bluuebunny/crossref_metadata_2025 huggingface dataset:
Vertical structure and the risk of rent extraction in the electricity industry
Authors: Boom Anette , Buehler Stefan
Published: August 2019

This paper studies how competition and vertical structure jointly determine generating capacities, retail prices, and welfare in the electricity industry. Analyzing a model in which demand is uncertain and retailers must commit to retail prices before they buy electricity in the wholesale market, we show that welfare is highest if competition in generation and retailing is combined with vertical separation. Vertically integrated generators choose excessively high retail prices and capacities to avoid rent extraction in the wholesale market when their retail demand exceeds their capacity. Vertical separation eliminates the risk of rent extraction and yields lower retail prices.
Monitoring codling moth (Lepidoptera: Tortricidae) with a four‐component volatile blend compared to a sex pheromone‐based blend
Authors: Knight Alan L. , Mujica Valentina , Larsson Herrera Sebastian , Tasin Marco
Published: August 2019

Monitoring adult codling moth, Cydia pomonella (L.), is a crucial component in implementing effective integrated management programmes in apple, Malus domestica Borkhausen. Use of sex pheromone lures to track male populations has been the traditional approach, but their use in orchards treated with sex pheromone for mating disruption (MD) has been problematic. Development of kairomone and kairomone–pheromone combination lures has allowed the catch of female moths and has benefited several aspects of codling moth management through improved spray timings and action thresholds. Recently, a new four‐component volatile blend (4‐K) comprised of pear ester, (E,Z)‐2,4‐ethyl decadienoate (PE), (E)‐11 4,8‐dimethyl‐1,3,7‐nonatriene, all isomers of pyranoid linalool oxide and acetic acid (AA) has been characterized that has increased female moth catch threefold versus any previous blend. Field trapping studies were conducted to compare moth catches in traps baited with 4‐K versus the use of sex pheromone, (E,E)‐8,10‐dodecadien‐1‐ol (PH) in combination with PE and AA. Trials were conducted in orchards left either untreated, or treated with PH or PH + PE. Traps baited with 4‐K and 4‐K + PH lures caught significantly more females than traps baited with PH + PE + AA lures. Traps baited with 4‐K + PH lures caught significantly more total moths than traps baited with PH + PE + AA lures in all three orchards. Adding a PH lure to traps with the 4‐K lure did not affect female catch, but significantly increased male and total moth catches. These studies demonstrate that codling moth can be trapped effectively in apple under MD without the use of sex pheromone lures. The significant increase in female codling moth catch with the 4‐K lure suggests that efforts to improve spray timings and action threshold determinations as well as mass trapping might be enhanced with this new lure.
Who Files for Personal Bankruptcy in the United States?
Authors: Fisher Jonathan D.
Published: August 2019

Who files for bankruptcy in the United States is not well understood. Previous research relied on small samples from surveys or a small number of states from administrative records. Using over ten million administrative bankruptcy records linked to the 2000 Decennial Census and the 2001–2009 American Community Surveys, I document who files for bankruptcy. Compared to the US population, bankruptcy filers are middle income, more likely to be divorced, more likely to be black, more likely to be veterans, less likely to be immigrants, and more likely to have a high school degree or some college. Filers are more likely to be employed. The bankruptcy population is aging faster than the US population as a whole. Lastly, using pseudo‐panels I study what happens in the years around bankruptcy. Individuals are likely to get divorced in the years before bankruptcy and then remarry. Income falls before bankruptcy and rises after bankruptcy.
Factors influencing well‐being in clinical nurses: A path analysis using a multi‐mediation model
Authors: Kim Sung Reul , Park Ok Lae , Kim Hye Young , Kim Ji Young
Published: August 2019

Aims and objectives

To test a hypothetical path model estimating the influence of resilience and gratitude disposition on well‐being in Korean clinical nurses and to verify the mediating effects of burnout, compassion satisfaction and job satisfaction using a multi‐mediation model.

Background

To improve the well‐being of nurses, it is necessary to consider their personal and work‐related characteristics comprehensively.

Design

A descriptive cross‐sectional design was used.

Methods

A total of 310 clinical nurses participated in this study. A structured questionnaire was used to collect data. A path analysis using a multi‐mediation model was performed using AMOS 23.0 to test the hypothetical path model. This study adhered to the STROBE guideline.

Results

The model's fit indices were adequate. Resilience and gratitude disposition both had significant direct effects on well‐being. Resilience and gratitude disposition had significant indirect effects on well‐being through the effect of burnout, compassion satisfaction and job satisfaction. Resilience, gratitude disposition, burnout, compassion satisfaction and job satisfaction explained 68.3% of the total variance of well‐being.

Conclusions

Intervention programmes considering these factors may be useful to improve nurses’ well‐being.

Relevance to clinical practice

Nurses’ well‐being should be assessed along with resilience, gratitude disposition, burnout, compassion satisfaction and job satisfaction. To improve the well‐being of clinical nurses, systematic and integrated intervention programmes need to be developed and applied, with consideration for a variety of factors related to well‐being.
Strategies for Assessing and Modeling Depressive Symptoms in Longitudinal Studies of Adolescents
Authors: Beal Sarah J. , Dorn Lorah D. , LoBraico Emily J. , Lutz Nathan , Ram Nilam
Published: August 2019

Studying age‐related change in psychosocial behavior is difficult because manifestation differs with development. While the use of age‐appropriate measurement instruments addresses developmental differences, changes in measurement also challenge researchers’ ability to study developmental trajectories. Leveraging 8‐occasion data from 262 girls (baseline ages 11 and 17 years) participating in a cross‐sequential study spanning childhood to adulthood, this paper (1) highlights the needs of developmental researchers seeking to measure change across large swaths of development, (2) forwards an initial formula to convert Beck Depression Inventory‐II scores into Children's Depression Inventory scores and facilitate longitudinal analysis and understanding of how depression develops across adolescence, and (3) suggests collection and analysis of new data that would better facilitate researcher's linking of child‐, adolescent‐, and adult‐oriented measurement instruments.
Review on antibacterial activity of Himalayan medicinal plants traditionally used to treat pneumonia and tuberculosis
Authors: Adnan Muhammad , Ali Shandana , Sheikh Khushboo , Amber Rahila
Published: August 2019

Objectives

The main objective of this review was to collect scattered literature on ethnomedicinal plants used to treat pneumonia and tuberculosis in the Himalayan region and their in-vitro validation against bacterial pathogens.

Key findings

Current review contains information on ethnomedicines of total 137 plants from Himalaya region. Out of these, 59 plants have been studied in vitro against bacteria while seven plants extracts have been checked for their toxicological effects. The most commonly used plant families for pneumonia and tuberculosis therapy in the study region were Asteraceae, Bignoniaceae and Fabaceae (seven plants in each); of these, Curcuma longa L., Punica granatum L. and Justicia adhatoda L. carried the most inhibiting potential against Staphylococcus aureus and Streptococcus pneumoniae while that of Acalypha indica L. against Mycobacterium tuberculosis. Different compounds such as ascorbic acid, curcumin, vasicine, piperine, quercetin, myricetin and gallic acid being reportedly isolated from these plants possess antibacterial potential.

Himalayan region has variety of ethnomedicinal plants used against pneumonia and tuberculosis; however, studies on in-vivo activity, toxicology and mechanism of action are very limited. Hence, detailed investigation on these aspects needs to be carried out for the development of novel antibacterial drugs from the studied plant species.
Muscone ameliorates diabetic peripheral neuropathy through activating AKT/mTOR signalling pathway
Authors: Dong Jie , Li Hua , Bai Yang , Wu Cong
Published: August 2019

Objectives

Emerging evidence showed that muscone could improve chronic inflammation after myocardial infarction and protect alcohol-induced osteonecrosis of the femoral head. However, the function of muscone on diabetic peripheral neuropathy (DPN) is obscure.

Methods

The neuronal Schwann cell RSC 96 cells were treated with 125 mmol/l glucose to simulate the cells in DPN. The RSC 96 cell viability was detected by cell counting kit-8. The RSC 96 cell cycle and apoptosis were determined by flow cytometry. The expression of marker proteins of apoptosis, autophagy and AKT/mTOR signalling pathway was assessed by Western blot.

Key findings

We observed that after high glucose (HG) treatment, the number of cell apoptosis was increased, cell proliferation was decreased, as well as the expression of apoptosis-related proteins and autophagy-related proteins were changed. However, this phenomenon can be reversed by muscone. Meanwhile, the expression of phosphorylated AKT and mammalian target of rapamycin (mTOR) was down-regulated with HG treatment, while the expression quantity was up-regulated after disposed with muscone.

Conclusions

Our outcomes demonstrated that autophagy and apoptosis of RSC 96 cells induced by HG can be alleviated by muscone through modulating AKT/mTOR signalling pathway, suggesting that muscone might be a potential molecule with influence in connection to DPN.
3,000 km and 1,500‐year presence of Aureococcus anophagefferens reveals indigenous origin of brown tides in China
Authors: Tang Ying Zhong , Ma Zhaopeng , Hu Zhangxi , Deng Yunyan , Yang Aoao , Lin Siheng , Yi Liang , Chai Zhaoyang , Gobler Christopher J.
Published: August 2019

The nonmotile, spherical, picoplanktonic (2‐μm‐sized) pelagophyte Aureococcus anophagefferens has caused numerous harmful blooms (“brown tides”) across global marine ecosystems. Blooms have developed along the east coast of the USA since 1985, a limited number of times in South Africa around 1997, and frequently in China since 2009. As a consequence, the harmful blooms have caused massive losses in aquaculture and coastal ecosystems, particularly mortalities in cultured shellfish. Therefore, whether A. anophagefferens was recently introduced to China via natural/artificial transport of resting stage cells or has been an indigenous species has become a question of profound ecological significance and broad interest, which motivated our extensive investigation on the geographic and historical presence of this species in the seas of China. We applied a combined approach of extensive PCR‐based detection and sequencing, germination experiments and monoclonal antibody staining of germlings to samples of surface sediment and sediment core (dated via combined isotopic measurements) collected from all four seas of China, and searched the supplementary data set of a recent Science publication. We discovered that A. anophagefferens does have a resting stage in the sediment, but it also has a wide geographic distribution both in China (covering a range of ~30° in latitude, ~15.7° in longitude and 2.5–3,456 m in water depth; temperate to tropical and coastal to open oceans) and in almost all oceans of the world and a historical presence of >1,500 years in the Bohai Sea, China. The work revealed that A. anophagefferens is not a recently introduced, but an indigenous species in China and has in fact a globally cosmopolitan distribution.
Psychometric evaluation of a new proxy‐instrument to assess participation in children aged 3–6 years with visual impairment: PAI‐CY 3‐6
Authors: Elsman Ellen B M , van Nispen Ruth M A , van Rens Gerardus H M B
Published: August 2019

Purpose

The Participation and Activity Inventory for Children and Youth 3–6 years (PAI‐CY 3‐6) was recently developed to assess the participation needs of children with visual impairment (VI) by means of parent‐proxy report. This study reports on its psychometric properties.

Methods

Parents of children aged 3–6 years registered at two low vision rehabilitation centers in the Netherlands were invited to participate and completed the 52‐item PAI‐CY. Satisfaction with the PAI‐CY 3‐6 was determined using an evaluation form. Basic item analyses was conducted, after which an item response theory (IRT) model (i.e. the graded response model, GRM) was fitted. Deletion of items was informed by results of item analyses, fulfillment of IRT assumptions, differential item functioning, fit to the GRM and item information content. Face and content validity were considered; professionals from low vision rehabilitation centers were asked for their opinion in the item deletion process. After obtaining a satisfactory set of items, known‐group validity, concurrent validity and test‐retest reliability were also investigated.

Results

Data of 237 parents were included in the analyses. Various aspects of the PAI‐CY 3‐6 were perceived as neutral to positive by over 85% of the respondents. After removing 17 items, the remaining 35 items reflected satisfactory fit to the GRM. Known‐group validity was supported, since participants with more severe VI and comorbidity scored significantly worse than those with less severe VI and without comorbidity after correcting for potential confounders. Test‐retest reliability was adequate, and the PAI‐CY showed to have good concurrent validity. Feedback from professionals motivated the maintenance of 3 of the 17 deleted items, although not included in the scoring. Furthermore, two new items were added, resulting in a 40‐item instrument.

Conclusions

The PAI‐CY 3‐6 has sound psychometric properties and can now be used to assess the participation needs of children aged 3–6 years with VI by means of proxy. Implementation in routine low vision rehabilitation care enables further optimization and investigation of its acceptability and feasibility.
The Lure of Power: Career Paths and Considerations among Policy Professionals in Sweden
Authors: Selling Niels , Svallfors Stefan
Published: August 2019

This article analyzes career paths and career considerations among policy professionals in Sweden. It builds on a longitudinal dataset where the professionals' careers are mapped and interviews conducted over a six‐year period. We found that: (1) skills such as the ability to navigate the political system make policy professionals employable in a variety of organizations; (2) considerations regarding different aspects of power were central to their career decisions; and (3) the barriers in their labor market are related to ideological commitments, loyalties, and value hierarchies that make policy professionals reluctant to move anywhere their skills could take them.

Related Articles

Corbett, Jack. 2013. “Politicians and Professionalization in the Pacific Islands: Revisiting Self‐Regulation?” Politics & Policy 41 (6): 852‐876. https://doi.org/10.1111/polp.12050

Francia, Peter L., and Paul S. Herrnson. 2007. “Candidate Attitudes toward Negative Campaigning.” Politics & Policy 35 (2): 246‐272. https://doi.org/10.1111/j.1747-1346.2007.00059.x

Svallfors, Stefan. 2016. “Out of the Golden Cage: PR and the Career Opportunities of Policy Professionals.” Politics & Policy 44 (1): 56‐73. https://doi.org/10.1111/polp.12149
Disaster Risk Management Policies and the Measurement of Resilience for Philippine Regions
Authors: Yonson Rio , Noy Ilan
Published: August 2019

How can a government prioritize disaster risk management policies across regions and types of interventions? Using an economic model to assess welfare risk and resilience to disasters, this article systematically tackles the questions: (1) How much asset and welfare risks does each region in the Philippines face from riverine flood disasters? (2) How resilient is each region to riverine flood disasters? (3) What are, per region, the possible interventions to strengthen resilience to riverine flood disasters and what will be their measured benefit? We study the regions of the Philippines to demonstrate the channels through which macroeconomic asset and output losses from disasters translate to consumption and welfare losses at the micro‐economic level. Apart from the regional prioritizations, we identify a menu of policy options ranked according to their level of effectiveness in increasing resilience and reducing welfare risk from riverine floods. The ranking of priorities varies for different regions when their level of expected value at risk is different. This suggests that there are region‐specific conditions and drivers that need to be integrated into considerations and policy decisions, so that these are effectively addressed.
South African individual retirement savings: An analysis of the social factors
Authors: Willows Gizelle Demarie
Published: August 2019

This study's primary aim is to determine whether members of a South African tertiary institution's retirement fund are en route to have sufficient retirement savings. Secondly, the results are analysed between different social factors namely: age, gender, race, education level, marital status, and cost of employment. Survey data and information received directly from the retirement fund were used as inputs in a customised model. This method was unique to this study, that is, it was able to consider broader circumstances other than the member's retirement savings within the fund only. Among the sample of 753 respondents, one‐third of respondents will have insufficient retirement savings and <10% will have enough. Single, younger and male respondents are most likely to have sufficient retirement savings and this is suggested to be as a result of advantageous annuity rates upon retirement. Black/African respondents were least likely to have sufficient retirement savings. Notwithstanding the racial population divide following apartheid, societal and cultural explanations speak to a culture of increased spending coupled with high financial dependency relationships. Thus, the findings provide rich information which necessitates policies which address leakage from retirement savings, appropriate defaults, and the availability of innovative and affordable savings vehicles.
First report of using low‐titer cold‐stored type O whole blood in massive postpartum hemorrhage
Authors: Bahr Timothy M. , DuPont Tara L. , Morris David S. , Pierson Spencer E. , Esplin Michael Sean , Brown Samuel M. , O'Brien Elizabeth A. , Ilstrup Sarah J. , Christensen Robert D.
Published: August 2019

BACKGROUND

In cases of massive hemorrhage in the US military, improved outcomes have been reported with the use of warm, fresh whole blood transfusions. Cold‐stored low‐titer type O whole blood (LTOWB) has become the preferred product for resuscitation of severe bleeding in deployed surgical units. Reports of LTOWB use in civilian trauma are becoming more frequent.

CASE REPORT

We report our experience with emergency transfusion of LTOWB for a woman with massive postpartum hemorrhage. The patient had two previous cesarean section deliveries at term without complications. With her third elective cesarean section at term, blood loss during surgery was not excessive, but 3 to 4 hours later she had an estimated blood loss of 3600 mL. Despite measures to control the hemorrhage, she rapidly became hypotensive and tachycardic, and our massive transfusion protocol (MTP) was activated. The transfusion service had very recently incorporated LTOWB into Trauma Pack 1 of the MTP. She received two LTOWB units, after which her hemorrhaging ceased, blood pressure normalized, and she became alert. One hour later she received one unit of fresh frozen plasma and one unit of red blood cells (RBCs). The following morning she received one unit of crossmatched RBCs, for a hematocrit of 20.7%. She was discharged home on Day 4, and she remains healthy.

CONCLUSIONS

This is the first report of which we are aware of massive postpartum hemorrhage treated using LTOWB. Our positive experience leads us to speculate that this approach could have a role in massive obstetric hemorrhage.
Ceratohyoidectomy in standing sedated horses
Authors: Racine Julien , O'Brien Thomas , Bladon Bruce M. , Cruz Antonio M. , Stoffel Michael H. , Haenssgen Kati , Rodgerson Dwayne H. , Livesey Michael A. , Koch Christoph
Published: August 2019

Objective

To investigate the feasibility and complications associated with ceratohyoidectomy (CHE) in standing sedated horses unaffected (experimental horses) and standing sedated horses affected (clinical cases) with temporohyoid osteoarthropathy (THO).

Study design

Case series.

Animals

Six experimental horses and four clinical cases.

Methods

Standing CHE was performed in six experimental horses euthanized 30 minutes (n = 3) and 7 days (n = 3) postoperatively. The four clinical cases were presented because of central facial nerve paralysis (n = 3), vestibular ataxia (n = 3), auricular hemorrhage (n = 2), quidding (n = 1), and oesophageal impaction (n = 1). Evolution was assessed by clinical examination during hospitalization and later by telephone interviews for the clinical cases.

Results

The procedure was successfully performed in all horses. Experimental horses did not show any short‐term postoperative complications. Hemorrhage was experienced intraoperatively in one of the clinical cases and was successfully managed with placement of hemostatic forceps. Vestibular ataxia and other symptoms of THO improved within days, but facial nerve paralysis did not improve until 9 days to 6 months after surgery. Follow‐up ranged from 9 to 24 months. All clinical cases returned to performance, and client satisfaction was excellent.

Conclusion

Ceratohyoidectomy was consistently feasible in standing sedated horses. The method did not result in postoperative complications and led to resolution of clinical signs associated with THO.

Clinical significance

Standing CHE should be considered in horses affected with THO, especially when horses present with marked vestibular deficits and ataxia, to reduce risks associated with recovery from general anesthesia.
Evaluating Chemistry Teachers Within the Context of Teacher Characteristics
Authors: Yüksel Mehmet
Published: August 2019

There are several characteristics arising from the role that education and training activities impose on teachers. That teachers have different characteristics stems from the fact that the teaching role has a multi-dimensional behavior pattern. Therefore, teacher characteristics are being researched in various fields of science and various subjects. One of these domains is about the characteristics of chemistry teachers. Teacher characteristics are decisive for both effective education and educational improvement. Therefore, it is important to analyze the characteristics of chemistry teachers within a systematic approach. The aim of this study is to try to propose a multi-criteria model for the analysis of characteristics of chemistry teachers and their evaluation in the context of teacher characteristics. With the multi-criteria decision-making model proposed in the study, a 9th grade chemistry teacher was evaluated in detail and holistically. The proposed model allowed the evaluation of teacher characteristics on the basis of cognitive, affective and psychomotor dimensions. In this study, the level of the roles of each of teacher characteristics in evaluating the effectiveness of chemistry education was also determined. Furthermore, the competence level of the chemistry teacher in this study was determined based on each characteristic.
Transformative learning opportunities for students and educators during interprofessional healthcare practice experiences in higher education: Viewed through the lens of Threshold Concepts Theory
Authors: Morgan Cecile Jane , Bowmar Alexander , McNaughton Susan , Flood Brenda , O'Brien Daniel
Published: August 2019

Introduction: The transformative nature of collaborative interprofessional learning experiences, for both students and educators, signals the importance of learning opportunities that transcend professional or disciplinary boundaries. Specifically, real-time clinical practice experiences where students and educators from a number of health professions learn with, from and about eachother, while working with patients, enables authentic interprofessional learning opportunities.Methods: This paper reports the qualitative interpretive findings from a mixed methods study on the learning experiences of students and educators from several undergraduate health and allied health programmes engaged in collaborative interprofessional practice in a university context. Interpretive thematic analysis of student and educator focus group transcripts revealed a number of transformational learning thresholds that students and educators transitioned through, over time.   Findings: Transformative learning occurred through cumulative collaborative learning experiences. Interprofessional thresholds were identified as: broadening perspectives on health practice; navigating collaborative roles through interprofessional practice (IPP); interprofessional team practice through active learning/learning by doing; integrative professional practice for actioning holistic, patient-centred healthcare. Conclusion: Threshold Concepts Theory (TCT) provided both an interpretive lens for viewing the experiential learning processes that occurred during the student-led interprofessional programme and a theoretical perspective into the transformative nature of knowledge and skills acquisition and integration during interprofessional learning opportunities.
Script concordance test examinations: Student perception and study approaches
Authors: Bacchi Stephen , Tan Ian , Chim Ivana , Dabarno Matthew , Lubarsky Stuart , Duggan Paul
Published: August 2019

Introduction: Script concordance test questions (SCTs) are a style of question that has been developed based upon the script theory of information storage and retrieval. SCTs use script theory to examine a clinical reasoning construct purported to be different from that assessed by multiple-choice questions (MCQs). Evidence regarding the construct validity of SCT is somewhat limited, but generally supportive.  Methods: This project involved a content-matched MCQ and SCT practice examination delivered to senior medical students (n = 211) from a single institution with an accompanying survey regarding educational consequences of SCT and MCQ examinations.  Results:Students’ responses differed significantly between how they would prepare for an MCQ examination as compared to an SCT examination. These differences were present in a number of areas, including greater focus on textbooks and use of websites for MCQ examination preparation (p < 0.001). Students reported that for an SCT examination they would benefit most from in-person teaching from local consultants involved in the process of SCT generation. Students felt that they would also benefit from further instruction regarding key elements of SCT technique, and from opportunities to provide written explanations of their reasoning during the exam.  Conclusions:The results suggest that SCTs have educational consequences different from MCQs. Further research into the educational consequences of SCTs, and how these consequences may differ from that of other methods of assessment, is warranted.
Establishing and sustaining a new interprofessional allied health student placement
Authors: Foley Wendy , Fagan Amy , Liddle Karen
Published: August 2019

Meeting the increasing demand for allied health (AH) clinical placements is challenging (McBride, Fitzgerald, Morrison, & Hulcombe, 2015), as is providing experience for AH students in authentic interprofessional practice (Copley et al., 2007). Furthermore, limited opportunities exist to develop AH students’ skills in working effectively with Indigenous clients (Hill, Nelson, Copley, Quinlan, & White, 2017), due to the low number of health professionals practising in Indigenous communities (Nelson, Shannon, & Carson, 2013; Whitford, Taylor, & Thomas, 2013). The need for paediatric AH services for developmentally-vulnerable children in the Inala Indigenous community was identified in 2014 by the Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care’s (CoE) visiting paediatrician. Children in the region are developmentally vulnerable in all domains, particularly in language and communication, where the average percentage of vulnerable children is twice that in the Queensland population and more than double the national figures (Commonwealth of Australia, 2015). In 2014, the demand for the local mainstream public child development service exceeded capacity, leading to lengthy waiting lists. With few nearby private AH practices offering paediatric services, many Inala paediatric patients were unable to access comprehensive AH assessments and care. At the time, no paediatric AH clinical services or training opportunities existed within the CoE.
Videos in the medical student objective structured clinical examination: A systematic review
Authors: Pham Huy-Dat , Pistorius Eduard Bernard , Bacchi Stephen , Jersmann Hubertus
Published: August 2019

Introduction: The use of video in objective structured clinical examinations (OSCEs) may serve as a means of facilitating assessment, as a component of the exam itself or utilised as a tool in other ways. The aim of this review was to summarise the evidence currently supporting the uses of video in relation to the OSCE process. Methods: A systematic search of Pubmed, Medline, EMBASE, Scopus and PsychInfo was conducted on 12 April 2017 using the subject heading “(OSCE OR objective structured clinical examination) AND (video OR recording)”. To be deemed eligible, the paper had to be a primary research paper, involve the analysis of OSCEs conducted for medical students and involve the use of video technology. Results: Thirty-six articles met eligibility criteria. Twenty-four investigated the use of video within OSCEs as a means of facilitating the exam, nine detailed cases where video was integrated as a part of an OSCE and three utilised videos in some other way. Of those that investigated the use of video as a means of facilitation, only one compared the use of video to traditional in-room examiners. Other articles in this category demonstrated good inter-rater reliability between different assessors marking via video. Conclusion: There is currently limited evidence regarding the usefulness and educational benefit of introducing video into the assessment of clinical skills, and minimal research evaluating the use of video compared to traditional live examiners as a means of facilitating the assessment of students currently exists. Preliminary results demonstrated reasonably high inter-rater reliability. This should be a topic of future research.
Insights into different etching properties of continuous wave and atomic layer etching processes for SiO2 and Si3N4 films using voxel-slab model
Authors: Kuboi Nobuyuki , Tatsumi Tetsuya , Komachi Jun , Yamakawa Shinya
Published: August 2019

This work describes the modeling of the surface reactions involved in atomic layer etching (ALE) of SiO2 and Si3N4 with a deposition step using C4F8/O2/Ar plasma and an Ar plasma etch step. In the etching step, the surface was assumed to consist of two layers: a C-F polymer layer and a reactive layer. The effects of residual F from the deposition step and F originating from the C-F polymer layer during the etch step and the influences of the O and N outfluxes generated from the reactive layer were considered, in terms of their effects on the etch rates of the SiO2 and Si3N4 films. Using a three-dimensional voxel-slab model that included the surface reactions described above, an analysis was performed based on the differences between the etching properties of continuous wave (CW) etching and ALE in the cases of blanket wafers and self-aligned contact layers from the viewpoints of numerical simulations. As a result of these analyses, it was found that the use of monoenergetic ion energy improves surface layer thickness controllability for both the polymer layer and the reactive layer and that quantitative control of time variations in both the C-F polymer layer thickness and the ion penetration depth is necessary for high selectivity of SiO2 over Si3N4 (SiO2/Si3N4) and for low plasma-induced damage on the Si3N4 film. Furthermore, in the authors’ simulations, a relatively high SiO2 etch rate was obtained for a modified quasi-ALE (43 nm/min) while maintaining high SiO2/Si3N4 selectivity (more than 100) after optimization of the C-F polymer layer thickness, the ion energy, and the ALE cycle time; this represents a solution in terms of the important issue of the very low etch rate of ALE. These simulation results indicate that accurate prediction of the surface reaction, further quantitative control of the plasma parameters, and optimization of the pattern layout design are necessary to realize higher ALE process performance for practical use in mass production.
Artificial intelligence for art investigation: Meeting the challenge of separating x-ray images of the
Ghent Altarpiece
Authors: Sabetsarvestani Z. , Sober B. , Higgitt C. , Daubechies I. , Rodrigues M. R. D.
Published: August 2019

Artificial intelligence aids in the separation of x-ray images of two-sided paintings.
Heat Shock Protein 90 Ensures the Integrity of Rubella Virus p150 Protein and Supports Viral Replication
Authors: Sakata Masafumi , Katoh Hiroshi , Otsuki Noriyuki , Okamoto Kiyoko , Nakatsu Yuichiro , Lim Chang-Kweng , Saijo Masayuki , Takeda Makoto , Mori Yoshio
Published: August 2019

Accumulating evidence indicates that RNA viruses use numerous host factors during replication of their genomes. However, the host factors involved in rubella virus (RUBV) genome replication are largely unknown. In this study, we demonstrate that the HSP90 molecular chaperone is needed for the efficient replication of the RUBV genome. Further, we reveal that HSP90 interacts with RUBV nonstructural protein p150 and its precursor polyprotein, p200. HSP90 contributes to the stability of p150 and the processing of p200 via its protease domain in the p150 region. We conclude that the cellular molecular chaperone HSP90 is a key host factor for functional maturation of nonstructural proteins for RUBV genome replication. These findings provide novel insight into this host-virus interaction.
Global warming leads to Early Triassic nutrient stress across northern Pangea
Authors: Grasby Stephen E. , Knies Jochen , Beauchamp Benoit , Bond David P.G. , Wignall Paul , Sun Yadong
Published: August 2019

The largest extinction in Earth history, in the latest Permian, was followed throughout most of the Early Triassic by a prolonged period of ecologic recovery. What factors delayed biotic recovery are still under debate and partly revolve around impacts of global warming on primary marine productivity. We examined N isotope records from the Festningen section on Spitsbergen, Arctic Norway, to examine changes in nutrient availability through the Early to Middle Triassic along the northern margin of Pangea. Our results show progressive decline in N availability throughout the Griesbachian, leading to severe nutrient limitations through the remainder of the Early Triassic, until returning to a highly productive continental margin in Middle Triassic time. These results are consistent with other studies from northern and western Pangea and thus show regional nutrient limitations occurred in what should have been the main zone of marine primary productivity. Such nutrient limitation likely stressed primary production and consequently contributed to prolonged marine recovery. We suggest this was driven by high ocean temperatures depressing the marine nutricline.
Importance of screening in physical therapy: vertebral fracture of thoracolumbar junction in a recreational runner
Authors: Maselli Filippo , Rossettini Giacomo , Viceconti Antonello , Testa Marco
Published: August 2019

Running is one of the most popular sports worldwide. Studies suggest that 11%–85% of recreational runners have at least one running-related injury (RRI) each year, resulting in a reduction or interruption in training. A high risk for running-related injuries (RRIs) represents an important inconvenience counterbalancing the beneficial effects of running. RRIs primarily affect the joints of the lower limb and lumbar spine. Noteworthy, in some cases, the clinical presentation of signs and symptoms is confusing and may hide serious conditions; thus, clinicians have to pay special attention when potential factors arise, such as the presence of red flags. As reported in this case report, patients can present with low back pain (LBP) as a primary problem, mimicking a red flag such as a fracture of the spine. The aim of this case report was to describe a case of a recreational runner presenting with LBP as the sole symptom of an underlying thoracolumbar fracture.
Development of a contemporary evidence-based practice workshop for health professionals with a focus on pre-appraised evidence and shared decision-making: a before-after pilot study
Authors: Albarqouni Loai , Glasziou Paul , Bakhit Mina , Del Mar Chris , Hoffmann Tammy C
Published: August 2019

Shared decision-making (SDM) has emerged as a key skill to assist clinicians in applying evidence-based practice (EBP). We aimed to develop and pilot a new approach to teaching EBP, which focuses on teaching knowledge and skills about SDM and pre-appraised evidence. We designed a half-day workshop, informed by an international consensus on EBP core competencies and invited practicing clinicians to participate. Skills in SDM and communicating evidence were assessed by audio-recording consultations between clinicians and standardised patients (immediately pre-workshop and post-workshop). These were rated by two independent assessors using the OPTION (Observing Patient Involvement, 0 to 100 points) and ACEPP (Assessing Communication about Evidence and Patient Preferences, 0 to 5 points) tools. Participants also completed a feedback questionnaire (9 Likert scale and four open-ended questions). Fourteen clinicians participated. Skills in SDM and communicating research evidence improved from pre-workshop to post-workshop (mean increase in OPTION score=5.5, 95% CI 1.0 to 9.9; increase in ACEPP score=0.5, 95% CI 0.02 to 1.06). Participant feedback was positive, with most indicating ‘agree’ or ‘strongly agree’ to the questions. A contemporary approach to teaching clinicians EBP, with a focus on SDM and pre-appraised evidence, was feasible, perceived as useful, and showed modest improvements in skills. Results should be interpreted cautiously because of the small study size and pre-post design.
Balance of benefits and harms of different blood pressure targets in people with multiple chronic conditions: a quantitative benefit-harm assessment
Authors: Aschmann Hélène E , Boyd Cynthia M , Robbins Craig W , Mularski Richard A , Chan Wiley V , Sheehan Orla C , Wilson Renée F , Bennett Wendy L , Bayliss Elizabeth A , Yu Tsung , Leff Bruce , Armacost Karen , Glover Carol , Maslow Katie , Mintz Suzanne , Puhan Milo A
Published: August 2019

Objective

Recent studies suggest that a systolic blood pressure (SBP) target of 120 mm Hg is appropriate for people with hypertension, but this is debated particularly in people with multiple chronic conditions (MCC). We aimed to quantitatively determine whether benefits of a lower SBP target justify increased risks of harm in people with MCC, considering patient-valued outcomes and their relative importance.

Design

Highly stratified quantitative benefit-harm assessment based on various input data identified as the most valid and applicable from a systematic review of evidence and based on weights from a patient preference survey.

Setting

Outpatient care.

Participants

Hypertensive patients, grouped by age, gender, prior history of stroke, chronic heart failure, chronic kidney disease and type 2 diabetes mellitus.

Interventions

SBP target of 120 versus 140 mm Hg for patients without history of stroke.

Primary and secondary outcome measures

Probability that the benefits of a SBP target of 120 mm Hg outweigh the harms compared with 140 mm Hg over 5 years (primary) with thresholds >0.6 (120 mm Hg better), <0.4 (140 mm Hg better) and 0.4 to 0.6 (unclear), number of prevented clinical events (secondary), calculated with the Gail/National Cancer Institute approach.

Results

Considering individual patient preferences had a substantial impact on the benefit-harm balance. With average preferences, 120 mm Hg was the better target compared with 140 mm Hg for many subgroups of patients without prior stroke, especially in patients over 75. For women below 65 with chronic kidney disease and without diabetes and prior stroke, 140 mm Hg was better. The analyses did not include mild adverse effects, and apply only to patients who tolerate antihypertensive treatment.

Conclusions

For most patients, a lower SBP target was beneficial, but this depended also on individual preferences, implying individual decision-making is important. Our modelling allows for individualised treatment targets based on patient preferences, age, gender and co-morbidities.
Outcome reporting from clinical trials of non-valvular atrial fibrillation treated with traditional Chinese medicine or Western medicine: a systematic review
Authors: Qiu Ruijin , Hu Jiayuan , Huang Ya , Han Songjie , Zhong Changming , Li Min , He Tianmai , Lin Yiyi , Guan Manke , Chen Jing , Shang Hongcai
Published: August 2019

Objectives

To examine variation in outcomes, outcome measurement instruments (OMIs) and measurement times in clinical trials of non-valvular atrial fibrillation (NVAF) and to identify outcomes for prioritisation in developing a core outcome set (COS) in this field.

Design

This study was a systematic review.

Data sources

Clinical trials published between January 2015 and March 2019 were obtained from PubMed, the Cochrane Library, Web of Science, Wanfang Database, the China National Knowledge Infrastructure and SinoMed.

Eligibility criteria

Randomised controlled trials (RCTs) and observational studies were considered. Interventions included traditional Chinese medicine and Western medicine. The required treatment duration or follow-up time was ≥4 weeks. The required sample size was ≥30 and≥50 in each group in RCTs and observational studies, respectively. We excluded trials that aimed to investigate the outcome of complications of NVAF, to assess the mechanisms or pharmacokinetics, or for which full text could not be acquired.

Data extraction and synthesis

The general information and outcomes, OMIs and measurement times were extracted. The methodological and outcome reporting quality were assessed. The results were analysed by descriptive analysis.

Results

A total of 218 articles were included from 25 255 articles. For clinical trials of antiarrhythmic therapy, 69 outcomes from 16 outcome domains were reported, and 28 (31.82%, 28/88) outcomes were reported only once; the most frequently reported outcome was ultrasonic cardiogram. Thirty-one outcomes (44.93%, 31/69) were provided definitions or OMIs; the outcome measurement times ranged from 1 to 20 with a median of 3. For clinical trials of anticoagulation therapy, 82 outcomes from 18 outcome domains were reported; 38 (29.23%, 38/130) outcomes were reported only once. The most frequently reported outcome was ischaemic stroke. Forty (48.78%, 40/82) outcomes were provided OMIs or definitions; and the outcome measurement times ranged from 1 to 27 with a median of 8.

Conclusion

Outcome reporting in NVAF is inconsistent. Thus, developing a COS that can be used in clinical trials is necessary.
Perspectives of non-attenders for cervical cancer screening in Norway: a qualitative focus group study
Authors: Aasbø Gunvor , Solbrække Kari Nyheim , Waller Jo , Tropé Ameli , Nygård Mari , Hansen Bo Terning
Published: August 2019

Objective

The attendance rate for cervical cancer screening in Norway is currently suboptimal at 69%, and an in-depth understanding of postponement of cervical cancer screening from the perspective of non-attenders is lacking. This study aims to generate knowledge about how non-attenders for cervical cancer screening reflect on booking a screening appointment.

Methods

Using the Norwegian cervical cancer screening registry, we identified and recruited women who were non-attenders to screening. Nine focus group interviews were carried out, with 41 women participating in the interviews.

Results

Four main themes were generated, which provide a comprehensive understanding of how women who are overdue for screening reflect on their hesitancy to book a screening appointment: ‘It’s easy to forget about it’, ‘Women have to arrange their own appointment’, ‘It has to be a ‘must’’ and ‘It’s a humiliating situation’.

Conclusion

The degree to which women regard screening as important is affected by the nudging strategies employed in the screening programme and the facilitation of attendance provided by healthcare services. Dependence on one’s personal initiative to schedule a screening appointment and perception of a lack of responsibility on the part of healthcare services to attend screening may undermine informed and shared decision-making about screening attendance.
Soft clustering using real-world data for the identification of multimorbidity patterns in an elderly population: cross-sectional study in a Mediterranean population
Authors: Violán Concepción , Foguet-Boreu Quintí , Fernández-Bertolín Sergio , Guisado-Clavero Marina , Cabrera-Bean Margarita , Formiga Francesc , Valderas Jose Maria , Roso-Llorach Albert
Published: August 2019

Objectives

The aim of this study was to identify, with soft clustering methods, multimorbidity patterns in the electronic health records of a population ≥65 years, and to analyse such patterns in accordance with the different prevalence cut-off points applied. Fuzzy cluster analysis allows individuals to be linked simultaneously to multiple clusters and is more consistent with clinical experience than other approaches frequently found in the literature.

Design

A cross-sectional study was conducted based on data from electronic health records.

Setting

284 primary healthcare centres in Catalonia, Spain (2012).

Participants

916 619 eligible individuals were included (women: 57.7%).

Primary and secondary outcome measures

We extracted data on demographics, International Classification of Diseases version 10 chronic diagnoses, prescribed drugs and socioeconomic status for patients aged ≥65. Following principal component analysis of categorical and continuous variables for dimensionality reduction, machine learning techniques were applied for the identification of disease clusters in a fuzzy c-means analysis. Sensitivity analyses, with different prevalence cut-off points for chronic diseases, were also conducted. Solutions were evaluated from clinical consistency and significance criteria.

Results

Multimorbidity was present in 93.1%. Eight clusters were identified with a varying number of disease values:nervous and digestive; respiratory, circulatory and nervous; circulatory and digestive; mental, nervous and digestive, female dominant; mental, digestive and blood, female oldest-old dominant; nervous, musculoskeletal and circulatory, female dominant; genitourinary, mental and musculoskeletal, male dominant; andnon-specified, youngest-old dominant. Nuclear diseases were identified for each cluster independently of the prevalence cut-off point considered.

Conclusions

Multimorbidity patterns were obtained using fuzzy c-means cluster analysis. They are clinically meaningful clusters which support the development of tailored approaches to multimorbidity management and further research.