bluuebunny/crossref_metadata_2025 huggingface dataset:
Determinanten der Niederlassung als Allgemeinmediziner – eine
qualitative Studie
Authors: Zwierlein Ruben , Portenhauser Frank , Flägel Kristina , Steinhäuser Jost
Published: April 2020

Ziel der Studie In den letzten Jahren kann beobachtet werden, dass die
Motivation der nachrückenden Fachärzte für
Allgemeinmedizin sich in einer eigenen Praxis niederzulassen
rückläufig ist. Mit der Kenntnis der hier fördernden und
hemmenden Faktoren, können Strategien zur Förderung der
Niederlassung abgeleitet werden. Ziel dieser Studie war es daher diese
Determinanten zu erheben.

Methodik Es wurden niedergelassene Fachärzte für
Allgemeinmedizin aus Baden-Württemberg (BW) im Zeitraum von April bis
Oktober 2016 eingeladen, an einer qualitativen Interviewstudie teilzunehmen. Die
Stratifikation der Ärzte aus einer Gruppe von insgesamt 553, die
zwischen 2008 und 2011 am Förderprogramm Allgemeinmedizin in BW
teilnahmen und sich in den Jahren 2008 bis 2014 niederließen, erfolgte
anhand der Verdichtungsräume im ländlichen Raum, der Randzonen
um Verdichtungsräume und der Verdichtungsräume selbst. Die
Transkripte der Interviews wurden von zwei Autoren inhaltsanalytisch nach
Mayring ausgewertet, zusammengefasst und im zweiten Schritt in eine
Konsensversion überführt.

Ergebnisse Es konnten 23 Allgemeinmediziner rekrutiert werden, die zu
57% weiblich und im Durchschnitt 42 Jahre alt waren sowie mehrheitlich
in Kooperation arbeiteten. Hauptmotivation sich niederzulassen lag in dem Wunsch
die Situation gegenüber dem Klinikalltag zu verbessern. Hierzu
zählten insbesondere eine geringere Dienstbelastung und
familienfreundlichere Arbeitszeiten. Relevante, unterstützende Faktoren
während des Niederlassungsprozesses waren der familiäre
Rückhalt, die (Verbund-)Weiterbildung und professionelle Beratung.
Hemmende Faktoren waren Ängste vor Regressen und Verschuldung, das als
kompliziert erlebte Abrechnungssystem und der als bürokratisch erlebte
Zulassungsprozess.

Schlussfolgerungen Die Studie zeigt zum einen, dass die vielen Vorteile
als niedergelassener Allgemeinmediziner, wie z. B. die gute
Familienkompatibilität, besser kommuniziert und die finanziellen
Bedenken entschärft werden müssen. Zum anderen zeigt sich der
Bedarf nach Lehrangeboten in der Ausbildung zum Praxismanagement. Ein
standardisierter und optimierter Niederlassungsprozess mit verbesserter
Übersicht und einem kollegialen Ansprechpartner kann die Entscheidung
für die Niederlassung und die Durchführung erleichtern.
Nuclear medicine in SARS-CoV-2 pandemia: 18F-FDG-PET/CT to visualize COVID-19
Authors: Lütje Susanne , Marinova Milka , Kütting Daniel , Attenberger Ulrike , Essler Markus , Bundschuh Ralph Alexander
Published: April 2020

The current outbreak of coronavirus SARS-CoV-2 has reached multiple countries worldwide. While the number of newly diagnosed cases and fatalities is rising quickly, far-reaching measures were enacted to prevent further spread. Diagnosis relies on clinical presentation, exposure history, PCR using specimens from the respiratory tract together with computed tomography (CT) imaging. One of the hallmarks of a critical course of COVID-19 is the development of severe acute respiratory distress syndrome (ARDS). As management of COVID-19 can be considered a multi-disciplinary approach involving various medical specialties, we here review the first 18F-FDG-PET/CT scans of COVID-19 to discuss how Nuclear Medicine could contribute to management of this disease.
Thrombocytopenia in Surgery and Neuraxial Anesthesia
Authors: Estcourt Lise J.
Published: April 2020

This is a review of the evidence for the use of different platelet count thresholds prior to invasive procedures and surgery. This review will focus on three procedures that are common in patients with thrombocytopenia—central venous catheter insertion, liver biopsy, and lumbar punctures and epidural catheters—as well as highlighting the lack of evidence for more major surgery. Tunneled or untunneled central venous catheters are low-risk procedures and can be safely performed without any intervention when the platelet count is 20 × 109/L or above. Evidence for their safety is more limited below this threshold, but as bleeding is easily treated, interventions should focus on treating any bleeding that occurs rather than preventative strategies. The available evidence for neuraxial anesthesia is based on very low-quality evidence from observational studies. Based on this evidence, the risk of an epidural hematoma is less than 0.19% (upper limit of 95% confidence interval) for pregnant women undergoing an epidural anesthetic when the platelet count is between 70 and 99 × 109/L. No randomized trials have been performed in children, nor have any randomized trials been performed in major or emergency surgeries.
Plasma electron source for generating a ribbon beam in the forevacuum pressure range
Authors: Klimov A. S. , Bakeev I. Yu. , Oks E. M. , Tran V. T. , Zenin A. A.
Published: April 2020

We describe a plasma-cathode electron beam source based on a hollow cathode glow discharge and operating in the forevacuum pressure range that produces a steady-state ribbon beam. The electron beam is generated in the pressure range of 10–30 Pa. A multi-aperture electron extraction and beam formation system is used to provide beam stability and enhanced uniformity of beam current density, allowing the use of this kind of device for beam-plasma surface modification over relatively large areas.
Stimulated Raman scattering mechanisms and scaling behavior in planar direct-drive experiments at the National Ignition Facility
Authors: Rosenberg M. J. , Solodov A. A. , Seka W. , Follett R. K. , Myatt J. F. , Maximov A. V. , Ren C. , Cao S. , Michel P. , Hohenberger M. , Palastro J. P. , Goyon C. , Chapman T. , Ralph J. E. , Moody J. D. , Scott R. H. H. , Glize K. , Regan S. P.
Published: April 2020

Stimulated Raman scattering (SRS) has been explored comprehensively in planar-geometry experiments at the National Ignition Facility in conditions relevant to the corona of inertial confinement fusion ignition-scale direct-drive targets. These experiments at measured electron temperatures of 4 to 5 keV simulated density scale lengths Ln of 400 to 700 μm, and laser intensities at the quarter-critical density of up to 1.5 × 1015 W/cm2 have determined SRS thresholds and the scaling behavior of SRS for various beam geometries. Several SRS mechanisms, including saturated absolute SRS near the quarter-critical density and additional SRS, including near-backscatter or sidescatter at lower densities, have been identified. Correlation of time-dependent SRS at densities ∼0.15 to 0.21 of the critical density with hot-electron signatures as well as the magnitudes of these signatures across different experiments, is observed. Further modeling work is needed to definitively identify the density region in which hot electrons are generated and will guide SRS and hot-electron preheat mitigation strategies for direct-drive-ignition designs.
Continuum electromagnetic gyrokinetic simulations of turbulence in the tokamak scrape-off layer and laboratory devices
Authors: Hakim Ammar H. , Mandell Noah R. , Bernard T. N. , Francisquez M. , Hammett G. W. , Shi E. L.
Published: April 2020

We present algorithms and results from Gkeyll, a full-f continuum, electromagnetic gyrokinetic code, designed to study turbulence in the edge region of fusion devices. The edge is computationally very challenging, requiring robust algorithms that can handle large-amplitude fluctuations and stable interactions with plasma sheaths. We present an energy-conserving high-order discontinuous Galerkin scheme that solves gyrokinetic equations in Hamiltonian form. Efficiency is improved by a careful choice of basis functions and automatically generated computation kernels. Previous verification tests were performed in the straight-field-line large plasma device [Shi et al., J. Plasma Phys. 83, 905830304 (2017)] and the Texas Helimak, a simple magnetized torus [Bernard et al., Phys. Plasmas 26, 042301 (2019)], including the effect of end-plate biasing on turbulence. Results for the scrape-off layer for NSTX parameters with a model helical magnetic geometry with bad curvature have been obtained [Shi et al., Phys. Plasmas 26, 012307 (2019)]. In this paper, we present algorithms for the two formulations of electromagnetic gyrokinetics: the Hamiltonian and the symplectic. We describe each formulation and show results of benchmark tests. Although our scheme works for the Hamiltonian formulation, the presence of spurious numerical modes for high-β and large k⊥2ρs2 regimes shows that the symplectic formulation is more robust. We then review our recent algorithm for the symplectic formulation [Mandell et al., J. Plasma Phys. 86, 905860109 (2020)], along with example application of this new capability. Maintaining positivity of the distribution function can be challenging, and we describe a new and novel exponential recovery based algorithm to address this.
MOCVD growth of InP-based 1.3
μ
m quantum dash lasers on (001) Si
Authors: Luo Wei , Xue Ying , Shi Bei , Zhu Si , Dong Xu , Lau Kei May
Published: April 2020

Quantum dot and quantum dash (QDash) lasers exhibit lower threshold, less temperature sensitivity, and larger modulation bandwidths than the conventional quantum well lasers. For III–V lasers monolithically grown on Si, the stronger carrier confinement and the discrete distribution of these three-dimensional (3D) quantum structures add to their immunity to material defects resulted from hetero-epitaxy. In this study, we report InAs/InAlGaAs/InP QDash lasers emitting at 1.3 μm directly grown on compliant InP/Si substrates by metalorganic chemical vapor deposition. Room-temperature lasing has been demonstrated on both nano-V-groove patterned and unpatterned planar (001) Si under pulsed electrical pumping, with a low threshold current density of 1.05 kA/cm2. A comparison of lasers grown on these two categories of InP/Si templates in terms of material quality and device performance is presented. Results presented in this work demonstrate the possibility of integrating both datacom and telecom lasers on Si, using the same InAs/InP quantum dash material system on a developed InP-on-Si virtual substrate.
The Second-Order-Polarization-Propagator-Approximation (SOPPA) in a four-component spinor basis
Authors: Schnack-Petersen Anna Kristina , Simmermacher Mats , Fasshauer Elke , Jensen Hans Jørgen Aa. , Sauer Stephan P. A.
Published: April 2020

A theoretical framework for understanding molecular structures is crucial for the development of new technologies such as catalysts or solar cells. Apart from electronic excitation energies, however, only spectroscopic properties of molecules consisting of lighter elements can be computationally described at a high level of theory today since heavy elements require a relativistic framework, and thus far, most methods have only been derived in a non-relativistic framework. Important new technologies such as those mentioned above require molecules that contain heavier elements, and hence, there is a great need for the development of relativistic computational methods at a higher level of accuracy. Here, the Second-Order-Polarization-Propagator-Approximation (SOPPA), which has proven to be very successful in the non-relativistic case, is adapted to a relativistic framework. The equations for SOPPA are presented in their most general form, i.e., in a non-canonical spin–orbital basis, which can be reduced to the canonical case, and the expressions needed for a relativistic four-component SOPPA are obtained. The equations are one-index transformed, giving more compact expressions that correspond to those already available for the four-component RPA. The equations are ready for implementation in a four-component quantum chemistry program, which will allow both linear response properties and excitation energies to be calculated relativistically at the SOPPA level.
The calculations of thermophysical properties of low-temperature gallium plasma
Authors: Apfelbaum E. M.
Published: April 2020

We have developed a model for the calculation of the thermophysical properties (pressure, internal energy, conductivity, thermal conductivity, and thermal power) and the chemical composition of gallium plasma at temperatures 10–100 kK and densities less than 6 g/cm3. In this area, there have not been any published data on the considered properties for gallium plasma until now. The model was constructed on the basis of the chemical approach and relaxation time approximation. We have also estimated the region of applicability of the model due to the used approximations.
Inconsistent allocations of harms versus benefits may exacerbate environmental inequality
Authors: Makov Tamar , Newman George E. , Zauberman Gal
Published: April 2020

Significance

Local environmental conditions, such as air and water quality, are shaped, in part, by how societies allocate environmental harms and benefits. Since environmental conditions have long-lasting impacts on people’s lives, understanding the psychology behind such allocation decisions is critical. Across studies, we demonstrate that people are less likely to support decisions that increase environmental equality when considering the allocation of environmental harms (vs. benefits). Our findings suggest that careful attention to the way that the allocation of environmental harms is presented to the public could change the support for decisions that address environmental inequality.
The European Union Emissions Trading System reduced CO
2
emissions despite low prices
Authors: Bayer Patrick , Aklin Michaël
Published: April 2020

International carbon markets are an appealing and increasingly popular tool to regulate carbon emissions. By putting a price on carbon, carbon markets reshape incentives faced by firms and reduce the value of emissions. How effective are carbon markets? Observers have tended to infer their effectiveness from market prices. The general belief is that a carbon market needs a high price in order to reduce emissions. As a result, many observers remain skeptical of initiatives such as the European Union Emissions Trading System (EU ETS), whose price remained low (compared to the social cost of carbon). In this paper, we assess whether the EU ETS reduced

C
O

2

emissions despite low prices. We motivate our study by documenting that a carbon market can be effective if it is a credible institution that can plausibly become more stringent in the future. In such a case, firms might cut emissions even though market prices are low. In fact, low prices can be a signal that the demand for carbon permits weakens. Thus, low prices are compatible with successful carbon markets. To assess whether the EU ETS reduced carbon emissions even as permits were cheap, we estimate counterfactual carbon emissions using an original sectoral emissions dataset. We find that the EU ETS saved about 1.2 billion tons of

C
O

2

between 2008 and 2016 (3.8%) relative to a world without carbon markets, or almost half of what EU governments promised to reduce under their Kyoto Protocol commitments. Emission reductions in sectors covered under the EU ETS were higher.
Activity in grafted human iPS cell–derived cortical neurons integrated in stroke-injured rat brain regulates motor behavior
Authors: Palma-Tortosa Sara , Tornero Daniel , Grønning Hansen Marita , Monni Emanuela , Hajy Mazin , Kartsivadze Sopiko , Aktay Sibel , Tsupykov Oleg , Parmar Malin , Deisseroth Karl , Skibo Galyna , Lindvall Olle , Kokaia Zaal
Published: April 2020

Significance

Many stroke patients exhibit long-term disability. Transplantation of stem cells has been proposed as a novel therapeutic strategy to promote recovery. However, little is known about whether these cells can form functionally integrated connections with neurons in the stroke-injured recipient’s brain. Here we show extensive morphological and functional integration of axonal projections from intracortically transplanted human iPS cell–derived cortical neurons in brains of rats with ischemic lesions in the cerebral cortex. We also demonstrate that neuronal activity in these grafts is involved in the regulation of the stroke-affected animals’ motor behavior. Our findings raise the possibility that injured neural circuitry might be restored by stem cells also in humans affected by stroke, which would have major clinical implications.
Primary cilia control glucose homeostasis via islet paracrine interactions
Authors: Hughes Jing W. , Cho Jung Hoon , Conway Hannah E. , DiGruccio Michael R. , Ng Xue Wen , Roseman Henry F. , Abreu Damien , Urano Fumihiko , Piston David W.
Published: April 2020

Pancreatic islets regulate glucose homeostasis through coordinated actions of hormone-secreting cells. What underlies the function of the islet as a unit is the close approximation and communication among heterogeneous cell populations, but the structural mediators of islet cellular cross talk remain incompletely characterized. We generated mice specifically lacking β-cell primary cilia, a cellular organelle that has been implicated in regulating insulin secretion, and found that the β-cell cilia are required for glucose sensing, calcium influx, insulin secretion, and cross regulation of α- and δ-cells. Protein expression profiling in islets confirms perturbation in these cellular processes and reveals additional targets of cilia-dependent signaling. At the organism level, the deletion of β-cell cilia disrupts circulating hormone levels, impairs glucose homeostasis and fuel usage, and leads to the development of diabetes. Together, these findings demonstrate that primary cilia not only orchestrate β-cell–intrinsic activity but also mediate cross talk both within the islet and from islets to other metabolic tissues, thus providing a unique role of cilia in nutrient metabolism and insight into the pathophysiology of diabetes.
Venous Thromboembolism Prophylaxis in Aesthetic Surgery: A Survey of Plastic Surgeons’ Practices
Authors: Aimé Victoria L , Neville Matthew R , Thornburg Danielle A , Noland Shelley S , Mahabir Raman C , Bernard Robert W
Published: April 2020

Background

Deep venous thrombosis and pulmonary embolism, collectively known as venous thromboembolism (VTE), are among the most feared yet preventable surgical complications. Although many recommendations exist to reduce the risk of VTE, the actual VTE prophylaxis practices of aesthetic plastic surgeons remain unknown.

Objectives

The primary aim of this study was to elucidate plastic surgeons’ experiences with VTE, preferred VTE prophylaxis practices, and areas in which VTE prevention may be improved.

Methods

Members of The Aesthetic Society were queried via a 55-question electronic survey regarding their experience with VTE as well as their VTE prophylaxis practices. Anonymous responses were collected and analyzed by the Mayo Clinic Survey Research Center.

Results

The survey was sent to 1729 of The Aesthetic Society members, of whom 286 responded. Fifty percent, 38%, and 6% of respondents reported having had a patient develop a deep venous thrombosis, pulmonary embolism, or death secondary to VTE, respectively. Procedures performed on the back or trunk were associated with the highest rate of VTE. Lower extremity procedures were associated with a significantly higher rate of VTE than expected. Over 90% of respondents reported utilizing a patient risk stratification assessment tool. Although at least one-half of respondents reported that the surgical facility in which they operate maintains some form of VTE prophylaxis protocol, 39% self-reported nonadherence with these protocols.

Conclusions

Considerable variability exists in VTE prophylaxis practices among The Aesthetic Society responders. Future efforts should simplify guidelines and tailor prophylaxis recommendations to the aesthetic surgery population. Furthermore, education of plastic surgeons performing aesthetic surgery and more diligent surgical venue supervision is needed to narrow the gap between current recommendations and actual practices.
Community-Based Antibiotic Prescribing Attributable to Respiratory Syncytial Virus and Other Common Respiratory Viruses in Young Children: A Population-Based Time-series Study of Scottish Children
Authors: Fitzpatrick Tiffany , Malcolm William , McMenamin Jim , Reynolds Arlene , Guttmann Astrid , Hardelid Pia
Published: April 2020

Background

Inappropriate antibiotic prescribing, such as for viral illness, remains common in primary care. The objective of this study was to estimate the proportion of community-prescribed antibiotics to children aged less than 5 years attributable to common respiratory viruses.

Methods

We fitted time-series negative binomial models to predict weekly antibiotic prescribing rates from positive viral pathogen tests for the period 1 April 2009 through 27 December 2017 using comprehensive, population-based administrative data for all children (<5 years) living in Scotland. Multiple respiratory viral pathogens were considered, including respiratory syncytial virus (RSV), influenza, human metapneumovirus (HMPV), rhinovirus, and human parainfluenza (HPIV) types 1–4. We estimated the proportion of antibiotic prescriptions explained by virus circulation according to type of virus, by age group, presence of high-risk chronic conditions, and antibiotic class.

Results

We included data on 6 066 492 antibiotic prescriptions among 452 877 children. The antibiotic-prescribing rate among all Scottish children (<5 years) was 609.7 per 1000 child-years. Our final model included RSV, influenza, HMPV, HPIV-1, and HPIV-3. An estimated 6.9% (95% confidence interval, 5.6–8.3%), 2.4% (1.7–3.1%), and 2.3% (.8–3.9%) of antibiotics were attributable to RSV, influenza, and HMPV, respectively. RSV was consistently associated with the highest proportion of prescribed antibiotics, particularly among children without chronic conditions and for amoxicillin and macrolide prescriptions.

Conclusions

Nearly 14% of antibiotics prescribed to children in this study were estimated to be attributable to common viruses for which antibiotics are not recommended. A future RSV vaccine could substantially reduce unnecessary antibiotic prescribing among children.
Blinding multiprobe cosmological experiments
Authors: Muir J , Bernstein G M , Huterer D , Elsner F , Krause E , Roodman A , Allam S , Annis J , Avila S , Bechtol K , Bertin E , Brooks D , Buckley-Geer E , Burke D L , Carnero Rosell A , Carrasco Kind M , Carretero J , Cawthon R , Costanzi M , da Costa L N , De Vicente J , Desai S , Dietrich J P , Doel P , Eifler T F , Everett S , Fosalba P , Frieman J , García-Bellido J , Gerdes D W , Gruen D , Gruendl R A , Gschwend J , Hartley W G , Hollowood D L , James D J , Jarvis M , Kuehn K , Kuropatkin N , Lahav O , March M , Marshall J L , Melchior P , Menanteau F , Miquel R , Ogando R L C , Palmese A , Paz-Chinchón F , Plazas A A , Romer A K , Sanchez E , Scarpine V , Schubnell M , Serrano S , Sevilla-Noarbe I , Smith M , Suchyta E , Tarle G , Thomas D , Troxel M A , Walker A R , Weller J , Wester W , Zuntz J ,   (DES Collaboration)
Published: April 2020

The goal of blinding is to hide an experiment’s critical results – here the inferred cosmological parameters – until all decisions affecting its analysis have been finalized. This is especially important in the current era of precision cosmology, when the results of any new experiment are closely scrutinized for consistency or tension with previous results. In analyses that combine multiple observational probes, like the combination of galaxy clustering and weak lensing in the Dark Energy Survey (DES), it is challenging to blind the results while retaining the ability to check for (in)consistency between different parts of the data. We propose a simple new blinding transformation, which works by modifying the summary statistics that are input to parameter estimation, such as two-point correlation functions. The transformation shifts the measured statistics to new values that are consistent with (blindly) shifted cosmological parameters while preserving internal (in)consistency. We apply the blinding transformation to simulated data for the projected DES Year 3 galaxy clustering and weak lensing analysis, demonstrating that practical blinding is achieved without significant perturbation of internal-consistency checks, as measured here by degradation of the χ2 between the data and best-fitting model. Our blinding method’s performance is expected to improve as experiments evolve to higher precision and accuracy.
An asymmetric explosion mechanism may explain the diversity of Si ii linewidths in Type Ia supernovae
Authors: Livneh Ran , Katz Boaz
Published: April 2020

Near maximum brightness, the spectra of Type Ia supernovae (SNe Ia) present typical absorption features of Silicon II observed at roughly $6100$ and $5750\, \mathring{\rm A}$. The two-dimensional distribution of the pseudo-equivalent widths (pEWs) of these features is a useful tool for classifying SNe Ia spectra (Branch plot). Comparing the observed distribution of SNe on the Branch plot to results of simulated explosion models, we find that one-dimensional models fail to cover most of the distribution. In contrast, we find that tardis radiative transfer simulations of the white dwarf head-on collision models along different lines of sight almost fully cover the distribution. We use several simplified approaches to explain this result. We perform order-of-magnitude analysis and model the opacity of the Si ii lines using local thermodynamic equilibrium and non-local thermodynamic equilibrium approximations. Introducing a simple toy model of spectral feature formation, we show that the pEW is a good tracer for the extent of the absorption region in the ejecta. Using radiative transfer simulations of synthetic SN ejecta, we reproduce the observed Branch plot distribution by varying the luminosity of the SN and the Si density profile of the ejecta. We deduce that the success of the collision model in covering the Branch plot is a result of its asymmetry, which allows for a significant range of Si density profiles along different viewing angles, uncorrelated with a range of 56Ni yields that cover the observed range of SN Ia luminosity. We use our results to explain the shape and boundaries of the Branch plot distribution.
Nonmelanoma Skin Cancers: Embryologically Relevant Sites and UV Exposure
Authors: Nicoletti Giovanni , Tresoldi Marco Mario , Malovini Alberto , Francesco Borelli , Faga Angela
Published: April 2020

Background:

Traditionally, nonmelanoma skin cancers (NMSCs) are considered mainly UV-related malignancies. Nevertheless, a strong correlation between the embryologically relevant sites (ERS) of the head and neck and the preferential sites of onset of basal cell carcinomas (BCCs) has long been supposed and demonstrated. The aim of this research was the investigation of the potential correlation between the ERS of the head and neck and the sites of tumor onset in all of the NMSCs.

Methods:

The distribution of 1165 NMSC was correlated with the ERS of the head and neck using the universally accepted anatomical diagrams featuring the congenital head and neck clefts and an original anatomical diagram showing the most credited sites of the embryonic fusion planes of the auricle.

Results:

In our sample, both BCC and SSC display an increased likelihood of onset in the ERS of the head and neck. A proportion of 93.10% BCCs was distributed within ERS, while 6.90% derived from non-embryologically relevant sites (P < 0.001). A proportion of 69.70% SCCs was distributed within ERS, while 30.30% derived from non-embryologically relevant sites (P < 0.001). The probability of tumors within ERS was significantly higher for BCC versus SCC (P < 0.001), with BCCs having a 5-fold increase in the probability of occurring in ERS compared to SCCs (P < 0.001).

Conclusions:

The ERS might host areas of cellular instability yielding to the development of an NMSC. The environmental UV exposure plays a relatively main role versus dysontogenic factors in the pathogenesis of SCC.
Bleeding Events in Patients 75 Years of Age and Older Under Long-term Anticoagulant Therapy: A Real-life Study
Authors: Conti Alberto , Renzi Noemi , Catarzi Stefania , Mazzucchelli Mariuccia , Covelli Antonella , Pampana Alessandro , Bongini Giada , Bini Giacomo , Leorin Marco , Ghiadoni Lorenzo
Published: April 2020

Objective:

To investigate the risk of bleeding events in older patients under oral anticoagulant with a 4-year survey of a catchment area with 197,722 inhabitants of whom 15,267 were on warfarin and 10,397 on direct oral anticoagulants (DOACs).

Methods:

Patients presented to the Emergency Department with major bleeding were enrolled and stratified according to age ≥75 years and ongoing warfarin or DOACs. Primary endpoint was 1-month death.

Results:

Out of 1919 major bleeding, those of patients ≥75 years of age were 1127 (59%) versus 792 (41%) <75 years of age, P < 0.0001. In patients ≥75 years of age, brain hemorrhage accounted for 612 (54%) patients, gastrointestinal hemorrhage for 301 (27%), hematuria for 104 (9%), and other hemorrhage for 108 (10%). In patients ≥75 years of age, those on warfarin accounted for 175 versus 53 on DOACs, without difference of Charlson Comorbidity Index (5.25 ± 1.92 versus 5.09 ± 1.61; P = 0.5824). One-month death in patients ≥75 of age versus <75 years of age accounted for 77 (4.0%) versus 20 (1.0%); P < 0.0001. One-month death in patients ≥75 of age on DOACs was very low, without difference versus <75 years and within DOACs. Among DOACs, absolute bleeding events showed differences as follows: 3 bleeding events for edoxaban versus 21 for dabigatran; P < 0.001; versus 16 for rivaroxaban, P = 0.006; and versus 13 for apixaban, P = 0.02.

Conclusions:

Major bleeding and 1-month death accounted for higher percentage in patients ≥75 years of age and in patients receiving warfarin. Among DOACs, edoxaban presented the lowest absolute rate of hemorrhage among the 4 available DOACs, without difference in mortality.
Practice Patterns of Family Physicians With and Without Sports Medicine Certification
Authors: Cox Rachel , Morgan Zachary J. , Nithyanandam Srikanth , Puffer James C. , Peterson Lars E.
Published: April 2020

Objective:

To update information regarding practice patterns of family physicians with a certificate of added qualifications (CAQ) in Sports Medicine (SM), because it has been over 10 years since the last comprehensive study.

Design:

Cross-sectional analysis of 2017 and 2018 American Board of Family Medicine (ABFM) Family Medicine Certification and SM CAQ examination registration practice demographic questionnaire data.

Setting:

N/A.

Participants:

Family physicians with a CAQ in SM [sports medicine family physicians (SM-FPs)] and family physicians without a CAQ registering for the ABFM Family Medicine Certification or SM CAQ examinations.

Intervention:

N/A.

Main Outcomes:

Self-reported time spent practicing SM, activities in SM, scope of practice, and practice setting.

Results:

Sports medicine family physicians are predominately men (78.7%) and below 49 years (65.8%). Most SM-FPs spend 60% of their time or less practicing SM and the scope of practice of SM-FPs is only slightly narrower than that of their family physician counterparts without a CAQ. In addition, 92.8% of SM-FPs are practicing in an urban setting.

Conclusions:

The similarity of scope of practice for SM-FPs and family physicians without a CAQ and the time spent practicing SM by SM-FPs suggests that most SM-FPs are spending a significant amount of time continuing to practice their primary specialty. Sports medicine family physicians are largely attracted to urban practice settings, most likely because of the higher likelihood of employment opportunities. Finally, factors that may be dissuading women from entering the field of SM deserve further investigation.
Comparison of transmissibility of coronavirus between symptomatic and asymptomatic patients: Reanalysis of the Ningbo Covid-19 data
Authors: Yin Guosheng , Jin Huaqing
Published: April 2020

We investigate the transmissibility of coronavirus for symptomatic and asymptomatic patients using the Ningbo Covid-19 data1. Through more in-depth and comprehensive statistical analysis, we conclude that there is no difference in the transmission rates of coronavirus between the symptomatic and asymptomatic patients, which is consistent with the original findings in Chen et al.1
Longitudinal analysis of laboratory findings during the process of recovery for patients with COVID-19
Authors: Tian Suyan , Zhu Xuetong , Sun Xuejuan , Wang Jinmei , Zhou Qi , Wang Chi , Chen Li , Xu Jiancheng
Published: April 2020

Objective

To explore longitudinal change patterns of key laboratory tests in patients with COVID-19, and to identify independent prognostic factors by examining the associations between laboratory findings and outcomes of patients.

Methods

The multicenter study prospectively included 59 patients with COVID-19 treated at Jilin province from January 21, 2020 to May 5, 2020. Laboratory tests were included haematological, biochemical, and immunological tests.

Results

Laboratory findings, the characteristics of epidemiological and demographic data were extracted from electronic medical records. Eosinopenia was shown in 52.6% cases at onset, and the average value of eosinophil continued to significantly increase thereafter. Lymphopenia was found in 40.4% cases at onset, and the average value of lymphocyte was slowly elevated after day 5. Thrombocytopenia was shown in 12.3% cases at onset, and the average value of mean platelet volume was decreased sharply after day 7. The values of aspartate aminotransferase, lactate dehydrogenase, creatine kinase, creatinine kinase-muscle/brain activity, and cardiac troponin I, serum cardiac markers, were beyond the upper limit of RI from 6.1% to 30.6% at onset. The abnormity of liver function tests, kidney function tests, electrolytes was 2.0%∼59.2%, 2.0%∼4.1%, 6.0%∼30.0%, respectively. Eosinophil, platelet and carbondioxide combining power were selected as the prognostic factors.

Conclusions

The haematological, biochemical, and immunological tests were found significant abnormity at onset and longitudinal change patterns in the patients with COVID-19. Age, Eosinophil, PLT and CO2 may used to predict the recovery probability. Risk stratification and management could be improved for the patients with COVID-19 according to temporal trajectories of laboratory tests.

Article Summary

The longitudinal change patterns of the laboratory characteristics of affected patients were important to identify prognosis. Eosinophil, platelet and carbondioxide combining power may be independent predictors of recovery in patients with COVID-19.
Age-dependent differences in functional brain networks are atypical in Tourette syndrome
Authors: Nielsen Ashley N. , Gratton Caterina , Kim Soyoung , Church Jessica A. , Black Kevin J. , Petersen Steven E. , Schlaggar Bradley L. , Greene Deanna J.
Published: April 2020

Tourette syndrome (TS) is a neurodevelopmental disorder characterized by motor and vocal tics. TS is complex, with symptoms that involve sensory, motor, and top-down control processes and that fluctuate over the course of development. While many have studied atypical brain structure and function associated with TS, the neural substrates supporting the complex range and time-course of symptoms is largely understudied. Here, we used functional connectivity MRI to examine functional networks across the whole-brain in children and adults with TS. To investigate the functional neuroanatomy of childhood and adulthood TS, we separately considered the sets of connections within each functional network and those between each pair of functional networks. We tested whether developmental stage (child, adult), diagnosis (TS, control), or an interaction between these factors was present among these connections. We found that developmental changes for most functional networks in TS were unaltered (i.e., developmental differences in TS were similar to those in typically developing children and adults). However, there were several within-network and cross-network connections that exhibited either “divergent” or “attenuated” development in TS. Connections involving the somatomotor, cingulo-opercular, auditory, dorsal attention, and default mode networks diverged from typical development in TS, demonstrating enhanced functional connectivity in adulthood TS. In contrast, connections involving the basal ganglia, thalamus, cerebellum, auditory, visual, reward, and ventral attention networks showed attenuated developmental differences in TS. These results suggest that adulthood TS is characterized by increased functional connectivity among functional networks that support cognitive control and attention, which may be implicated in suppressing, producing, and attending to tics. In contrast, subcortical systems that have been implicated in the initiation and production of tics may be immature in adulthood TS. Jointly, our results reveal how several cortical and subcortical functional networks interact and differ across development in TS.
Supporting the digital professor: information, training and support
Authors: Coles Shanna , Martin Florence , Polly Drew , Wang Chuang
Published: April 2020

Purpose

The purpose of this paper is to provide insight into institutions of higher education (IHE) on how to support faculty in the integration of digital technologies. The research explores faculty interest in types of digital technology information and training, and the types of support faculty are likely to participate in related to digital technology integration. The association of demographic factors of primary teaching method, and experience teaching online or hybrid is provided.

Design/methodology/approach

A sample of 247 faculty from 53 institutions in the USA completed an online survey related to information, training and support for digital technology integration. The analysis included exploring the descriptive ratings overall and by demographic variable and conducting the one-way multivariate analysis of variance (MANOVA) with reported effect sizes and Scheffe post-hoc tests.

Findings

From a list of digital technologies that included the LMS, Collaboration Tools (social media and online meeting tools), Audio-Visual Tools (video creation and podcasts), and Technology Trends (mobile learning, games and adaptive learning), faculty ranked LMS highest in interest for training and information. Faculty who have taught hybrid are most interested in collaboration tools and trend tools. For support type, faculty ranked web resources slightly higher than other types of support.

Practical implications

IHE units involved in faculty development can use the findings to plan faculty support initiatives for future institutional needs.

Originality/value

This paper gathers insight from faculty on their preferences for information, training, and support for integrating digital technologies.
Siblingship beyond siblings? Cousins and the shadows of social mobility in the central Philippines
Authors: Cruz Resto
Published: April 2020

This article examines cousinship as a border zone that encompasses distance and intimacy, sameness and difference, and which mediates and is mediated by other kinship ties. It investigates how cousinship may bear traces of discord afflicting preceding generations; how it may further or augment them, or allow their repair; and how it is shaped by multiple and contending ideals. It does so in the context of social mobility in post‐1945 central Philippines. Integrating ‘old’ and ‘new’ kinship studies, it analyses cousinship beyond consanguineous marriages; revisits the paradigm of siblingship that has dominated the anthropology of kinship in Southeast Asia; and attends to how inequalities and enmities arise, and are absorbed, within kinship.
“My village fell apart”: Parents' Views on Seeking Informal Mentoring Relationships for Their Children
Authors: Weiler Lindsey M. , Keyzers Angela , Scafe Meredith , Anderson Amber , Cavell Timothy A.
Published: April 2020

Objective

To assess parents' perceptions of barriers and facilitators to promoting informal mentoring relationships for their children with caring adults in their existing social network.

Background

Supportive relationships with nonparental adults are critical to positive youth development, social capital, healthy living, and upward mobility, but not all children experience such relationships. Because parents are the primary gatekeepers to children's social networks, we presumed that parents could play a role in shaping children's informal mentoring relationships.

Method

We conducted eight focus groups and used a semistructured interview to ask participants about mentoring and potential barriers or facilitators to connecting children with informal mentors. Participants were 55 parents/caregivers (Mage = 41.43 years; 96.4% female; 77.9% unmarried).

Results

Parents were open to the involvement of nonparental adults in children's lives, but they differed in the extent to which their social network offered viable mentor candidates. Other barriers included feeling too proud to ask for help and concerns that informal mentors would be unsafe or inconsistent. Facilitative factors included appreciating the benefits of informal mentoring relationships, feeling connected to one's community, and being able and willing to ask for help in the face of doubt or fear.

Conclusion

Parents were generally positive about children receiving support from informal mentors and acknowledged the potential role they could play in forming those connections; they also recognized potential barriers to making those connections.

Implications

Parents' perception about their “village” suggests the need to develop and evaluate programs that help parents connect children with supportive informal mentors.
Vimentin S‐glutathionylation at Cys328 inhibits filament elongation and induces severing of mature filaments in vitro
Authors: Kaus‐Drobek Magdalena , Mücke Norbert , Szczepanowski Roman H. , Wedig Tatjana , Czarnocki‐Cieciura Mariusz , Polakowska Magdalena , Herrmann Harald , Wysłouch‐Cieszyńska Aleksandra , Dadlez Michał
Published: April 2020

Vimentin intermediate filaments are a significant component of the cytoskeleton in cells of mesenchymal origin. In vivo, filaments assemble and disassemble and thus participate in the dynamic processes of the cell. Post‐translational modifications (PTMs) such as protein phosphorylation regulate the multiphasic association of vimentin from soluble complexes to insoluble filaments and the reverse processes. The thiol side chain of the single vimentin cysteine at position 328 (Cys328) is a direct target of oxidative modifications inside cells. Here, we used atomic force microscopy, electron microscopy and a novel hydrogen–deuterium exchange mass spectrometry (HDex‐MS) procedure to investigate the structural consequences of S‐nitrosylation and S‐glutathionylation of Cys328 for in vitro oligomerisation of human vimentin. Neither modification affects the lateral association of tetramers to unit‐length filaments (ULF). However, S‐glutathionylation of Cys328 blocks the longitudinal assembly of ULF into extended filaments. S‐nitrosylation of Cys328 does not hinder but slows down the elongation. Likewise, S‐glutathionylation of preformed vimentin filaments causes their extensive fragmentation to smaller oligomeric species. Chemical reduction of the S‐glutathionylated Cys328 thiols induces reassembly of the small fragments into extended filaments. In conclusion, our in vitro results suggest S‐glutathionylation as a candidate PTM for an efficient molecular switch in the dynamic rearrangements of vimentin intermediate filaments, observed in vivo, in response to changes in cellular redox status. Finally, we demonstrate that HDex‐MS is a powerful method for probing the kinetics of vimentin filament formation and filament disassembly induced by PTMs.
Application and challenge of reflectance confocal microscopy in the diagnosis of pigmented nevus
Authors: Tang Zhen , Huang Jian , Lu Jianyun , Chen Jing , Guo Aiyuan , Ding Shu
Published: April 2020

Objective

To investigate the application and challenge of reflectance confocal microscopy (RCM) in the diagnosis of pigmented nevus.

Method

A total of 997 patients with clinical diagnosis of pigmented nevus were included in the study, and RCM imaging was performed on the lesion of each patient. A biopsy was performed in 78 of these patients for histological diagnosis. We retrospectively analyzed the results of RCM diagnosis and histological diagnosis and then found the RCM characteristics of the histologically confirmed lesion.

Results

According to the RCM images, 823 of the 997 (82.55%) patients were diagnosed with pigmented nevus, while 113 (11.33%) were not diagnosed by dermatologists using RCM. Of the 78 biopsy lesions, 36 of the 46 (78.26%) cases diagnosed with pigmented nevus were consistent with histological diagnosis, while three were rediagnosed with dermatofibromas, four were seborrheic keratosis, one was malignant melanoma in situ, and two were lentigo.

Conclusion

RCM exhibits a high diagnostic accuracy for patients with clinical diagnosis of pigmented nevus. However, due to the limitation of RCM scanning depth and the commonality of the microscopic characteristics of related diseases, RCM still faces certain challenges in the diagnosis of pigmented nevus.
Diversity of Secondary Metabolism in Aspergillus nidulans Clinical Isolates
Authors: Drott M. T. , Bastos R. W. , Rokas A. , Ries L. N. A. , Gabaldón T. , Goldman G. H. , Keller N. P. , Greco C.
Published: April 2020

Much of what we know about the genetics underlying secondary metabolite (SM) production and the function of SMs in the model fungusAspergillus nidulanscomes from a single reference genome. A growing body of research indicates the importance of biosynthetic gene cluster (BGC) and SM diversity within a species. However, there is no information about the natural diversity of secondary metabolism inA. nidulans. We discovered six novel clusters that contribute to the considerable variation in both BGC content and SM production withinA. nidulans. We characterize a diverse set of mutations and emphasize how findings of single nucleotide polymorphisms (SNPs), deletions, and differences in evolutionary history encompass much of the variation observed in nonmodel systems. Our results emphasize thatA. nidulansmay also be a strong model to use within-species diversity to elucidate regulatory cross talk, fungal ecology, and drug discovery systems.
Multiconsensus of Second-Order Multiagent Networks via Pulse-Modulated Intermittent Control
Authors: Chi Ming , Wang Xu-Long , He Ding-Xin , Liu Zhi-Wei
Published: April 2020

This paper studies the multiconsensus problem of multiagent networks based on sampled data information via the pulse-modulated intermittent control (PMIC) which is a general control framework unifying impulsive control, intermittent control, and sampling control. Two kinds of multiconsensus, including stationary multiconsensus and dynamic multiconsensus of multiagent networks, are taken into consideration in such control framework. Based on the eigenvalue analysis and algebraic graph theory, some necessary and sufficient conditions on the feedback gains and the control period are established to ensure the multiconsensus. Finally, several simulation results are included to show the theoretical results.