bluuebunny/crossref_metadata_2025 huggingface dataset:
Kosi-Ganga-River-Creek 35 years’ Additive Time Series and Seasonal Analysis Using Remote Sensing Data.
Authors: Tiyasha Tiyasha , Bhagat Suraj Kumar , Emmanuel Babalola Olusola , Ramaswamy Krishnaraj
Published: July 2023

Climate change effect can be observed around the globe but the most devastation is faced by economically weak and farmers in India. Kosi-Ganga-River-Creek area has witnessed frequent floods and heavy rainfall over the years. The study area is the creek where Kosi and Ganga river joins together in the Katihar district of Bihar, India. Two variables, total daily precipitation (PTot) and max daily air temperature (Tmax) (remote sensing climatological data) were fetched from ERA5 dataset using Google Earth Engine Coder to assess the climate change in the study area. The data shows stochastically fitting in further forecasting methods is as important to conduct as settings the approach reliability. This study applied exclusively time series analysis (such as decomposing a time series, seasonal subseries, and autocorrelation function (ACF) and lag time series) along with descriptive statistical analysis for both parameters of the dataset. The study found the changes in Tmax over the 30-year time period show significant variability in temperature. Tmax peaked during the year of 1990, 1995, 1998, 2004, 2008, 2012 and 2014 whereas a drop in Tmax before and after such rise was observed in the series pattern. The exponential increase in the seasonal monthly precipitation (Ptot) also correlates with the temperature increase. However, the increase is more during non-monsoon seasons like January, February and March. Although significant reduction in Ptot can be observed during May, June, July, August and September. The changes in Ptot and Tmax have caused severe damage to the agriculture and economy of the area. Thus it is essential to study climate change and forecast the probable changes in future along with other climatological conditions to mitigate the extreme weather effect. Without proper study, monitoring, assessment and management policies in Bihar will most likely continue to suffer due to agricultural losses, lively hood, life, economic losses and infrastructure.
Measurements and statistical analysis of CO2 efflux and related parameters from crop and forested lands
Authors: Lucian Laslo , Monica Matei , Mădălina Boboc , György Deák , Ioana Cătuneanu , Natalia Enache , Rahim Nurliza
Published: July 2023

The LULUCF sector (land use, land use change and forestry) can act as a carbon dioxide (CO2) sink, either by increasing the removal of greenhouse gasses from the atmosphere or by reducing their current emissions. This paper intends to analyze the results of the CO2 monitoring methodology by the chamber method in order to estimate the effect of different land use cover and management techniques. For this purpose, seasonal CO2 efflux field measurements were conducted in two types of ecosystems (forested land and wheat crop) located in the adjacent area of Bucharest. CO2 efflux was analysed for each land cover in relation to the physical characteristics of the soil, respectively soil temperatures and humidity, but also together with the main weather parameters. The measurements were performed simultaneously in both land covers at relevant time intervals. The difference in measured values between the two ecosystems was recorded but the results of the statistical analysis showed a lack of differences in the correlation between the CO2 efflux. This indicates that the CO2 efflux can be affected by particular elements of the environment which facilitates differences in soil temperature and humidity in the same weather conditions.
Determination of the hybridization rate of Acipenser stellatus and Huso huso based on microsatellite analysis
Authors: Matache Razvan , Holban Elena , Gyorgy Deak , Prangate Raluca , Matei Monica , Boboc Madalina , Popescu Raoul , Izhar Tengku Nuraiti Tengku
Published: July 2023

On the basis of the in situ analysis of the sturgeon condition within the Lower Danube River, the aim was to carry out a research that would complement the results obtained from the monitoring and ultrasonic tagging methods. Thus, DNA samples were taken selectively from each ultrasonically tagged specimen in order to determine whether or not there is a possibility of hybridization between the species Acipenser stellatus and Huso huso. Thus, the microsatellite loci were investigated and certain parameters like diagnostic alleles, repeated sequences and specific molecular markers which were used to determine the degree of hybridism.
Assessing the self-healings properties of nano -Ca(OH)2 – TiO2 – ZnO materials used in monuments conservation works
Authors: Mihaela-Andreea Moncea , Gyogy Deak , Florina-Diana Gheorghe (Dumitru) , Nor Norazian Mohamed , Nurliza Rahim
Published: July 2023

Consolidates based on Ca(OH)2 have been prepared as macro- and/or nanoparticles dispersed in different alcohols, regardless of the precursor nature. Their efficiency is related to the small dimensions of the particles and the dispersion media, which allows their penetration into the deteriorated material substrates, as well as to an increased reactivity towards CO2. Besides the consolidating effect there is a strong need for the newly developed materials to also tackle other properties like self cleaning and antimicrobial activity, especially with regards to white monuments. In this context the present work highlights the effect of treating with stable alcoholic suspension containing nano - Ca(OH)2 – TiO2 – ZnO the physical support models consisting of mortar cubic samples from hydraulic / aerial lime, a commonly used materials in consolidation works.
Solid Waste Characterization for Identifying Recyclable Materials at Peruvian Military Headquarters
Authors: Balbuena Jose , Segura Homar , Rojas Gladys , Sosa Jorge
Published: July 2023

In Peru the solid waste management is an important task for the government, which have been increasing over the years; however, some activities of the solid waste management are not performed. Most of the solid waste ends incinerated or in the landfill, in consequence recyclable material are not recuperated and reused. According to the Peruvian Ministry of Environment only 1.9% of the usable materials were recycled, and public institutions are not unrelated to this recycling issue. The Peruvian Military Headquarter is a public institution focused mainly in all the administrative work of the Peruvian army, so most of the solid waste is office material with high potential to be recycled. In this article, a solid waste segregation and characterization process was included in the former solid waste management of the Peruvian Army Headquarters with the purpose of identifying potential recyclable materials. The results of the characterization and segregation process allowed to recognize three classes of recyclable solid waste, in addition, it was estimated that an approximate of 798 kg of usable material is produced per week at the military facilities.
Effects of Physical and Mechanical Properties of Soft Soil on Subgrades Performances in Lubuk Bayas Village, Serdang Bedagai Regency
Authors: Juliana Nova , Bawadi Nor Faizah binti
Published: July 2023

Generally, the existence of soft soil in Indonesia will be a problem in the construction of highway construction. One factor that influences and needs to be known in road construction is the characteristics of the subgrade where the pavement construction will be placed on it. Poor soil characteristics can cause bumpy road surfaces, cracks, or other road damage. Therefore, before carrying out a soil improvement, it is necessary to know its characteristics through the physical and mechanical properties of the subgrade. This research was conducted in Lubuk Bayas Village, Serdang Bedagai Regency, North Sumatra Province. Tests of physical properties in this study include sieve analysis, water content, specific gravity, plasticity limit test, and liquid limit test. The soil shear strength test and California Bearing Ratio (CBR) test were carried out to test the mechanical properties using a Dynamic Cone Penetrometer (DCP). From the results of testing the physical properties of the soil, it was found that Samples 1, 2, and 3 were fine-grained soils with the percentage of soil passing the No.200 sieve greater than 50%. The USCS classification system shows that samples 1 and 2 of the soil are in the Lean Clay (CL) group, while sample 3 is in the Fat Clay (CH) group. Samples 1, 2, and 3 include soils with high plasticity because the PI value is >17. The results of testing the mechanical properties of the soil Sample 1 obtained the value of c = 0.1299 kg/cm2 and Ø = 13.2°, in Sample 2 obtained the value of c = 0.1075 kg/cm2 and the value of Ø = 11.2° and in Sample 3 obtained the value of c = 0.1275 kg/cm2 and the value of Ø = 11.9°. DCP testing on samples 1, 2 and 3 obtained CBR values of 5.35%, 4.73% and 3.15%. From the CBR results, it can be seen that the soil in this location has a low soil bearing capacity, so if it is to be used as a subgrade layer, it will be necessary to repair the soil first so that structural damage does not occur in the future. Soil improvement can be made by stabilizing the soil using natural materials to maintain environmental sustainability. Natural materials that can be used include sand with certain gradations, stone ash, palm shell ash, and various other natural materials.
Captive growth analysis of Siberian sturgeon juveniles (Acipenser baerii J. F. Brandt, 1869) fed on a commercial fodder and its importance to a sustainable development of the aquaculture sector
Authors: Deák György , Burlacu Laurențiu , Lumânăroiu Lucian , Jawdhari Abdulhusein , Gheorghe Petrache Ionuț , Raischi Marius , Holban Elena , Zakarya Irnis Azura
Published: July 2023

Sturgeon aquaculture is an important continuously developing sector within freshwater aquaculture and its sustainability is one of the most pressing matters nowadays. Thus, the urge to apprehend the mechanics of sturgeon growth in captivity as well as in nature is of immediate importance, considering the increase in customers’ requests for captive-grown sturgeon meat, caviar, and adjacent by-products. The present study evaluates several canonical growth indices in a controlled, indoor environment that included fluctuations in temperature, dissolved oxygen saturation, and ponderal density (g/L), known to affect sturgeon growth performance. Over the 91 days of evaluation, no significant correlation was found between the weight gain and the ponderal density, dissolved oxygen values, and temperature, among the 4 tanks used in the experiment setup, indicating, along with the lack of significant variance for the RCI per tank, that the growth observed is correlated only with the fodder fed to the fish.
The Effect of Graphene Addition on the Microstructure and Properties of Graphene/Copper Composites for Sustainable Energy Materials
Authors: Jamadon Nashrah Hani , Rasid Nurul Izzati Muhamad , Ahmad Mohd Azwan , Lutfi Maisarah , Adzila Sharifah , Jamal Nur Ayuni , Muhamad Norhamidi
Published: July 2023

Graphene is a single thin layer (mono layer) of a hexagon-bound carbon atom and is an allotropic carbon in the form of a hybrid atomic plane, with a molecular bond length of 0.142 nm. Graphene is the thinnest and lightest material with 0.77 mg square meters, which exhibited excellent electricity and heat conductor. However, the perfect uniform microstructure, strength and optimum thermal properties of copper-graphene composites cannot be achieved because the amount of graphene does not reach the optimum level. In order to solve this problem, copper-graphene composites were produced by metal injection molding method (MIM) with various percentage of graphene, specifically 0.5%, 1.0% and 1.5% in the composite, to compare the physical and mechanical properties of these samples. MIM process involves the preparation of feed materials, pre-mixing process, mixing process, mold injection process, binding process and sintering processes. Feeding materials were used are copper and graphene, which have the powder loading of 62% with a mix of binder comprising 73% polyethylene glycol (PEG), 25% polymethyl methacrylate (PMMA), and 2% stearic acid (SA). Densification and tensile test were conducted to determine the mechanical properties. Scanning electron microstructure (SEM) was performed to obtain the microstructure of the composites. From the research, the result revealed that the 0.5% graphene content had the optimum parameter, which the hardness and tensile stress values were at 94.2 HRL and 205.22 MPa.
The effect of fly ash to alkaline activator ratio to the mechanical properties of stabilized lateritic soil using fly ash based geopolymer
Authors: Ahmad Muhammad Munsif , Muhamad Khairunnisa , Razak Rafiza Abdul , Abdullah Mohd Mustafa Al Bakri , Hashim Nurul Huda , Othman Nur Amira Farhani
Published: July 2023

Stabilization of fill soil improve its physical and mechanical properties and led to better load carrying capacity and enable steeper temporary slope to be formed during construction period. In this study an industrial by-product, fly-ash (FA), was used as precursor to produce geopolymer as chemical stabilizer to improve the physical and mechanical properties of fill soil. Sodium silicate solution (Na2SiO3) and sodium hydroxide (NaOH) at a concentration of 15 molars were combined as the liquid alkaline activator (AA). The effect of different fly ash to alkaline activator ratio (0, 1.0, 1.5, 2.5 and 3.0) on the physical and mechanical properties of treated fill soil were measured using Atterberg limit test and unconfined compressive strength (UCS) test. All sample were tested at 1 day and 3 days of curing period under room temperature. The result indicates that the highest compressive strength is obtained with fly ash to alkaline activator ratio of 2.5 for both 1 day and 3 days of curing. In addition, the plasticity index of the treated sample for all fly ash/alkaline activator were lower than that of the untreated fill soil.
Assessment of Water Quality and Nutrient Uptake of Azolla in Different Fertilizers
Authors: Zakarya Irnis Azura , Nasir Nor Anis Nadhirah Md , Razali Najiha , Ibrahim Mahamad Hakimi , Boboc Madalina
Published: July 2023

The improvement of water quality through aquatic plants’ nutrient uptake is one of the crucial elements in achieving a sustainable ecosystem. Water quality is affected by a variety of variables, including dissolved oxygen concentrations, nutrient overabundance, bacterial populations, salt content, and the number of suspended particles in the water. This experiment was performed to evaluate the biological and biochemical characteristics of azolla using various fertilizers (compost food waste, cow dung, liquid fertilizer, mushroom block fertilizer). It also examined the ability and effectiveness of aquatic macrophytes, Azolla pinnata to absorb amounts of nutrients including phosphate, potassium, and nitrogen ammonia in a nutrient-rich medium. The water quality during the cultivation period, including its turbidity, pH, and the temperature was monitored. The biological and biochemical characteristics of azolla have been assessed in a variety of fertilizers, including cow dung, liquid fertilizer, mushroom block fertilizer, and compost food waste, at various concentrations of 5g, 10g, and 15g. The study findings indicated that the most suitable fertilizer for azolla growth is cow dung fertilizer and the least suitable fertilizer is liquid fertilizer. The rapid growth of azolla between days 15 to 25 were observed for the cow dung fertilizer at all concentration as compared to control and other fertilizers. Water quality for each parameter increase over time. The ability of azolla to absorb nutrients shows great potential for the phosphorus element when compared to potassium and nitrogen uptake. To reduce the amount of excessive phosphorus and potassium in water, azolla is a great candidate for eco-friendly phytoremediation.
Fabrication, characterization and optimal selection of aluminium alloy 8011 composites reinforced with B
4
C-aloe vera ash
Authors: Sharma Rajesh , Pradhan M K , Jain Pankaj
Published: July 2023

The aim  of this study is to determine the use of B
4
C along with AVA as economical reinforcements to improve the mechanical properties of aluminium alloy 8011. The purpose of this investigation is the development of cost-effective hybrid metal matrix composites. The present investigation assessed the mechanical characteristics of Al-8011 alloy, Al-8011/3AVA, Al-8011/4B
4
C, Al-8011/2.5B
4
C/2.5AVA, and Al-8011/3B
4
C/3AVA composites, which were manufactured through stir-casting techniques. Scanning electron microscope (SEM) imaging with an energy-dispersive spectroscope (EDS) was performed on the fabricated composites to confirm the presence of reinforcements, and the images revealed a uniform distribution of reinforcements in the matrix. The density of the composite decreased with an increase in weight % of AVA-B
4
C in comparison with that of matrix aluminum alloy 8011. Results obtained for tensile strength and hardness exhibit the optimal results from adding 3 wt.% B
4
C with 3 wt.% AVA. The present paper also investigates the application of three multiple criteria decision-making (MCDM) methodological approaches to select the best option.
The effect of the number of hydrophobic tails of cationic ammonium surfactants on mesoporous TiO2 synthesized
Authors: Fisli Adel , Velasufah Wasfi , Arofah Nurmaya , Mulyawan Ade , Mustika Deni , Ridwan  , Karo Aloma Karo , Yusuf Saeful , Mulyaningsih Th. Rina
Published: July 2023

Mesoporous titanium dioxide (TiO2) is one of the most studied mesoporous materials considering its special character and various applications. In the present work, mesoporous TiO2 was synthesized by a sol–gel method employing different hydrophobic tails of ammonium cationic surfactants templates. The prepared samples were characterized by various techniques. The XRD profiles confirmed that all samples crystallized into the TiO2 anatase phase. The crystallite size of all samples was found to vary in the range of 8.60 nm to 13.61 nm. The transition temperature of the anatase phase was increased to several Celsius degrees since TiO2 was fabricated with a template assistant. The surface area of the mesoporous TiO2 was increased in the range of 93 m2.g−1 (CTAB) − 116.8 m2.g−1 (MTAB). These values were larger than the TiO2 synthesized without a template (72 m2.g−1). The total pore volume was also increased between 0.1704 cm3.g−1 (CTAB) and 0.300 cm3.g−1 (MTAB), while the TiO2 synthesized without a template was only 0.161 cm3.g−1. Using CTAB and DDAB yield a uniform mesopore size distribution. MTAB tends to produce non-uniform pore of the mesoporous system. The soft-templating method opens up new possibilities for synthesizing mesoporous metal oxides.
Graphene fortified polyvinyl alcohol based nanofibre membranes for preserving perishable food
Authors: Gupta Manjula , Sheikh Lubna , Kumar Navin , Kumar Nitish , Gupta Dara Singh , Pramanik Chandrani
Published: July 2023

In recent years, graphene as a biomaterial has received considerable attention due to its outstanding physio-mechanical properties. In the present work, we found superior tensile strength, hydrophobic and antibacterial activities in graphene incorporated polyvinyl alcohol (PVA) based nanofibers, prepared by electrospinning. A series of ultrafine graphene-based ink (G-Ink) incorporated PVA nanofiber (GPN) with different concentrations of graphene (0, 0.008, 0.02, 0.04, 0.06, and 0.08% w/v) was fabricated. To overcome difficulty in direct dispersing graphene into the PVA solution, we have prepared graphene-based ink for dispersing into polymer solution. The morphology, composition, mechanical behaviour, and surface wettability of these membranes was investigated. The Fourier transform infrared spectra and the Raman spectra confirmed the successful incorporation of graphene into the GPN. Graphene when used as a nanofiller in polymers, provides excellent mechanical properties (814%), hydrophobicity (40%), and antibacterial properties. In the current study we tested GPN membranes for preserving two fast rotting foods like coriander leaves and tomato. We found that GPN membrane can be used safely for food packaging applications to increase the shelf life of perishing food items, such as up to 3 days for coriander leaves and 8 days for tomatoes.
Machine Learning based tumor diagnosis using compressive sensing in MRI images
Authors: Mathew Nimmy Ann , Stanley Ishita Maria , Jose Renu
Published: July 2023

Despite the widespread use of Magnetic Resonance Imaging (MRI) analysis for disease diagnosis, processing and analyzing the substantial amount of acquired data may be challenging. Compressive Sensing (CS) offers a promising solution to this problem. MRI diagnosis can be performed faster and more accurately using CS since it requires fewer data for image analysis. A combination of CS with conventional and Deep Learning (DL) models, specifically VGGNet-16, is proposed for categorizing reconstructed MRI images into healthy and unhealthy. The model is properly trained using a dataset containing both normal and tumor images. The method is evaluated using a variety of parameters, including recall, F1-score, accuracy, and precision. Using the VGGNet-16 model, the proposed work achieved a classification accuracy of 98.7%, which is comparable with another state-of-the-art method based on traditionally acquired MRI images. The results indicate that CS may be useful in clinical settings for improving the efficiency and accuracy of MRI-based tumor diagnosis. Furthermore, the approach could be extended to other medical imaging modalities, possibly improving diagnosis accuracy. The study illustrates how CS can enhance medical imaging analysis, particularly in the context of tumor diagnosis using MRI images. It is necessary to conduct further research to investigate the potential applications of CS in other medical imaging contexts.
Interdecadal variation and possible causes of summer extreme precipitation over northern Xinjiang province, northwestern China
Authors: Li Minggang , Zhao Yong , Li Yang , Meng Lixia , Chen Dong
Published: July 2023

Using daily precipitation data from 25 stations, NCEP/NCAR reanalysis data, and 12 climate indices for boreal summers from 1963 to 2017, we investigate the interdecadal variation and causes of extreme precipitation in northern Xinjiang Province (NXJ), northwestern China. The summer frequency of daily precipitation extremes (DPEs), summer precipitation from DPEs, and contribution of precipitation from DPEs to total summer precipitation have increased significantly since the early 1990s, and this increase in extreme precipitation is more intense at stations in the eastern part of NXJ. Comparing the periods 1963–1988 and 1992–2017, the anomalous circulation over the Mongolian Plateau changed from cyclonic to anti-cyclonic, and the center of the anomalous cyclonic circulation over Central Asia shifted northward from the Iranian Plateau to the Aral Sea. These changes in anomalous circulation pattern induced changes in the paths of water vapor transport and the distribution of moisture convergence, which explain well the interdecadal increase in extreme precipitation and its spatial variability. Further analysis confirms evident impacts of the Indian Ocean basin mode (IOBM) and Scandinavia teleconnection pattern on the development of anomalous circulation related to the interdecadal increase in extreme precipitation. A positive IOBM favors the northward transport of moisture from the northern Indian Ocean to Xinjiang Province and the development of anomalous cyclonic circulation over Central Asia in the middle and upper troposphere. The negative phase of the Scandinavia pattern, which has prevailed since the late 1970s, and the enhanced out of phase connection between the anomalous circulation over Scandinavia Peninsula and the West Siberia during 1992–2017 favors the development of anomalous anti-cyclonic circulation over the Mongolian Plateau.
Data-driven dynamics reconstruction using RBF network
*
Authors: Du Cong-Cong , Wang Xuan , Wang Zhangsen , Wang Da-Hui
Published: July 2023

Constructing the governing dynamical equations of complex systems from observational data is of great interest for both theory and applications. However, it is a difficult inverse problem to explicitly construct the dynamical equations for many real complex systems based on observational data. Here, we propose to implicitly represent the dynamical equations of a complex system using a radial basis function (RBF) network trained on the observed data of the system. We show that the RBF network trained on trajectory data of the classical Lorenz and Chen system can faithfully reproduce the orbits, fixed points, and local bifurcations of the original dynamical equations. We also apply this method to electrocardiogram (ECG) data and show that the fixed points of the RBF network trained using ECG can discriminate healthy people from patients with heart disease, indicating that the method can be applied to real complex systems.
A novel monocrystalline PV array configuration for enhancing the maximum power under partial shading conditions
Authors: Vunnam Sarayu , Vanithasri M , Alla RamaKoteswaraRao
Published: July 2023

Solar photovoltaic (PV) systems have gained importance as a promising renewable energy source in recent years. PV arrays are prone to variable irradiance levels under partial shading conditions due to non-uniform shading. As a result, there will be a decrease in the amount of power produced and hotspots will occur. To overcome these issues, it is essential to select an appropriate PV material and a suitable array configuration. To obtain the maximum output power from a PV array under partial shading conditions, this paper suggests a novel triple-series–parallel ladder topology with monocrystalline PV material. Considering short and wide, long and wide, short and narrow, long and narrow, middle and diagonal shading situations, a 6 × 6-sized array has been considered and compared with other existing configurations such as total cross-tied, bridge-link, honeycomb, series–parallel and series–parallel cross-tied. The proposed configuration has an optimal number of cross ties to produce maximum power. It has 4 cross ties fewer than a honeycomb, 3 cross ties fewer than a bridge link, 16 cross ties fewer than a total cross-tied and 7 cross ties fewer than series–parallel cross-tied configurations. The proposed configuration has an improvement in power of 0.1% to 20% compared with other configurations under the considered shading scenarios.
Habitat and food preferences of European rabbits in core and edge populations along the invasion front Patagonia-Monte, Argentina
Authors: Bobadilla Sabrina Yasmin , Dacar María A , Jaksic Fabián M , Ojeda Ricardo A , Fernanda Cuevas María
Published: July 2023

The European rabbit Oryctolagus cuniculus is an exotic herbivorous mammal undergoing an active phase of geographical expansion in the arid ecosystems of Argentina. The Adaptive Flexibility Hypothesis states that populations at the range edge (new populations) will exhibit greater flexibility in the use of resources compared with populations located in the range core (older populations). The objective of this work was to compare the rabbit’s use of spatial and trophic resources in relation to the establishment time of their populations. The sampling was carried out for 2 years (2017 and 2018) in sites with different establishment times for rabbit populations. Random sampling stratified by type of habitat was applied using 115 fixed strip transects of 1,000 m2 laid out across the study areas. Fresh rabbit signs were recorded in each transect, and environmental and anthropic variables were measured. Our results show that the individuals from the range edge are more selective in the use of habitat than those from the range core. At the microhabitat level, we observed a pattern in the particular components of habitat use by rabbits mainly linked to food availability and proximity to water. From a trophic perspective, rabbits could show flexible adjustment to novel conditions and environments in the range edge. The variability in resource use by the European rabbit confirms its ecological flexibility, pivotal for their advance toward new environments in Argentina.
Tuberculosis case finding in a public healthcare setting in South Africa: using QI worksheets and a social network learning platform for rapid data-driven improvement
Authors: Youngleson Michele , Tshabalala Maureen , Ngozo Jacqueline , Zulu Nokuthula , Kamoga Nelson , Linda Zanele , Sodzi-Tettey Sodzi , Barker Pierre
Published: July 2023

Background

The Coronavirus 2019 (COVID-19) pandemic diverted attention and resources away from tuberculosis (TB) and other non-COVID services and decreased clinic attendance.

Objective

The objective was to rapidly restore TB case finding to pre-pandemic levels using a data-driven, quality improvement (QI) approach, adapted to constraints of the pandemic.

Method

A mixed-methods assessment of a QI intervention in 129 health facilities from five rural health districts in KwaZulu-Natal province was performed. Eight worksheets guided clinical teams, using QI principles, to improve routine data quality and implement preselected change ideas for TB case finding in Human Immunodefiency Virus-positive clinic subpopulations. Facility teams shared data and learnings and were coached in person and via a social media platform and virtual encounters.

Results

We observed high rates of engagement by district TB managers and facility teams (94% of facilities posted worksheets on WhatsApp each month). The number of worksheets posted, TB investigations undertaken, and TB cases confirmed increased rapidly over time. Facility data quality improved significantly over time (median 40% errors at start vs 5% errors at end).

Conclusion

The Sprint initiative showed that a novel simplified QI intervention that integrated clinical protocols and data tracking was rapidly adopted and improved TB case finding despite the constraints of the COVID-19 pandemic. Two key innovations—a simplified set of data-focused QI worksheets and a social engagement and learning platform—were used to drive a focused QI effort. The approach should be considered for improving gaps in focused health system priorities in low- and middle-income country settings beyond the pandemic.
Technical note—the use of an inclinometer to accurately guide intra-operative femoral de-rotational osteotomies
Authors: Mayne Alistair Iw , Diamond Owen J
Published: July 2023

Femoral de-rotational osteotomies are a safe and effective treatment for symptomatic excessive femoral anteversion or retroversion. The author’s preferred technique for performing a de-rotational osteotomy is via a subtrochanteric transverse osteotomy with intramedullary nail fixation. We describe a method for guiding femoral de-rotation correction intra-operatively using a bubble inclinometer.
Real-world efficacy and safety of cabozantinib following immune checkpoint inhibitor failure in Japanese patients with advanced renal cell carcinoma
Authors: Ishihara Hiroki , Nemoto Yuki , Tachibana Hidekazu , Fukuda Hironori , Yoshida Kazuhiko , Kobayashi Hirohito , Iizuka Junpei , Hashimoto Yasunobu , Kondo Tsunenori , Takagi Toshio
Published: July 2023

Background

Real-world data of cabozantinib after failure of immune checkpoint inhibitors for advanced renal cell carcinoma in Japanese population are limited. Additionally, prognostic factors of cabozantinib in this setting are still unknown.

Methods

We retrospectively evaluated data of 56 patients treated with cabozantinib subsequent to failed immune checkpoint inhibitors at four institutions. Regarding the efficacy profile, progression-free survival, overall survival and objective response rate were assessed. In terms of the safety profile, rate of adverse events, dose reduction and treatment interruption were assessed. Furthermore, risk factors of progression-free survival were analyzed.

Results

Twenty-nine patients (52%) were treated with cabozantinib as second-line therapy. Most frequent prior immune checkpoint inhibitor treatment was nivolumab plus ipilimumab combination therapy as first-line therapy (n = 30, 54%). Median progression-free survival and overall survival were 9.76 and 25.5 months, respectively, and objective response rate was 34%. All patients experienced at least one adverse event, and grade ≥ 3 adverse events were observed in 31 patients (55%). Forty-four (79%) and 31 (55%) patients needed dose reduction and treatment interruption, respectively. Multivariate analysis showed that reduced initial dose (i.e. <60 mg) (hazard ratio: 2.50, P = 0.0355) and presence of lymph node metastasis (hazard ratio: 2.50, P = 0.0172) were independent factors of shorter progression-free survival.

Conclusion

Cabozantinib in Japanese patients with advanced renal cell carcinoma who failed immune checkpoint inhibitors was efficacious and had a manageable safety profile. These results appear to be similar to those of previous clinical trials.
Parasitization of the pedicle: a rare form of TRAM flap recurrence
Authors: Binks Matthew J , Guo CiCi , Sabanathan Danusha , Sathasivam Sivapirabu , Edirimanne Senarath
Published: July 2023

Local recurrence after mastectomy and autologous breast reconstruction is uncommon and tends to occur predictably within the superficial tissues or at the chest wall. We present a unique case of breast cancer recurrence involving the superficial and deep tissues. By parasitizing the pedicle of a free transverse rectus abdominis myocutaneous flap pedicle, the tumour was seen to extend through the chest wall to the right pleura.
Use of botulinum toxin as a non-surgical treatment option for idiopathic hallux varus: a case report
Authors: Gottlich Caleb , Murphy Alexandria , Jain Neil , Grimes Jerry
Published: July 2023

Hallux varus presents with midline deviation of the hallux at the first metatarsophalangeal joint. If left untreated, it may lead to pain and difficulty with normal daily activities. Here, we present a case of spontaneous hallux varus in an 84-year-old female treated non-operatively with injection of botulinum toxin in the Abductor Hallucis Brevis. Ultrasound guidance with electromyography was used to assist in all injections. Near total symptomatic relief and resumption of daily activities was obtained for up to 12 weeks at a time. Radiographic correction seen was improvement from 14° to 7° on weight bearing radiographs. After five rounds of treatment, no adverse reactions had been observed.
Battlefield Acupuncture as a Treatment Option for Chronic Tinnitus: A Pilot Study
Authors: Cesario Erin , Larionova Nicole , Scalo Julieta , Tepe Victoria , Esquivel Carlos , Spear Samuel A
Published: July 2023

Introduction

There is no cure for tinnitus, which is a highly prevalent condition in service members and veterans. Battlefield acupuncture (BFA) can be used to manage pain and stress-related symptoms. We investigated BFA as a safe, low-cost treatment for tinnitus perception and coping in eight chronic tinnitus patients who were followed for 6 months after two BFA treatments to identify changes in tinnitus severity or impact.

Materials and Methods

Patients completed case history, Tinnitus Screener, Tinnitus Functional Index (TFI), Tinnitus Reaction Questionnaire (TRQ), and Hospital Anxiety and Depression Scale (HADS) questionnaires at baseline, at two BFA treatment sessions (2 weeks apart), and at four follow-up sessions (at 1, 2, 4 and 6 months after treatment). Questionnaire score changes were evaluated over time by using restricted maximum likelihood hierarchical regression modeling from baseline to 1-, 2-, 4-, and 6-month post-treatment follow-ups.

Results

TFI and TRQ group means were both significantly reduced at 1 month after treatment, and these reductions persisted through the 2- and 4-month follow-ups. The TRQ group mean remained significantly reduced after 6 months.

Conclusions

Findings from eight chronic tinnitus sufferers who received two BFA treatment sessions are reported here, suggesting at least short-term treatment benefits observed as reductions in tinnitus-related psychological distress and impact. Although these findings are constrained by the study’s small sample size and limited treatment period, its findings underscore the need for further research to determine the potential benefits of BFA for individuals who suffer from chronic tinnitus. Future research should consider the possibility of more lasting benefits through extended BFA treatment, with a comparison of BFA treatment against other treatment methods.
BurstDECONV: a signal deconvolution method to uncover mechanisms of transcriptional bursting in live cells
Authors: Douaihy Maria , Topno Rachel , Lagha Mounia , Bertrand Edouard , Radulescu Ovidiu
Published: July 2023

Monitoring transcription in living cells gives access to the dynamics of this complex fundamental process. It reveals that transcription is discontinuous, whereby active periods (bursts) are separated by one or several types of inactive periods of distinct lifetimes. However, decoding temporal fluctuations arising from live imaging and inferring the distinct transcriptional steps eliciting them is a challenge. We present BurstDECONV, a novel statistical inference method that deconvolves signal traces into individual transcription initiation events. We use the distribution of waiting times between successive polymerase initiation events to identify mechanistic features of transcription such as the number of rate-limiting steps and their kinetics. Comparison of our method to alternative methods emphasizes its advantages in terms of precision and flexibility. Unique features such as the direct determination of the number of promoter states and the simultaneous analysis of several potential transcription models make BurstDECONV an ideal analytic framework for live cell transcription imaging experiments. Using simulated realistic data, we found that our method is robust with regards to noise or suboptimal experimental designs. To show its generality, we applied it to different biological contexts such as Drosophila embryos or human cells.
Linking folding dynamics and function of SAM/SAH riboswitches at the single molecule level
Authors: Liao Ting-Wei , Huang Lin , Wilson Timothy J , Ganser Laura R , Lilley David M J , Ha Taekjip
Published: July 2023

Riboswitches are regulatory elements found in bacterial mRNAs that control downstream gene expression through ligand-induced conformational changes. Here, we used single-molecule FRET to map the conformational landscape of the translational SAM/SAH riboswitch and probe how co-transcriptional ligand-induced conformational changes affect its translation regulation function. Riboswitch folding is highly heterogeneous, suggesting a rugged conformational landscape that allows for sampling of the ligand-bound conformation even in the absence of ligand. The addition of ligand shifts the landscape, favoring the ligand-bound conformation. Mutation studies identified a key structural element, the pseudoknot helix, that is crucial for determining ligand-free conformations and their ligand responsiveness. We also investigated ribosomal binding site accessibility under two scenarios: pre-folding and co-transcriptional folding. The regulatory function of the SAM/SAH riboswitch involves kinetically favoring ligand binding, but co-transcriptional folding reduces this preference with a less compact initial conformation that exposes the Shine–Dalgarno sequence and takes min to redistribute to more compact conformations of the pre-folded riboswitch. Such slow equilibration decreases the effective ligand affinity. Overall, our study provides a deeper understanding of the complex folding process and how the riboswitch adapts its folding pattern in response to ligand, modulates ribosome accessibility and the role of co-transcriptional folding in these processes.
Dot1l cooperates with Npm1 to repress endogenous retrovirus MERVL in embryonic stem cells
Authors: Zhao Xin , Li Xiaomin , Sun Haiyang , Zhao Xuan , Gao Tingting , Shi Panpan , Chen Fuquan , Liu Lin , Lu Xinyi
Published: July 2023

Dot1l is a histone methyltransferase without a SET domain and is responsible for H3K79 methylation, which marks active transcription. In contradiction, Dot1l also participates in silencing gene expression. The target regions and mechanism of Dot1l in repressing transcription remain enigmatic. Here, we show that Dot1l represses endogenous retroviruses in embryonic stem cells (ESCs). Specifically, the absence of Dot1l led to the activation of MERVL, which is a marker of 2-cell-like cells. In addition, Dot1l deletion activated the 2-cell-like state and predisposed ESCs to differentiate into trophectoderm lineage. Transcriptome analysis revealed activation of 2-cell genes and meiotic genes by Dot1l deletion. Mechanistically, Dot1l interacted with and co-localized with Npm1 on MERVL, and depletion of Npm1 similarly augmented MERVL expression. The catalytic activity and AT-hook domain of Dot1l are important to suppress MERVL. Notably, Dot1l-Npm1 restricts MERVL by regulating protein level and deposition of histone H1. Furthermore, Dot1l is critical for Npm1 to efficiently interact with histone H1 and inhibit ubiquitination of H1 whereas Npm1 is essential for Dot1l to interact with MERVL. Altogether, we discover that Dot1l represses MERVL through chaperoning H1 by collaborating with Npm1. Importantly, our findings shed light on the non-canonical transcriptional repressive role of Dot1l in ESCs.
Set Up to Fail? Barriers Impeding Resident Communication Training in Neonatal Intensive Care Units
Authors: Cheng Anita , Molinaro Monica , Ott Mary , Cristancho Sayra , LaDonna Kori A.
Published: July 2023

Purpose

Learning to navigate difficult clinical conversations is an essential feature of residency training, yet much of this learning occurs “on the job,” often without the formative, multisource feedback trainees need. To generate insight into how on-the-job training influences trainee performance, the perspectives of parents and health care providers (HCPs) who engaged in or observed difficult conversations with Neonatal Intensive Care Unit (NICU) trainees were explored.

Method

The iterative data generation and analysis process was informed by constructivist grounded theory. Parents (n = 14) and HCPs (n = 10) from 2 Canadian NICUs were invited to participate in semistructured interviews informed by rich pictures—a visual elicitation technique useful for exploring complex phenomena like difficult conversations. Themes were identified using the constant comparative approach. The study was conducted between 2018 and 2021.

Results

According to participants, misalignment between parents’ and trainees’ communication styles, HCPs intervening to protect parents when trainee-led communication went awry, the absence of feedback, and a culture of sole physician responsibility for communication all conspired against trainees trying to develop communication competence in the NICU. Given beliefs that trainees’ experiential learning should not trump parents’ well-being, some physicians perceived the art of communication was best learned by observing experts. Sometimes, already limited opportunities for trainees to lead conversations were further constricted by perceptions that trainees lacked the interest and motivation to focus on so-called “soft” skills like communication during their training.

Conclusions

Parents and NICU staff described that trainees face multiple barriers against learning to navigate difficult conversations that may set them up to fail. A deeper understanding of the layered challenges trainees face, and the hierarchies and sociocultural norms that interfere with teaching, may be the start of breaking down multiple barriers trainees and their clinician supervisors need to overcome to succeed.
The Sanders Classification and Obesity: Do Obese Kids With AIS Present With More Advanced Skeletal Maturity?
Authors: Henstenburg Jeffrey , Heard Jeremy , Jaynes Lance , Gnam Ashley , Laughter Kirk , Townsend Will , Smyly Aubrey , Sukkarieh Hamdi , Shah Suken A. , Brooks Jaysson T. , McDonald Tyler C.
Published: July 2023

Introduction:

Obese and overweight (OOW) patients with adolescent idiopathic scoliosis (AIS) have been shown to initially present with a more advanced Risser score compared to normal weight (NW) patients. The Sanders Maturity Scale (SMS) is now more commonly used by surgeons to assist with treatment decisions because it more reliably predicts skeletal maturity. However, the relationship between SMS and obesity has not been described. We hypothesize that in patients with AIS, OOW patients will have a higher SMS score on initial presentation when compared to NW patients.

Methods:

Billing data from 2 different institutions were used to identify patients with AIS presenting to a pediatric orthopaedic spine surgeon for an initial visit between July 2012 and March 2020. We excluded those without height/weight data, spine radiographs, or left-hand radiographs for measuring SMS stage. Body mass index-for-age percentiles were calculated and used to group patients into NW (<85th percentile) or OOW (85th percentile and above) per Centers for Disease Control guidelines. After collecting preliminary data, a power analysis was performed using average SMS scores between NW and OOW patients with an alpha of 0.5, determining a needed sample size of approximately 300 male and 300 female subjects.

Results:

Five hundred ninety patients (296 female, 294 male) were identified. The SMS stage at presentation was significantly greater in OOW compared to NW patients for both females (5.9±1.8 vs. 5.2±1.7; P=0.003) and males (4.9±1.9 vs. 4.1±1.8; P=0.002). The major curve magnitude for OOW females was significantly different from NW females (36±16 degrees vs. 30±16 degrees; P=0.004). The major curve magnitude was not different for OOW and NW males (P=0.3).

Conclusion:

At initial presentation, OOW patients present at a greater skeletal maturity as measured by the SMS compared with NW patients. OOW female patients present with a greater major curve magnitudes than NW female patients. These results highlight negative implications of the pediatric obesity epidemic as it relates to the AIS population. These findings can be used to counsel families and provide anticipatory guidance for the AIS treatment plan.

Level of Evidence:

Level III—cross-sectional study.