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Kayla E Prokopakis,1 Todd Bolotin,1,2 Chad Donley,1,2 Mark Lomasney,1 Jason Harter,1 Jack Graham,1 Quincy Chopra,1 Steven Olsen,1,2 Joseph Noga,1,2 Matthew Gatchel,2 Brendan Paull,1 Victoria Greyslak,1 Bret Bradford,1 Anna Plummer,1 Carrie Powell3 1Department of Emergency Medicine, Mercy Health St. Elizabeth Boardman Hospital, Boardman, OH, USA; 2Department of Emergency Medicine, Mercy Health St. Elizabeth Youngstown Hospital, Youngstown, OH, USA; 3Lake Erie College of Osteopathic Medicine, Erie, PA, USACorrespondence: Kayla E Prokopakis, Department of Emergency Medicine, Mercy Health St. Elizabeth Boardman Hospital, Boardman, OH, USA, Email kprokopakis32@gmail.comStudy Objective: The SARS-CoV-2 (COVID-19) pandemic significantly impacted emergency department volume and acuity. The Delta and Omicron variants contributed to additional surges. We describe the impact that the initial pandemic phase had on frequency and severity of typically non-life-threatening emergencies using upper extremity injuries as a model for other potentially emergent presentation as compared to pre-pandemic times. We do this using the epidemiology of pre-defined significant upper extremity injuries at our facility as a specific example of what occurred at an urban trauma center.Methods: We conducted a comparison of two 6-month periods: between March 2019 and August 2019 (prior to COVID-19) and between March 2020 and August 2020 after the onset of the initial COVID-19 wave. We performed a retrospective chart review of patients who presented with upper extremity injury chief complaints using analysis of the electronic medical record at a single urban tertiary care trauma center in the Midwestern United States. We investigated examination findings, imaging, frequency of surgical procedures and final diagnosis.Results: In the 2019 study period, there were 31,157 ED patients, including 429 with upper extremity injuries, of which 108 patients had significant injuries. In the 2020 study period, there were 24,295 patient presentations, of which 118 of 296 upper extremity presentations were significant. We a priori defined significant injury as follows: fractures, dislocations, neurovascular injuries, or need for operative intervention within 24 hours of ED presentation. Specifically, 25.2% of injuries were significant pre-COVID-19 and 39.9% (p < 0.001) during the initial COVID-19 surge. The absolute number and percentage of significant injuries increased from pre-COVID-19 compared to the initial COVID-19 surge despite an overall 22% decrease in total patient volume.Conclusion: The incidence of significant upper extremity musculoskeletal injuries increased during the pandemic even though the overall number of ED presentations for upper extremity musculoskeletal injuries decreased.Keywords: COVID-19, musculoskeletal complaints, emergency department presentation, upper extremity

Superconducting Sr1-xLaxCuO2 thin films have been grown on GdScO3 substrates by reflection high-energy electron diffraction calibrated layer-by-layer molecular-beam epitaxy. X-ray diffraction analysis has confirmed the infinite layer structure after an in situ vacuum annealing step. In situ photoemission spectroscopy indicates that the vacuum annealing step employed immediately after film growth to achieve superconducting films results in oxygen loss from the films. The superconducting critical temperature depends on the La content x, with the highest value obtained for x∼0.10. Resistivity as a function of temperature ρ(T) curves of optimally doped samples show a T2 temperature dependence characteristic of a scattering process where electron-electron interactions dominate. [ABSTRACT FROM AUTHOR]

The superconducting properties of Sr1–xLaxCuO2 thin films are strongly affected by sample preparation procedures, including the annealing step, which are not always well controlled. We have studied the evolution of Cu L2,3 and O K edge x-ray absorption spectra (XAS) of Sr1–xLaxCuO2 thin films as a function of reducing annealing, both qualitatively and quantitatively. By using linearly polarized radiation, we are able to identify the signatures of the presence of apical oxygen in the as-grown sample and its gradual removal as a function of duration of 350 °C Ar annealing performed on the same sample. Even though the as-grown sample appears to be hole doped, we cannot identify the signature of the Zhang-Rice singlet in the O K XAS, and it is extremely unlikely that the interstitial excess oxygen can give rise to a superconducting or even a metallic ground state. XAS and x-ray linear dichroism analyses are, therefore, shown to be valuable tools to improving the control over the annealing process of electron doped superconductors. [ABSTRACT FROM AUTHOR]

Three-dimensional impedance maps (3DZMs) are virtual volumes of acoustic impedance values constructed from histology to represent tissue microstructure acoustically. From the 3DZM, the ultrasonic backscattered power spectrum can be predicted and model based scatterer properties, such as effective scatterer diameter (ESD), can be estimated. Additionally, the 3DZM can be exploited to visualize and identify possible scattering sites, which may aid in the development of more effective scattering models to better represent the ultrasonic interaction with underlying tissue microstructure. In this study, 3DZMs were created from a set of human fibroadenoma samples. ESD estimates were made assuming a fluid-filled sphere form factor model from 3DZMs of volume 300×300×300 μm. For a collection of 33 independent human fibroadenoma tissue samples, the ESD was estimated to be 111±40.7 μm. The 3DZMs were then investigated visually to identify possible scattering sources which conformed to the estimated model scatterer dimensions. This estimation technique allowed a better understanding of the spatial distribution and variability of the estimates throughout the volume. [ABSTRACT FROM PUBLISHER]

Guidelines for translating educational and psychological assessments for use across different languages and cultures have been developed by the International Test Commission and the Joint Committee on Standards for Educational and Psychological Testing. Common themes in these guidelines and standards are when translating items both judgmental and statistical techniques should be used to ensure item comparability across languages, and rigorous quality-control steps should be included in the translation process. In this study, the authors use differential item functioning methodology to evaluate the comparability of translated items at two different points in time--after the initial translation and 4 years later after the translations were revisited using a more rigorous translation model. The results indicated that the revised translations led to improvements in some but not all items. Improvements in the process of translating survey items, even when based on accepted professional standards, should be statistically evaluated. This methodology illustrates how evaluations can be conducted on translated survey items. [ABSTRACT FROM AUTHOR]

Barrett's esophagus is a condition that develops in approximately 10-15% of patients with chronic gastroesophageal reflux disease and is the only known major risk factor for esophageal adenocarcinoma. The incidence of esophageal adenocarcinoma has increased by 350% over the last 3 decades and the reasons for this dramatic increase are unclear. At the time of cancer diagnosis up to 50% of patients will have advanced regional or distant metastatic disease, with little or no chance of cure. The overall 5-year survival rate with advanced disease remains poor at <10%. Several studies have demonstrated an early stage of diagnosis and a marked improvement in the survival of patients with esophageal cancer detected by routine endoscopic surveillance in patients known to have pre-existing Barrett's esophagus. The aim of endoscopic surveillance in patients with Barrett's esophagus is the early diagnosis of esophageal cancer, when it is still potentially curable. The desired outcome is to further decrease the mortality rate associated with esophageal adenocarcinoma and identify and screen populations at risk for the development of dysplasia arising from Barrett's esophagus. This is the principle of the current screening and surveillance guidelines set out by several societies, including the American College of Gastroenterology, the American Society of Gastrointestinal Endoscopy, and the European Society of Gastrointestinal Endoscopy. However, as most patients with Barrett's esophagus do not develop adenocarcinoma, the cost effectiveness of endoscopic screening and surveillance strategies is questionable. To date, no prospective, randomized trials have been performed to evaluate the effectiveness of surveillance, the survival benefit in patients undergoing surveillance or the subsequent impact on healthcare costs. In this article, we focus on the basic principles and reasoning underlying the surveillance guidelines for Barrett's esophagus. In particular, that the disease is clinically important and has a high prevalence; the transition to adenocarcinoma could have a high death and/or disability rate; early diagnosis of adenocarcinoma should reduce mortality; and the screening method should be easily applied, safe, relatively inexpensive, and applicable to a large number of patients. We then review arguments for and against screening and surveillance as they apply to these principles and discuss the current literature that reviews the effectiveness of such surveillance strategies, including an outline of cost analysis. [ABSTRACT FROM AUTHOR]

L-lysine, a cationic essential amino acid, has been reported to affect calcium transport in both intestine and kidney. In order to investigate whether this effect is associated with changes in cytosolic calcium homeostasis, we studied the effect of L-lysine deprivation on intracellular calcium concentration ([Ca2+]i), as well as 45Ca efflux and accumulation in normal human fibroblasts. Steady state [Ca2+]i, measured using fura-2 fluorescence in cells cultured for 18 hours in a L-lysine-free medium, was significantly higher than in cells grown in the presence of as little as 4 microM L-lysine. L-lysine deprivation also led to a significant decrease of 45Ca fractional efflux compared with cells grown in complete medium. This effect was paralleled by a significant decrease in 45Ca accumulation. Lack of L-arginine from the growth medium for the same time period had no effect on either [Ca2+]i, 45Ca efflux, or 45Ca accumulation rate. Presumably, the lack of L-lysine for a significant amount of time impairs the active mechanisms of calcium extrusion, which is only partially compensated by a reduction of calcium accumulation rate. This leads to an increased steady state [Ca2+]i. It is concluded that L-lysine is an important modulator of cytosolic calcium homeostasis. [ABSTRACT FROM AUTHOR]

We have used a combination of ultrafast coherent phonon spectroscopy, ultrafast thermometry, and time-dependent Landau theory to study the inversion symmetry breaking phase transition at Tc=200 K in the strongly spin-orbit coupled correlated metal Cd2Re2O7. We establish that the structural distortion at Tc is a secondary effect through the absence of any softening of its associated phonon mode, which supports a purely electronically driven mechanism. However, the phonon lifetime exhibits an anomalously strong temperature dependence that decreases linearly to zero near Tc. We show that this behavior naturally explains the spurious appearance of phonon softening in previous Raman spectroscopy experiments and should be a prevalent feature of correlated electron systems with linearly coupled order parameters. [ABSTRACT FROM AUTHOR]

The newly discovered 112-type ferropnictide superconductors contain chains of As atoms that break the tetragonal symmetry between the a and b axes. This feature eliminates the need for uniaxial strain that is usually required to stabilize large single domains in the electronic nematic state that exists in the vicinity of magnetic order in the iron-based superconductors. We report detailed structural symmetry measurements of 112-type Ca0.73La0.27FeAs2 using rotational anisotropy optical second-harmonic generation. This technique is complementary to diffraction experiments and enables a precise determination of the point-group symmetry of a crystal. By combining our measurements with density functional theory calculations, we uncover a strong optical second-harmonic response of bulk electric dipole origin from the Fe and Ca 3d-derived states that enables us to assign C2 as the crystallographic point group. This makes the 112-type materials high-temperature superconductors without a center of inversion, allowing for the possible mixing of singlet and triplet Cooper pairs in the superconducting state. We also perform pump-probe transient reflectivity experiments that reveal a 4.6-THz phonon mode associated with the out-of-plane motion of As atoms in the FeAs layers. We do not observe any suppression of the optical second-harmonic response or shift in the phonon frequency upon cooling through the reported monoclinic-to-triclinic transition at 58 K. This allows us to identify C1 as the low-temperature crystallographic point group but suggests that structural changes induced by long-range magnetic order are subtle and do not significantly affect electronic states near the Fermi level. [ABSTRACT FROM AUTHOR]

The effect of lutetium doping on the structural, electronic, and magnetic properties of epitaxial EuO thin films grown by reactive molecular-beam epitaxy is experimentally investigated. The behavior of Lu-doped EuO is contrasted with doping by lanthanum and gadolinium. All three dopants are found to behave similarly despite differences in electronic configuration and ionic size. Andreev reflection measurements on Lu-doped EuO reveal a spin-polarization of 96% in the conduction band, despite non-magnetic carriers introduced by 5% lutetium doping. [ABSTRACT FROM AUTHOR]

An abstract of the article "Evaluation of human cervical microstructure with quantitative ultrasound," by H. Feltovich and colleagues, is presented.