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Neuromodulation, encompassing techniques such as electroconvulsive therapy, transcranial magnetic stimulation, and notably, deep brain stimulation (DBS), represents a pivotal advancement in both clinical and research settings for manipulating neural circuitry. DBS, originally developed to mimic early neurosurgical interventions, stands out for its capacity to nondestructively modulate brain circuit “nodes,” inducing widespread neural changes. This review narrows its focus to DBS’s mechanisms and its clinical applications in psychiatric disorders, highlighting its evolution from a neurosurgical novelty to an established treatment modality. With over 200,000 implantations worldwide, DBSs efficacy in improving neuropsychiatric disorders is undisputed.

Lithium-sulfur (Li-S) batteries are restricted by cathode polysulfide shuttling and anode lithium dendrite formation. Jin, Zuo, and coworkersrecently showed that Li-S batteries with high capacities and cycling stabilities emerge from intentionally designed covalent organic framework (COF) electrodes. This report highlights how COF design can address fundamental challenges in organic electrode engineering.

Climate change causes and exacerbates disease, creates and worsens health disparities, disrupts health care delivery, and imposes a significant disease burden in the US and globally. Critical knowledge gaps hinder an evidence-based response and are perpetuated by scarce federal research funds. We identified and described extramural US federal research funding (that is, grants provided to organizations and institutions outside of federal agencies) that both addressed health outcomes associated with climate change and was awarded between 2010 and 2020. During this eleven-year period, 102 grants met our criteria, totaling approximately $58.7 million, or approximately $5.3 million per year (2020 adjusted US dollars). Federal investments in climate change and health research during this period failed to address the breadth of climate-sensitive exposures, health outcomes, and impacts on vulnerable populations. Moving forward, in addition to increasing investment in climate and health research across all known hazards, critical attention should be placed on vulnerable populations and health equity. To achieve this, increased federal research coordination and cooperation are needed, as well as a mechanism to track this funding.

A 68-year-old woman with positional dizziness and progressive imbalance presented for vestibular evaluation. Examination was notable for spontaneous downbeat nystagmus (DBN), horizontal and vertical gaze-evoked nystagmus (GEN) with centripetal and rebound nystagmus, and positional apogeotropic nystagmus. There was also mild–moderate slowing of saccades horizontally and vertically and poor fast phases with an optokinetic stimulus. Further consultation by a movement disorder specialist uncovered asymmetric decrementing bradykinesia and rigidity, masked facies, and a wide-based stance without camptocormia. Screening serum laboratory results for metabolic, rheumatologic, infectious, heavy metal, endocrine, or vitamin abnormalities was normal. Surveillance imaging for neoplasms was unremarkable, and cerebrospinal fluid (CSF) analysis was negative for 14-3-3 and real-time quaking-induced conversion (RT-QuIC). However, her anti-glutamic acid decarboxylase-65 (GAD65) immunoglobulin G (IgG) level was markedly elevated in serum to 426,202 IU/mL (reference range 0–5 IU/mL) and in CSF to 18.1 nmol/L (reference range <0.03 nmol/L). No other autoantibodies were identified on the expanded paraneoplastic panel. The patient was referred to neuroimmunology, where torso rigidity, spasticity, and significant paravertebral muscle spasms were noted. Overall, the clinical presentation, examination findings, and extensive workup were consistent with a diagnosis of anti-GAD65-associated stiff person syndrome-plus (musculoskeletal plus cerebellar and/or brainstem involvement). She was subsequently treated with intravenous immunoglobulin (IVIg) and has been stable since commencing this therapy. In patients with centripetal nystagmus, especially in association with other cerebellar findings, an autoimmune cerebellar workup should be considered.

The U.S. Food and Drug Administration approval of dupilumab for moderate-to-severe atopic dermatitis shifted the paradigm from use of broad, systemic immunosuppressants to a safer, targeted treatment and led to the emergence of newer interleukin (IL)-4/IL-13 directed biologics and small molecule therapies, namely Janus kinase (JAK) inhibitors (JAKi). Tralokinumab and emerging (not yet approved) lebrikizumab, which both target IL-13, are alternative biologics to dupilumab. The emerging anti–IL-31 receptor nemolizumab is likely to be used second-line to other biologics, primarily for pruritus. Three JAKi are currently in use for treating atopic dermatitis, 2 of which, abrocitinib and upadacitinib, are U.S. Food and Drug Administration–approved. This review provides an in-depth, practical discussion on use of these biologics and JAKi that are approved or have completed phase 3 clinical trials in pediatric patients and adults, comparing the groups of medications based on available efficacy and safety data.

A lone farmhouse window briefly blazes; the prairie bathes in mellower, yellower light, and the sinking sun becomes a low and golden glowing, splendid on the prairie's edge." FEATURES A speech by Sharon Butala for the 75th anniversary celebration of the publication of Who Has Seen the Wind, November 29, 2022, Calgary Public Library. Even though Mitchell broke that mould with Who Has Seen the Wind, for many years after that too many prairie writers - myself included - kept on writing realistic fiction, for the most part, unable to find a way to do what Mitchell had done. [Extracted from the article]

A 58-year-old previously healthy woman presents with 3 years of rapidly progressive ataxia, parkinsonism, dysautonomia, peripheral neuropathy, leg weakness, spasticity, hyperreflexia, and mild vertical-gaze palsy. She has a matrilineal family history of neurodegenerative diseases. She was initially postulated to have spinocerebellar ataxia or atypical parkinsonism with cerebellar features. However, on closer inspection, her abnormal extraocular eye movements suggested rare mimicking disorders such as prion disease as part of the differential diagnosis, requiring further evaluation. This case highlights how deep phenotyping can open new diagnostic considerations, inform additional workup, and yield the precise diagnosis of Gerstmann-Sträussler-Scheinker syndrome (GSS).

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Palliative radiotherapy (PRT) is well-tolerated, effective treatment for pain, bleeding, obstruction, and other symptoms/complications of advanced cancer. It is an important component of multidisciplinary management. It should be considered even for patients with poor prognosis, because it can offer rapid symptomatic relief. Furthermore, expanding indications for treatment of noncurable disease have shown that PRT can extend survival for select patients. For those with good prognosis, advanced PRT techniques may improve the therapeutic ratio, maximizing tumor control while limiting toxicity. PRT referral should be considered for any patient with symptomatic or asymptomatic sites of disease where local control is desired.

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IMPORTANCE: After disparate results from observational and small randomized studies, the COMPLETE trial demonstrated superiority of multivessel (MV) percutaneous coronary intervention (PCI) over culprit-only PCI for ST-elevation myocardial infarction (STEMI). OBJECTIVE: To describe temporal trends and institutional variation of MV PCI use for STEMI in the United States to inform how new evidence may influence clinical practice. DESIGN, SETTING, AND PARTICIPANTS: This cohort study included STEMI admissions involving MV disease from 1598 institutions in the National Cardiovascular Data Registry CathPCI Registry from the third quarter of 2009 to the first quarter of 2018. An MV PCI was defined as a PCI to a nonculprit lesion within 45 days of the index procedure. EXPOSURES: Multivessel PCI, defined as placement of coronary stents in 2 or more major epicardial vessels or the staged placement of 1 or more coronary stents in a major epicardial vessel distinct from the index culprit vessel, within 45 days of the index PCI. MAIN OUTCOMES AND MEASURES: Outcomes included the proportional use of MV PCI among STEMI admissions with MV disease, and the timing of MV PCI (an index procedure, a staged procedure during index hospitalization, or a postdischarge procedure within 45 days). RESULTS: Among 359 879 admissions with STEMI and MV disease, MV PCI was performed in 38.5% (n = 138 380; mean [SD] age of patients, 62.3 [12.3] years; 102 266 men [73.9%]) within 45 days. Of those receiving MV PCIs, 30.8% (n = 42 629) had a procedure performed during the index procedure, 31.6% (n = 43 696) as a staged procedure during the index hospitalization, and 37.6% (n = 52 055) within 45 days of discharge. Complete revascularization of all diseased arteries was performed in 76.2% (n = 105 389). From the third quarter of 2009 to the second quarter of 2013, MV PCI use declined by 10%, from 42.7% (3230 of 7572 cases) to a nadir of 32.7% (3386 of 10 342 cases), followed by an increase to 44.0% (5062 of 11 497 cases) by the fourth quarter of 2017. During this time, there was a 13.6% decline in use of postdischarge staged MV PCI (from 23.4% of STEMI cases [1772 of 7572 cases] in the third quarter of 2009 to 9.9% [1094 of 11 171 cases] in the fourth quarter of 2014) and an 12.5% increase in MV PCI performed during the index admission (from 19.3% [1458 of 7572 cases] in the third quarter of 2009 to 31.8% [3557 of 11 171 cases] in the first quarter of 2018). Multivessel PCI use varied substantially across institutions, with a median use of 37.9% (interquartile range, 30.0%-46.5%). CONCLUSIONS AND RELEVANCE: In this large, nationwide analysis, MV PCI use for patients with STEMI has been increasing through early 2018 but was used in the minority of patients and with wide variability across US institutions. The adoption of new trial results into guidelines and practice may further promote the growth of MV PCI.

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IMPORTANCE: The US Centers for Medicare and Medicaid Services recently released an updated national coverage determination proposal for transcatheter aortic valve replacement (TAVR) that maintains a focus on hospital TAVR volume and percutaneous coronary intervention (PCI) volume, and the national coverage determination for transcatheter mitral valve repair (TMVr) also has PCI volume requirements. However, the associations between hospital PCI volume and TAVR and TMVr outcomes are unknown. OBJECTIVE: To investigate whether hospital inpatient PCI volume is associated with rates of risk-adjusted in-hospital mortality and 30-day hospital readmission after TAVR and TMVr. DESIGN, SETTING, AND PARTICIPANTS: This population-based cross-sectional study of the 2016 Nationwide Readmissions Database included procedures completed in hospitals with a minimum of 5 TAVR or 5 TMVr procedures between January 1, 2016, and November 30, 2016. EXPOSURES: Hospitals were divided into quartiles based on annual inpatient PCI volumes. MAIN OUTCOMES AND MEASURES: Primary outcomes were in-hospital mortality and 30-day readmission rates. The associations between hospital inpatient PCI quartile and outcomes were evaluated using Kruskal-Wallis tests. Risk adjustment for in-hospital mortality rates was done through inclusion of variables based on the Elixhauser comorbidity classification, and risk adjustment for 30-day readmission rates was done in accordance with the Hospital-Wide Readmission Measure methodology used by the Centers for Medicare and Medicaid Services for public reporting. RESULTS: There were 283 hospitals that performed at least 5 TAVRs, with a median inpatient PCI volume of 386 (interquartile range, 299-571) procedures, and 125 hospitals that performed at least 5 TMVr procedures, with a median inpatient PCI volume of 451 (interquartile range, 326-651) procedures. There was no association between hospital inpatient PCI volume and median TAVR risk-standardized in-hospital mortality (median [IQR] rates: bottom quartile, 1.82% [1.77%-1.90%]; second quartile, 1.81% [1.76%-1.86%]; third quartile, 1.81% [1.75%-1.90%]; top quartile, 1.82% [1.76%-1.91%]; P = .75) or the 30-day readmission (median [IQR] rates: bottom quartile, 13.6% [13.2%-14.3%]; second quartile, 13.3% [12.7%-14.0%]; third quartile, 13.5% [12.7%-14.3%]; top quartile, 13.8% [12.8%-14.3%]; P = .10) rates. Similarly, there was no association between hospital inpatient PCI volume and median TMVr risk-standardized in-hospital mortality rates (median [IQR] rates: bottom quartile, 1.84% [1.47%-2.53%]; second quartile, 1.65% [1.21%-3.02%]; third quartile, 1.80% [1.52%-3.58%]; top quartile, 1.76% [1.33%-4.20%]; P = .71) or 30-day readmission rates (median [IQR] rates: bottom quartile, 13.4% [13.1%-13.6%]; second quartile, 13.1% [12.9%-13.5%]; third quartile, 13.1% [12.9%-13.5%]; top quartile, 13.3% [12.8%-13.6%]; P = .30). CONCLUSIONS AND RELEVANCE: In this study, there was no association between inpatient PCI volume and TAVR or TMVr outcomes. Further evidence is needed to support inclusion of PCI volume minimums in national coverage determination requirements for hospital TAVR and TMVr programs.

ABSTRACTWith the intensive development and implementation of information and communication technologies in manufacturing, large amounts of heterogeneous data are now being generated, gathered and stored. Handling large amounts of complex data – often referred to as big data – represents a challenge as there are many new approaches, methods, techniques, and tools for data analytics that open up new possibilities for exploiting data by converting them into useful information and/or knowledge.However, the application of advanced data analytics in manufacturing lags behind in terms of penetration and diversity in comparison with other domains such as marketing, healthcare and business, meaning that the available data often remain unexploited. This paper proposes a new conceptual framework for systematically introducing big-data analytics into manufacturing systems. To this end, the paper defines a new stepwise procedure that identifies what knowledge and skills, and which reference models, software and hardware tools, are needed for the development, implementation and operation of data-analytics solutions in manufacturing systems. The feasibility of the proposed conceptual framework is demonstrated in a case study from an engineer-to-order company and by mapping the framework to several previous data-analytics projects.

Sulfur cathodes in conversion reaction batteries offer high gravimetric capacity but suffer from parasitic polysulfide shuttling. We demonstrate here that transition metal chalcogels of approximate formula MoS3.4achieve a high gravimetric capacity close to 600 mAh g–1(close to 1000 mAh g–1on a sulfur basis) as electrode materials for lithium-ion batteries. Transition metal chalcogels are amorphous and comprise polysulfide chains connected by inorganic linkers. The linkers appear to act as a “glue” in the electrode to prevent polysulfide shuttling. The Mo chalcogels function as electrodes in carbonate- and ether-based electrolytes, which further provides evidence of polysulfide solubility not being a limiting issue. We employ X-ray spectroscopy and operandopair distribution function techniques to elucidate the structural evolution of the electrode. Raman and X-ray photoelectron spectroscopy track the chemical moieties that arise during the anion-redox-driven processes. We find the redox state of Mo remains unchanged across the electrochemical cycling and, correspondingly, the redox is anion-driven.

Zirconium metal–organic frameworks (Zr-MOFs) are renowned for their extraordinary stability and versatile chemical tunability. Several Zr-MOFs demonstrate a tolerance for missing linker defects, which create “open sites” that can be used to bind guest molecules on the node cluster. Herein, we strategically utilize these sites to stabilize reactive lithium thiophosphate (Li3PS4) within the porous framework for targeted application in lithium–sulfur (Li–S) batteries. Successful functionalization of the Zr-MOF with PS43–is confirmed by an array of techniques including NMR, XPS, and Raman spectroscopy, X-ray pair distribution function analysis, and various elemental analyses. During electrochemical cycling, we find that even a low incorporation extent of lithium thiophosphate in Zr-MOFs improves sulfur utilization and polysulfide encapsulation to deliver a sustainably high capacity over prolonged cycling. The functionalized MOF additives also prevent cell damage under abusive cycling conditions and recover high capacities when the cell is returned to lower charge/discharge rates, imperative for future energy storage devices. Our unique approach marries the promising chemical attributes of the purely inorganic Li3PS4with the stability and high surface area of MOFs, creating a Li–S cathode architecture with a performance beyond the sum of its component parts. More broadly, this novel functionalization strategy opens new avenues for facile syntheses of “designer materials” where chemical components from discrete disciplines can be united and tailored for specific applications.

TiNb2O7is a Wadsley–Roth phase with a crystallographic shear structure and is a promising candidate for high-rate lithium ion energy storage. The fundamental aspects of the lithium insertion mechanism and conduction in TiNb2O7, however, are not well-characterized. Herein, experimental and computational insights are combined to understand the inherent properties of bulk TiNb2O7. The results show an increase in electronic conductivity of seven orders of magnitude upon lithiation and indicate that electrons exhibit both localized and delocalized character, with a maximum Curie constant and Li NMR paramagnetic shift near a composition of Li0.60TiNb2O7. Square-planar or distorted-five-coordinate lithium sites are calculated to invert between thermodynamic minima or transition states. Lithium diffusion in the single-redox region (i.e., x≤ 3 in LixTiNb2O7) is rapid with low activation barriers from NMR and DLi= 10–11m2s–1at the temperature of the observed T1minima of 525–650 K for x≥ 0.75. DFT calculations predict that ionic diffusion, like electronic conduction, is anisotropic with activation barriers for lithium hopping of 100–200 meV down the tunnels but ca. 700–1000 meV across the blocks. Lithium mobility is hindered in the multiredox region (i.e., x> 3 in LixTiNb2O7), related to a transition from interstitial-mediated to vacancy-mediated diffusion. Overall, lithium insertion leads to effective n-type self-doping of TiNb2O7and high-rate conduction, while ionic motion is eventually hindered at high lithiation. Transition-state searching with beyond Li chemistries (Na+, K+, Mg2+) in TiNb2O7reveals high diffusion barriers of 1–3 eV, indicating that this structure is specifically suited to Li+mobility.

In manufacturing processes the automated identification of faulty operating conditions that might lead to insufficient product quality and reduced availability of the equipment is an important and challenging task. This paper proposes a data mining approach to the identification of complex faults, i.e. unplanned machine stops in plastic injection molding. Several data mining methods are considered, with a focus on the abilities to reveal patterns of faulty operating conditions and on the interpretation of the induced models with the objective to find the data mining method that best corresponds to the nature of the plastic-injection-molding process and the related data. Well-known data mining methods, i.e. J48, random forests, JRip rules, naïve Bayes, and k-nearest neighbors are applied to real industrial data. The results show that tested data mining methods can be effectively used to reveal patterns related to faulty operating conditions. The interpretation capacity of the tested methods, their ability to describe the operating conditions, and to reveal patterns related to faulty operating conditions, are demonstrated and discussed.

Persons with Parkinson’s disease (PwP) have many known risk factors for suicide and suicidal ideation (SI). Despite this, there is limited understanding of suicidality in this population. We conducted a systematic review to synthesise the available literature on suicidality in PwP and highlight areas for potential intervention and further research. We identified 116 articles discussing SI, suicidal behaviours, suicide attempts and/or fatal suicide in PwP. These articles describe prevalence, suicide methods, risk factors for suicide and SI and treatment of suicidality. In this review, we summarise the current literature and provide suggestions for how clinicians can identify and treat PwP who are at risk for suicide, for example, through aggressive treatment of depression and improved screening for access to lethal means.

The drive toward high energy density alternatives to Li-ion batteries has led to great interest in energy storage materials not inherently constrained by the capacity limits of the currently employed intercalation electrode materials. Among the alternatives under consideration are electrode materials with theoretical capacities many times greater than intercalation electrodes that store charge through so-called conversion reactions. However, the significant structural changes that enable the high theoretical capacity of conversion systems contribute to issues of poor efficiency and short cycle life. To better understand cycling issues in conversion systems, we study the local structure evolution of CoS2during Li storage. Being metallic and potentially capable of redox on both anion and cation sites, CoS2would be expected to display promise as a cathode material. Through combined ex situ X-ray absorption near-edge spectroscopy and pair distribution function analysis from operando X-ray total scattering, we describe the reactions that take place over the first 1.5 cycles. In doing so, we identify the irreversible formation of a Co9S8-like local structure with significantly limited electrochemical activity as the primary source of capacity fade. The methods employed here and the insights that emerge could inform the rational design of conversion systems for electrochemical energy storage.

Identification of expertise of people, academic societies, companies, and institutions is an important professional and social activity for nurturing professional networks, forming project consortia, etc. Today, a lot of information about the skills and expertise is openly available from websites and public personal profiles on professional and scientific social networks. With computerised methods, such as web crawling, text mining, and keyword classification, it is possible to identify expertise networks from the raw unstructured data. The paper presents and analyses the extended expertise network of the CIRP scientific community and proposes a web-based tool for the structuring and management of the community’s expertise.

Manufacturing data offers big potential for improving management of manufacturing operations. The paper addresses an approach to data analytics in engineer-to-order (ETO) manufacturing systems where the product quality and due-date reliability play a key role in management decisionmaking. The objective of the research is to investigate manufacturing data which are collected by a manufacturing execution system (MES) during operations in an ETO enterprise and to develop tools for supporting scheduling of operations. The developed tools can be used for simulation of production and forecasting of potential resource overloads.

The patho-physiological cross-talk between diabetes and obesity is well established. However, the choices of drugs suitable for combined treatment of diabetes and obesity are limited. Integration of complementary and alternative medicines (CAMs), like Ayurveda, with modern medicine would be a promising strategy to fill this gap. The diagnostic principles of Ayurveda define obesity as one of the predisposing factors of Madhumeha(correlated as diabetes) and recommends specific formulations for managing obese-diabetes. Lodhrasavamis one such poly-herbal formulation prescribed for obese-diabetic patients.

In the context of advanced manufacturing, new models inspired by Internet technologies are being developed. The cloud manufacturing model strives to offer a similar experience for seekers of manufacturing services as cloud computing does for the users of the web: manufacturing clouds intend to offer manufacturing resources as services, much like processing power and storage space are available as services in cloud computing. The resulting business situation is favourable for both the service providers and the service end-users, especially in a highly dynamic manufacturing environment. Existing cloud manufacturing models operate in a centralised way through a cloud manufacturing platform, the management of which is identified as a critical part of the manufacturing cloud operation. In the article, a decentralised network architecture for cloud manufacturing is proposed. The architecture builds upon the concept of autonomous work systems for use as service providers. The operation of the system based on the architecture is described, wherein special attention is given to the communication within the emerged networks of service providers. Technical feasibility of the approach is also demonstrated. It is expected that the decentralised approach will enable a more flexible and scalable manufacturing cloud, which will have the ability to actively co-evolve with its environment.

Malignant hyperthermia susceptibility (MHS) is a disorder of the regulation of calcium in skeletal muscle. Muscular individuals have been shown to have a 13.6-fold increased risk of death during malignant hyperthermia (MH) episodes and are more likely to experience a recurrence after initial treatment. Twenty-five percent of severe MH episodes have occurred in elite athletes. This study investigated the association between MHS and muscular body build. Data were obtained from existing reports in the North American Malignant Hyperthermia Registry, including the Report of Muscle Biopsy and Contracture Testing (caffeine-halothane contracture test [CHCT]) as well as Adverse Metabolic or Muscular Reaction to Anesthesia (AMRA) reports. Malignant hyperthermia susceptible individuals were compared with MH negative individuals with regard to body build and reason for testing. Males were also compared with females. Both the CHCT and the AMRA forms were reviewed for comments. Of the 1,292 individuals diagnosed with MHS by CHCT, males were more likely to be diagnosed with the disorder than females (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.99 to 2.7; P< 0.001). Muscular individuals were more likely to be diagnosed with MHS than non-muscular individuals (OR, 1.94; 95% CI, 1.51 to 2.49; P< 0.001). Males were more likely to be tested after having a possible MH episode (OR, 2.33; 95% CI, 1.45 to 2.1; P< 0.001). Logistic regression showed that male sex (OR, 2.28; 95% CI, 1.93 to 2.7; P< 0.001) and muscular body build (OR, 2.17; 95% CI, 1.21 to 3.9; P= 0.01) were independently predictive of MHS. The interaction between muscular body build and male sex was not significant (P= 0.13). Indications for testing, MH episode vsfamily history of MH, did not differ between muscular and non-muscular individuals (P= 0.44). Eight of 839 AMRAs and two reports of CHCT had comments describing athletic abilities. Ryanodine receptor type 1 (RYR1) gene mutations were found in five of these athletes. Muscular body build and male sex are strongly associated with MHS. La susceptibilité à l’hyperthermie maligne (SHM) est un trouble de la régulation du calcium dans les muscles squelettiques. Il a été démontré que les personnes musclées couraient un risque 13,6 fois plus élevé de décès pendant des épisodes d’hyperthermie maligne (HM) ainsi qu’un risque plus élevé de récurrence après un premier traitement de la maladie. Vingt-cinq pour cent des épisodes graves d’HM sont survenus chez des athlètes de pointe. Cette étude a examiné l’association entre la SHM et la constitution musculaire. Des données ont été obtenues à partir de rapports existants dans le Registre nord-américain de l’hyperthermie maligne (North American Malignant Hyperthermia Registry), y compris le Rapport de biopsie musculaire et de test de contracture (Report of Muscle Biopsy and Contracture Testing)(test de contracture à la caféine et à l’halothane [CHCT]) ainsi que les rapports de réactions métaboliques ou musculaires négatives à l’anesthésie (Adverse Metabolic or Muscular Reaction to Anesthesia- AMRA). Les personnes susceptibles à l’hyperthermie maligne ont été comparées aux personnes négatives à l’HM quant à leur constitution physique et à la raison de leur test. On a également fait une comparaison hommes-femmes. Les formulaires de CHCT et d’AMRA ont été passés en revue afin d’en extraire tout commentaire ou remarque. Parmi les 1292 personnes ayant reçu un diagnostic de SHM après avoir passé un test de CHCT, les hommes étaient plus enclins à être diagnostiqués avec ce trouble que les femmes (rapport de cotes [RC], 2,33; intervalle de confiance [IC] 95 %, 1,99 à 2,7; P< 0,001). Les personnes musclées couraient un risque plus élevé de diagnostic de SHM que les personnes non musclées (RC, 1,94; IC 95 %, 1,51 à 2,49; P< 0,001). Les hommes couraient un risque plus élevé de passer un test après avoir subi un possible épisode d’HM (RC, 2,33; IC 95 %, 1,45 à 2,1; P< 0,001). L’analyse de régression logistique a montré que le sexe masculin (RC, 2,28; IC 95 %, 1,93 à 2,7; P< 0,001) et un corps musclé (RC, 2,17; IC 95 %, 1,21 à 3,9; P= 0,01) étaient des prédicteurs indépendants de SHM. L’interaction entre avoir un corps musclé et le sexe masculin n’était pas significative (P= 0,13). Les indications pour envisager un test, prévoir un épisode d’HM vsles antécédents familiaux d’HM ne différaient pas entre les personnes musclées et non musclées (P= 0,44). Huit des 839 AMRA et deux rapports de CHCT comportaient des commentaires décrivant des capacités athlétiques. Des mutations du gène RYR1 (récepteur de ryanodine de type 1) ont été observées chez cinq de ces athlètes. Un corps musclé et le sexe masculin sont associés de façon significative à une susceptibilité à l’hyperthermie maligne.

Janez Peklenik was one of the outstanding scientists and engineers of the twentieth century, who left visible trails in manufacturing engineering research and education. He contributed to the advancement of manufacturing from soft empirical science into pure hard science. As a practitioner he was striving toward perfection and toward implementation of research ideas and results in real life. He was also a great scholar who was aware of the needs of industry on one side and of the problems that young students were confronted with on the other side, while trying to bridge over these two worlds.

The complexity of manufacturing systems is increasing due to the increased requirements related to the variety and quality of the products, their complexity, and due to the general technological developments. In turn, the data related to the manufacturing processes is growing in size and in complexity. This presents new challenges for real-time monitoring, diagnostics, and prognostics of the processes. The challenges are addressed by new tools, methodologies, and concepts, collectively referred to as Big Data. The paper deals with the use of advanced methods for prognostics of infrequent faults on available but highly dimensional manufacturing process data. A holistic approach, which includes data generation, acquisition, storage, processing, and prognostics, is shown in a case of a plastic injection moulding process. Real industrial data acquired from five injection moulding machines and the Manufacturing Execution System within a period of six months is used. It is shown how the approach is able to tackle the high dimensionality and the large size of the data to create and evaluate prediction models for prognostics of the unplanned machine stops.

We present a multiinstrumented approach for the analysis of the Arctic ionosphere during the 19 February 2014 highly complex, multiphase geomagnetic storm, which had the largest impact on the disturbance storm-time index that year. The geomagnetic storm was the result of two powerful Earth-directed coronal mass ejections (CMEs). It produced a strong long lasting negative storm phase over Greenland with a dominant energy input in the polar cap. We employed global navigation satellite system (GNSS) networks, geomagnetic observatories, and a specific ionosonde station in Greenland. We complemented the approach with spaceborne measurements in order to map the state and variability of the Arctic ionosphere. In situ observations from the Canadian CASSIOPE (CAScade, Smallsat and IOnospheric Polar Explorer) satellite's ion mass spectrometer were used to derive ion flow data from the polar cap topside ionosphere during the event. Our research specifically found that (1) thermospheric O/N2measurements demonstrated significantly lower values over the Greenland sector than prior to the storm time. (2) An increased ion flow in the topside ionosphere was observed during the negative storm phase. (3) Negative storm phase was a direct consequence of energy input into the polar cap. (4) Polar patch formation was significantly decreased during the negative storm phase. This paper addresses the physical processes that can be responsible for this ionospheric storm development in the northern high latitudes. We conclude that ionospheric heating due to the CME's energy input caused changes in the polar atmosphere resulting in Neupwelling, which was the major factor in high-latitude ionosphere dynamics for this storm. Multiinstrument analysis of the Arctic ionosphere during the 19 February 2014 storm is presentedObserved negative ionospheric storm is found to be the direct consequence of energy input into the polar capPolar patch generation significantly decreased during the negative storm phase

This case report describes a female with p.Lys4876Arg amino acid change in the ryanodine receptor type 1 (RYR1) and a sibling who died of malignant hyperthermia (MH) during anesthesia. After her diagnosis as MH susceptible, this patient was administered low-dose dantrolene daily for greater than 25 years for treatment of chronic muscle spasm and pain in her lower extremities and back limiting sleep. Her creatine phosphokinase (CPK) was as high as 2390 IU/L during labor and 900 IU at rest. With 25 mg dantrolene daily, muscle cramps were eliminated, and sleep was improved. Gait instability was noted with dantrolene in the morning, but not when taken at bedtime. There was no evidence of liver injury. This case suggests that low dose dantrolene by mouth could be considered for the treatment of chronic muscle pain in individuals with MH susceptibility.

Complex manganese oxides have been extensively studied as intercalation Li-ion battery electrodes. The simple oxide MnO has been proposed as a conversion anode material with a theoretical capacity of 756 mAh g–1for full reduction to the metal. We report the reaction of MnO with Li using in situ X-ray diffraction and find no sign of crystalline products upon either discharge or charge. However, the absence of reflections, paired with electrochemical impedance spectroscopy, suggests disordered discharge products. We also examine composite electrodes with porous particles of MnO as the active component, with pores generated through the reductive heating of Mn3O4. We compare the behavior of these with more dense MnO powders, including studies of the electrode morphologies pre- and postcyling. We find differences in the first discharge relevant to the utility of such mesostructuring in conversion reaction materials. Specifically, we find this type of mesostructure, which gives advantage in intercalation and pseudocapacitive storage, does not yield the same benefits for conversion reaction systems.

Using network analysis, an increase in 1 additional organ procurement organization to which a kidney is given by an OPO with high-volume procurement is associated with 2% lower likelihood of discard for a given kidney, but 2% higher likelihood of discard among OPOs with low-volume procurement. There are mixed associations with recipient outcomes.

The recent developments in Information and Communication Technologies enable remote monitoring and control of distributed work systems and, in turn, development of new products and services related to their operations and maintenance (O&M). The paper focuses on O&M of small hydropower plants (SHP) and assesses the feasibility of different levels of O&M automation. A model for O&M of SHPs is developed and used as a basis for an event-based simulation. A case analysis of 85 Slovenian SHPs is presented. The parameters of the model are determined based on publicly available data and data gathered through a survey amongst the SHP operators. The feasibility calculations are performed for three scenarios describing different levels of automation. The results show how the presented approach can assist in decision-making of individual SHP operators, O&M services providers, and policy makers.

The transfer of patients with hand injuries involves a commitment of substantial resources, emphasizing the importance of understanding factors that may influence referral patterns. Anecdotal experience suggests that the likelihood of transfer increases during nights and weekends. This study aimed to analyze patterns of hand trauma transfers to Duke University Medical Center with respect to timing and patient insurance status.

A significant challenge in a distributed production organisation is finding suitable production resources. In this study, we develop the concept of a production resource search system that can be used to organise a distributed manufacturing system in a global environment.

The mechanotransduction mechanisms linking distraction device activation to new bone formation remain unknown. We hypothesize that the tension stress of activation during distraction osteogenesis is transmitted through lacunocanalicular fluid flow to initiate the osteogenic signaling cascade. Adult Sprague-Dawley rats (N = 24) were subjected to mandibular osteotomy and application of an external distraction device. After a 3-day latency period, half the animals (n = 12) underwent device activation at 0.25 mm twice daily for 6 days (total activation, 3 mm), and the other half (n = 12) had no activation. On day 10, the animals were injected with fluorescent reactive red lacunocanalicular tracer before killing. Mandibles were harvested, embedded, and sectioned, and reactive red epifluorescence lacunocanalicular flow was measured. Protein was harvested for focal adhesion kinase 1 (FAK1), NESPRIN1, SUN1, LAMIN AC, and SMAD1 Western blotting as well as for bone morphogenetic protein (BMP)-2 enzyme-linked immunosorbent assay and alkaline phosphatase assay. Lacunocanalicular fluid flow was significantly greater in the distracted samples (60.5 ± 14 vs 10.3 ± 4 molecules of equivalent soluble fluorochrome per megapixel, P= 0.01). Flow distribution demonstrated the highest lacunocanalicular flow near the center of the distraction gap. Increased lacunocanalicular flow resulted in increased FAK1 (P= 0.009), NESPRIN1 (P= 0.01), SUN1 (P= 0.01), and LAMIN AC (P= 0.008) expression. Focal adhesion kinase 1 activation in the presence of BMP-2 protein expression (P= 0.001) resulted in increased intranuclear SMAD1 phosphorylation (P= 0.04) and alkaline phosphatase activity (P< 0.0001). These findings suggest that activation of the distraction osteogenesis device affects cellular response through changes in lacunocanalicular fluid flow.

This manuscript presents magnetic flux tube analysis of L‐band signal scintillation in the nighttime equatorial and low‐latitude ionosphere. Residues of the scintillation index S4estimated from the L‐band signals received from Geostationary Earth Orbit (GEO) satellites are employed in the analysis. The S4estimates have been shown to be associated with simultaneous GPS VTEC variations derived from JPL's GIPSY‐GIM package. We have applied the wavelet decomposition technique simultaneously on the S4time series in a flux tube over the equatorial and low‐latitude regions. The technique decomposes the S4signal to identify the dominant mode of variabilities and the temporal variations of scintillation‐producing irregularities in the context of a flux tube. Statistically significant regions of the wavelet power spectra considered in our study have mainly shown that (a) dominant plasma irregularities associated with S4variabilities in a flux tube have periods of about 4 to 15 minutes (horizontal irregularity scales of about 24 to 90 km). These periods match short period gravity waves, (b) scintillation‐producing irregularities are anisotropic along the flux tube and in the east‐west direction, and (c) the occurrences of scintillation‐producing irregularities along the flux tube indicate that the entire flux tube became unstable. However, plasma instability occurrences were not simultaneous in most cases along the flux tube, there were time delays of various orders. Understanding the attributes of L‐band scintillation‐producing irregularities could be important for developing measures to mitigate L‐band signal degradation. L‐band ionospheric scintillation in the context of a ‐Irregularities related to S4 have 5 to 15 min periods matching gravity wavesScintillation‐producing irregularities are anisotropic

Although some studies have found an association between delayed graft function (DGF) after kidney transplantation and worse long-term outcomes, a causal relationship remains controversial. We investigated this relationship using an instrumental variables model (IVM), a quasi-randomization technique for drawing causal inferences.

Strong operations support is one of the key requirements for competitive success of modern manufacturing organisations. An important aspect of operations support is Statistical Process Control (SPC); the use of statistical methods for monitoring and control of manufacturing processes and products. However, implementation of SPC requires a certain amount of statistical knowledge and understanding. Although this is not an issue for big companies (e.g. in automotive sector), smaller companies are unable to provide the required knowledge in-house. In this paper, a service-driven approach for SPC is proposed, in which SPC is outsourced through the use of modern information and communication technologies, such as web services. This Statistical Process Control as a Service approach is illustrated and discussed through an industrial case study.