bluuebunny/crossref_metadata_2025 huggingface dataset:
Parsnip.
Authors: Allender Charlotte J.
Published: August 2020

This chapter focuses on the importance of parsnip (Pastinaca sativa) as a root crop best suited for production in cool climates. Informaton on the various cultivation areas, developmental and production characteristics and postharvest systems of parsnips are also presented.
Tuberous-rooted chervil.
Authors: Briard Mathilde , le Clerc Valérie , Huet Sébastien , Granger Jacky , Geoffriau Emmanuel
Published: August 2020

Tuberous-rooted chervil, Chaerophyllum bulbosum, has been collected in the wild and used as a food since antiquity. The crop was first described in Austria in 1601. After realizing success as a crop during the 19th and beginning of the 20th centuries, particularly in France and Germany, it was forgotten by growers until the beginning of the last decade. This chapter discusses the importance, growing areas, plant development, cropping system (including soil preparation, sowing, irrigation and fertilizer (N, P and K) requirements, pest and disease management, and harvesting), postharvest storage and product quality of tuberous-rooted chervil.
An analytically based method to estimate the effective thermal diffusivity of a heat pipe
Authors: Chen Hong-Long , Wang Chi-Chuan
Published: August 2020

An analytically based method is proposed to estimate the equivalent thermal diffusivity (α) of a heat pipe. This novel method, which enables real-time screening, features simple, fast, inexpensive and accurate characteristics in obtaining the corresponding α value. Different from the traditional Angstrom method, which uses a sinusoidal pulse heating source for measuring the offset of two separate waves triggered in an intermittent time span; the proposed method merely uses a water bath as the heating source with the derived closed-form solution as a core computing algorithm, and the correct α value can be obtained. The examination process only takes less than 30 s and can be deployed in production lines for real-time screening. The closed-form analytical solution is associated with an infinite power series and is validated with heat pipes of 6 mm in diameter and 260 mm in length. The equivalent thermal diffusivity of the heat pipe is 0.00382 m2 s−1, which is about 35 times higher than copper and 3.6 times higher than graphite. The analytical predictions are in line with experimental results for the transient temperature rise of the heat pipe.
Two blocks connected by a string with variable tension: a dynamic case
Authors: Suárez H J Herrera , Machado-Higuera M , Muñoz J H
Published: August 2020

In this paper, the dynamic case of a system made up of two blocks connected by a string over a smooth pulley is revisited. One mass lies on a horizontal surface without friction, and the other mass has a vertical displacement. The motion equation is obtained and its solution is determined using the Mathematica package. Also an experimental montage for this system is made and experimental data for the vertical position y in the function of time t are obtained using a data acquisition system and Tracker video analysis. The relation y vs t can be represented by a polynomial of degree six. An average relative error of 3.61(10.14)% is obtained between the theoretical results acquired with Mathematica and the data taken from Tracker (data acquisition system).
Experimental evidence that acorn woodpeckers recognize relationships among third parties no longer living together
Authors: Pardo Michael A , Walters Eric L , Koenig Walter D
Published: August 2020

Triadic awareness, or knowledge of the relationships between others, is essential to navigating many complex social interactions. While some animals maintain relationships with former group members post-dispersal, recognizing cross-group relationships between others may be more cognitively challenging than simply recognizing relationships between members of a single group because there is typically much less opportunity to observe interactions between individuals that do not live together. We presented acorn woodpeckers (Melanerpes formicivorus), a highly social species, with playback stimuli consisting of a simulated chorus between two different individuals, a behavior that only occurs naturally between social affiliates. Subjects were expected to respond less rapidly if they perceived the callers as having an affiliative relationship. Females responded more rapidly to a pair of callers that never co-occurred in the same social group, and responded less rapidly to callers that were members of the same social group at the time of the experiment and to callers that last lived in the same group before the subject had hatched. This suggests that female acorn woodpeckers can infer the existence of relationships between conspecifics that live in separate groups by observing them interact after the conspecifics in question no longer live in the same group as each other. This study provides experimental evidence that nonhuman animals may recognize relationships between third parties that no longer live together and emphasizes the potential importance of social knowledge about distant social affiliates.
The Association Between High and Unnecessary Antibiotic Prescribing: A Cohort Study Using Family Physician Electronic Medical Records
Authors: Kitano Taito , Langford Bradley J , Brown Kevin A , Pang Andrea , Chen Branson , Garber Gary , Daneman Nick , Tu Karen , Leung Valerie , Candido Elisa , Wu Julie Hui-Chih , Hwee Jeremiah , Silverman Michael , Schwartz Kevin L
Published: August 2020

Background

Approximately 25% of outpatient antibiotic prescriptions are unnecessary among family physicians in Canada. Minimizing unnecessary antibiotics is key for community antibiotic stewardship. However, unnecessary antibiotic prescribing is much harder to measure than total antibiotic prescribing. We investigated the association between total and unnecessary antibiotic use by family physicians and evaluated inter-physician variability in unnecessary antibiotic prescribing.

Methods

This was a cohort study based on electronic medical records of family physicians in Ontario, Canada, between April 2011 and March 2016. We used predefined expected antibiotic prescribing rates for 23 common primary care conditions to calculate unnecessary antibiotic prescribing rates. We used multilevel Poisson regression models to evaluate the association between total antibiotic volume (number of antibiotic prescriptions per patient visit), adjusted for multiple practice- and physician-level covariates, and unnecessary antibiotic prescribing.

Results

There were 499 570 physician–patient encounters resulting in 152 853 antibiotic prescriptions from 341 physicians. Substantial inter-physician variability was observed. In the fully adjusted model, we observed a significant association between total antibiotic volume and unnecessary prescribing rate (adjusted rate ratio 2.11 per 10% increase in total use; 95% CI 2.05–2.17), and none of the practice- and physician-level variables were associated with unnecessary prescribing rate.

Conclusions

We demonstrated substantial inter-physician variability in unnecessary antibiotic prescribing in this cohort of family physicians. Total antibiotic use was strongly correlated with unnecessary antibiotic prescribing. Total antibiotic volume is a reasonable surrogate for unnecessary antibiotic use. These results can inform community antimicrobial stewardship efforts.
Pretreatment and Acquired Antiretroviral Drug Resistance Among Persons Living With HIV in Four African Countries
Authors: Crowell Trevor A , Danboise Brook , Parikh Ajay , Esber Allahna , Dear Nicole , Coakley Peter , Kasembeli Alex , Maswai Jonah , Khamadi Samoel , Bahemana Emmanuel , Iroezindu Michael , Kiweewa Francis , Owuoth John , Freeman Joanna , Jagodzinski Linda L , Malia Jennifer A , Eller Leigh Ann , Tovanabutra Sodsai , Peel Sheila A , Ake Julie A , Polyak Christina S ,   AFRICOS Study Group
Published: August 2020

Background

Emerging HIV drug resistance (HIVDR) could jeopardize the success of standardized HIV management protocols in resource-limited settings. We characterized HIVDR among antiretroviral therapy (ART)-naive and experienced participants in the African Cohort Study (AFRICOS).

Methods

From January 2013 to April 2019, adults with HIV-1 RNA >1000 copies/mL underwent ART history review and HIVDR testing upon enrollment at 12 clinics in Uganda, Kenya, Tanzania, and Nigeria. We calculated resistance scores for specific drugs and tallied major mutations to non-nucleoside reverse transcriptase inhibitors (NNRTIs), nucleoside reverse transcriptase inhibitors (NRTIs), and protease inhibitors (PIs) using Stanford HIVDB 8.8 and SmartGene IDNS software. For ART-naive participants, World Health Organization surveillance drug resistance mutations (SDRMs) were noted.

Results

HIVDR testing was performed on 972 participants with median age 35.7 (interquartile range [IQR] 29.7–42.7) years and median CD4 295 (IQR 148–478) cells/mm3. Among 801 ART-naive participants, the prevalence of SDRMs was 11.0%, NNRTI mutations 8.2%, NRTI mutations 4.7%, and PI mutations 0.4%. Among 171 viremic ART-experienced participants, NNRTI mutation prevalence was 83.6%, NRTI 67.8%, and PI 1.8%. There were 90 ART-experienced participants with resistance to both efavirenz and lamivudine, 33 (36.7%) of whom were still prescribed these drugs. There were 10 with resistance to both tenofovir and lamivudine, 8 (80.0%) of whom were prescribed these drugs.

Conclusions

Participants on failing ART regimens had a high burden of HIVDR that potentially limited the efficacy of standardized first- and second-line regimens. Management strategies that emphasize adherence counseling while delaying ART switch may promote drug resistance and should be reconsidered.
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a newly emerged pathogen: an overview
Authors: Rathore Jitendra Singh , Ghosh Chaitali
Published: August 2020

Coronavirus disease 2019 (COVID-19) is a viral pneumonia, responsible for the recent pandemic, and originated from Wuhan, China, in December 2019. The causative agent of the outbreak was identified as coronavirus and designated as severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2). Few years back, the severe acute respiratory syndrome coronavirus (SARS- CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV) were reported to be highly pathogenic and caused severe infections in humans. In the current situation SARS-CoV-2 has become the third highly pathogenic coronavirus that is responsible for the present outbreak in human population. At the time of this review, there were more than 14 007 791 confirmed COVID-19 patients which associated with over 597 105 deaths in more then 216 countries across the globe (as reported by World Health Organization). In this review we have discussed about SARS-CoV, MERS-CoV and SARC-CoV-2, their reservoirs, role of spike proteins and immunogenicity. We have also covered the diagnosis, therapeutics and vaccine status of SARS-CoV-2.
Development of a porcine model of emergency resternotomy at a low-volume cardiac surgery centre
Authors: Guenther Timothy M , Chen Sarah A , Gustafson Joshua D , Wozniak Curtis J , Kiaii Bob
Published: August 2020

Emergency resternotomy in the intensive care unit (ICU) is a rarely performed, yet potentially life-saving intervention. Success relies on recognition of a deteriorating clinical condition, timely deployment of equipment/personnel and rapid execution. Given how infrequently it is performed, we sought to develop a large animal model of resternotomy to prepare ICU nurses and technicians at our low-volume cardiac surgery military centre. A porcine model of resternotomy was developed at the end of an already-scheduled trauma lab. Participants worked their way through a pre-planned simulation scenario, culminating in the need for resternotomy. Pre-simulation surveys assessing knowledge and comfort level with aspects of resternotomy were compared to post-simulation surveys. Participants improved their knowledge of resternotomy by 20.4% (P < 0.0001; 14.7% for nurses and 26.9% for technicians). Improvements were seen in all aspects assessed relating to subjective comfort/preparedness of resternotomy. The model was an effective and realistic method to augment training of ICU staff about resternotomy. Costs associated with this model can be reduced when used in conjunction with large animal labs. This model should be used together with mannequin-based methods of resternotomy training to provide a realistic training environment and assessment of skills at capable institutions.
Fraïssé–Hintikka theorem in institutions
Authors: Găină Daniel , Kowalski Tomasz
Published: August 2020

We generalize the characterization of elementary equivalence by Ehrenfeucht–Fraïssé games to arbitrary institutions whose sentences are finitary. These include many-sorted first-order logic, higher-order logic with types, as well as a number of other logics arising in connection to specification languages. The gain for the classical case is that the characterization is proved directly for all signatures, including infinite ones.
Global 3D hydrodynamic modeling of absorption in Lyα and He 10830 A lines at transits of GJ3470b
Authors: Shaikhislamov I F , Khodachenko M L , Lammer H , Berezutsky A G , Miroshnichenko I B , Rumenskikh M S
Published: August 2020

Warm Neptune GJ3470b has been recently observed in 23S-23P transition of metastable helium, yielding absorption of about 1 per cent in Doppler velocity range of [-40; 10] km/s. Along with previous detection of absorption in Lyα with depth of 20–40 per cent in the blue and red wings of the line, it offers a complex target for simulation and testing of the current models. Obtained results suggest that absorption in both these lines comes from interaction of expanding upper planetary atmosphere with stellar plasma wind, allowing to constrain the stellar plasma parameters and the helium abundance in planet atmosphere.
They Don’t See a Lot of People My Color: A Mixed Methods Study of Racial/Ethnic Stereotype Threat Among Medical Students on Core Clerkships
Authors: Bullock Justin L. , Lockspeiser Tai , del Pino-Jones Amira , Richards Regina , Teherani Arianne , Hauer Karen E.
Published: August 2020

Purpose

Stereotype threat is an important psychological phenomenon in which fear of fulfilling negative stereotypes about one’s group impairs performance. The effects of stereotype threat in medical education are poorly characterized. This study examined the prevalence of racial/ethnic stereotype threat amongst fourth-year medical students and explored its impact on students’ clinical experience.

Method

This was an explanatory sequential mixed methods study at 2 institutions in 2019. First, the authors administered the quantitative Stereotype Vulnerability Scale (SVS) to fourth-year medical students. The authors then conducted semistructured interviews among a purposive sample of students with high SVS scores, using a qualitative phenomenographic approach to analyze experiences of stereotype threat. The research team considered reflexivity through group discussion and journaling.

Results

Overall, 52% (184/353) of students responded to the survey. Collectively, 28% of students had high vulnerability to stereotype threat: 82% of Black, 45% of Asian, 43% of Latinx, and 4% of White students. Eighteen students participated in interviews. Stereotype threat was a dynamic, 3-stage process triggered when students experienced the workplace through the colored lens of race/ethnicity by standing out, reliving past experiences, and witnessing microaggressions. Next, students engaged in internal dialogue to navigate racially charged events and workplace power dynamics. These efforts depleted cognitive resources and interfered with learning. Finally, students responded and coped to withstand threats. Immediate and deferred interventions from allies reduced stereotype threat.

Conclusions

Stereotype threat is common, particularly among non-White students, and interferes with learning. Increased minority representation and developing evidence-based strategies for allyship around microaggressions could mitigate effects of stereotype threat.
Expanding the Traditional History and Physical Examination to Address Chronic Diseases and Social Needs: A Multisite Randomized Control Trial of 4 Medical Schools
Authors: Kirley Kate , Hayer Rupinder , Khan Tamkeen , Johnson Eric , Sanchez Erin Stephany , Kosowicz Lynn , Terry Valerie , Henderson David , Krebsbach Cory , Park Yoon Soo , Dekhtyar Michael , Williams Brent C.
Published: August 2020

Purpose

This study gathers validity evidence of an expanded History and Physical examination (H&P 360) to address chronic diseases through incorporation of biopsychosocial elements that are lacking in traditional H&P assessments via a multisite randomized controlled trial among medical students.

Method

Third- and fourth-year medical students (n = 159) at 4 schools participated in an Objective Structured Clinical Examination designed with 2 cases for chronic disease. Students were randomized into the treatment group, which involved brief written instructions on how to use the H&P 360 followed by a standardized patient (SP) interaction, or the control group, which used the traditional H&P in an SP interaction without additional instructions. Validity evidence was gathered for content (alignment with an empirically derived expanded history list), response process (feedback from raters and learners on the process), internal structure (reliability and item-level psychometrics), relations to other variables (comparison between treatment and control groups), and consequences (survey results from learners on experience).

Results

H&P 360 items were blueprinted by faculty experts. SP observation checklist grading was consistent, and postassessment debrief confirmed favorable educational experience among learners. The reliability of the H&P 360 was .76. Overall mean scores on the H&P 360 content (mean = 15.96, standard deviation [SD] = 3.66) were significantly higher compared with the traditional H&P (mean = 10.99, SD = 2.69, Cohen’s d = 1.17, P < .001).

Conclusions

Medical students using the H&P 360 collected significantly more biopsychosocial information compared with students using the traditional H&P, providing empirical support for teaching and assessing biopsychosocial information. The assessment demonstrated strong validity evidence supporting the use of the H&P 360 assessment in medical schools.
The Hiker’s Guide to the RIME Supplement: Choosing Directions in Research
Authors: Sewell Justin L. , Leep Hunderfund Andrea N. , Schumacher Daniel J. , Zaidi Zareen
Published: August 2020

In this Commentary, the authors seek to build on prior RIME commentaries by considering how researchers transition from worldviews, focal lengths, and research goals to research directions and methodological choices. The authors use the analogy of a hiker to illustrate how different researchers studying a similar phenomenon can choose among different research directions, which lead down different paths and offer different perspectives on a problem. Following the hiker analogy, the authors use the “Research Compass” to categorize the 15 research papers included in the 2020 Research in Medical Education supplement according to their research aim and corresponding methodological approach. The authors then discuss implications of the relative balance of these study types within this supplement and within health professions education research at large, emphasizing the critical importance of studying a topic from multiple vantage points to construct a richer and more nuanced understanding of health professions education challenges. The authors conclude by recognizing the challenges we face in the current era of COVID-19 and by calling health professions education researchers and practitioners to continue our collective efforts to improve learner education and patient care, as we together navigate the unfamiliar terrain of the present day.
Patients, Pride, and Prejudice: Exploring Black Ontarian Physicians’ Experiences of Racism and Discrimination
Authors: Mpalirwa Joseph , Lofters Aisha , Nnorom Onye , Hanson Mark D.
Published: August 2020

Purpose

Black physicians’ and trainees’ experiences of racism are not well documented in Canada, reflecting a knowledge gap needing correction to combat racism in Canadian health care. The authors undertook a descriptive study of Black physicians and trainees in the Canadian province of Ontario. The goal of this study was to report upon racism experienced by participant Ontarian physicians to challenge the purported rarity of racism in Canadian health care.

Method

An anonymous online survey of physicians and trainees who self-identify as Black (African/Afro-Canadian/African American/Afro-Caribbean) was administered in March and April 2018 through the Black Physicians’ Association of Ontario (BPAO) listserv. The survey was modeled on qualitative interview guides from American studies. Snowball sampling was employed whereby BPAO members forwarded the survey to eligible colleagues (non-BPAO members) to maximize responses. Survey data were analyzed and key themes described.

Results

Survey participants totalled 46, with a maximal response rate of 38%. Participants reported positive experiences of collegiality with Black colleagues and strong bonds with Black patients. Negative discrimination experiences included differential treatment and racism from peers, superiors, and patients. Participants reported race as a major factor in their selection of practice location, more so than selection of career. Participants also expressed a lack of mentorship, and there was a strong call for increased mentorship from mentors with similar ethno-racial backgrounds.

Conclusions

This study challenges the notion that racism within Canadian health care is rare. Future systematic collection of information regarding Black physicians’ and trainees’ experiences of racism will be key in appreciating the prevalence and nature of these experiences.
A New Approach for Lateral Sinus Floor Elevation
Authors: Covani Ugo , Giammarinaro Enrica , Marconcini Simone
Published: August 2020

The lateral sinus lift procedure has been extensively investigated and described as a reliable surgical solution aimed at facilitating implant placement and rehabilitation when the posterior upper maxilla is atrophic. The standard technique consists in a lateral antrostomy, the careful raising of the sinus membrane, and following apposition of a bone substitute between the membrane and the sinus floor. The present technical note illustrates a new conservative technique enabling lateral sinus lift without the use of bone substitutes and with predictable outcomes.
Early Recognition of Raised Intracranial Pressure in Craniosynostosis Using Optical Coherence Tomography
Authors: Rufai Sohaib R. , Jeelani Noor ul Owase , McLean Rebecca J.
Published: August 2020

Objective:

Craniosynostosis can be associated with raised intracranial pressure (ICP), which can pose deleterious effects on the brain and vision if untreated. Estimating ICP in children is challenging, whilst gold standard direct intracranial measurement of ICP is invasive and carries risk. This systematic review aims to evaluate the role of optical coherence tomography (OCT), a noninvasive imaging technique, for detecting raised ICP in children with craniosynostosis.

Methods:

The authors conducted a systematic review of the literature published from inception until 19 August, 2019 in the Cochrane Central Register of Controlled Trials, PubMed, MEDLINE, and EMBASE. Eligible studies evaluated the role of OCT in detecting raised ICP in children aged 0 to 16 years with craniosynostosis. Main outcome measures were sensitivity and specificity of OCT parameters for raised ICP. Quality assessment was performed using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies.

Results:

Out of 318 records identified, data meeting the inclusion criteria were obtained from 3 studies. The quality of 2 studies was poor whilst 1 was fair. Optical coherence tomography demonstrated higher sensitivity and specificity for detecting raised ICP compared to fundus examination, clinical history, radiological testing, and visual field testing.

Conclusions:

This systematic review demonstrated a lack of quality evidence for OCT as a screening tool for children with craniosynostosis. Further research is required to clarify the strength of OCT in this role and to determine which OCT parameters are most appropriate.
Finite Element Analysis of 2- and 3-Point Internal Fixation Methods for the Treatment of Zygomaticomaxillary Complex Fracture
Authors: Li Yan , Wu Pengsen , Liu Shuyi , Tang Meiting , Yu Shen , Kikkawa Don O. , Lu Wei
Published: August 2020

Open reduction followed by internal fixation (ORIF) has been regarded as the most effective technique for surgical repair of zygomaticomaxillary complex (ZMC) fractures. However, the ideal internal fixation method to achieve stable reduction remains controversial. This research aims to assess and compare the stability of the 2- and 3-point screw-plate fixation methods using finite element method (FEM). Based on computed tomography (CT), the finite element models of 2-point (ZFS + IOR) and 3-point (ZFS + IOR + ZMB) fixation for isolated displaced ZMC fracture were reconstructed. The force of 120 N was applied to the models to simulate the masseter muscle strength. The maximum stress and displacement of the 2 models were measured to compare the stability. Two geometrically accurate and finite element models were reconstructed successfully. In both the 2- and 3-point fixation models, the maximum stress was significantly lower than the mechanical properties of pure titanium and titanium alloys and the maximum displacement was ≤0.1 mm. The results of this study suggested that both 2- and 3-point fixation of isolated displaced ZMC fractures provide good stability. The FEM innovatively applied in this study can not only show the biomechanical properties of the orbital skeleton and masseter muscle but also assess the stability of the two fixation methods and provide a theoretical reference. This study verifies the effectiveness of 2-point fixation and combined with the clinical benefits of reduced incisions, shorter operative time and lower cost, make this an attractive method.
Pharyngoplasty for Speech Disorders Following Brain Injury
Authors: Johnston Emma , Martin Serena , McLarnon Michael , Hill Chris
Published: August 2020

Introduction:

Dysarthria is one of the commonest neurological speech disorders resulting from brain injury. However, hypernasality commonly co-exists in this subgroup of patients and is commonly overlooked. The authors aim to investigate the merit of surgery in improving hypernasality and speech intelligibility in patients with a mixed pattern of dysarthria and hypernasality secondary to brain injury.

Materials and Methods:

Data was collected from the regional plastic surgery unit over a 10-year period. All patients who underwent a pharyngoplasty for speech improvement following total brain injury from either a traumatic injury or a cerebrovascular accident were included. Patients were followed up post-operatively to assess; improvement in speech rehabilitation, complications and the need for surgical revision.

Results:

Six patients had a pharyngoplasty for speech improvement. Either a Hynes or Jackson pharyngoplasty was performed, with one patient requiring a hemi-pharyngoplasty. Post-operatively, 1 patient experienced self-limiting sleep apnea which resolved within 1 month. One patient developed obstructive symptoms and required revision. Overall, 83% of patients had clear improvement in speech intelligibility and articulation.

Conclusions:

The authors have shown that surgical intervention, in the form of a pharyngoplasty, is an effective method of improving speech intelligibility and articulation, by improving hypernasality and restoring communication in this cohort of patients. The aim of this paper is to highlight this option to colleagues and to heighten the awareness that many patients with a total brain injury have a mixed pattern of speech disturbance and not solely the dysarthria that is attributed to this condition.
Congenital Deficiency of Alar Cartilage
Authors: Günebakan Çağlar , Kuzu Selçuk
Published: August 2020

Alar cartilage anatomically determines the size, position, and shape of the nose type. It is also effective in the respiratory function of the nose. The structure of alar cartilage differs from person to person. Congenital anomalies of the nose due to absence of alar cartilage are extremely rare. Usually, trauma and infections are blamed for etiology. The absence of nasal alar cartilage causes both aesthetically nasal deformities and respiratory dysfunction problems. In the literature, congenital alar cartilage defect has been reported as cases with a substantial partial defect. In this study, it is aimed to present a case with unilateral, isolated, complete alar cartilage absence detected in a patient who underwent septorhinoplasty, and with the treatment approach applied in light of current literature knowledge.
Scoping Zygomaticomaxillary Complex Fractures With the Eyes of Virtual Reality: Operative Protocol and Proposal of a Modernized Classification
Authors: Tel Alessandro , Sembronio Salvatore , Costa Fabio , Robiony Massimo
Published: August 2020

Introduction:

Fractures of the zygomaticomaxillary complex (ZMC) represent an extremely heterogeneous group of injuries to the midfacial skeleton. Traditionally, the diagnosis of such fractures was based on 2-dimensional radiograms and, more recently, on volumetric computed tomography (CT) scans, while the treatment was exclusively based on the surgeon's experience. Many classification attempts have been made in the past, but no paper has taken into account the importance of virtual surgical planning (VSP) in proving a modernized classification. The authors propose a classification based on the use of VSP which can guide the surgeon to identify the optimal reduction method and reproduce it in the operating room through the use of navigation.

Methods:

Patients with ZMC fractures were collected to create a study model. The VSP was used to generate 3-dimensional models of fractures. Fractured segments were duplicated and digitally put in the optimal reduction position. Repositioned fragments were overlapped to their original preoperative counterparts and exported to the surgical navigator to be navigated. Planned virtual reduction was overlaid to postoperative CT scan to assess the accuracy of reduction, explored using color maps and the calculation of root mean square error.

Results:

For all patients, the application of VSP was successfully accomplished. High accuracy was confirmed between the planned virtual reduction and the postoperative CT scan. A 5-item classification based on VSP is proposed. All patients were included in the presented subclasses.

Conclusions:

The adoption of virtual planning in ZMC fractures allows for an improved study of the displacement of the fracture and might indicate to the surgeons the required maneuvers to achieve optimal reduction. The presented proposal of classification might be an aid to simplify the choice of the most appropriate reduction method and might provide a deeper insight into the morphologic characteristics of fractures.
On the need to evaluate costs and benefits of synzoochory for plant populations
Authors: Zwolak Rafał , Bogdziewicz Michał , Crone Elizabeth E.
Published: August 2020

Many species interactions occur along a continuum from mutualistic to antagonistic. Among these interactions, the effects of seed‐dispersing granivores (synzoochory) are especially interesting because the benefits and costs are so striking.

Here, we respond to a commentary by C. M. Moore and J. W. Dittel (‘On mutualism, models, and masting: the effects of seed‐dispersing animals on the plants they disperse’). We focus on the points that were most thought‐provoking to us, specifically the notions that (a) synzoochory is widespread, and therefore ought to be beneficial for plants, (b) dispersal should reduce negative density dependence and (c) plant life spans are at least an order of magnitude longer than typical study lengths.

We argue that (a) widespread occurrence of an interaction cannot serve as an argument that this interaction is mutualistic, (b) dispersal effects on density dependence are variable and need to be tested for every particular species pair and (c) Short‐term studies can be used to gain mechanistic understanding of interactions even without risky long‐term extrapolations.

Synthesis. Evaluating the costs and benefits of synzoochory for plant populations under different ecological contexts will help to understand the ecological principles of the interaction but also allows to move the interaction towards each end of the antagonism–mutualism continuum in nature management and conservation.
Energy‐Related Environmental Policy and Its Impacts on Energy Use in Asia
Authors: Arimura Toshi H. , Sugino Makoto
Published: August 2020

Economic growth in Asia has increased in the past three decades and has heightened energy demand, resulting in rising greenhouse gas emissions and severe air pollution. To tackle these issues, fuel switching and the deployment of renewables are essential. In the present paper, we discuss the environmental regulations, mainly carbon pricing, implemented in Asia and discuss their achievements. Empirical studies using microdata have shown that carbon pricing in Asia can reduce carbon emissions by promoting energy efficiency. At the macro level, we observe some evidence of fuel switching from coal to natural gas among major emitters. However, more carbon pricing is necessary in Asia if we aim for the decarbonization of the economy.
Discrimination of ascitic fluid infection in malignant ascites by polymorphonuclear neutrophil ratio and count: Investigating the validity of count ≥250/mm3 as the one‐size‐fits‐all criterion
Authors: Moon Hae , Kim Hak Jin , Woo Sang Myung , Park In Hae , Sim Sung Hoon
Published: August 2020

Aim

Neutrocytic ascites, traditionally defined as a polymorphonuclear neutrophil count ≥250/mm3, is infrequently reported during paracenteses to relieve malignant ascites (MA). This study aims to explore new potential diagnostic criteria to discriminate ascitic fluid infection associated with MA and to examine the clinical and laboratory characteristics of neutrocytic ascites.

Methods

The investigators retrospectively collected data on paracenteses to relieve MA at the Emergency Department of National Cancer Center, Korea, from January 2014 to February 2017. We analyzed the patients whose ascites fulfilled the traditional criteria for classification as neutrocytic ascites; polymorphonuclear neutrophils ≥250/mm3 with no history of either hepatocellular carcinoma or liver cirrhosis.

Results

In total, 1467 patients underwent paracentesis to relieve MA. Excluding 98 follow‐up paracenteses cases, 112 cases (8.2%) showed neutrocytic ascites. Of these 112 patients, 27 (24.1%) had positive culture results. Receiver‐operating characteristic analysis indicated that the area under the curve (AUC) values were 0.90 (95% CI 0.82‐0.95) and 0.86 (95% CI 0.78‐0.92) for polymorphonuclear neutrophil ratio and count, respectively. The difference between the two AUCs was not statistically significant (P = .29). Moreover, the best cutoff points were 70% and 1500/mm3 for polymorphonuclear neutrophil ratio and count, respectively. In addition, extensive liver metastasis was a significant independent risk factor of MA associated with ascitic fluid infection.

Conclusions

Both polymorphonuclear neutrophil ratio and count had good discriminative abilities for culture results in MA. Polymorphonuclear neutrophil ratio was somewhat better despite lacking statistical significance compared to polymorphonuclear neutrophil count, with 70% as best cutoff.
Statistical Learning of Orthographic Regularities in Chinese Children With and Without Dyslexia
Authors: Tong Shelley (Xiuli) , Zhang Puyuan , He Xinjie
Published: August 2020

This study examined distributional statistical learning of positional, phonetic, and semantic regularities of an artificial orthography in Chinese children aged 8–10 years: 29 with dyslexia, 29 age‐matched controls, and 30 reading‐level matched controls. Despite having positional regularity learning performance comparable to the controls, the children with dyslexia were poorer at learning left‐right structured characters than top‐bottom structured characters in high‐ and low‐consistency conditions. Moreover, they showed difficulties in mapping a given sound or meaning to a specific character compared with the typically developing controls. These findings suggest that children with dyslexia have deficits in some, though not all, aspects of statistical learning of character orthography, which may reflect their difficulties in coping with distractors and inconsistency of orthographic input.
Brain white matter lesions are associated with reduced hypothalamic volume and cranial radiotherapy in childhood‐onset craniopharyngioma
Authors: Fjalldal Sigridur , Rylander Lars , van Westen Danielle , Holmer Helene , Follin Cecilia , Gabery Sanaz , Petersen Åsa , Erfurth Eva Marie
Published: August 2020

Context

White matter lesions (WML) are caused by obstruction of small cerebral vessels associated with stroke risk. Craniopharyngioma (CP) patients suffer from increased cerebrovascular mortality.

Objective

To investigate the effect of reduced HT volume and cranial radiotherapy (CRT) on WML in childhood‐onset CP patients.

Design

A cross‐sectional study of 41 patients (24 women) surgically treated childhood‐onset CP in comparison to controls.

Setting

The South Medical Region of Sweden (2.5 million inhabitants).

Methods

With magnetic resonance imaging (MRI), we analysed qualitative measurement of WML based on the visual rating scale of Fazekas and quantitative automated segmentation of WML lesion. Also, measurement HT volume and of cardiovascular risk factors were analysed.

Results

Patients had a significant increase in WML volume (mL) (P = .001) compared to controls. Treatment with cranial radiotherapy (CRT) vs no CRT was associated with increased WML volume (P = .02) as well as higher Fazekas score (P = .001). WML volume increased with years after CRT (r = 0.39; P = .02), even after adjustment for fat mass and age. A reduced HT volume was associated with increased WML volume (r = −0.61, P < .001) and explained 26% of the variation (r2 = 0.26). Altogether, 47% of the WML volume was explained by age at investigation, HT volume and CRT. Patients with more WML also had higher cardiovascular risk.

Conclusions

CRT may be associated directly with increased WML volume or indirectly with reduced HT volume associated with higher cardiovascular risk. Risk factors should be carefully monitored in these patients.
Brain morphometric abnormalities in boys with attention‐deficit/hyperactivity disorder revealed by sulcal pits‐based analyses
Authors: Li Xin‐Wei , Jiang Yu‐Hao , Wang Wei , Liu Xiao‐Xue , Li Zhang‐Yong
Published: August 2020

Aim

Attention‐deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder associated with widespread brain morphological abnormalities. Here, we utilized a sulcal pits‐based method to provide new insight into the atypical cortical folding morphology in ADHD.

Methods

Sulcal pits, the locally deepest points in each fold, were first extracted from magnetic resonance imaging data of 183 boys with ADHD (10.62 ± 1.96 years) and 167 age‐ and gender‐matched typically developing controls (10.70 ± 1.73 years). Then, the geometrical properties of sulcal pits were statistically compared between ADHD and controls.

Results

Our results demonstrated that the number of sulcal pits was reduced and confined to the superficial secondary sulci in the ADHD group relative to controls (P < .05). We also found that ADHD boys were associated with significantly increased pit depth in the left superior frontal junction, circular insular sulcus, right inferior frontal junction, and bilateral cingulate sulcus, as well as significantly decreased pit depth in the bilateral orbital sulcus (P < .05, corrected).

Conclusion

The experimental findings reveal atypical sulcal anatomy in boys with ADHD and support the feasibility of sulcal pits as anatomic landmarks for disease diagnosis.
Systematic exploration and uncertainty dominate young children's choices
Authors: Blanco Nathaniel J. , Sloutsky Vladimir M.
Published: August 2020

Organisms need to constantly balance the competing demands of gathering information and using previously acquired information to obtain rewarding outcomes (i.e., the “exploration–exploitation” dilemma). Exploration is critical to obtain information to discover how the world works, which should be particularly important for young children. While studies have shown that young children explore in response to surprising events, little is known about how they balance exploration and exploitation across multiple decisions or about how this process changes with development. In this study, we compare decision‐making patterns of children and adults and evaluate the relative influences of reward seeking, random exploration, and systematic switching (which approximates uncertainty‐directed exploration). In a second experiment, we directly test the effect of uncertainty on children's choices. Influential models of decision‐making generally describe systematic exploration as a computationally refined capacity that relies on top‐down cognitive control. We demonstrate that (a) systematic patterns dominate young children's behavior (facilitating exploration), despite protracted development of cognitive control; and (b) that uncertainty plays a major, but complicated, role in determining children's choices. We conclude that while young children's immature top‐down control should hinder adult‐like systematic exploration, other mechanisms may pick up the slack, facilitating broad information gathering in a systematic fashion to build a foundation of knowledge for use later in life.
Disasters and the Disablement Process framework: an analysis of the great east Japan earthquake and tsunami of 2011
Authors: Minagawa Yuka , Saito Yasuhiko
Published: August 2020

This study used the Disablement Process framework to examine how exposure to the great east Japan earthquake and tsunami on 11 March 2011 was related to elders’ experiences of disability—that is, ‘a gap between personal capability and environmental demand’ (Verbrugge and Jette, 1994, p. 1). Data were derived from two waves (2009 and 2013) of the Nihon University Japanese Longitudinal Study of Aging, involving a representative sample of citizens aged 65 or more. Logistic regression was employed to model how the disaster was associated with the prevalence and incidence of disability. A significant relationship was documented between the two. Those impacted by the event exhibited greater odds of reporting a disability in 2013 and developing one between 2009 and 2013. Disasters destroy social infrastructure and disrupt daily life, widening the lacuna between the environment and personal resources. Given the increasing number of disasters, more policy attention should be directed to reducing their adverse consequences for health.
A framework for scaffolding academic reflective writing in dentistry
Authors: Bowman Marion
Published: August 2020

Introduction

Being able to demonstrate reflection on clinical practice is a key competency required of undergraduate dental students and registrants alike. Academic reflective writing (ARW) is an increasingly widely used genre of writing which evidences reflective practice. ARW is complex, as students need to achieve balance from a challenging mix of personal, academic and evaluative writing. The aim of this study is to analyse four student ARW tasks from a UK Dental School in order to make recommendations regarding the systematic development of student ARW through the dental curriculum.

Methods

In this study, a detailed linguistic analysis of high‐scoring examples of two first year and two fourth year ARW tasks was undertaken, complemented by comments from interviews with markers of the tasks.

Results

The linguistic analysis of high‐scoring student ARW revealed five consistent reflective aspects common to all tasks, viz description, feelings, analysis, evaluation and conclusion and action planning. Entry‐level and final‐year ARW showed a different balance between reflective aspects. Markers’ expectations in the lower years were found to equate to high‐quality technical reflection, whereas markers in the higher years expected students to have shifted their perspectives to achieve critical reflection.

Conclusion

Whilst this study is limited in its generalisability due to its small‐scale exploratory nature, it is hoped that the five reflective aspects, and the categories of reflection put forward here will be useful in stimulating discussion about how to scaffold the development of student ARW (and associated reflective thinking) longitudinally through the dental curriculum.
A rundown of merger target run‐ups
Authors: Dutordoir Marie , Vagenas‐Nanos Evangelos , Verwijmeren Patrick , Wu Betty
Published: August 2020

We provide evidence of a drastic drop in stock run‐ups of U.S. target firms preceding merger and acquisition (M&A) announcements over the past decades. The median target run‐up declines from approximately 10% in the 1980s to 2% after 2010. The trend in target run‐ups cannot be fully explained by deal or firm characteristics associated with deal anticipation. However, it disappears after controlling for changes in the strength of U.S. insider trading regulation over the research period. Further analyses corroborate our conclusion that more stringent insider trading regulation is the most likely explanation for the reduction in target run‐ups.
The price and volume response to earnings announcements in the corporate bond market
Authors: Woodley Melissa , DaDalt Peter , Wingender John R.
Published: August 2020

We examine abnormal returns and trading activity in bond markets around earnings announcements. Previous work provides mixed evidence on the relative impact of positive and negative surprises and the degree of response in investment‐grade and speculative‐grade bonds. We find that these announcements convey value‐relevant information for both positive and negative earnings surprises in both investment and speculative‐grade bonds. We also document significant heterogeneity in the response across industries, with muted responses in both abnormal returns and trading activity for bonds of firms in the financial and utilities industries.
Do Financial Literacy Training and Clarifying Pay Calculations Reduce Abuse at Work?
Authors: Toosi Negin R. , Voegeli Elyse N. , Antolin Ana , Babbitt Laura G. , Brown Drusilla K.
Published: August 2020

Understanding the link between effort and pay is important for workers. Yet, in many parts of the world, women lack critical financial literacy skills and have employers who do not clearly communicate compensation schemes. Using randomized controlled trials, we first examined the effects of a training program to improve financial literacy among female workers in apparel factories in India and Bangladesh (baseline N = 1,085). Training increased workers’ financial planning through the use of a budget and utilization of banking systems, both of which contributed to increased savings. We next examined the effects of a management intervention in factories in Myanmar (baseline N = 429) and found improvements among the predominantly female workers in perceived pay clarity. Pay clarity, in turn, was associated with lower verbal abuse in study factories. Results indicate that both financial literacy and pay clarity are important in shaping female workers’ experiences and vulnerability to financial exploitation.