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In this study, we report the results of an active-source seismology and ground-penetrating radar survey performed in northwestern Greenland at a site where the presence of a subglacial lake beneath the accumulation area has previously been proposed. Both seismic and radar results show a flat reflector approximately 830–845 m below the surface, with a seismic reflection coefficient of −0.43 ± 0.17, which is consistent with the acoustic impedance contrast between a layer of water and glacial ice. Additionally, in the seismic data we observe an intermittent lake bottom reflection arriving between 14–20 ms after the lake top reflection, corresponding to a lake depth of approximately 10–15 m. A strong coda following the lake top and lake bottom reflections is consistent with a package of lake bottom sediments although its thickness and material properties are uncertain. Finally, we use these results to conduct a first-order assessment of the lake origins using a one-dimensional thermal model and hydropotential modeling based on published surface and bed topography. Using these analyses, we narrow the lake origin hypotheses to either anomalously high geothermal flux or hypersalinity due to local ancient evaporite. Because the origins are still unclear, this site provides an intriguing opportunity for the first in situ sampling of a subglacial lake in Greenland, which could better constrain mechanisms of subglacial lake formation, evolution, and relative importance to glacial hydrology.

Aims: People with severe, persistent low back pain (LBP) may be offered lumbar spine fusion surgery if they have had insufficient benefit from recommended non-surgical treatments. However, National Institute for Health and Care Excellence (NICE) 2016 guidelines recommended not offering spinal fusion surgery for adults with LBP, except as part of a randomized clinical trial. This survey aims to describe UK clinicians’ views about the suitability of patients for such a future trial, along with their views regarding equipoise for randomizing patients in a future clinical trial comparing lumbar spine fusion surgery to best conservative care (BCC; the FORENSIC-UK trial). Methods: An online cross-sectional survey was piloted by the multidisciplinary research team, then shared with clinical professional groups in the UK who are involved in the management of adults with severe, persistent LBP. The survey had seven sections that covered the demographic details of the clinician, five hypothetical case vignettes of patients with varying presentations, a series of questions regarding the preferred management, and whether or not each clinician would be willing to recruit the example patients into future clinical trials. Results: There were 72 respondents, with a response rate of 9.0%. They comprised 39 orthopaedic spine surgeons, 17 neurosurgeons, one pain specialist, and 15 allied health professionals. Most respondents (n = 61,84.7%) chose conservative care as their first-choice management option for all five case vignettes. Over 50% of respondents reported willingness to randomize three of the five cases to either surgery or BCC, indicating a willingness to participate in the future randomized trial. From the respondents, transforaminal interbody fusion was the preferred approach for spinal fusion (n = 19, 36.4%), and the preferred method of BCC was a combined programme of physical and psychological therapy (n = 35, 48.5%). Conclusion: This survey demonstrates that there is uncertainty about the role of lumbar spine fusion surgery and BCC for a range of example patients with severe, persistent LBP in the UK. Cite this article: Bone Jt Open 2024;5(7):612–620.

Aims: The purpose of this survey study was to examine the demographic and lifestyle factors of women currently in orthopaedic surgery. Methods: An electronic survey was conducted of practising female orthopaedic surgeons based in the USA through both the Ruth Jackson Society and the online Facebook group “Women of Orthopaedics”. Results: The majority of surveyed female orthopaedic surgeons reported being married (76.4%; 285/373) and having children (67.6%; 252/373). In all, 66.5% (247/373) were collegiate athletes; 82.0% (306/373) reported having no female orthopaedic surgeon mentors in undergraduate and medical school. Their mean height is 65.8 inches and average weight is 147.3 lbs. Conclusion: The majority of female orthopaedic surgeons did not have female mentorship during their training. Additionally, biometrically, their build is similar to that of the average American woman. Cite this article: Bone Jt Open 2024;5(5):419–425.

Abstract In Josephson diodes the asymmetry between positive and negative current branch of the current-phase relation leads to a polarity-dependent critical current and Josephson inductance. The supercurrent nonreciprocity can be described as a consequence of the anomalous Josephson effect —a φ 0-shift of the current-phase relation— in multichannel ballistic junctions with strong spin-orbit interaction. In this work, we simultaneously investigate φ 0-shift and supercurrent diode efficiency on the same Josephson junction by means of a superconducting quantum interferometer. By electrostatic gating, we reveal a direct link between φ 0-shift and diode effect. Our findings show that spin-orbit interaction in combination with a Zeeman field plays an important role in determining the magnetochiral anisotropy and the supercurrent diode effect.

Pangolins are the most trafficked mammals in the world and are severely threatened by poaching the loss, degradation, and fragmentation of habitat. In Malaysian Borneo, conservation initiatives for the Sunda pangolin (Manis javanica) are hindered by a paucity of data on their distribution and population size. Using MaxEnt niche modelling and consolidated species location data, we projected the distribution of Sunda pangolins in Sabah. Additionally, we assessed the accessibility of their forest habitats to humans to understand potential threats. Our model indicated that, as of 2015, approximately half of Sabah’s land area (39,530 km²) is suitable for pangolins, with 43% in protected forests, 38% in production forests, and 19% outside of these areas. Alarmingly, our data suggest that nearly all (91%) of these suitable habitats are relatively easily accessible to poachers. Our findings provide a state-level baseline understanding of Sunda pangolin distribution and assess potential threats in Sabah. These can inform short- and long-term conservation management plans for pangolin to safeguard this critically endangered species.

Objectives An estimated 14–23% of patients with traumatic brain injury (TBI) incur multiple lifetime TBIs. The relationship between prior TBI and outcomes in patients with moderate to severe TBI (msTBI) is not well delineated. We examined the associations between prior TBI, in-hospital mortality, and outcomes up to 12 months after injury in a prospective US msTBI cohort.Methods Data from hospitalized subjects with Glasgow Coma Scale score of 3–12 were extracted from the Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study (enrollment period: 2014–2019). Prior TBI with amnesia or alteration of consciousness was assessed using the Ohio State University TBI Identification Method. Competing risk regressions adjusting for age, sex, psychiatric history, cranial injury and extracranial injury severity examined the associations between prior TBI and in-hospital mortality, with hospital discharged alive as the competing risk. Adjusted HRs (aHR (95% CI)) were reported. Multivariable logistic regressions assessed the associations between prior TBI, mortality, and unfavorable outcome (Glasgow Outcome Scale-Extended score 1–3 (vs. 4–8)) at 3, 6, and 12 months after injury.Results Of 405 acute msTBI subjects, 21.5% had prior TBI, which was associated with male sex (87.4% vs. 77.0%, p=0.037) and psychiatric history (34.5% vs. 20.7%, p=0.010). In-hospital mortality was 10.1% (prior TBI: 17.2%, no prior TBI: 8.2%, p=0.025). Competing risk regressions indicated that prior TBI was associated with likelihood of in-hospital mortality (aHR=2.06 (1.01–4.22)), but not with hospital discharged alive. Prior TBI was not associated with mortality or unfavorable outcomes at 3, 6, and 12 months.Conclusions After acute msTBI, prior TBI history is independently associated with in-hospital mortality but not with mortality or unfavorable outcomes within 12 months after injury. This selective association underscores the importance of collecting standardized prior TBI history data early after acute hospitalization to inform risk stratification. Prospective validation studies are needed.Level of evidence IV.Trial registration number NCT02119182.

Abstract Optimal control of qubits requires the ability to adapt continuously to their ever-changing environment. We demonstrate a real-time control protocol for a two-electron singlet-triplet qubit with two fluctuating Hamiltonian parameters. Our approach leverages single-shot readout classification and dynamic waveform generation, allowing full Hamiltonian estimation to dynamically stabilize and optimize the qubit performance. Powered by a field-programmable gate array (FPGA), the quantum control electronics estimates the Overhauser field gradient between the two electrons in real time, enabling controlled Overhauser-driven spin rotations and thus bypassing the need for micromagnets or nuclear polarization protocols. It also estimates the exchange interaction between the two electrons and adjusts their detuning, resulting in extended coherence of Hadamard rotations when correcting for fluctuations of both qubit axes. Our study highlights the role of feedback in enhancing the performance and stability of quantum devices affected by quasistatic noise.

Background: While the importance of structured rehabilitation following anterior cruciate ligament reconstruction (ACLR), particularly in the return-to-sport phase, is known, for most patients, supervised physical therapy is often completed before this time point. The recent emergence of telerehabilitation and other digital health interventions has the potential to address this ?rehabilitation gap.? Methods: The study was conducted as a cross-section, online survey collecting qualitative and quantitative data from open and closed questions. Inclusion criteria included local qualified physical therapists or other professionals working with ACLR patients. Results: Eighty-three percent of respondents experienced a ?rehabilitation gap? with their ACLR patients. Few reported currently utilizing apps or websites (9.74%). The majority (41/58) reported experience with telerehabilitation, and 84% felt that there was a role for digital rehabilitation strategies to address the ?rehabilitation gap.? The vast majority (94.74%) of participants felt that standard commercial insurance did not permit sufficient rehabilitation. Discussion: While the majority of our respondents acknowledged the existence of a ?rehabilitation gap,? as well as familiarity with and confidence in telerehabilitation, few were using this technique at the time of our survey. This suggests an opportunity for development in this space.

Abstract The Josephson junction (JJ) is an essential element of superconducting (SC) devices for both fundamental and applied physics. The short-range coherent coupling of two adjacent JJs forms Andreev molecule states (AMSs), which provide a new ingredient to engineer exotic SC phenomena such as topological SC states and Andreev qubits. Here we provide tunneling spectroscopy measurements on a device consisting of two electrically controllable planar JJs sharing a single SC electrode. We discover that Andreev spectra in the coupled JJ are highly modulated from those in the single JJs and possess phase-dependent AMS features reproduced in our numerical calculation. Notably, the SC gap closing due to the AMS formation is experimentally observed. Our results help in understanding SC transport derived from the AMS and promoting the use of AMS physics to engineer topological SC states and quantum information devices.

Abstract The ongoing evolution of SARS-CoV-2 into more easily transmissible and infectious variants has provided unprecedented insight into mutations enabling immune escape. Understanding how these mutations affect the dynamics of antibody-antigen interactions is crucial to the development of broadly protective antibodies and vaccines. Here we report the characterization of a potent neutralizing antibody (N3-1) identified from a COVID-19 patient during the first disease wave. Cryogenic electron microscopy revealed a quaternary binding mode that enables direct interactions with all three receptor-binding domains of the spike protein trimer, resulting in extraordinary avidity and potent neutralization of all major variants of concern until the emergence of Omicron. Structure-based rational design of N3-1 mutants improved binding to all Omicron variants but only partially restored neutralization of the conformationally distinct Omicron BA.1. This study provides new insights into immune evasion through changes in spike protein dynamics and highlights considerations for future conformationally biased multivalent vaccine designs.

In a medium energy proton synchrotron, strong enough partial Siberian snakes can be used to avoid both imperfection and vertical intrinsic depolarizing resonances. However, partial snakes tilt the stable spin direction away from vertical, which generates depolarizing resonances associated with horizontal tune. The relatively weak but numerous horizontal intrinsic resonances are the main source of the residual polarization losses. A pair of horizontal tune jump quads have been used in the Brookhaven Alternating Gradient Synchrotron to overcome these weak resonances. The locations of the two quads have to be chosen such that the disturbance to the beam optics is minimum. The emittance growth has to be mitigated for this method to work. In addition, this technique needs very accurate jump timing. Using two partial Siberian snakes, with vertical tune inside the spin tune gap and 80% polarization at the Alternating Gradient Synchrotron injection, polarized proton beam had reached 1.5×10^{11} proton per bunch with 65% polarization. With the tune jump timing optimized and emittance preserved, more than 70% polarization with 2×10^{11} protons per bunch has been achieved. The polarization transport efficiency is close to 90%.

Electrospinning is a widely employed manufacturing platform for tissue engineering applications because it produces structures that closely mimic the extracellular matrix. Herein, we demonstrate the potential of poly(vinyl alcohol) (PVA) electrospun nanofibers as scaffolds for tissue engineering. Nanofibers were created by needleless direct current electrospinning from PVA with two different degrees of hydrolysis (DH), namely 98% and 99% and subsequently heat treated at 180 °C for up to 16 h to render them insoluble in aqueous environments without the use of toxic cross-linking agents. Despite the small differences in the PVA chemical structure, the changes in the material properties were substantial. The higher degree of hydrolysis resulted in non-woven supports with thinner fibres (285 ± 81 nm c.f. 399 ± 153 nm) that were mechanically stronger by 62% (±11%) and almost twice as more crystalline than those from 98% hydrolysed PVA. Although prolonged heat treatment (16 h) did not influence fibre morphology, it reduced the crystallinity and tensile strength for both sets of materials. All samples demonstrated a lack or very low degree of haemolysis (

Abstract Objective: This comprehensive literature scoping review outlines available infection prevention and control (IPC) methods for viral-mediated gene therapies and provides one IPC strategy for the healthcare setting based on a single-center recommendation. Methods: A team of experts in pharmacy, healthcare epidemiology, and biosafety with experience in viral-mediated gene therapy was assembled within a pediatric hospital to conduct a comprehensive literature scoping review. The comprehensive review included abstracts and full-text articles published since 2009 and utilized prespecified search terms of the five viral vectors of interest: adenovirus (AV), retrovirus (RV), adeno-associated virus (AAV), lentivirus (LV), and herpes simplex virus (HSV). Case reports, randomized controlled trials, and bench research studies were all included, while systematic reviews were excluded. Results: A total of 4473 case reports, randomized control trials, and benchtop research studies were identified using the defined search criteria. Chlorine compounds were found to inactivate AAV and AV, while alcohol-based disinfectants were ineffective. There was a relative paucity of studies investigating surface-based disinfection for HSV, however, alcohol-based disinfectants were effective in one study. Ultraviolent irradiation was also found to inactivate HSV in numerous studies. No studies investigated disinfection for LV and RV vectors. Conclusions: The need to define IPC methods is high due to the rapid emergence of viral-mediated gene therapies to treat rare diseases, but published clinical guidance remains scarce. In the absence of these data, our center recommends a 1:10 sodium hypochlorite solution in clinical and academic environments to ensure complete germicidal activity of viral-mediated gene therapies.

The relationship between systemic inflammation and secondary injury in traumatic brain injury (TBI) is complex. We investigated associations between inflammatory markers and clinical confirmation of TBI diagnosis and prognosis. The prospective TRACK-TBI Pilot (Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot) study enrolled TBI patients triaged to head computed tomography (CT) and received blood draw within 24?h of injury. Healthy controls (HCs) and orthopedic controls (OCs) were included. Thirty-one inflammatory markers were analyzed from plasma. Area under the receiver operating characteristic curve (AUC) was used to evaluate discriminatory ability. AUC >0.7 was considered acceptable. Criteria included: TBI diagnosis (vs. OC/HC); moderate/severe vs. mild TBI (Glasgow Coma Scale; GCS); radiographic TBI (CT positive vs. CT negative); 3- and 6-month Glasgow Outcome Scale-Extended (GOSE) dichotomized to death/greater relative disability versus less relative disability (GOSE 1?4/5?8); and incomplete versus full recovery (GOSE

The four electron stripping stages leading to fully stripped gold ions in the Relativistic Heavy Ion Collider (RHIC) are briefly described. The third stripper, which removes 46 electrons from the Au^{31+} ions leading to heliumlike Au^{77+}, offers the greatest challenges in terms of energy loss and induced energy spread. These problems are described in detail as well as recent advances in the design and performance of this stripper. Measurements performed with several carbon and aluminum strippers show general agreement with a semiempirical model but small systematic deviations suggest that some model adjustments may be in order. The best performance is predicted and obtained with a combined carbon-aluminum foil system. Measurements showing the enhanced performance in the alternating gradient synchrotron are described. The stripper that removes the last two electrons has also been improved and the results of relevant calculations and measurements are presented.

Two partial Siberian snakes were used to avoid all the spin imperfection and vertical intrinsic resonances in the alternating gradient synchrotron (AGS) at Brookhaven National Laboratory. However, the horizontal betatron motion can cause polarization loss resulting from the nonvertical stable spin direction in the presence of two partial snakes. This type of resonance, called a horizontal intrinsic spin resonance, was observed and systematically studied in the AGS. A simplified analytic model and numerical simulation have been developed to compare with experimental data. Properties of the horizontal intrinsic resonance are discussed.

Yeast expression of human G-protein-coupled receptors (GPCRs) can be used as a biosensor platform for the detection of pharmaceuticals. Cannabinoid receptor type 1 (CB1R) is of particular interest, given the cornucopia of natural and synthetic cannabinoids being explored as therapeutics. We show for the first time that engineering the N-terminus of CB1R allows for efficient signal transduction in yeast, and that engineering the sterol composition of the yeast membrane modulates its performance. Using an engineered cannabinoid biosensor, we demonstrate that large libraries of synthetic cannabinoids and terpenes can be quickly screened to elucidate known and novel structure–activity relationships. The biosensor strains offer a ready platform for evaluating the activity of new synthetic cannabinoids, monitoring drugs of abuse, and developing therapeutic molecules.

This paper summarizes the low-loss design for the Spallation Neutron Source accumulator ring [“Spallation Neutron Source Design Manual” (unpublished)]. A hybrid lattice consisting of FODO arcs and doublet straights provides optimum matching and flexibility for injection and collimation. For this lattice, optimization focuses on six design goals: a space-charge tune shift low enough (below 0.15) to avoid strong resonances, adequate transverse and momentum acceptance for efficient beam collimation, injection optimized for desired target beam shape and minimal halo development, compensation of magnet field errors, control of impedance and instability, and prevention against accidental system malfunction. With an expected collimation efficiency of more than 90%, the uncontrolled fractional beam loss is expected to be at the 10^{-4} level.

Case. We report an 11-year-old male who sustained a lesser tuberosity avulsion fracture of the proximal humerus upon making contact with a baseball during an at-bat. This injury was neglected for 14 months and was eventually detected by an axillary radiograph and subsequent MRI. He successfully underwent an open surgical repair and regained full range of motion and level of activity at 1-year follow-up. Conclusion. In pediatric baseball players, lesser tuberosity avulsion fractures may occur upon striking a baseball with a bat. Even after being neglected for several months, these injuries can be treated successfully with an open surgical repair.

We use a superconducting microresonator as a cavity to sense absorption of microwaves by a superconducting quantum point contact defined by surface gates over a proximitized two-dimensional electron gas. Renormalization of the cavity frequency with phase difference across the point contact is consistent with coupling to Andreev bound states. Near π phase difference, we observe random fluctuations in absorption with gate voltage, related to quantum interference-induced modulations in the electron transmission. Close to pinch-off, we identify features consistent with the presence of a single Andreev bound state and describe the Andreev-cavity interaction using a Jaynes-Cummings model. By fitting the weak Andreev-cavity coupling, we extract ∼GHz decoherence consistent with charge noise and the transmission dispersion associated with a localized state.

This nonrandomized pilot study utilized the health belief model and the theory of planned behavior to assess the effectiveness of perceived behavioral control to determine the impact of a micronutrient-dense plant-rich (mNDPR) dietary intervention on employee health and wellness at the worksite. Seventy-one employees and/or spouses (≥18 years) who met the inclusion criteria were recruited from a regional medical center and a local university. Participants were provided more than 14 hours of in-person lecture combined with take-home materials, and electronic resources to support participants in their transition and adherence to the dietary plan. The study consisted of a 6-hour introductory session followed by weekly 1-hour meetings for 7 consecutive weeks and then monthly 1-hour meetings, for 4 consecutive months over the span of 6 months. Retention of participants was approximately 55 percent. Participants were assessed for measures of weight, waist circumference, and blood pressure; physiological measures of blood cholesterol, triglycerides, blood glucose, and hemoglobin A1c; and well-being measures of gastroesophageal reflux disease, depression, sleep, pain, and worksite productivity, pre-, mid-, and post-intervention. A significant reduction was seen in weight (F(2, 78) = 19.81, p