bluuebunny/crossref_metadata_2025 huggingface dataset:
Calcium and fluorine signals in HS-LEIS for CaF2(111) and powder—Quantification of atomic surface concentrations using LiF(001), Ca, and Cu references
Authors: Průša Stanislav , Bábík Pavel , Mach Jindřich , Strapko Tomáš , Šikola Tomáš , Brongersma Hidde H.
Published: October 2020

The powder of CaF2 has been proposed as a practical reference for the quantitation of Ca and F in low energy ion scattering (LEIS) analysis. It is chemically inert, easy to clean, and inexpensive. LEIS is extremely surface sensitive. Thus, in contrast to surface analytic techniques such as x-ray photoelectron spectroscopy and secondary ion mass spectroscopy, the surface termination of a sample is clearly reflected in the LEIS results. It is, thus, unlikely that in LEIS, the F/Ca ratio for CaF2 is 2.0. This paper supports the reliability of the CaF2 powder reference by evaluating the calcium and fluorine atomic surface concentrations, roughness factor and shows that the surface termination of the powder is the same as that of CaF2(111). The CaF2 samples are treated by annealing at 725 K and measured at 625 K. The presented spectra are practically free of contamination. Ion scattering by LiF (001), an evaporated Ca layer, and a Cu foil are used as basic references for Ca and F. The atomic sensitivity factors and the relative sensitivity factors have been determined for F, Ca, and Cu (3 keV He+, 145°). The F/Ca atomic ratio is found to be the same (2.3 ± 0.1) for CaF2(111) and its powder. For the powder, the Ca and F signals are reduced by a factor of 0.77 ± 0.03 in comparison with those for the single crystal.
The Effect of Upper-Body Positioning on the Aerodynamic–Physiological Economy of Time-Trial Cycling
Authors: Faulkner Steve H. , Jobling Philippa
Published: October 2020

Purpose:Cycling time trials (TTs) are characterized by riders’ adopting aerodynamic positions to lessen the impact of aerodynamic drag on velocity. The optimal performance requirements for TTs likely exist on a continuum of rider aerodynamics versus physiological optimization, yet there is little empirical evidence to inform riders and coaches. The aim of the present study was to investigate the relationship between aerodynamic optimization, energy expenditure, heat production, and performance.Methods:Eleven trained cyclists completed 5 submaximal exercise tests followed by a TT. Trials were completed at hip angles of 12° (more horizontal), 16°, 20°, 24° (more vertical), and their self-selected control position.Results:The largest decrease in power output at anaerobic threshold compared with control occurred at 12° (−16 [20] W,P = .03; effect size [ES] = 0.8). There was a linear relationship between upper-body position and heat production (R2 = .414,P = .04) but no change in mean body temperature, suggesting that, as upper-body position and hip angle increase, convective and evaporative cooling also rise. The highest aerodynamic–physiological economy occurred at 12° (384 [53] W·CdA−1·L−1·min−1, ES = 0.4), and the lowest occurred at 24° (338 [28] W·CdA−1·L−1·min−1, ES = 0.7), versus control (367 [41] W·CdA−1·L−1·min−1).Conclusion:These data suggest that the physiological cost of reducing hip angle is outweighed by the aerodynamic benefit and that riders should favor aerodynamic optimization for shorter TT events. The impact on thermoregulation and performance in the field requires further investigation.
Effects of Ice Massage Prior to an Iontophoresis Treatment Using Dexamethasone Sodium Phosphate
Authors: Smith Brady M. , Draper David O. , Hyldahl Robert D. , Rigby Justin H.
Published: October 2020

Context: Low current intensity iontophoresis treatments have increased skin perfusion over 700% from baseline potentially altering drug clearance from or diffusion to the targeted area. Objective: To determine the effects of a preceding 10-minute ice massage on subcutaneous dexamethasone sodium phosphate (Dex-P) concentration and skin perfusion during and after a 4-mA iontophoresis treatment. Design: Controlled laboratory study. Setting: Research laboratory. Patients or Other Participants: Twenty-four participants (male = 12, female = 12; age = 25.6 [4.5] y, height = 173.9 [8.51] cm, mass = 76.11 [16.84] kg). Intervention(s): Participants were randomly assigned into 2 groups: (1) pretreatment 10-minute ice massage and (2) no pretreatment ice massage. Treatment consisted of an 80-mA·minute (4 mA, 20 min) Dex-P iontophoresis treatment. Microdialysis probes (3 mm deep in the forearm) were used to assess Dex-P, dexamethasone (Dex), and its metabolite (Dex-Met) concentrations. Skin perfusion was measured using laser Doppler flowmetry. Main Outcome Measure(s): Microdialysis samples were collected at baseline, at conclusion of treatment, and every 20 minutes posttreatment for 60 minutes. Samples were analyzed to determine Dex-Total (Dex-Total = Dex-P + Dex + Dex-Met). Skin perfusion was calculated as a percentage change from baseline. A mixed-design analysis of variance was used to determine Dex-Total and skin perfusion difference between groups overtime. Results: There was no difference between groups (P = .476), but [Dex-Total] significantly increased over the course of the iontophoresis and posttreatment time (P < .001). Dex-P was measured in 18 of 24 participants with a mean concentration of 0.67 (1.09) μg/mL. Skin perfusion was significantly greater in the no ice treatment group (P = .002). Peak skin perfusion reached 27.74% (47.49%) and 117.39% (103.45%) from baseline for the ice and no ice groups, respectively. Conclusions: Ice massage prior to iontophoresis does not alter the tissue [Dex-Total] even with less skin perfusion.
A human tissue screen identifies a regulator of ER secretion as a brain-size determinant
Authors: Esk Christopher , Lindenhofer Dominik , Haendeler Simon , Wester Roelof A. , Pflug Florian , Schroeder Benoit , Bagley Joshua A. , Elling Ulrich , Zuber Johannes , von Haeseler Arndt , Knoblich Jürgen A.
Published: October 2020

Functional screen for microcephaly genes

Genetic screens are widely used to identify regulators in biological processes. Human screens are currently limited to two-dimensional cell cultures, which lack the ability to score tissue-dependent gene function. Esk
et al.
combined CRISPR-Cas9 screening with barcoded cellular lineage tracing to enable loss-of-function screening in three-dimensional human cerebral organoid tissue. By testing microcephaly candidate genes, the endoplasmic reticulum was found to control extracellular matrix protein secretion regulating tissue integrity and brain size. This genetic screen in human brain tissue implicates multiple pathways in microcephaly and provides a tool for systematic testing of genes in organoids.

Science
, this issue p.
935
Untapped computer scientists
Authors: Frierson Henry T. , Gilbert Juan E. , Waisome Jeremy A. M.
Published: October 2020

Underrepresented U.S. women of color (UWOC)—Black Americans, Latina Americans, Native Americans, and Indigenous Pacific Islanders—have long been underrepresented among Ph.D. recipients in computer science. The number of computer science Ph.D. degrees annually awarded to UWOC is miniscule. Moreover, even when compared with white women, the discrepancies are overwhelming. The Computer Research Association's Taulbee Survey revealed that in 2019, only seven UWOC (U.S. citizens) received Ph.D. degrees in computer science—a mere 0.43% of all computer science doctorates attained that year and only 2.1% of the doctorates awarded to all women.
Optimization of an Assay To Determine Colonization Resistance to Clostridioides difficile in Fecal Samples from Healthy Subjects and Those Treated with Antibiotics
Authors: Harris Hannah C. , Best Emma L. , Normington Charmaine , Saint-Lu Nathalie , Sablier-Gallis Frédérique , de Gunzburg Jean , Andremont Antoine , Wilcox Mark H. , Chilton Caroline H.
Published: October 2020

A healthy, intact gut microbiota is often resistant to colonization by gastrointestinal pathogens. During periods of dysbiosis, however, organisms such as
Clostridioides difficile
can thrive. We describe an optimized
in vitro
colonization resistance assay for
C. difficile
in stool (CRACS) and demonstrate the utility of this assay by assessing changes in colonization resistance following antibiotic exposure. Fecal samples were obtained from healthy volunteers (
n
 = 6) and from healthy subjects receiving 5 days of moxifloxacin (
n
 = 11) or no antibiotics (
n
 = 10).
Late Pleistocene slip rate of the central Haiyuan fault constrained from optically stimulated luminescence, 14C, and cosmogenic isotope dating and high-resolution topography
Authors: Shao Yanxiu , Liu-Zeng Jing , Van der Woerd Jérôme , Klinger Yann , Oskin Michael E. , Zhang Jinyu , Wang Peng , Wang Pengtao , Wang Wei , Yao Wenqian
Published: October 2020

To better constrain the long-term millennial slip rate of the Haiyuan fault in its central part, we revisited the site of Daqing, where there are multiple paired offset terraces. We used 0.1-m-resolution terrestrial light detection and ranging (LiDAR) and uncrewed aerial vehicle imagery to survey the offset terraces, quantify their geomorphology, and map the fault trace. From these observations, we refined the geomorphological interpretation of the site, measured terrace riser offsets, and determined their relation to terrace formation. The well-constrained age of the highest terrace, T3, at 13.7 ± 1.5 ka, determined from a combination of surface and subsurface optically stimulated luminescence, 14C, and terrestrial in situ 10Be cosmogenic radionuclide dating, associated with an offset of 88 m, yields a late Pleistocene minimum slip rate of 6.4 ± 1.0 mm/yr. The less-well-constrained offset (72 ± 3 m) of the T3/T2 riser base and the age (>9.3 ± 0.6 ka) of terrace T2 yield a maximum slip rate of 7.7 ± 0.6 mm/yr. The smallest offset of a gully incised into T1 of 6.0 ± 0.5 m is potentially associated with the most recent slip event that occurred in the last millennia. Overall, these offsets and ages constrain a geological rate of 5–8 mm/yr (preferred rate >6.4 mm/yr), similar to geodetic estimates. Our collocated high-resolution topography and precise chronology make it possible to reveal the geomorphic complexities of terrace riser offsets and their postformational evolution, and to show how previously determined geological rates along the fault were both under- and overestimated.
Timing and magnitude of progressive exhumation and deformation associated with Eocene arc-continent collision in the NE Caribbean plate
Authors: Román Y.A. , Pujols E.J. , Cavosie A.J. , Stockli D.F.
Published: October 2020

Puerto Rico and the northern Virgin Islands together preserve a unique archive of island arc construction and plate margin deformation along the northeastern edge of the Caribbean plate. In Eocene times, arc-continent collision of the Caribbean plate and the North American plate led to transpressional deformation along two major fault systems in Puerto Rico, resulting in an island-wide depositional hiatus. Although styles and kinematics of this deformational event are seemingly well understood, the lack of chronologic constraints have left uncertainties related to the timing of inception and activity, the magnitude of crustal exhumation, and the character of deformation (i.e., progressive or polyphase). New zircon and apatite (U-Th)/He ages reveal that deformation associated with arc-continent collision started in the early Eocene (ca. 52 Ma) and ended in the early Oligocene (ca. 29 Ma). Over this 23 m.y. time frame, deformation was not restricted to major faults, instead it propagated gradually eastward, with punctuated episodes of vertical exhumation in the early Eocene (ca. 52–34 Ma) and late Eocene (ca. 36–29 Ma). In contrast, the northern Virgin Islands experienced rapid cooling and exhumation in the early Miocene (ca. 24–21 Ma) associated with the extensional opening of the Anegada Passage. The modeled thermal histories for the central and northeastern part of Puerto Rico indicate collision-related peak transpressional deformation between 36 and 29 Ma and an average exhumation rate 0.9 ± 0.6 km/m.y. These results represent the first direct constraints on the timing and magnitude of collisional exhumation and offer insights into the deformational evolution of the northeastern edge of the Caribbean plate.
Unarousable child with a short bowel
Authors: Cortellazzo Wiel Luisa , Conversano Ester , Carlone Giorgia , Di Leo Grazia , Gortani Giulia , Zanchi Chiara , Barbi Egidio
Published: October 2020

Unarousable child with short bowel

A 4-year-old boy was admitted with progressive lethargy of a few hours’ duration and no other symptoms. His medical history was relevant for short bowel syndrome (SBS), following neonatal volvulus, with residual bowel length of 23 cm and intact ileocecal valve. He had similar self-limiting episodes in the past, after weaning parenteral nutrition, especially after eating large meals. The day before, he had consumed a large amount of apples.

Arterial blood gas (ABG) analysis showed metabolic acidosis with normal lactacidaemia (pH 7.09, pCO2 19 mm Hg, pO2 101 mm Hg, HCO3 5.8 mmol/L, BE −24, anion gap 29.4, chloride 116 mmol/L, L-lactate level 4 mmol/L).

On admission, the child could be awakened, but he was confused with slurred speech (Glasgow Coma Scale 14), with a body temperature of 37 C°, a heart rate of 125 beats/min and a respiratory rate of 38 breaths/min. The abdomen was distended, without guarding and with normal bowel sounds. Blood glucose levels were normal, as well as white blood cell count, liver and kidney function test and C reactive protein. An abdominal ultrasound ruled out an intussusception. An abdominal X-ray was performed too (see figure 1).

Figure 1

Abdominal distension with gas and bloating.

Questions

Which is the most likely diagnosis?

Encephalitis

D-lactic acidosis

Dehydration with third space fluid collection and acidosis

Hereditary fructose intolerance.

How is this diagnosis confirmed?

D lactic dosage

Breath test for bacterial overgrowth

Urine organic acid dosage

Search for reductive substances in the stools.

How should this patient be managed?

Intravenous fluids to facilitate D-lactic excretion

Restrict carbohydrates in the diet

Intravenous bicarbonates

Antibiotic treatment to reduce bowel bacterial overgrowth.

Answers can be found on page 2.
Head computed tomography in suspected physical abuse: time to rethink?
Authors: Glenn Kathryn , Nickerson Elizabeth , Bennett C Verity , Naughton Aideen , Cowley Laura Elizabeth , Morris Emily , Murtagh Una , Kontos Katina , Kemp Alison Mary
Published: October 2020

Background

National guidance recommends CT-head for all children <1 year old with suspected physical abuse, and to be considered for those <2 years old to exclude abusive head trauma.

Objectives

To investigate whether this guidance is followed, and the associations between clinical presentation and CT findings, to determine whether guidance could be refined.

Materials and methods

A retrospective case note review of all children <2 years old who underwent medical assessment for suspected abuse (2009–2017). Outcome measures were frequency of CT-head, and diagnostic yield of intracranial injury, skull fracture or both.

Results

CT-head was undertaken in 60.3% (152/252) of children <12 months old and 7.8% (13/167) of those aged 12–24 months. The diagnostic yield in children who had a CT-head was 27.1% in children <6 months old, 14.3% in those 6–12 months old (p=0.07) and 42.6% (6/13) in those 12–24 months old. For those with head swelling or neurological impairment, it was 84.2% (32/38). In children <12 months old without these clinical features, the estimated prevalence of occult head injury was 6.1% (7/115). The strongest predictors of an abnormal CT-head were swelling to the head (OR 46.7), neurological impairment (OR 20.6) and a low haemoglobin (OR 11.8).

Conclusion

All children <2 years of age with suspected physical abuse and neurological impairment or head swelling should undergo CT-head. Where the technical skills and the requisite expertise to interpret MRI exist, an MRI scan may be the optimal first-line neuroimaging investigation in infants who are neurologically stable with injuries unrelated to the head to minimise cranial radiation exposure.
Solitary popliteal neurofibroma: an unusual encounter
Authors: Sahoo Ankit , Ali Sheik Manwar
Published: October 2020

Diagnosing a popliteal fossa mass can be intriguing at times, and are not always Baker’s cysts, as expected. We present an uncommon case of a young lady who presented with a palpable firm mass in the popliteal fossa with no neurological deficit or compromised distal pulsations. On surgical exploration, it was found to be a well defined, firm mass, closely abutting the neurovascular bundle, which on histopathological study revealed a solitary encapsulated neurofibroma.
Does proning on NIV improve oxygenation?
Authors: Nasser Syed Muhammad Tahir , Narayanan Madan
Published: October 2020

Proning intubated patients with acute respiratory distress syndrome (ARDS) is an established practice to improve oxygenation temporarily. We present two cases of patients on our intensive care unit with ARDS, on non-invasive ventilation (NIV), in whom proning improved oxygenation at a stage when intubation was the next step. We discuss the mechanisms by which proning improves oxygenation as well as the potential risks proning on NIV brings, for which we make specific recommendations.
Aseptic abscess syndrome
Authors: Fillman Hannah , Riquelme Patricio , Sullivan Peter D , Mansoor André Martin
Published: October 2020

A 43-year-old woman with Crohn’s disease was admitted to the hospital with weight loss and 1 week of fever, abdominal pain and diarrhoea. At presentation, the patient was not on steroids or other immunosuppressive agents. Cross-sectional imaging of the abdomen revealed active colitis and multiple splenic and hepatic abscesses. All culture data were negative, including aspiration of purulent material from the spleen. Despite weeks of intravenous antibiotics, daily fever and abdominal pain persisted, the intra-abdominal abscesses grew, and she developed pleuritic chest pain and consolidations of the right lung. The patient was ultimately diagnosed with aseptic abscess syndrome, a rare sequelae of inflammatory bowel disease. All antimicrobials were discontinued and she was treated with high-dose intravenous steroids, resulting in rapid clinical improvement. She was transitioned to infliximab and azathioprine as an outpatient and repeat imaging demonstrated complete resolution of the deep abscesses that had involved her spleen, liver and lungs.
Guillain-Barré syndrome after COVID-19 in Japan
Authors: Hirayama Takehisa , Hongo Yu , Kaida Kenichi , Kano Osamu
Published: October 2020

We report the first case of Guillain-Barré syndrome (GBS) associated with SARS-CoV-2 infection in Japan. A 54-year-old woman developed neurological symptoms after SARS-CoV-2 infection. We tested for various antiganglioside antibodies, that had not been investigated in previous cases. The patient was diagnosed with GBS based on neurological and electrophysiological findings; no antiganglioside antibodies were detected. In previous reports, most patients with SARS-CoV-2-infection-related GBS had lower limb predominant symptoms, and antiganglioside antibody tests were negative. Our findings support the notion that non-immune abnormalities such as hyperinflammation following cytokine storms and microvascular disorders due to vascular endothelial damage may lead to neurological symptoms in patients with SARS-CoV-2 infection. Our case further highlights the need for careful diagnosis in suspected cases of GBS associated with SARS-CoV-2 infection.
Rare complication of COVID-19 presenting as isolated headache
Authors: Asif Rehan , O' Mahony Marcella Sinead
Published: October 2020

An 18-year-old man presented with persistent isolated headache 2 weeks after recovering from acute COVID-19 illness. Extensive cerebral venous sinus thrombosis (CVST) was detected on CT venogram despite him having no other thrombotic risk factors. CVST can complicate COVID-19. A high index of clinical suspicion is warranted as it can often have a subtle presentation with paucity of neurological symptoms.
Impact of financial management centralisation in a health system under austerity: a qualitative study from South Africa
Authors: Wishnia Jodi , Goudge Jane
Published: October 2020

Introduction

International calls for universal health coverage (UHC) have led many countries to implement health sector reforms, however, since the 2008 global recession, economic growth has slowed in many lower-income and middle-income countries. In a renewed interest in public financial management (PFM), international organisations have emphasised the importance of giving spending control to those responsible for healthcare. However, centralisation is a common response when there is a need to cut expenditure due to a reduced budget; yet failure to decentralise often hampers the achievement of important goals. This paper examines the effect of centralising financial decision-making on the functioning of the South African health system.

Methods

We used a case study design with an ethnographic approach. Primary data collection was conducted through participant-observation and semistructured interviews, over 1 year. Member checking was conducted.

Results

New management implemented centralisation due to a reduced budget, a history of financial mismanagement, the punitive regulatory environment financial managers face, and their fear of poor audit outcomes. The reform, together with an authoritarian management style to ensure compliance, created a large power distance between financial and clinical managers. District managers felt that there was poor communication about the reform and that decision-making was opaque. This lowered commitment to the reform, even for those who thought it was necessary. It also reduced communal action, creating an individualistic environment. The authoritarian management style, and the impact of centralisation on service delivery, negatively affected planning and decision making, impairing organisational functioning.

Conclusion

As public health systems become even more financially constrained, recognising how PFM reforms can influence organisational culture, and how the negative effects can be mitigated, is of international importance. We highlight the importance of a participatory culture that encourages shared decision making and coproduction, particularly as countries grapple with how to achieve UHC with limited funds.
TNIP1/ABIN1 and lupus nephritis: review
Authors: Brady Makayla P , Korte Erik A , Caster Dawn J , Powell David W
Published: October 2020

SLE is a complex autoimmune disease with genetic, epigenetic, immune-regulatory, environmental and hormonal factors. Kidney inflammation and injury, termed lupus nephritis (LN), occurs in over half of patients with SLE and is a leading cause of disability and death. There is a high degree of short-term and long-term side effects associated with current LN therapies and they are not effective for many patients. Thus, novel therapies with reduced toxicity and improved efficacy are drastically needed. Many of the known LN susceptibility genes have functions that mediate inflammation via cytokine/chemokine production and activation of myeloid and B cells. Understanding the cellular and molecular mechanisms mediated by these variant gene products provides valuable insight for the development of improved and personalised diagnostics and therapeutics. This review describes variants in the TNIP1 (tumour necrosis factor α-induced protein 3-interacting protein 1) gene associated with risks for SLE and LN and potential roles for loss of function of its protein product ABIN1 in the activation of myeloid and B-cell-mediated injury in LN.
Angiographic control versus ischaemia-driven management of patients undergoing percutaneous revascularisation of the unprotected left main coronary artery with second-generation drug-eluting stents: rationale and design of the PULSE trial
Authors: De Filippo Ovidio , Bianco Matteo , Tebaldi Matteo , Iannaccone Mario , Gaido Luca , Guiducci Vincenzo , Santarelli Andrea , Zaccaro Lorenzo , Depaoli Alessandro , Vaudano Paolo , Quadri Giorgio , Gagnor Andrea , Boccuzzi Giacomo , Solitro Federica , Cortese Giancarlo , Guarnaccia Carla , Tore Davide , Veltri Andrea , Franchin Luca , Angelini Filippo , Garbo Roberto , Giammaria Massimo , Varbella Ferdinando , Marchisio Filippo , Fonio Paolo , De Ferrari Gaetano Maria , Cerrato Enrico , Campo Gianluca , D'Ascenzo Fabrizio
Published: October 2020

Background

The role of planned angiographic control (PAC) over a conservative management driven by symptoms and ischaemia following percutaneous coronary intervention (PCI) of the unprotected left main (ULM) with second-generation drug-eluting stents remains controversial. PAC may timely detect intrastent restenosis, but it is still unclear if this translated into improved prognosis.

Methods and analysis

PULSE is a prospective, multicentre, open-label, randomised controlled trial. Consecutive patients treated with PCI on ULM will be included, and after the index revascularisation patients will be randomised to PAC strategy performed with CT coronary after 6 months versus a conservative symptoms and ischaemia-driven follow-up management. Follow-up will be for at least 18 months from randomisation. Major adverse cardiovascular events at 18 months (a composite endpoint including death, cardiovascular death, myocardial infarction (MI) (excluding periprocedural MI), unstable angina, stent thrombosis) will be the primary efficacy outcome. Secondary outcomes will include any unplanned target lesion revascularisation (TLR) and TLR driven by PAC. Safety endpoints embrace worsening of renal failure and bleeding events. A sample size of 550 patients (275 per group) is required to have a 80% chance of detecting, as significant at the 5% level, a 7.5% relative reduction in the primary outcome.

Trial registration number

NCT04144881
Incomplete pentalogy of Cantrell in a Border terrier puppy
Authors: Williams Phillipa , Booth Malcolm , Rossanese Matteo
Published: October 2020

A 4‐month‐old, 6.4‐kg, male entire, Border terrier was referred for investigation of exercise intolerance and a suspected congenital midline defect. Physical examination revealed a sternal and a supraumbilical abdominal defect. Thoracic radiography and CT confirmed a congenital sternal cleft, a large supraumbilical diastasis rectus and a pleuroperitoneal diaphragmatic hernia. No congenital cardiac defect was detected during echocardiographic examination. These findings were consistent with an incomplete Cantrell’s pentalogy. Surgical reconstruction involved diaphragmatic reconstruction, abdominal muscle herniorrhaphy and novel closure of a sternal cleft with crimped monofilament nylon leader line. The dog had grown since surgery to a mature adult size and did not exhibit exercise intolerance 18 months postoperatively. Cantrell’s pentalogy is a collection of congenital midline defects that are rare in the dog and cat but can be successfully treated surgically, especially if diagnosed at a young age and if not involving intracardiac defects.
Reliability assessment of slopes with three-dimensional rotated transverse anisotropy in soil properties
Authors: Huang L. , Leung Y.F.
Published: October 2020

The influence of soil variability on three-dimensional (3D) probabilistic slope stability analysis has been investigated previously for soils that display isotropic spatial variability features or anisotropic horizontal fabric patterns. However, due to various soil deposition processes, weathering, filling or tectonic movements, the assumptions of isotropy or horizontal layering may not always be realistic. This study presents 3D analyses of slopes with spatially variable soils associated with rotated transverse anisotropy features. The results show that for cross-dip slopes where the strike direction of soil strata is perpendicular to the out-of-plane direction of the slope, the reliability depends on various factors including strata rotation angle and autocorrelation distances, and differs significantly from slopes with horizontally deposited soil fabric. The influence of strata orientation is also pronounced for dip slopes and reverse dip slopes, and these are presented in terms of reliability indices of the slopes and statistics of the length of sliding mass and elaborated by considering the failure mechanism under different scenarios. Through these analyses, this paper discusses the key features of slope reliability considering rotated transverse anisotropy in soil properties, and their major differences from situations involving horizontal soil layers or two-dimensional probabilistic assessments.
Ab initio investigation of ultrasmall silicon nanocrystal doping by phosphorous
Authors: Makhkamov Shermakhmat , Umarova Feruza , Normurodov Asror , Sulaymonov Nadimbek , Tashmetov Mannab , Ismailova Oksana
Published: October 2020

The influence of a single phosphorous impurity on structural and electronic properties of spherical, diamond-like, hydrogen-passivated, ultrasmall Si[Formula: see text]H[Formula: see text], Si[Formula: see text]H[Formula: see text], Si[Formula: see text]H[Formula: see text] and Si[Formula: see text]H[Formula: see text] nanocrystals with silicon core diameters of 0.88, 1.03, 1.26 and 1.58 nm was studied by density function theory calculations. In this ultrasmall length scale, the dependence of structural deformation and electronic properties with gradually increasing sizes has not been practically investigated. A detailed analysis of the structural deformation and charge distribution initiated by the presence of the impurity is conducted to understand how structural change occurs within this length scale, where quantum confinement effects become predominant. The Si[Formula: see text]P[Formula: see text]H[Formula: see text] nanocrystal with P[Formula: see text] located in its center is completely deformed. In a larger nanocrystal, the spherical surrounding impurity remains and the P–Si bond lengths increase. In Si[Formula: see text]P[Formula: see text]H[Formula: see text], the first sphere is expanded, energies of phosphorous formation in central and subsurface positions differ insignificantly, and the P atom can be located in both the central and subsurface positions. In all nanoparticles, the charges of central P[Formula: see text] atoms are negative. The width of the bandgap in undoped nanocrystals is much larger than in bulk silicon and depends on their sizes. The phosphorous introduces the splitting level in the bandgap located closer to the conduction band.
Dupuytren Disease Management Trends: A Survey of Hand Surgeons
Authors: Paynter Jessica Anne , Tobin Vicky , Rozen Warren M. , Hunter-Smith David J.
Published: October 2020

Background: Management of Dupuytren Disease is variable, and influenced by multiple factors including location, extent of disease, surgical preference and familiarity with different treatment techniques. The objective of this study was to determine current Dupuytren Disease management trends in Australia.

Methods: A questionnaire was sent through The Australian Hand Surgery Society to all members. In addition to demographic data, indications and preferences for different management interventions were surveyed on location of disease, age and activity level of the patient.

Results: 99 (48%) of the Australian Hand Surgery Society members completed the survey. Respondents were primarily Orthopaedic (50%) or Plastic (49%) Surgeons, and most worked in private (99%) and public (71%) practice. Surgeon’s believed that Tubiana’s treatment goals to correct deformity was the most important (60%) and to shorten post-operative recovery (60%) was the least important. Only 42% of respondents perform needle aponeurotomy for Dupuytren Disease. In contrast 70% of respondents perform collagenase injections, with manipulation most commonly undertaken on the second day (46%) and skin tears (52%) the most common complication. Seventy-five percent of the respondents feel there is sufficient evidence to support the treatment of Dupuytren disease with collagenase injections. Ninety nine percent of all respondents perform fasciectomes for Dupuytren Disease, with Limited (without graft) (76%) the most routine performed.

Conclusions: Several procedural options for the treatment of Dupuytren Disease exist within Australia. This study shows current Australian practice trends and highlights the increasing use of collagenase.
Nontraumatic Perforation of the Metacarpal by the Stem of a Flexible Silicone Implant in a Patient with Rheumatoid Arthritis
Authors: Sakuma Yu , Tobimatsu Haruki , Ikari Katsunori
Published: October 2020

A 49-year-old woman with rheumatoid arthritis who underwent replacement arthroplasty of second to fifth left metacarpophalangeal joints with silastic implant seven years ago presented with a complaint of mild pain and discomfort on the replaced joint of index finger. Ulnar deviation had relapsed, with severe swan neck deformities. Computed tomography examination demonstrated that the tip of the stem of the silicon implant penetrated the second metacarpal. We confirmed that finding surgically, and we performed a revision surgery successfully with autogenous bone grafting from distal radius. As the patient had undergone finger joint replacement surgery with silastic implant, nontraumatic perforation of the bone cortex by the implant could happen in a long-term process. On long-term follow up of silastic arthroplasty of finger joint, the possibility of nontraumatic perforation of the finger bone by the prosthesis should be considered, especially in the coexistence of severe finger deformities such as swan neck deformity.
Floating Shoulder Injury Resulting in Delayed Onset of Infraclavicular Brachial Plexus Palsy
Authors: Venkatramani Hari , Bhardwaj Praveen , Raja Sabapathy S. , Bandari Gopinath , Zhang Dafang , Dheenadhayalan J
Published: October 2020

As the brachial plexus traverses the costoclavicular space, it is susceptible to compression by pathologies affecting the clavicle. Clavicle nonunions with hypertrophic callus may cause a delayed onset of brachial plexus palsy. We present a rare case of a floating shoulder injury causing medial and posterior cord brachial plexus palsy two months after initial injury. After the diagnosis was established, the patient was treated successfully with expeditious brachial plexus decompression, callus excision, and rigid osteosynthesis, with healing of the clavicle nonunion and scapular fracture, and recovery of sensory and motor deficits.
Autophagy and heat: a potential role for heat therapy to improve autophagic function in health and disease
Authors: McCormick James J. , Dokladny Karol , Moseley Pope L. , Kenny Glen P.
Published: October 2020

Autophagy is a crucial cell survival mechanism that involves the degradation and recycling of old or damaged organelles and proteins to maintain cellular homeostasis. Impairments in autophagy are central to the pathogenesis of many conditions including metabolic and neurodegenerative disorders, cardiovascular and pulmonary diseases, diabetes, and aging. Although various pharmacological agents may be able to stimulate autophagic function, to our knowledge, few interventions exist that have been deemed safe and effective in humans. An emerging body of evidence suggests that targeting the autophagic pathway via passive heating (heat therapy) may stimulate autophagic function. Therefore, the primary focus of the present review is to analyze the mechanisms in which passive heating induces autophagy as defined by in vitro and in vivo (animal and human) models. Our secondary focus is to examine the implications of utilizing passive heating to restore dysfunctional autophagy in chronic disease and aging. Finally, we discuss potential therapeutic strategies to implement passive heating to stimulate autophagic function in humans.
Utility of a Modified Oropharyngeal Airway for Performing Tracheal Intubation Using a Fiberoptic Bronchoscope and Video Stylet: A Randomized Crossover Trial Using a Manikin
Authors: Lee Jang Hee , Na Ji Ung , Shin Dong Hyuk , Choi Pil Cho , Park Sang O , Kim Won Jae , Han Sang Kuk
Published: October 2020

Purpose. The purpose of this study was to assess if a modified airway (MA), developed by the authors, would act as a guide and improve the performance of intubation when used with a video stylet (VS) or fiberoptic bronchoscope (FOB) for endotracheal intubation. Methods. This randomized crossover simulation study using manikins was conducted with 36 novice operators. Time to complete intubation, time to see the glottis, and success rate of intubation of each device were measured and compared with or without use of MA. Results. For intubation using FOB with MA, the median time to complete intubation significantly reduced from 46 to 31 seconds with a medium effect size (

p
=
0.004

, r = 0.483), and the median time to see the glottis significantly reduced from 7 to 5 seconds with a medium effect size (

p
=
0.032

, r = 0.357). The overall success rate was not statistically different between FOB with MA (33/36, 91.7%) and FOB alone (31/36, 86.1%); however, the cumulative success rate over time for FOB with MA was higher than that for FOB alone (

p
=
0.333

). For intubation using VS, there were no differences in the time to see the glottis and time to complete intubation between VS with MA and VS alone (

p
=
0.065

and

p
=
0.926

, respectively), and the cumulative success rate was not statistically significant (

p
=
0.594

). Conclusion. Adjunct use of MA helped reduce time to complete intubation in FOB, but not in VS. If an inexperienced operator uses FOB, it would be helpful to use MA as an adjunct device.
Keratinocyte Function in Normal and Diabetic Wounds and Modulation by FOXO1
Authors: Wang Yulan , Graves Dana T.
Published: October 2020

Diabetes has a significant and negative impact on wound healing, which involves complex interactions between multiple cell types. Keratinocytes play a crucial role in the healing process by rapidly covering dermal and mucosal wound surfaces to reestablish an epithelial barrier with the outside environment. Keratinocytes produce multiple factors to promote reepithelialization and produce factors that enhance connective tissue repair through the elaboration of mediators that stimulate angiogenesis and production of connective tissue matrix. Among the factors that keratinocytes produce to aid healing are transforming growth factor-β (TGF-β), vascular endothelial growth factor-A (VEGF-A), connective tissue growth factor (CTGF), and antioxidants. In a diabetic environment, this program is disrupted, and keratinocytes fail to produce growth factors and instead switch to a program that is detrimental to healing. Changes in keratinocyte behavior have been linked to high glucose and advanced glycation end products that alter the activities of the transcription factor, FOXO1. This review examines reepithelialization and factors produced by keratinocytes that upregulate connective tissue healing and angiogenesis and how they are altered by diabetes.
Stimulation of Epithelial Sodium Channels in Endothelial Cells by Bone Morphogenetic Protein-4 Contributes to Salt-Sensitive Hypertension in Rats
Authors: Yang Xu , Niu Na , Liang Chen , Wu Ming-Ming , Tang Liang-Liang , Wang Qiu-Shi , Lou Jie , Song Bin-Lin , Zheng Wei-Wan , Ma He-Ping , Zhang Zhi-Ren
Published: October 2020

Previous studies have shown that high salt induces artery stiffness by causing endothelial dysfunction via increased sodium influx. We used our unique split-open artery technique combined with protein biochemistry and in vitro measurement of vascular tone to test a hypothesis that bone morphogenetic protein 4 (BMP4) mediates high salt-induced loss of vascular relaxation by stimulating the epithelial sodium channel (ENaC) in endothelial cells. The data show that high salt intake increased BMP4 both in endothelial cells and in the serum and that exogenous BMP4 stimulated ENaC in endothelial cells. The data also show that the stimulation is mediated by p38 mitogen-activated protein kinases (p38 MAPK) and serum and glucocorticoid-regulated kinase 1 (Sgk1)/neural precursor cell expressed developmentally downregulated gene 4-2 (Nedd4-2) (Sgk1/Nedd4-2). Furthermore, BMP4 decreased mesenteric artery relaxation in a benzamil-sensitive manner. These results suggest that high salt intake stimulates endothelial cells to express and release BMP4 and that the released BMP4 reduces artery relaxation by stimulating ENaC in endothelial cells. Therefore, stimulation of ENaC in endothelial cells by BMP4 may serve as another pathway to participate in the complex mechanism of salt-sensitive (SS) hypertension.
An Improved ip − iq Harmonic Detection Method Based on Time-Varying Integral Duration
Authors: Li Jifang , Wang Jidong , Song Kunlin , Feng Zhen
Published: October 2020

By analyzing harmonic related to instantaneous active current and instantaneous reactive current, we propose an improved harmonic detection method to remedy long response delay and low detection accuracy corresponding to harmonic of power system. This method introduces a series connection scheme composed of Low-Pass Filter (LPF) and a current average module firstly. Then, detection accuracy of harmonic current is enhanced by adaptive tuning cut-off frequency of LPF and integration time which was obtained by proposed algorithm of the current average module. Moreover, feedback loop is introduced to compensated delay caused by LPF. Simulations including uncontrollable rectifier and three-phase voltage type inverter show proposed method has many advantages such as high detection accuracy, low response delay and good generality. Our method provides reliable harmonic current detection for later harmonic suppression and harmonic compensation.
Developing a Framework to Support the Delivery of Effective Pain Management for Children: An Exploratory Qualitative Study
Authors: Simons Joan , Carter Bernie , Craske Jennie
Published: October 2020

Two million children are admitted to hospital every year in the UK and between 59% and 94% will experience pain, with 27–40% of them experiencing moderate to severe pain. Currently, there are a number of well-researched guidelines on children’s pain available, yet pain prevalence is high. Despite the guidelines, there is a lack of an overall framework that includes the necessary components to deliver effective pain management. This study was built on previous work about key elements that support children’s pain management, by exploring their relevance and practical application with 43 healthcare practitioners. We carried out focus groups with band 5 nurses (n = 6) and advanced nurse practitioners (n = 11) and semistructured interviews with pain nurses (n = 16) and consultants (n = 10). We also presented and discussed our findings with an advisory group. Findings demonstrated that the following elements were considered to be important: delivering pain management with confidence, supporting colleagues with protocols and guidance, empowering parents to be involved in pain management, and adopting an individual approach to a child and family. These elements formed the basis of a framework for children’s pain management. Some practitioners indicated that pain management required education and more resources, and that the culture of an area could influence pain management practice. The framework brings together elements that have the potential to improve the management of children’s pain through its use as an education tool. Each interrelated element of the framework plays an important part in the overall management of children’s pain. The need now is to make the dissemination of the findings accessible to health care practitioners, parents, and educators. Next steps include the development of infographic posters, an animation, and a free online course, which will incorporate the use of Bloom’s taxonomy.
miR-21 Overexpression Promotes Esophageal Squamous Cell Carcinoma Invasion and Migration by Repressing Tropomyosin 1
Authors: Shen Zhuojian , Xu Xia , Lv Liangzhan , Dai Honglue , Chen Ju , Chen Baishen
Published: October 2020

The migration and invasion of esophageal squamous cell carcinoma are associated with clinical outcomes, however, the mechanisms remain poorly understood. Here, we found that miR-21 is significantly overexpressed in ESCC, lung cancer, and bladder cancer compared with the adjacent normal tissue. MiR-21 and TPM1 expressions were analyzed by RT-qPCR and WB in 30 ESCC, 10 lung cancer, and 10 bladder cancer clinical specimens, each with matched adjacent normal tissue. Knockdown and overexpression of miR-21 as well as knockdown of TPM1 in ESCC cell lines were performed using synthetic oligonucleotides. TPM1 3

′

UTR luciferase reporter constructs were used to investigate targeting of TPM1 by miR-21. ESCC migration and invasion were assessed using transwell migration and invasion assays. Inhibition of miR-21 reduced migration and invasion in two ESCC cell lines, and overexpression of miR-21 promoted migration and invasion in vitro. Interestingly, TPM1 exhibited inverse patterns of expression compared with miR-21 in tissues and cell lines. Luciferase reporter assays demonstrated that TPM1 was directly regulated by miR-21. Moreover, the forced overexpression of miR-21 repressed the TPM1 expression, while silencing of miR-21 restored the TPM1 expression in ESCC cell lines. What is more, simultaneous silencing of miR-21 and TPM1 expressions did not alter the migratory and invasive characteristics demonstrating that the effects of miR-21 were mediated through TPM1. In conclusion, the aberrant overexpression of miR-21 is common in cancer and promotes the migration and invasion of ESCC through inhibiting the TPM1 expression. These results suggest that miR-21 may be a novel predictive marker and therapeutic target for treatment of ESCC.
Latrine Availability and Associated Factors among Religious Institutions in Northern Ethiopia, 2018
Authors: Abrha Mulugeta Woldu , Demoz Ghebremedhin Kiros , Teklemariam Weldeslasie Tesfay
Published: October 2020

Background. Religious institutions found in the community not only uphold belief and cultural values but can also act as a force for positive change and development. Improved sanitation and hygiene are crucial in these institutions to decrease preventable infections due to unsanitary conditions. However, there are no studies among religious institutions on availability of latrines. Therefore, this study was conducted to assess latrine availability and associated factors among religious institutions in the Tigray Region, Ethiopia. Method. An institution-based cross-sectional study design was conducted in the Tigray Region, Northern Ethiopia. Multistage sampling was used to sample 385 religious institutions. Data were collected using a pretested, structured questionnaire and observation checklist. Logistic regression was fitted, and an odds ratio with 95% confidence interval (CI) with

p

value less than 0.05 was used to determine the predictors of latrine availability. Analysis was carried out using the SPSS 20TM software package. Results. In this study, latrine availability was 32.8%. It was significantly affected by currently saved money towards having a latrine (adjusted odds ratio (AOR): 0.32, 95% confidence interval (CI) [0.25, 0.42]), any messages seen, heard, or received on sanitation and hygiene (AOR: 0.43, 95% CI [0.38, 0.51]), and the place where messages were seen, heard, or received (AOR: 2.95, 95% CI [1.11, 5.55]). Conclusion. Latrine availability was very low when compared to the national target of 100% among religious institutions and was affected by the currently saved money towards having a latrine, any messages seen, heard, or received on sanitation and hygiene, and the place where the messages were received. Information regarding latrine availability should be provided to the community visiting religious institutions through available channels and promotion of practical models.