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Silver describes the implementation of a monitoring system using an open-source software package to improve the availability of services and reduce the response time when troubles occur. He provides a [...]

YBa2Cu3O7(Y123) thin films were grown by pulsed laser deposition (PLD) on YSZ (100), SrTiO3 (100), and LaAlO3 (100) single crystal substrates. Prior to the film deposition, a discontinuous layer of Ag nano-dots was deposited on the substrates. The Y123 films grown on such surfaces modified with Ag nano-dots were characterized by Atomic Force Microscopy (AFM), X-ray diffraction (XRD), scanning electron microscopy (SEM), AC susceptibility and DC magnetization. The effects of the density of Ag nano-dots, which was controlled by the numbers of PLD shots, on the microstructures and resultant critical current density Jc have been studied systematically. Results showed that at fixed physical deposition conditions Jc increased monotonically with number of Ag shots, n, for films grown on both STO and LAO substrates. At 77 K, the Jc increased from 106 to 3.2 × 10° A/cm² for LAO and from 8 × 105 to 3.5 × 106 A/cm² for STO as n increased from 0 to 150. At 5 K, the enhancement of Jc was approximately four times at both low and high fields. However, for films grown on YSZ substrate, Jc increased from 2 × 105 to 2 × 106 A/cm² as Ag shots increased from 0 to 30, and decreased to 9 × 105 for n ≥ 60. Detailed microstructure investigations indicated that the crystallinity and ab alignment gradually improved as the number of Ag-nano-dots increased. [ABSTRACT FROM AUTHOR]

The processing, microstructures and properties of La0.7Sr0.3Mn1−xZnxO3 perovskite manganite, with x=0, 0.1, 0.2, and 0.3 have been investigated. X-ray diffraction, scanning electron microscopy (SEM) and other characterisation methods were used to study the relations of microstructure and properties. The X-ray powder diffraction results show a single phase for the 0 region that confirms the zinc incorporation into the Mn site. The SEM images with magnification 1500× indicate that the studied system is a single phase. The transport measurements show decreasing of insulator to metal transition temperature, Tt, with increasing the zinc concentration on the Mn site, while the resistivity increases with increasing the zinc doping level for 0 The maximum resistivities are found at 380 and 160 K, respectively.The PPMS measurements show that the magnetisation value is greatest for x=0.1 and drastically decrease for the parent material, as well as with increasing the zinc doping concentration above 20%, when the compound changes from ferromagnetic to paramagnetic. The paramagnetic to ferromagnetic transition temperature variations, Tc, agrees with the insulator to metal variations, Tt, from the transport measurements for the parent and 10% doped material. For zinc doping levels above 20%, the behavior of the studied system changes from ferromagnetic to paramagnetic. [Copyright &y& Elsevier]

The processing, microstructures and properties of La0.7Sr0.3Mn1-xZnxO3 perovskite manganite, with x=0, 0.1, 0.2, and 0.3 have been investigated. X-ray diffraction, scanning electron microscopy (SEM) and other characterisation methods were used to study the relations of microstructure and properties. The X-ray powder diffraction results show a single phase for the 0c, agrees with the insulator to metal variations, Tt, from the transport measurements for the parent and 10% doped material. For zinc doping levels above 20%, the behavior of the studied system changes from ferromagnetic to paramagnetic. [ABSTRACT FROM AUTHOR]

Even though traumatic brain injury (TBI) is a major cause of death globally, detailed data on the location and accumulation of primary head injuries, and prevalence of secondary injuries in distinct injury circumstances such as falls and assaults is limited. This study aimed to highlight the differences in injury patterns between falls and assaults among neuropathologically examined medico-legal autopsy cases. Data were collected on a total of 128 cases from the Forensic Medicine Unit, Finnish Institute for Health and Welfare, between the years 2016 and 2022. All cases had suspected or confirmed acute head injuries and underwent a full neuropathological examination. Background and circumstantial variables, as well as the presence of head and brain injuries, were extracted from the medico-legal autopsy case files. Comparative analyses were conducted between assured falls (n = 26) and assaults (n = 23). Any primary head injury was observed in 57.0 % of the full sample; the most common primary injuries were scalp haemorrhage (47.7 %), subarachnoid haemorrhage (SAH) (24.2 %), and diffuse traumatic axonal injury (13.3 %). Assault cases showed a significantly higher prevalence of scalp haemorrhage (82.6 % vs. 46.2 %, p = 0.016) and SAH (52.2 % vs. 11.5 %, p = 0.004) compared to fall cases. In assault cases, the left hemisphere was clearly more frequently affected than the right one (91.3 % vs. 65.2 %). Of secondary injuries, brain oedema was more common in assaults than falls (47.8 % vs. 7.7 %, p = 0.003). In conclusion, this study highlights differences in head and brain injury patterns between falls and assaults. Scalp haemorrhage and SAH are more common in assaults than falls. Assaults appear to lead to a higher frequency and diversity of injuries, particularly in the left hemisphere., Competing Interests: Declaration of Competing Interest The authors have no competing interests to declare that are relevant to the content of this article., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: This study aimed to identify and resolve discordant variant interpretations across clinical molecular genetic laboratories through the Canadian Open Genetics Repository (COGR), an online collaborative effort for variant sharing and interpretation., Methods: Laboratories uploaded variant data to the Franklin Genoox platform. Reports were issued to each laboratory, summarising variants where conflicting classifications with another laboratory were noted. Laboratories could then reassess variants to resolve discordances. Discordance was calculated using a five-tier model (pathogenic (P), likely pathogenic (LP), variant of uncertain significance (VUS), likely benign (LB), benign (B)), a three-tier model (LP/P are positive, VUS are inconclusive, LB/B are negative) and a two-tier model (LP/P are clinically actionable, VUS/LB/B are not). We compared the COGR classifications to automated classifications generated by Franklin., Results: Twelve laboratories submitted classifications for 44 510 unique variants. 2419 variants (5.4%) were classified by two or more laboratories. From baseline to after reassessment, the number of discordant variants decreased from 833 (34.4% of variants reported by two or more laboratories) to 723 (29.9%) based on the five-tier model, 403 (16.7%) to 279 (11.5%) based on the three-tier model and 77 (3.2%) to 37 (1.5%) based on the two-tier model. Compared with the COGR classification, the automated Franklin classifications had 94.5% sensitivity and 96.6% specificity for identifying actionable (P or LP) variants., Conclusions: The COGR provides a standardised mechanism for laboratories to identify discordant variant interpretations and reduce discordance in genetic test result delivery. Such quality assurance programmes are important as genetic testing is implemented more widely in clinical care., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: It has been posited that the consumption of extra protein (> 0.8 g/kg/d) may be deleterious to bone mineral content. However, there is no direct evidence to show that consuming a high-protein diet results in a demineralization of the skeleton. Thus, the primary endpoint of this randomized controlled trial was to determine if a high-protein diet affected various parameters of whole body and lumbar bone mineral content in exercise-trained women., Methods: Twenty-four women volunteered for this 6-month investigation ( n  = 12 control, n = 12 high-protein). The control group was instructed to consume their habitual diet; however, the high-protein group was instructed to consume ≥2.2 g of protein per kilogram body weight daily (g/kg/d). Body composition was assessed via dual-energy x-ray absorptiometry (DXA). Subjects were instructed to keep a food diary via the mobile app MyFitnessPal ® . Exercise or activity level was not controlled. Subjects were asked to maintain their current levels of exercise., Results: During the 6-month treatment period, there was a significant difference in protein intake between the control and high-protein groups (mean±SD; control: 1.5±0.3, high-protein: 2.8±1.1 g/kg/d); however, there were no differences in the consumption total calories, carbohydrate or fat. Whole body bone mineral density did not change in the control (pre: 1.22±0.08, post: 1.22±0.09 g/cm 2 ) or high-protein group (pre: 1.25±0.11, post: 1.24±0.10 g/cm 2 ). Similarly, lumbar bone mineral density did not change in the control (pre: 1.08±0.16, post: 1.05±0.13 g/cm 2 ) or high-protein group (pre: 1.07±0.11, post: 1.08±0.12 g/cm 2 ). In addition, there were no changes in whole body or lumbar T-Scores in either group. Furthermore, there were no changes in fat mass or lean body mass., Conclusion: Despite an 87% higher protein intake (high-protein versus control), 6 months of a high-protein diet had no effect on whole body bone mineral density, lumbar bone mineral density, T-scores, lean body mass or fat mass., Competing Interests: JA coordinated and supervised all data collection, data analysis and manuscript preparation. AE and CE conducted most of the data collection. TS and CP were involved in study design, data analysis and manuscript preparation. All authors approved the final version of this manuscript.None of the authors have a competing interest or conflict of interest.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The purpose of this investigation was to determine the effects of casein supplementation (54 grams) in the morning (Casein-MOR) or evening (Casein-EVE) (90 minutes or less prior to sleep) on measures of body composition and exercise performance in trained men and women. Twenty-six healthy men and women who had been training regularly for greater than 12 months completed this 8-week study (mean ± SD; Casein-MOR group [n=14, seven male, seven female]: 30.0 ± 8.2 yr; 170.7 ± 9.5 cm; 70.9 ± 13.9 kg. Casein-EVE group [n=12, nine male, three female]: 28.9 ± 9.5 yr; 172.9 ± 7.3 cm; 72.6 ± 10.9 kg). Subjects in each group supplemented with casein protein (54 grams) either in the morning (prior to 12:00pm) or evening (~90 minutes or less prior to sleep). Subjects were advised to not significantly alter their training program as well as to keep a diary of their workouts. Body composition was assessed via the Bod Pod®. In addition, subjects provided dietary self-reports via MyFitnessPal®. Approximately 24 daily dietary self-reports were provided from each subject that self-monitored their diet. The investigators monitored their diet throughout the study. Both the Casein-MOR and Casein-EVE groups consumed significantly more protein (post versus pre; p<0.05); however, there were no between-group differences regarding protein intake. Furthermore, there were no within- or between-group differences for any other measure. In trained subjects who did not significantly alter their training program, the addition of 54 grams of casein protein in the morning or evening had no significant effects on body composition. Furthermore, the additional consumption of protein calories did not result in an increase in fat mass despite the fact that exercise volume did not change.

Background: Assessment of the response to the 2014-15 Ebola outbreak indicates the need for innovations in data collection, sharing, and use to improve case detection and treatment. Here we introduce a Machine Learning pipeline for Ebola Virus Disease (EVD) prognosis prediction, which packages the best models into a mobile app to be available in clinical care settings. The pipeline was trained on a public EVD clinical dataset, from 106 patients in Sierra Leone., Methods/principal Findings: We used a new tool for exploratory analysis, Mirador, to identify the most informative clinical factors that correlate with EVD outcome. The small sample size and high prevalence of missing records were significant challenges. We applied multiple imputation and bootstrap sampling to address missing data and quantify overfitting. We trained several predictors over all combinations of covariates, which resulted in an ensemble of predictors, with and without viral load information, with an area under the receiver operator characteristic curve of 0.8 or more, after correcting for optimistic bias. We ranked the predictors by their F1-score, and those above a set threshold were compiled into a mobile app, Ebola CARE (Computational Assignment of Risk Estimates)., Conclusions/significance: This method demonstrates how to address small sample sizes and missing data, while creating predictive models that can be readily deployed to assist treatment in future outbreaks of EVD and other infectious diseases. By generating an ensemble of predictors instead of relying on a single model, we are able to handle situations where patient data is partially available. The prognosis app can be updated as new data become available, and we made all the computational protocols fully documented and open-sourced to encourage timely data sharing, independent validation, and development of better prediction models in outbreak response.

Background: Eight weeks of a high protein diet (>3 g/kg/day) coupled with a periodized heavy resistance training program has been shown to positively affect body composition with no deleterious effects on health. Using a randomized, crossover design, resistance-trained male subjects underwent a 16-week intervention (i.e., two 8-week periods) in which they consumed either their normal (i.e., habitual) or a higher protein diet (>3 g/kg/day). Thus, the purpose of this study was to ascertain if significantly increasing protein intake would affect clinical markers of health (i.e., lipids, kidney function, etc.) as well as performance and body composition in young males with extensive resistance training experience., Methods: Twelve healthy resistance-trained men volunteered for this study (mean ± SD: age 25.9 ± 3.7 years; height 178.0 ± 8.5 cm; years of resistance training experience 7.6 ± 3.6) with 11 subjects completing most of the assessments. In a randomized crossover trial, subjects were tested at baseline and after two 8-week treatment periods (i.e., habitual [normal] diet and high protein diet) for body composition, measures of health (i.e., blood lipids, comprehensive metabolic panel) and performance. Each subject maintained a food diary for the 16-week treatment period (i.e., 8 weeks on their normal or habitual diet and 8 weeks on a high protein diet). Each subject provided a food diary of two weekdays and one weekend day per week. In addition, subjects kept a diary of their training regimen that was used to calculate total work performed., Results: During the normal and high protein phase of the treatment period, subjects consumed 2.6 ± 0.8 and 3.3 ± 0.8 g/kg/day of dietary protein, respectively. The mean protein intake over the 4-month period was 2.9 ± 0.9 g/kg/day. The high protein group consumed significantly more calories and protein (p < 0.05) than the normal protein group. There were no differences in dietary intake between the groups for any other measure. Moreover, there were no significant changes in body composition or markers of health in either group. There were no side effects (i.e., blood lipids, glucose, renal, kidney function etc.) regarding high protein consumption., Conclusion: In resistance-trained young men who do not significantly alter their training regimen, consuming a high protein diet (2.6 to 3.3 g/kg/day) over a 4-month period has no effect on blood lipids or markers of renal and hepatic function. Nor were there any changes in performance or body composition. This is the first crossover trial using resistance-trained subjects in which the elevation of protein intake to over four times the recommended dietary allowance has shown no harmful effects.

The purpose of this investigation was to determine the effects of a high protein diet over a one-year period. Fourteen healthy resistance-trained men completed the study (mean ± SD; age 26.3 ± 3.9 yr; height 178.5 ± 8.4 cm; and average years of training 8.9 ± 3.4 yr). In a randomized crossover design, subjects consumed their habitual or normal diet for 2 months and 4 months and alternated that with a higher protein diet (>3 g/kg/d) for 2 months and 4 months. Thus, on average, each subject was on their normal diet for 6 months and a higher protein diet for 6 months. Body composition was assessed via the Bod Pod ® . Each subject provided approximately 100-168 daily dietary self-reports. During the subjects' normal eating phase, they consumed (mean ± SD) 29.94 ± 5.65 kcals/kg/day and 2.51 ± 0.69 g/kg/day of protein. This significantly increased ( p < 0.05) during the high protein phase to 34.37 ± 5.88 kcals/kg/day and 3.32 ± 0.87 g/kg/day of protein. Our investigation discovered that, in resistance-trained men that consumed a high protein diet (~2.51-3.32 g/kg/d) for one year, there were no harmful effects on measures of blood lipids as well as liver and kidney function. In addition, despite the total increase in energy intake during the high protein phase, subjects did not experience an increase in fat mass.

Background: The consumption of a high protein diet (>4 g/kg/d) in trained men and women who did not alter their exercise program has been previously shown to have no significant effect on body composition. Thus, the purpose of this investigation was to determine if a high protein diet in conjunction with a periodized heavy resistance training program would affect indices of body composition, performance and health., Methods: Forty-eight healthy resistance-trained men and women completed this study (mean ± SD; Normal Protein group [NP n = 17, four female and 13 male]: 24.8 ± 6.9 yr; 174.0 ± 9.5 cm height; 74.7 ± 9.6 kg body weight; 2.4 ± 1.7 yr of training; High Protein group [HP n = 31, seven female and 24 male]: 22.9 ± 3.1 yr; 172.3 ± 7.7 cm; 74.3 ± 12.4 kg; 4.9 ± 4.1 yr of training). Moreover, all subjects participated in a split-routine, periodized heavy resistance-training program. Training and daily diet logs were kept by each subject. Subjects in the NP and HP groups were instructed to consume their baseline (~2 g/kg/d) and >3 g/kg/d of dietary protein, respectively., Results: Subjects in the NP and HP groups consumed 2.3 and 3.4 g/kg/day of dietary protein during the treatment period. The NP group consumed significantly (p < 0.05) more protein during the treatment period compared to their baseline intake. The HP group consumed more (p < 0.05) total energy and protein during the treatment period compared to their baseline intake. Furthermore, the HP group consumed significantly more (p < 0.05) total calories and protein compared to the NP group. There were significant time by group (p ≤ 0.05) changes in body weight (change: +1.3 ± 1.3 kg NP, -0.1 ± 2.5 HP), fat mass (change: -0.3 ± 2.2 kg NP, -1.7 ± 2.3 HP), and % body fat (change: -0.7 ± 2.8 NP, -2.4 ± 2.9 HP). The NP group gained significantly more body weight than the HP group; however, the HP group experienced a greater decrease in fat mass and % body fat. There was a significant time effect for FFM; however, there was a non-significant time by group effect for FFM (change: +1.5 ± 1.8 NP, +1.5 ± 2.2 HP). Furthermore, a significant time effect (p ≤ 0.05) was seen in both groups vis a vis improvements in maximal strength (i.e., 1-RM squat and bench) vertical jump and pull-ups; however, there were no significant time by group effects (p ≥ 0.05) for all exercise performance measures. Additionally, there were no changes in any of the blood parameters (i.e., basic metabolic panel)., Conclusion: Consuming a high protein diet (3.4 g/kg/d) in conjunction with a heavy resistance-training program may confer benefits with regards to body composition. Furthermore, there is no evidence that consuming a high protein diet has any deleterious effects.

Background: The consumption of dietary protein is important for resistance-trained individuals. It has been posited that intakes of 1.4 to 2.0 g/kg/day are needed for physically active individuals. Thus, the purpose of this investigation was to determine the effects of a very high protein diet (4.4 g/kg/d) on body composition in resistance-trained men and women., Methods: Thirty healthy resistance-trained individuals participated in this study (mean ± SD; age: 24.1 ± 5.6 yr; height: 171.4 ± 8.8 cm; weight: 73.3 ± 11.5 kg). Subjects were randomly assigned to one of the following groups: Control (CON) or high protein (HP). The CON group was instructed to maintain the same training and dietary habits over the course of the 8 week study. The HP group was instructed to consume 4.4 grams of protein per kg body weight daily. They were also instructed to maintain the same training and dietary habits (e.g. maintain the same fat and carbohydrate intake). Body composition (Bod Pod®), training volume (i.e. volume load), and food intake were determined at baseline and over the 8 week treatment period., Results: The HP group consumed significantly more protein and calories pre vs post (p < 0.05). Furthermore, the HP group consumed significantly more protein and calories than the CON (p < 0.05). The HP group consumed on average 307 ± 69 grams of protein compared to 138 ± 42 in the CON. When expressed per unit body weight, the HP group consumed 4.4 ± 0.8 g/kg/d of protein versus 1.8 ± 0.4 g/kg/d in the CON. There were no changes in training volume for either group. Moreover, there were no significant changes over time or between groups for body weight, fat mass, fat free mass, or percent body fat., Conclusions: Consuming 5.5 times the recommended daily allowance of protein has no effect on body composition in resistance-trained individuals who otherwise maintain the same training regimen. This is the first interventional study to demonstrate that consuming a hypercaloric high protein diet does not result in an increase in body fat.

Blastomycosis is one of the most common systemic fungal infections in dogs in North America Pulmonary manifestations are most common; localized disease is rare. A case of localized oronasal blastomycosis mimicking oral neoplasia is described. Long-term therapy with itraconazole resulted in clinical cure.

Rationale and Objectives: The purpose of this study was to determine relative rates of missed diagnoses for radiologists as a measure of competence in interpreting chest radiographs., Materials and Methods: Cases involving differing interpretations of chest radiographs were collected from January 1994 through December 1999 by faculty (chest and nonchest radiology specialists) in an academic radiology department. A quarterly peer-review process designated cases months after the fact, and anonymously, as no miss or as class I (nondiagnosable), class II (very difficult diagnosis), class III (should be diagnosed most of time), or class IV (should almost always be diagnosed) missed diagnoses. The rates and classes of missed diagnoses were compared among chest faculty and for the nonchest radiology specialists as a group., Results: Chest radiologists read 184,977 studies, and nonchest radiologists read 300,684 studies. Of these, 243 missed diagnoses were classified (classes I and II, 184 cases; class III, 50; and class IV, nine). No difference was detected in the rate of class III and IV misses among chest faculty, but nonchest faculty had significantly more class III (P = .022) and class IV misses (P = .016)., Conclusion: Random sampling of differing interpretations can yield a relative rate of missed diagnoses for radiologists. No difference was detected in clinically important misses (ie, classes III and IV) among chest radiologists, but a statistically significantly higher rate of seemingly obvious misdiagnoses was found for nonchest specialty radiologists. Potential biases may have influenced this analysis, including disease prevalence, sampling, clinical factors, observer variability, and truth-in-diagnosis.

Objectives: The purpose of this study was to examine the relationship between annual operator volume and outcomes of percutaneous coronary interventions (PCIs) using contemporaneous data., Background: The 1997 American College of Cardiology (ACC)/American Heart Association task force based their recommendation that interventionists perform > or = 75 procedures per year to maintain competency in PCI on data collected largely in the early 1990s. The practice of interventional cardiology has since changed with the availability of new devices and drugs., Methods: Data were collected from 1994 through 1996 on 15,080 PCIs performed during 14,498 hospitalizations by 47 interventional cardiologists practicing at the five high volume (>600 procedures per hospital per year) hospitals in northern New England and one Massachusetts-based institution that support these procedures. Operators were categorized into terciles based on their annualized volume of procedures. Multivariate regression analysis was used to control for case-mix. In-hospital outcomes included death, emergency coronary artery bypass graft surgery (eCABG), non-emergency CABG (non-eCABG), myocardial infarction (MI), death and clinical success (> or = 1 attempted lesion dilated to < 50% residual stenosis and no death, CABG or MI)., Results: Average annual procedure rates varied across terciles from low = 68, middle = 115 and high = 209. After adjusting for case-mix, clinical success rates were comparable across terciles (low, middle and high terciles: 90.9%, 88.8% and 90.7%, Ptrend = 0.237), as were all the adverse outcomes including death (low-risk patients = 0.45%, 0.41%, 0.71%, Ptrend = 0.086; high-risk patients = 5.68%, 5.99%, 7.23%, Ptrend = 0.324), eCABG (1.74%, 2.05%, 1.75%, Ptrend = 0.733) and MI (2.57%, 1.90%, 1.86%, Ptrend = 0.065)., Conclusions: Using current data, there is no significant relationship between operator volumes averaging > or = 68 per year and outcomes at high volume hospitals. Future efforts should be directed at determining the generalizability of these results.

Populations of American black ducks have declined and it has been hypothesized that wetland acidification, which can alter food quality by increasing availability of cadmium and decreasing that of calcium, may have contributed. We tested whether low-level cadmium and reduced calcium intake affect tissue cadmium concentrations and behaviour of captive black ducks. Adults received diets that mimicked cadmium and calcium concentrations in invertebrate prey from acid and from circumneutral wetlands for three spring and summer months in 1991 and 1992. Behaviours were monitored both when birds were fed experimental diets and control (commercial) diets. Cadmium in kidneys and liver differed significantly among groups and low calcium facilitated cadmium uptake. After two breeding seasons, levels of accumulated Cd were not lethal. However, birds that received Cd were significantly more active than control birds. Increased activity may have implications for survival of birds in the wild.

Problems arising from the present rate of failure of vocational trainees in the MRCGP examination are outlined; and the role of formative assessment during training in reducing this rate is considered. A study is described in which trainees in a number of centres were assessed by a method designed to measure specified cognitive abilities and areas of knowledge. The method, based on written papers, provides each candidate with a profile of performance and generates comparative standards. Reliability of marking, the distribution of candidate-scores within and between areas of assessment and techniques for monitoring the effectiveness of questions are reported. Use of the method by College as an educational service to trainees is considered, along with its potential as a Part I MRCGP examination.

A new prosthetic device for the treatment of urinary incontinence, caused by a variety of etiologies, has been used 8 times at the University of Michigan Medical Center. Since the entire device is filled with contrast medium, the radiologist plays a major role in its evaluation. A brief description of the implantable urinary sphincter and its normal and abnormal roentgenographic appearances are presented and discussed. Roentgenologic findings which could lead to early clinical detection of mechanical failure are illustrated.