bluuebunny/crossref_metadata_2025 huggingface dataset:
Spontaneous Disappearance of Filar Cysts Diagnosed by Transabdominal Ultrasonography: A Report of Three Cases
Authors: Wu Jingping
Published: June 2021

Filar cysts (FCs) can be detected using ultrasound before or after delivery. They usually present as anechoic structures with a clear boundary just caudal to the lower end of the conus medullaris. They are generally considered a physiological variation and do not affect health. Some studies have pointed out that FCs in children can disappear spontaneously, as identified by ultrasound or magnetic resonance imaging. Three cases of FCs diagnosed by prenatal transabdominal ultrasound were reported in this study, and it was observed that FCs could disappear spontaneously in utero. The shortest time of disappearance was 4 weeks.
Seven practices for pursuing equity through learning health systems: Notes from the field
Authors: Parsons Allison , Unaka Ndidi I. , Stewart Constance , Foster Jennifer , Perez Valerie , Jones Nana‐Hawa Yayah , Kahn Robert , Beck Andrew F. , Riley Carley
Published: June 2021

Introduction

Despite learning health systems' focus on improvement in health outcomes, inequities in outcomes remain deep and persistent. To achieve and sustain health equity, it is critical that learning health systems (LHS) adapt and function in ways that directly prioritize equity.

Methods

We present guidance, including seven core practices, borne from theory, evidence, and experience, for actors within LHS pursuing equity.

Results

We provide a foundational definition of equity. We then offer seven core practices for how LHS may effectively pursue equity in health: establish principle, measure for equity, lead from lived experience, co‐produce, redistribute power, practice a growth mindset, and engage beyond the healthcare system. We include three use cases that illustrate ways in which we have begun to center equity in the work of our own LHS.

Conclusion

The achievement of equity requires real transformation at individual, institutional, and structural levels and requires sustained and persistent effort.
Developing organizational learning for scaling‐up community‐based primary health care in Ghana
Authors: Awoonor‐Williams John Koku , Phillips James F.
Published: June 2021

Introduction

Achieving effective community‐based primary health care requires evidence for guiding strategic decisions that must be made. However, research processes often limit data collection to particular organizational levels or disseminate results to specific audiences. Decision‐making that emerges can fail to account for the contrasting perspectives and needs of managers at each organizational level. The Ghana Health Service (GHS) addressed this problem with a multilevel and sequential research and action approach that has provided two decades of implementation learning for guiding community‐based primary health care development.

Method

The GHS implementation research initiatives progressed from (i) a participatory pilot investigation to (ii) an experimental trial of strategies that emerged to (iii) replication research for testing scale‐up, culminating in (iv) evidence‐based scale‐up of a national community‐based primary health care program. A reform process subsequently repeated this sequence in a manner that involved stakeholders at the community, sub‐district, district, and regional levels of the system. The conduct, interpretation, and dissemination of results that emerged comprised a strategy for achieving systems learning by conducting investigations in phases in conjunction with bottom‐up knowledge capture, lateral exchanges for fostering peer learning at each system level, and top‐down processes for communicating results as policy. Continuous accumulation of qualitative data on stakeholder reactions to operations at each organizational level was conducted in conjunction with quantitative monitoring of field operations.

Results

Implementation policies were enhanced by results associated with each phase. A quasi‐experiment for testing the reform process showed that scale‐up of community‐based primary health care was accelerated, leading to improvements in childhood survival and reduced fertility.

Conclusion

Challenges to system learning were overcome despite severe resource constraints. The integration of knowledge generation with ongoing management processes institutionalized learning for achieving evidence‐driven program action.
Free medialis tarsus flap transfer for reconstruction of toe necrosis: A case report
Authors: Tsukuura Reiko , Yamamoto Takumi
Published: June 2021

The medial tarsal area is a commonly used donor site for skin grafts to the digits and toes, with good color and texture match as well as a concealable donor site scar. Yet, there has been no report as a perforator free flap donor site. The purpose of this report is to present a new perforator flap harvested from medial tarsal region. We present a case of a soft tissue defect of the fifth toe due to essential thrombocythemia (ET), successfully treated with a free medialis tarsus flap (MTF) transfer. A 62‐year‐old male with ET suffered from the right fifth toe necrosis caused by digital artery thrombosis. After the manifestation of the necrosis, necrotic tissue was completely debrided, which resulted in a 3 × 1.5 cm skin defect with exposure of the tendon and the phalangeal bone. Sixth days after debridement, a 4.5 × 1.7 cm MTF was harvested transversely and inferiorly to the right medial ankle, locating the preoperatively detected posterior tibial artery perforator (PTAP) in the flap. Perforator‐to‐perforator anastomosis was done using the dorsal metatarsal artery perforator and the subcutaneous vein as recipient vessels. The donor site was closed primarily. Postoperative course was uneventful, and the reconstruction preserved the toe length and functions of extension and flexion at 9 months postoperatively. The patient could walk with conventional shoes by himself. MTF may be an option for small skin defect in the digits and toes where skin graft is not indicated.
Crack growth angle prediction of an internal crack under mixed mode load for unfilled elastomer using the strain energy density factor
Authors: El Yaagoubi Mohammed , Meier Jens
Published: June 2021

This article investigates the prediction of the crack growth angle of an existing internal crack under mixed mode loading at the crack tip for an unfilled ethylene propylene diene terpolymer rubber (EPDM). For the realization of mixed mode loading, the cracks of the uniaxial loaded specimens were oriented with different angles to the loading direction. The energy density factor was used as a potential criterion for determining the crack growth angle. The determination of the strain energy density factor was carried out simulatively in Abaqus. The second‐order Ogden model was used to describe the rubber‐like material behavior. The relative local minimum of the strain energy density factor provides the possible growth angle. The experimental investigations show that the initial cracks grow orthogonally to the loading direction for the different crack orientation angles. For the crack orientation angle parallel to the load direction, the crack growth was observed because the strong stretching of the specimen caused strong necking in the crack region. The crack growth for the remaining crack orientation angles were induced due to shear loading at the crack tip. The predictive angle of different crack orientation angles shows very good accordance to the measured crack growth angles.
Impact responses of an open‐cell natural rubber foam impregnated with shear thickening fluid
Authors: Kaewpradit Pornsiri , Kongchoo Arunya , Chonlathan Pannarai , Lehman Nussana , Kalkornsurapranee Ekwipoo
Published: June 2021

This research aims to investigate the impact responses of an impact absorbing material prepared from natural rubber (NR). Shear thickening fluid (STF) was developed in order to improve compatibility, and impact response capability of a NR foam. The material was prepared by impregnating NR foam with STF (30 wt% nanosilica with 10 nm). The obtained material is soft under normal circumstances, but immediately stiff when undergoing sudden impact before softening again. The effects of foam densities (0.098, 0.15, 0.24 g/cm3), STF contents (10, 20, 30 vol%), and fluid filling techniques were investigated. Experimental results show that the absorbed force tends to increase by increasing the foam density and the fluid content. Impact absorption capability of the proposed STF (STFA)/NR foam is higher than that of the conventional STF (STF0)/NR foam. In other words, STFA can improve the impact responses of the material providing comparable results with the commercial kneepad, which has the dilatant behavior.
Ultrasonographic prevalence of ulnar nerve displacement at the elbow in young baseball players
Authors: Kawabata Masashi , Miyata Toru , Tatsuki Hiroaki , Naoi Daichi , Ashihara Mitsuaki , Miyatake Kazuma , Kusaba Yohei , Watanabe Daiki , Matsuzaki Masashi , Suzuki Yuta , Kamiya Kentaro
Published: June 2021

Background

Overhead‐throwing athletes are at risk of elbow injury because of valgus stress, leading to unstable ulnar nerves and neuropathy. Studies regarding ulnar nerve damage/displacement have been performed primarily in adults.

Objective

To determine the prevalence and related factors associated with ulnar nerve displacement at the elbow in young baseball players.

Design

Cross‐sectional study.

Participants

Youth baseball players ages 10–12 years were eligible to participate. Exclusion criteria were history of neuropathic pain, trauma, or prior surgery of the upper limb. Fifty‐seven participants were eligible for inclusion in the study.

Main Outcome Measurements

Demographic data and ultrasonography findings of ulnar nerve dynamics at the cubital tunnel were analyzed in a total of 114 elbows. Elbows were grouped into nondislocation and displacement (subluxation or dislocation) groups according to ultrasound findings. Logistic generalized estimating equations were used to identify factors associated with ulnar nerve displacement.

Results

Thirty‐six (31.6%) elbows demonstrated sonographic findings of ulnar nerve displacement, with 13 (11.4%) subluxations and 23 (20.2%) dislocations. Fourteen (24.6%) participants experienced nerve displacement in the dominant elbow only, whereas nerve displacement in both elbows occurred in 11 (19.3%) participants. Nerve displacement in the nondominant elbow only was not observed. Hand dominance and tenderness of the arcade of Struthersʼ were factors associated with ulnar nerve displacement (odds ratio, 2.81, and 9.73; 95% confidence interval, 1.34–5.91 and 2.45–38.68; p = .006 and .001, respectively).

Conclusion

One‐third of the young baseball players evaluated had ultrasonographic findings compatible with ulnar nerve displacement at the elbow. Hand dominance and tenderness of Struthers arcade were the only factors associated with ulnar nerve displacement. Ultrasound may help identify patients with ulnar nerve displacement and contribute to the understanding of its pathophysiology in young baseball players.
Blood eosinophils, specific immunoglobulin E, and bronchiolitis severity
Authors: Mitri Elie J. , Zheng David X. , Garg Vebhav , Crifase Cassandra C. , Herrera Nicole M. , Espinola Janice A. , Hasegawa Kohei , Camargo Carlos A.
Published: June 2021

Background

Bronchiolitis is the leading cause of hospitalization for United States infants. Blood eosinophil and serum specific IgE (sIgE) levels are separately linked to clinical severity but few studies have examined these biomarkers together.

Objective

Among infants hospitalized for bronchiolitis, we investigated the association between (1) blood eosinophilia and severity, (2) sIgE sensitization and severity, and (3) interaction between the two biomarkers on severity.

Methods

We enrolled 1016 infants hospitalized for bronchiolitis between 2011 and 2014 across 17 U.S. hospitals into a prospective cohort study. Of those, 873 (86%) had eosinophils measured and all had sIgE levels from blood collected at hospitalization. We investigated higher bronchiolitis severity using intensive care therapy as the outcome (i.e., intensive care unit admission, intubation, and/or receipt of continuous positive pressure ventilation).

Results

Among 873 infants in the analytic cohort, 18% had blood eosinophilia of ≥3%, and 20% were positive for sIgE. With regard to bronchiolitis severity, 15% received intensive care therapy. In unadjusted analyses, eosinophils ≥3% was not associated with intensive care therapy, while sIgE was associated with a significantly higher risk (odds ratio [OR]: 1.44, 95% confidence interval [CI]: 1.08–1.92; p = .01). In a multivariable model for intensive care therapy, eosinophilia remained unassociated with severity, and sIgE remained associated (OR: 1.60, 95% CI: 1.05–2.45; p = .03). Also, sIgE did not modify the association between eosinophil level and intensive care therapy (pinteraction = .14).

Conclusion

Blood eosinophilia of ≥3% was not associated with bronchiolitis severity. By contrast, sIgE was independently associated with bronchiolitis severity and did not modify the association between eosinophil level and severity.
Intensity‐modulated radiotherapy combined with intensity‐modulated radiotherapy CT–guided iodine 125 seed brachytherapy for non‐small cell lung cancer: A case report
Authors: Gu Xinyi , Wang Zhe , Sun Yingming , Yang Liang , Wu Jinyu , Ju Zaishuang , Wang Ruoyu
Published: June 2021

Intensity‐modulated radiotherapy (IMRT) has been used to treat locally advanced non‐small cell lung cancer (LA‐NSCLC) disseminated to primary gross tumor volume (pGTV) and mediastinal lymph nodes (LNs). However, it is challenging to deliver definitive doses to the pGTV and regional LNs without exceeding the tolerance of the organs at risk (OAR). Iodine‐125 (I‐125) brachytherapy has recently been applied in clinical practice for the treatment of malignant tumors. Its merits include a higher dose to the primary tumor lesion and lower dose surrounding the tumor mass. Using brachytherapy in these settings may maximize the dose delivered to the pGTV while minimizing the dose delivered to the OAR. I‐125 brachytherapy combined with IMRT for the treatment of LA‐NSCLC has rarely been reported. Here we report a patient with peripheral squamous cell carcinoma of the lung who received I‐125 brachytherapy for pulmonary lung lesions and IMRT for metastatic mediastinal LNs. The patient received 16 months of follow‐up care with no evidence of complications or disease recurrence. Moreover, we compared brachytherapy plus IMRT to theoretically planned IMRT dosimetry to evaluate the merits of each approach. This treatment modality resulted in a higher target dose escalation and lower doses delivered to the OAR.
Layer of protection analysis as auxiliary technique in process safety incident investigations
Authors: Pawolocki Fernando Javier
Published: June 2021

This work demonstrates the usefulness in using layer of protection analysis (LOPA) concept as an auxiliary technique in process safety incident investigations. It allows the investigation team to go further in causal analysis, by identifying and exploring the role played by each layer of protection in the incident, looking for “holes” as findings (causes) to use in the investigation process. This approach achieves better quality investigations, with more accurate lessons learned, and recommendations, as well as developing a clearer way to communicate what happened. This approach helps anyone who reads the incident report understand and learn about the process safety incident. Moreover, it provides a clearer way to communicate what happened, helping everyone who sees the incident report to understand and learn about how the process safety incident evolved from process deviation going thru the layers of protection up to the emergency response. At the same time, it shows what a process safety incident is in a much more suitable and understandable way, which emphasizes the process safety point of view, impacting in the organization process safety culture.
Epoxydicoumarin Derivative is a Novel Non‐Nucleoside TLR8 Agonist: Screening, Synthesis and Biological Evaluation
Authors: Damuka Naresh , Kammari Kurumurthy , Potshangbam Angamba Meetei , Kondapi Anand Kumar , Vindal Vaibhav
Published: June 2021

Toll‐like receptors (TLRs) activate host innate immunity by recognizing microbial ligands and viral nucleic acids. Of late, TLR8 has emerged as an attractive target for antiviral activity, antitumor activity and vaccine development owing to its ability to recognize small synthetic molecules that induce pro‐inflammatory cytokines, type 1 interferons and chemokines. Of the many synthetic and natural ligands researched so far, ligands derived from coumarin have been known to have enhanced antiviral and immunomodulatory properties. Thus, the coumarin scaffold plays an important role through the modulation of cytokines by noncovalent interactions with various enzymes and receptors. The present study aims to identify a coumarin derivative that binds to the TLR8 receptor and induce NF‐κB activity. In silico screening and chemical synthesis were performed to realize novel coumarin leads with potential TLR8 agonistic activity. HEK‐Blue™ hTLR8 cell line was used to validate the TLR8 agonist evaluation In vitro. The key finding of this study brings out strong evidence supporting the binding of the 3,31‐(411‐N,N‐dimethylaminophenylmethylene)‐4,41‐epoxydicoumarin to TLR8 receptor in comparison to the co‐crystallized R848 ligand.
A Waterborne Polyurethane‐Based Dye with Green Fluorescence Excited by Visible Light
Authors: Li Mingjun , Hu Xianhai , Xian Yuxi , Liu Xiang , Liu Manli , Li Gen , Hu Pengwei , Cheng Congliang , Liu Jin , Wang Ping
Published: June 2021

A waterborne aminofluorescein polyurethane‐based dye (AF‐WPU) with green fluorescence excited by visible light was synthesized by anchoring aminofluorescein (AF) to waterborne polyurethane chains. The structural characteristics of AF‐WPU was confirmed by means of 1H‐NMR, FT‐IR and UV‐vis absorption. Compared with AF, there is a hypsochromic shift, and a new absorption peak generating in the UV‐vis spectra of AF‐WPU. Meanwhile, AF‐WPU emited excellent fluorescence. The fluorescence intensity of AF‐WPU increased five times at the same concentration. It is found that the fluorescence intensities of AF‐WPU decreaseed with increased temperature, and increased first and then decreased with increasing concentration. The fluorescence of AF‐WPU is very stable and insensitive to quenching agents. Moreover, AF‐WPU which excited by visible light is less phototoxic to health, and has a broad prospect in practical applications.
Defect‐Rich Core‐Shell Carbon Derived from Ionic Liquid for Direct Synthesis of Imines
Authors: He Peipei , Lv Ying , Shang Sensen , Chen Bo , Liang Hongliang , Niu Jingyang , Dai Wen
Published: June 2021

Development of metal‐free catalysis in chemical transformation is highly desirable due to its significant inherent advantages compared with conventional metal or metal oxide catalysts but challenging. Herein, ionic liquid 1‐ethyl‐3‐methylimidazolium dicyanamide and sodium tetraphenylborate were employed as joint precursors to facilely prepare micro‐mesoporous core‐shell carbon with specific surface area up to 2870 m2 g−1, consisting of smooth unpenetrated shell and secondary hollow spherical carbon core. The as‐obtained core‐shell carbon as metal‐free catalyst exhibited good performance for self‐coupling and cross‐coupling of amines to achieve the corresponding symmetry and asymmetry imines under mild and neat conditions. Excitingly, for the challenging aliphatic amines, the desired imines were achieved in our case in 55.9 % yield. The nearly linearly correlation between imine yield and ID/IG indicated that the resulting defects from departure of heteroatoms during pyrolysis may be active site.
Task‐Specific Deep Eutectic Solvent for Selective Oxidation of Aromatic Methyl to Aldehyde
Authors: Bhise Rupali S. , Patel Khushbu P. , Ghorpade Prashant V. , Shankarling Ganapati S.
Published: June 2021

Biodegradable and economically viable choline chloride‐FeCl2.H2O deep eutectic solvent (DES), was synthesized and successfully utilized as a catalyst and reaction medium for the selective oxidation of aromatic methyl groups to aldehydes. To demonstrate the synthetic potential of this protocol, the reaction was scaled up to the gram scale. The DES could be reused up to four times without considerable effect on the yield of the reaction. The key features of the protocol that qualify the process as green include the ambient reaction temperatures, easy isolation of the products, higher yields, recyclability of the catalyst, and reactions without the use of conventional organic solvents.
Late Cretaceous hydrothermal vent communities from the Troodos ophiolite, Cyprus: systematics and evolutionary significance
Authors: Kaim Andrzej , Little Crispin T.S. , Kennedy William J. , Mears Ellen M. , Anderson Louise M.
Published: June 2021

Modern hydrothermal vent communities are based on chemosynthesis by microbial primary producers. Molecular phylogenetic divergence estimates indicate that many of the dominant vent taxa arose during the Cenozoic and Cretaceous; however, the fossil record of vent communities from these time periods is poor. One occurrence of such Cretaceous vent communities pertains to six volcanogenic massive sulphide deposits in the Troodos ophiolite of Cyprus. These deposits represent hydrothermal activity on deep (2500–5000 m) arc‐related spreading ridge(s) in the Neotethyan Ocean over several million years during the late Cenomanian and earliest Turonian. The Cyprus vent communities consist of worm tubes, representing possible vestimentiferans and serpulids, together with a moderate diversity of abyssochrysoid gastropods, belonging to eight new species (Desbruyeresia kinousaensis sp. nov., Desbruyeresia memiensis sp. nov., Desbruyeresia kambiaensis sp. nov., Hokkaidoconcha morisseaui sp. nov., Ascheria canni sp. nov., Cyprioconcha robertsoni gen. et sp. nov., Paskentana xenophontosi sp. nov. and Paskentana dixoni sp. nov.) in five genera and three families; none of the species is shared between vent sites. A single gaudryceratid ammonite from one of the vent sites most likely represents a water‐logged shell that sank from surface waters. The gastropod fauna contains the first representatives of the genera Desbruyeresia, Hokkaidoconcha, Ascheria and Paskentana from hydrothermal vents, and also the youngest representative of the last‐named genus in any environment. The Cypriot vent communities share tube worms with slightly older (Cenomanian) and younger (Turonian–Santonian) vent communities elsewhere in the western part of the Neotethyan Ocean.
Investigation of impact behavior of reinforced concrete beam to column connection strengthened with carbon fiber‐reinforced polymer strips
Authors: Kaya Turgut , Aras Murat , Yilmaz Tolga , Çalişkan Özlem , Anil Özgür , Erdem R. Tuğrul
Published: June 2021

Reinforced concrete (RC) members may expose to impulsive dynamic loads due to the reasons such as the explosions occurring in the interior or exterior part of them, rockfall, the vehicle crash to the bridges, the collision of masses with the effects of floods and landslide. Many studies have investigated the effects of impulsive dynamic loads on the beam, column, and slab RC structural elements have been investigated in the literature. However, the authors have not encountered any study focused on the impact behavior of beam to column connections of the frames constructing the bearing system of reinforced concrete structures. Therefore, an experimental study has been planned to investigate RC beam impact behavior to column connections strengthened with carbon fiber‐reinforced polymer (CFRP) strips. The concrete compressive strength, shear reinforcement spacing, CFRP strip spacing, and input impact energy applied to test specimens were taken as experimental variables. The time histories of impact load acting on test specimens, accelerations, displacements, and the strains measured from CFRP strips have been recorded in experiments. The experimental variables' effect on dynamic responses of RC beam to column connections strengthened with CFRP strips subjected to impact load has been interpreted in detail. The study's scope and improved numerical analysis procedure have also been introduced to verify experimental results. Good agreement between numerical and experimental results demonstrated that the presented numerical procedures could be safely used for evaluation of impact behavior of RC beam to column connections strengthened with CFRP strips.
Antibiofilm activity of silver nanoparticles against biofilm forming Staphylococcus pseudintermedius isolated from dogs with otitis externa
Authors: Seo Mimi , Oh Taeho , Bae Seulgi
Published: June 2021

Background

Silver nanoparticles (AgNPs) are known to possess antimicrobial properties. Although the antibiofilm activity of AgNPs has been demonstrated in humans, this activity has not yet been elucidated in veterinary medicine.

Objectives

The purpose of this study was to evaluate the antibiofilm activity of silver nanoparticles against Staphylococcus pseudintermedius.

Methods

Ten isolates of S. pseudintermedius obtained from dogs with otitis externa were treated with AgNPs, and the antibiofilm activity was measured using a modified microtiter plate and Congo red agar (CRA) method and scanning electron microscopy.

Results

AgNPs displayed a significant dose‐dependent antibiofilm activity and reduced biofilm formation at concentrations of 20 and 10 µg/ml (p < 0.05). S. pseudintermedius exposed to 20 µg/ml of AgNPs formed less bacterial slime compared to the controls on CRA plates. Scanning electron micrographs showed that the biofilm had few individually scattered cells along its surface when treated with AgNP concentrations of 20 and 10 µg/ml. Untreated surfaces showed an aggregated biofilm.

Conclusions

Our results suggested that AgNP may be a valuable alternative antibiofilm agent for canine otitis externa.
Quantitative predictions from molecular simulations using explicit or implicit interactions
Authors: van der Spoel David , Zhang Jin , Zhang Haiyang
Published: June 2021

Equilibrium simulations of molecular systems allow to extract many physicochemical properties. Given an “accurate enough” model, a “large enough” simulation system and “long enough” simulations, such calculations should yield accurate predictions of properties that can be tested by experimental measurements. Non‐equilibrium simulations can be used as a tool to obtain specific properties like viscosity or conductivity, but they have the drawback that in general only one property per simulation is produced. In addition, a range of methods is available for computing free energy differences. We here review the state of the art of using classical simulation models for generating quantitative predictions. Popular force fields have significant predictive power already but there is room for improvement. Bonded force potentials may need to be replaced by more accurate ones to better reproduce vibrational frequencies. Simplification of non‐bonded force terms, such as cut‐offs for electrostatic or dispersion interactions, should be avoided. Routine usage of force field methods will therefore require some tuning of parameters. Despite the extensive toolbox that is available for producing quantitative results, the computational cost of explicit solvent simulation is significant and therefore, approximate methods like implicit solvent models remain popular and are still being developed. Based on fundamental arguments as well as on examples of solvation free energies, host–guest complexation and non‐covalent association of molecules in solution, we conclude that implicit solvents as well as algorithmic simplifications are most useful when validation using experimental data or rigorous theoretical treatments is possible.

This article is categorized under:

Molecular and Statistical Mechanics > Molecular Dynamics and Monte‐Carlo Methods

Theoretical and Physical Chemistry > Statistical Mechanics

Software > Simulation Methods
Quantification of pharmaceuticals in the sealant fluids of actively used waterless urinals
Authors: Thapa Utsav , Sharma Priyamvada , Hanigan David
Published: June 2021

Prior measurements at bench scale revealed that waterless urinal cartridges containing oily sealant fluids are capable of partitioning pharmaceuticals from urine and therefore reducing their concentration in wastewater. We sought to measure pharmaceutical removal from in‐use waterless urinals. We developed a method to quantify pharmaceuticals in the sealant phase, which resulted in 79 ± 30% and 71 ± 30% recovery of eight pharmaceuticals from two sealant fluids, respectively. The method was applied to sealant samples collected over three weeks from in‐use waterless urinals on a university campus. Six of eight pharmaceuticals were present in the sealant samples from 1.4 µg/L to 241 µg/L. Loads of the six pharmaceuticals detected in the sealants were removed from the receiving wastewater from 0.02 µg/day to 3.4 µg/day across the sampling period. The concentration of the pharmaceuticals were similar over time, indicating rapid saturation and washout of the sealant. We also observed relatively rapid loss of sealant at maintenance intervals consistent with the manufacturer's instructions. These findings indicate that while waterless urinals do remove some pharmaceuticals from the wastewater stream, meaningful changes to wastewater concentrations will only result if the sealant fluid and/or the urinal cartridge are significantly modified.

Practitioner points

We developed a quantification method for pharmaceuticals in oily waterless urinal sealants.

Pharmaceuticals were present at relatively low concentrations in the sealant phase of two in‐use waterless urinals.

We identify engineering challenges that must be overcome to meaningfully reduce pharmaceutical loads in wastewater with waterless urinals.
Tracking: B
Authors: Walrand Jean
Published: June 2021

In Chapter Tracking: A, we explained the estimation of a random variable based on observations. We also described the Kalman filter and we gave a number of examples. In this chapter, we derive the Kalman filter and explain some of its properties. We also discuss the extended Kalman filter.

Section 10.1 explains how to update an estimate as one makes additional observations. Section 10.2 derives the Kalman filter. The properties of the Kalman filter are explained in Sect. 10.3. Section 10.4 shows how the Kalman filter is extended to nonlinear systems.
Perspective and Complements
Authors: Walrand Jean
Published: June 2021

We have explored a number of topics motivated by concrete applications. It is time to stitch together these ideas into a complete panorama. In addition, we provide some complements.

Section 15.1 discusses the general question of inference: what can one deduce from observations? Section 15.2 explains the important notion of sufficient statistic: what is the relevant data in a set of observations? Section 15.3 presents the theory of Markov chains where the number of states is infinite. Section 15.4 explains the Poisson process. Section 15.5 discusses the boosting algorithm for choosing among experts. What drug should you further research; what noisy channel should one use? These are examples of multi-armed bandit problems. In such problems one faces the trade-off between exploiting known possibilities versus exploring potentially more rewarding but less well understood alternatives. Section 15.6 explains a key results for such multi-armed bandit problems. Information Theory studies the limits of communication systems: how fast can one transmit bits reliably over a noisy channel? How many bits should be transmitted to convey some information? Section 15.7 introduces some key concepts and results of Information Theory. When estimating the likelihood of errors or the reliability of some estimates, one usually has to calculate bounds on the probability that a random variable exceeds a given value. Section 15.8 discusses some useful probability bounds. Section 15.9 explains the main ideas of the theory of martingales and shows how it provides a proof of the law of large numbers.
Multiplexing: A
Authors: Walrand Jean
Published: June 2021

This chapter explores the fluctuations of random variables away from their mean value. You flip a fair coin 100 times. How likely is it that you get 60 heads? Conversely, if you get 60 heads, how likely is it that the coin is fair? Such questions are fundamental in extracting information from data.

In Sect. 3.1, we start by exploring the rate available to a user when a random number of them share a link, as illustrated in Sect. 3.1. Such calculations are central to network provisioning. The main analytical tool is the Central Limit Theorem explained in Sect. 3.2 where Gaussian random variables are also introduced and confidence intervals are defined. To share a common link, devices may be attached to a switch. For instance, the desktop computers in a building are typically connected to a switch that then sends the data to a common high-speed link. We explore the delays that packets face through the buffer of a switch in Sect. 3.3. The analysis uses a Markov chain model of the buffer. To share a wireless radio channel, devices use a multiple access protocol that regulates the transmissions. We study such schemes in Sect. 3.4. We use probabilistic models of the protocols.
Networks: A
Authors: Walrand Jean
Published: June 2021

Social networks connect people and enable them to exchange information. News and rumors spread through these networks. We explore models of such propagations. The technology behind social networks is the internet where packets travel from queue to queue. We explain some key results about queueing networks.

Section 5.1 explores a model of how rumors spread in a social network. Epidemiologists use similar models to study the spread of viruses. Section 5.2 explains the cascade of choices in a social network where one person’s choice is influenced by those of people she knows. Section 5.3 shows how seeding the market with advertising or free products affects adoptions. Section 5.4 studies a model of how media can influence the eventual consensus in a social network. Section 5.5 explores the randomness of the consensus in a group. Sections 5.6 and 5.7 present a different class of network models where customers queue for service. Section 5.6 studies a single queue and Sect. 5.7 analyzes a network of queues. Section 5.8 explains a classical optimization problem in a communication network: how to choose the capacities of different links. Section 5.9 discusses the suitability of queueing networks as models of the internet. Section 5.10 presents a classical result about a class of queueing networks known as product-form networks.
Networks—B
Authors: Walrand Jean
Published: June 2021

This chapter provides the derivations of the results in the previous chapter. It also develops the theory of continuous-time Markov chains.

Section 6.1 proves the results on the spreading of rumors. Section 6.2 presents the theory of continuous-time Markov chains that are used to model queueing networks, among many other applications. That section explains the relationships between continuous-time and related discrete-time Markov chains. Sections 6.3 and 6.4 prove the results about product-form networks by using a time-reversal argument.
Digital Link—A
Authors: Walrand Jean
Published: June 2021

In a digital link, a transmitter converts bits into signals and a receiver converts the signals it receives into bits. The receiver faces a decision problem that we study in Sect. 7.1. The main tool is Bayes’ Rule. The key notions are maximum a posteriori and maximum likelihood estimates. Transmission systems use codes to reduce the number of bits they need to transmit. Section 7.2 explains the Huffman codes that minimize the expected number of bits needed to transmit symbols; the idea is to use fewer bits for more likely symbols. Section 7.3 explores a commonly used model of a communication channel: the binary symmetric channel. It explains how to calculate the probability of errors. Section 7.4 studies a more complex modulation scheme employed by most smartphones and computers: QAM. Section 7.5 is devoted to a central problem in decision making: how to infer which situation is in force from observations. Does a test reveal the presence of a disease; how to balance the probability of false positive and that of false negative? The main result of that section is the Neyman–Pearson Theorem that the section illustrates with many examples.
Correction to: Policies for Later-Life Families in a Comparative European Perspective
Authors: Dykstra Pearl A. , Djundeva Maja
Published: June 2021

∎∎∎
Seeing the entanglement wedge
Authors: Levine Adam , Shahbazi-Moghaddam Arvin , Soni Ronak M
Published: June 2021

Abstract

We study the problem of revealing the entanglement wedge using simple operations. We ask what operation a semiclassical observer can do to bring the entanglement wedge into causal contact with the boundary, via backreaction.

In a generic perturbative class of states, we propose a unitary operation in the causal wedge whose backreaction brings all of the previously causally inaccessible ‘peninsula’ into causal contact with the boundary. This class of cases includes entanglement wedges associated to boundary sub-regions that are unions of disjoint spherical caps, and the protocol works to first order in the size of the peninsula. The unitary is closely related to the so-called Connes Cocycle flow, which is a unitary that is both well-defined in QFT and localised to a sub-region. Our construction requires a generalization of the work by Ceyhan & Faulkner to regions which are unions of disconnected spherical caps. We discuss this generalization in the appendix. We argue that this cocycle should be thought of as naturally generalizing the non-local coupling introduced in the work of Gao, Jafferis & Wall.
Estrogen receptor-α signaling in post-natal mammary development and breast cancers
Authors: Rusidzé Mariam , Adlanmérini Marine , Chantalat Elodie , Raymond-Letron I. , Cayre Surya , Arnal Jean-François , Deugnier Marie-Ange , Lenfant Françoise
Published: June 2021

17β-estradiol controls post-natal mammary gland development and exerts its effects through Estrogen Receptor ERα, a member of the nuclear receptor family. ERα is also critical for breast cancer progression and remains a central therapeutic target for hormone-dependent breast cancers. In this review, we summarize the current understanding of the complex ERα signaling pathways that involve either classical nuclear “genomic” or membrane “non-genomic” actions and regulate in concert with other hormones the different stages of mammary development. We describe the cellular and molecular features of the luminal cell lineage expressing ERα and provide an overview of the transgenic mouse models impacting ERα signaling, highlighting the pivotal role of ERα in mammary gland morphogenesis and function and its implication in the tumorigenic processes. Finally, we describe the main features of the ERα-positive luminal breast cancers and their modeling in mice.
Ascon v1.2: Lightweight Authenticated Encryption and Hashing
Authors: Dobraunig Christoph , Eichlseder Maria , Mendel Florian , Schläffer Martin
Published: June 2021

Authenticated encryption satisfies the basic need for authenticity and confidentiality in our information infrastructure. In this paper, we provide the specification ofAscon-128 andAscon-128a. Both authenticated encryption algorithms provide efficient authenticated encryption on resource-constrained devices and on high-end CPUs. Furthermore, they have been selected as the “primary choice” for lightweight authenticated encryption in the final portfolio of the CAESAR competition. In addition, we specify the hash functionAscon-Hash, and the extendable output functionAscon-Xof. Moreover, we complement the specification by providing a detailed overview of existing cryptanalysis and implementation results.
A Novel IFITM5 Variant Associated with Phenotype of Osteoporosis with Calvarial Doughnut Lesions: A Case Report
Authors: Mäkitie R. E. , Pekkinen M. , Morisada N. , Kobayashi D. , Yonezawa Y. , Nishimura G. , Ikegawa S. , Mäkitie O.
Published: June 2021

Osteogenesis imperfecta (OI) and other decreased bone density disorders comprise a heterogeneous group of heritable diseases with skeletal fragility. Recently, it was discovered that mutations inSGMS2, encoding sphingomyelin synthetase 2, result in aberrant sphingomyelin metabolism and lead to a novel form of OI termed osteoporosis with calvarial doughnut lesions (OP-CDL) with moderate to severe skeletal fragility and variable cranial hyperostotic lesions. This study describes a Japanese family with the skeletal phenotype of OP-CDL. The affected individuals have moderately severe, childhood-onset skeletal fragility with multiple long-bone fractures, scoliosis and bone deformities. In addition, they exhibit multiple CDLs or calvarial bumps with central radiolucency and peripheral radiopacity. However,SGMS2sequencing was normal. Instead, whole-exome sequencing identified a novelIFITM5missense mutation c.143A>G (p.N48S) (classified as a VUS by ACMG).IFITM5encodes an osteoblast-restricted protein BRIL and a recurrent c.-14C>T mutation in its 5' UTR region results in OI type V, a distinctive subtype of OI associated with hyperplastic callus formation and ossification of the interosseous membranes. The patients described here have a phenotype clearly different from OI type V and with hyperostotic cranial lesions, feature previously unreported in association withIFITM5.Our findings expand the genetic spectrum of OP-CDL, indicate diverse phenotypic consequences of pathogenicIFITM5variants, and imply an important role for BRIL in cranial skeletogenesis.
A novel assay based on pre-equilibrium titration curves for the determination of enzyme inhibitor binding kinetics
Authors: Noppen Bernard , Vanbelle Anouk , Stitt Alan W. , Vanhove Marc
Published: June 2021

Selection of pharmacological agents based on potency measurements performed at equilibrium fail to incorporate the kinetic aspects of the drug–target interaction. Here we describe a method for screening or characterization of enzyme inhibitors that allows the concomitant determination of the equilibrium inhibition constant in unison with rates of complex formation and dissociation. The assay is distinct from conventional enzymatic assays and is based on the analysis of inhibition curves recorded prior to full equilibration of the system. The methodology is illustrated using bicyclic peptide inhibitors of the serine protease plasma kallikrein.
A pathological indicator for dysthyroid optic neuropathy: tritan color vision deficiency
Authors: Garip Kuebler Aylin , Halfter Kathrin , Reznicek Lukas , Klingenstein Annemarie , Priglinger Siegfried , Rudolph Günther , Hintschich Christoph
Published: June 2021

Purpose

To investigate the sensitivity of the color vision test by Arden in patients with dysthyroid optic neuropathy (DON) to improve diagnosis.

Methods

In this observational, retrospective study, we included the medical records of 92 eyes (48 patients) with diagnosis of DON between 2008 and 2019 in order to evaluate the full spectrum of findings from the color vision test by Arden, and to determine potential importance of this test. Thirty-five patients were female, and 13 patients were male. The mean age was 58.0 years (range: 34–79) at the time of the DON diagnosis.

Results

Forty-one eyes displayed relatively good BCVA with ≤ 0.2 LogMAR. We found a protan value exceeding the threshold of ≥ 8% in 57 eyes (30 patients) at the time of the diagnosis. The sensitivity of protan was 61.9% (95% CI 51.2–71.8%), while that of tritan was a striking 98.9% (95% CI 94.1–99.9%).

We discovered one pathological sign, tritan deficiency (based on a threshold of ≥ 8%) consistently in all eyes but one at the time of the diagnosis, regardless of the visual field defects or any changes in best-corrected visual acuity (BCVA).

Conclusion

We found blue-yellow (tritan) deficiency, to be a sensitive and reliable indicator of dysthyroid optic neuropathy. We conclude that, in cases with suspected DON, a color vision test that can detect tritan deficiency is an essential tool for the adequate assessment, diagnosis, and treatment of DON.
Pituitary apoplexy induced by gonadotropin-releasing hormone (GnRH) agonist administration for treatment of prostate cancer: a systematic review
Authors: Raj Rishi , Elshimy Ghada , Jacob Aasems , Arya P. V. Akhila , Unnikrishnan Dileep C. , Correa Riccardo , Myint Zin W.
Published: June 2021

Objective

We aimed to review of literature on the clinical presentation, management and outcomes of pituitary apoplexy following gonadotrophic release hormone (GnRH) agonist administration for the treatment of prostate cancer.

Methods

We used PRISMA guidelines for our systematic review and included all English language original articles on pituitary apoplexy following GnRH agonist administration among prostate cancer patients from Jan 1, 1995 to Dec 31, 2020. Data on patient demographics, prostate cancer type, Gleason score at diagnosis, history of pituitary adenoma, clinical presentation, GnRH agonist, interval to pituitary apoplexy, laboratory evaluation at admission, radiologic findings, treatment of pituitary apoplexy, time to surgery if performed, pathology findings, and clinical/hormonal outcomes were collected and analyzed.

Results

Twenty-one patients with pituitary apoplexy met our inclusion criteria. The mean age of patients was 70 (60–83) years. Leuprolide was the most common used GnRH agonist, used in 61.9% of patients. Median duration to symptom onset was 5 h (few minutes to 6 months). Headache was reported by all patients followed by ophthalmoplegia (85.7%) and nausea/vomiting (71.4%). Three patients had blindness at presentation. Only 8 cases reported complete anterior pituitary hormone evaluation on presentation and the most common endocrine abnormality was FSH elevation. Tumor size was described only in 15 cases and the mean tumor size was 26.26 mm (18–48 mm). Suprasellar extension was the most common imaging finding seen in 7 patients. 71.4% of patients underwent pituitary surgery, while 23.8% were managed conservatively. Interval between symptoms onset to pituitary surgery was 7 days (1–90 days). Gonadotroph adenoma was most common histopathologic finding. Clinical resolution was comparable, while endocrine outcomes were variable among patients with conservative vs surgical management.

Conclusion

Although the use of GnRH agonists is relatively safe, it can rarely lead to pituitary apoplexy especially in patients with pre-existing pituitary adenoma. Physicians should be aware of this complication as it can be life threatening. A multidisciplinary team approach is recommended in treating individuals with pituitary apoplexy.