bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
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

AbstractTo 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 (&gt;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 &gt;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

AbstractPuerto 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 bowelA 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 1Abdominal distension with gas and bloating.QuestionsWhich is the most likely diagnosis?EncephalitisD-lactic acidosisDehydration with third space fluid collection and acidosisHereditary fructose intolerance.How is this diagnosis confirmed?D lactic dosageBreath test for bacterial overgrowthUrine organic acid dosageSearch for reductive substances in the stools.How should this patient be managed?Intravenous fluids to facilitate D-lactic excretionRestrict carbohydrates in the dietIntravenous bicarbonatesAntibiotic 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

BackgroundNational 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.ObjectivesTo investigate whether this guidance is followed, and the associations between clinical presentation and CT findings, to determine whether guidance could be refined.Materials and methodsA 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.ResultsCT-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).ConclusionAll 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.
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

IntroductionInternational 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.MethodsWe 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.ResultsNew 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.ConclusionAs 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.
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

BackgroundThe 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 analysisPULSE 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 numberNCT04144881
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.
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.
Lattice-Based Linearly Homomorphic Signature Scheme over

F

2
Authors: Cai Jie , Jiang Han , Wang Hao , Xu Qiuliang 
Published: October 2020

In this paper, we design a new lattice-based linearly homomorphic signature scheme over

F

2

. The existing schemes are all constructed based on hash-and-sign lattice-based signature framework, where the implementation of preimage sampling function is Gaussian sampling, and the use of trapdoor basis needs a larger dimension

m
≥
5
n

log

q

. Hence, they cannot resist potential side-channel attacks and have larger sizes of public key and signature. Under Fiat–Shamir with aborting signature framework and general SIS problem restricted condition

m
≥
n

log

q

, we use uniform sampling of filtering technology to design the scheme, and then, our scheme has a smaller public key size and signature size than the existing schemes and it can resist side-channel attacks.