The Origins, Spectral Interpretation, Resource Identification, and Security–Regolith Explorer (OSIRIS-REx) mission revealed that the asteroid Bennu has ~1500 impact craters (Bierhaus et al., 2022). ...Here we use data from the OSIRIS-REx laser altimeter (OLA) to measure the depths, d, and diameters, D, of a sample of small (D ≤ 10 m) impact craters that span a broad range of latitudes and longitudes. d/D in this sample ranges from 0.04 to 0.27, with a mean of 0.13 ± 0.04. Compared to larger (D ≥ 10 m) craters on Bennu, those studied here have a greater average d/D. The mean d/D of craters on Bennu's younger, Rugged Unit is statistically larger than the mean d/D of those on the older, Smooth Unit. One of the studied craters contains an interior mound that may indicate the presence of stronger material at depth. A large fraction of craters studied here are located near large boulders whose lengths are >50% the diameter of the crater. Some of these large boulders cross the crater rim crest, protruding into and perched above the crater interior. In the most extreme cases, the boulder length is ~2.5 times the crater diameter. The d/D of craters near large boulders is bimodal, which could be a consequence of how boulders affect crater formation. Laboratory experiments and results from Hayabusa2's Small Carry-On Impactor experiment indicate that preexisting boulders and heterogeneities affect crater formation and d/D. The abundance of small craters on Bennu makes the asteroid a rich resource for understanding impact processes.
•Craters on Bennu smaller than ~10 m have depth-diameter (d/D) ratios between 0.04 and 0.27, with a mean of 0.13 0.04.Craters on the Rugged Unit have a larger average d/D than those on the Smooth Unit.•The number of craters with a central mound is consistent with predictions based larger craters.•The distribution of d/D suggests that crater formation is affected by how far large boulders protrude above the crater.
Abstract
Objectives
To test the effectiveness of a quality improvement programme to promote adherence to national quality standards (QS) for patients hospitalized with community-acquired pneumonia ...(CAP), exploring the factors that hindered improvements in clinical practice.
Methods
An improvement bundle aligned to the QS was deployed using plan-do-study-act methodology in a 600 bed hospital in northern Vietnam from July 2018 to April 2019. Proposed care improvements included CURB65 score guided hospitalization, timely diagnosis and inpatient antibiotic treatment review to limit the spectrum and duration of IV antibiotic use. Interviews with medical staff were conducted to better understand the barriers for QS implementation.
Results
The study found that improvements were made in CURB65 score documentation and radiology results available within 4 h (P < 0.05). There were no significant changes in the other elements of the QS studied. We documented institutional barriers relating to the health reimbursement mechanism and staff cultural barriers relating to acceptance and belief as significant impediments to implementation of the standards.
Conclusions
Interventions led to some process changes, but these were not utilized by clinicians to improve patient management. Institutional and behavioural barriers documented may inhibit wider national uptake of the QS. National system changes with longer term support and investment to address local behavioural barriers are likely to be crucial for future improvements in the management of CAP, and potentially other hospitalized conditions, in Vietnam.
The Postnatal Growth and Retinopathy of Prematurity (G-ROP) Study showed that the addition of postnatal weight gain to birth weight and gestational age detects similar numbers of infants with ROP, ...but requires examination of fewer infants.
To determine the incremental cost-effectiveness of screening with G-ROP compared with conventional screening.
We built a microsimulation model of a 1-year US birth cohort <32 weeks gestation, using data from the G-ROP study. We obtained resource utilization estimates from the G-ROP dataset and from secondary sources, and test characteristics from the G-ROP cohort.
Among 78,281 infants nationally, screening with G-ROP detected ~25 additional infants with Type 1 ROP. This was accomplished with 36,233 fewer examinations, in 14,073 fewer infants, with annual cost savings of approximately US$2,931,980 through hospital discharge.
Screening with G-ROP reduced costs while increasing the detection of ROP compared with current screening guidelines.
Agritourism is an increasing new trend in the global tourism industry. Vietnam has a long tradition of agricultural production combined with diverse natural resources stretching from the north to the ...south, bringing advantages in the development of agritourism. The study aims to choose the most appropriate agritourism location in Vietnam for long-term investment. A hybrid fuzzy multi-criteria decision model (FMCDM) is proposed to find the optimal location based on eco-nomic, social, and environmental factors. In the first stage, the fuzzy analytic hierarchy process (FAHP) is used to estimate the relative criteria rating through the evaluation process. In the second stage, the fuzzy technique for order preference using similarities to ideal solution (FTOPSIS) is applied to rank the potential alternative locations. Finally, the best alternative to tourist site investment is Can Tho (A8), which maximizes resources and enhances the local benefits. Future research can also be used to support similar site-selection processes in other regions or could be applied to other types of tourism.
Tetanus remains common in many low- and middle-income countries, but as critical care services improve, mortality from tetanus is improving. Nevertheless, patients develop severe syndromes associated ...with autonomic nervous system disturbance (ANSD) and the requirement for mechanical ventilation (MV). Understanding factors associated with worse outcome in such settings is important to direct interventions. In this study, we investigate risk factors for disease severity and long-term physical outcome in adults with tetanus admitted to a Vietnamese intensive care unit.
Clinical and demographic variables were collected prospectively from 180 adults with tetanus. Physical function component scores (PCS), calculated from Short Form Health Survey (SF-36), were assessed in 79 patients at hospital discharge, 3 and 6 months post discharge.
Age, temperature, heart rate, lower peripheral oxygen saturation (SpO
) and shorter time from first symptom to admission were associated with MV (OR 1.03 95% confidence interval (CI) 1.00, 1.05, p = 0.04; OR 2.10 95% CI 1.03, 4.60, p = 0.04; OR 1.04 95% CI 1.01, 1.07, p = 0.02); OR 0.80 95% CI 0.66, 0.94, p = 0.02 and OR 0.65 95% CI 0.52, 0.79, p < 0.001, respectively). Heart rate, SpO
and time from first symptom to admission were associated with ANSD (OR 1.03 95% CI 1.01, 1.06, p < 0.01; OR 0.95 95% CI 0.9, 1.00, p = 0.04 and OR 0.64 95% CI 0.48, 0.80, p < 0.01, respectively). Median interquartile range PCS at hospital discharge, 3 and 6 months were 32.37 24.95-41.57, 53.0 41.6-56.3 and 54.8 51.6-57.3, respectively. Age, female sex, admission systolic blood pressure, admission SpO
, MV, ANSD, midazolam requirement, hospital-acquired infection, pressure ulcer and duration of ICU and hospital stay were associated with reduced 0.25 quantile PCS at 6 months after hospital discharge.
MV and ANSD may be suitable endpoints for future research. Risk factors for reduced physical function at 3 months and 6 months post discharge suggest that modifiable features during hospital management are important determinants of long-term outcome.
Hypothalamic gonadotropin-releasing hormone (GnRH) neurons are at the apex of the hypothalamic-pituitary-gonadal axis that regulates mammalian fertility. Herein we demonstrate a critical role for the ...homeodomain transcription factor ventral anterior homeobox 1 (VAX1) in GnRH neuron maturation and show that Vax1 deletion from GnRH neurons leads to complete infertility in males and females. Specifically, global Vax1 knock-out embryos had normal numbers of GnRH neurons at 13 d of gestation, but no GnRH staining was detected by embryonic day 17. To identify the role of VAX1 specifically in GnRH neuron development,Vax1(flox)mice were generated and lineage tracing performed in Vax1(flox/flox):GnRH(cre):RosaLacZ mice. This identified VAX1 as essential for maintaining expression of Gnrh1 The absence of GnRH staining in adult Vax1(flox/flox):GnRH(cre)mice led to delayed puberty, hypogonadism, and infertility. To address the mechanism by which VAX1 maintains Gnrh1 transcription, the capacity of VAX1 to regulate Gnrh1 transcription was evaluated in the GnRH cell lines GN11 and GT1-7. As determined by luciferase and electrophoretic mobility shift assays, we found VAX1 to be a direct activator of the GnRH promoter through binding to four ATTA sites in the GnRH enhancer (E1) and proximal promoter (P), and able to compete with the homeoprotein SIX6 for occupation of the identified ATTA sites in the GnRH promoter. We conclude that VAX1 is expressed in GnRH neurons where it is required for GnRH neuron expression of GnRH and maintenance of fertility in mice.
Infertility classified as idiopathic hypogonadotropic hypogonadism (IHH) is characterized by delayed or absent sexual maturation and low sex steroid levels due to alterations in neuroendocrine control of the hypothalamic-pituitary-gonadal axis. The incidence of IHH is 1-10 cases per 100,000 births. Although extensive efforts have been invested in identifying genes giving rise to IHH, >50% of cases have unknown genetic origins. We recently showed that haploinsufficiency of ventral anterior homeobox 1 (Vax1) leads to subfertility, making it a candidate in polygenic IHH. In this study, we investigate the mechanism by which VAX1 controls fertility finding that VAX1 is required for maintenance of Gnrh1 gene expression and deletion of Vax1 from GnRH neurons leads to complete infertility.
Increasing SERCA2 (sarcoendo-plasmic reticulum Ca
ATPase 2) activity is suggested to be beneficial in chronic heart failure, but no selective SERCA2-activating drugs are available. PDE3A ...(phosphodiesterase 3A) is proposed to be present in the SERCA2 interactome and limit SERCA2 activity. Disruption of PDE3A from SERCA2 might thus be a strategy to develop SERCA2 activators.
Confocal microscopy, 2-color direct stochastic optical reconstruction microscopy, proximity ligation assays, immunoprecipitations, peptide arrays, and surface plasmon resonance were used to investigate colocalization between SERCA2 and PDE3A in cardiomyocytes, map the SERCA2/PDE3A interaction sites, and optimize disruptor peptides that release PDE3A from SERCA2. Functional experiments assessing the effect of PDE3A-binding to SERCA2 were performed in cardiomyocytes and HEK293 vesicles. The effect of SERCA2/PDE3A disruption by the disruptor peptide OptF (optimized peptide F) on cardiac mortality and function was evaluated during 20 weeks in 2 consecutive randomized, blinded, and controlled preclinical trials in a total of 148 mice injected with recombinant adeno-associated virus 9 (rAAV9)-OptF, rAAV9-control (Ctrl), or PBS, before undergoing aortic banding (AB) or sham surgery and subsequent phenotyping with serial echocardiography, cardiac magnetic resonance imaging, histology, and functional and molecular assays.
PDE3A colocalized with SERCA2 in human nonfailing, human failing, and rodent myocardium. Amino acids 277-402 of PDE3A bound directly to amino acids 169-216 within the actuator domain of SERCA2. Disruption of PDE3A from SERCA2 increased SERCA2 activity in normal and failing cardiomyocytes. SERCA2/PDE3A disruptor peptides increased SERCA2 activity also in the presence of protein kinase A inhibitors and in phospholamban-deficient mice, and had no effect in mice with cardiomyocyte-specific inactivation of SERCA2. Cotransfection of PDE3A reduced SERCA2 activity in HEK293 vesicles. Treatment with rAAV9-OptF reduced cardiac mortality compared with rAAV9-Ctrl (hazard ratio, 0.26 95% CI, 0.11 to 0.63) and PBS (hazard ratio, 0.28 95% CI, 0.09 to 0.90) 20 weeks after AB. Mice injected with rAAV9-OptF had improved contractility and no difference in cardiac remodeling compared with rAAV9-Ctrl after aortic banding.
Our results suggest that PDE3A regulates SERCA2 activity through direct binding, independently of the catalytic activity of PDE3A. Targeting the SERCA2/PDE3A interaction prevented cardiac mortality after AB, most likely by improving cardiac contractility.
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