bluuebunny/crossref_metadata_2025 huggingface dataset:
Conceptualising spaced learning in health professions education: A scoping review
Authors: Versteeg Marjolein , Hendriks Renée A. , Thomas Aliki , Ommering Belinda W. C. , Steendijk Paul
Published: December 2019

Objectives

To investigate the definitions and applications of ‘spaced learning’ and to propose future directions for advancing its study and practice in health professions education.

Method

The authors searched five online databases for articles published on spaced learning in health professions education prior to February 2018. Two researchers independently screened articles for eligibility with set inclusion criteria. They extracted and analysed key data using both quantitative and qualitative methods.

Results

Of the 2972 records retrieved, 120 articles were included in the review. More than 90% of these articles were published in the last 10 years. The definition of spaced learning varied widely and was often not theoretically grounded. Spaced learning was applied in distinct contexts, including online learning, simulation training and classroom settings. There was a large variety of spacing formats, ranging from dispersion of information or practice on a single day, to intervals lasting several months. Generally, spaced learning was implemented in practice or testing phases and rarely during teaching.

Conclusions

Spaced learning is infrequently and poorly defined in the health professions education literature. We propose a comprehensive definition of spaced learning and emphasise that detailed descriptions of spacing formats are needed in future research to facilitate the operationalisation of spaced learning research and practice in health professions education.
Is it time for a new model of education in the health professions?
Authors: Norcini John
Published: December 2019

Karolinska Prize winner John Norcini offers an argument for how micro‐credentials offer an educational model that can support the development of competence across professions and careers.
Epigenetic control of tumor angiogenesis
Authors: Ribatti Domenico , Tamma Roberto
Published: December 2019

The term “epigenetic” is used to refer to heritable alterations in chromatin that are not due to changes in DNA sequence. Different growth factors and vascular genes mediate the angiogenic process, which is regulated by epigenetic states of genes. The aim of this article is to analyze the role of epigenetic mechanisms in the control and regulation of tumor angiogenetic processes. The reversibility of epigenetic events in contrast to genetic aberrations makes them potentially suitable for therapeutic intervention. In this context, DNA methyltransferase (DNMT) and HDAC inhibitors indirectly—via the tumor cells—exhibit angiostatic effects in vivo, and inhibition of miRNAs can contribute to the development of novel anti‐angiogenesis therapies.
Increased Twist and ZEB2 expression in a cutaneous metastasis of high‐grade glioma
Authors: Nagaishi Masaya , Fujii Yoshiko , Sugiura Yoshiki , Takano Issei , Takigawa Tomoji , Yokoo Hideaki , Suzuki Kensuke
Published: December 2019

Extra‐central nervous system metastasis of gliomas is extremely rare, and the biological mechanism underlying it remains poorly understood. Epithelial‐to‐mesenchymal transition (EMT) has received attention as one of the important processes of cancer metastasis. Here we describe the case of a 32‐year‐old man with cutaneous metastasis of high‐grade glioma, together with the analysis of EMT‐related molecules. Our patient presented with a high‐grade glioma in the right frontal lobe. Cutaneous metastasis under the surgical scar developed 17 months after complete resection of the intracranial tumor. Histopathology of both the original and metastatic tumors revealed hypercellularity; the tumors predominantly comprised glial tumor cells with poor cellular processes. Immunohistochemical analysis demonstrated intense expression of nestin, focal expression of glial fibrillary acid protein, and absence of expression of oligodendrocyte transcription factor 2, endothelial membrane antigen, or neurofilament. Genetic analyses could not provide definitive diagnostic information of glioma subtypes. Immunohistochemical analysis for EMT‐related biomarkers demonstrated increased Twist, zinc finger E‐box‐binding homeobox 2 (ZEB2), matrix metalloproteinase 2 (MMP2), and MMP9 expressions in tumor cells of the metastatic lesion compared with those of the primary lesion. Slug, E‐cadherin, and N‐cadherin expression were absent in both primary and metastatic lesions; however, ZEB1 expression was present in both. Our results suggest that Twist, ZEB2, MMP2, and MMP9 facilitate cutaneous metastasis of gliomas.
Objectivity in rare disease research: A philosophical approach
Authors: Hews‐Girard Julia , Obilar Helen N. , Camargo Plazas Pilar
Published: December 2019

Individuals living with rare conditions are faced with important challenges derived from the rarity of their conditions and aggravated by the low priority given to rare disease research. However, current realities of rare disease research require consideration of the relationship between subjectivity and ‘traditional’ objectivity. Objectivity in research has traditionally been associated with processes and descriptions that are independent of the investigator. The need for researchers to provide unbiased knowledge and achieve a balance between objectivity and the underlying values in nursing and scientific research requires an examination of how objectivity is conceptualized within the context of rare disease research. The aim of this paper is to examine scientific objectivity in rare disease research from a philosophical viewpoint and, in doing so, demonstrate the need to redefine it to reflect the current scientific environment. As such, healthcare providers working on this field need to redefine objectivity around ethical and moral obligation to advance science in an equitable manner with the end goal to produce knowledge that is trustworthy and beneficial to our patients.
Conditioning the soil microbiome through plant–soil feedbacks suppresses an aboveground insect pest
Authors: Pineda Ana , Kaplan Ian , Hannula S. Emilia , Ghanem Wadih , Bezemer T. Martijn
Published: December 2019

Soils and their microbiomes are now recognized as key components of plant health, but how to steer those microbiomes to obtain their beneficial functions is still unknown. Here, we assess whether plant–soil feedbacks can be applied in a crop system to shape soil microbiomes that suppress herbivorous insects in above‐ground tissues.

We used four grass and four forb species to condition living soil. Then we inoculated those soil microbiomes into sterilized soil and grew chrysanthemum as a focal plant. We evaluated the soil microbiome in the inocula and after chrysanthemum growth, as well as plant and herbivore parameters.

We show that inocula and inoculated soil in which a focal plant had grown harbor remarkably different microbiomes, with the focal plant exerting a strong negative effect on fungi, especially arbuscular mycorrhizal fungi. Soil inoculation consistently induced resistance against the thrips Frankliniella occidentalis, but not against the mite Tetranychus urticae, when compared with sterilized soil. Additionally, plant species shaped distinct microbiomes that had different effects on thrips, chlorogenic acid concentrations in leaves and plant growth.

This study provides a proof‐of‐concept that the plant–soil feedback concept can be applied to steer soil microbiomes with the goal of inducing resistance above ground against herbivorous insects.
Mutant analysis in the nonlegume Parasponia andersonii identifies NIN and NF‐YA1 transcription factors as a core genetic network in nitrogen‐fixing nodule symbioses
Authors: Bu Fengjiao , Rutten Luuk , Roswanjaya Yuda Purwana , Kulikova Olga , Rodriguez‐Franco Marta , Ott Thomas , Bisseling Ton , van Zeijl Arjan , Geurts Rene
Published: December 2019

Nitrogen‐fixing nodulation occurs in 10 taxonomic lineages, with either rhizobia or Frankia bacteria. To establish such an endosymbiosis, two processes are essential: nodule organogenesis and intracellular bacterial infection. In the legume–rhizobium endosymbiosis, both processes are guarded by the transcription factor NODULE INCEPTION (NIN) and its downstream target genes of the NUCLEAR FACTOR Y (NF‐Y) complex.

It is hypothesized that nodulation has a single evolutionary origin c. 110 Ma, followed by many independent losses. Despite a significant body of knowledge of the legume–rhizobium symbiosis, it remains elusive which signalling modules are shared between nodulating species in different taxonomic clades. We used Parasponia andersonii to investigate the role of NIN and NF‐YA genes in rhizobium nodulation in a nonlegume system.

Consistent with legumes, P. andersonii PanNIN and PanNF‐YA1 are coexpressed in nodules. By analyzing single, double and higher‐order CRISPR‐Cas9 knockout mutants, we show that nodule organogenesis and early symbiotic expression of PanNF‐YA1 are PanNIN‐dependent and that PanNF‐YA1 is specifically required for intracellular rhizobium infection.

This demonstrates that NIN and NF‐YA1 have conserved symbiotic functions. As Parasponia and legumes diverged soon after the birth of the nodulation trait, we argue that NIN and NF‐YA1 represent core transcriptional regulators in this symbiosis.
Humans in the cold: Regulating energy balance
Authors: McInnis Kurt , Haman François , Doucet Éric
Published: December 2019

For humans to maintain a stable core temperature in cold environments, an increase in energy expenditure (EE) is required. However, little is known about how cold stimulus impacts energy balance as a whole, as energy intake (EI) has been largely overlooked. This review focuses on the current state of knowledge regarding how cold exposure (CE) impacts both EE and EI, while highlighting key gaps and shortcomings in the literature. Animal models clearly reveal that CE produces large increases in EE, while decreasing environmental temperatures results in a significant negative dose‐response effect in EI (r=‐.787, P<.001), meaning animals eat more as temperature decreases. In humans, multiple methods are used to administer cold stimuli, which result in consistent yet quantitatively small increases in EE. However, only two studies have measured ad libitum food intake in combination with acute CE in humans. Chronic CE (i.e., cold acclimation) studies have been shown to produce minimal changes in body weight, with an average compensation of ~126%. Although more studies are required to investigate how cold impacts EI in humans, results presented in this review warrant caution before presenting or considering CE as a potential adjunct to weight loss strategies.
Exogenous FGF8 signaling in osteocytes leads to mandibular hypoplasia in mice
Authors: Xu Jue , Wang Linyan , Huang Zhen , Chen YiPing , Shao Meiying
Published: December 2019

Objective

Fibroblast growth factor 8 (FGF8) signaling is essential in regulating craniofacial osteogenesis. This study aims to explore the effect of altered FGF8 signaling in maxillomandibular development during embryogenesis.

Materials and Methods

Dmp1Cre;R26RmTmG mice were generated to trace Dmp1+ cell lineage, and Dmp1Cre;R26RFgf8 mice were generated to explore the effects of augmented FGF8 signaling in Dmp1+ cells on osteogenesis with a focus on maxillomandibular development during embryogenesis, as assessed by whole mount skeletal staining, histology, and immunostaining. Additionally, cell proliferation rate and the expression of osteogenic genes were examined.

Results

Osteocytes of maxillomandibular bones were found Dmp1‐positive prenatally, and Fgf8 over‐expression in Dmp1+ cells led to mandibular hypoplasia. While Dmp1Cre allele functions in the osteocytes of the developing mandibular bone at as early as E13.5, and enhanced cell proliferation rate is observed in the bone forming region of the mandible in Dmp1Cre;R26RFgf8 mice at E14.5, histological examination showed that osteogenesis was initially impacted at E15.5, along with an inhibition of osteogenic differentiation markers.

Conclusions

Augmented FGF8 signaling in Dmp1+ cells lead to osteogenic deficiency in the mandibular bones, resulting in mandibular hypoplasia.
A Comparative Study of Intramedullary Nail Strengthened with Auxiliary Locking Plate or Steel Wire in the Treatment of Unstable Trochanteric Fracture of Femur
Authors: Wang Zheng‐hao , Li Kai‐nan , Lan Hai , Wang Xiao‐dong
Published: December 2019

Objective

To compare the clinical outcomes of unstable femoral trochanteric fracture treated by proximal femoral intramedullary nail enhanced with lateral locking plate versus cerclage steel wire.

Methods

A retrospective study was conducted on 83 patients who received open reduction and internal fixation with proximal femoral intramedullary nail combined with lateral enhanced fixations for unstable femoral trochanteric fractures from March 2015 to January 2017 in our hospital. Of these patients, 39 received the lateral enhanced fixation with locking plate, while the remaining 44 had cerclage wire as additional fixation. The clinical data were compared between the two groups.

Results

All the patients in the study had surgical procedures performed smoothly. Although the plate group had significantly longer operation times and significantly higher hospitalization expenses than the wire group (P < 0.05), no statistically significant differences in intraoperative blood loss and hospital stay were proved between the groups (P > 0.05). The follow‐up period lasted for 12–24 months with an average of (16.81 ± 2.92) months. The plate group returned to full‐weight bearing significantly earlier than the wire group (P < 0.05). The Harris Hip Score (HHS) significantly increased in both groups over time postoperatively (P < 0.05). The plate group achieved a higher HHS than the wire group, which was statistically significant at 3 months (P < 0.05), whereas it became insignificant at 6 and 12 months postoperatively (P > 0.05). Regarding radiographic assessment, an excellent rate of fracture reduction was proved in 71.79% of the plate group, compared to 45.45% of the wire group, which was statistically significant (P < 0.05). In addition, fracture healing was achieved significantly earlier in the plate group than the wire group (P < 0.05); nevertheless, no statistically significant difference was noted in neck‐shaft angle at the latest follow‐up between the two groups (P > 0.05). At the latest follow‐up, two cases of implant loosening and two cases of coxa varus were found in the plate group, while one case of femoral head necrosis and three cases of coxa varus were revealed by radiographs in the wire group.

Conclusion

The cerclage wire has benefits of saving time and operation costs; however, the locking plate has the advantages of improving fracture reduction quality, shortening time to full weight bearing and fracture healing, and improving hip function recovery due to the lateral additional fixations to proximal femoral intramedullary nail for unstable trochanteric fractures.
Rate and Risk Factors of Superior Facet Joint Violation during Cortical Bone Trajectory Screw Placement: A Comparison of Robot‐Assisted Approach with a Conventional Technique
Authors: Le Xiao‐feng , Shi Zhan , Wang Qi‐long , Xu Yun‐feng , Zhao Jing‐wei , Tian Wei
Published: December 2019

Objective

To compare the incidence and risk factors of superior facet joint violation (FJV) during cortical bone trajectory screw placement in robot‐assisted approach versus conventional technique.

Methods

A retrospective study, including 69 patients having cortical bone trajectory (CBT) screw instrumentation for symptomatic degenerated diseases or trauma, was conducted between June 2015 to January 2019. All patients underwent CBT surgery performed by the same team of experienced surgeons. Patients were randomly divided into two groups: a conventional group (CG, 46 cases) and a robot group (RG, 23 cases). The surgical robotic system was used for screw instrumentation in the robot group and the traditional screw instrumentation with fluoroscopic guidance was used in the conventional group. Cortical screws followed a medio‐to‐lateral path in the transverse plane and a caudal‐to‐cephalad path in the sagittal plane. Preoperative and postoperative computed tomography (CT) scans were obtained to determine the degree and incidence of FJV. The violation status of facet joint was evaluated according to the modified classification: grade 0, no violation; grade 1, screw shaft, screw head or rod within 1 mm of or abutting the facet joint, but did not enter the articular facet joint; grade 2, screw shaft, screw head or rod clearly in the facet joint. The following factors that may contribute to the occurrence of FJV were analyzed: age, sex, body mass index (BMI), proximal fusion level, fusion length, the side of screw, preoperative vertebral slip, superior facet angle, and degenerative scoliosis. The chi‐squared test and Student's t‐test were used for analysis of the variables for significance (P < 0.05).

Results

FJV occurred in 41.3% of patients in CG and 17.3% of patients in RG. A chi‐squared analysis revealed a significantly lower rate of FJV for RG compared with CG (P= 0.04). In the CG, 17 of the 109 cephalad screws were grade 1 (15.6%), and five were grade 2 (4.6%). In the RG, three of the 46 cephalad screws were grade 1 (6.5%), and three were grade 2 (6.5%). There was a statistically significant difference in the incidence of FJV between the left and right screw with fluoroscopy‐assisted CBT screw instrumentation (P < 0.05). A significant correlation between scoliosis with the FJV was found in CG (P < 0.05) and in RG (P < 0.05). With regard to superior facet angle, a measurement ≥45° was a significant risk factor of FJV in CG (P < 0.05) and in RG (P < 0.05).

Conclusions

A robot‐assisted approach could reduce the incidence of FJV compared with the conventional approach in CBT technique.
Associations between health‐related quality of life and health care costs among children with atopic dermatitis and their caregivers: A cross‐sectional study
Authors: Olsson Maja , Bajpai Ram , Yew Yik Weng , Koh Mark Jean Aan , Thng Steven , Car Josip , Järbrink Krister
Published: December 2019

Background/objectives

Atopic dermatitis is associated with a decreased health‐related quality of life and contributes to substantial health care costs. It is important to understand what accelerates health care costs to inform various stakeholders, so they can effectively meet health care needs. This cross‐sectional study aims to explore associations between health‐related quality of life, health care costs, and cost‐accelerating variables.

Methods

Information on health‐related quality of life (HRQoL) was collected through generic and disease‐specific instruments from caregivers and children <16 years of age with a physician‐confirmed diagnosis of atopic dermatitis. The economic impact of atopic dermatitis was evaluated by analyzing information on health service utilization and other health care costs related to managing the condition.

Results

Children with high impact on health‐related quality of life presented an annual health care cost of US$ 3787 compared with US$ 2548 for moderately impacted and US$ 2258 among children for which the condition had low impact. The severity of atopic dermatitis, disease duration, and a lower health‐related quality of life was associated with greater health care costs. Analyses of subdomains of health‐related quality of life revealed correlations between “mood” and “personal relationships” on one hand and caregivers’ physical health and health care costs on the other hand.

Conclusions

Highly affected HRQoL is associated with increased health care costs and could be a valuable complement to traditional severity assessments. By using HRQoL instruments, burdens and symptoms beyond severity can be identified and addressed with interventions to increase HRQoL and subsequently reduce health care costs.
Characteristics of nonoliguric hyperkalemia in preterm infants: A case‐control study in a single center
Authors: Aoki Kuraaki , Akaba Kazuhiro
Published: December 2019

Background

Preterm infants often present with hyperkalemia during the first days after birth without showing oliguria. This is known as nonoliguric hyperkalemia (NOHK). As its clinical features have not been completely understood to date, we aimed to elucidate the characteristics of NOHK, including its risk factors, in preterm infants.

Methods

For this case‐control study, we reviewed the files of all infants born before 32 weeks of gestational age in our neonatal intensive care unit between 2011 and 2018. We distinguished the NOHK and non‐NOHK groups and compared their characteristics and blood potassium levels. Nonoliguric hyperkalemia was defined as peak blood potassium concentration of ≥6.0 mmol/L during the first 72 h of life with a urine output of ≥1 mL/kg/h.

Results

Of the 99 infants enrolled, 21 (21%) demonstrated NOHK. Infants with NOHK were more likely to have been exposed to antenatal magnesium sulfate (MgSO4) (P = 0.019) than those in the non‐NOHK group. Acute morbidities and mortality were not statistically different. Multivariate analysis indicated that administration of maternal MgSO4 for longer than 24 h at any point before delivery was a risk factor for NOHK. Its adjusted odds ratio and 95% confidence interval were 4.0 and 1.4–12.3, respectively (P = 0.012).

Conclusions

In this study, maternal MgSO4 administration for longer than 24 h proved to be a risk factor for NOHK in infants born before 32 weeks of gestational age. Infants born to mothers who have received MgSO4 should be regularly monitored for their electrolytes.
Ingenious floral structure drives explosive pollination in Hydrilla verticillata (Hydrocharitaceae)
Authors: Zhang Q. , Fu W.‐L. , Wang X.‐F. , Huang L.‐J.
Published: December 2019

In explosive pollination, many structures and mechanisms have evolved to achieve high‐speed stamen movement. The male flower of the submerged plant Hydrilla verticillata is reported to be able to release pollen explosively some time after leaving the mother plant time, but the mechanism of stamen movement and the related functional structure in this species are unclear.

In this study, we observed the male flower structure and pollen dispersal process of H. verticillata. We analysed the stamen movements during the pollen dispersal process and conducted several controlled experiments to study the process of storage and release of elastic potential energy in explosive pollination.

When the male flower of H. verticillata is bound to the united bracts, the sepals accumulate elastic potential energy through the expansion of basal extensor cells. After the male flower is liberated from the mother plant, the stamens unfold rapidly with the sepals under adhesion and transfer the elastic potential energy to the filament in seconds. Once stamens unfold to a critical angle, at which the elasticity of the filament just exceeds the adhesion between sepals and anthers, the stamens automatically rebound and release pollen in milliseconds.

These results reveal that Catapult‐like stamens, spoon‐shaped sepals and enclosed united bracts in the spathe together constitute the functional structure in rapid stamen movement of H. verticillata. They ensure that the pollen can be released on the water surface, and thus adapt successfully to the pollen‐epihydrophilous pollination.
Immediate response of fish communities and water chemistry to causeway breaching and bridge installation in the Kaouk River estuary, British Columbia, Canada
Authors: Gerwing Travis G. , Plate Elmar , Kidd Jess , Sinclair Jesse , Burns Christopher W. , Johnson Shane , Roias Steven , McCulloch Cameron , Bocking Robert C.
Published: December 2019

The Kaouk River estuary is located on the northwest coast of Vancouver Island, British Columbia, Canada, in the Treaty Settlement Lands of the Ka:'yu:'k't'h'/Che:k'tles7et'h First Nations. Stretching across the widest point of this estuary is a causeway providing road access to Fair Harbour. This causeway was observed to decrease habitat connectivity throughout the estuary, specifically limiting juvenile salmon access to high‐quality rearing habitat in the tidal marsh. As such, the causeway was breached in 2019 and a bridge was installed. Juvenile salmon were observed using the new connection and were captured both up and downstream of the causeway immediately following breaching. Postbreach water chemistry (dissolved oxygen, pH, salinity, and temperature) near the causeway was recorded within the range of values observed throughout the estuary. Use of the breach by juvenile salmon and homogenized water chemistry indicate the project succeeded in improving habitat connectivity within the Kaouk River estuary and has enhanced juvenile salmon access to 2.7 km2 of wetland rearing habitat.
Role of latitudinal shift and climate change in evolution of red and yellow palaeosols of the Himalayas: Implications for early Oligocene seasonality and Mid‐Miocene enhanced precipitation
Authors: Upreti Neha , Srivastava Pankaj
Published: December 2019

Cenozoic atmospheric circulation, climatic changes, sedimentation and weathering over the Indian sub‐continent were mainly influenced by the northward drift of the Indian Plate, the shrinking Paratethys, India‐Asia collision and the rise of the Himalayas. This study is aimed at exploring the fluvial sedimentary record of the north‐west part of the Himalayan Foreland Basin to interpret weathering and pedogenesis during early Oligocene to Mid‐Miocene time. Palaeopedological investigation of a 3.1 km thick succession from Kangra sub‐basin of the Himalayan Foreland Basin shows that the lower 2 km part of the succession is characterized by the red (10R hue) and the upper 1.1 km part of the succession by the yellow (2.5Y hue) palaeosols with varying intensity of weathering and pedogenesis. The association of sedimentary rocks and pedogenic expression in palaeosols indicate four (Type‐A to Type‐D) pedofacies in the entire Oligocene–Miocene succession. The pedofacies are defined by a decrease in the intensity of palaeopedogenic development from strongly‐developed palaeopedofeatures in Type‐A, moderately‐developed palaeopedofeatures in Type‐B, weakly‐developed palaeopedofeatures in Type‐C and to the only incipient stage of palaeopedogenesis in Type‐D pedofacies. The palaeolatitudinal shift during the convergence of the Indian Plate played a major role in weathering and palaeopedogenesis with the inception of seasonality during the early Oligocene, which is demonstrated by the formation of the red palaeosols with pedogenic CaCO3 and vertic features in tropical conditions. The transition to yellow palaeosols at about 20 Ma is marked by increased humidity, rapid aggradation, pronounced uplift and enhanced erosion of the hinterland. These yellow palaeosols are characterized by the abundance of weakly‐developed Bw and Bss horizons, pure clay pedofeatures and absence of any pedogenic CaCO3 during short pedogenic intervals in subtropical conditions.
Examining the links between beliefs and institutional emergence
Authors: Dromi Shai M.
Published: December 2019

Although the study of institutions is one of the longest standing sociological topics, numerous recent studies have revisited questions about the genesis of new institutions and institutional domains. In this review, I argue for increased attention to the role cultural beliefs play in the emergence of new institutions. I highlight three substantive research areas where sociologists have demonstrated a relatively independent causal effect of beliefs on the genesis of new institutions: (a) studies of states and state institutions; (b) studies of emergent markets; and (c) studies of the charitable aid sector. I conclude by highlighting promising avenues for future research on beliefs and institutional emergence.
Students' use of STEM content in design justifications during engineering design‐based STEM integration
Authors: Siverling Emilie A. , Suazo‐Flores Elizabeth , Mathis Corey A. , Moore Tamara J.
Published: December 2019

Engineering design‐based STEM integration is one potential model to help students integrate content and practices from all of the STEM disciplines. In this study, we explored the intersection of two aspects of pre‐college STEM education: the integration of the STEM disciplines, and the NGSS practice of engaging in argument from evidence within engineering. Specifically, our research question was: While generating and justifying solutions to engineering design problems in engineering design‐based STEM integration units, what STEM content do elementary and middle school students discuss? We used naturalistic inquiry to analyze student team audio recordings from seven curricular units in order to identify the variety of STEM content present as students justified their design ideas and decisions (i.e., used evidence‐based reasoning). Within the four disciplines, fifteen STEM content categories emerged. Particularly interesting were the science and mathematics categories. All seven student teams used unit‐based science, and five used unit‐based mathematics, to support their design ideas. Five teams also applied science and/or mathematics content that was outside the scope of the units' learning objectives. Our results demonstrate that students integrated content from all four STEM disciplines when justifying engineering design ideas and solutions, thus supporting engineering design‐based STEM integration as a curricular model.
Preservice teachers’ use of mathematics and science learning processes
Authors: Cormas Peter C. , Middlemiss Samantha
Published: December 2019

Mathematics and science have similar learning processes (SLPs) and it has been proposed that courses focused on these and other similarities promote transfer across disciplines. However, it is not known how the use of these processes in lessons taught to children change throughout a preservice teacher education course or which are most likely to transfer within and between disciplines. Three hundred and ninety lesson plans written by 113 preservice teachers (PSTs) from 10 sections of an elementary mathematics/science methods course were analyzed. PSTs taught an eight‐lesson sequence to children: five science lessons followed by three mathematics lessons. The findings suggested that: (a) PSTs needed to only teach three mathematics lessons, after five science lessons, to reach the same number of SLPs used in the five science lessons; (b) some SLPs are highly correlated processes (HCPs) and are more likely to transfer within and between science and mathematics lessons; and (c) PSTs needed to teach no mathematics lessons, after four science lessons, to reach the same number of HCPs used in the four science lessons. Implications include centering courses on multiple and varied representations of learning processes within problem‐solving, and HCPs may be essential similarities of problem‐solving which promote transfer.
Land suitability evaluation using image processing based on determination of soil texture–structure and soil features
Authors: Mahmoodi‐Eshkaftaki Mahmood , Haghighi Amin , Houshyar Ehsan
Published: December 2019

Land evaluation is the process of land performance predictions over time based on land uses and soil features. Traditional methods in determining soil features are proved to be time‐consuming and costly. Therefore, in order to overcome these limitations, a simpler automated method using the image segmentation was developed in this study. The method was designed by integrating dynamic region merging and genetic algorithm. An area index was calculated for each soil profile using the automated method. It was used to present the amount of soil coarse particles and thereupon to determine the rating value of text‐structure. Using the method, the mean intersection over union of above 0.7 was obtained for detecting the coarse particles which confirms its suitability. Data analysis showed that (a) compared to the Storie‐land index (R2 = 0.71), the Square root‐land index was more correlated to the harvest index (R2 = 0.73), and (b) comparing to manual methods, not only the automated text‐structure had a higher correlation with the harvest index (R2 = 0.64) but also it decreased the determination time (>3.75 times). Furthermore, among the models developed by response surface methodology for estimation of soil features, the developed model for estimation of soil lime showed the highest accuracy (R2 = 0.89). In conclusion, since the developed method is more accurate, more economic and faster than the usual manual methods, it can be widely used in land suitability evaluation.
The Academy for Emerging Leaders in Patient Safety: developing a community of practice
Authors: Oates Kim , Burgess Annette , Dalton Sarah , Sammut John , Mayer David
Published: December 2019

Background

There is a high incidence of preventable error in health care. Many of these errors are the result of poor teamwork between different health professionals and not listening to the patient voice. We describe changes in attitudes to patient safety from potential future health care leaders who participated in an interactive programme focusing on these attributes.

Methods

A total of 87 scholars from medicine, nursing and pharmacy participated in an annual 4‐day intensive programme, repeated over 3 years. Their attitudes about patient safety were measured before and after the programme using the Attitudes to Patients Safety Questionnaire (APSQ3) and qualitative data about their experiences during the course. Data were analysed using descriptive statistics and qualitative measures.

Results

The majority showed shifts in attitudes, particularly about the value of teamwork, patients being more involved in their own care, the importance of learning about patient safety and the value of self‐care as ways of reducing error. Qualitative data showed that the course was valuable in networking with like‐minded people, having faculty members on site with a flattened hierarchy and being encouraged to promote change in their own workplaces.

Discussion

We showed that an interprofessional immersive course can change the thinking of young clinicians in a way that may be able contribute to improved health care.
‘Know‐Can’ gap: gap between knowledge and skills related to childhood diarrhoea and pneumonia among frontline workers in rural Uttar Pradesh, India
Authors: Ray Saraswati Lopamudra , Baker Margaret , Mishra Ashutosh , Bhandari Prince , Rai Animesh , Mishra Punit , Chandan Ambrish , Crockett Maryanne , Pelly Lorine , Anthony John , Shetye Mrunal , Krotki Karol , Kraemer John
Published: December 2019

Objectives

In India, frontline workers (FLWs) – public accredited social health activists (ASHAs) and private rural medical providers (RMPs) – are important for early detection and treatment of childhood diarrhoea and pneumonia. This cross‐sectional study aims to measure knowledge and skills, and the gap between the two (‘know‐can’ gap), regarding assessment of childhood diarrhoea with dehydration and pneumonia among FLWs, and to explore factors associated with them.

Methods

We surveyed 473 ASHAs and 447 RMPs in six districts of Uttar Pradesh. We assessed knowledge and skills using face‐to‐face interviews and video vignettes, respectively, about key signs of both conditions. The ‘know‐can’ gap corresponds to absent skills among FLWs with correct knowledge. We used logistic regression to identify the correlates of knowledge and skills.

Results

FLWs’ correct knowledge ranged from 23% to 48% for dehydration signs and 27% to 37% for pneumonia signs. Their skills ranged from 3% to 42% for dehydration and 3% to 18% for pneumonia. There was a significant ‘know‐can’ gap in all the signs, except ‘sunken eyes’. Training and supervisory support was associated with better knowledge and skills for diarrhoea with dehydration, but only better knowledge for pneumonia.

Conclusions

FLWs are crucial to the Indian health system, and high‐quality FLW services are necessary for continued progress against under‐five deaths. The gap between FLWs’ knowledge and skills warrants immediate attention. In particular, our results suggest that knowledge‐focused trainings are insufficient for FLWs to convert knowledge into appropriate assessment skills.
Changing trends in measles vaccination status between 2004 and 2014 among children aged 12–23 months in Bangladesh
Authors: Jahan Yasmin , Moriyama Michiko , Rahman Md. Moshiur , Shahid Abu Sadat Mohammad Sayeem Bin , Rahman Atiqur , Hossain Nasif , Das Sumon Kumar , Hossain Md. Iqbal , Golam Faruque Abu Syed , Chisti Mohammod Jobayer
Published: December 2019

Objective

To assess the current measles vaccination status in Bangladesh, explain changing differentials in measles vaccination, and determine contexts that may improve measles vaccination coverage.

Methods

Secondary data analysis of datasets (2004–2014) from the nationally representative Bangladesh Demographic and Health Surveys that followed stratified, multi‐stage cluster sampling design conducted both in urban and rural contexts.

Results

5468 children aged 12–23 months were surveyed, of whom 892 (16%) reported non‐compliance to measles vaccine. After simultaneous adjusting for covariates in multivariate logistic regression, children who came from a poor socio‐economic background, who had mothers with no formal schooling, who were underweight, of higher birth order (≥4), who had adolescent mothers, who had a history of home delivery and who had no exposure to media were observed to be significantly associated with lack of measles vaccination. Measles vaccination coverage among children of adolescent mothers was consistently low. Despite lack of media exposure, measles vaccination status gradually increased from 26% in 2004 to 33% in 2014. Lack of maternal education was no longer associated with measles vaccination status in 2007, 2011 and 2014. Stunted children continued to be associated with lack of measles immunisation in 2014. Children with higher birth order demonstrated 53% excess risk for not being immunised with measles vaccine. Mothers with no exposure to mass media were two times more likely to have children without measles immunisation as indicated by BDHS 2014 data.

Conclusions

Our findings will help policy makers formulate strategies for expanding measles vaccination coverage in order to achieve further reduction in disease burden and mortality in Bangladesh.
Gynaecological morbidity associated with caesarean niche: increasing awareness, prevention and management
Authors: Brook Adam J , Clarke Fiona R , Bhatia Kalsang
Published: December 2019

Key content

Caesarean section rates are rising globally; while obstetric consequences are well defined, long‐term gynaecological sequelae are frequently overlooked.

Caesarean niche results from poor healing of the uterine scar and is being increasingly reported as an important factor in a variety of new gynaecological symptoms reported after caesarean section.

Until recently, a lack of high‐quality evidence has hampered diagnostic assessment.

Recent publications provide a useful consensus for improved diagnosis and guidance on management, with thoughts that caesarean section technique potentially contributes to niche development.

Learning objectives

To describe the gynaecological morbidity associated with caesarean niche.

To understand theories regarding caesarean niche development, its sonographic assessment for clinical relevance and subsequent management.

To reflect on surgical techniques for caesarean section to minimise niche development.

Ethical issues

With rising caesarean section rates, caesarean niche is an emerging clinical problem.

Should we advise women of the possibility of long‐term gynaecological consequences of the caesarean niche?
Ultrasound is a poor predictor of early or overt liver or spleen metastasis in dogs with high‐risk mast cell tumours
Authors: Pecceu Evi , Serra Varela Juan Carlos , Handel Ian , Piccinelli Chiara , Milne Elspeth , Lawrence Jessica
Published: December 2019

Conflicting evidence exists regarding the importance of routine abdominal ultrasound (US) with hepatic and splenic fine needle aspiration (FNA) cytology during staging of canine mast cell tumours (MCT). The objective of this study was to correlate ultrasonographic and cytologic findings in dogs with strictly defined high‐risk MCTs and to determine the influence on outcome. Our hypothesis was that US poorly predicts visceral metastasis in high‐risk MCTs and that early metastasis is associated with improved outcome when compared to overt metastasis. US of liver and spleen correlated to cytologic results, categorized as no metastasis, early metastasis or overt metastasis. Of 82 dogs prospectively enrolled, 18% had early visceral metastasis and 7% had overt metastasis on cytology; 67% with visceral metastasis had regional LN metastasis. US was a poor predictor of metastasis with sensitivity, specificity, positive predictive value and negative predictive value for the spleen of 67%, 68%, 21% and 94%, respectively and for the liver of 29%, 93%, 56% and 82%, respectively. Median time to progression (TTP) for dogs with no metastasis, early metastasis and overt metastasis was not reached, 305 and 69 days, respectively (P < .001). Median survival time (MST) for the 3 groups were not reached, 322 and 81 days, respectively (P < .001). High Patnaik or Kiupel grade, early metastasis, overt metastasis and adequate local control were significantly associated with outcome. Early visceral metastasis was associated with poorer outcome compared to dogs without metastasis, however, a subset of dogs experienced long‐term control.
Weed hosts of Meloidogyne spp. and the effect of aqueous weed extracts on egg hatching
Authors: Lopes A P M , Soares M R C , Chidichima L P S , Dias‐Arieira C R
Published: December 2019

Weeds have a great economic impact on agricultural production because they compete with crops for resources and are alternative hosts for pests, microbial pathogens and plant‐parasitic nematodes. This study aimed to investigate the susceptibility of weeds to the root‐knot nematodes Meloidogyne javanica and Meloidogyne incognita and assess the effect of aqueous weed extracts on M. javanica egg hatching. Four experiments were conducted, two for each nematode species. Weeds were inoculated with 2000 nematode eggs and grown for 60 days under greenhouse conditions. Soyabean cv. Monsoy 7110 was used as control. The weeds Ipomoea grandifolia, Solanum americanum, Digitaria horizontalis, Amaranthus deflexus, Sorghum halepense and Commelina benghalensis were susceptible to M. javanica and M. incognita in at least one experiment (reproduction factor, RF >1). Crotalaria juncea and Eleusine indica were susceptible to M. incognita in one experiment, and Digitaria insularis, Sida rhombifolia, Bidens pilosa, Urochloa decumbens, Crotalaria breviflora, Cenchrus echinatus, Crotalaria ochroleuca and Crotalaria spectabilis were immune or resistant (RF <1 or RF = 0). Alternanthera tenella, C. juncea, S. rhombifolia, C. ochroleuca, C. spectabilis, C. breviflora, B. pilosa, E. indica, U. decumbens and C. echinatus were resistant or immune to M. javanica (RF <1 or RF = 0). Compared with the control (water), all weed extracts reduced M. javanica egg hatch. Our results highlight the importance of weed control in agricultural systems, as nematodes can survive and multiply in weed roots during the off‐season. Weed leaves and shoots, however, may be an interesting source of compounds with nematicidal activity.
New classes of topological crystalline insulators having surface rotation anomaly
Authors: Fang Chen , Fu Liang
Published: December 2019

Rotation symmetry–protected topological states with “anomalous” gapless surface states are predicted.
Quasiparticle interference evidence of the topological Fermi arc states in chiral fermionic semimetal CoSi
Authors: Yuan Qian-Qian , Zhou Liqin , Rao Zhi-Cheng , Tian Shangjie , Zhao Wei-Min , Xue Cheng-Long , Liu Yixuan , Zhang Tiantian , Tang Cen-Yao , Shi Zhi-Qiang , Jia Zhen-Yu , Weng Hongming , Ding Hong , Sun Yu-Jie , Lei Hechang , Li Shao-Chun
Published: December 2019

Chiral Fermi arc states are confirmed on CoSi surfaces, and a large spin-orbit coupling is identified in these arc states.
Directed aging, memory, and nature’s greed
Authors: Pashine Nidhi , Hexner Daniel , Liu Andrea J. , Nagel Sidney R.
Published: December 2019

Plastic deformation produced by external strains directs the aging of disordered materials to create unusual elastic response.
Single-molecule detection of biomarker and localized cellular photothermal therapy using an optical microfiber with nanointerface
Authors: Li Hongtao , Huang Yunyun , Hou Guanhua , Xiao Aoxiang , Chen Pengwei , Liang He , Huang Yugang , Zhao Xiaotian , Liang Lili , Feng Xinhuan , Guan Bai-Ou
Published: December 2019

An optical microfiber with nanointerface is developed for single-molecule detection and cellular photothermal therapy.
A new metal transfer process for van der Waals contacts to vertical Schottky-junction transition metal dichalcogenide photovoltaics
Authors: Went Cora M. , Wong Joeson , Jahelka Phillip R. , Kelzenberg Michael , Biswas Souvik , Hunt Matthew S. , Carbone Abigail , Atwater Harry A.
Published: December 2019

We develop a new technique for transferring metal contacts to create ultrathin solar cells from 2D materials.
Tailoring excitonic states of van der Waals bilayers through stacking configuration, band alignment, and valley spin
Authors: Hsu Wei-Ting , Lin Bo-Han , Lu Li-Syuan , Lee Ming-Hao , Chu Ming-Wen , Li Lain-Jong , Yao Wang , Chang Wen-Hao , Shih Chih-Kang
Published: December 2019

We report the layer-hybridized valley excitons in 2D hetero- and homobilayers manifested by band alignment and valley spin.
Wave physics as an analog recurrent neural network
Authors: Hughes Tyler W. , Williamson Ian A. D. , Minkov Momchil , Fan Shanhui
Published: December 2019

Analog machine learning computations are performed passively by propagating light and sound waves through programmed materials.
Composite super-moiré lattices in double-aligned graphene heterostructures
Authors: Wang Zihao , Wang Yi Bo , Yin J. , Tóvári E. , Yang Y. , Lin L. , Holwill M. , Birkbeck J. , Perello D. J. , Xu Shuigang , Zultak J. , Gorbachev R. V. , Kretinin A. V. , Taniguchi T. , Watanabe K. , Morozov S. V. , Anđelković M. , Milovanović S. P. , Covaci L. , Peeters F. M. , Mishchenko A. , Geim A. K. , Novoselov K. S. , Fal’ko Vladimir I. , Knothe Angelika , Woods C. R.
Published: December 2019

Researchers combine moiré patterns to break the geometric limitations in graphene superlattices, and access new energy scales.
Early-life programming of mesenteric lymph node stromal cell identity by the lymphotoxin pathway regulates adult mucosal immunity
Authors: Li Conglei , Lam Evelyn , Perez-Shibayama Christian , Ward Lesley A. , Zhang Jianbo , Lee Dennis , Nguyen Albert , Ahmed Musaddeque , Brownlie Emma , Korneev Kirill V. , Rojas Olga , Sun Tian , Navarre William , He Housheng Hansen , Liao Shan , Martin Alberto , Ludewig Burkhard , Gommerman Jennifer L.
Published: December 2019

Early-life LTβR signaling programs the mesenteric lymph node stromal cell environment, optimizing gut IgA responses in the adult mouse.