bluuebunny/crossref_metadata_2025 huggingface dataset:
Point-of-Care Ultrasound in Internal Medicine: A National Survey of Educational Leadership
Authors: Schnobrich Daniel J. , Gladding Sophie , Olson Andrew P. J. , Duran-Nelson Alisa
Published: July 2013

Background

Ultrasound is a valuable tool in the safe performance of an increasing number of procedures. It has additionally emerged as a powerful instrument for point-of-care assessment by offering internists an opportunity to extend their traditional physical examination.

Objective

This study explored how internal medicine (IM) educators perceive the use of ultrasound for procedures and point-of-care assessments, the extent to which curricula for teaching IM residents ultrasound skills exist, and perceived barriers to teaching its use.

Methods

In February 2012, we administered a 27-question survey to all members of the Association of Program Directors in Internal Medicine, eliciting their opinions about the use of point-of-care ultrasound.

Results

Of 2200 surveys distributed electronically, 234 were returned (a 11% response rate), including 167 by program directors or assistant program directors. Respondents highly rated the usefulness of ultrasound for central-line placement, thoracentesis, paracentesis, and diagnosis of pleural effusions. Evaluation of vena cava and heart, and placement of radial artery catheters received somewhat lower usefulness scores. Forty-five respondents (25%) reported having formal curricula to teach point-of-care ultrasound, and 46 respondents without current ultrasound programs were planning to initiate them in the next 12 months. Potential barriers to teaching and use of ultrasound included the time and cost to train faculty, the cost of ultrasound machines, and the time required to train residents.

Conclusions

Educational leaders in IM view point-of-care ultrasound as a valuable tool in diagnosis and procedures, and many residency programs are teaching these skills to their learners.
Defining Scholarly Activity in Graduate Medical Education
Authors: Grady Erin C. , Roise Adam , Barr Daniel , Lynch Douglas , Lee Katherine Bao-Shian , Daskivich Timothy , Dhand Amar , Butler Paris D.
Published: July 2013

Background

Scholarly activity is a requirement for accreditation by the Accreditation Council for Graduate Medical Education. There is currently no uniform definition used by all Residency Review Committees (RRCs). A total of 6 of the 27 RRCs currently have a rubric or draft of a rubric to evaluate scholarly activity.

Objective

To develop a definition of scholarly activity and a set of rubrics to be used in program accreditation to reduce subjectivity of the evaluation of scholarly activity at the level of individual residency programs and across RRCs.

Methods

We performed a review of the pertinent literature and selected faculty promotion criteria across the United States to develop a structure for a proposed rubric of scholarly activity, drawing on work on scholarship by experts to create a definition of scholarly activity and rubrics for its assessment.

Results

The literature review showed that academic institutions in the United States place emphasis on all 4 major components of Boyer's definition of scholarship: discovery, integration, application, and teaching. We feel that the assessment of scholarly activity should mirror these findings as set forth in our proposed rubric. Our proposed rubric is intended to ensure a more objective evaluation of these components of scholarship in accreditation reviews, and to address both expectations for scholarly pursuits for core teaching faculty and those for resident and fellow physicians.

Conclusion

The aim of our proposed rubric is to ensure a more objective evaluation of these components of scholarship in accreditation reviews, and to address expectations for scholarly pursuits for core teaching faculty as well as those for resident and fellow physicians.
Successful Efforts to Increase Diversity in a Cardiology Fellowship Training Program
Authors: Auseon Alex J. , Kolibash Albert J. , Capers Quinn
Published: July 2013

Background

A large volume of literature has documented racial disparities in the delivery of cardiovascular care in the United States and that decreased access to procedures and undertreatment lead to worse outcomes. A lack of diversity among physicians is considered to be a major contributor. The fellowship training program in cardiovascular medicine at The Ohio State University Medical Center had never trained a fellow from a minority group underrepresented in medicine (URM) before 2007.

Intervention

In 2005, the fellowship made it a priority to recruit and match URM candidates in an effort to address the community's lack of diversity and disparities in cardiovascular care.

Methods

Program leaders revised the recruitment process, making diversity a high priority. Faculty met with members of diverse residency programs during visits to other institutions, the focus of interview day was changed to highlight mentorship, additional targeted postinterview communications reached out to highly competitive applicants, and a regular mentoring program was constructed to allow meaningful interaction with URM faculty and fellows.

Results

Since these changes were implemented, the program has successfully matched a URM fellow for 5 consecutive years. Such candidates currently make up 4 of 16 total trainees (25%) in the fellowship in cardiovascular medicine.

Conclusions

The cardiovascular medicine fellowship training program at The Ohio State University was able to revise recruitment to attract competitive URM applicants as part of a concerted effort. Other educational programs facing similar challenges may be able to learn from the university's experiences.
Use of Portfolios for Assessment of Resident Teaching Skills
Authors: Donato Anthony A. , Harris Ilene
Published: July 2013

Background

Portfolios are effective instruments for assessment of teaching skills among professional teachers and have recently been adapted in medical education. However, scoring rubrics are needed to effectively guide assessors.

Intervention

Portfolio assessors reviewed and made assessment comments about the resident-as-teacher sections of 11 internal medicine residents' electronic portfolios and discussed their assessments in an assessor group discussion. We performed qualitative analyses of written and oral comments. Major themes were identified, and member checking and triangulation with the literature was performed to evaluate the trustworthiness of the qualitative analysis.

Results

Three faculty educators reviewed and commented on 241 uploaded e-portfolio documents accompanying reflections. Three major themes were identified: Application of Teaching Skills, Presentation Skills, and Insights as a Teacher. Themes and subthemes matched closely to several components of the conceptual framework of effective presentations formulated in Glassick standards for scholarly work, as well as themes found in assessments of professional teachers' portfolios.

Conclusions

Assessments of portfolios by experienced faculty educators appear to be useful for identifying many important facets of formal teaching presentations and may be useful for creation of a scoring rubric.
Early Feedback on the Use of the Internal Medicine Reporting Milestones in Assessment of Resident Performance
Authors: Aagaard Eva , Kane Gregory C. , Conforti Lisa , Hood Sarah , Caverzagie Kelly J. , Smith Cynthia , Chick Davoren A. , Holmboe Eric S. , Iobst William F.
Published: July 2013

Background

The educational milestones were designed as a criterion-based framework for assessing resident progression on the 6 Accreditation Council for Graduate Medical Education competencies.

Objective

We obtained feedback on, and assessed the construct validity and perceived feasibility and utility of, draft Internal Medicine Milestones for Patient Care and Systems-Based Practice.

Methods

All participants in our mixed-methods study were members of competency committees in internal medicine residency programs. An initial survey assessed participant and program demographics; focus groups obtained feedback on the draft milestones and explored their perceived utility in resident assessment, and an exit survey elicited input on the value of the draft milestones in resident assessment. Surveys were tabulated using descriptive statistics. Conventional content analysis method was used to assess the focus group data.

Results

Thirty-four participants from 17 programs completed surveys and participated in 1 of 6 focus groups. Overall, the milestones were perceived as useful in formative and summative assessment of residents. Participants raised concerns about the length and complexity of some draft milestones and suggested specific changes. The focus groups also identified a need for faculty development. In the exit survey, most participants agreed that the Patient Care and Systems-Based Practice Milestones would help competency committees assess trainee progress toward independent practice.

Conclusions

Draft reporting milestones for 2 competencies demonstrated significant construct validity in both the content and response process and the perceived utility for the assessment of resident performance. To ensure success, additional feedback from the internal medicine community and faculty development will be necessary.
Financial Implications of Different Interpretations of ACGME Anesthesiology Program Requirements for Rotations in the Operating Room
Authors: Backeris Mark E. , Forte Patrick J. , Beaman Shawn T. , Metro David G.
Published: July 2013

Background

The Accreditation Council for Graduate Medical Education (ACGME) standards for resident education in anesthesiology mandate required rotations including rotations inside the operating room (OR). When residents complete rotations outside the OR, other providers must be used to maintain the OR's clinical productivity.

Objective

We quantified and compared the costs of replacing residents by using two different working patterns that are compliant with the ACGME anesthesiology program requirements: (1) the minimum amount of time in the OR, and (2) working the maximum amount of time permitted in the OR.

Methods

We calculated resident replacement costs over a 36-month residency period in both a minimum and maximum OR time model. We used a range of Certified Registered Nurse Anesthetist (CRNA) pay scales determined by a local market analysis for cost comparisons.

Results

Depending on CRNA pay rates, the cost differentials to replace a resident in the OR between the minimum and maximum OR time models ranged from $236,000 to $581,876, assuming a 50-hour resident work week, and $373,400 to $931,001, assuming an 80-hour resident work week. This cost was per resident over the entire 3 years of their residency.

Conclusions

Varying the amount of time residents work in the OR (as allowed under ACGME program requirements) has significant financial implications over a 36-month anesthesiology residency. The larger the residency, the more significant will be the impact on the department and sponsoring institution.
Twenty-one Years Clinical Experience of 461 Femoral Revision Total Hip Arthroplasties with a Calcar Replacement Prosthesis
Authors: Berend Michael E , Ritter Merrill A , Meding John B , Davis Peter
Published: July 2013

Outcomes following femoral reconstruction during revision total hip arthroplasty (THA) may be influenced by femoral deformity, fixation interface and implant type. The purpose of this study was to determine the long-term clinical and radiographic outcomes of a series of 461 femoral reconstructions with a calcar replacement prosthesis performed over a 21-year period. Multivariate analysis was performed based on age, femoral Paprosky class, implant length, modularity and mode of failure. Mean follow-up was 5.6 years. There were 18 stem revisions for an overall stem survivorship of 96.3%. Infection (n = 13) and dislocation (n = 2) were the most common indications for revision. Two stems were revised for aseptic loosening for an aseptic failure rate of 0.4%. Increased femoral deformities had higher revision rates due to all failure modes (p < 0.006). Overall complication rate was 13.4%, most commonly instability, infection and periprosthetic fracture, but most often did not lead to stem revision. We conclude that an uncemented bowed calcar replacement prosthesis has excellent clinical results in a wide range of femoral deformities, and most complications are unrelated to the femoral implant. All implants in this study have FDA approval.

Berend ME, Ritter MA, Meding JB, Davis P. Twenty-one years Clinical Experience of 461 Femoral Revision Total Hip Arthroplasties with a Calcar Replacement Prosthesis. The Duke Orthop J 2012;2(1):1-4.
Total Hip Arthroplasty after Vascularized Fibular Grafting
Authors: Vail Thomas P , Dimitroulias Apostolos , Hodrick Jeff , Brand Rusty , Viens Nicholas , Attarian David E
Published: July 2013

Background

Vascularized fibular grafting has been reported as a successful joint preserving surgery for patients with femoral head osteonecrosis. Few reports exist regarding the outcomes associated with total hip arthroplasty after failed vascularized fibular grafting. This study aims to highlight the early results and complications associated with this procedure.

Materials and methods

We retrospectively reviewed charts and radiographs of 30 patients (38 hips) who underwent conversion of prior vascularized fibular grafting to an uncemented total hip arthroplasty utilizing modern bearings (highly cross-linked polyethylene-on-metal or metal-on-metal). Mean follow-up was 41 months. A control group of 15 osteonecrosis patients (19 hips) was used who had a history of total hip arthroplasty without previous surgery. Outcome measures used were perioperative complications, clinical and radiological findings.

Results

The prior vascularized fibular grafting group had longer surgical times and more perioperative complications (calcar fracture and persistent wound drainage requiring early reoperation). In the prior vascularized fibular grafting group there were two cases requiring revision for aseptic loosening (one femoral and one acetabular component) and three cases of asymptomatic radiographic loosening (two femoral and one acetabular component). Furthermore, three patients reported symptoms of trochanteric bursitis. None of the above complications were seen in the control group. There was one dislocation in each group; and both were treated successfully with closed reduction. There was no significant difference between the two groups in the final postoperative Harris Hip Score (HHS).

Conclusion

Despite an increased complication rate, comparable clinical outcomes can be expected after conversion of vascularized fibular grafting to total hip arthroplasty.

Dimitroulias A, Hodrick J, Brand R, Viens N, Attarian DE Vail TP, Bolognesi MP. Total Hip Arthroplasty after Vascularized Fibular Grafting. The Duke Orthop J 2012; 2(1):12-17.
Distinguishing Superior Labral Tears from Normal Meniscoid Insertions with Magnetic Resonance Imaging
Authors: Manvar Ankur M , Bhalani Sheetal M , Garrigues Grant E , Major Nancy M
Published: July 2013

Objective

To improve the magnetic resonance imaging (MRI) and magnetic resonance arthrogram (MRA) interpretation of a ‘meniscoid-type’ superior labrum vs a superior labral tear by evaluation of a simple sign.

Materials and methods

Retrospective analysis of our institution's shoulder MRIs and MRAs yielded 144 patients thought to have a superior labral tear. Fifty-five patients had arthroscopy. Analysis of the orthopaedic database for superior labral repair surgeries performed in the same time frame yielded seven additional patients without prospective MRI/MRA diagnosis of superior labral tear.

Results

Two of 17 (11.8%) patients thought to have superior labral tears by MRI or MRA were found to have no labral pathology at arthroscopy. Both cases failed to have extension of high signal intensity behind the biceps anchor to the most posterior oblique coronal image. Nine of 38 (23.7%) patients thought to have superior labral tears by MRI or MRA were found to have no labral pathology at arthroscopy, but a meniscoid-type superior labrum. Four of seven patients known to have superior labral tears by arthroscopy but incorrectly diagnosed as meniscoid-type superior labrum on MRI or MRA, were retrospectively found to have extension of high signal intensity in the superior labrum to the most posterior image.

Conclusion

Signal abnormality that continues through the remainder of the superior labrum posterior to the biceps anchor indicates a superior labral tear. Absence of this sign in the setting of more anterior high signal under the labrum may indicate a meniscoid variant.

Manvar AM, Bhalani SM, Garrigues GE, Major NM. Distinguishing Superior Labral Tears from Normal Meniscoid Insertions with Magnetic Resonance Imaging. The Duke Orthop J 2012;2(1):44-49.
Osteolysis in Lumbar Interbody Fusions: The Role of Recombinant Human Bone Morphogenetic Protein-2 (rhBMP-2)
Authors: Nasca Richard J
Published: July 2013

Osteolysis may occur following lumbar interbody fusion procedures in which recombinant human bone morphogenetic protein-2, more commonly known as rhBMP-2, is used. The actual incidence of this process is unknown. Osteolysis results from an osteoclastic, rather than an osteoblastic response to rhBMP-2 and its carrier on trabecular vertebral bone, early in the sequence of bone graft healing. This osteoclastic response may represent an idiosyncratic reaction in those affected. The patient usually does well in the immediate postoperative period with resolution of their preoperative complaints of axial and radicular pain. However, at 4 to 12 weeks following the index surgery, the patient experiences a recurrence of severe back and radicular pain corresponding to the dermatomal level(s) operated upon. Laboratory studies including erythrocyte sedimentation rate, C reactive protein, and cultures are negative for infection. Imaging studies show areas of bone destruction and cyst formation containing fluid. In the majority of post-operative patients with osteolysis, there is an osteoblastic healing response with symptom resolution. Supportive, nonoperative care is usually effective in managing the patient.

Nasca RJ. Osteolysis in Lumbar Interbody Fusions: The Role of Recombinant Human Bone Morphogenetic Protein-2 (rhBMP-2). The Duke Orthop J 2012;2(1):50-54.
Unstable Ankle Fractures in Older Patients: A Consecutive Series with Modern Internal Fixation Techniques
Authors: Adams Samuel B , Viens Nicholas A , Sutter E Grant , Mangiapani Daniel S
Published: July 2013

Background

Ankle fractures are among the most common injuries sustained by older patients. Management of these fractures remains both controversial and challenging. Clinical outcomes from a series of older patients treated surgically for unstable ankle fractures were reviewed to determine the effects of patient, injury and fixation factors on postoperative outcomes.

Materials and methods

A retrospective series of 58 consecutive patients age 60 years and older with 63 unstable ankle fractures treated surgically by a single surgeon over a 5- year period was reviewed. Forty-seven females (81.0%) and 11 males (19.0%) with a mean age of 72.6 (range, 60 to 88.4) years made up the sample.

Results

The most common injuries were OTA type 44-B2 (66.7%) or Lauge-Hansen supination-external rotation type-4 (76.2%) fractures. Forty-seven (74.6%) fractures were due to a low energy mechanism. Nineteen (30.6%) injuries were fracturedislocations and seven (11.1%) fractures were open. Augmented techniques were used in 31 (49.2%) cases overall. Ten (17.2%) patients experienced postoperative complications. Males, patients with fracture dislocations, high energy fractures, and open fractures experienced significantly worse outcomes (p < 0.05). Age, fracture type and the use of augmented technique were not predictive of clinical outcomes.

Conclusion

Overall in this series, older patients treated surgically for ankle fractures experienced good clinical outcomes. Further investigations are required in order to find patient and injury factors that can assist preoperative planning and predict outcomes.

Viens NA, Sutter EG, Mangiapani DS, Adams SB, Zura RD. Unstable Ankle Fractures in Older Patients: A Consecutive Series with Modern Internal Fixation Techniques. The Duke Orthop J 2013;3(1):25-31.
The Anatomic Variability of the ‘Rotator Interval Capsule’: A Comparison of Arthroscopic and Open Investigations
Authors: Svoboda Steven J , Magnussen Robert A
Published: July 2013

Introduction:

Variably present rotator interval capsular openings (RICOs) complicate anterior shoulder capsular anatomy. Open and arthroscopic approaches may lead to differences in the appearance and size of RICOs. The purposes of this study are to: (1) Confirm that RICOs viewed from inside and outside the joint are the same structures, and (2) compare the size of RICOs when approached in an open manner vs arthroscopically.

Materials and methods

Twelve fresh cadaveric shoulders were randomized to two different approaches in order to identify and mark RICOs. In the first group, the superior glenohumeral ligament (SGHL) and middle glenohumeral ligament (MGHL) were marked arthroscopically. Sutures were placed in these structures in an open fashion. Repeat arthroscopy was then performed to determine whether the sutures penetrated the marked SGHL and MGHL. In the second group, these steps were reversed and arthroscopically placed sutures were evaluated in an open manner. Dimensions of the RICOs were measured both arthroscopically and open in each shoulder.

Results

All specimens had a RICO visualized both arthroscopically and open. Five of 12 specimens had an additional second RICO. RICO size measurements were similar for the arthroscopic and open techniques. Sutures placed via both the arthroscopic and open technique were noted to penetrate the marked structures in all cases. In addition, sutures placed through the SGHL while viewing arthroscopically always captured the coracohumeral ligament (CHL). Sutures placed through the SGHL with an open technique never engaged the CHL.

Conclusion

The capsular openings in the rotator interval were confirmed to be the same structures when observed arthroscopically and through an open approach.

Svoboda SJ, Taylor DC, Magnussen RA. The Anatomic Variability of the ‘Rotator Interval Capsule’: A Comparison of Arthroscopic and Open Investigations. The Duke Orthop J 2013;3(1):54-60.
Relative Age Effect: Beyond the Youth Phenomenon
Authors: Garrett William E , Joyner Patrick W , Mallon William J , Kirkendall Donald T
Published: July 2013

The relative age effect (RAE) refers to the oversampling of youth born in the first quarter of the birth year when auditioning for selected age-restricted sports. This advantage conferred to the older athlete is the result of the older athlete being more physically and emotionally mature and, therefore, assumed to be a more advanced player. Chosen players will be exposed to better coaching, competition, teammates, and facilities in their respective sport. This RAE was first described in 1988 for ice hockey, and has since been described in numerous other sports, with a vast majority of the literature demonstrating an RAE in small cohorts, as well as in team sports and sports that incorporate a ball (i.e. soccer, basketball, hockey, etc). We extended the exploration of an RAE beyond specific sports by examining the birth quarter of over 44,000 Olympic athletes birth dates, born between 1964 and 1996. Our hypothesis is that not only did an RAE exist in Olympic athletes, but that it existed across selected categories of athletes (by gender), such as team vs individual sports, winter vs summer athletes, and sports using a ball vs those not using a ball. The fractions of births in the first vs the fourth quarter of the year were significantly different (p < 0.001) from each other for the summer and winter Olympians, ball and nonball sports, and team as well as individual sports. This significant difference was not gender specific. We found the general existence of an RAE in Olympic athletes regardless of global classification.

Joyner PW, Mallon WJ, Kirkendall DT, Garrett WE Jr. Relative Age Effect: Beyond the Youth Phenomenon. The Duke Orthop J 2013;3(1):74-79.
Restoration of Shoulder Abduction after Radial to Axillary Nerve Transfer following Trauma or Shoulder Arthroplasty
Authors: Nunley James A , Leversedge Fraser J , Wray Walter H , Aldridge J Mack
Published: July 2013

Purpose

A loss of active shoulder abduction due to axillary nerve dysfunction may be caused by brachial plexus or isolated axillary nerve injury and is often associated with a severe functional deficit. The purpose of this study was to evaluate retrospectively the restoration of deltoid strength and shoulder abduction after transfer of a branch of the radial nerve to the axillary nerve for patients who had sustained an axillary nerve injury.

Materials and methods

We retrospectively reviewed all patients who underwent transfer of a branch of the radial nerve to the anterior branch of the axillary nerve at our institution, either alone or in combination with other nerve transfers, between 2004 and 2011. We identified, by chart review, 12 patients with an average follow-up of 16.7 months (6-36 months) who met inclusion criteria.

Results

Active shoulder abduction significantly improved from an average of 9.6° (0-60°) to 84.5° (0-160°) (p < 0.005). Average initial deltoid strength significantly improved from 0.3 (0-2) on the M scale to an average postoperative deltoid strength of 2.8 (0-5) (p < 0.005). Five of 12 (41.7%) achieved at least M4 strength and eight of 12 (66.7%) achieved at least M3 strength. No statistically significant difference was seen when subgroup analysis was performed for isolated nerve transfer vs multiple nerve transfer, mechanism of injury with MVC vs shoulder arthroplasty, age, branch of radial nerve transferred, or time from injury to surgery. No significant change in triceps strength was observed with an average of 4.9 (4-5) strength preoperatively and 4.8 (4-5) postoperatively (p = 0.34). There were three patients who achieved no significant gain in shoulder abduction or deltoid strength for unknown reasons.

Conclusion

Transfer of a branch of the radial nerve to the anterior branch of the axillary nerve is successful in improving deltoid strength and shoulder abduction in most patients. Our series, the largest North American series to our knowledge, has not shown outcomes as favorable as other series. Larger multicenter trials are needed.

Type of study/Level of evidence

This is a retrospective case series representing a level IV study.

Funding

No outside funding was received and the authors have no conflicts of interest to disclose.

Wray WH III, Aldridge JM III, Nunley JA II, Ruch DS, Leversedge FJ. Restoration of Shoulder Abduction after Radial to Axillary Nerve Transfer following Trauma or Shoulder Arthroplasty. The Duke Orthop J 2013;3(1):99-103.
Remote sensing of annual terrestrial gross primary productivity from MODIS: an assessment using the FLUXNET La Thuile dataset
Authors: Verma M. , Friedl M. A. , Richardson A. D. , Kiely G. , Cescatti A. , Law B. E. , Wohlfahrt G. , Gielen B. , Roupsard O. , Moors E. J. , Toscano P. , Vaccari F. P. , Gianelle D. , Bohrer G. , Varlagin A. , Buchmann N. , van Gorsel E. , Montagnani L. , Propastin P.
Published: July 2013

Abstract. Gross primary productivity (GPP) is the largest and most variable component of the global terrestrial carbon cycle. Repeatable and accurate monitoring of terrestrial GPP is therefore critical for quantifying dynamics in regional-to-global carbon budgets. Remote sensing provides high frequency observations of terrestrial ecosystems and is widely used to monitor and model spatiotemporal variability in ecosystem properties and processes that affect terrestrial GPP. We used data from the Moderate Resolution Imaging Spectroradiometer (MODIS) and FLUXNET to assess how well four metrics derived from remotely sensed vegetation indices (hereafter referred to as proxies) and six remote sensing-based models capture spatial and temporal variations in annual GPP. Specifically, we used the FLUXNET "La Thuile" data set, which includes several times more sites (144) and site years (422) than previous efforts have used. Our results show that remotely sensed proxies and modeled GPP are able to capture statistically significant amounts of spatial variation in mean annual GPP in every biome except croplands, but that the total variance explained differed substantially across biomes (R2 ≈ 0.1−0.8). The ability of remotely sensed proxies and models to explain interannual variability GPP was even more limited. Remotely sensed proxies explained 40–60% of interannual variance in annual GPP in moisture-limited biomes including grasslands and shrublands. However, none of the models or remotely sensed proxies explained statistically significant amounts of interannual variation in GPP in croplands, evergreen needleleaf forests, and deciduous broadleaf forests. Because important factors that affect year-to-year variation in GPP are not explicitly captured or included in the remote sensing proxies and models we examined (e.g., interactions between biotic and abiotic conditions, and lagged ecosystems responses to environmental process), our results are not surprising. Nevertheless, robust and repeatable characterization of interannual variability in carbon budgets is critically important and the carbon cycle science community is increasingly relying on remotely sensing data. As larger and more comprehensive data sets derived from the FLUXNET community become available, additional systematic assessment and refinement of remote sensing-based methods for monitoring annual GPP is warranted.
Glurbanization of the Chinese megacity Guangzhou – image-building and city development through entrepreneurial governance
Authors: Bercht A. L.
Published: July 2013

Abstract. The continuing integration of the Chinese economy into the globalizing world and increasing intercity competition have had significant and comparatively recent implications for post-socialist urbanization in China. Driven by market-oriented development and globalization, decentralization of economic decision-making and downscaling of governance from the central state to local governments and authorities characterize the changing role of the state from urban managerialism to urban entrepreneurialism. Drawing on Jessop's definition of the entrepreneurial city and his concept of glurbanization, this paper aims to identify and analyse different modes of entrepreneurial urban governance based on the example of Guangzhou, a Chinese megacity that has been under intense pressure to revitalize its leading role as an economic, commercial and cultural centre in the Pearl River Delta and the rest of southern China. To face globalization and promote competitiveness, Guangzhou pursues various innovative interscalar entrepreneurial strategies in an active entrepreneurial fashion through adopting an entrepreneurial discourse. This is critically reflected upon within this article.
Impact of modellers' decisions on hydrological a priori predictions
Authors: Holländer H. M. , Bormann H. , Blume T. , Buytaert W. , Chirico G. B. , Exbrayat J.-F. , Gustafsson D. , Hölzel H. , Krauße T. , Kraft P. , Stoll S. , Blöschl G. , Flühler H.
Published: July 2013

Abstract. The purpose of this paper is to stimulate a re-thinking of how we, the catchment hydrologists, could become reliable forecasters. A group of catchment modellers predicted the hydrological response of a man-made 6 ha catchment in its initial phase (Chicken Creek) without having access to the observed records. They used conceptually different model families. Their modelling experience differed largely. The prediction exercise was organized in three steps: (1) for the 1st prediction modellers received a basic data set describing the internal structure of the catchment (somewhat more complete than usually available to a priori predictions in ungauged catchments). They did not obtain time series of stream flow, soil moisture or groundwater response. (2) Before the 2nd improved prediction they inspected the catchment on-site and attended a workshop where the modellers presented and discussed their first attempts. (3) For their improved 3rd prediction they were offered additional data by charging them pro forma with the costs for obtaining this additional information. Holländer et al. (2009) discussed the range of predictions obtained in step 1. Here, we detail the modeller's decisions in accounting for the various processes based on what they learned during the field visit (step 2) and add the final outcome of step 3 when the modellers made use of additional data. We document the prediction progress as well as the learning process resulting from the availability of added information. For the 2nd and 3rd step, the progress in prediction quality could be evaluated in relation to individual modelling experience and costs of added information. We learned (i) that soft information such as the modeller's system understanding is as important as the model itself (hard information), (ii) that the sequence of modelling steps matters (field visit, interactions between differently experienced experts, choice of model, selection of available data, and methods for parameter guessing), and (iii) that added process understanding can be as efficient as adding data for improving parameters needed to satisfy model requirements.
Storage water value as a signature of the climatological balance between resource and uses
Authors: François B. , Hingray B. , Hendrickx F. , Creutin J. D.
Published: July 2013

Abstract. Water is stored in reservoirs to adapt in time the availability of the water resource to the various water demands like hydropower production, irrigation or ecological constraints. Deterministic dynamic programming retrospectively identifies optimal reservoir operations that could have been achieved to balance resource and demand during a given time period in the ideal configuration where future inflows and demand are perfectly known. A by-product of dynamic programming is the estimation of the storage water value (SWV) which is the marginal value of the future benefits potentially obtained from an additional unit of water volume stored in a reservoir and which determines the optimal storage strategy. The SWV depends on the reservoir level and shows seasonal as well as inter-annual variations. This paper uses the SWV as an index of the adequacy between water resources and water demands for a simplified water resource system in a mountainous region in France. It characterizes how and why the adequacy and optimal strategy could change for this system if the climate and/or demand change. Changes in mean regional temperature (increase) and/or precipitation (decrease) are analyzed. The influence of the nature of water demand on the SWV is also described (energy production or minimum lake level maintenance). In the studied case, the adequacy between water resources and demand either improves or degrades depending on the considered future scenario. In all scenarios, the seasonality of SWV changes with for example earlier water storage is to efficiently satisfy increasing summer water demand.
Turbulent dispersion properties from a model simulation of the western Mediterranean
Authors: Nefzi H. , Elhmaidi D. , Carton X.
Published: July 2013

Abstract. Using a high resolution primitive equation model of the western Mediterranean Sea, we analyzed the dispersion properties of a set of homogeneously distributed, passive particle pairs. These particles were initially separated by different distances D0 (D0 = 5.55, 11.1 and 16.5 km), and were seeded in the model at initial depths of 44 and 500 m. This realistic ocean model, which reproduces the main features of the regional circulation, puts in evidence the three well-known regimes of relative dispersion. The first regime due to the chaotic advection at small scales, lasts only a few days (3 days at 44 m depth, a duration comparable with the integral time scale) and the relative dispersion is then exponential. In the second regime, extending from 3 to 20 days, the relative dispersion has a power law tα where α tends to 3 as D0 becomes small. In the third regime, a linear growth of the relative dispersion is observed starting from the twentieth day. For the relative diffusivity, the D2 growth is followed by the Richardson regime D4/3. At large scales, where particle velocities are decorrelated, the relative diffusivity is constant. At 500 m depth, the integral time scale increases (> 4 days) and the intermediate regime becomes narrower than that at 44 m depth due to weaker effect of vortices (this effect decreases with depth). The turbulent properties become less intermittent and more homogeneous and the Richardson law takes place.
Determinants of Spanish Regions' Tourism Performance: A Two-Stage, Double-Bootstrap Data Envelopment Analysis
Authors: Benito Bernardino , Solana José , López Pilar
Published: July 2013

Despite the current international financial crisis, the tourism sector has managed to maintain high levels of activity. Against a backdrop of weak demand and stiff competition, efficiency has come to the fore as a key issue, especially in consolidated markets, such as Spain, where hopes that the sector will lead the way to economic recovery contrast with statements from the Competitiveness Monitor of the World Travel & Tourism Council that Spain is losing its competitiveness. In this article, the two-stage Simar and Wilson procedure is used to estimate the effect of a group of nine environmental factors on robust data envelopment analysis (DEA) estimates which act as a proxy of destination competitiveness for the Spanish autonomous communities (or regions) between 2002 and 2010. A brief discussion in terms of D- and E-attraction and cluster D-attraction is also included. The article contributes to the destination industry literature by adopting an approach that has not hitherto been applied to Spain.
Points in Time: Direct Radiocarbon Dates on Great Basin Projectile Points
Authors: Smith Geoffrey M. , Barker Pat , Hattori Eugene M. , Raymond Anan , Goebel Ted
Published: July 2013

Typological cross-dating is the primary means by which archaeological sites are placed into chronological frameworks. This approach relies on the assumption that artifacts at undated sites—usually projectile points—are coeval with similar artifacts found at Other, dated sites. While typological cross-dating is necessary in regions dominated by open-air lithic scatters, the approach can be problematic when undated and dated sites are separated by significant distances. Here, we present radiocarbon dates on projectile points with organic hafting material still attached or found within organic storage bags. Our results provide unequivocal ages for various morphological projectile point types at several Great Basin locales and should be useful to researchers seeking local age estimates for those point types, which often involves relying on chronological data from more distant sites. The results also highlight potential issues with uncritically applying typological cross-dating using typologies based on metric attributes, and in two cases, suggest the need to revise the age ranges for certain point styles in the western Great Basin.
Capacity building and predictors of success for HIV‐1 drug resistance testing in the Asia‐Pacific region and Africa
Authors: Land Sally , Zhou Julian , Cunningham Philip , Sohn Annette H , Singtoroj Thida , Katzenstein David , Mann Marita , Sayer David , Kantor Rami
Published: July 2013

Background

The TREAT Asia Quality Assessment Scheme (TAQAS) was developed as a quality assessment programme through expert education and training, for laboratories in the Asia‐Pacific and Africa that perform HIV drug‐resistance (HIVDR) genotyping. We evaluated the programme performance and factors associated with high‐quality HIVDR genotyping.

Methods

Laboratories used their standard protocols to test panels of human immunodeficiency virus (HIV)‐positive plasma samples or electropherograms. Protocols were documented and performance was evaluated according to a newly developed scoring system,agreement withpanel‐specificconsensus sequence, anddetection of drug‐resistance mutations (DRMs) and mixtures of wild‐type and resistant virus (mixtures). High‐quality performance was defined as detection of ≥95% DRMs.

Results

Over 4.5 years, 23 participating laboratories in 13 countries tested 45 samples (30 HIV‐1 subtype B; 15 non‐B subtypes) in nine panels. Median detection of DRMs was 88–98% in plasma panels and 90–97% in electropherogram panels. Laboratories were supported to amend and improve their test outcomes as appropriate. Three laboratories that detected <80% DRMs in early panels demonstrated subsequent improvement. Sample complexity factors – number of DRMs (p<0.001) and number of DRMs as mixtures (p<0.001); and laboratory performance factors – detection of mixtures (p<0.001) and agreement with consensus sequence (p<0.001), were associated with high performance; sample format (plasma or electropherogram), subtype and genotyping protocol were not.

Conclusion

High‐quality HIVDR genotyping was achieved in the TAQAS collaborative laboratory network. Sample complexity and detection of mixtures were associated with performance quality. Laboratories conducting HIVDR genotyping are encouraged to participate in quality assessment programmes.
Mortality Disparities Among Arrestees by Race, Sentencing Disposition, and Place
Authors: Zuo George , Kilmer Beau , Nicosia Nancy
Published: July 2024

Importance

Understanding mortality disparities among justice system–involved populations is crucial for public health and policy, especially for marginalized racial groups such as American Indian/Alaska Native persons.

Objective

To examine racial disparities in mortality within the broader justice system–involved population in South Dakota, focusing on different sentencing dispositions and the role of place.

Design, Setting, and Participants

This observational study used administrative criminal records linked to mortality data from January 2000 to December 2016. The statewide data linked data from South Dakota Attorney General’s Office and South Dakota Department of Health. Individuals aged 18 years and older with arrests were analyzed in this population-based sample. Data were analyzed from August 1, 2022, to July 30, 2023.

Exposure

Sentencing dispositions were categorized as arrest only, fine, probation, jail, and prison.

Main Outcomes and Measures

The main outcomes were mortality rates (both all-cause and cause-specific) calculated using Poisson regression models, adjusted for demographic and county variables.

Results

Of 182 472 individuals with 422 987 arrests, the study sample included 29 690 American Indian/Alaska Native arrestees (17 900 [60%] male; mean [SD] age, 29.4 [11.0] years) and 142 248 White arrestees (103 471 [73%] male; mean [SD] age, 32.6 [12.9] years). American Indian/Alaska Native persons accounted for 16% of arrestees and 26% of arrests, but only 9% of the population in South Dakota. Across dispositions, mortality risk was greater for White individuals sentenced to probation, jail, and prison relative to White individuals who were arrested only. In terms of racial disparities, all-cause mortality risk was 2.37 (95% CI, 1.95-2.88) times higher for American Indian/Alaska Native than White arrestees in the arrest-only disposition. Disparities persisted across all dispositions but narrowed substantially for probation and prison. Results were similar for cause-specific mortality risk, except for cancer risk. In urban areas, mortality risk was 2.70 (95% CI, 1.29-2.44) times greater for American Indian/Alaska Native individuals relative to White individuals among those with arrest-only dispositions.

Conclusions and Relevance

In this population-based observational study, mortality risk and associated racial disparities among justice system–involved individuals differed substantially across dispositions and places, underscoring the need for public health interventions tailored to these factors. Further research is needed to understand the mechanisms through which sentencing and place shape these disparities.
Report calls for decisive action to guide growth in psychedelics
Authors: Enos Gary
Published: July 2024

With interest in psychedelic drugs clearly back on the public's radar, policymakers should act now to take measures that would avoid a repeat of mistakes made during the mass commercialization of cannabis, a new report suggests.
Giant Thermomechanical Bandgap Modulation in Quasi‐2D Tellurium
Authors: Hussain Naveed , Ahmed Shehzad , Tepe Hüseyin U. , Ullah Kaleem , Shehzad Khurram , Wu Hui , Shcherbakov Maxim R.
Published: July 2024

Lattice deformation via substrate‐driven mechanical straining of 2D materials can profoundly modulate their bandgap by altering the electronic band structure. However, such bandgap modulation is typically short‐lived and weak due to substrate slippage, which restores lattice symmetry and limits strain transfer. Here, it is shown that a non‐volatile thermomechanical strain induced during hot‐press synthesis results in giant modulation of the inherent bandgap in quasi‐2D tellurium nanoflakes (TeNFs). By leveraging the thermal expansion coefficient (TEC) mismatch and maintaining a pressure‐enforced non‐slip condition between TeNFs and the substrate, a non‐volatile and anisotropic compressive strain is attained with ε = −4.01% along zigzag lattice orientation and average biaxial strain of −3.46%. This results in a massive permanent bandgap modulation of 2.3 eV at a rate S (ΔEg) of up to 815 meV/% (TeNF/ITO), exceeding the highest reported values by 200%. Furthermore, TeNFs display long‐term strain retention and exhibit robust band‐to‐band blue photoemission featuring an intrinsic quantum efficiency of 80%. The results show that non‐volatile thermomechanical straining is an efficient substrate‐based bandgap modulation technique scalable to other 2D semiconductors and van der Waals materials for on‐demand nano‐optoelectronic properties.
Indium‐Doping‐Induced Nanocomposites with Improved Oxygen Reaction Activity and Durability for Reversible Protonic Ceramic Electrochemical Cell Air Electrodes
Authors: Du Zhiwei , Xu Kang , Zhu Feng , Xu Yangsen , He Fan , Gao Hui , Gong Wenjie , Choi YongMan , Chen Yu
Published: July 2024

Reversible protonic ceramic electrochemical cells (R‐PCECs) are very promising as energy conversion and storage devices with high efficiency at intermediate temperatures (500–700 °C). Unfortunately, the sluggish reaction kinetics on air electrodes severely hamper the commercial application of R‐PCECs. In this work, an In‐doped PrBaCo2O5+δ air electrode is developed with a designed formula of PrBaCo1.9In0.1O5+δ, which however consists of a dominated double perovskite PrBa0.95Co1.85In0.09O5+δ and a minor cubic perovskite BaCo0.85In0.15O3‐δ phase, as suggested by the XRD refinements. The formation of nanocomposites induced by the In‐doping has markedly improved the activity of oxygen reduction reaction (ORR) and oxygen evolution reaction (OER), due likely to the increased oxygen vacancies, enhanced the oxygen surface exchange and bulk diffusion capabilities when compared to the bare PrBaCo2O5+δ. Excellent electrochemical performances in fuel cell (FC) mode (2.25 W cm−2) and electrolysis cell (EC) mode (−4.41 A cm−2 at 1.3 V) are achieved on the single cells with such nanocomposite air electrodes at 700 °C. In addition, promising durability tests of cells in modes of FC (100 h), EC (100 h), and cycling (210 h) are demonstrated at 600 °C. This In‐doped strategy provides a novel approach to developing new air electrode materials.