bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk-Reducing Salpingo-Oophorectomy and Breast Cancer Risk Reduction in the Gynecologic Oncology Group Protocol-0199 (GOG-0199)
Authors: Mai Phuong L , Miller Austin , Gail Mitchell H , Skates Steven , Lu Karen , Sherman Mark E , Ioffe Olga B , Rodriguez Gustavo , Cohn David E , Boggess John , Rutherford Thomas , Kauff Noah D , Rader Janet S , Phillips Kelly-Anne , DiSilvestro Paul A , Olawaiye Alexander B , Ridgway Mildred R , Greene Mark H , Piedmonte Marion , Walker Joan L
Published: October 2019

Background

Risk-reducing salpingo-oophorectomy (RRSO) has been associated with approximately 50% breast cancer risk reduction among women with a pathogenic variant in BRCA1 or BRCA2 (BRCA1/2), a finding that has recently been questioned.

Methods

We estimated incidence rates of breast cancer and all cancers combined during 5 years of follow-up among participants selecting RRSO or ovarian cancer screening (OCS) among women with a BRCA1/2 pathogenic variant or strong breast and/or ovarian cancer family history. Ovarian or fallopian tube or peritoneal cancer incidence rates were estimated for the OCS group. Breast cancer hazard ratios (HRs) for time-dependent RRSO were estimated using Cox regression with age time-scale (4943 and 4990 women-years in RRSO and OCS cohorts, respectively). All statistical tests were two-sided.

Results

The RRSO cohort included 925 participants, and 1453 participants were in the OCS cohort (381 underwent RRSO during follow-up), with 88 incident breast cancers diagnosed. Among BRCA1/2 pathogenic variant carriers, a non-statistically significant lower breast cancer incidence was observed in the RRSO compared with the OCS cohort (HR = 0.86, 95% confidence interval  = 0.45 to 1.67; P = .67). No difference was observed in the overall population or among subgroups stratified by prior breast cancer history or menopausal status. Seven fallopian tube and four ovarian cancers were prospectively diagnosed in the OCS cohort, and one primary peritoneal carcinoma occurred in the RRSO cohort.

Conclusions

These data suggest that RRSO might be associated with reduced breast cancer incidence among women with a BRCA1/2 pathogenic variant, although the effect, if present, is small. This evolving evidence warrants a thorough discussion regarding the impact of RRSO on breast cancer risk with women considering this intervention.
Physical Activity and Mortality in Cancer Survivors: A Systematic Review and Meta-Analysis
Authors: Friedenreich Christine M , Stone Chelsea R , Cheung Winson Y , Hayes Sandra C
Published: October 2019

Background

Recommendations for improved survival after cancer through physical activity (PA) exist, although the evidence is still emerging. Our primary objective was to conduct a systematic review and meta-analysis of the association between prediagnosis and postdiagnosis PA and survival (cancer-specific, all-cause, and cardiovascular disease mortality) for all cancers and by tumor site. Secondary objectives were to examine the associations within population subgroups, by PA domain, and to determine the optimal dose of PA related to survival.

Methods

PubMed, EMBASE, and SportsDiscus databases were searched from inception to November 1, 2018. DerSimonian-Laird random-effects models were used to estimate the summary hazard ratios (HRs) and 95% confidence intervals (CI) for primary and secondary analyses and to conduct dose-response analyses.

Results

Evidence from 136 studies showed improved survival outcomes with highest vs lowest levels of prediagnosis or postdiagnosis total or recreational PA for all-cancers combined (cancer specific mortality: HR = 0.82, 95% CI = 0.79 to 0.86, and HR = 0.63, 95% CI = 0.53 to 0.75, respectively) as well as for 11 specific cancer sites. For breast and colorectal cancers, greater reductions were observed for postdiagnosis PA (HR = 0.58–0.63) compared with prediagnosis PA (HR = 0.80–0.86) for cancer-specific and all-cause mortality. Survival benefits through PA were observed in most subgroups (within sex, body mass index, menopausal status, colorectal subtypes, and PA domain) examined. Inverse dose-response relationships between PA and breast cancer-specific and all-cause mortality were observed, with steep reductions in hazards to 10–15 metabolic equivalent hours per week.

Conclusion

Higher prediagnosis and postdiagnosis levels of PA were associated with improved survival outcomes for at least 11 cancer types, providing support for global promotion of PA guidelines following cancer.
Before Bandung: Afro-Asian Cross-referencing and Comparative Racialization
Authors: Agathocleous Tanya , Neary Janet
Published: October 2019

This essay analyzes the rhetorical and political connections between African American and South Asian critiques of race and empire in the century leading up to the Bandung conference in 1955. Specifically, we trace the way “caste” emerges as a key rhetorical term in the mid-to-late nineteenth century for linking the oppressions of race, slavery, and its aftermath in the United States to those of caste and empire in India. Building on work by Nico Slate and Antoinette Burton, we identify a strategic citational practice we call Afro-Asian cross-referencing, which the writers under consideration use to advance anti-racism in sometimes very local contexts. Focusing on the dynamic periodical culture of the period, our study analyzes anti-caste sentiment as an expression of cross-racial solidarity uniting anti-colonial movements in India with racial uplift movements in the United States. Because the concept of “Afro-Asian solidarity” first took hold at the Bandung conference of 1955 and the Non-Aligned Movement that it helped to originate, the phenomenon itself remains most visible in relation to this later period and the Cold War context. By shifting focus to an earlier moment in the history of Afro-Asian solidarity, we illuminate the work that the idea of caste did in defining strategic transnational connections—as well as missed opportunities for connection—later in the century.
Three Methods of Preserving Guttural Consonants in the Tiberian Tradition: , ,
Authors: Ariel Chanan
Published: October 2019

This article identifies three methods of preserving the guttural consonants and in the Tiberian tradition in sequences comprised of a non-guttural consonant, a guttural consonant, and a vowel: (a) geminating the consonant before the guttural consonant; (b) vocalizing this consonant with ḥatef; (c) omitting the gemination of the consonant prior to the guttural consonant. The article deals with the relationship between these three methods, and discusses forms that have been correctly described in the research literature alongside forms for which no convincing explanation has yet been offered. The unexplained forms are interpreted here in light of these identified methods.
The Negative Image and the Repentance of Ishmael in Targum Pseudo-Jonathan: Some Implications for an Anti-Islamic Polemic
Authors: Zhakevich Iosif J
Published: October 2019

The image of Ishmael in Targum Pseudo-Jonathan (Tg. Ps.-J.) has been interpreted either as thoroughly negative or as ambiguous. While the negative presentation of Ishmael has been used to argue for an anti-Ishmael and an anti-Islamic polemic within the Targum, the Tar-gum's mention of Ishmael's repentance has been submitted as evidence of the Targum’s ambiguous perspective of Ishmael, with the implication that Tg. Ps.-J. is not anti-Ishmael and therefore not anti-Islamic. Beyond this, each interpretation has been used to argue for a relative date of the composition of Tg. Ps.-J. — an ambiguous image suggesting a pre-Islamic date, and a negative image suggesting a post-Islamic date. Focusing on the implications of Ishmael's repentance for the image of Ishmael in Tg. Ps-J, this paper seeks to show that the repentance of Ishmael does not subvert the Targum’s negative por-trayal of Ishmael. On the one hand, the targumist exploits Ishmael's repentance to honour Abraham and Isaac, not Ishmael. On the other, the targumist confirms the negative image of Ishmael by disparaging him in the very context of his repentance. This conclusion, then, affirms that (1) Ishmael is a thoroughly negative character-type in Tg. Ps-J; that (2) the negative representation of Ishmael is a plausible literary device used to deliver an anti-Islamic polemic; and that (3) the composition of Tg. Ps.-J. is better suited for a post-Islamic date — when a Jewish targumist would have had reason to disparage a traditional ancestor of Islam and in this way to promote the Jewish claim of superiority over Islam.
How does geopolitics affect energy law: North America—an illustrative example
Authors: De León Mendoza Isaac J , Fernández Gómez César
Published: October 2019

Global energy trade has changed over the last decade. Increased energy flows to Asia present a major shift in energy trade as Asia’s share of global energy demand rises. The shale revolution has enabled the United States (U.S.) to become the world’s largest oil and gas producer accounting for more than half of the world’s production. Renewable energy sources have become more important as countries are challenged to meet the climate goals set by the Paris Agreement. Nuclear Energy seems to be the energy source that can most dramatically help reducing carbon emissions rapidly. Gas demand will grow rapidly over the next 20 years as countries move to decarbonize their energy matrix, given it is a cleaner fuel for power generation than coal. The purpose of this article is to show the effects of global energy trade, its effects on the way countries interact with each other and how local energy law and policy are nonetheless affected by the shifts in the energy market. We will use North America (Canada, Mexico and the U.S.) as an example of the complexity of such interactions and the effects is having (or should have) in regional energy markets. The purpose then of this article is not to attempt to resolve these complex issues, but rather to motivate readers, energy lawyers and policymakers to start asking the right questions regarding global (and local) energy trade.
It Takes a Village to Raise a Child: Solidarity in the Courts—Judicial Justification for Posthumous Use of Sperm by Bereaved Parents
Authors: Gilbar Roy , Ram-Tiktin Efrat
Published: October 2019

The practice of posthumous use of sperm raises social, ethical, and legal questions. We examine the issue of who should be allowed to use the sperm—only the deceased’s spouse or the deceased’s parents as well—from the perspective of solidarity and relational autonomy. Following a theoretical discussion of various accounts of solidarity and relational autonomy, the legal status of posthumous assisted reproduction is examined in three jurisdictions—the USA, Australia, and Israel—in which most applications to the courts were submitted by the deceased’s parents. In Israel, we found fifteen court rulings on requests for posthumous use of sperm and fourteen in Australia. A smaller number were found in the case of the USA. The analysis reveals that Israeli and Australian courts employ solidarity-based arguments to justify their decisions to allow posthumous use of sperm, particularly when the deceased’s true wishes are unknown. We thus conclude that the posthumous use of sperm can be legally extended to include the deceased’s parents based on solidarity and relational autonomy arguments.
Fungal NOX is an essential factor for induction of TG2 in human hepatocytes
Authors: Huang Yao , Fujii Keisuke , Chen Xinyue , Iwatani Shun , Chibana Hiroji , Kojima Soichi , Kajiwara Susumu
Published: October 2019

NADPH oxidases (Nox) generate reactive oxygen species (ROS) such as superoxide anion radical (O2−) and hydrogen peroxide (H2O2). The pathogenic fungi Candida albicans and Candida glabrata enhance cellular transglutaminase 2 (TG2) activity levels in co-cultured human hepatic cells in a ROS-mediated manner. Deletion of NOX1 (CgNOX1) in C. glabrata blocks the ability of C. glabrata to induce TG2 activity. Here, we investigated whether Nox proteins from C. albicans and Saccharomyces cerevisiae are related with induction of TG2 activity in hepatic cells. C. albicans CFL11 (CaCFL11) was identified as a key factor in this fungus for hepatic TG2 induction in the co-cultures. The cfl11 mutant of C. albicans did not induce TG2 activity in hepatocytes. In addition, overexpression of YNO1, a homolog of CgNOX1, in S. cerevisiae led to induction of ROS generation and TG2 activity in hepatic cells in co-incubation experiments. These findings indicated that a fungal Nox plays a role in enhancing TG2 activity in human hepatocytes and leads to apoptosis.
Molecular epidemiology of Sporothrix schenkii isolates in Malaysia
Authors: Kamal Azam Nurul Khalisah , Selvarajah Gayathri Thevi , Santhanam Jacinta , Abdul Razak Mohd Fuat , Ginsapu Stephanie Jane , James Jasper Elvin , Suetrong Satinee
Published: October 2019

Sporothrix schenkii is a dimorphic fungus that causes infections in both humans and animals. We report on 25 S. schenkii isolates collected in 2017 from humans and cats clinically diagnosed with sporotrichosis, in Malaysia. These isolates were phenotypically identified as S. schenkii sensu lato and further defined as S. schenckii sensu stricto based on partial calmodulin gene sequence. Isolates from both humans and cats were genotypically identical but displayed phenotypic variation. Phylogenetic analyses based on partial calmodulin sequence showed that the Malaysian isolates clustered with global S. schenkii sensu stricto strains, in particular, of the AFLP type E. This analysis also revealed that partial calmodulin sequence alone was sufficient for classifying global S. schenckii sensu stricto strains into their respective AFLP types, from A to E. The genetically conserved S. schenkii sensu stricto species isolated from humans and cats is suggestive of a clonal strain present in Malaysia. To the best of our knowledge, this is the first report on molecular identification of Sporothrix schenkii strains from human infections in Malaysia. Further studies are required in order to elucidate the clonal nature of Malaysian S. schenkii isolates. Our findings indicate the presence of a predominant S. schenkii genotype in the environment, causing infections in both cats and humans in Malaysia.
Detecting the neutral IGM in filaments with the SKA
Authors: Kooistra Robin , Silva Marta B , Zaroubi Saleem , Verheijen Marc A W , Tempel Elmo , Hess Kelley M
Published: October 2019

The intergalactic medium (IGM) plays an important role in the formation and evolution of galaxies. Recent developments in upcoming radio telescopes are starting to open up the possibility of making a first direct detection of the 21 cm signal of neutral hydrogen (H i) from the warm gas of the IGM in large-scale filaments. The cosmological hydrodynamical EAGLE simulation is used to estimate the typical IGM filament signal. Assuming the same average signal for all filaments, a prediction is made for the detectability of such a signal with the upcoming mid-frequency array of the Square Kilometer Array (SKA1-mid) or the future upgrade to SKA2. The signal to noise (S/N) then only depends on the size and orientation of each filament. With filament spines inferred from existing galaxy surveys as a proxy for typical real filaments, we find hundreds of filaments in the region of the sky accessible to the SKA that can be detected. Once the various phases of the SKA telescope become operational, their own surveys will be able to find the galaxies required to infer the position of even more filaments within the survey area. We find that in 120 h, SKA1-mid/SKA2 will detect H i emission from the strongest filaments in the field with an S/N of the order of 10 to ∼150 for the most pessimistic model considered here. Some of the brighter filaments can be detected with an integration time of a few minutes with SKA1-mid and a few seconds with SKA2. Therefore, SKA2 will be capable of not only detecting but also mapping a large part of the IGM in these filaments.
Magnetically driven jets and winds from weakly magnetized accretion discs
Authors: Jacquemin-Ide J , Ferreira J , Lesur G
Published: October 2019

Semi-analytical models of disc outflows have successfully described magnetically driven, self-confined super-Alfvénic jets from near-Keplerian accretion discs. These jet-emitting discs (JEDs) are possible for high levels of disc magnetization μ defined as μ = 2/β, where beta is the usual plasma parameter. In near-equipartition JEDs, accretion is supersonic and jets carry away most of the disc angular momentum. However, these solutions prove difficult to compare with cutting-edge numerical simulations, for the reason that numerical simulations show wind-like outflows but in the domain of small magnetization. In this work, we present for the first time self-similar isothermal solutions for accretion–ejection structures at small magnetization levels. We elucidate the role of magnetorotational instability-like (MRI) structures in the acceleration processes that drive this new class of solutions. The disc magnetization μ is the main control parameter: Massive outflows driven by the pressure of the toroidal magnetic field are obtained up to μ ∼ 10−2, while more tenuous centrifugally driven outflows are obtained at larger μ values. The generalized parameter space and the astrophysical consequences are discussed. We believe that these new solutions could be a stepping stone in understanding the way astrophysical discs drive either winds or jets. Defining jets as self-confined outflows and winds as uncollimated outflows, we propose a simple analytical criterion based on the initial energy content of the outflow, to discriminate jets from winds. We show that jet solution is achieved at all magnetization levels, while winds could be obtained only in weakly magnetized discs that feature heating.
Towards the analysis of JWST exoplanet spectra: the effective temperature in the context of direct imaging
Authors: Baudino Jean-Loup , Taylor J , Irwin P G J , Garland R
Published: October 2019

The current sparse wavelength range coverage of exoplanet direct imaging observations, and the fact that models are defined using a finite wavelength range, lead both to uncertainties on effective temperature determination. We study these effects using blackbodies and atmospheric models and we detail how to infer this parameter. Through highlighting the key wavelength coverage that allows for a more accurate representation of the effective temperature, our analysis can be used to mitigate or manage extra uncertainties being added in the analysis from the models. We find that the wavelength range coverage will soon no longer be a problem. An effective temperature computed by integrating the spectroscopic observations of the James Webb Space Telescope will give uncertainties similar to, or better than, the current state–of–the–art, which is to fit models to data. Accurately calculating the effective temperature will help to improve current modelling approaches. Obtaining an independent and precise estimation of this crucial parameter will help the benchmarking process to identify the best practice to model exoplanet atmospheres.
The tidal evolution of dark matter substructure – I. subhalo density profiles
Authors: Green Sheridan B , van den Bosch Frank C
Published: October 2019

Accurately predicting the abundance and structural evolution of dark matter subhaloes is crucial for understanding galaxy formation, modelling galaxy clustering, and constraining the nature of dark matter. Due to the non-linear nature of subhalo evolution, cosmological N-body simulations remain its primary method of investigation. However, it has recently been demonstrated that such simulations are still heavily impacted by artificial disruption, diminishing the information content on small scales, and reducing the reliability of all simulation-calibrated semi-analytical models. In this paper, we utilize the recently released DASH library of high-resolution, idealized simulations of the tidal evolution of subhaloes, which are unhindered by numerical overmerging due to discreteness noise or force softening, to calibrate an improved, more accurate model of the evolution of the density profiles of subhaloes that undergo tidal heating and stripping within their host halo. By testing previous findings that the structural evolution of a tidally truncated subhalo depends solely on the fraction of mass stripped, independent of the details of the stripping, we identify an additional dependence on the initial subhalo concentration. We provide significantly improved fitting functions for the subhalo density profiles and structural parameters (Vmax and rmax) that are unimpeded by numerical systematics and applicable to a wide range of parameter space. This model will be an integral component of a future semi-analytical treatment of substructure evolution, which can be used to predict key quantities, such as the evolved subhalo mass function and annihilation boost factors, and validate such calculations performed with cosmological simulations.
The rate of planet–star coalescences due to tides and stellar evolution
Authors: Popkov Alexander V , Popov Sergei B
Published: October 2019

Orbits of close-in planets can shrink significantly due to dissipation of tidal energy in a host star. This process can result in star–planet coalescence within the Galactic lifetime. In some cases, such events can be accompanied by an optical or/and UV/X-ray transient. Potentially, these outbursts can be observed in near future with new facilities such as LSST from distances about few Mpc. We use a population synthesis model to study this process and derive the rate of star–planet mergers of different types. Mostly, planets are absorbed by red giants. However, these events, happening with the rate about 3 per year, mostly do not produce detectable transients. The rate of mergers with main sequence stars depends on the effectiveness of tidal dissipation; for reasonable values of stellar tidal quality factor, such events happen in a Milky Way-like galaxy approximately once in 70 yr or more rarely. This rate is dominated by planets with low masses. Such events do not produce bright transients having maximum luminosities ≲ 1036.5 erg s−1. Brighter events, related to massive planets, with maximum luminosity ∼1037.5–1038 erg s−1, have the rate nearly five times smaller.
Extensions to the halo occupation distribution model for more accurate clustering predictions
Authors: Jiménez Esteban , Contreras Sergio , Padilla Nelson , Zehavi Idit , Baugh Carlton M , Gonzalez-Perez Violeta
Published: October 2019

We test different implementations of the halo occupation distribution (HOD) model to reconstruct the spatial distribution of galaxies as predicted by a version of the L-GALAXIES semi-analytical model (SAM). We compare the measured two-point correlation functions of the HOD mock catalogues and the SAM samples to quantify the fidelity of the reconstruction. We use fixed number density galaxy samples selected according to stellar mass or star formation rate (SFR). We develop three different schemes to populate haloes with galaxies with increasing complexity, considering the scatter of the satellite HOD as an additional parameter in the modelling. We modify the SAM output, removing assembly bias and using a standard Navarro–Frenk–White density profile for the satellite galaxies as the target to reproduce with our HOD mocks. We find that all models give similar reproductions of the two-halo contribution to the clustering signal, but there are differences in the one-halo term. In particular, the HOD mock reproductions work equally well using either the HOD of central and satellites separately or using a model that also accounts for whether or not the haloes contain a central galaxy. We find that the HOD scatter does not have an important impact on the clustering predictions for stellar mass-selected samples. For SFR selections, we obtain the most accurate results assuming a negative binomial distribution for the number of satellites in a halo. The scatter in the satellites HOD is a key consideration for HOD mock catalogues that mimic ELG or SFR-selected samples in future galaxy surveys.
Dissecting the Compton scattering kernel I: Isotropic media
Authors: Sarkar Abir , Chluba Jens , Lee Elizabeth
Published: October 2019

Compton scattering between electrons and photons plays a crucial role in astrophysical plasmas. Many important aspects of this process can be captured by using the so-called Compton scattering kernel. For isotropic media, exact analytic expressions (valid at all electron and photon energies) do exist but are hampered by numerical issues and often are presented in complicated ways. In this paper, we summarize, simplify, and improve existing analytic expressions for the Compton scattering kernel, with an eye on clarity and physical understanding. We provide a detailed overview of important properties of the kernel covering a wide range of energies and highlighting aspects that have not been appreciated as much previously. We discuss analytic expressions for the moments of the kernel, comparing various approximations and demonstrating their precision. We also illustrate the properties of the scattering kernel for thermal electrons at various temperatures and photon energies, introducing new analytic approximations valid to high temperatures. The obtained improved formulae for the kernel and its moments should prove useful in many astrophysical computations, one of them being the evolution of spectral distortions of the cosmic microwave background in the early Universe. A novel code, cspack, for efficient computations of the Compton scattering kernel and its properties (in the future also including anisotropies in the initial electron and photon distributions) is being developed in a series of papers and will be available within one month.
QTLbase: an integrative resource for quantitative trait loci across multiple human molecular phenotypes
Authors: Zheng Zhanye , Huang Dandan , Wang Jianhua , Zhao Ke , Zhou Yao , Guo Zhenyang , Zhai Sinan , Xu Hang , Cui Hui , Yao Hongcheng , Wang Zhao , Yi Xianfu , Zhang Shijie , Sham Pak Chung , Li Mulin Jun
Published: October 2019

Recent advances in genome sequencing and functional genomic profiling have promoted many large-scale quantitative trait locus (QTL) studies, which connect genotypes with tissue/cell type-specific cellular functions from transcriptional to post-translational level. However, no comprehensive resource can perform QTL lookup across multiple molecular phenotypes and investigate the potential cascade effect of functional variants. We developed a versatile resource, named QTLbase, for interpreting the possible molecular functions of genetic variants, as well as their tissue/cell-type specificity. Overall, QTLbase has five key functions: (i) curating and compiling genome-wide QTL summary statistics for 13 human molecular traits from 233 independent studies; (ii) mapping QTL-relevant tissue/cell types to 78 unified terms according to a standard anatomogram; (iii) normalizing variant and trait information uniformly, yielding >170 million significant QTLs; (iv) providing a rich web client that enables phenome- and tissue-wise visualization; and (v) integrating the most comprehensive genomic features and functional predictions to annotate the potential QTL mechanisms. QTLbase provides a one-stop shop for QTL retrieval and comparison across multiple tissues and multiple layers of molecular complexity, and will greatly help researchers interrogate the biological mechanism of causal variants and guide the direction of functional validation. QTLbase is freely available at http://mulinlab.org/qtlbase.
Epidemiology and Socioeconomic Trends in Adult Spinal Deformity Care
Authors: Safaee Michael M , Ames Christopher P , Smith Justin S
Published: October 2019

Adult spinal deformity (ASD) has gained significant attention over the past decade with improvements in diagnostic tools, classification schemes, and surgical technique. The demographics of the aging population in the United States are undergoing a fundamental shift as medical care advances and life expectancy increases. The “baby boomers” represent the fastest growing demographic in the United States and by 2050, the number of individuals 65 yr and older is projected to reach 89 million, more than double its current size. Based on current prevalence estimates there are approximately 27.5 million elderly individuals with some form of spinal deformity, which will place a significant burden on our health care systems. Rates of surgery for ASD and case complexity are both increasing, with concomitant increase in the cost of deformity care. At the same time, patients are more medically complex with increasing number of comorbidities that result in increased surgical risk and complication profiles. This review aims to highlight recent trends in the epidemiology and socioeconomic patterns in surgery for ASD.
Local and Systemic Analgesic Effects of Nerve-Specific Acupuncture in Healthy Adults, Measured by Quantitative Sensory Testing
Authors: Dimitrova Alexandra , Colgan Dana Dharmakaya , Oken Barry
Published: October 2019

Objective

This study aims to assess whether acupuncture analgesia’s effects are local or systemic and whether there is a dose response for these effects.

Methods

Twenty-eight healthy volunteers aged 18–45 were randomized to two doses of acupuncture using points closely associated with peripheral nerves in the legs. The lower-dose group involved acupoints overlying the deep peroneal nerve (DP), and the higher-dose involved acupoints overlying the deep peroneal and posterior tibial nerves (DPTN). Baseline and acupuncture quantitative sensory testing (QST) assessments were obtained locally in the calf and great toe and systemically in the hand. Results were analyzed using factorial repeated-measures analysis of variance for each of the QST variables—cold detection threshold (CDT), vibration detection threshold (VDT), heat pain threshold (HP0.5), and heat pain perception of 5/10 (HP5.0). Location (leg/hand) and time (baseline/acupuncture) were within-subject factors. Intervention (DP/DPTN) was a between-subject factor.

Results

CDT was increased in the calf (P < 0.001) and in the hand (P < 0.001). VDT was increased in the toe (P < 0.001) but not in the hand. HP0.5 was increased in the calf (P < 0.001) and in the hand (P < 0.001). HP5.0 was increased in the calf (P = 0.002) and in the hand (P < 0.001), with the local effect being significantly greater than the systemic (P = 0.004). In all of the above QST modalities, there was no difference between the low-dose (DP) and high-dose (DPTN) acupuncture groups.

Conclusions

Acupuncture caused comparable local and systemic analgesic effects in cold detection and heat pain perception and only local effects in vibration perception. There was no clear acupuncture dose response to these effects.
Effects of Biopsychosocial Education on the Clinical Judgments of Medical Students and GP Trainees Regarding Future Risk of Disability in Chronic Lower Back Pain: A Randomized Control Trial
Authors: Dwyer Christopher P , MacNeela Pádraig , Durand Hannah , O’Connor Laura L , Main Chris J , McKenna-Plumley Phoebe E , Hamm Robert M , Reynolds Bronagh , Conneely Sinéad , Slattery Brian W , Taheny Darragh , NicGabhainn Saoirse , Murphy Andrew W , Kropmans Thomas , McGuire Brian E
Published: October 2019

Background

Chronic lower back pain (CLBP) is a major health care burden and often results in workplace absenteeism. It is a priority for appropriate management of CLBP to get individuals back to work as early as possible. Interventions informed by the flags approach, which integrates cognitive and behavioral approaches via identification of biopsychosocial barriers to recovery, have resulted in reduced pain-related work absences and increased return to work for individuals with CLBP. However, research indicates that physicians’ adherence to biopsychosocial guidelines is low.

Objective

The current study examined the effects of a flags approach–based educational intervention on clinical judgments of medical students and general practitioner (GP) trainees regarding the risk of future disability of CLBP patients.

Design

Randomized controlled trial (trial registration number: ISRCTN53670726).

Setting

University classroom.

Subjects

Medical students and GP trainees.

Methods

Using 40 fictional CLBP cases, differences in clinical judgment accuracy, weighting, and speed (experimental N = 32) were examined pre- and postintervention, as were flags approach knowledge, pain attitudes and beliefs, and empathy, in comparison with a no-intervention control group (control N = 31).

Results

Results revealed positive effects of the educational intervention on flags approach knowledge, pain-related attitudes and beliefs, and judgment weighting of psychologically based cues; results are discussed in light of existing theory and research.

Conclusions

Short flags approach–based educational video interventions on clinical judgment-making regarding the risk of future disability of CLBP patients may provide opportunities to gain biopsychosocial knowledge, overcome associated attitude barriers, and facilitate development of clinical judgment-making more aligned with psychological cues.
Motivations to Pursue Physical Therapy Residency Training: A Q-Methodology Study of Stakeholder Perspectives
Authors: Osborne Raine , Janson Chris , Black Lisa , Jensen Gail M
Published: October 2019

Background

Residency training is recognized as a valuable form of professional development and pathway to specialization. Currently residency is voluntary for physical therapists, with less than 12% of DPT students choosing to apply upon graduation. Motivations that drive the decision to pursue residency are currently unknown as is the extent of similarity and difference in perspective among various stakeholders.

Objective

The purpose of this study was to identify the dominant perspectives on motivations to pursue residency held by various stakeholders.

Design

This study was conducted using Q Methodology, which incorporates aspects of quantitative and qualitative techniques into the examination of human subjectivity.

Methods

Program directors, faculty, and current residents from all accredited physical therapy residency programs were invited to complete a forced-choice sorting activity where potential motivations for residency were sorted by perceived level of importance. Principal component analysis was used to identify dominant perspectives, which were interpreted based on emergent themes in the cluster of motivations identified as most important.

Results

Four dominant perspectives were identified: (1) desire to provide better patient care, (2) preparation for specialty practice, (3) fast track to expert practice, and (4) career advancement. These perspectives provided context and utility to 2 broad meta-motivations: improved clinical reasoning and receiving mentoring. Both within- and between-group differences among stakeholders were identified. However, subsets from each role-group population were found to share similar perspectives.

Limitations

Results from this study may not apply to potential residents in all specialty areas, and the implications of having a particular perspective are unknown.

Conclusions

Identification of the dominant perspective on motivations for pursuing residency may aid in promoting participation, program development, matching residents to programs and mentors, and future research.
Normative Responses to Clinical Tests for Cervicogenic Dizziness: Clinical Cervical Torsion Test and Head-Neck Differentiation Test
Authors: Treleaven Julia , Joloud Vladimir , Nevo Yoav , Radcliffe Clare , Ryder Mollie
Published: October 2019

Background

The clinical diagnosis of cervicogenic dizziness (CGD) is challenging because of a lack of sensitive and specific diagnostic tests. It is vital for clinicians to know normative responses to suggested clinical tests to help them develop the method and interpretation of these tests and maximize their diagnostic value for CGD.

Objective

The purpose of the study was to determine normative responses to the clinical application of the cervical torsion test and the head-neck differentiation test, with consideration of different age groups and sex.

Design

This was an observational study.

Methods

One hundred forty-seven people who were healthy and asymptomatic served as controls and performed both tests, which involved 3 components: cervical torsion, cervical rotation, and en bloc rotation (head and trunk rotation together).

Results

Thirty-five (23.81%) of the 147 participants reported some symptoms (mild dizziness, visual disturbances, unusual eye movements on opening eyes after the test, motion sickness, or nausea) on 1 or more of the 3 test components in either test. The specificity when using a positive response to torsion alone (ie, a negative response to the rotation or en bloc component) was high (for the cervical torsion test, 98.64%; for the head-neck differentiation test, 89.8%), as participants with likely global sensorimotor sensitivity were eliminated. The combined specificity was 100%, as no participants presented with exclusive positive torsion results in both tests. Age and sex did not influence the results.

Limitations

There were several examiners who were not blinded.

Conclusions

Confirmation of the high specificity of these clinical tests with the method used in this study to conduct and interpret the results will allow future research to determine the sensitivity of these clinical measures in a population with CGD and specificity in those with dizziness of other origins.
A COMPREHENSIVE CHARACTERISTIC OF 222Rn ACTIVITY CONCENTRATION CHANGES AND IONISING RADIATION EXPOSURE IN NEWLY DISCOVERED PARTS OF BEAR CAVE IN KLETNO, POLAND
Authors: Fijałkowska-Lichwa Lidia , Przylibski Tadeusz A
Published: October 2019

The article presents the results of research into 222Rn activity concentration changes and ionising radiation exposure in newly discovered parts of Bear Cave in Kletno, unknown until 2012. 222Rn activity concentration was registered at three measurement points located inside over 500-m-long newly discovered cave passages. The air in these parts of the cave is characterised by a stable temperature of about 5°C and a relative humidity of 100%. The measurements started in September 2013 and were completed by mid-July 2016. The measured data were recorded continuously, including hourly registration of 222Rn activity concentration with the use of three Polish semiconductor detectors SRDN-3a. Three data sets were obtained. Two of them, containing the same numbers of data, were recorded between 4 September 2013 and 10 July 2016 by SRDN-3a detectors no 7 and 9 located at sites no 1 and no 3, respectively. The third set comprises data registered between 27 October 2014 and 10 July 2016 by SRDN-3a probe no 8 at site no 2. Distinct daily changes in 222Rn activity concentration in the new parts of Bear Cave occur in early spring (from March to May) and in autumn (October). This observation confirms the notion that radon concentration changes depend on natural convective air exchange between the cave and the atmosphere. It has been shown that daily radon concentration changes in other seasons are irregular and rather small. The highest values of 222Rn activity concentration inside the cave are more frequent in daytime, i.e. from the morning to midday. The recorded annual mean values of 222Rn activity concentration in successive measurement years are comparable for all the three sites and range from 2690 to 3179 Bqm−3 in 2013, from 2676 to 2973 Bqm−3 in 2014, from 2587 to 2917 Bqm−3 in 2015 and from 2581 to 3719 Bqm−3 in 2016. These values exceed those recommended as maximum allowable radon concentrations in such spaces (0.5–1.5 kBqm−3) and are many times as high as the values recommended for workplaces (0.3 kBqm−3). The recorded values of 222Rn activity concentration in the air of the new parts of Bear Cave in Kletno result in a risk of exposure to a radiation dose higher than the national standard of 1 mSv per year adopted for the general public. In the most unfavourable conditions, it appears as early as after 25 hours spent inside the cave. The minimum effective dose to which a person staying inside the cave is exposed within 1 hour is 0.002 mSv, and the maximum dose is 0.04 mSv. The results of the conducted measurements demonstrate the necessity of introducing appropriate solutions, crucial in terms of radiological protection and legislation, that would minimise the risk of exposure to ionising radiation in the new parts of Bear Cave.
ESTIMATION OF RADIATION DOSE IN CT VENOGRAPHY OF THE LOWER EXTREMITIES: PHANTOM EXPERIMENTS USING DIFFERENT AUTOMATIC EXPOSURE CONTROL SETTINGS AND SCAN RANGES
Authors: Inoue Yusuke , Itoh Hiroyasu , Nagahara Kazunori , Takahashi Yuka
Published: October 2019

We performed phantom experiments to assess radiation dose in computed tomography (CT) venography of the lower extremities. CT images of a whole-body phantom were acquired using different automatic exposure control settings and scan ranges, simulating CT venography. Tube current decreased in the lower extremities compared to the trunk. The scout direction and dose modulation strength affected tube current, dose length product (DLP) and effective dose. The middle and distal portions of the lower extremities contributed substantially to DLP but not to effective dose. When effective dose was estimated by multiplying DLP by a single conversion factor, overestimation was evident; this became more pronounced as the scan range narrowed. In CT venography of the lower extremities, the scout direction and modulation strength affect radiation dose. Use of DLP severely overestimates radiation dose and underestimates effects of scan range narrowing.
Comparative anatomy and phylogeny of the Forcipulatacea (Echinodermata: Asteroidea): insights from ossicle morphology
Authors: Fau Marine , Villier Loïc
Published: October 2019

A new phylogenetic analysis of the superorder Forcipulatacea is presented. Forcipulatacea is one of the three major groups of sea stars (Asteroidea: Echinodermata), composed of 400 extant species. The sampled taxa are thought to represent the morphological diversity of the group. Twenty-nine forcipulate taxa were sampled belonging to Asteriidae, Stichasteridae, Heliasteridae, Pedicellasteridae, Zoroasteridae and Brisingida. Specimens were dissected with bleach. Detailed description of the skeleton and the anatomy of the ossicles were investigated using scanning electron microscopy. Comparative anatomy allowed the scoring of 115 phylogenetically informative characters. The consensus tree resulting from the analysis recovers Asteriidae, Stichasteridae, Zoroasteridae and Brisingida as monophyletic. All types of morphological features contribute to tree resolution and may be appropriate for taxon diagnosis. The synapomorphies supporting different clades are described and discussed. Brisingida and Zoroasteridae are the best-supported clades. The potentially challenging position of Brisingida in the tree may be explained by homoplastic changes, but also by the presence of numerous non-applicable characters.
Evolution of an Accelerated 3-Year Pathway to the MD Degree: The Experience of New York University Grossman School of Medicine
Authors: Cangiarella Joan , Cohen Elisabeth , Rivera Rafael , Gillespie Colleen , Abramson Steven
Published: October 2019

The revision of the curriculum at New York University Grossman School of Medicine in 2010, with a reduction of the preclerkship curriculum to 18 months, made it possible to offer an accelerated 3-year pathway in 2013 for students who know their career path. The goals of the program include individualizing education, reducing student debt, and integrating undergraduate and graduate medical education. This accelerated 3-year doctor of medicine (3YMD) pathway is the first program of its kind in the United States to offer conditional acceptance to residency programs in all specialties through the National Resident Matching Program. Since inception of the pathway 6 years ago, 81 students have graduated. Critical components to successfully launch and implement the program are described.

Unwavering commitment to the program as a high institutional priority by the dean and vice dean for education facilitated the support required by department chairs and residency program directors and the flexibility needed for success. Alignment between the 3- and 4-year pathways has made it possible to add points of entry into the 3-year pathway during the second and third years and to shift back into the 4-year pathway, as warranted. Modifications to how 3YMD students are mentored included changing the role of the departmental advisor and adding a dedicated 3YMD pathway advisor who serves as an advocate for both the students and the program. Having a relatively large number of 3YMD students has contributed to the success of the program and facilitated acceptance by the residencies.
Association of rs8444 polymorphism in the LASS2 3′-UTR and bladder cancer risk in Chinese population
Authors: Huang Yinglong , Wang Haifeng , Fu Shi , Luan Ting , Zuo Yigang , Li Ning , Ding Mingxia , Chen Yujin , Wang Jiansong
Published: October 2019

The aim of the present study was to explore the correlations between single nucleotide polymorphisms in LASS2 gene 3′-untranslated regions and bladder cancer risk in Chinese population. We first performed PCR and sequence for LASS2-3′-UTR in 105 bladder cancer patients and 100 control subjects. Next, multivariate logistic regression analysis was used to determine the relationship between single nucleotide polymorphisms frequency and susceptibility of bladder cancer, and clinical features in 105 cases. In addition, survival curves and Cox Regression analysis were used to investigate the effect of single nucleotide polymorphisms on clinical outcome in 58 cases. Finally, quantitative reverse-transcription PCR and immunohistochemical were performed to explore the influence of single nucleotide polymorphisms on LASS2 expression. We found that a single nucleotide polymorphism (rs8444 C>T) located in the 3′-UTR of LASS2 was significantly associated with the risk of bladder cancer. We also showed the frequency of rs8444 T genotype was higher in bladder cancer group and correlated with the risk of clinical prognosis. Yet, there were no significant correlations between T/C allele frequencies and the distributions of rs8444 genotype and tumor-node-metastasis stage, histological grade and distant metastasis in bladder cancer. Furthermore, we demonstrated that rs8444 C>T could affect LASS2 expression by single nucleotide polymorphism-related mRNA stability. Our results showed that LASS2-3′-UTR rs8444 C>T polymorphism was significantly associated with the individual risk and the poor overall survival of bladder cancer, suggesting that rs8444 TT genotype maybe act as an independent risk factor of susceptibility and clinical prognosis for bladder cancer in Chinese population.