bluuebunny/crossref_metadata_2025 huggingface dataset:
Buckling loads for sandwich structures having FRP faces and FGM core
Authors: Muc A , Kędziora P , Chwał M
Published: July 2019

The aim of the present paper is to present a consistent 2D formulation of sandwiches (CS – classical sandwiches and FGMs – functionally gradient materials) that is accurate enough for a prediction of thermo-mechanical buckling load. Various kinematical hypothesis and variational formulations are studied in order to compare them with 3D finite element modelling and to estimate the effectiveness of 2D approximations. The examples deal with the compressed rectangular plates and shallow cylindrical panels. The effects of boundary conditions on both values of thermal and mechanical buckling loads as well on the variations of bifurcation loads with fibre orientations are discussed in details.
Preparation of graphene coated aluminum composite powders by high-energy ball milling
Authors: Heping Liu , Fenger Sun , Yibo Gao , Shaolei Cheng , Xingbin Jing
Published: July 2019

The preparation of composite powders has an important impact on the properties of the synthesized bulk materials. In this work, graphene coated aluminum composite powders were successfully prepared by high-energy ball milling. The microstructure of graphene/aluminum mixed powders was characterized by scanning electron microscope (SEM) and X-ray diffraction (XRD). The effects of the micro-morphology of the composite powders and the ratio of the ball to the particle size of the graphene-coated aluminum composite powders were analyzed in detail. The results show that graphene can be uniformly dispersed in aluminum powder without significant agglomeration in the case of ball milling parameters with a ball-to-powder ratio of 5:1. When the ratio of ball to material is 6:1, the dispersion effect was not so obvious. However, the level of agglomeration in the composite powders at ratios 7:1 and 8:1 differed respectively; some particles were deformed and the dispersion effect was reduced. The particle size of the graphene coated aluminum composite powder increased with the increase of ball to material ratio. Thermodynamic analysis of the interface reaction between graphene and aluminum composite powders shows that the maximum content of graphene microflakes on the surface of aluminum powder is 0.3wt%.
Study on Vibration and Acoustic Radiation Characteristics of Composite Material Superstructures of Underwater Vehicles
Authors: Gao Cong , Huang Xichun , Huang Guobing , Dai Huiling
Published: July 2019

Composite materials have been widely used in underwater ships for advantages of high specific strength, excellent acoustic performance and well designability. As an important indicator to measure combat effectiveness and vitality of underwater ships, structural radiation noise is the main target of acoustic detection weapons and the main factor that interferes with sonars. Underwater vibration and acoustic radiation characteristics of superstructure using composite sandwich panels directly affects the acoustic performance of underwater vehicles and the comfort and safety of personnel, therefore, research on vibration and acoustic radiation characteristics of underwater vehicle superstructure with composite material has important theoretical value and engineering prospect.
Static Characteristics Analysis and Research on the Energy-Storage Flywheel Rotor Based on Finite Element
Authors: Zhang Xiu-hua , Song Kang-jie , Pu Jiang , Su Ya-feng , Feng Zhi-guo
Published: July 2019

The energy-storage flywheel system has been becoming a kind of energy storage device with broad application prospect. It has the advantages of high energy storage density, high power, high efficiency, short charging time, long life, etc. In order to prevent energy storage flywheel system components deformation or failure under high speed, the static characteristic analyses on the flywheel rotor were done respectively under two types of the permanent magnet don’t act on the rotor internal wall and the permanent magnet acts on the rotor internal wall, the deformation, equivalent stress, tangential stress, radial stress of the rotor were researched. The work can provides certain reference for the structure design, optimization design of the flywheel system.
Physical properties of Ti3SiC2/Zr heterojunction under hydrostatic pressure
Authors: Li Y , Mao C , Tu R , Xue L , Li H , Wang J , Chen Z , Ni H , Hu Y
Published: July 2019

The geometric structure, elastic constants and electronic properties of Ti3SiC2/Zr heterojunctions under high hydrostatic pressure (0-10GPa) were investigated by first-principles calculations. It’s found that the increase of hydrostatic pressure loaded on the Ti3SiC2/Zr heterojunctions induces the monotonically decrease of their lattice parameters. Under hydrostatic pressure below 10GPa, the Ti3SiC2/Zr heterojunction is stable and its elastic properties change linearly with pressure. Ti3SiC2/Zr heterojunction under hydrostatic pressure is found to be ductile material, and its anisotropy is weak. Finally, Ti3SiC2/Zr heterojunction under hydrostatic pressure retains metallic properties, and hydrostatic pressure slightly changes the band structure of Ti3SiC2/Zr heterojunction.
Look4TRs: a de novo tool for detecting simple tandem repeats using self-supervised hidden Markov models
Authors: Velasco Alfredo , James Benjamin T , Wells Vincent D , Girgis Hani Z
Published: July 2019

Motivation

Simple tandem repeats, microsatellites in particular, have regulatory functions, links to several diseases and applications in biotechnology. There is an immediate need for an accurate tool for detecting microsatellites in newly sequenced genomes. The current available tools are either sensitive or specific but not both; some tools require adjusting parameters manually.

Results

We propose Look4TRs, the first application of self-supervised hidden Markov models to discovering microsatellites. Look4TRs adapts itself to the input genomes, balancing high sensitivity and low false positive rate. It auto-calibrates itself. We evaluated Look4TRs on 26 eukaryotic genomes. Based on F measure, which combines sensitivity and false positive rate, Look4TRs outperformed TRF and MISA—the most widely used tools—by 78 and 84%. Look4TRs outperformed the second and the third best tools, MsDetector and Tantan, by 17 and 34%. On eight bacterial genomes, Look4TRs outperformed the second and the third best tools by 27 and 137%.

Availability and implementation

https://github.com/TulsaBioinformaticsToolsmith/Look4TRs.

Supplementary information

Supplementary data are available at Bioinformatics online.
Machine learning predicts per-vessel early coronary revascularization after fast myocardial perfusion SPECT: results from multicentre REFINE SPECT registry
Authors: Hu Lien-Hsin , Betancur Julian , Sharir Tali , Einstein Andrew J , Bokhari Sabahat , Fish Mathews B , Ruddy Terrence D , Kaufmann Philipp A , Sinusas Albert J , Miller Edward J , Bateman Timothy M , Dorbala Sharmila , Di Carli Marcelo , Germano Guido , Commandeur Frederic , Liang Joanna X , Otaki Yuka , Tamarappoo Balaji K , Dey Damini , Berman Daniel S , Slomka Piotr J
Published: July 2019

Aims

To optimize per-vessel prediction of early coronary revascularization (ECR) within 90 days after fast single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) using machine learning (ML) and introduce a method for a patient-specific explanation of ML results in a clinical setting.

Methods and results

A total of 1980 patients with suspected coronary artery disease (CAD) underwent stress/rest 99mTc-sestamibi/tetrofosmin MPI with new-generation SPECT scanners were included. All patients had invasive coronary angiography within 6 months after SPECT MPI. ML utilized 18 clinical, 9 stress test, and 28 imaging variables to predict per-vessel and per-patient ECR with 10-fold cross-validation. Area under the receiver operator characteristics curve (AUC) of ML was compared with standard quantitative analysis [total perfusion deficit (TPD)] and expert interpretation. ECR was performed in 958 patients (48%). Per-vessel, the AUC of ECR prediction by ML (AUC 0.79, 95% confidence interval (CI) [0.77, 0.80]) was higher than by regional stress TPD (0.71, [0.70, 0.73]), combined-view stress TPD (AUC 0.71, 95% CI [0.69, 0.72]), or ischaemic TPD (AUC 0.72, 95% CI [0.71, 0.74]), all P < 0.001. Per-patient, the AUC of ECR prediction by ML (AUC 0.81, 95% CI [0.79, 0.83]) was higher than that of stress TPD, combined-view TPD, and ischaemic TPD, all P < 0.001. ML also outperformed nuclear cardiologists’ expert interpretation of MPI for the prediction of early revascularization performance. A method to explain ML prediction for an individual patient was also developed.

Conclusion

In patients with suspected CAD, the prediction of ECR by ML outperformed automatic MPI quantitation by TPDs (per-vessel and per-patient) or nuclear cardiologists’ expert interpretation (per-patient).
Chromosomal-level assembly of the blood clam, Scapharca (Anadara) broughtonii, using long sequence reads and Hi-C
Authors: Bai Chang-Ming , Xin Lu-Sheng , Rosani Umberto , Wu Biao , Wang Qing-Chen , Duan Xiao-Ke , Liu Zhi-Hong , Wang Chong-Ming
Published: July 2019

Background

The blood clam, Scapharca (Anadara) broughtonii, is an economically and ecologically important marine bivalve of the family Arcidae. Efforts to study their population genetics, breeding, cultivation, and stock enrichment have been somewhat hindered by the lack of a reference genome. Herein, we report the complete genome sequence of S. broughtonii, a first reference genome of the family Arcidae.

Findings

A total of 75.79 Gb clean data were generated with the Pacific Biosciences and Oxford Nanopore platforms, which represented approximately 86× coverage of the S. broughtonii genome. De novo assembly of these long reads resulted in an 884.5-Mb genome, with a contig N50 of 1.80 Mb and scaffold N50 of 45.00 Mb. Genome Hi-C scaffolding resulted in 19 chromosomes containing 99.35% of bases in the assembled genome. Genome annotation revealed that nearly half of the genome (46.1%) is composed of repeated sequences, while 24,045 protein-coding genes were predicted and 84.7% of them were annotated.

Conclusions

We report here a chromosomal-level assembly of the S. broughtonii genome based on long-read sequencing and Hi-C scaffolding. The genomic data can serve as a reference for the family Arcidae and will provide a valuable resource for the scientific community and aquaculture sector.
Emergence of ceftazidime/avibactam resistance in KPC-3-producing Klebsiella pneumoniae in vivo
Authors: Göttig Stephan , Frank Denia , Mungo Eleonora , Nolte Anika , Hogardt Michael , Besier Silke , Wichelhaus Thomas A
Published: July 2019

Objectives

The β-lactam/β-lactamase inhibitor combination ceftazidime/avibactam is active against KPC-producing Enterobacterales. Herein, we present molecular and phenotypic characterization of ceftazidime/avibactam resistance in KPC-3-producing Klebsiella pneumoniae that emerged in vivo and in vitro.

Methods

Sequence analysis of blaKPC-3 was performed from clinical and in vitro-generated ceftazidime/avibactam-resistant K. pneumoniae isolates. Time–kill kinetics and the Galleria mellonella infection model were applied to evaluate the activity of ceftazidime/avibactam and imipenem alone and in combination.

Results

The ceftazidime/avibactam-resistant clinical K. pneumoniae isolate revealed the amino acid change D179Y in KPC-3. Sixteen novel mutational changes in KPC-3 among in vitro-selected ceftazidime/avibactam-resistant isolates were described. Time–kill kinetics showed the emergence of a resistant subpopulation under selection pressure with either imipenem or ceftazidime/avibactam. However, combined selection pressure with imipenem plus ceftazidime/avibactam prevented the development of resistance and resulted in bactericidal activity. Concordantly, the G. mellonella infection model revealed that monotherapy with ceftazidime/avibactam is prone to select for resistance in vivo and that combination therapy with imipenem results in significantly better survival.

Conclusions

Ceftazidime/avibactam is a valuable antibiotic against MDR and carbapenem-resistant Enterobacterales. Based on time–kill kinetics as well as an in vivo infection model we postulate a combination therapy of ceftazidime/avibactam and imipenem as a strategy to prevent the development of ceftazidime/avibactam resistance in KPC-producing Enterobacterales in vivo.
Judicial Inference of the ‘Intent to Destroy’
Authors: Anderson Kjell
Published: July 2019

This article tackles the issue of genocidal intent by placing emphasis on the nature of genocide as a hierarchical and collective crime. While traditionally it is the collective dimension of victimization that is highlighted, in this article the author highlights the collective dimension of perpetration, which is often downplayed in genocide cases. This is done by examining two specific cases pertaining to the genocide in Bosnia (Trbić and Nikolić) and the evidentiary patterns followed by the judges in these cases. Moreover, the author relies on his interviews with perpetrators (in Rwanda, Burundi, Bosnia, and Cambodia). Broadly speaking, the approach taken is that often the intent of individual perpetrators is conflated with more general collective policies and there are elements of this interplay that should be taken into account. It would seem more appropriate for the author to emphasize these collective aspects rather than inferring genocidal intent of individual perpetrators from a set of contextual elements which may not really be sufficient in determining the special intent required.
Reconstructing the Face of War
Authors: Farber Scott J , Latham Kerry P , Kantar Rami S , Perkins Jonathan N , Rodriguez Eduardo D
Published: July 2019

Introduction

Ongoing combat operations in Iraq, Afghanistan, and other theaters have led to an increase in high energy craniomaxillofacial (CMF) wounds. These challenging injuries are typically associated with complex tissue deficiencies, evolving areas of necrosis, and bony comminution with bone and ballistic fragment sequestrum. Restoring form and function in these combat-sustained CMF injuries is challenging, and frequently requires local and distant tissue transfers. War injuries are different than the isolated trauma seen in the civilian sector. Donor sites are limited on patients with blast injuries and they may have preferences or functional reasons for the decisions to choose flaps from the available donor sites.

Methods

A case series of patients who sustained severe combat-related CMF injury and were treated at Walter Reed National Military Medical Center (WRNMMC) is presented. Our study was exempt from Institutional Review Board review, and appropriate written consent was obtained from all patients included in the study for the use of representative clinical images.

Results

Four patients treated by the CMF team at Walter Reed National Military Medical Center are presented. In this study, we highlight their surgical management by the CMF team at WRNMMC, detail their postoperative course, and illustrate the outcomes achieved using representative patient clinical images. We also supplement this case series demonstrating military approaches to complex CMF injuries with CMF reconstructive algorithms utilized by the senior author (EDR) in the management of civilian complex avulsive injuries of the upper, mid, and lower face are thoroughly reviewed.

Conclusion

While the epidemiology and characteristics of military CMF injuries have been well described, their management remains poorly defined and creates an opportunity for reconstructive principles proven in the civilian sector to be applied in the care of severely wounded service members. The War on Terror marks the first time that microsurgery has been used extensively to reconstruct combat sustained wounds of the CMF region. Our manuscript reviews various options to reconstruct these devastating CMF injuries and emphasizes the need for steady communication between the civilian and military surgical communities to establish the best care for these complex patients.
Hospitalization Costs and Length of Stay in Chinese Naval Hospitals Between 2008 and 2016 Based on Influencing Factors: A Longitudinal Comparison
Authors: Xu Zhenqing , Xue Chen , Zhao Fangjie , Hu Chaoqun , Wu Yaomin , Zhang Lulu
Published: July 2019

Introduction

A retrospective review conducted in three hospitals of Guangdong and Hainan, China. To analyze the variation tendency of mean hospitalization costs and length of stay (LOS) in naval hospitals over nine years, paying special attention to the factors affecting hospitalization costs and LOS to provide a reference base for health resource allocation in naval hospitals.

Materials and Methods

A total of 21,375 cases of military patients who were hospitalized and treated in three naval hospitals between January 2008 to December 2016 were extracted from the military health system. There were 16,278 complete and effective cases during those nine years. The situation, trends, and factors influencing hospitalization costs and LOS were analyzed using descriptive statistics, Mann-Whitney U test, Kruskal–Wallis H test, and multiple linear regressions.

Results

The following factors showed statistically significant differences in hospitalization costs: special care, primary care, year, military rank, critical illness, allergies, and condition (p < 0.0001); and number of hospitalizations, gender, and age (p < 0.01). The following factors showed statistically significant differences in hospital LOS: year, number of hospitalizations, outcomes, military rank, special care, severity of illness, and condition (p < 0.0001); allergy (p < 0.01); and service and gender (p < 0.05). LOS between 2008–2016 showed a decreasing tendency, while hospitalization costs showed an increasing trend. There were 6 factors that affected Abstract (or Structured Summary) both the cost of hospitalization and LOS: special care, year, military rank, condition, allergy, and gender.

Conclusions

The results suggest that improving efficiency of military hospital require strengthening hierarchical referrals and controlling hospital LOS. Shortening LOS, optimizing clinical pathways, and reasonably controlling the costs associated with medicines and surgery can help reduce hospitalization costs for military patients. Controlling the growth of hospitalization costs can help avoid the physical and psychological burden of medical over-treatment on patients and may also optimize the allocation of military health resources.
Usefulness of C-Reactive Protein in Differentiating Acute Leptospirosis and Dengue Fever in French Guiana
Authors: Le Turnier Paul , Bonifay Timothée , Mosnier Emilie , Schaub Roxane , Jolivet Anne , Demar Magalie , Bourhy Pascale , Nacher Mathieu , Djossou Félix , Epelboin Loïc
Published: July 2019

Objective

Leptospirosis and dengue fever (DF) are hard-to-differentiate diseases in cocirculating areas, especially during DF epidemics. Misdiagnosis and ensuing lack of antibiotic therapy can be detrimental in leptospirosis. The objective of this study was to identify factors that help differentiate acute leptospirosis from dengue fever on admission.

Method

Patients with leptospirosis (positive serology or polymerase chain reaction) were compared with patients with DF (positive nonstructural 1 [NS1] antigen) in a case-control study with age matching. Data on admission were compared using bivariate analysis and multivariate analysis.

Results

Seventy-two patients with leptospirosis were compared to 216 patients with DF. In bivariate analysis, the factors associated with leptospirosis were male gender, cough, anemia, and elevated blood levels of C-reactive protein (CRP), leukocytes, creatinine, bilirubin, and creatine phosphokinase. Exanthema, purpura, myalgia, headache, and neutropenia were associated with DF. In multivariate analysis, elevated blood levels of leukocytes, bilirubin, and CRP were associated with leptospirosis. The CRP threshold of 50 mg/L taken alone had elevated sensitivity and specificity.

Conclusions

The CRP level, an easy-to-obtain biomarker, was a powerful tool to differentiate on admission leptospirosis and DF. Facing a dengue-like syndrome in cocirculating areas and awaiting new specific rapid diagnostic tests, CRP dosing could help the clinician to promptly consider the diagnosis of leptospirosis and initiate antibiotic therapy early.
Reforming a System That Cannot Reform Itself: Child Welfare Reform by Class Action Lawsuits
Authors: Lee Joyce Y , Gilbert Terri , Lee Shawna J , Staller Karen M
Published: July 2019

Class action lawsuits have become an increasingly common way to facilitate institutional reform. The purpose of this article is to provide an introduction to social workers of child welfare reform by class action lawsuits and subsequent consent decrees. The authors provide an overview of class action lawsuits, with a focus on their role in implementing systematic change in the United States. They highlight consent decrees as a means of settling class action lawsuits. They illustrate the current state of the child welfare system and how child advocacy groups have used class action lawsuits to initiate reform. Authors provide two case examples of child welfare reform by consent decree and engage in comparative analysis to investigate similarities and differences in the two cases. Finally, they note implications for social work practice and education and provide recommendations to equip and train social workers involved in child welfare services.
Bermuda Court exercises inherent jurisdiction to appoint protectors
Authors: Robinson Keith , Fife Ashley
Published: July 2019

In the matter of the H Trust [2019] SC (Bda) 27 Com (30 April 2019), the Supreme Court of Bermuda delivered an important judgment in which it exercised its inherent supervisory powers over trusts to appoint protectors. In its decision, the court also reaffirmed the wide breadth of the court’s jurisdiction under section 47 of the Trustee Act 1975 (‘section 47’) to grant powers to trustees to vary trusts when it is satisfied it is ‘expedient’ to do so.
Annie Kenney and the Politics of Class in the Women’s Social and Political Union
Authors: Jenkins Lyndsey
Published: July 2019

This article argues that an analysis of Annie Kenney’s public representation and private relationships offers a new way of evaluating how class was understood, experienced, and negotiated within the Women’s Social and Political Union (WSPU). Annie Kenney was a well-known suffrage activist from Lancashire, usually described as the only working-class woman to achieve prominence in the organization. This article analyses how the WSPU initially made much of Annie Kenney’s social origins, attracting significant press attention. However, it also demonstrates that their assumption that she could effectively speak for all working-class women was problematic, since it assumed a homogeneity of working-class experience. As the WSPU shifted its focus to recruiting more middle-class women, it sought instead to celebrate Annie Kenney’s commitment to the cause. Ironically, she was often more effective in building relationships with wealthier women, forming substitute families that provided significant support and benefits. Yet though the depth of these relationships was extraordinary in the context of contemporary class relations, they remained exceptional rather than typical. This article thus develops the work of scholars including Sandra Stanley Holton, Sue Thomas, and Laura Schwartz, who have analysed how class fragmented and shaped the women’s movement. It demonstrates that the significance of class within the WSPU was fluid and shifting rather than fixed and static and indicates both the potential for, and barriers to, meaningful and lasting cross-class collaboration.
Water transport from stem to stomata: the coordination of hydraulic and gas exchange traits across 33 subtropical woody species
Authors: Liu Xiaorong , Liu Hui , Gleason Sean M , Goldstein Guillermo , Zhu Shidan , He Pengcheng , Hou Hao , Li Ronghua , Ye Qing
Published: July 2019

Coordination between sapwood-specific hydraulic conductivity (Ks) and stomatal conductance (gs) has been identified in previous studies; however, coordination between leaf hydraulic conductance (Kleaf) and gs, as well as between Kleaf and Ks is not always consistent. This suggests that there is a need to improve our understanding of the coordination among hydraulic and gas exchange traits. In this study, hydraulic traits (e.g., Ks and Kleaf) and gas exchange traits, including gs, transpiration (E) and net CO2 assimilation (Aarea), were measured across 33 co-occurring subtropical woody species. Kleaf was divided into two components: leaf hydraulic conductance inside the xylem (Kleaf-x) and outside the xylem (Kleaf-ox). We found that both Kleaf-x and Kleaf-ox were coordinated with gs and E, but the correlations between Kleaf-ox and gs (or E) were substantially weaker, and that Ks was coordinated with Kleaf-x, but not with Kleaf-ox. In addition, we found that Ks, Kleaf-x and Kleaf-ox together explained 63% of the variation in gs and 42% of the variation in Aarea across species, with Ks contributing the largest proportion of explanatory power, whereas Kleaf-ox contributed the least explanatory power. Our results demonstrate that the coordination between leaf water transport and gas exchange, as well as the hydraulic linkage between leaf and stem, were weakened by Kleaf-ox. This highlights the possibility that water transport efficiencies of stem and leaf xylem, rather than that of leaf tissues outside the xylem, are important determinants of stomatal conductance and photosynthetic capacity across species.
Root-Associated Streptomyces Isolates Harboring melC Genes Demonstrate Enhanced Plant Colonization
Authors: Chewning Sarah Stuart , Grant David L. , O’Banion Bridget S. , Gates Alexandra D. , Kennedy Brandon J. , Campagna Shawn R. , Lebeis Sarah L.
Published: July 2019

Streptomycetaceae assemble into the internal, root endophytic compartment of a wide variety of plants grown in soils worldwide, suggesting their ability to survive during root microbiome assembly. A previous study found that among four nonpathogenic, root-isolated Streptomyces strains (303, 299, CL18, and 136), only 303 and 299 colonized endophytic root tissue of the majority of Arabidopsis thaliana roots when inoculated with 34 other bacterial isolates. Here we demonstrate that 303 and 299 also colonize significantly more in singly inoculated A. thaliana seedlings. The genomes of melanin-producing 303 and 299 each contain two copies of the gene encoding tyrosinase (melC2 and melD2), an enzyme necessary for melanin biosynthesis in Streptomyces. These genes were not found in the genomes of 136 or CL18. Tyrosinase activity was detected in 303 and 299 whole cell and supernatant protein extracts, suggesting functional intracellular and extracellular enzymes.. Because tyrosinase oxidizes phenolic compounds and Streptomyces colonization of A. thaliana appears to be influenced by the phenolic compound salicylic acid (SA), we measured direct sensitivity of Streptomyces isolates to the phenolic compounds catechol, ferulic acid (FA), and SA in vitro. While both 303 and 299 showed higher numbers of surviving colonies than CL18 and 136 in the presence of catechol, only 303 demonstrated a higher number of surviving colonies when isolates were challenges with FA and SA. Finally, when seedlings were singly inoculated with a collection of related plant-associated Streptomyces isolates, colonization was significantly higher in isolates possessing two tyrosinase gene copies than isolates with zero or one gene copy. Overall, we describe a connection between microbial tyrosinase activity and increased seedling colonization of nonpathogenic Streptomyces isolates in A. thaliana. We propose tyrosinase activity in Streptomyces partially protects against harmful plant-produced phenolic compounds as they transition into an endophytic lifestyle.
Describing the Evidence Base for Accreditation in Undergraduate Medical Education Internationally: A Scoping Review
Authors: Tackett Sean , Zhang Christiana , Nassery Najlla , Caufield-Noll Christine , van Zanten Marta
Published: July 2019

Purpose

To summarize the state of evidence related to undergraduate medical education (UME) accreditation internationally, describe from whom and where the evidence has come, and identify opportunities for further investigation.

Method

The authors searched Embase, ERIC, PubMed, and Scopus from inception through January 31, 2018, without language restrictions, to identify peer-reviewed articles on UME accreditation. Articles were classified as scholarship if all Glassick’s criteria were met and as nonscholarship if not all were met. Author, accrediting agency, and study characteristics were analyzed.

Results

Database searching identified 1,379 nonduplicate citations, resulting in 203 unique, accessible articles for full-text review. Of these and with articles from hand searching added, 36 articles were classified as scholarship (30 as research) and 85 as nonscholarship. Of the 36 scholarship and 85 nonscholarship articles, respectively, 21 (58%) and 44 (52%) had an author from the United States or Canada, 8 (22%) and 11 (13%) had an author from a low- or middle-income country, and 16 (44%) and 43 (51%) had an author affiliated with a regulatory authority. Agencies from high-income countries were featured most often (scholarship: 28/60 [47%]; nonscholarship: 70/101 [69%]). Six (17%) scholarship articles reported receiving funding. All 30 research studies were cross-sectional or retrospective, 12 (40%) reported only analysis of accreditation documents, and 5 (17%) attempted to link accreditation with educational outcomes.

Conclusions

Limited evidence exists to support current UME accreditation practices or guide accreditation system creation or enhancement. More research is required to optimize UME accreditation systems’ value for students, programs, and society.
Evolution of the Surgical Technique for “Breast in a Day” Direct-to-Implant Breast Reconstruction: Transitioning from Dual-Plane to Prepectoral Implant Placement
Authors: Antony Anuja K. , Poirier Jennifer , Madrigrano Andrea , Kopkash Katherine A. , Robinson Emilie C.
Published: July 2019

Background:

Direct-to-implant breast reconstruction offers the intuitive advantages of shortening the reconstructive process and reducing costs. In the authors’ practice, direct-to-implant breast reconstruction has evolved from dual-plane to prepectoral implant placement. The authors sought to understand postoperative complications and aesthetic outcomes and identify differences in the dual-plane and prepectoral direct-to-implant subcohorts.

Methods:

A retrospective review of a prospectively maintained database was conducted from November of 2014 to March of 2018. Postoperative complication data, reoperation, and aesthetic outcomes were reviewed. Aesthetic outcomes were evaluated by a blinded panel of practitioners using standardized photographs.

Results:

One hundred thirty-four direct-to-implant reconstructions were performed in 81 women: 42.5 percent were dual-plane (n = 57) and 57.5 percent were prepectoral (n = 77). Statistical analysis was limited to patients with at least 1 year of follow-up. Total complications were low overall (8 percent), although the incidence of prepectoral complications [n = 1 (2 percent)] was lower than the incidence of dual-plane complications [n = 7 (12 percent)], with the difference approaching statistical significance (p = 0.07). Panel evaluation for aesthetic outcomes favored prepectoral reconstruction. Pectoralis animation deformity was completely eliminated in the prepectoral cohort.

Conclusions:

The authors present the largest comparative direct-to-implant series using acellular dermal matrix to date. Transition to prepectoral direct-to-implant reconstruction has not resulted in increased complications, degradation of aesthetic results, or an increase in revision procedures. Prepectoral reconstruction is a viable reconstructive option with elimination of animation deformity and potential for enhanced aesthetic results.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
Gender Imbalance at Academic Plastic Surgery Meetings
Authors: Santosa Katherine B. , Larson Ellen L. , Vannucci Bianca , Lapidus Jodi B. , Gast Katherine M. , Sears Erika D. , Waljee Jennifer F. , Suiter Amy M. , Sarli Cathy C. , Mackinnon Susan E. , Snyder-Warwick Alison K.
Published: July 2019

Background:

Participation in scientific meetings yields multiple benefits, yet participation opportunities may not be equally afforded to men and women. The authors’ primary goal was to evaluate the representation of men and women at five major academic plastic surgery meetings in 2017. Secondarily, the authors used bibliometric data to compare academic productivity between male and female physician invited speakers or moderators.

Methods:

The authors compiled information regarding male and female invited speakers from meeting programs. Bibliometric data (h-index, m-value) and metrics of academic productivity (numbers of career publications, publications in 2015 to 2016, career peer-reviewed publications, first and senior author publications) for invited speakers were extracted from Scopus and analyzed.

Results:

There were 282 academic physician invited speakers at the five 2017 meetings. Women constituted 14.5 percent. Univariate analysis showed no differences in h-index, m-value, or numbers of total career publications or first and last author publications at the assistant and associate professor ranks, but higher values for men at the professor level. A model of academic rank based on bibliometric and demographic variables showed male gender significantly associated with increased probability of holding a professor title, even when controlling for academic achievement markers (OR, 2.17; 95 percent CI, 1.61 to 2.92).

Conclusions:

Although the impact of women’s published work was no different than that of men among junior and midcareer faculty, women constitute a minority of invited speakers at academic plastic surgery meetings. Sponsorship is imperative for achieving gender balance within plastic surgery and to ultimately create more diverse and effective teams to improve patient care.
Evolution with complex selection and transmission
Authors: Rice Sean H.
Published: July 2019

Inheritance is the key factor making biological evolution possible. Despite this central role, transmission is often bundled into the simplifying assumptions of evolutionary models, making it difficult to see how changes in the patterns of transmission influence evolutionary dynamics. We present a mathematical formalism for studying phenotypic evolution, under any selection regime and with any transmission rules, that clearly delineates the roles played by transmission, selection, and interactions between the two.

To illustrate the approach, we derive models in which heritability and and fitness are influenced by the same environmental factors – producing a covariation between selection and transmission. By itself, variation in heritability does not influence directional evolution. However, we show that any covariation between heritability and selection can have a sub-stantial effect on trait evolution. Moderate differences in heritability between environments can lead to organisms adapting much more to environments with higher heritability, and can pull a population off of an “adaptive peak”. When habitat preference is allowed to evolve as well, variation in heritability between environments can lead to organisms exclusively using the environment in which heritability is highest. This effect is most pronounced when initial habitat selection is weak.
A novel gammaproteobacterial methanotroph from Methylococccaeae; strain FWC3, isolated from canal sediment from Western India
Authors: Khatri Kumal , Pandit Pranitha S. , Mohite Jyoti , Bahulikar Rahul A. , Rahalkar Monali C.
Published: July 2019

We isolated a gammaproteobacterial methanotrophic strain FWC3, from canal sediment from Western India. The strain oxidizes methane and can also grow on methanol. The draft genome of the same was sequenced which showed a size of ∼3.4 Mbp and 63% GC content. FWC3 is a coccoid, pale pink pigmented methanotroph and is seen in the form of diplococci, triplets, tetrads or small aggregates. After comparison of the complete 16S rRNA gene sequence, average amino-acid similarities and digital DNA-DNA hybridization values with that of the neighboring type species, we propose that the strain belongs to a novel genus and species, Ca. Methylolobus aquaticus FWC3Ts.
RepeatFiller newly identifies megabases of aligning repetitive sequences and improves annotations of conserved non-exonic elements
Authors: Osipova Ekaterina , Hecker Nikolai , Hiller Michael
Published: July 2019

Transposons and other repetitive sequences make up a large part of complex genomes. Repetitive sequences can be co-opted into a variety of functions and thus provide a source for evolutionary novelty. However, comprehensively detecting ancestral repeats that align between species is difficult since considering all repeat-overlapping seeds in alignment methods that rely on the seed-and-extend heuristic results in prohibitively high runtimes. Here, we show that ignoring repeat-overlapping alignment seeds when aligning entire genomes misses numerous alignments between repetitive elements. We present a tool – RepeatFiller – that improves genome alignments by incorporating previously-undetected local alignments between repetitive sequences. By applying RepeatFiller to genome alignments between human and 20 other representative mammals, we uncover between 22 and 84 megabases of previously-undetected alignments that mostly overlap transposable elements. We further show that the increased alignment coverage improves the annotation of conserved non-exonic elements, both by discovering numerous novel transposon-derived elements that evolve under constraint and by removing thousands of elements that are not under constraint in placental mammals. In conclusion, RepeatFiller contributes to comprehensively aligning repetitive genomic regions, which facilitates studying transposon co-option and genome evolution.

Source code

https://github.com/hillerlab/GenomeAlignmentTools
A model for sustainable laser tattoo removal services for adult probationers
Authors: Ojeda Victoria D. , Romero Laura , Ortiz Arisa
Published: July 2019

Purpose

The purpose of this paper is to describe a sustainable free laser tattoo removal clinic for economically disadvantaged adult probationers.

Design/methodology/approach

This paper describes the partnerships, methods and challenges/lessons learned from the implementation of a free monthly laser tattoo removal program for adult probationers within a medical school setting in California.

Findings

Possible patients are identified via a collaboration with the county’s Probation Department. Founded in 2016, this monthly program has provided tattoo removal services to >37 adult patient probationers, many of whom receive follow-up treatments. Clients seek to remove about four blue/black ink tattoos. Since its inception, 23 dermatology residents have volunteered in the program. Challenges to patients’ ongoing participation primarily pertain to scheduling issues; strategies for overcoming barriers to participation are provided. No safety concerns have emerged.

Social implications

Programs such as this public-private partnership may benefit probationers by eliminating financial barriers associated with tattoo removal. This model supports the training of cohorts of dermatologists seeking community service opportunities related to laser medicine. Others seeking to implement a similar program may also consider expanding treatment days/times to facilitate access for working probationers, providing enrollment options for other health and social services (e.g. public insurance, food stamp programs) and hosting a mobile onsite clinic to address clients’ physical and mental health needs.

Originality/value

This paper describes a unique collaboration between law enforcement and a medical school and it may assist other jurisdictions in establishing free tattoo removal programs for the benefit of probationers. The methods described overcome challenges regarding the implementation of this specialized clinical service.
School educational policy in Egypt: societal assessment perspective
Authors: Zaki Ewiss M.A. , Abdelgawad Fatma , Elgendy Azza
Published: July 2019

Purpose

Educational policy is crucial to society. Its process is related to political, economic and cultural variables. Nevertheless, there is a paucity of research in the field of applied social sciences, about how educational policies help to achieve societal objectives and welfare. This study aims to assess the concept and features of school education in Egypt during 1990-2017.

Design/methodology/approach

Secondary data were collected using governmental reports and educational institutional reports and assessed through specialized focus groups.

Findings

Results showed that, despite the multiplicity of strategies to reform the educational system, achievements and outcomes of educational processes are modest, and the developmental status of Egypt is lower than that of other countries. Studying educational outcomes indicated that school-education suffered from the predominance of quantity over quality and a serious inability to meet requirements of new knowledge era.

Originality/value

A novel future-oriented proposal for context, ethos and reforming aspects of educational policy will be suggested.
Culture and the multinational advertising agency: the rise and fall of Mojo-MDA, 1964-1991
Authors: Crawford Robert
Published: July 2019

Purpose

This paper aims to trace the emergence, rise and eventual fall of Mojo-MDA. Established as a creative consultancy in 1975, Mojo embarked on an ambitious growth strategy that would see it emerge as Australia’s first multinational agency. By examining the agency’s trajectory over the 1970s and 1980s, this paper revisits the story of an Australian agency with boundless confidence to develop a more nuanced understanding of the dynamic role played by corporate culture in the agency's fortunes.

Design/methodology/approach

This study uses reports and features published in the Australian advertising trade press, along with other first-hand accounts, including oral history interviews and personal correspondence with former agency staff.

Findings

By identifying the forces and influences affecting Mojo-MDA’s outlook and operations, this paper demonstrates the important yet paradoxical role that corporate culture plays in both building and undermining an agency’s ambitions and the need for marketing historians to pay closer attention to it.

Originality/value

This examination of an agency’s inner machinations over an extended period presents a unique perspective of the ways that advertising agencies operate, as well as the forces that drive and impede them, at both national and global levels. The Mojo-MDA story also illustrates the need for marketing and business historians to pay close attention to corporate culture and the different ways that it affects marketing business and practices.
Muslim Hoedowns, Tenuous Language and the Uncertain Lives of an Urban Majority
Authors: Simone AbdouMaliq
Published: July 2019

Drawing upon diverse elements of Islamic thought, this essay examines the notions of gathering and footwork to think through the elaborations of a material sensibility embedded in the everyday navigations of contemporary urban life. From reflections on the surreptitious encounters of African Americans in various contexts of subjection, to zar practices in Amman and to popular orientations to megacomplex residencies in Jakarta, the essay attempts to address what it means to think and act collectively in urban contexts that fragment, track, evict and erase long‐relied‐upon forms of collaboration. How might we discover in the seeming contraction of urban sociality something else besides intensive individuation, and what kinds of vernaculars and rhythmic encounters, of bodies moving towards and away from each other, might turn the peripheral forms of the urban into sites of new generativity?
Synergistic effects of depression and obesity on type 2 diabetes incidence in Chinese adults
Authors: Ning Feng , Zhang Dong , Xue Bai , Zhang Lei , Zhang Jintai , Zhu Zhigang , Zhang Dongfeng , Gao Ruqin , Pang Zengchang , Qiao Qing ,   on behalf of the Qingdao Diabetes Prevention Program
Published: July 2019

Background

Cross‐sectional studies have supported the association among depression, obesity, and type 2 diabetes, but the causality remains controversial in Chinese adults. In this longitudinal study, we evaluated the synergistic effect of depression and obesity on the risk of type 2 diabetes.

Methods

This study included 2809 participants randomly selected from the Qingdao Diabetes Prevention Program, and their type 2 diabetes incidence was determined over a follow‐up period of 3 years. The WHO 2006 criteria and the Zung Self‐Rating Depression Scale score were employed to identify type 2 diabetes and depression at baseline, respectively. Multivariable‐adjusted logistic regression was used to evaluate the synergistic effects of depression and obesity indicators on type 2 diabetes, with adjustment for age, sex, family history of diabetes, and other potential risk factors.

Results

During 3‐year follow‐up, 316 new incident cases were identified. The relative risk and 95% confidence interval of depression for diabetes incidence was 1.52 (1.05‐2.21), after controlling for potential confounders. Sensitivity analysis showed that depression was significantly associated with diabetes incidence in women, younger people, and obese people (1.82 [1.14‐2.92], 1.94 [1.25‐3.02], and 4.29 [1.44‐12.78], respectively]. The synergistic effects of positive depression and body mass index ≥30 kg/m2 on type 2 diabetes incidence were observed, with a synergy index of 5.49 (1.75‐17.19).

Conclusions

Depression was associated with a 52% increased risk of type 2 diabetes incidence and exerts synergistic effects with obesity on diabetes incidence in Chinese adults. Early identification and intervention for depression and obesity can reduce the risk of diabetes.
Myocardial injury and mortality in patients with excessive oxygen administration before cardiac arrest
Authors: Grønbek K. S. , Mørch S. S. , Pedersen N. E. , Petersen T. S. , Meyhoff C. S.
Published: July 2019

Introduction

Hyperoxia after cardiac arrest may be associated with higher mortality, and trials have found that excess oxygen administration in patients with myocardial infarction is associated with increased infarct size. The effect of hyperoxia before cardiac arrest is sparsely investigated. Our aim was to assess the association between excessive oxygen administration before cardiac arrest and the extent of subsequent myocardial injury.

Methods

We performed a retrospective study including patients who had in‐hospital cardiac arrest during 2014 in the Capital Region of Denmark. We excluded patients without peripheral oxygen saturation measurements within 48 hours before cardiac arrest. Patients were divided in three groups of pre‐arrest oxygen exposure, based on average peripheral oxygen saturation and supplemental oxygen. Primary outcome was peak troponin concentration within 30 days. Secondary outcomes included 30‐day mortality. Data were analyzed using multiple logistic regression and Wilcoxon rank sum test.

Results

Of 163 patients with cardiac arrest, 28 had excessive oxygen administration (17%), 105 had normal oxygen administration (64%) and 30 had insufficient oxygen administration (18%) before cardiac arrest. Peak troponin was median 224 ng/L in the excessive oxygen administration group vs 365 ng/L in the normal oxygen administration group (P = .54); 20 of 28 (71%) in the excessive oxygen administration group died within 30 days compared to 54 of 105 (51%) in the normal oxygen administration group. (OR 1.87, 95% CI 0.56‐6.19)

Conclusions

Excessive oxygen administration within 48 hours before in‐hospital cardiac arrest was not statistically associated with significantly higher peak troponin or mortality.