug-resistant organisms. Our aim was to evaluate the combination of fosfomycin and meropenem against 20 MBL-producing P. aeruginosa (100% meropenem-resistant and 20% fosfomycin-resistant) using both an Etest minimal inhibitory concentration (MIC): MIC method and time-kill assay. MICs for fosfomycin and meropenem were determined by Etest and by broth microdilution method for the latter. The combination demonstrated synergy by Etest in 3/20 (15%) isolates and 5/20 (25%) isolates by time-kill assay. Results from the Etest method and time-kill assay were in agreement for 14/20 (70%) of isolates. No antagonism was found. Comparing both methods, Etest MIC: MIC method may be useful to rapidly evaluate other antimicrobial combinations.
Remitting Seronegative Symmetrical Synovitis with Pitting Edema: A Review
Authors: Lakhmalla Mounika , Dahiya Dushyant Singh , Kichloo Asim , Fatima Tehreem , Edigin Ehizogie , Wani Farah
Published: October 2020

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare benign rheumatological condition characterized by sudden-onset symmetrical distal extremity edema. It can present as an isolated disease process or could be associated with other conditions. Rheumatoid factor and anticitrullinated protein antibodies are negative by definition. In current literature, there is paucity of data about the disease process. We performed a literature search using the PubMed database to identify 38 articles that met our inclusion and exclusion criteria. Our literature review focuses on the clinical picture and its diverse associations. Role of various acute phase reactants has also been outlined. There is a generalized consensus among clinicians on using moderate dose steroids for treatment. Other management options for refractory cases have also discussed. Value of several imaging modalities in diagnostic evaluation of this disease entity is touched on. Since RS3PE can be associated with other diseases, specifically cancer, timely diagnosis of this condition is necessary.
Molecular screening in a longitudinal cohort of young men who have sex with men and young transgender women: associations with focus on the emerging sexually transmitted pathogenMycoplasma genitalium
Authors: Munson Erik , Morgan Ethan , Sienkiewicz Laura , Thomas Yazmine , Buehler Kathleen , Ryan Daniel , Clifford Antonia , Mustanski Brian
Published: October 2020

Objectives

This investigation sought to characterise risk factors associated with acquisition of traditional and emerging agents of sexually transmitted infection (STI) in a cohort of young men who have sex with men and transgender women.

Methods

917 participants provided urine and rectal swab submissions assessed by transcription-mediated amplification (TMA)-based assays forChlamydia trachomatisandNeisseria gonorrhoeaeand by off-label TMA-basedTrichomonas vaginalisandMycoplasma genitaliumtesting. A subset provided specimens at 6-month and 12-month follow-up visits.

Results

Prevalence ofM. genitaliumfrom rectal and urine specimens (21.7% and 8.9%, respectively) exceeded that ofC. trachomatis(8.8% and 1.6%) and other STI agents. Black participants yielded higher prevalence ofM. genitalium(30.6%) than non-black participants (17.0%; χ²=22.39; p<0.0001).M. genitaliumprevalence from rectal specimens was 41.5% in HIV-positive participants vs 16.3% in HIV-negative participants (χ²=57.72; p<0.0001). Participant age, gender identity, condomless insertive anal/vaginal sexual practice and condomless receptive anal sexual practice were not associated with rectalC. trachomatis(p≥0.10),N. gonorrhoeae(p≥0.29),T. vaginalis(p≥0.18) orM. genitalium(p≥0.20) detection. While prevalence ofT. vaginaliswas calculated at ≤1.0%, baseline rectal and urine screening status was predictive of detection/non-detection at follow-up. A non-reactiveM. genitaliumbaseline rectal or urine screening result was less predictive of non-reactive follow-up versusC. trachomatis,N. gonorrhoeaeandT. vaginalis.

Conclusions

RectalM. genitaliumdetection is associated with black race and HIV seropositivity. BaselineM. genitaliuminfection influences subsequent detection of the organism.
MRI of the upper airways in children and young adults: the MUSIC study
Authors: Elders Bernadette , Ciet Pierluigi , Tiddens Harm , van den Bosch Wytse , Wielopolski Piotr , Pullens Bas
Published: October 2020

Rationale

Paediatric laryngotracheal stenosis (LTS) is often successfully corrected with open airway surgery. However, respiratory and vocal sequelae frequently remain. Clinical care and surgical interventions could be improved with better understanding of these sequelae.

Objective

The objective of this cross-sectional study was to develop an upper airway MRI protocol to obtain information on anatomical and functional sequelae post-LTS repair.

Methods

Forty-eight patients (age 14.4 (range 7.5–30.7) years) and 11 healthy volunteers (15.9 (8.2–28.8) years) were included. Spirometry and static and dynamic upper airway MRI (3.0 T, 30 min protocol) were conducted. Analysis included assessment of postoperative anatomy and airway lumen measurements during static and dynamic (inspiration and phonation) acquisitions.

Main results

Good image quality without artefacts was achieved for static and dynamic images in the majority of MRIs. MRI showed vocal cord thickening in 80.9% of patients and compared with volunteers, a significant decrease in vocal cord lumen area (22.0 (IQR 17.7–30.3) mm2vs 35.1 (21.2–54.7) mm2, p=0.03) but not cricoid lumen area (62.3±27.0 mm2vs 66.2±34.8 mm2, p=0.70). Furthermore, 53.2% of patients had an A-frame deformation at site of previous tracheal cannula, showing lumen collapse during inspiration. Dynamic imaging showed incomplete vocal cord abduction during inspiration in 42.6% and incomplete adduction during phonation in 61.7% of patients.

Conclusions

Static and dynamic MRI is an excellent modality to non-invasively image anatomy, tissue characteristics and vocal cord dynamics of the upper airways. MRI-derived knowledge on postsurgical LTS sequelae might be used to improve surgery.
Kerr–Sen–Taub–NUT spacetime and circular geodesics
Authors: Siahaan Haryanto M.
Published: October 2020

We present a solution obeying classical equation of motion in the low energy limit of heterotic string theory. The solution represents a rotating mass with electric charge and gravitomagnetic monopole moment. The corresponding conserved charges are discussed, and the separability of Hamilton–Jacobi equation for a test body in the spacetime is also investigated. Some numerical results related to the circular motions on equatorial plane are presented, but there is none that supports the existence of such geodesics.
The Anatomy, Presentation and Management Options of Cubital Tunnel Syndrome
Authors: Thakker Arjuna , Gupta Vinay Kumar , Gupta Keshav Kumar
Published: October 2020

Cubital tunnel syndrome is the second most common nerve compression syndrome seen in the upper limb. Paresthesia and weakness are the two most common presentations in the hand. If left untreated, compression can lead to irreversible nerve damage, resulting in a loss of function of the forearm and hand. Therefore, recognizing the various clinical presentations of cubital tunnel syndrome can lead to early detection and prevention of nerve damage. Conservative management is usually tried first and involves supporting the elbow using a splint. If this fails and symptoms do not improve, surgical management is indicated. There are 3 main surgical techniques used to relieve compression of the nerve. These are simple decompression, anterior transposition and medial epicondylectomy. Studies comparing the techniques have demonstrated particular advantages to using one or another. However, the overall technique of choice is based on both the clinical scenario and the surgeon’s digression. Following primary cubital tunnel surgery, recurrent symptoms can often occur due to a variety of pathological and non-pathological causes and revision surgery is usually warranted. This article provides a complete review of cubital tunnel syndrome.
Retained Foreign Body Which Should be Suspected as a Cause of Retractable Chronic Hand Inflammation and Diagnostic Capacity of Ultrasonography
Authors: Suh Jeong Duk , Jung Young Soo , Lee Hyun-Joo , Yoon Jong-Pil , Lee Suk-Joong , Kim Poong-Taek
Published: October 2020

Background: Foreign bodies in the hand are common but easily and often missed in the initial evaluation of injury. Diagnosing retained foreign bodies is difficult due to radiolucent foreign bodies. Purpose of this study is to emphasize the need of consideration of foreign bodies in patients with chronic synovitis in hand.

Methods: Twenty-five patients who had retained foreign body in soft tissue of hand with chronic inflammation symptoms were included. Ultrasonography was conducted in all of the patients. Patient age, sex, localization of foreign body, duration of symptom, history of injury, follow up period, complication, and biopsy results were recorded and reviewed. Also, patients’ demographics and clinical results were retrospectively reviewed.

Results: Nine of the 25 patients diagnosed with a foreign body in the hand did not remember the initial presentation of injury. The average symptom duration (from injury to hospitalization) was 10.5 months (range 1–96 months). The middle finger and the proximal interphalangeal joint were the most common site of a retained foreign body (10 patients). All patients were diagnosed via ultrasonography and underwent surgery. Biopsy results showed mainly chronic inflammation, fibrosis, granuloma, and foreign bodies.

Conclusions: Patient with symptoms of cellulitis, osteomyelitis, and palpable mass in hand for over a month without a diagnosis should be suspected of retained FBs.
A Novel Technique for Dynamic External Fixation of Proximal Interphalangeal Joint Fracture-Dislocations
Authors: Sastravaha Nattawut , Limudomporn Kanon , Taweewuthisub Worasun
Published: October 2020

Background: The pins and rubbers traction system is widely used to treat unstable proximal interphalangeal (PIP) joint fracture-dislocations. However, dealing with rubber bands can be difficult due to its elasticity and weakness. The purpose of this study was to report the results of an alternative dynamic external fixator technique for unstable PIP joint injuries.

Methods: Thirteen patients with acute unstable PIP joint fracture-dislocation (n = 8), pilon fracture (n = 2), or comminuted shaft fractures of a middle phalanx with or without PIP joint extension (n = 3) were enrolled. The alternative fixator used a plastic syringe to maintain distraction force instead of the commonly used rubber bands. Four patients underwent combined open reduction due to unsatisfactory reduction by closed mean. The fixator was removed when there was radiographic evidence of healing.

Results: At 6 months after the operation, the mean active ROM of the injured PIP joint was 89° (range, 70–104°), and the mean Quick-DASH score was 9.78 (range, 0–40.9). The mean NRS of pain before fixator removal was 1 (range, 0–4). One patient had a pin tract infection and underwent debridement and fixator removal at 33 days postoperatively. There was no loss of reduction or implant failure in the study.

Conclusions: The results were comparable to other dynamic external fixation techniques used for unstable PIP joint fracture-dislocations. The main advantages of this technique were strength of the system, procedure simplicity, the compact design, and relatively low cost. In addition, this technique can also be used in pilon fractures and comminuted shaft fractures of a middle phalanx with or without PIP joint extension.