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Abstract This study explores the optimization of ironing parameters in Material Extrusion (MEX) technology, specifically targeting improvements in the mechanical properties of polylactic acid (PLA) printed objects, with a focus on enhancing Ultimate Tensile Strength (UTS) and minimizing printing time. To achieve this, we employed a systematic experimental approach that varied flow rate, path speed, and spacing between passes, followed by a comprehensive statistical analysis using Analysis of Variance (ANOVA). Our findings indicate that path speed and spacing between passes significantly influence both UTS and printing time, while flow rate has a minor effect within the tested range. Optimal parameters were determined to be a flow rate of 14.34%, path speed of 30 mm/s, and spacing between passes of 0.3 mm, achieving a composite desirability of 0.970537. Validation using the response optimizer feature in Minitab software confirmed a strong correlation between predicted and experimental results. This research provides practical insights for optimizing MEX parameters, contributing to enhanced mechanical properties and efficiency in additive manufacturing processes.

Since 2011, the Global Energy and Water cycle Exchanges (GEWEX) Water Vapor Assessment (G-VAP) has provided performance analyses for state-of-the-art reanalysis and satellite water vapour products to the GEWEX Data and Analysis Panel (GDAP) and the user community in general. A significant component of the work undertaken by G-VAP is to characterise the quality and uncertainty of these water vapour records to (i) ensure full exploitation and (ii) avoid incorrect use or interpretation of results. This study presents results from the second phase of G-VAP, where we have extended and expanded our analysis of total column water vapour (TCWV) from phase 1, in conjunction with updating the G-VAP archive. For version 2 of the archive, we consider 28 freely available and mature satellite and reanalysis data products, remapped to a regular longitude–latitude grid of 2° × 2° and on monthly time steps between January 1979 and December 2019. We first analysed all records for a “common” short period of 5 years (2005–2009), focusing on variability (spatial and seasonal) and deviation from the ensemble mean. We observed that clear-sky daytime-only satellite products were generally drier than the ensemble mean, and seasonal variability/disparity in several regions up to 12 kg m−2 related to original spatial resolution and temporal sampling. For 11 of the 28 data records, further analysis was undertaken between 1988–2014. Within this “long period”, key results show (i) trends between −1.18 ± 0.68 to 3.82 ± 3.94 kg m−2 per decade and −0.39 ± 0.27 to 1.24 ± 0.85 kg m−2 per decade were found over ice-free global oceans and land surfaces, respectively, and (ii) regression coefficients of TCWV against surface temperatures of 6.17 ± 0.24 to 27.02 ± 0.51 % K−1 over oceans (using sea surface temperature) and 3.00 ± 0.17 to 7.77 ± 0.16 % K−1 over land (using surface air temperature). It is important to note that trends estimated within G-VAP are used to identify issues in the data records rather than analyse climate change. Additionally, breakpoints have been identified and characterised for both land and ocean surfaces within this period. Finally, we present a spatial analysis of correlations to six climate indices within the long period, highlighting regional areas of significant positive and negative correlation and the level of agreement among records.

Abstract Background Patients who have recurrent atrial fibrillation (AF) following redo catheter ablation may eventually be managed with a pace‐and‐ablate approach, involving pacemaker implant followed by atrioventricular nodal ablation (AVNA). We sought to determine which factors would predict subsequent AVNA in patients undergoing redo AF ablation. Methods We analyzed patients undergoing redo AF ablations between 2013 and 2019 at our institution. Follow‐up was censored on December 31, 2021. Patients with no available follow‐up data were excluded. Time‐to‐event analysis with Cox proportional hazard regression was used to compare those who underwent AVNA to those who did not. Results A total of 467 patients were included, of whom 39 (8.4%) underwent AVNA. After multivariable adjustment, female sex (aHR 4.68 [95% CI 2.30–9.50]; p

Abstract Far infrared (FIR) emission from the Earth's polar regions has become an area of increasing scientific interest and value. FIR emission is important for understanding Earth's radiative balance and improving global climate models, especially in rapidly changing Arctic conditions. Far‐infrared emission from Earth is not currently being monitored from space, except as part of broadband emission channels of Earth radiation budget measurements like those from the CERES project, and only limited measurements in the FIR spectrum exist. The Absolute Radiance Interferometer (ARI), developed as a prototype of the infrared spectrometer for CLARREO at the University of Wisconsin‐Madison, Space Science and Engineering Center, measures absolute spectrally resolved infrared (IR) radiance from 200 to 2,000 cm−1 (or 5–50 μm) at 0.5 cm−1 resolution with high accuracy (

Background: A rotator cuff tear (RCT) is a common shoulder diagnosis and its etiology may be acute, traumatic, or chronic degenerative. Differentiation between the 2 etiologies may be important for multiple reasons, but remains difficult based on imaging. Further knowledge about radiographic and magnetic resonance findings to distinguish traumatic from degenerative RCT is needed. Methods: We analyzed magnetic resonance arthrograms (MRAs) of 96 patients with traumatic or degenerative superior RCT, which were matched according their age and the affected rotator cuff muscle into the 2 groups. Patients older than 66 years of age were excluded from the study to avoid including cases with pre-existing degeneration. In the case of traumatic RCT, the time between the trauma and MRA had to be less than 3 months. Various parameters of the supraspinatus (SSP) muscle-tendon unit were assessed (tendon thickness, presence of a remaining tendon stump at the greater tubercle, magnitude of retraction, layer appearance). The retraction of the 2 SSP layers were individually measured to determine the difference of retraction. Additionally, edema of the tendon and muscle, the tangent- and kinking-sign as well as the newly introduced Cobra-sign (bulging of the distal part of the ruptured tendon with slim configuration of the medial part of the tendon) were analyzed. Results: Edema within the SSP muscle (sensitivity 13%, specificity 100%, P = .011) or the tendon (sensitivity 86%, specificity 36%, P = .014) are more frequent in traumatic RCT. The same association was found for the kinking-sign (sensitivity 53%, specificity 71%, P = .018) and the Cobra sign (sensitivity 47%, specificity 84%, P = .001). Even though not statistically significant, tendencies were observed toward thicker tendon stumps in traumatic RCT, and greater difference in retraction between the 2 SSP layers in the degenerative group. The cohorts had no difference in the presence of a tendon stump at the greater tuberosity. Conclusion: Muscle and tendon edema, as well as tendon kinking appearance and the newly introduced cobra-sign are suitable MRA parameters to distinguish between traumatic and degenerative etiology of a superior RTC.

Micropropagation of hemp (Cannabis sativa) is constrained by problems with hyperhydricity and culture decline of microshoots. These problems can be reduced by increasing agar and nutrients in the media during micropropagation stages 1 and 2, respectfully. Performance of microshoots of ‘Abacus’ and ‘Wife’ hemp cultured in Driver and Kuniyuki Walnut medium (DKW) for 15 weeks (6 weeks of stage 1 + 9 weeks of stage 2), with subculturing every 3 weeks during both stages 1 and 2, or in Murashige and Skoog with vitamins medium (MS) for 6 weeks (stage 1) followed by Lubell-Brand Cannabis medium (LBC) for 9 weeks (stage 2), with subculturing every 3 weeks during both stages 1 and 2, was evaluated. In a separate study, microshoot performance of ‘Abacus’ and ‘Wife’ in MS for 3 weeks (stage 1) followed by LBC for 6 weeks (stage 2), with subculturing every 3 weeks, using boxes (Magenta GA-7) with lids featuring a vent with a diameter of 10 mm and a pore size of 0.2 µM or using microboxes (Sac O2 O95/114 + OD95) with lids featuring a filter (Sac O2 #10) were evaluated. Shoot multiplication rate (SMR) and explant height were greater for ‘Abacus’ in LBC than DKW. For ‘Wife’, SMR at 9 weeks was greater in LBC, as LBC provided more nutrients and water than cultures had received in MS initially during stage 1. Culture medium did not influence ex vitro rooting success, which was 75% for ‘Abacus’ and ≥ 90% for ‘Wife’. Microboxes resulted in greater hyperhydricity of shoots and a lower ex vitro rooting percentage than boxes. For cultivars that are highly prone to developing hyperhydricity, like ‘Abacus’, the microboxes were not adequate to control this condition.

This paper reports the findings of the second and the third year of a four year longitudinal empirical research into the modification of 'step-by-step' instructions to practical activities which require one or more steps to be designed by the students. This method had been successfully applied for a short period for 14-15 years old students. However, the first year of the current longitudinal study, investigating the approach's effectiveness (a) for younger students and (b) over a period of time, did not produce the expected results. Therefore the research model was modified at the beginning of the second year which began in September 2017 with over 800 13-14-year-old students. Each school year they spent six lessons carrying out practical activities using worksheets we provided. The participating classes were allocated to one of three groups. Group 1 was the control group. Students simply followed the step-by-step instructions. Groups 2 and 3 were experimental groups. Group 2 students followed the same instructions, but from the beginning of the second school year their worksheets explained the principles related to the experimental design of the step-by-step experiments carried out. Group 3 students followed the same instructions, but one or more steps were incomplete and students were required to design these steps, as in the first year. However, from the second year onwards Group 3 students were taught the relevant principles of the experimental design before they started planning and carrying out the experiments. The impact of the intervention on the students' experimental design skills and disciplinary content knowledge was measured by structured tests. After the second school year of the project it was clear that both types of instruction (used in case of Group 2 and Group 3) had a significant positive effect on the results of the students disciplinary content knowledge and experimental design skills. However, the development seemed to stop in the third year of the project. In the third year, a student's achievement was influenced mostly by their school ranking.

Accurate thermal infrared (TIR) fast-forward models are critical for weather forecasting via numerical weather prediction (NWP) satellite radiance assimilation and operational environmental data record (EDR) retrieval algorithms. The thermodynamic and compositional data about the surface and lower troposphere are derived from semi-transparent TIR window bands (i.e., surface-sensitive channels) that can span into the far-infrared (FIR) region under dry polar conditions. To model the satellite observed radiance within these bands, an accurate a priori emissivity is necessary for the surface in question, usually provided in the form of a physical or empirical model. To address the needs of hyperspectral TIR satellite radiance assimilation, this paper discusses the research, development, and preliminary validation of a physically based snow/ice emissivity model designed for practical implementation within operational fast-forward models such as the U.S. National Oceanic and Atmospheric Administration (NOAA) Community Radiative Transfer Model (CRTM). To accommodate the range of snow grain sizes, a hybrid modeling approach is adopted, combining a layer scattering model based on the Mie theory (viz., the Wiscombe–Warren 1980 snow albedo model, its complete derivation provided in the Appendices) with a specular facet model. The Mie-scattering model is valid for the smallest snow grain sizes typical of fresh snow and frost, whereas the specular facet model is better suited for the larger sizes and welded snow surfaces typical of aged snow. Comparisons of the model against the previously published spectral emissivity measurements show reasonable agreement across zenith observing angles and snow grain sizes, and preliminary observing system experiments (OSEs) have revealed notable improvements in snow/ice surface window channel calculations versus hyperspectral TIR satellite observations within the NOAA NWP radiance assimilation system.

Objectives: Chlorine has a strong antibacterial property and is the disinfectant most frequently used in swimming pools. Therefore, the microbiota community in the oral cavity of those who practice water sports is assumed to be special due to their regular immersion in water. Adverse changes in the composition of oral cavity microbiota may have serious health consequences. We aimed to compare the oral microbiome between water polo players and non-athletes. We hypothesized that the oral cavity microbiota community differed between water polo players and non-athletes. Materials and Methods: Altogether, 124 water polo players (62 males and 62 females, aged between 9 and 20 years) and 16 non-athlete youths (control group, eight males and eight females, aged between 16 and 20 years, mean age + SD = 17.1 + 1.4 years) who participated in body structure examinations voluntarily agreed to participate in the study. In a randomly selected subsample of water polo players (n: 29, aged between 16 and 20 years, mean age + SD = 17.3 + 1.0 years), saliva samples were also collected. Saliva samples were collected from all non-athlete youths (n: 16, aged between 16 and 20 years). The oral microbiome was determined from a saliva sample, and DNA was isolated using the QIAmp DNA Blood Mini Kit. The 16S rRNA gene amplicon sequencing method was used to analyze the microbiome community. PCR primers were trimmed from the sequence reads with Cutadapt. R library DADA2 was used to process reads in the abundance analysis. Results: In general, Streptococcus, Veilonella, and Prevotella genera constituted more than 50% of the oral microbiome community in the two participant groups combined (n = 45). The oral microbial profile had significant sexual dimorphism and differed between water polo players and the non-athletes. Compared to females, males had a higher (p < 0.05) relative abundance of the Atopobium (medium effect size) and Pravotella_7 (very large effect size) genera and a lower (p < 0.05) relative abundance of the Fusobacterium (large effect size), Gemella (large effect size), and Streptococcus (large effect size) genera. Compared to non-athletes, water polo players had higher (p < 0.05, medium effect size) relative abundance of the genus Veillonella and lower (p < 0.05, large effect size) relative abundance of the genus Gemella. Conclusions: The results suggest that regular water training can unfavorably alter the composition of the oral microbial community.

Soft objects squeezing through small apertures are crucial for many in vivo and in vitro processes. Red blood cell transit time through splenic inter-endothelial slits (IESs) plays a crucial role in blood filtration and disease progression, while droplet velocity through constrictions in microfluidic devices is important for effective manipulation and separation processes. As these transit phenomena are not well understood, we sought to establish analytical and numerical solutions of viscous droplet transit through a rectangular slit. This study extends from our former theory of a circular pore because a rectangular slit is more realistic in many physiological and engineering applications. Here, we derived the ordinary differential equations (ODEs) of a droplet passing through a slit by combining planar Poiseuille flow, the Young–Laplace equations, and modifying them to consider the lubrication layer between the droplet and the slit wall. Compared to the pore case, we used the Roscoe solution instead of the Sampson one to account for the flow entering and exiting a rectangular slit. When the surface tension and lubrication layer were negligible, we derived the closed-form solutions of transit time. When the surface tension and lubrication layer were finite, the ODEs were solved numerically to study the impact of various parameters on the transit time. With our solutions, we identified the impact of prescribed pressure drop, slit dimensions, and droplet parameters such as surface tension, viscosity, and volume on transit time. In addition, we also considered the effect of pressure drop and surface tension near critical values. For this study, critical surface tension for a given pressure drop describes the threshold droplet surface tension that prevents transit, and critical pressure for a given surface tension describes the threshold pressure drop that prevents transit. Our solutions demonstrate that there is a linear relationship between pressure and the reciprocal of the transit time (referred to as inverse transit time), as well as a linear relationship between viscosity and transit time. Additionally, when the droplet size increases with respect to the slit dimensions, there is a corresponding increase in transit time. Most notably, we emphasize the initial antagonistic effect of surface tension which resists droplet passage but at the same time decreases the lubrication layer, thus facilitating passage. Our results provide quantitative calculations for understanding cells passing through slit-like constrictions and designing droplet microfluidic experiments.

Background: The need for coracoclavicular (CC) stabilization in the fixation of fractures with CC instability (Neer type IIB and V) was biomechanically demonstrated by higher construct strength than isolated locking plate osteosynthesis. It was the purpose of this study to prove noninferiority of the new cow-hitch suture repair technique compared with the well-established suture tape double-button fixation with regard to overall fixation strength and cyclic loading properties. Methods: Twelve human cadaver shoulders (7 right and 5 left) were matched for sex and age (mean age: 75 ± 5 years). An oblique parasagittal fracture line 20 mm medial to the acromioclavicular joint line was created, and the CC ligaments were dissected. Six shoulders were reconstructed by a double FiberTape fixation with two suture buttons (group DB), and the remaining six shoulders by a cow-hitch suture repair using a double FiberWire with only coracoid button fixation (group CH). Both reconstruction techniques were tested in a servo-hydraulic material testing machine for cyclic displacement (mm), stiffness (N/mm), and maximum load-to-failure (N) after 500 cycles at 3 mm/s and inferosuperior load between 15 and 70 N. Superior fragment displacement in space was recorded using a MicroScribe digitizer. Results: There were no statistically significant differences regarding cyclic displacement (group DB: 0.7 mm; group CH: 1.3 mm; P = .36), stiffness (group DB: 177 N/mm; group CH: 116 N/mm; P = .17), maximum load-to-failure (group DB: 560 N; group CH: 492 N; P = .59), and superior displacement in space of the medial fragment (group DB: 3.2 mm; group CH: 1.6 mm; P = .48). Conclusion: Fixation of unstable distal clavicle fractures using a double FiberWire cow-hitch suture repair with isolated coracoid button fixation for stand-alone CC stabilization resulted in similar biomechanical properties to a double-suture button fixation with FiberTapes while avoiding prominent clavicular implants.

Introduction Unruptured intracranial aneurysms (UIA) are common in the adult population, but only a relatively small proportion will rupture. It is therefore essential to have accurate estimates of rupture risk to target treatment towards those who stand to benefit and avoid exposing patients to the risks of unnecessary treatment. The best available UIA natural history data are the PHASES study. However, this has never been validated and given the known heterogeneity in the populations, methods and biases of the constituent studies, there is a need to do so. There are also many potential predictors not considered in PHASES that require evaluation, and the estimated rupture risk is largely based on short-term follow-up (mostly 1 year). The aims of this study are to: (1) test the accuracy of PHASES in a UK population, (2) evaluate additional predictors of rupture and (3) assess long-term UIA rupture rates.Methods and analysis The Risk of Aneurysm Rupture study is a longitudinal multicentre study that will identify patients with known UIA seen in neurosurgery units. Patients will have baseline demographics and aneurysm characteristics collected by their neurosurgery unit and then a single aggregated national cohort will be linked to databases of hospital admissions and deaths to identify all patients who may have subsequently suffered a subarachnoid haemorrhage. All matched admissions and deaths will be checked against medical records to confirm the diagnosis of aneurysmal subarachnoid haemorrhage. The target sample size is 20 000 patients. The primary outcome will be aneurysm rupture resulting in hospital admission or death. Cox regression models will be built to test each of the study’s aims.Ethics and dissemination Ethical approval has been given by South Central Hampshire A Research Ethics Committee (21SC0064) and Confidentiality Advisory Group support (21CAG0033) provided under Section 251 of the NHS Act 2006. The results will be disseminated in peer-reviewed journals.Trial registration number ISRCTN17658526.

Background: The treatment of complex proximal humerus fractures with hemiarthroplasty is associated with a high failure rate due to secondary displacement of the tuberosities. It was the aim of this in-vitro study to compare the mechanical stability of tuberosity reattachment obtained with the so-called “Cow-Hitch” (CH) cerclage compared with conventional tuberosity reattachment. Methods: A 4-part proximal humerus fracture was created in 10 fresh-frozen, human cadaveric shoulders. The greater and lesser tuberosity were reattached to the hemiarthroplasty stem with in total 4 CH Cerclages in the Cow-Hitch group. The conventional technique—recommended for the tested implant—was used in the control group using 6 sutures. A total of 5000 loading cycles with forces of 350N were applied, while motion (in mm) of the tuberosities was recorded in 3 directions (anteroposterior = AP, mediolateral = ML, inferosuperior = IS) with a telecentric camera. Results: After 5000 loading cycles, the CH group showed less fragment displacement (AP: 2.3 ± 2.3 mm, ML: 1.8 ± 0.9 mm, IS: 1.3 ± 0.5 mm) than the conventional group (AP: 9.8 ± 12.3 mm, ML: 5.5 ± 5.6 mm, IS: 4.5 ± 4.7 mm). The differences were not statistically significant (AP: P = .241; ML: P = .159; IS: P = .216). The lesser tuberosity fragment displacement in the CH group after 5000 cycles was less in the AP (2.3 ± 3.3 vs. 4.0 ± 2.8, P = .359) and IS (1.9 ± 1.2 vs. 3.1 ± 1.8; P = .189) directions but higher in the ML direction (7.2 ± 5.7 vs 6.3 ± 3.6, P = .963). Conclusions: In-vitro, “Cow-Hitch” cerclage results in mean greater tuberosity displacements of 2 mm and reliably prevents displacements greater than 5 mm. In contrast, the conventional fixation technique yields unreliable, variable stability with low to complete displacement upon cyclical loading.

There is demand for micropropagated Cannabis sativa liner plants, because they are uniform, vigorous, and pathogen free; however, availability is limited because of challenges with in vitro culture decline and ex vitro rooting. Ex vitro rooting success of microcuttings was evaluated for ‘Abacus’ and ‘Wife’ when cultures were 6, 9, 12, 15, and 18 weeks old from initiation. Microcuttings of ‘Wife’ harvested from 6, 9, and 12-week-old cultures rooted at or above 80%, but rooting declined to 50% and 30% for 15- and 18-week-old cultures, respectively. Rooting for ‘Abacus’ remained relatively constant between 47% and 70% for microcuttings harvested from 6- to 18-week-old cultures. ‘Wife’ plants grown from microcuttings, stem cuttings, and retip cuttings (cuttings taken from new shoots on recently micropropagated plants) had equivalent total shoot length, number of shoots, and flower dry weight, whereas micropropagated ‘Abacus’ plants had less shoot length and flower dry weight than plants from stem cuttings. However, when micropropagated ‘Abacus’ plants were provided an extra week of vegetative growth to reach an initial size equivalent to stem and retip plants, all plants performed the same. Propagation method did not change cannabinoid content for both ‘Abacus’ and ‘Wife’. Retip cuttings of ‘Abacus’ and ‘Wife’ rooted at 76% to 81% without rooting hormone, which is comparable to rates reported for stem cuttings of C. sativa treated with rooting hormone. Propagators should consider retipping to expand their liner production, because retips root well and possess the same desirable attributes as micropropagated plants.

Background: Functional internal rotation (fIR) of the shoulder is frequently limited after reverse shoulder arthroplasty (RTSA). The objective of this study was to study a cohort of satisfied patients after RTSA who had comparable active mobility except for fIR and to identify factors associated with selective loss of fIR. Methods: A retrospective cohort study was conducted to compare 2 patient groups with either poor (≤ 2 points in the Constant-Murley score [CS]) or excellent (≥8 points in CS) fIR after RTSA at a minimum follow-up of 2 years. Influencing factors (demographic, surgical or implant related, radiographic parameters) and clinical outcome were analyzed. Results: Fifty-two patients with a mean age of 72.8 (±9.3) and a mean follow-up of 41 months were included in the IR≤2 group and 63 patients with a mean age of 72.1 (±8.0) and a mean follow-up of 59 months in the IR≥8 group. All patients had undergone RTSA with the same implant type and only 2 different glenosphere sizes (36 and 40) for comparable indications. A multivariate analysis identified the following significant risk factors for poor postoperative fIR: poor preoperative fIR (pts in CS: 3 [range: 2-6] vs. 6 [range: 4-8], P

Abstract Background Understanding muscle and tendon anatomy is of tremendous importance to achieve optimal surgical execution and results in tendon transfers around the shoulder. The aim of this study was to introduce and describe an additional distal muscle slip of the teres major (TM). Methods Sixteen fresh-frozen cadaver shoulders were dissected with the deltopectoral approach. The ventral latissimus dorsi (LD) tendon was harvested, and the shoulders were analyzed for the presence/absence of a distal teres major slip (dTMs) and its dimensions and relationship with the TM and LD tendons. Results The dTMs was identified in 12 shoulders (75%). It was always distal to the TM tendon and visible during the deltopectoral approach. There was a clear separation between the TM proximally and dTMs tendon distally. At the humeral insertion, both tendons had a common epimyseal sheet around the teres major and inserted continuously at the humerus. The mean width of the dTMs tendon at the insertion was 13 ± 4 mm (range, 7–22 mm). The total lengths of the dTMs tendon and LD tendon were 40 ± 7 mm (range, 25–57 mm) and 69 ± 7 mm (range, 57–79 mm), respectively (p

Infrared (IR) land surface emissivity (LSE) plays an important role in numerical weather prediction (NWP) models through the satellite radiance assimilation. However, due to the large uncertainties in LSE over the desert, many land-surface sensitive channels of satellite IR sensors are not assimilated. This calls for further assessments of the quality of satellite-retrieved LSE in these desert regions. A set of LSE observations were made from field experiments conducted on 16–18 October 2013 along a south/north desert road in the Taklimakan Desert (TD), China. The observed LSEs (EOBS) are thus used in this study as the reference values to evaluate the quality of Combined ASTER MODIS Emissivity over Land (CAMEL) data. Analysis of these data shows four main results. First, the CAMEL datasets appear to sufficiently capture the spatial variations in LSE from the oasis to the hinterland of the TD (this is especially the case in the quartz reststrahlen band). From site 1 at the southern edge of the Taklimakan Desert to site 10 at the northern edge, the measured LSE and the corresponding CAMEL observation in the quartz reststrahlen band first decrease and reach their minimum around sites 4–6 in the hinterland of the Taklimakan Desert. Then, the LSE increases gradually and finally reaches its maximum at site 10, which has a clay ground surface, showing that the LSE is higher at the edges of the desert and lower in the center. Second, the CAMEL values at 11.3 μm have a zonal distribution characterized by a northeast–southwest strike, though such an artifact might have been introduced by ASTER LSE data during the merging process that created the CAMEL dataset. Third, the unrealistic variation of the original EOBS can be filtered out with useful signals, as identified by the first six principal components of the PCA conducted on the laboratory-measured hyperspectral emissivity spectra (ELAB). Fourth, the CAMEL results correlate well with the measured LSE at the 10 observation sites, with the observed LSE being slightly smaller than the CAMEL values in general.

With the exponential growth of catheter ablation for atrial fibrillation (AF), there is increasing interest in associated health care costs. Pulsed field ablation (PFA) using a single-shot pentaspline multielectrode catheter has been shown to be safe and effective for AF ablation, but its cost efficiency compared to conventional thermal ablation modalities (cryoballoon [CB] or radiofrequency [RF]) has not been evaluated. The purpose of this study was to compare cost, efficiency, effectiveness, and safety between PFA, CB, and RF for AF ablation. We studied 707 consecutive patients (PFA: 208 [46.0%]; CB: 325 [29.4%]; RF: 174 [24.6%]) undergoing first-time AF ablation. Individual procedural costs were calculated, including equipment, laboratory use, and hospital stay, and compared between ablation modalities, as were effectiveness and safety. Skin-to-skin times and catheter laboratory times were significantly shorter with PFA (68 and 102 minutes, respectively) than with CB (91 and 122 minutes) and RF (89 and 123 minutes) (P <.001). General anesthesia use differed across modalities (PFA 100%; CB 10.2%; RF 61.5%) (P <.001). Major complications occurred in 1% of cases, with no significant differences between modalities. Shorter procedural times resulted in lower staffing and laboratory costs with PFA, but these savings were offset by substantially higher equipment costs, resulting in higher overall median costs with PFA (£10,010) than with CB (£8106) and RF (£8949) (P <.001). In this contemporary real-world study of the 3 major AF ablation modalities used concurrently, PFA had shorter skin-to-skin and catheter laboratory times than did CB and RF, with similarly low rates of complications. However, PFA procedures were considerably more expensive, largely because of higher equipment cost. [Display omitted] [ABSTRACT FROM AUTHOR]

No study has assessed the durability of pulmonary vein isolation (PVI) with radiofrequency (RF) and cryoballoon (CB) in patients with persistent atrial fibrillation. These data are especially lacking for those with significantly diseased left atria (LA). The goals of this study were to assess PVI durability in patients with significant LA disease and to compare reconnection rates between RF and CB. Forty-four patients (mean age 63 years; 34 (77%) male; median time since atrial fibrillation diagnosis 22.5 months; median indexed LA volume 36 mL/m2) were randomized 1:1 to RF or CB PVI. A redo procedure using ultra-high-density electroanatomic mapping was mandated at 2 months, where PV reconnections were identified and reisolated. Thirty-eight patients underwent both procedures (CB n = 17; RF n = 21). Index RF procedures were longer (median 158 minutes vs 97 minutes; P <.001) but required less fluoroscopy (9.5 minutes vs 23 minutes; P <.001). At the index RF procedure, a median of 47% of LA myocardium had voltage < 0.5 mV, suggesting that half of the mapped LA comprised scar. PV reconnection was observed in 73 of 152 PVs (48.0%) and was more frequent with CB (58.8%) than with RF (39.3%) (P =.022). Reconnection of at least 1 PV was detected in >75% of patients. Significantly more ablation was required during the redo procedure to reisolate PVs in the CB arm (median 10.8 minutes vs 1.2 minutes; P <.001). PVI durability may be poor in those with significant LA scarring and dilatation, even with modern thermal ablation technologies. RF resulted in significantly better PVI durability than did CB in this complex population. [ABSTRACT FROM AUTHOR]

Abstract Background Although social anxiety disorder is one of the most frequent disorders, it often remained unrecognized. Utilizing brief, yet reliable screening tools, such as the Social Interaction Anxiety Scale (SIAS-6) and the Social Phobia Scale (SPS-6) are helping to solve this problem in parts of Western Europe and the US. Still some countries, like Hungary, lag behind. For this purpose, previous studies call for further evidence on the applicability of the scales in various populations and cultures, as well as the elaborative validity of the short forms. Here, we aimed to provide a thorough analysis of the scales in five studies. We employed item response theory (IRT) to explore the psychometric properties of the SIAS-6 and the SPS-6 in Hungarian adults (n = 3213, age range:19–80) and adolescents (n = 292, age range:14–18). Results In both samples, IRT analyses demonstrated that the items of SIAS-6 and SPS-6 had high discriminative power and cover a wide range of the latent trait. Using various subsamples, we showed that (1) the scales had excellent convergent and divergent validity in relation to domains of anxiety, depression, and cognitive emotion regulation in both samples. Further, that (2) the scales discriminated those with a history of fainting or avoidance from those without such history. Lastly, (3) the questionnaires can discriminate people diagnosed with social anxiety disorder (n = 30, age range:13–71) and controls. Conclusions These findings suggest that the questionnaires are suitable for screening for SAD in adults and adolescents. Although the confirmation of the two-factor structure may be indicative of the validity of the “performance only” specifier of SAD in DSM-V, the high correlation between the factors and the similar patter of convergent validity might indicate that it is not a discrete entity but rather a part of SAD; and that SAD is latently continuous.

An operational data product available for both the Suomi National Polar-orbiting Partnership (S-NPP) and National Oceanic and Atmospheric Administration-20 (NOAA-20) platforms provides high-spatial-resolution infrared (IR) absorption band radiances for Visible Infrared Imaging Radiometer Suite (VIIRS) based on a VIIRS and Crosstrack Infrared Sounder (CrIS) data fusion method. This study investigates the use of these IR radiances, centered at 4.5, 6.7, 7.3, 9.7, 13.3, 13.6, 13.9, and 14.2 µm, to construct atmospheric moisture products (e.g., total precipitable water and upper tropospheric humidity) and to evaluate their accuracy. Total precipitable water (TPW) and upper tropospheric humidity (UTH) retrieved from hyperspectral sounder CrIS measurements are provided at the associated VIIRS sensor's high spatial resolution (750 m) and are compared subsequently to collocated operational Aqua Moderate Resolution Imaging Spectroradiometer (MODIS) and S-NPP VIIRS moisture products. This study suggests that the use of VIIRS IR absorption band radiances will provide continuity with Aqua MODIS moisture products.

BackgroundThe sinoatrial/sinus node (SAN) is the primary pacemaker of the heart. In humans, SAN is surrounded by the paranodal area (PNA). Although the PNA function remains debated, it is thought to act as a subsidiary atrial pacemaker (SAP) tissue and become the dominant pacemaker in the setting of sinus node disease (SND). Large animal models of SND allow characterization of SAP, which might be a target for novel treatment strategies for SAN diseases.MethodsA goat model of SND was developed (n = 10) by epicardially ablating the SAN and validated by mapping of emergent SAP locations through an ablation catheter and surface electrocardiogram (ECG). Structural characterization of the goat SAN and SAP was assessed by histology and immunofluorescence techniques.ResultsWhen the SAN was ablated, SAPs featured a shortened atrioventricular conduction, consistent with the location in proximity of atrioventricular junction. SAP recovery time showed significant prolongation compared to the SAN recovery time, followed by a decrease over a follow-up of 4 weeks. Like the SAN tissue, the SAP expressed the main isoform of pacemaker hyperpolarization-activated cyclic nucleotide-gated channel 4 (HCN4) and Na+/Ca2+ exchanger 1 (NCX1) and no high conductance connexin 43 (Cx43). Structural characterization of the right atrium (RA) revealed that the SAN was located at the earliest activation [i.e., at the junction of the superior vena cava (SVC) with the RA] and was surrounded by the paranodal-like tissue, extending down to the inferior vena cava (IVC). Emerged SAPs were localized close to the IVC and within the thick band of the atrial muscle known as the crista terminalis (CT).ConclusionsSAN ablation resulted in the generation of chronic SAP activity in 60% of treated animals. SAP displayed development over time and was located within the previously discovered PNA in humans, suggesting its role as dominant pacemaker in SND. Therefore, SAP in goat constitutes a promising stable target for electrophysiological modification to construct a fully functioning pacemaker.

Background: Patients who have recurrent atrial fibrillation (AF) following redo catheter ablation may eventually be managed with a pace-and-ablate approach, involving pacemaker implant followed by atrioventricular nodal ablation (AVNA). We sought to determine which factors would predict subsequent AVNA in patients undergoing redo AF ablation. Methods: We analyzed patients undergoing redo AF ablations between 2013 and 2019 at our institution. Follow-up was censored on December 31, 2021. Patients with no available follow- up data were excluded. Time-to-event analysis with Cox proportional hazard regression was used to compare those who underwent AVNA to those who did not. Results: A total of 467 patients were included, of whom 39 (8.4%) underwent AVNA. After multivariable adjustment, female sex (aHR 4.68 [95% CI 2.30-9.50]; p < 0.001), ischemic heart disease (aHR 2.99 [95% CI 1.25-7.16]; p = 0.014), presence of a preexisting pacemaker (aHR 3.25 [95% CI 1.10-9.60]; p = 0.033), and persistent AF (aHR 2.22 [95% CI 1.07-4.59]; p = 0.032) were associated with increased risk of subsequent AVNA requirement. Conclusion: Female sex, ischemic heart disease, and persistent AF may be useful clinical predictors of the requirement for subsequent AVNA and may be considered as part of shared clinical decision making. [ABSTRACT FROM AUTHOR]

Abstract Background It is not exactly known whether guided growth or definitive epiphysiodesis techniques are superior in treating limb length discrepancy (LLD). The purpose of the present study was therefore to find out if definitive epiphysiodesis is associated with more powerful LLD correction than tension band plate epiphysiodesis. Methods Pediatric patients with LLD treated either with tension band plating as a guided growth technique (temporary epiphysiodesis) or a percutaneous drilling technique (definitive epiphysiodesis) around the knee and a minimum follow-up of 12 months were included in this retrospective study. Radiographic measurements were performed by two independent reviewers. The reduction in side difference between preoperative radiographs and last follow-up was calculated and compared between surgical techniques. Results Thirty-eight patients (mean age 13.6 years) were included, 17 treated with temporary and 21 with definitive epiphysiodesis. Average follow-up was at 578 days. The reduction of the LLD in 12 months was 5.7 mm in patients treated with temporary epiphysiodesis and 8.4 mm with definitive epiphysiodesis, respectively (p = 0.22). In both groups, LLD could be statistically significantly reduced after 12 and 24 months. Definitive epiphysiodesis had a lower revision rate (4.8% vs. 17.6%). Intra- and interobserver reliability of the measurements was excellent. Conclusions As in earlier studies supposed, temporary epiphysiodesis with tension band plating seems to correct LLD less powerful compared to definitive percutaneous epiphysiodesis. However, in the present study, the differences of LLD correction were not statistically significant. We do not recommend the use of tension band plates for LLD correction due to inferior correction with higher complication and revision rate.

Introduction In the field of arthroscopic rotator cuff repair (ARCR), reporting standards of published studies differ dramatically, notably concerning adverse events (AEs). In addition, prognostic studies are overall methodologically poor, based on small data sets and explore only limited numbers of influencing factors. We aim to develop prognostic models for individual ARCR patients, primarily for the patient-reported assessment of shoulder function (Oxford Shoulder Score (OSS)) and the occurrence of shoulder stiffness 6 months after surgery. We also aim to evaluate the use of a consensus core event set (CES) for AEs and validate a severity classification for these events, considering the patient’s perspective.Methods and analysis A cohort of 970 primary ARCR patients will be prospectively documented from several Swiss and German orthopaedic clinics up to 24 months postoperatively. Patient clinical examinations at 6 and 12 months will include shoulder range of motion and strength (Constant Score). Tendon repair integrity status will be assessed by ultrasound at 12 months. Patient-reported questionnaires at 6, 12 and 24 months will determine functional scores (subjective shoulder value, OSS), anxiety and depression scores, working status, sports activities, and quality of life (European Quality of Life 5 Dimensions 5 Level questionnaire). AEs will be documented according to a CES. Prognostic models will be developed using an internationally supported regression methodology. Multiple prognostic factors, including patient baseline demographics, psychological, socioeconomic and clinical factors, rotator cuff integrity, concomitant local findings, and (post)operative management factors, will be investigated.Ethics and dissemination This project contributes to the development of personalised risk predictions for supporting the surgical decision process in ARCR. The consensus CES may become an international reference for the reporting of complications in clinical studies and registries. Ethical approval was obtained on 1 April 2020 from the lead ethics committee (EKNZ, Basel, Switzerland; ID: 2019-02076). All participants will provide informed written consent before enrolment in the study.Trial registration number NCT04321005.Protocol version Version 2 (13 December 2019).

Arthroscopic repair of subscapularis tendon tears has shown to be a reliable and reproducible technique and is now considered the gold standard method over open repair. However, most arthroscopic techniques use several working portals and the procedure can be technically challenging and time-consuming, especially when knot-tying is required and when multiple anchors are used. Recently, single-portal knotless techniques have been popularized for upper-third lesions (e.g. Lafosse type 1 or 2 tears). Here, we describe a technique of repairing complete tears of the subscapularis tendon (Lafosse type 3 and 4) using knotless suture anchors through a single portal. This technique is quick and allows a safe anatomic footprint repair to the lesser tuberosity.

The Global Energy and Water cycle Exchanges (GEWEX) Data and Assessments Panel (GDAP) initiated the GEWEX Water Vapor Assessment (G-VAP), which has the main objectives to quantify the current state of the art in water vapour products being constructed for climate applications and to support the selection process of suitable water vapour products by GDAP for its production of globally consistent water and energy cycle products. During the construction of the G-VAP data archive, freely available and mature satellite and reanalysis data records with a minimum temporal coverage of 10 years were considered. The archive contains total column water vapour (TCWV) as well as specific humidity and temperature at four pressure levels (1000, 700, 500, 300 hPa) from 22 different data records. All data records were remapped to a regular longitude–latitude grid of 2° × 2°. The archive consists of four different folders: 22 TCWV data records covering the period 2003–2008, 11 TCWV data records covering the period 1988–2008, as well as 7 specific humidity and 7 temperature data records covering the period 1988–2009. The G-VAP data archive is referenced under the following digital object identifier (doi): https://doi.org/10.5676/EUM_SAF_CM/GVAP/V001. Within G-VAP, the characterization of water vapour products is, among other ways, achieved through intercomparisons of the considered data records, as a whole and grouped into three classes of predominant retrieval condition: clear-sky, cloudy-sky and all-sky. Associated results are shown using the 22 TCWV data records. The standard deviations among the 22 TCWV data records have been analysed and exhibit distinct maxima over central Africa and the tropical warm pool (in absolute terms) as well as over the poles and mountain regions (in relative terms). The variability in TCWV within each class can be large and prohibits conclusions about systematic differences in TCWV between the classes.

The Latarjet procedure is widely used to address anterior shoulder instability, especially in case of glenoid bone loss. Recently, cortical suture button fixation for coracoid transfer has been used to mitigate complications seen with screw placement. The aim of this biomechanical study was to evaluate the stability of a novel and cost-effective cow-hitch suture button technique, designed to be performed through a standard open deltopectoral approach, and compare this to a well-established double suture button technique. We randomly assigned 12 fresh frozen cadaveric shoulders to undergo the Latarjet procedure with either 4 suture button (S&N EndoButton) fixations (SB group; n = 6, age 72 ± 9.8 years) or cow-hitch suture button technique using a 1.7-mm FiberTape looped sequentially in 2 suture buttons (Arthrex Pectoralis Button) placed from anterior on the posterior glenoid (CH-SB group; n = 6, age 73 ± 9.3 years). After fixation, all shoulders underwent biomechanical testing with direct loading on the graft via a material testing system. Cyclic loading was performed for 100 cycles (10-100 N) to determine axial displacement with time; each graft was then monotonically loaded to failure. The maximum cyclic displacement was 4.3 ± 1.6 mm for the cow-hitch suture button technique and 5.0 ± 1.7 mm for the standard double suture button technique (P =.46). Ultimate load to failure and stiffness were, respectively, 190 ± 82 N and 221 ± 124 N/mm for the CH-SB technique and 172 ± 48 N and 173 ± 34 N/mm for the standard double SB technique (P =.66 and.43). The most common failure mode was suture cut-through at the anteroinferior aspect of the glenoid for both fixation groups. The cow-hitch suture button technique resulted in a similar elongation, stiffness, and failure load compared to an established double suture button technique. Therefore, this cost-effective fixation may be an alternative, eligible for open approaches, to the established double suture button techniques. [ABSTRACT FROM AUTHOR]

This paper compares the tropospheric moisture data records derived from High-resolution Infrared Radiation Sounder (HIRS) and Moderate Resolution Imaging Spectro-radiometer (MODIS) measurements from the years 2003 through 2013. Total Precipitable Water Vapor (TPW) and Upper Tropospheric Precipitable Water Vapor (UTPW) are derived using the infrared spectral bands in the CO2 and H2O absorption bands as well as in the atmospheric windows. Retrieval of TPW and UTPW uses a statistical regression algorithm performed using clear sky radiances (and Brightness Temperatures) measured over land and ocean for both day and night. The TPW and UTPW seasonal cycles of HIRS and MODIS observations are found to be in synchronization with zonal mean values for one degree latitude bands within 2.0 mm and 0.07 mm, respectively.

The Combined ASTER (Advanced Spaceborne Thermal Emission and Reflection Radiometer) MODIS (Moderate Resolution Imaging Spectroradiometer) Emissivity over Land (CAMEL) Version 2 (V002) has been available since March 2019 from the NASA LP DAAC (Land Processes Distributed Active Archive Center) and provides global, monthly infrared land surface emissivity and uncertainty at 0.05 degrees (~5 km) resolution. A climatology of the CAMEL V002 product is now available at the same spatial, temporal, and spectral resolution, covering the CAMEL record from 2000 to 2016. Characterization of the climatology over case sites and IGBP (International Geosphere-Biosphere Programme) land cover categories shows the climatology is a stable representation of the monthly CAMEL emissivity. Time series of the monthly CAMEL V002 product show realistic seasonal changes but also reveal subtle artifacts known to be from calibration and processing errors in the MODIS MxD11 emissivity. The use of the CAMEL V002 climatology mitigates many of these time dependent errors by providing an emissivity estimate which represents the complete 16-year record. The CAMEL V002 climatology’s integration into RTTOV (Radiative Transfer for TOVS) v12 is demonstrated through the simulation of IASI (Infrared Atmospheric Sounding Interferometer) radiances. Improved stability in CAMEL Version 3 is expected in the future with the incorporation of the new MxD21 and VIIRS VNP21 emissivity products in MODIS Collection 6.1.

The coordination compounds of the trivalent lanthanide ions (Ln(III)) have unique photophysical properties. Ln(III) excitation is usually performed through a light-harvesting antenna. To enable Ln(III)-based emitters to reach their full potential, an understanding of how complex structure affects sensitization and quenching processes is necessary. Here, the role of the linker between the antenna and the metal binding fragment was studied. Four macrocyclic ligands carrying coumarin 2 or 4-methoxymethylcarbostyril sensitizing antennae linked to an octadentate macrocyclic ligand binding site were synthesized. Complexation with Ln(III) (Ln = La, Sm, Eu, Gd, Tb, Yb and Lu) yielded species with overall −1, 0, or +2 and +3-charge. Paramagnetic 1H NMR spectroscopy indicated subtle differences between the coumarin- and carbostyril-carrying Eu(III) and Yb(III) complexes. Cyclic voltammetry showed that the effect of the linker on the Eu(III)/Eu(II) apparent reduction potential was dependent on the electronic properties of the N-substituent. The Eu(III), Tb(III) and Sm(III) complexes were all luminescent. Coumarin-sensitized complexes were poorly emissive; photoinduced electron transfer was not a major quenching pathway in these species. These results show that seemingly similar emitters can undergo very different photophysical processes, and highlight the crucial role the linker can play.

Category: Bunion Introduction/Purpose: In hallux valgus deformity less weight can be borne by the first ray which may lead to transfer metatarsalgia and lesser toe deformities. Depending on the exact configuration of the bone cuts during the scarf procedure, an iatrogenic shortening of the first metatarsal may occur which may diminish weightbearing ability of the first ray as well, causing transfer metatarsalgia. The aim of the present study was therefore to determine preoperative and postoperative changes in length of the first metatarsal by using different methods of measuring metatarsal length. Methods: A consecutive series of 118 feet in 106 patients (89% female, 11% male) was enrolled, who underwent correctional osteotomy (Scarf-with/without Akin-Osteotomy) from May 2015 to July 2017 at a single institution. Patients, who underwent additional shortening osteotomy of the metatarsals, were excluded. Average age at the time of surgery was 51 years (range, 14 to 83 years). Pre- and postoperative angle measurement of hallux valgus- and intermetatarsal angle was assessed at between six weeks and three months postoperatively on standardized weight-bearing radiographs in dorsoplantar plane. We also identified early complications in hallux valgus surgery. An assessment and comparison of different methods of measuring metatarsal length (length of first metatarsal, ratio first to second metatarsal, Coughlin method) postoperatively was performed to identify the amount of shortening with this technique. Results: Hallux valgus angle was statistically significant reduced by an average of 18.6° (28.3° preoperatively to 9.7° postoperatively, p < 0.001), intermetatarsal angle by 7.7° (12.8° to 5.1°, p < 0.001). Measuring the length of the first metatarsal, in all three methods a statistically significant reduction of the first metatarsal length could be detected. Mean absolute shortening of 1.8 mm was measured (p < 0.001). The ratio of the first metatarsal to the second metatarsal averaged -0.03 (p = 0.02). The mean relative lengthening of the second metatarsal, using the method described by Coughlin, was 0.42 mm (from 4.51 to 4.89 mm, p < 0.001) on average. Of those three methods, the Coughlin method showed the highest correlation. 6 minor complications were observed (5%). Conclusion: In the current study we could demonstrate a significant reduction of hallux valgus angle and intermetatarsal angle with hallux valgus correction using Scarf-/Akin-Osteotomy, with a low complication rate. However, statistically significant shortening of the first metatarsal could be detected as well. Further research is required to improve and establish a hallux valgus correction technique without shortening of the first metatarsal.