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In this work, we studied the magnetic properties and hysteresis loops of a mixed spin-1/2and spin-3/2bilayer system using the mean-field approximation based on the Bogoliubov free-energy inequality. The two layers are separated by a number of non-magnetic layers with a graphene structure. First, we plotted a ground-state phase diagram at zero temperature. Then, we explored the thermal behavior of total magnetization under the effect of the indirect exchange interaction JRbetween the two layers, and we deduced the phase diagram for T≠0. We also examined the influence of non-magnetic layers on magnetic hysteresis behavior for different temperatures.

•Adopting global standards for data systems to use the same terminology is a conceptional approach internationally. So what about nationally?•The analysis of the nomenclature of implantable medical devices included in this list through a comparison with the global nomenclature of MD (GMDN) and the European nomenclature of MD (EMDN).•The 170 DM codes of the refundable DMs list are mapped by cardinality to the two databases with metric identification by Sørensen-Dice coefficient of terminological similarity.

Purpose: Adolescent idiopathic scoliosis is a chronic disease that may require correction surgery. The finite element method (FEM) is a popular option to plan the outcome of surgery on a patient-based model. However, it requires considerable computing power and time, which may discourage its use. Machine learning (ML) models can be a helpful surrogate to the FEM, providing accurate real-time responses. This work implements ML algorithms to estimate post-operative spinal shapes. Methods: The algorithms are trained using features from 6400 simulations generated using the FEM from spine geometries of 64 patients. The features are selected using an autoencoder and principal component analysis. The accuracy of the results is evaluated by calculating the root-mean-squared error and the angle between the reference and predicted position of each vertebra. The processing times are also reported. Results: A combination of principal component analysis for dimensionality reduction, followed by the linear regression model, generated accurate results in real-time, with an average position error of 3.75 mm and orientation angle error below 2.74 degrees in all main 3D axes, within 3 ms. The prediction time is considerably faster than simulations based on the FEM alone, which require seconds to minutes. Conclusion: It is possible to predict post-operative spinal shapes of patients with AIS in real-time by using ML algorithms as a surrogate to the FEM. Clinicians can compare the response of the initial spine shape of a patient with AIS to various target shapes, which can be modified interactively. These benefits can encourage clinicians to use software tools for surgical planning of scoliosis.

Purpose: The premise of this research is that the coupling of reinforcement learning algorithms and computational dynamics can be used to design efficient control strategies and to improve the cooling of hot components by quenching, a process that is classically carried out based on professional experience and trial-error methods. Feasibility and relevance are assessed on various 2-D numerical experiments involving boiling problems simulated by a phase change model. The purpose of this study is then to integrate reinforcement learning with boiling modeling involving phase change to optimize the cooling process during quenching. Design/methodology/approach: The proposed approach couples two state-of-the-art in-house models: a single-step proximal policy optimization (PPO) deep reinforcement learning (DRL) algorithm (for data-driven selection of control parameters) and an in-house stabilized finite elements environment combining variational multi-scale (VMS) modeling of the governing equations, immerse volume method and multi-component anisotropic mesh adaptation (to compute the numerical reward used by the DRL agent to learn), that simulates boiling after a phase change model formulated after pseudo-compressible Navier–Stokes and heat equations. Findings: Relevance of the proposed methodology is illustrated by controlling natural convection in a closed cavity with aspect ratio 4:1, for which DRL alleviates the flow-induced enhancement of heat transfer by approximately 20%. Regarding quenching applications, the DRL algorithm finds optimal insertion angles that adequately homogenize the temperature distribution in both simple and complex 2-D workpiece geometries, and improve over simpler trial-and-error strategies classically used in the quenching industry. Originality/value: To the best of the authors' knowledge, this constitutes the first attempt to achieve DRL-based control of complex heat and mass transfer processes involving boiling. The obtained results have important implications for the quenching cooling flows widely used to achieve the desired microstructure and material properties of steel, and for which differential cooling in various zones of the quenched component will yield irregular residual stresses that can affect the serviceability of critical machinery in sensitive industries. [ABSTRACT FROM AUTHOR]

Transfer RNA dynamics contribute to cancer development through regulation of codon-specific messenger RNA translation. Specific aminoacyl-tRNA synthetases can either promote or suppress tumourigenesis. Here we show that valine aminoacyl-tRNA synthetase (VARS) is a key player in the codon-biased translation reprogramming induced by resistance to targeted (MAPK) therapy in melanoma. The proteome rewiring in patient-derived MAPK therapy-resistant melanoma is biased towards the usage of valine and coincides with the upregulation of valine cognate tRNAs and of VARS expression and activity. Strikingly, VARS knockdown re-sensitizes MAPK-therapy-resistant patient-derived melanoma in vitro and in vivo. Mechanistically, VARS regulates the messenger RNA translation of valine-enriched transcripts, among which hydroxyacyl-CoA dehydrogenase mRNA encodes for a key enzyme in fatty acid oxidation. Resistant melanoma cultures rely on fatty acid oxidation and hydroxyacyl-CoA dehydrogenase for their survival upon MAPK treatment. Together, our data demonstrate that VARS may represent an attractive therapeutic target for the treatment of therapy-resistant melanoma.

The main objective of this study was to understand and predict the evolution of physical, chemical, and mechanical properties of a new composite material and its interactions with its surroundings. This study enhances scientific understanding of sorption mechanisms involved in calcinated eggshell powder/clay composites. By utilizing calcinated eggshell powder in composite materials, waste from the food industry can be recycled, contributing to the development of environmentally sustainable solutions. The eggshells were calcinated at 300, 600, and 800 °C. Their degradation at elevated temperatures was determined using thermogravimetric analysis (ATG). The chemical composition of the calcinated eggshells was analyzed using Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction analysis (XRD). Clay/calcinated eggshell bio-composites were developed, dried, and evaluated for their shrinkage and mechanical resistance at different moisture levels. To assess the durability and predict the performance of the new composite structures, desorption/adsorption isotherms were established. The sorption isotherms obtained were of sigmoid shape and of type II of Brunauer classification. The fitting of sorption isotherms of the new bio-ceramic materials using five equations demonstrates that the Guggenheim-Andersen-de Boer (GAB) model can accurately predict the moisture content at equilibrium for different water activities. Sorption isotherm data were used to determine the thermodynamic properties mainly isosteric heat of sorption, sorption entropy, net integral enthalpy, and entropy of clay/calcinated eggshell bio-composites. All these properties were analyzed and compared.

The function of polysaccharides is intimately associated with their size, which is largely determined by the processivity of transferases responsible for their synthesis. A tunnel active center architecture has been recognized as a key factor that governs processivity of several glycoside hydrolases (GHs), e.g., cellulases and chitinases. Similar tunnel architecture is also observed in the Limosilactobacillus reuteri121 GtfB (Lr121 GtfB) α-glucanotransferase from the GH70 family. The molecular element underpinning processivity of these transglucosylases remains underexplored. Here, we report the synthesis of the smallest (α1 → 4)-α-glucan interspersed with linear and branched (α1 → 6) linkages by a novel 4,6-α-glucanotransferase from L. reuteriN1 (LrN1 GtfB) with an open-clefted active center instead of the tunnel structure. Notably, the loop swapping engineering of LrN1 GtfB and Lr121 GtfB based on their crystal structures clarified the impact of the loop-mediated tunnel/cleft structure at the donor subsites −2 to −3 on processivity of these α-glucanotransferases, enabling the tailoring of both product sizes and substrate preferences. This study provides unprecedented insights into the processivity determinants and evolutionary diversification of GH70 α-glucanotransferases and offers a simple route for engineering starch-converting α-glucanotransferases to generate diverse α-glucans for different biotechnological applications.

Women currently represent approximately 70% of the global healthcare workforce, 60.9% of the global dental workforce, 77.6% of the US healthcare workforce, and 36.7% of the US dental workforce. The American Dental Association states that the number of practicing women dentists in the United States has increased by 2.25 times since 2001, with a projected trajectory to level off by 2040. Despite having a major impact on the healthcare sector globally, women earn 24% less than men and only serve in 25% of senior leadership positions. In the US dental schools, only 14% of faculty serve in administrative roles, and as of April 2022, 28.6% of the US dental school deans were women, indicating gender underrepresentation in the highest roles of academic leadership. This corresponds to the data on gender parity still not being the norm in many societies and workplaces and can be attributed to public policies, stereotypical perceptions, and individual factors. Five key factors have been identified to be crucial for women's entry or advancement in global health leadership: a) public policy, b) community, c) institutional, d) interpersonal, and e) individual. Individual self‐improvement and institutional practices may be used to overcome these barriers to women's leadership in healthcare and shift the power dynamics toward reinforcing gender equality. These transformative changes are measured through women's collective capacities and skills, relationship dynamics, community perceptions, and environmental practices. This article recognizes the present obstacles to women in healthcare leadership and proposes strategies to achieve gender equality both through individual and institutional practices.

Pseudoaneurysms are frequent vascular anomalies. This review article aims to describe the unique specific aspect of pseudoaneurysm (PSA) that allows to make the diagnosis using different modalities: colour Doppler ultrasound, computed tomographic angiography, magnetic resonance angiography and conventional angiography. It is essential to know the various aetiologies of PSA: iatrogenic, traumatic, dissecting and anastomotic; different locations and the possible complications, information to help clinicians choose the best treatment. Our review is supported by illustrated series of cases.

ABSTRACT Being a hygroscopic material, wood is subjected to dimensional variation from a hygric state to another. These variations affect strongly its physical properties and consequently its structural functions in [...]

α-Glucanotransferases of the CAZy family GH70 convert starch-derived donors to industrially important α-glucans. Here, we describe characteristics of a novel GtfB-type 4,6-α-glucanotransferase of high enzyme activity (60.8 U mg–1) from Limosilactobacillus reuteriN1 (LrN1 GtfB), which produces surprisingly large quantities of soluble protein in heterologous expression (173 mg pure protein per L of culture) and synthesizes the reuteran-like α-glucan with (α1 → 6) linkages in linear chains and branch points. Protein structural analysis of LrN1 GtfB revealed the potential crucial residues at subsites −2∼+2, particularly H265, Y214, and R302, in the active center as well as previously unidentified surface binding sites. Furthermore, molecular dynamic simulations have provided unprecedented insights into linkage specificity hallmarks of the enzyme. Therefore, LrN1 GtfB represents a potent enzymatic tool for starch conversion, and this study promotes our knowledge on the structure–function relationship of GH70 GtfB α-glucanotransferases, which might facilitate the production of tailored α-glucans by enzyme engineering in future.

Study Design A modified Delphi study.Objective To assess current practice patterns in the management of cervical spinal cord injury (SCI) and develop a simplified, practical classification system which offers ease of use in the acute setting, incorporates modern diagnostic tools and provides utility in determining treatment strategies for cervical SCI.Methods A three-phase modified Delphi procedure was performed between April 2020 and December 2021. During the first phase, members of the AOSpine SCI Knowledge forum proposed variables of importance for classifying and treating cervical SCI. The second phase involved an international survey of spine surgeons gauging practices surrounding the role and timing of surgery for cervical SCI and opinions regarding factors which most influence these practices. For the third phase, information obtained from phases 1 and 2 were used to draft a new classification system.Results 396 surgeons responded to the survey. Neurological status, spinal stability and cord compression were the most important variables influencing decisions surrounding the role and timing of surgery. The majority (>50%) of respondents preferred to perform surgery within 24 hours post-SCI in clinical scenarios in which there was instability, severe cord compression or severe neurology. Situations in which <50% of respondents were inclined to operate early included: SCI with mild neurological impairments, with cord compression but without instability (with or without medical comorbidities), and SCI without cord compression or instability.Conclusions Spinal stability, cord compression and neurological status are the most important variables influencing surgeons’ practices surrounding the surgical management of cervical SCI. Based on these results, a simplified classification system for acute cervical SCI has been proposed.

Sinusitis is a common diagnosis that can be erroneously associated with routine weather‐related barometric pressure changes. In actuality, these pressure changes likely exacerbate migraine headaches, which can cause facial pain and pressure rather than true sinus inflammation. The present study sought to characterize the representation of both sinusitis and migraine in association with barometric pressure changes across websites on the Internet. An Internet search for relevant terms was conducted, and content of the resulting pages was assessed for associations between weather‐related pressure changes and either sinusitis or migraine. Variations in reported results across different subtypes of Internet sources were analyzed. The primary outcomes measured were (1) whether a given media source associated barometric weather changes with sinusitis, (2) whether that source associated barometric weather changes with migraine, and (3) treatment options offered by that source. Of the 116 included webpages, 36 (31.03%) associated sinusitis and routine barometric pressure changes. Of these, 10 (27.77%) were otolaryngology practice sites. Sixty‐seven webpages (57.76%) associated migraine and routine barometric pressure changes. Of these, nonotolaryngology webpages were more likely to report this link. Otolaryngology practice sites were observed to be the most frequent professional medical resource reporting the unsubstantiated claim that routine barometric pressure changes are associated with sinusitis. Nonotolaryngology sources were more likely to link weather‐related pressure changes to migraine. These results suggest that opportunities exist for otolaryngology practice sites to educate patients about nonrhinogenic headache etiologies. 31.03% of websites erroneously associated sinusitis with barometric pressure changes; of these, 27.77% were otolaryngology practice sites. Non‐otolaryngology sites were more likely to correctly associate migraine with barometric pressure changes. This study found that websites of otolaryngology practices most frequently reported an association between routine barometric pressure changes and sinusitis, while nonotolaryngology sources were more likely to correctly link these pressure changes to migraine.These findings suggest that public otolaryngology resources can improve in the delivery of accurate and diagnostically helpful information to patients. This study found that websites of otolaryngology practices most frequently reported an association between routine barometric pressure changes and sinusitis, while nonotolaryngology sources were more likely to correctly link these pressure changes to migraine. These findings suggest that public otolaryngology resources can improve in the delivery of accurate and diagnostically helpful information to patients.

Study Design Clinical practice guideline development.Objectives Acute spinal cord injury (SCI) can result in devastating motor, sensory, and autonomic impairment; loss of independence; and reduced quality of life. Preclinical evidence suggests that early decompression of the spinal cord may help to limit secondary injury, reduce damage to the neural tissue, and improve functional outcomes. Emerging evidence indicates that “early” surgical decompression completed within 24 hours of injury also improves neurological recovery in patients with acute SCI. The objective of this clinical practice guideline (CPG) is to update the 2017 recommendations on the timing of surgical decompression and to evaluate the evidence with respect to ultra-early surgery (in particular, but not limited to, <12 hours after acute SCI).Methods A multidisciplinary, international, guideline development group (GDG) was formed that consisted of spine surgeons, neurologists, critical care specialists, emergency medicine doctors, physical medicine and rehabilitation professionals, as well as individuals living with SCI. A systematic review was conducted based on accepted methodological standards to evaluate the impact of early (within 24 hours of acute SCI) or ultra-early (in particular, but not limited to, within 12 hours of acute SCI) surgery on neurological recovery, functional outcomes, administrative outcomes, safety, and cost-effectiveness. The GRADE approach was used to rate the overall strength of evidence across studies for each primary outcome. Using the “evidence-to-recommendation” framework, recommendations were then developed that considered the balance of benefits and harms, financial impact, patient values, acceptability, and feasibility. The guideline was internally appraised using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool.Results The GDG recommended that early surgery (≤24 hours after injury) be offered as the preferred option for adult patients with acute SCI regardless of level. This recommendation was based on moderate evidence suggesting that patients were 2 times more likely to recover by ≥ 2 ASIA Impairment Score (AIS) grades at 6 months (RR: 2.76, 95% CI 1.60 to 4.98) and 12 months (RR: 1.95, 95% CI 1.26 to 3.18) if they were decompressed within 24 hours compared to after 24 hours. Furthermore, patients undergoing early surgery improved by an additional 4.50 (95% 1.70 to 7.29) points on the ASIA Motor Score compared to patients undergoing surgery after 24 hours post-injury. The GDG also agreed that a recommendation for ultra-early surgery could not be made on the basis of the current evidence because of the small sample sizes, variable definitions of what constituted ultra-early in the literature, and the inconsistency of the evidence.Conclusions It is recommended that patients with an acute SCI, regardless of level, undergo surgery within 24 hours after injury when medically feasible. Future research is required to determine the differential effectiveness of early surgery in different subpopulations and the impact of ultra-early surgery on neurological recovery. Moreover, further work is required to define what constitutes effective spinal cord decompression and to individualize care. It is also recognized that a concerted international effort will be required to translate these recommendations into policy.

Study design Systematic review and meta-analysis.Objective Surgical decompression is a cornerstone in the management of patients with traumatic spinal cord injury (SCI); however, the influence of the timing of surgery on neurological recovery after acute SCI remains controversial. This systematic review aims to summarize current evidence on the effectiveness, safety, and cost-effectiveness of early (≤24 hours) or late (>24 hours) surgery in patients with acute traumatic SCI for all levels of the spine. Furthermore, this systematic review aims to evaluate the evidence with respect to the impact of ultra-early surgery (earlier than 24 hours from injury) on these outcomes.Methods A systematic search of the literature was performed using the MEDLINE database (PubMed), Cochrane database, and EMBASE. Two reviewers independently screened the citations from the search to determine whether an article satisfied predefined inclusion and exclusion criteria. For all key questions, we focused on primary studies with the least potential for bias and those that controlled for baseline neurological status and specified time from injury to surgery. Risk of bias of each article was assessed using standardized tools based on study design. Finally, the overall strength of evidence for the primary outcomes was assessed using the GRADE approach. Data were synthesized both qualitatively and quantitively using meta-analyses.Results Twenty-one studies met inclusion and exclusion criteria and formed the evidence base for this review update. Seventeen studies compared outcomes between patients treated with early (≤24 hours from injury) compared to late (>24 hours) surgical decompression. An additional 4 studies evaluated even earlier time frames: <4, <5, <8 or <12 hours. Based on moderate evidence, patients were 2 times more likely to recover by ≥ 2 grades on the ASIA Impairment Score (AIS) at 6 months (RR: 2.76, 95% CI 1.60 to 4.98) and 12 months (RR: 1.95, 95% CI 1.26 to 3.18) if they were decompressed within 24 hours compared to after 24 hours. Furthermore, moderate evidence suggested that patients receiving early decompression had an additional 4.50 (95% CI 1.70 to 7.29) point improvement on the ASIA motor score. With respect to administrative outcomes, there was low evidence that early decompression may decrease acute hospital length of stay. In terms of safety, there was moderate evidence that suggested the rate of major complications does not differ between patients undergoing early compared to late surgery. Furthermore, there was no difference in rates of mortality, surgical device-related complications, sepsis/systemic infection or neurological deterioration based on timing of surgery. Firm conclusions were not possible with respect to the impact of ultra-early surgery on neurological, functional or safety outcomes given the poor-quality studies, imprecision and the overlap in the time frames examined.Conclusions This review provides an evidence base to support the update on clinical practice guidelines related to the timing of surgical decompression in acute SCI. Overall, the strength of evidence was moderate that early surgery (≤24 hours from injury) compared to late (>24 hours) results in clinically meaningful improvements in neurological recovery. Further studies are required to delineate the role of ultra-early surgery in patients with acute SCI.

The coastal basin of Tarfaya is part of the Meso-Cenozoic basins of the Moroccan Atlantic margin which developed following the bursting of Pangea. In this study, Landsat-8 OLI/TIR images were used as a tool for the extraction of geological lineaments. A more detailed statistical analysis of the spatial distribution of the lineaments was applied by comparing the means of their lengths and their orientations in four areas of the basin using the Kruskal–Wallis test. In addition, an ascending hierarchical classification was used to group individuals according to lineament orientation. The results showed that the basin is fractured by a network of 1603 lineaments. The variance analysis of the lineament orientation means proved the subdivision of the basin into four structural zones. The ascending hierarchical classification (CHA) classified the lineaments in the coastal basin of Tarfaya into six groups high-frequency orientations organized into three directions classes (ENE–WSW, NW–SE to NNW–SSE and NE–SW to NNE–SSW) with proportions of 29%, 28% and 43% respectively. These directions reveal the fracturing of the studied area by the reactivation of pre-existing structures during the Variscan and Atlasic tectonic episodes. Thus, during the Hercynian Orogeny, the basin underwent NNW–SSE directed compression and rotation related to late Variscan deformation that led to the partial stress reversal that became NE–SW to NNE–SSW. The ENE–WSW directions represent the reactivation of the Alpine orogeny in the Meso-Cenozoic formations of the basin. The application of multivariate statistical methods for analyzing lineaments in the basin introduces an innovative approach to fracture analysis.

The presence of bronchus-associated lymphoid tissue (BALT) in donor lungs has been suggested to accelerate graft rejection after lung transplantation. Although chronic smoke exposure can induce BALT formation, the impact of donor cigarette use on alloimmune responses after lung transplantation is not well understood. Here, we show that smoking-induced BALT in mouse donor lungs contains Foxp3+T cells and undergoes dynamic restructuring after transplantation, including recruitment of recipient-derived leukocytes to areas of pre-existing lymphoid follicles and replacement of graft-resident donor cells. Our findings from mouse and human lung transplant data support the notion that a donor’s smoking history does not predispose to acute cellular rejection or prevent the establishment of allograft acceptance with comparable outcomes to nonsmoking donors. Thus, our work indicates that BALT in donor lungs is plastic in nature and may have important implications for modulating proinflammatory or tolerogenic immune responses following transplantation.

Targeted therapeutics for high-risk cancers remain an unmet medical need. Here we report the results of a large-scale screen of over 11,000 molecules for their ability to inhibit the survival and growth in vitro of human leukemic cells from multiple sources including patient samples, de novo generated human leukemia models, and established human leukemic cell lines. The responses of cells from de novo models were most similar to those of patient samples, both of which showed striking differences from the cell-line responses. Analysis of differences in subtype-specific therapeutic vulnerabilities made possible by the scale of this screen enabled the identification of new specific modulators of apoptosis, while also highlighting the complex polypharmacology of anti-leukemic small molecules such as shikonin. These findings introduce a new platform for uncovering new therapeutic options for high-risk human leukemia, in addition to reinforcing the importance of the test sample choice for effective drug discovery.

Purpose: Apical stress redistribution (ASR) is proposed to mitigate failure risks after anterior vertebral body tethering for adolescent idiopathic scoliosis. It consists in releasing set-screws at peri-apical levels following curve tensioning to redistribute stresses within the construct. This study determines the biomechanical impact and curve correction obtained with ASR. Methods: Finite element models of anterior vertebral body tethering were constructed for three typical scoliotic patients with Lenke 1 curves. ASR was simulated by releasing tension on the cable at the level of the three apical set screws (i.e. untightening three consecutive periapical set screws), followed by retightening of the set screws without further tensioning. Cable tension, implant forces and spine geometry were compared before and after performing ASR. Results: Periapical cable tension decreased post-ASR, and ASR also reduced the maximum tensions proximally and distally. Postoperative disc height was similar between conventional and ASR approaches. Apical intervertebral disc stresses were shifted from concave to convex compression intra and postoperatively, with a similar pattern between the conventional and ASR techniques. The ASR technique achieved scoliotic curve corrections of 54%, 68%, and 79%, while the conventional technique resulted in corresponding corrections (54%, 68%, and 80%) for subjects 1, 2, and 3. The periapical coronal curves exhibited similar patterns. Conclusion: ASR demonstrated promising apical cable and implant forces re-equilibrium compared to the conventional approach. This novel technique did not impair immediate and postoperative curve correction, while maintaining similar apical intervertebral stress distribution. ASR shows potential to modulate growth while reducing maximum cable tension infra- and supra-apical.

This study focuses on a numerical data-driven machine learning (ML) approach applied to predict critical parameters, including hardness, Von Mises stress, and equivalent plastic strain in various ceramic multilayer coatings on a Ti alloy substrate, such as Ti/TiN, Ti/TiVN, Ti/TiZrN, Cr/CrN, Cr/CrAlN, and Ta/Ti-Zr-Ta, through the nanoindentation process. The regression analysis demonstrated the model’s effectiveness in predicting these parameters, with heightened accuracy in hardness and stress compared to plastic strain. The remarkable efficiency of the proposed hierarchical ML model derives from its ability to unravel complex interdependencies within the dataset, revealing subtle relationships that traditional models often overlook. The outcomes also revealed a direct correlation between increases in output targets, such as hardness and average Von Mises stress, and the amplification of weight factors associated with processing parameters. Conversely, heightened values of equivalent plastic strain demonstrated a proportional increase in weight factors associated with material properties. This observation underscores the individual contributions of processing parameters and material characteristics in modeling the mechanical behavior of multilayer coatings. Moreover, the ML model significantly enhanced the predictive performance for multilayer coatings by providing a detailed relevance score for the material properties of the layers. These properties included factors such as elastic modulus, hardness, Poisson ratio, and yield strength.

Background: With a rising incidence of cerebrospinal fluid (CSF) leaks, endoscopic endonasal CSF leak repair is increasingly performed. Current approaches utilize a variety of materials including free mucosal grafts and vascularized flaps, but post-op leaks continue to be reported. Steroid-eluting bioabsorbable stents (SES) are used during functional endoscopic sinus surgery for chronic rhinosinusitis to reduce inflammation and scarring while maintaining patency of sinus ostia.Objective: The aim of this study is to assess the feasibility of SES as a graft/flap bolster for endoscopic endonasal CSF leak repair.Methods: This is a retrospective review of patients undergoing endoscopic endonasal CSF leak repair with SES placed as part of the bolster technique at a tertiary care center between January 2019 and May 2022. Age, sex, BMI, comorbid idiopathic intracranial hypertension, pathology, location of CSF leak, intraoperative CSF leak flow, reconstruction type, and presence of post-op CSF leak were recorded.Results: Twelve patients (mean age 52, median BMI 30.9, 58% female) had SES placement as part of the bolster technique. The most common pathology was meningoencephalocele (75%). Reconstruction was performed with either a free mucosal graft (6), or a flap (6). No post-op CSF leaks occurred at a reconstruction site with a stent, and no known complications were reported. All sinusotomies were patent at the last follow-up visit.Conclusions: SES placement as an adjunct to graft and/or flap bolster appears to be safe and feasible during anterior skull base reconstruction and CSF leak repair providing longer term structural support and preserving sinus drainage patency.

ABSTRACT Hemp concrete is a bio-based material used in buildings construction. It presents particularly interesting hygrothermal properties. This very heterogeneous material is constituted by hemp particles embedded in a mineral [...]

ABSTRACT The use of recycled polystyrene beads in cement-based materials is a solution to improve the insulation in buildings and reduce the energy consumption. This also helps limiting landfill by [...]

Abandoned oil and gas wells can act as leakage pathways for methane, a potent greenhouse gas, and other fluids to migrate through the subsurface and to the atmosphere. National estimates of methane emissions remain highly uncertain, and available measurements do not provide details on whether the emissions are associated with well integrity failure (indicating subsurface leaks) or aboveground well infrastructure leaks. Therefore, we directly measured methane emission rates from 238 unplugged and plugged abandoned wells across Alberta and Saskatchewan, Canada, separately quantified emissions from surface casing vents and other emissions from the wellhead (non-surface casing vent), and developed emission factors to estimate Canada-wide emissions from abandoned wells. Our highest measured emission rate (5.2 × 106mg CH4/hr) from an unplugged gas well was two to three times higher than the largest previously published emission rate from an abandoned well. We estimated methane emissions from abandoned wells in Canada to be 85–93 kilotonnes of methane per year, of which surface casing vent emissions represented 75–82% (70 kilotonnes of methane per year). We found that subsurface leaks, as evidenced by surface casing vent flows, occurred at 32% of abandoned wells in Alberta, substantially higher than previously estimated using provincial data alone (6 and 11%). Therefore, well integrity failures and groundwater contamination are likely to be more common than previous studies suggest.

In lung transplantation, antibody-mediated rejection (AMR) diagnosed using the International Society for Heart and Lung Transplantation criteria is uncommon compared with other organs, and previous studies failed to find molecular AMR (ABMR) in lung biopsies. However, understanding of ABMR has changed with the recognition that ABMR in kidney transplants is often donor-specific antibody (DSA)-negative and associated with natural killer (NK) cell transcripts. We therefore searched for a similar molecular ABMR-like state in transbronchial biopsies using gene expression microarray results from the INTERLUNG study (#NCT02812290). After optimizing rejection-selective transcript sets in a training set (N = 488), the resulting algorithms separated an NK cell-enriched molecular rejection-like state (NKRL) from T cell-mediated rejection (TCMR)/Mixed in a test set (N = 488). Applying this approach to all 896 transbronchial biopsies distinguished 3 groups: no rejection, TCMR/Mixed, and NKRL. Like TCMR/Mixed, NKRL had increased expression of all-rejection transcripts, but NKRL had increased expression of NK cell transcripts, whereas TCMR/Mixed had increased effector T cell and activated macrophage transcripts. NKRL was usually DSA-negative and not recognized as AMR clinically. TCMR/Mixed was associated with chronic lung allograft dysfunction, reduced one-second forced expiratory volume at the time of biopsy, and short-term graft failure, but NKRL was not. Thus, some lung transplants manifest a molecular state similar to DSA-negative ABMR in kidney and heart transplants, but its clinical significance must be established.

Organic scintillators are widely used for neutron/gamma detection. Pulse shape discrimination algorithms have been commonly used to discriminate the detected radiations. These algorithms have several limits, in particular with plastic scintillator which has lower discrimination ability, compared to liquid scintillator. Recently, machine learning (ML) models have been explored to enhance discrimination performance. Nevertheless, obtaining an accurate ML model or evaluating any discrimination approach requires a reference neutron dataset. The preparation of this is challenging because neutron sources are also gamma-ray emitters. Therefore, this paper proposes a pipeline to prepare clean labeled neutron/gamma datasets acquired by an organic scintillator. The method is mainly based on a Time of Flight setup and Tail-to-Total integral ratio (TTTratio) discrimination algorithm. In the presented case, EJ276 plastic scintillator and 252Cf source were used to implement the acquisition chain. The results showed that this process can identify and remove mislabeled samples in the entire ToF spectrum, including those that contribute to peak values. Furthermore, the process cleans ToF dataset from pile-up events, which can significantly impact experimental results and the conclusions extracted from them.

To compare dental students’ preparedness in clinical periodontal education following their participation in a discipline‐based predoctoral periodontics clinic with dental students that received a general practice‐based periodontal education. 114 third‐year dental students and 112 fourth‐year dental students at the University of Texas Health Science Center in San Antonio, were emailed an online survey consisting of questions on their proficiency and confidence levels in diagnosing periodontal diseases and conditions, treatment planning, performing non‐surgical periodontal treatment, identifying the need for referral, and their perceived impediments on their clinical periodontics education. Approximately 97% of third‐year dental students that participated in discipline‐based predoctoral periodontics agree that they are overall confident in providing excellent periodontal care to their patients, and 91% of these students feel that their participation in the predoctoral periodontics clinic has enhanced their knowledge in periodontics as well as their confidence level when providing periodontal patient care. While 95% of fourth‐year dental students agree that they feel confident in providing excellent periodontal care to their patients, only 83% felt that level of confidence during their third‐year in dental school, and 77% believe that given the option to participate in the pre‐doctoral periodontics clinic, their periodontal education would have been strengthened. Our results show that the integration of a discipline based predoctoral periodontics clinic has benefited the dental students and boosted their knowledge and confidence in diagnosing and treating periodontal patients. This model can be improved by addressing space and time limitations.

ABSTRACT Fibrous-woods have very complex morphology and high heterogeneity, hence their properties are not well-known and need to be investigated, especially concerning microstructural changes due to hygrothermal loads. The present, [...]

The code used to prepare the dataset in the above article [1] contained a minor error. Different values for the standard deviation of the created Gaussian window were employed to clean the neutron and gamma-ray signals from pile-up events, as described in [2]. The process outlined in the above article [1] was repeated, and the dataset was prepared using a Gaussian standard deviation of 0.1. Consequently, Table II–IV and Figs. 2, 7, and 8 should be as follows. The corrected versions are presented in the right column.

Pulse shape discrimination algorithms have been commonly implemented on embedded systems to discriminate neutron/gamma radiations detected by organic scintillators in several applications. These algorithms have a number of limitations, especially when used with plastic scintillators, which have low intrinsic discriminating ability. Machine learning (ML) models have recently been explored as a way to improve discriminating performance. Most of these methods are proposed for liquid and stilbene scintillators and do not address the integrated implementation. Reducing the sampling frequency of a discrimination system helps to minimize the size and cost of the embedded implementation. The purpose of this study is to explore whether the use of ML tools, compared to the tail-to-total integral ratio (TTTratio) algorithm, can lead to a reduction in the minimum required sampling frequency in EJ276 plastic scintillator, as well as an enhancement in the classification performance. The results obtained highlight the superior performance of the ML model.

Adaptive displays have long been touted as a means of improving the usability of different types of interfaces. However, purely eye tracking-based adaptive displays have not yet lived up to the initial promise. In many cases, adaptive displays are tailored to users with special needs, developed to supplement virtual reality, or combine eye tracking with other physiological measures. This mapping review focuses instead on recent adaptive displays that rely solely on eye tracking input to understand a user’s needs while interacting with a regular computer display. We aimed to answer three main research questions related to 1) the application domains of such adaptive displays, 2) the eye tracking metrics that have been adopted to track attention allocation in real time, and 3) the adaptation triggering mechanisms. We provide a summary of the current state of eye tracking-based adaptive displays, identify gaps in the literature, and suggest topics for future work.

Many patients with fibromyalgia (FM) report using cannabis as a strategy to improve pain. Given that pain often co‐occurs with symptoms of anxiety and depression (i.e., negative affect) and sleep problems among patients with FM, improvements in these symptoms might indirectly contribute to reductions in pain intensity following cannabis use. The main objective of the study was to examine whether changes in pain intensity following initiation of medical cannabis among patients with FM could be attributed to concurrent changes (i.e., reductions) in negative affect and sleep problems. This was a 12‐month prospective cohort study among patients with FM (n = 323) initiating medical cannabis under the care of physicians. Patients were assessed at baseline, and follow‐up assessment visits occurred every 3 months after initiation of medical cannabis. Patients’ levels of pain intensity, negative affect, and sleep problems were assessed across all visits. Multilevel mediation analyses indicated that reductions in patients’ levels of pain intensity were partly explained by concurrent reductions in sleep problems and negative affect (both P< 0.001). This remained significant even when accounting for patients’ baseline characteristics or changes in medical cannabis directives over time (all P> 0.05). Our findings provide preliminary insight into the potential mechanisms of action underlying pain reductions among patients with FM who are using medical cannabis. Given the high attrition rate (i.e., 75%) observed in the present study at 12 months, our findings cannot be generalized to all patients with FM who are using medical cannabis.

Albardine (Lygeum spartumL.) is one of the major native grass species of the semi-arid and arid regions of the Mediterranean basin. In Algeria, it is much more widespread on the high plateaus of southern Oranais. This species occupies an important place in the steppe region because it has many ecological, economic, and fodder interests. The present work aims to study the tolerance of L. spartumseeds to water and salt stress, two abiotic factors that affect the physiology of the plant during the germinal stage. The methodology adopted consists of using increasing concentrations under a controlled temperature (15°C) for 21 days of germination. The germination responses of the seeds to different degrees of salt stress induced by NaCl (2, 4, 6, 8, 10 g/l) and water stress induced by polyethylene glycol (PEG;−2, -4, -6, -8, −10 bar), showed that the salt and water stresses retarded the germination rate of L. spartumL. seeds and also decreased their percentage during the time of the experiment. However, seeds soaked in distilled water (control) recorded a maximum germination rate of 80%. The results of this study show that L. spartumseeds are moderately salt and drought tolerant with a depressive effect on germination rate at a salt concentration of 10g/l and an osmotic pressure of −10 bar.

Purpose: To compare pain perception associated with two computer-controlled local anesthesia devices, the WAND™ STA (Milestone Scientific Inc., Livingston, NJ, USA) and the Calaject (Rønvig dental MFG, Daugaard, Denmark) in young children. Methods: A split-mouth randomized clinical trial comprising 30 patients, aged 6–12 years, received randomly, in two separate sessions, a local anesthesia injection in the maxillary using either the wand STA or the Calaject. Pain perception was evaluated using the patient’s heart rate, an 11-point numerical scale (NRS), and the Sound, Eye, and Motor (SEM) body movements. Statistical difference was set at p= 0.05. Repeated measures analysis of variance were conducted to compare the mean pulse for Calaject and STA at different times. It was followed by univariate analysis and Bonferroni multiple comparisons tests. Wilcoxon tests were performed to compare NRS, SEM, and injection duration between Calaject and STA. Results: There was no significant statistical difference between Calaject and STA in pulse rate before injection (p= 0.720), during injection (p= 0.767), and after injection (p= 0.757). The mean NRS score was significantly greater with STA in comparison with Calaject (p= 0.017). The mean SEM score was also significantly greater with STA in comparison with Calaject (p= 0.002). However, the mean duration was significantly longer with Calaject (p= 0.001). Conclusions: Calaject was more effective than STA in reducing pain perception associated with periapical injection in young children.

Butyrate-producing human gut microbiota members are recognized for their strong association with a healthy immune‐homeostasis and protection from inflammatory disorders and colorectal cancer. These effects are attributed to butyrate, the terminal electron sink of glycan fermentation by prevalent and abundant colonic Firmicutes from the Lachnospiraceae and Oscillospiraceae families. Remarkably, our insight into the glycan utilization mechanisms and preferences of butyrogenic Firmicutes remains very limited as compared with other gut symbionts, especially from the Bacteroides, Bifidobacterium, and Lactobacillus genera. Here, we summarize recent findings on the strategies that colonic butyrate producers have evolved to harvest energy from major dietary fibres, especially plant structural and storage glycans, such as resistant starch, xylans, and mannans. Besides dietary fibre, we also present the unexpected discovery of a conserved protein apparatus that confers the growth of butyrate producers on human milk oligosaccharides (HMOs), which are unique to mother’s milk. The dual dietary fibre/HMO utilization machinery attests the adaptation of this group to both the infant and adult guts. These finding are discussed in relation to the early colonization of butyrogenic bacteria and the maturation of the microbiota during the transition from mother’s milk to solid food. To date, the described butyrogenic Firmicutes are glycan utilization specialists that target only a few glycans in a highly competitive manner relying on co‐regulated glycan utilization loci. We describe the common pillars of this machinery, highlighting butyrate producers as a source for discovery of biochemically and structurally novel carbohydrate active enzymes.

Objective(s) For patients with cancer, the emergence of acute palliative care units (APCU) may hold promise in curtailing hospital readmissions. The study aims to describe the characteristics of patients readmitted to an APCU.Methods This retrospective study examined patients with cancer readmitted within 30 days to an APCU. Readmissions were further classified as either potentially preventable or non-preventable.Results Out of 734 discharges from July 1, 2014 to July 1, 2015, 69 (9%) readmissions were identified and analyzed. For index admissions, median length of stay was five days, and one (1%) was discharged home with hospice care. For readmissions, median time from index admission to readmission was nine days, median length of stay was six days, three (4%) patients died, and 20 (30%) went home with hospice. Ten (14.5%) readmissions were deemed potentially preventable (95% CI 7.2-25.0%). Race/ethnicity—White/Black/Hispanic/Others—was 60%, 10%, 20% and 10%, respectively, among potentially preventable readmissions and 76%, 22%, 2% and 0%, respectively, among potentially non-preventable readmissions (P = .012). Potentially preventable readmissions were more likely to have venous thromboembolism (40% vs. 12%, P = .046) and more reasons for readmission (median 2 vs. 1, P = .019).Conclusions Among patients with cancer readmitted to an APCU, one out of seven was potentially preventable and a far larger proportion was discharged with hospice care compared to the index admission. Recognition of disease course, meaningful goals of care discussions and timely transition to hospice care may reduce rehospitalization in this population.

The magnetic and thermal properties of a ferrimagnetic mixed spin-1 and spin-2 cubic Ising nanowire are studied by using the Monte Carlo simulation. The influences of the nearest (JAB) and next-nearest neighbor (JA and JB) exchange interactions and the single-ion anisotropies (DA and DB) on the critical and compensation temperatures are illustrated. Moreover, the phase diagrams on the (temperature, anisotropy) plane are plotted for several values of JA/|JAB|. The system shows very rich and interesting behaviors, namely first and second order phase transitions, tricritical points and compensation phenomenon. Finally, the dependence of hysteresis loops on the anisotropies, the exchange interactions and the temperature is also investigated.

Antibody-mediated rejection (AMR) is a form of lung allograft rejection that is emerging as an important risk factor for chronic lung allograft dysfunction and decreased long-term survival. In this review, we provide a brief overview of our current understanding of its pathophysiology with an emphasis on donor-specific antibodies before moving on to focus on the current diagnostic criteria and treatment strategies. Our goal is to discuss the limitations of our current knowledge and explore how novel diagnostic and therapeutic options aim to improve outcomes through earlier definitive diagnosis and preemptive targeted treatment.

AbstractOlder adults continue learning for intrinsic and extrinsic reasons. Literature has often portrayed the reasons for learning in older age as either intentional or as predetermined by socialisation. This emphasis on either agency or social structures is found, not least, in the humanist and critical principles of older adult education. This article addresses the question ‘why do older adults learn?’ Using the concepts of ontological security (Giddens) and habitus (Bourdieu), it provides a sociological interpretation of the motivational reasons to learn in terms of their individual and social nature. A reflexive thematic analysis was conducted on 11 interview transcripts from current and previous older learners at a university for the third age (U3A) in Lebanon. I categorise the motivational reasons for learning as contextual, intrinsic, educational and conducive. I conclude that the reasons for joining the U3A are complex – both individual and social – as they include reflexive and socially determined elements. As a result, I recommend that a restatement of the principles of educational gerontology would further our understanding of how the reasons for learning in older age are shaped by both the agency of individuals as well as socialisation.