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In conventional gunshot injuries to targets containing bone the resulting osseous fragments do not precede but follow the bullet on its further way through adjacent soft tissues. The term "secondary projectiles" for the particles does not appear to be appropriate since they are not believed to have enough energy necessary for creating their own wound channels away from the temporary cavity. Former studies have shown that in angled shots to glass panes the bulk of splinters does not follow the bullet's trajectory: The majority of the glass fragments, especially the larger ones, move at right angles to the pane shot through. The aim of the presented study was to examine whether osseous fragments behave like glass splinters in angled shots to flat synthetic bone. In this context, it should also be assessed, whether the bone fragments might act as secondary projectiles in rare cases. To answer these questions, test shots were fired to composite models consisting of flat synthetic bone and ballistic gelatin. Pistol cartridges 9 mm Luger were used to fire the shots which were video-documented with a high-speed camera. Afterwards, the composite models underwent CT examination and macroscopic inspection. Video-documentation revealed that the larger bone particles from the perforation site move at a roughly right angle from the osseous sheet into the gelatin, causing an eccentric bulge of the temporary cavity. The smaller bone fragments were also lodged along the bullet's path, predominantly in the cracks radiating from the permanent wound channel. [ABSTRACT FROM AUTHOR]

A 29-year-old right-handed woman presented to an outside emergency department with right small finger pain, swelling, and concern for a retained wooden splinter. Diagnosis and treatment were delayed for 2 weeks due to the inability to identify the foreign body clinically or radiographically. Ultimately, ultrasonography by a fellowship-trained specialist was used to localize the wooden splinter. It was embedded within the flexor tendon sheath but had migrated away from its initial point of entry. The patient underwent subsequent surgical extraction, irrigation, and debridement. Two weeks following surgery, she had regained full range of motion through her digit without signs of infection. This case highlights the use of diagnostic ultrasound to identify a radiolucent foreign body, such as a wooden splinter, and to guide subsequent surgical extraction.

A 21-year-old woman presented with 1 year history of progressive dorsal right foot pain with no recollection of trauma. The physical exam did not reveal any unusual appearance to the plantar or dorsal skin surfaces. Specifically, no scars were seen. Foot radiographs were unremarkable. The presumed etiology after Doppler ultrasound (US) and MRI was a likely venous or venolymphatic malformation. She received 2 rounds of sclerotherapy 12 months apart with transient symptomatic clinical improvement. After the second sclerotherapy treatment, repeat MRI revealed dorsal extension of the lesion with skin involvement, prompting referral for surgical intervention. At surgery, a 3 cm wood splinter was found surrounded by granulation tissue. After showing the patient the resected splinter, she recalled stepping on a wooden broomstick that punctured the bottom of her foot in her childhood. She stated she also remembered pulling a splinter out of her foot. This case demonstrates the unusual and rare appearance of a chronic retained foreign body creating a cystic lesion in the foot presumed to be a low-flow vascular malformation on US and MRI.

A splinter is a notion of singularity that has seen numerous recent applications, especially in connection with the direct summand theorem, the mixed characteristic minimal model program, Cohen–Macaulayness of absolute integral closures and cohomology vanishing theorems. Nevertheless, many basic questions about these singularities remain elusive. One outstanding problem is whether the splinter property spreads from a point to an open neighborhood of a noetherian scheme. Our paper addresses this problem in prime characteristic, where we show that a locally noetherian scheme that has finite Frobenius or that is locally essentially of finite type over a quasi-excellent local ring has an open splinter locus. In particular, all varieties over fields of positive characteristic have open splinter loci. Intimate connections are established between the openness of splinter loci and F -compatible ideals, which are prime characteristic analogues of log canonical centers. We prove the surprising fact that for a large class of noetherian rings with pure (aka universally injective) Frobenius, the splinter condition is detected by the splitting of a single generically étale finite extension. We also show that for a noetherian N -graded ring over a field, the homogeneous maximal ideal detects the splinter property. [ABSTRACT FROM AUTHOR]

Word Formation Guide (WFG) – one of the services of the Information System of Resources of the Lithuanian Language E. kalba (E -Language). It is intended to quickly and concisely introduce the means of word formation of Lithuanian nouns and the essential regularities of their formation. This guide is intended for the general public, but may also be useful for the specialists in word formation. The article briefly introduces a fast and detailed data search in the WFG. The quick search provides two ways of searching for means of word formation, focusing on their formal expression or derivative and lexical semantics. The detailed search is designed to search according to several features of the word formation means, base, and the semantics of the derivatives. In this search various combinations of the features are possible. Next, the article discusses several problematic issues that arose during the creation of the WFG data structure and data management. This is the homonymy of means of word formation, the classification of initial and final borrowed (neoclassical and other) formatives of words (prefixes, combining forms etc.) and their place in the word formation system of the Lithuanian language, and in the guide under discussion, experimental separation of (lexical) semantic features. In conclusion, the development possibilities of the Word Formation guide are introduced, not only by increasing the number of examples of noun derivatives and compounds but also by redesigning the current data structure and including the word formation data of other parts of speech.

We describe several aspects of the theory of strongly F-regular rings, including how they should be defined without the hypothesis of F-finiteness, and its relationship to tight closure theory, to F-signature, and to cluster algebras. As a necessary prerequisite, we give a quick introduction to tight closure theory, without proofs, but with discussion of underlying ideas. This treatment includes characterizations, important applications, and material concerning the existence of various kinds of test elements, since test elements play a considerable role in the theory of strongly F-regular rings. We introduce both weakly F-regular and strongly F-regular rings. We give a number of characterizations of strong F-regularity. We discuss techniques for proving strong F-regularity, including Glassbrenner's criterion and several methods that have been used in the literature. Many open questions are raised. [ABSTRACT FROM AUTHOR]

Although there are several ways of creating new words, the article investigates the morphological process that is referred to as lexical blending. Even if this minor word-formation process is increasingly popular, it is still not clearly defined and limited. This process is present in many languages, and is clear proof of how inventive a language can be. The first part of the article presents an examination of defining characteristics of blending and blend words according to different authors. The second part of the article is of a practical nature. Some of the key characteristics of blends discussed in the first part are tested on the basis of a corpus, which was compiled specifically for this purpose and contains 458 English and 396 French blends. Blends from each language are analysed separately in order to reveal any major discrepancies between English and French. The focal points of the analysis are the lexical categories of blends and of the source words entering each blend, the presence or absence of shortening of source words, the type of shortening of source words, the structural patterns of blends, the presence or absence of overlap between the source words, the type of overlap and the frequency of infixation. These parameters are corroborated by the statistical analysis of the corpus in order to reveal any prominent structural patterns in both languages. Additionally, some of these points of analysis are compared to the findings presented by Vincent Renner in "French and English lexical blends in contrast" (2018). His study includes 97 French and 374 English blends from two corresponding dictionaries in both languages, namely the Grand Robert de la langue française and the Shorter Oxford English Dictionary. [ABSTRACT FROM AUTHOR]

We are reporting a tree-related injury of a young adult who was thrown out through the windshield of a vehicle after a traffic accident and brought to the emergency room with a large tree branch stuck in his leg. Tree-related injuries are associated with difficult weather conditions, tree-stands of hunters and traffic accidents. When faced with such injuries, large branches should be carefully removed, care should be taken to avoid secondary damage caused by small branches and splinters and ultrasonography should be preferred primarily for imaging in cases where there is a suspicion of splinter injuries.

Insurgent organizations often experience internal fragmentation when a faction breaks away to form a separate group with independent leadership. Following a split, what factors influence the relative durability and status of groups within larger nationalist movements? Existing theory attributes variation in groups' performance after a division to rebel strategy. Specifically, some work argues that extremist groups using violence will outbid more moderate competitors; however, alternate research contends organizations using strategic non-violence will have more success. Contrary to previous work, this inquiry argues that in many instances rebel strategy following a split has little influence on the duration and status of groups. Instead, organizations' relative membership size at the time of a division is the most important factor influencing their subsequent performance. That is, after a split larger core groups are more likely to survive for longer periods and to advance within their broader nationalist movements than splinter groups. However, in cases when divisions result in groups of similar size and strength, strategy may still play a significant role in rebel organizations' comparative longevity and status. [ABSTRACT FROM AUTHOR]

Neste texto, abordamos as formações piri-X (piripobre, piricrente) e X-guete (vovoguete, coroguete), ambas oriundas da palavra derivada recém-criada na língua periguete (“mulher vulgar, trajada com roupas extravagantes”). A análise toma por base a noção de splinter recentemente formulada na literatura morfológica contemporânea (BAUER, 2004; BOOIJ, 2004; GONÇALVES, 2013) e examina tanto os aspectos formais quanto os aspectos semânticos que aproximam e afastam essas formas da classe dos radicais e dos afixos mais prototípicos. Com isso, abordamos a interface da composição com a derivação, mostrando estar diante de dois elementos morfológicos que atuam nas fronteiras entre esses dois principais processos de formação de palavras. Os dados que embasam a análise foram retirados da Internet, sobretudo de blogs, tweets e postagens no Facebook, em decorrência de serem espaços virtuais com interação mais natural e espontânea. Os dados de fala provêm de entrevistas realizadas com informantes (homens e mulheres) de diferentes faixas etárias e graus de escolaridade. Concluímos o estudo mostrando que as duas formas, piri- e -guete, possuem características tanto derivacionais quanto composicionais, encontrando-se em uma posição intermediária entre os dois processos. Assumimos, portanto, que as duas formas fornecem evidências empíricas sobre a existência de um continuum composição-derivação.

Fragmentation of armed opposition movements through the rise of new rebel groups constitutes a significant challenge to conflict termination and peacebuilding. Yet, the question of why some rebel movements remain cohesive whereas others see a number of contending groups during the course of the armed conflict has received limited attention in existing research. This article addresses this gap by analyzing the determinants of the rise of rebel contenders in intrastate armed conflicts worldwide, 1975–2013. The theoretical framework focuses on barriers to entry, that is, variations in the costs and disadvantages that must be borne by nascent rebel contenders that are not borne to the same extent by incumbent rebel groups. The study proposes that strong social networks underpinning incumbent groups create structural barriers to entry for nascent groups by aggravating challenges of organization building. It further suggests that the interaction between incumbent groups and the government influences strategic barriers to entry as changes in government policies produce windows of opportunity for nascent groups to form. Consistent with these arguments, the study finds that when incumbent groups have strong networks – because rebels either tap into ethnic networks or draw on a leftist ideology – the risk of fragmentation is lower. Furthermore, when the government accommodates groups, through either negotiations or democratic concessions, the risk of fragmentation increases. [ABSTRACT FROM AUTHOR]

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Key message: Transformation resulted in deletions and translocations at T-DNA inserts, but not in genome-wide small mutations. A tiny T-DNA splinter was detected that probably would remain undetected by conventional techniques. Abstract: We investigated to which extent Agrobacterium tumefaciens-mediated transformation is mutagenic, on top of inserting T-DNA. To prevent mutations due to in vitro propagation, we applied floral dip transformation of Arabidopsis thaliana. We re-sequenced the genomes of five primary transformants, and compared these to genomic sequences derived from a pool of four wild-type plants. By genome-wide comparisons, we identified ten small mutations in the genomes of the five transgenic plants, not correlated to the positions or number of T-DNA inserts. This mutation frequency is within the range of spontaneous mutations occurring during seed propagation in A. thaliana, as determined earlier. In addition, we detected small as well as large deletions specifically at the T-DNA insert sites. Furthermore, we detected partial T-DNA inserts, one of these a tiny 50-bp fragment originating from a central part of the T-DNA construct used, inserted into the plant genome without flanking other T-DNA. Because of its small size, we named this fragment a T-DNA splinter. As far as we know this is the first report of such a small T-DNA fragment insert in absence of any T-DNA border sequence. Finally, we found evidence for translocations from other chromosomes, flanking T-DNA inserts. In this study, we showed that next-generation sequencing (NGS) is a highly sensitive approach to detect T-DNA inserts in transgenic plants. [ABSTRACT FROM AUTHOR]

Introduction: Penetrating hand injuries are common and improper assessment can result in missed foreign bodies. These bodies can result in a wide range of complications. Aim: The aim of our study was to study the profile of patients reporting with missed foreign bodies in the hand. Materials and methods: All the cases treated in the Department of Surgery, Sheri Kashmir Institute of Medical Sciences (medical college), Kashmir, for missed foreign bodies in hands from June 2003 to May 2009 were studied retrospectively. Results: A total of 61 cases with missed foreign bodies of different nature were treated over the period of six years. Wooden splinters were the most common foreign bodies missed. Preoperative localization was accomplished with plain radiographs and ultrasonograms. Most of the cases were treated on outpatient basis. Conclusions: Foreign bodies should be suspected and ruled out in all cases of penetrating injuries of hands. Missed foreign bodies need to be removed after proper localization by imaging.

Small foreign bodies superficially embedded in the acral skin can be difficult to remove. Typical treatment includes using forceps and pressure to attempt removal, which is painful and not always successful. Here we present a patient with a prolonged presentation of a superficially embedded foreign body on his finger. The method for extracting the foreign body was successful and painless through the paring of the skin to gently remove the object. This method decreases pain and swelling, making it a more efficient way of extracting small foreign bodies that are lodged in the superficial skin layer. This case report focuses on more efficient and painless removal of superficially lodged foreign body removal in the clinical office setting., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Oberdorfer et al.)

This paper investigates a new type of formative in English that frequently gives rise to a productive word-formation process. Three questions that have been discussed controversially in previous research will be addressed: What is the origin of these formatives? What type of morpheme do they represent? What type of word-formation process are they involved in? The paper argues that the secretion, productive use and subsequent lexicalization of these formatives is a recent development in English word-formation that presents challenges to morphological theory and grammaticalization. In addition, data from other languages suggest that processes of language contact are related to the emergence of this new formative in languages other than English. [ABSTRACT FROM AUTHOR]

A 25-year-old male Syrian refugee presented in our hospital with recurrent hip infections after having undergone hip arthroplasty abroad following destruction of his right hip joint by shell splinters in the Syrian civil war. The patient underwent hip arthroplasty revision with implantation of a cement spacer. CT-scan with rectal contrast media filling revealed a rectoacetabular fistula. Consecutively, the patient underwent ileostomy formation. The fistula was then successfully closed by endoscopic over-the-scope clipping (OTSC®). Fistulas between intestines and joints rarely develop and in the few cases published mostly extensive abdominal rescue surgery has been performed. Here, we present a case of a traumatic rectoacetabular fistula that was successfully closed by OTSC. This innovative method could represent a safe and suitable option to effectively close fistulas between joints and intestines thereby avoiding extensive rescue surgery with bowel resection or permanent ostomy. [ABSTRACT FROM AUTHOR]

Splinter or foreign body removal from the hand and foot is a common occurrence. Usually only the deep seated, broken or missed splinters are referred to the surgeon for removal. Unless the object is radio-opaque, plain radiograph will not give any useful information, hence removal can sometimes be very difficult and traumatic. We are reporting a case where a radiolucent splinter was removed with the aid of ultrasonography. This modality can help to localize a splinter at the pre and intra-operative period, minimizing amount of exploration and time of operation.

Longitudinal erythronychia (LE) is a term for red streaks in the nail which can be caused by a range of diseases. The specific type of longitudinal erythronychia can correlate with certain associated conditions making it important to properly categorize when discovered. A 71-year-old Hispanic male presented to the clinic with a type 1A LE associated with subungual keratosis that had been asymptomatic for approximately 12 months. The patient denied injury, pain, cold sensitivity, or cosmetic distress. The working diagnosis was squamous cell carcinoma in situ (SCCIS) vs. onychopapilloma or glomus tumor. A 4mm punch biopsy from the distal nail matrix was performed, and dermatopathology revealed that the LE was secondary to a wooden splinter. After a literature review, it was discovered that this is the first confirmed case of LE secondary to a splinter. Future providers should keep splinters as a potential differential diagnosis, especially as they evaluate LE, but ultimately all suspicious type IA lesions should be biopsied to rule out potential insidious pathologies, such as SCCIS and malignant melanoma., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Dowdle et al.)

Mainstream word-formation is concerned with the formation of new words from morphemes. As morphemes are full linguistic signs, the resulting neologisms are transparent: speakers can deduce the meanings of the new formations from the meanings of their constituents. Thus, morphematic word-formation processes can be analysed in terms of their modifier/head relationship, with A + B > AB, and AB = (a kind of) B. This pattern applies to compounding and affixation. There are, however, certain word-formation processes that are not morpheme-based and that do not have a modifier/head structure. Acronyms like NATO are formed from the initial letters of word groups; blends like motel ‘mix’ or conflate submorphemic elements; clippings like prof shorten existing words. In order to analyse these word-formation processes, we need concepts below the morpheme level. This paper will analyse the role played by elements below the morpheme level in the production of these non-morphematic word-formation processes which have been particularly productive in the English language since the second half of the 20th century.

Background: Rare genetic variation in the human population is a major source of pathophysiological variability and has been implicated in a host of complex phenotypes and diseases. Finding disease-related genes harboring disparate functional rare variants requires sequencing of many individuals across many genomic regions and comparing against unaffected cohorts. However, despite persistent declines in sequencing costs, population-based rare variant detection across large genomic target regions remains cost prohibitive for most investigators. In addition, DNA samples are often precious and hybridization methods typically require large amounts of input DNA. Pooled sample DNA sequencing is a cost and time-efficient strategy for surveying populations of individuals for rare variants. We set out to 1) create a scalable, multiplexing method for custom capture with or without individual DNA indexing that was amenable to low amounts of input DNA and 2) expand the functionality of the SPLINTER algorithm for calling substitutions, insertions and deletions across either candidate genes or the entire exome by integrating the variant calling algorithm with the dynamic programming aligner, Novoalign. Results: We report methodology for pooled hybridization capture with pre-enrichment, indexed multiplexing of up to 48 individuals or non-indexed pooled sequencing of up to 92 individuals with as little as 70 ng of DNA per person. Modified solid phase reversible immobilization bead purification strategies enable no sample transfers from sonication in 96-well plates through adapter ligation, resulting in 50% less library preparation reagent consumption. Custom Y-shaped adapters containing novel 7 base pair index sequences with a Hamming distance of ≥2 were directly ligated onto fragmented source DNA eliminating the need for PCR to incorporate indexes, and was followed by a custom blocking strategy using a single oligonucleotide regardless of index sequence. These results were obtained aligning raw reads against the entire genome using Novoalign followed by variant calling of non-indexed pools using SPLINTER or SAMtools for indexed samples. With these pipelines, we find sensitivity and specificity of 99.4% and 99.7% for pooled exome sequencing. Sensitivity, and to a lesser degree specificity, proved to be a function of coverage. For rare variants (≤2% minor allele frequency), we achieved sensitivity and specificity of ≥94.9% and ≥99.99% for custom capture of 2.5 Mb in multiplexed libraries of 22-48 individuals with only ≥5-fold coverage/chromosome, but these parameters improved to ≥98.7 and 100% with 20-fold coverage/ chromosome. Conclusions: This highly scalable methodology enables accurate rare variant detection, with or without individual DNA sample indexing, while reducing the amount of required source DNA and total costs through less hybridization reagent consumption, multi-sample sonication in a standard PCR plate, multiplexed pre-enrichment pooling with a single hybridization and lesser sequencing coverage required to obtain high sensitivity. [ABSTRACT FROM AUTHOR]

Introduction: Penetrating hand injuries are common and improper assessment can result in missed foreign bodies. These bodies can result in a wide range of complications. Aim: The aim of our study was to study the profile of patients reporting with missed foreign bodies in the hand. Materials and methods: All the cases treated in the Department of Surgery, Sheri Kashmir Institute of Medical Sciences (medical college), Kashmir, for missed foreign bodies in hands from June 2003 to May 2009 were studied retrospectively. Results: A total of 61 cases with missed foreign bodies of different nature were treated over the period of six years. Wooden splinters were the most common foreign bodies missed. Preoperative localization was accomplished with plain radiographs and ultrasonograms. Most of the cases were treated on outpatient basis. Conclusions: Foreign bodies should be suspected and ruled out in all cases of penetrating injuries of hands. Missed foreign bodies need to be removed after proper localization by imaging. [ABSTRACT FROM AUTHOR]

We evaluated the diagnostic sensitivity of ultrasound, nonenhanced computed tomography (CT) and nonenhanced magnetic resonance (MR) imaging in detecting wooden foreign bodies in the canine manus. Identical wooden splinters were manually inserted into 30 cadaver canine manus, and the limbs were evaluated using ultrasound, CT, and MR imaging by independent observers. All sites were rated as positive or negative for the presence of a foreign body, and observer certainty was scored on a 1–10 scale. Using receiver operating characteristic analysis, CT was the most accurate modality for detection of wooden foreign bodies overall and within each of the three individual regions, followed by ultrasound and MR imaging, respectively. Ultrasound evaluations were most limited in the metacarpal pad, where distal acoustic shadowing from the pad surface hindered evaluation of the tissues in some specimens. [ABSTRACT FROM AUTHOR]

Abstract: A 58 year old male patient visited to dental clinic with complains of inability to open mouth for the past two months. Patient had a history of accidental blast in a laboratory set up. He was treated in a hospital by general surgeons and all glass splinters were supposed to be removed at that time. The patient reported of pain in the same region from which the splinters had been removed. After thorough investigations a glass splinter was found to be lodged in infra-orbital region. This was operated and removed from the site. Clinical relevance: It is of vital importance for professional knowledge about the possible foreign body existence on the patient''s head and neck segment in order to decrease the delayed foreign body''s removal due to several common misdiagnosis errors, reducing the complications that are likely to occur when foreign bodies are retained in the organism. Objective: Foreign bodies are often encountered by dental surgeons and may present a diagnostic challenge, due to many factors such as misleading history, the difficult access and a close anatomical relationship of the foreign body to vital structures. [Copyright &y& Elsevier]

Background Structural variants in DNA such as translocations are increasingly found as key oncogenic events in tumors, and detection is clinically relevant for therapy choice in many conditions. Despite developments in targeted and whole genome gene sequencing, the robust detection of structural variants remains a challenge, especially in FFPE specimens. Methods Targeted proximity ligation assays selectively amplify and sequence entire genes based on the crosslinking of physically proximal sequences, and thereby enable complete sequencing of genes of interest, including single nucleotide and structural variants. Because these assays are based on the crosslinking and fragmenting of DNA, they have particular advantages in the analysis of FFPE samples, in which DNA is inherently crosslinked and fragmented. Results We will show that we have successfully developed targeted proximity ligation assays on representative clinical FFPE samples with considerably fragmented DNA. By making use of the DNA crosslinks in these samples, we can generate very broad sequence information over 100's of kb's, where other targeted NGS technologies are limited by the fragment size. We will show that we can detect NTRK fusions at DNA level, including determination of the fusion partner and the exact translocation breakpoint sequence. The latter can be used as a very sensitive and cancer-specific marker for minimal residual disease (MRD) testing and ctDNA monitoring with PCR. Conclusions Our newly developed targeted proximity ligation assays enable robust detection of structural variation in FFPE samples and the development of personalized MRD/ctDNA tests. Legal entity responsible for the study Cergentis. Funding Cergentis via Horizon2020 SME funding. Disclosure H. Feitsma: Full / Part-time employment: Cergentis. M. Yilmaz: Full / Part-time employment: Cergentis. J. Swennenhuis: Full / Part-time employment: Cergentis. A. Rakszewska: Full / Part-time employment: Cergentis. K. Hajo: Full / Part-time employment: Cergentis. E. Splinter: Full / Part-time employment: Cergentis. M. Simonis: Full / Part-time employment: Cergentis. M. Van Min: Shareholder / Stockholder / Stock options, Full / Part-time employment: Cergentis. All other authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]