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This paper presents a multidisciplinary design methodology for a single-stage radial compressor of a small-scale gas turbine jet engine. The entire engine, producing more than 600 N thrust with an engine diameter of less than 30 cm, will be manufactured by additive manufacturing (AM) in a single piece. Therefore, it is crucial to pinpoint the design limitations that may arise due to the AM methods. The preliminary design calculations are carried out in the Von Karman Institute for Fluid Dynamics (VKI's) in-house centrifugal compressor off-design (CCOD) code. The detailed design and optimization studies coupled with computational fluid dynamics (CFD) simulations are performed to improve the aerodynamic performance of the radial compressor by using the sequential quadratic programming (SQP) method with an Adjoint solver in the VKI's in-house computer aided design and optimization (CADO) tool. In the final design, a large increase in thrust is obtained and the manufacturing constraints are satisfied. [ABSTRACT FROM AUTHOR]

Background and Aims This study aimed to identify microbial drivers of inflammatory bowel disease [IBD], by investigating mucosal-associated bacteria and their detrimental products in IBD patients. Methods We directly cultured bacterial communities from mucosal biopsies from paediatric gastrointestinal patients and examined for pathogenicity-associated traits. Upon identifying Clostridium perfringens as toxigenic bacteria present in mucosal biopsies, we isolated strains and further characterized toxicity and prevalence. Results Mucosal biopsy microbial composition differed from corresponding stool samples. C. perfringens was present in eight of nine patients' mucosal biopsies, correlating with haemolytic activity, but was not present in all corresponding stool samples. Large IBD datasets showed higher C. perfringens prevalence in stool samples of IBD adults [18.7–27.1%] versus healthy controls [5.1%]. In vitro , C. perfringens supernatants were toxic to cell types beneath the intestinal epithelial barrier, including endothelial cells, neuroblasts, and neutrophils, while the impact on epithelial cells was less pronounced, suggesting C. perfringens may be particularly damaging when barrier integrity is compromised. Further characterization using purified toxins and genetic insertion mutants confirmed perfringolysin O [PFO] toxin was sufficient for toxicity. Toxin RNA signatures were found in the original patient biopsies by PCR, suggesting intestinal production. C. perfringens supernatants also induced activation of neuroblast and dorsal root ganglion neurons in vitro , suggesting C. perfringens in inflamed mucosal tissue may directly contribute to abdominal pain, a frequent IBD symptom. Conclusions Gastrointestinal carriage of certain toxigenic C. perfringens may have an important pathogenic impact on IBD patients. These findings support routine monitoring of C. perfringens and PFO toxins and potential treatment in patients. [ABSTRACT FROM AUTHOR]

Skulls from 305 red foxes (Vulpes vulpes) were examined using predefined criteria to assess for the presence and severity of dental and temporomandibular joint (TMJ) pathology. Of the 305 specimens examined, 131 were male (42.9%), 103 were female (33.4%), 71 were of unknown sex (23.3%), 238 were adults (78.03%) and 67 were young adults (21.97%), with juveniles excluded from the study. Of a maximum of 12,810 possible teeth, 12,355 (96.5%) were present for examination, 72 (0.6%) were absent congenitally, 97 (0.8%) were acquired tooth loss and 280 (2.2%) were absent artefactually. Eight teeth (0.06%) in five specimens (1.6%) had abnormal tooth form and four (0.03%) supernumerary teeth were present across four (1.3%) specimens. Ten persistent deciduous teeth were present in seven (2.3%) specimens and six (0.05%) unerupted teeth were found in four (1.1%) specimens. Root number variation was present in 51 (0.4%) teeth, predominantly premolar teeth. Twenty-one (6.9%) specimens had lesions consistent with enamel hypoplasia and 42 (13.8%) showed root fenestrations in the maxillary alveolar bone. Periodontitis and attrition/abrasion were present in most specimens (56.7% and 96.1%, respectively). Three-hundred and eighty (3.1%) teeth were fractured, with the most common fracture type being root fractures. Eleven periapical lesions were found in nine (0.03%) specimens. Six-hundred and eight TMJs were evaluated and many specimens (11.5%) had evidence of low-grade TMJ osteoarthritis. Overall, these red foxes share similar dental pathology to other foxes, but had a higher prevalence of congenital tooth absence, persistent deciduous teeth, TMJ pathology and enamel hypoplasia. [ABSTRACT FROM AUTHOR]

In the 1870s, the Illinois state legislature passed a series of increasingly restrictive laws regarding the promotion and sale of drugs that could induce abortion. The laws limited what could be advertised, what could be sold, and if drugs could be marketed to specifically female consumers. Designed to inhibit access to everything from traditional botanical remedies to pharmaceutical blends, the laws extended beyond the typical prescriptions and patent medicines to include all possible types of preparations. Despite the Comstock Act and Illinois's requirements, pharmacies and mail-order catalogs continued to distribute contraceptive and abortifacient products to the public across the state of Illinois. I use Dodd's Drugstore and the Hofferkamp family in Springfield, Illinois, as a case study to explore how drugstores and consumers may have complied with and subverted these restrictive laws in the late nineteenth century. The Hofferkamps frequented Dodd's Drugstore, leaving an archaeological signature of chronic pain and archival records of disability. Artifacts uncovered at the Hofferkamp home site indicate that the family may have engaged in family planning with products obtained from Dodd's Drugstore. By combining newspaper advertisements, archaeological artifacts, spatial analysis, and public records, I discuss how pharmacies dispensed these restricted remedies to patients and customers who sought the preparations despite obstructive regulations and societal perceptions. [ABSTRACT FROM AUTHOR]

In the 1870s, the Illinois state legislature passed a series of increasingly restrictive laws regarding the promotion and sale of drugs that could induce abortion. The laws limited what could be advertised, what could be sold, and if drugs could be marketed to specifically female consumers. Designed to inhibit access to everything from traditional botanical remedies to pharmaceutical blends, the laws extended beyond the typical prescriptions and patent medicines to include all possible types of preparations. Despite the Comstock Act and Illinois's requirements, pharmacies and mail-order catalogs continued to distribute contraceptive and abortifacient products to the public across the state of Illinois. I use Dodd's Drugstore and the Hofferkamp family in Springfield, Illinois, as a case study to explore how drugstores and consumers may have complied with and subverted these restrictive laws in the late nineteenth century. The Hofferkamps frequented Dodd's Drugstore, leaving an archaeological signature of chronic pain and archival records of disability. Artifacts uncovered at the Hofferkamp home site indicate that the family may have engaged in family planning with products obtained from Dodd's Drugstore. By combining newspaper advertisements, archaeological artifacts, spatial analysis, and public records, I discuss how pharmacies dispensed these restricted remedies to patients and customers who sought the preparations despite obstructive regulations and societal perceptions. [ABSTRACT FROM AUTHOR]

The EuroQol Group is exploring the development of a health-related quality of life measure for toddlers and infant populations (EuroQoL Toddler and Infant Populations [EQ-TIPS]) aged 0 to 36 months. This study aimed to report on the cross-cultural adaptation and validity of the South African Afrikaans EQ-TIPS. The development of the Afrikaans EQ-TIPS followed the EuroQol guidelines including forward-backward translation and cognitive interviews with 10 caregivers of children aged 0 to 36 months. Thereafter, 162 caregivers of children 0 to 36 months of age were recruited from a pediatric hospital inpatient and outpatient facility. The EQ-TIPS; Ages and Stages Questionnaire; face, legs, activity, cry, and consolability; and dietary information were completed by all caregivers. The distribution of dimension scores, Spearman's correlation, analysis of variance, and regression analysis were used to explore the validity of the EQ-TIPS. The descriptive system of the EQ-TIPS was generally well understood and accepted by caregivers. The correlation coefficients for concurrent validity were significant and moderate for pain and weak and significant for the other dimensions hypothesized to correlate. Known groups were compared and inpatients had a significantly higher report of pain (χ2 = 7.47, P =.024) and more problems reported across all EQ-TIPS dimensions (recorded on the level sum score) (Kruskal Wallis H = 3.809, P =.05) and reported significantly worse health on the visual analog scale (Kruskal Wallis H = 15.387, P <.001). There were no age-related differences except for a lower report of problems with movement in the 0- to 12-month group (χ2 = 10.57, P =.032). The Afrikaans version of the EQ-TIPS is well understood and accepted by caregivers and valid for use with children aged 0 to 36 months in South Africa. • Measuring and valuing health-related quality of life in children younger than 5 years have gained interest in recent years resulting in the development of a number of new measures including the EuroQoL Toddler and Infant Populations (EQ-TIPS) for children 0 to 36 months. • These results suggest that the Afrikaans version of the EQ-TIPS is a valid measure for toddlers and infants with a health condition in the South African context. • Further research is needed on the EQ-TIPS to establish the acceptability and psychometric properties from a global context and within diverse disease groups. [ABSTRACT FROM AUTHOR]

• Moxifloxacin daily doses of 2400 mg were tolerated over several months. • M. tuberculosis drug resistance could be overcome by a high-dose treatment regimen. • No occurrence of cardiac AEs despite high doses of QTc interval prolonging drugs. • No eradication of M. tuberculosis despite longstanding culture conversion. • Development of pretomanid resistance on an insufficient treatment regimen. [ABSTRACT FROM AUTHOR]

Personal data is an essential concept for information privacy law. Privacy's boundaries are set by personal data: for a privacy violation to occur, personal data must be involved. Furthermore, an individual's right to control information extends only to personal data. However, current theorizing about personal data is woefully incomplete. In light of this incompleteness, this Article offers a new conceptual approach to personal data. To start, this Article argues that personal data is simply a legal construct that describes the set of information that an individual should be able to control, or circumstances where an individual should be able to exercise such control. After displacing the mythology about the naturalness of personal data, this Article fashions a new theory of personal data that more adequately tracks when a person should be able to control specific information. Current approaches to personal data rightly examine the relationship between a person and information; however, they misunderstand what relationship is necessary for legitimate control interests. Against the conventional view, this Article suggests that how the information is used is an indispensable part of the analysis of the relationship between a person and data that determines whether the data should be considered personal. In doing so, it employs the philosophical concept of separability as a method for making determinations about which uses of information are connected to a person and, therefore, should trigger individual privacy protections, and which are not. This framework offers a superior foundation to extant theories for capturing the existence and scope of individual interests in data. By doing so, it provides an indispensable contribution for crafting an ideal regime of information governance. Separability enables privacy and data protection laws to better identify when a person's interests are at stake. And further, separability offers a resilient normative foundation for personal data that grounds control interests in a philosophical foundation of autonomy and dignity values -- which are incorrectly calibrated in existing theories of personal data. Finally, this Article's reimagination of personal data will allow privacy and data protection laws to more effectively combat modern privacy harms such as manipulation and inferences. [ABSTRACT FROM AUTHOR]

Museum skull specimens from 224 Arctic foxes (Vulpes lagopus) were examined macroscopically using an established protocol for examination of mammalian skull specimens. Foxes were collected from coastal and island regions of Alaska, USA, except for two individuals. Collection years ranged from 1931 to 2016 with most specimens collected during the 1950s and 1960s. The study population comprised more females (n = 134, 59.8%) than males (n = 83, 37.0%) and individuals of unknown sex (n = 7, 3.1%). There were 108 (48.2%) young adults, 115 (51.3%) adults, and one (0.4%) individual of unknown age. A total of 8,891 teeth (94.5%) were available for examination. The most common types of pathology observed were periodontitis (n = 222, 99.1%), dental fractures (n = 175, 78.1%) and attrition/abrasion (n = 198, 88.4%). Periapical lesions (n = 12, 5.3%), temporomandibular joint (TMJ) osteoarthritis (n = 3, 1.3%) and root number variation (n = 5, 2.2%) were less common. Enamel hypoplasia was noted in eight foxes (3.6%), all of which were discovered on St. Matthew Island, Alaska, in 1963. As in other canid species, periodontitis, attrition/abrasion and tooth fractures are common in the Arctic fox, while TMJ pathology is rare. Loss of tooth crown substance probably reflects the influence of diet, interspecific and conspecific aggression and oral trauma due to trapping and hunting methods. The high prevalence of periodontitis is probably also due to the combined effects of diet, genetics and host immune reaction to oral bacteria. [ABSTRACT FROM AUTHOR]

Museum skull specimens from 318 island foxes (Urocyon littoralis) were examined macroscopically according to predefined criteria. The study population included males (n = 129, 40.6%), females (n = 93, 29.3%) and animals of unknown sex (n = 96, 30.2%), and comprised 182 (57.2%) adults, 118 (37.1%) young adults and 18 (5.7%) individuals of unknown age, with juveniles and neonates excluded. The number of teeth present for examination was 11,438 (85.6%) with 1918 (14.4%) absent artefactually, 4 (0.03%) absent congenitally and 243 (1.82%) lost ante mortem through acquired tooth loss. There were seven persistent deciduous teeth (0.05%) in three specimens and 11 supernumerary teeth (0.08%) in 10 specimens. Teeth with extra roots were found in 38 skulls (11.9%) with 0.48% of all teeth affected. Two (0.63%) specimens had one tooth with an abnormal form. Fifty-eight (18.2%) specimens had bone fenestrations. Of the alveoli examined, 5361 (46.9%) displayed bony changes suggestive of periodontitis, with 315 (99.1%) of skulls affected. Of the teeth available for examination in 310 specimens (97.5%), most (n = 6,040, 52.8%) had some degree of attrition or abrasion. Fractures affected 1217 (11.0%) of the teeth present in 266 specimens (83.6%). Twenty-three periapical lesions (0.20%) were present in 16 skulls (5.03%). Evidence of temporomandibular joint osteoarthritis was found in seven specimens (0.02%) on either the mandibular head of the condylar process or on the mandibular fossa of the temporal bone. [ABSTRACT FROM AUTHOR]

Skulls from 112 Steller sea lions (Eumetopias jubatus) were examined according to predefined criteria. Of the specimens, 73 (65.2%) were from males, 29 (25.9%) from females and 10 (8.9%) were of unknown sex, with 50 adults (44.6%), 61 young adults (54.5%) and one of unknown age (0.9%). The number of teeth evaluated was 3,521. Adults had more acquired tooth loss than young adults (P <0.0001). A total of 1,660 teeth (47.1%) from 111 specimens (99.1%) had evidence of attrition or abrasion. Adults displayed more attrition or abrasion than young adults (P <0.0001). A total of 241 teeth (6.8%) from 47 specimens (42%) had tooth fractures. Adults had more fractured teeth than young adults (P <0.0001). Bony changes consistent with periodontitis affected 36.7% of teeth. Adults had more teeth affected by periodontitis than young adults (P <0.0001). Temporomandibular joint osteoarthritis lesions were found in 54 specimens (48.2%) with more in adults than in young adults (P <0.0001). Although the significance of our findings is unknown, the occurrence and severity of these lesions may play an important role in the morbidity and mortality of Steller sea lions. [ABSTRACT FROM AUTHOR]

This study aimed to compare the performance of the EQ-5D-Y 3-level version (Y-3L) and the expanded 5-level version, the EQ-5D-Y 5-level version (Y-5L). Children or adolescents with an acute or chronic health condition and from the general population completed the Y-5L and Y-3L self-report questionnaires. The performance of the Y-5L and Y-3L was determined by comparing feasibility, redistribution of dimension responses, discriminatory power, validity, and test-retest reliability. A total of 550 children/adolescents completed baseline measures and 173 completed repeat measures. The ceiling effect decreased by 15% from the Y-3L to Y-5L. Informativity of dimensions improved by 0.094 on the Y-5L. There was a range of 4% to 9% inconsistent responses moving from the Y-3L to Y-5L. Convergent validity of the visual analog scale and Y-3L and Y-5L dimensions was similar and weak to moderate (r s range 0.18-0.38) but similar and strong on paired Y-3L and Y-5L dimensions: Kendall tau B (range 0.69-0.80) and gamma (range 0.92-0.98). The Y-5L and Y-3L showed moderate to substantial agreement for test-retest reliability across dimensions and visual analog scale scores in stable chronic health conditions and fair agreement for the general population. The Y-5L is a valid, reliable extension of the Y-3L for children or adolescents across health conditions and healthy children/adolescents. The expanded levels reduced the ceiling effect. The relative informativity of report across dimensions increased on the Y-5L compared with the Y-3L with retention of the evenness of reporting. The convergent validity and test-retest reliability of the Y-5L was comparable with the Y-3L. • The EQ-5D-Y 3-level version has been used extensively as a health-related quality of life outcome measure in clinical research in children or adolescents. • Very few existing studies have compared the use of the 3-level version with the newly developed EQ-5D-Y 5-level in the clinical pediatric population. • The results of this current research indicate that the newly expanded 5-level version is valid and reliable across health conditions and in healthy children. The ceiling effect is reduced and the relative informativity of report across the dimensions is increased, with increased discriminatory power, resulting in improved sensitivity. [ABSTRACT FROM AUTHOR]

Examination of newspaper ads and store records of available products combined with data generated from the archaeological record provide insight into how individuals and communities kept pace with national and global trends in medicine and advertising. Decades of archaeological investigation in Springfield, Illinois, by Fever River Research have yielded a rich data set that provides diverse insights into the community. The goal of this case study is to apply a commodity access model to the Springfield, Illinois, data to examine the accuracy of modern researchers' ideas about the impact of market access on consumer choice. The combination of archaeological artifacts and archival data forms a compelling picture of a community that took advantage of unprecedented access to medicine and commodities during the rise of America's Gilded Age. In contrast to the original results of the commodity model, the results of this analysis indicate that the expansion of trade networks and interaction spheres may not have been the critical factor in consumer choice. Instead, social structures on a local level—between neighborhoods, competing stores, and the consumer—become more important in areas with diverse product access. [ABSTRACT FROM AUTHOR]

Fake news presents a complex regulatory challenge in the increasingly democratized and intermediated on-line information ecosystem. Inaccurate information is readily created by actors with varying goals, rapidly distributed by platforms motivated more by financial incentives than by journalistic norms or the public interest, and eagerly consumed by users who wish to reinforce existing beliefs. Yet even as awareness of the problem grew after the 2016 U.S. presidential election, the meaning of the term "fake news" has become increasingly disputed and diffused. This Article first addresses that definitional challenge, offering a useful taxonomy that classifies species of fake news based on two variables: their creators' motivation and intent to deceive. In particular, it differentiates four key categories of fake news: satire, hoax, propaganda, and trolling. This analytical framework can provide greater rigor to debates over the issue. Next, the Article identifies key structural problems that make each type of fake news difficult to address, albeit for different reasons. These include the ease with which authors can produce usergenerated content online and the financial stakes that platforms have in highlighting and disseminating that material. Authors often have a mixture of motives in creating content, making it less likely that a single solution will be effective. Consumers of fake news have limited incentives to invest in challenging or verifying its content, particularly when the material reinforces their existing beliefs and perspectives. Finally, fake news rarely appears alone: it is frequently mingled with more accurate stories, such that it becomes harder to categorically reject a source as irredeemably flawed. Then, the Article classifies existing and proposed interventions based upon the four regulatory modalities catalogued by Larry Lessig: law, architecture (code), social norms, and markets. It assesses the potential and shortcomings of extant solutions. Finally--and perhaps most importantly--the Article offers a set of model interventions, classified under the four regulatory modalities, that can reduce the harmful effects of fake news while protecting interests such as free expression, open debate, and cultural creativity. It closes by assessing these proposed interventions based upon data from the 2020 election cycle. [ABSTRACT FROM AUTHOR]

The effect of improper tension in reverse total shoulder arthroplasty (RTSA) can cause both joint looseness potentially leading to instability and dislocation and joint tightness potentially leading to limited joint motion and acromial or scapular spine stress fractures. Intra-articular load sensors offer an innovative technology providing information on real-time joint load parameters. The objective of this study is to evaluate a novel load sensor in a cadaveric RTSA model, to measure joint loads in shoulder positions required for activities of daily living (ADLs), with and without subscapularis repair. Our hypothesis is that an in situ joint load sensor can reliably measure the magnitude of joint load, and that subscapularis repair both increases joint load magnitude and improves the concentricity of the articulation at end range motion. Nine freshly frozen full body cadaver shoulders were selected for this study. All shoulders were implanted with RTSA implants with the humeral insert incorporating a wireless load measuring sensor. Three ADL postures ("across chest", "behind back", and "overhead reach") were each evaluated 5 times by a single observer that was blinded to the real time loads displayed by the sensor software interface. Joint load magnitude and resultant location of the load (centroid) were recorded for each ADL posture. The subscapularis was then repaired in the native location, and the ADL posture and load measurement protocol were repeated. All 3 postures demonstrated an intra-class correlation coefficient of over 0.9, indicating high repeatability of the load magnitude measured on the same specimen. Load magnitudes ranged from 5 lbf to 70 lbf "where 1lbf =.454kgf" depending on the posture and position. Subscapularis repair statistically significantly increased mean joint loads in the behind back position (P =.046) and the "overhead reach" posture (P <.001). The centroid location differed between the "behind back" and "overhead reach" postures for both radial distance (R) and angular position (θ) (P <.05). Subscapularis repair did not change R or theta for any of the three ADL postures compared to testing with subscapularis unrepaired. Sensors placed within the trial insert can reliably measure joint loads in selected ADL postures. Subscapularis tendon repair increases the magnitude of joint load but does not appear to improve concentricity of resultant load when the shoulder is placed in ADL postures. Future work will involve sensor usage in a clinical setting to evaluate if measured joint load parameters correlate with improved clinical outcomes. Basic Science Study; Biomechanics [ABSTRACT FROM AUTHOR]

The need for secondary orthognathic surgery (OS) after a high condylectomy (HC) in patients with active unilateral condylar hyperplasia was assessed in 25 patients, reviewing patient characteristics and treatment planning. At 6–12 months after HC, 13 patients (52%) required secondary OS. The amount of mandibular dental midline shift before the HC (P = 0.037), and a dental crossbite that was present before the HC (P = 0.017) were significantly associated with the need for secondary OS. Overall, the mandibular dental midline coincided with the facial midline in eight patients (32%) at 2 weeks after HC. In 16% of the patients, no additional OS was needed despite this being the initial treatment plan. Additionally, the initially planned type of secondary OS was modified in six other patients. Early HC in skeletally immature patients provided very good results, both aesthetic and functional, with only two of them needing supplementary OS at 6–12 months after HC. The HC remains a valuable treatment in patients with active unilateral condylar hyperplasia, as it can eliminate the need for secondary OS and is very well tolerated by most patients. [ABSTRACT FROM AUTHOR]

Patients who decline blood transfusions, including members of the Jehovah's Witness faith, often face challenges when they require or desire prolonged operations such as free tissue transfer (FTT). This study aims to outline our institution's experience with treating bloodless medicine patients and offers the first anatomically comprehensive evaluation of FTT in this population. All patients undergoing FTT from 2017 to 2020 at a single institution were retrospectively reviewed. Patients who declined blood products were selected. Outcomes of interest include flap success, operative complications, and changes to hemoglobin measurements. Ten patients undergoing 11 FTT procedures were identified. Average age was 62.4 years (SD 7.6). Most patients were female (n = 9) and Black (n = 8). Average body mass index was 31.3 (SD 5.6), American Society of Anesthesiologists Physical Status was 2.9 (SD 0.5), and Charlson Comorbidity Index was 3.8 (SD 1.1). Sites of FTT reconstruction were breast (6), lower extremity (3), and scalp (2). Average operative time was 390 min (SD 85.1), with an average estimated blood loss of 170 mL (SD 100.4). The difference between preoperative hemoglobin to first postoperative hemoglobin measurement averaged 2.2 g/dL (SD 1.4). Average patient follow-up was 12 months (SD 7.8). Flap success occurred in 10 cases. One patient with flap failure was successfully reconstructed with a second procedure. Despite a small, heterogeneous cohort, our success rate in this highly comorbid population indicates that FTT can be performed effectively for patients who cannot use blood products. Bloodless medicine protocols are beneficial to providers serving patients with transfusion restrictions and systems that strive to limit transfusion volume and risk. [ABSTRACT FROM AUTHOR]