bluuebunny/crossref_metadata_2025 huggingface dataset:
Japanese structure survey of radiation oncology in 2015
Authors: Numasaki Hodaka , Nakada Yoshihiro , Okuda Yasuo , Ohba Hisateru , Teshima Teruki , Ogawa Kazuhiko ,   Japanese Society for Radiation Oncology Database Committee
Published: January 2022

This article describes the ongoing structure of radiation oncology in Japan in terms of equipment, personnel, patient load and geographic distribution to identify and overcome any existing limitations. From May 2016 to August 2018, the Japanese Society for Radiation Oncology conducted a questionnaire based on the Japanese national structure survey of radiation oncology in 2015. Data were analyzed based on the institutional stratification by the annual number of new patients treated with radiotherapy per institution. The estimated annual numbers of new and total (new plus repeat) patients treated with radiation were 225 000 and 271 000, respectively. Additionally, the estimated cancer incidence was 891 445 cases with approximately 25.2% of all newly diagnosed patients being treated with radiation. The types and numbers of treatment devices actually used included linear accelerator (linac; n = 936), Gamma Knife (n = 43), 60Co remote afterloading system (RALS; n = 21), and 192Ir RALS (n = 129). The linac system used dual-energy functions in 754 units, 3D conformal radiotherapy functions in 867, and intensity-modulated radiotherapy (IMRT) functions in 628. There were 899 Japan Radiological Society/Japanese Society for Radiation Oncology-certified radiation oncologists (RO), 1213.9 full-time equivalent (FTE) ROs, 2394.2 FTE radiotherapy technologists (RTT), 295.7 FTE medical physicists, 210.2 FTE radiotherapy quality managers, and 906.1 FTE nurses. The frequency of IMRT use significantly increased during this time. In conclusion, the Japanese structure of radiation oncology has clearly improved in terms of equipment and utility although there was a shortage of personnel in 2015.
Phytomelatonin: an unexpected molecule with amazing performances in plants
Authors: Arnao Marino B , Cano Antonio , Hernández-Ruiz Josefa
Published: January 2022

Phytomelatonin, a multifunctional molecule that has been found to be present in all plants examined to date, has an important role in plants as a modulatory agent (a biostimulator) that improves plant tolerance to both biotic and abiotic stress. We present a review of phytomelatonin that considers its roles in plant metabolism and in particular its interactions with plant hormone network. In the primary metabolism of plants, melatonin improves the rate and efficiency of photosynthesis, as well related factors such as stomatal conductance, intercellular CO2, and Rubisco activity. It has also been shown to down-regulate some senescence transcription factors. Melatonin up-regulates many enzyme transcripts related to carbohydrates (including sucrose and starch), amino acids, and lipid metabolism, optimizing N, P, and S uptake. With respect to the secondary metabolism, clear increases in polyphenol, glucosinolate, terpenoid, and alkaloid contents have been described in numerous melatonin-treated plants. Generally, the most important genes of these secondary biosynthesis pathways have been found to be up-regulated by melatonin. The great regulatory capacity of melatonin is a result of its control of the redox and plant hormone networks. Melatonin acts as a plant master regulator, up-/down-regulating different plant hormone levels and signalling, and is a key player in redox homeostasis. It has the capacity to counteract diverse critical situations such as pathogen infections and abiotic stresses, and provide plants with varying degrees of tolerance. We propose possible future applications of melatonin for crop improvement and post-harvest product preservation.
Combating the Current Pandemic and Preparing for the Next: Lessons Learned From the COVID-19 Pandemic From the Perspective of Deployed Special Operations Forces
Authors: Scheiber Christopher J , Simmons Lemar M , Neading Richard D , Becker Casey F , Scarborough Tyler R , Lenn David G , Moreno Peter , Brown Dixon S , Griffiths Dylan M , Pearson Jeffrey A , Hamm Andrew R , Tucker Anthony A , Monson Michael J E
Published: January 2022

The coronavirus 2019 (COVID-19) pandemic continues to be a threat to global health, including the health of deployed armed forces. Servicemembers had to adjust to the “new normal” while maintaining the interests of the nation’s security as well as that of our host nation partners. This commentary examines how Special Operations Forces operating within four different regions worldwide leveraged the challenges presented by the onset of this pandemic in maintaining stability, sustaining a ready force, and operating forward deployed. Deployed forces face constant difficulties with logistical support, varied medical resources access and a medical system predominantly focused on trauma care. At the onset of the COVID-19 pandemic there was little guidance specific to these circumstances which required an improvised adaptation of the recommendations set by national and Department of Defense medical authorities. Plans were constantly revised to match the ever changing medical and operational environment. Strategies such as the “Bubble Philosophy” and tiered force protection measures helped our units to maintain a rigorous training cycle. New methods of communication and training with our host nation partners such as the use of Unmanned Aerial Systems (UAS) platforms to survey host nation training became standard. Through these measures all of our forces were able to maintain operational capacity, protect the force, and maintain rapport with the host nations. We hope these experiences will provide a rough framework for future forces faced with a similar struggle. We also want to stress that challenges vary depending on the area of operations and the pathogen responsible for the pandemic. Any feedback and collaboration that may come from this work is appreciated and encouraged.
Energy functions of fast radio bursts derived from the first CHIME/FRB catalogue
Authors: Hashimoto Tetsuya , Goto Tomotsugu , Chen Bo Han , Ho Simon C-C , Hsiao Tiger Y-Y , Wong Yi Hang Valerie , On Alvina Y L , Kim Seong Jin , Kilerci-Eser Ece , Huang Kai-Chun , Santos Daryl Joe D , Yamasaki Shotaro
Published: January 2022

Fast radio bursts (FRBs) are mysterious millisecond pulses in radio, most of which originate from distant galaxies. Revealing the origin of FRBs is becoming central in astronomy. The redshift evolution of the FRB energy function, i.e. the number density of FRB sources as a function of energy, provides important implications for the FRB progenitors. Here, we show the energy functions of FRBs selected from the recently released Canadian Hydrogen Intensity Mapping Experiment (CHIME) catalogue using the Vmax method. The Vmax method allows us to measure the redshift evolution of the energy functions as it is without any prior assumption on the evolution. We use a homogeneous sample of 164 non-repeating FRB sources, which are about one order of magnitude larger than previously investigated samples. The energy functions of non-repeating FRBs show Schechter function-like shapes at z ≲ 1. The energy functions and volumetric rates of non-repeating FRBs decrease towards higher redshifts similar to the cosmic stellar-mass density evolution: there is no significant difference between the non-repeating FRB rate and cosmic stellar-mass density evolution with a 1 per cent significance threshold, whereas the cosmic star-formation rate scenario is rejected with a more than 99 per cent confidence level. Our results indicate that the event rate of non-repeating FRBs is likely controlled by old populations rather than young populations that are traced by the cosmic star-formation rate density. This suggests old populations, such as old neutron stars and black holes, as more likely progenitors of non-repeating FRBs.
Discovery of 74 new bright ZZ Ceti stars in the first three years of TESS
Authors: Romero Alejandra D , Kepler S O , Hermes J J , Amaral Larissa Antunes , Uzundag Murat , Bognár Zsófia , Bell Keaton J , VanWyngarden Madison , Baran Andy , Pelisoli Ingrid , Oliveira Gabriela da Rosa , Koester Detlev , Klippel T S , Fraga Luciano , Bradley Paul A , Vučković Maja , Heintz Tyler M , Reding Joshua S , Kaiser B C , Charpinet Stéphane
Published: January 2022

We report the discovery of 74 new pulsating DA white dwarf stars, or ZZ Cetis, from the data obtained by the Transiting Exoplanet Survey Satellite mission, from Sectors 1 to 39, corresponding to the first 3 cycles. This includes objects from the Southern hemisphere (Sectors 1–13 and 27–39) and the Northern hemisphere (Sectors 14–26), observed with 120 s- and 20 s-cadence. Our sample likely includes 13 low-mass and one extremely low-mass white dwarf candidate, considering the mass determinations from fitting Gaia magnitudes and parallax. In addition, we present follow-up time series photometry from ground-based telescopes for 11 objects, which allowed us to detect a larger number of periods. For each object, we analysed the period spectra and performed an asteroseismological analysis, and we estimate the structure parameters of the sample, i.e. stellar mass, effective temperature, and hydrogen envelope mass. We estimate a mean asteroseismological mass of 〈Msis〉 = 0.635 ± 0.015 M⊙, excluding the candidate low or extremely low-mass objects. This value is in agreement with the mean mass using estimates from Gaia data, which is 〈Mphot〉 = 0.631 ± 0.040 M⊙, and with the mean mass of previously known ZZ Cetis of 〈M*〉 = 0.644 ± 0.034 M⊙. Our sample of 74 new bright ZZ Cetis increases the number of known ZZ Cetis by ∼20 per cent.
Transverse oscillations of the incompressible MHD mode in the visco-resistive plasmas: an explanation of Alfvénic to Landau-type characteristics
Authors: Pandey V S , Kumar Ankit , Nayak M K
Published: January 2022

In this paper, we characterize transverse oscillations as either Alfvénic or Landau-type in an incompressible non-ideal magnetohydrodynamic (MHD) fluid. We consider shear viscosity and magnetic diffusivity as dissipation mechanisms to derive a general dispersion relation for the incompressible MHD waves. The solutions of this dispersion relation for k as a function of ω – denoting by the source for any value of θ up to which magnetic tension acts as restoring force and dominates over internal friction forces – result in four roots, as follows. Two roots, which have a high phase velocity $c_{\rm A}\cos\theta $ are identified as almost undamped propagating Alfvén waves. The other two roots, which have a phase velocity $(2c_{\rm A}\cos\theta)/(\sqrt{\eta/\nu} + \sqrt{\nu/\eta})$, result in Alfvénic-type disturbances of a much shorter decay length than the wavelength. In contrast, when internal frictional forces start dominating over magnetic tension (i.e. for the propagation perpendicular to the background magnetic field, where the tension in the magnetic field becomes zero), the solutions of the dispersion are akin to Landau-type transverse oscillations. Transverse waves of this type were initially reported by Landau in an ordinary viscous fluid. However, our study corresponds to MHD visco-resistive fluid. The prediction for these lateral propagating transverse waves to be of Landau type may be very useful to explain the heating of observed filamentary structures across the magnetic field on a very small spatial scale in the solar coronal plasma, wherein the heating rate is directly proportional to the operating frequency of the driver, while its damping length is inversely proportional to the square root of the frequency.
ATOMS: ALMA three-millimeter observations of massive star-forming regions – VII. A catalogue of SiO clumps from ACA observations
Authors: Liu Rong , Liu Tie , Chen Gang , Liu Hong-Li , Wang Ke , Li Jin-Zeng , Lee Chang Won , Liu Xunchuan , Juvela Mika , Garay Guido , Dewangan Lokesh , Soam Archana , Bronfman Leonardo , He Jinhua , Eswaraiah Chakali , Zhang Si-Ju , Zhang Yong , Xu Feng-Wei , Tóth L Viktor , Shen Zhi-Qiang , Li Shanghuo , Wu Yue-Fang , Qin Sheng-Li , Ren Zhiyuan , Zhang Guoyin , Tej Anandmayee , Goldsmith Paul F , Baug Tapas , Luo Qiuyi , Zhou Jianwen , Zhang Chang
Published: January 2022

To understand the nature of SiO emission, we conducted ACA observations of the SiO (2-1) lines toward 146 massive star-forming regions, as part of the ALMA Three-millimeter Observations of Massive Star-forming regions (ATOMS) survey. We detected SiO emission in 128 (87.7${{\ \rm per\ cent}}$) sources and identified 171 SiO clumps, 105 of which are spatially separated from 3 mm continuum emission. A large amount of the SiO line profiles (60${{\ \rm per\ cent}}$) are non-Gaussian. The velocity dispersion of the SiO lines ranges from 0.3 to 5.43 km s−1. In 63 sources the SiO clumps are associated with H ii regions characterized by H40α emission. We find that 68${{\ \rm per\ cent}}$ (116) of the SiO clumps are associated with strong outflows. The median velocity dispersion of the SiO line for outflow sources and non-outflow sources is 1.91 km s−1 and 0.99 km s−1, respectively. These results indicate that outflow activities could be connected to strongly shocked gas. The velocity dispersion and [SiO]/[H13CO+] intensity ratio do not show any correlation with the dust temperature and particle number density of clumps. We find a positive correlation between the SiO line luminosity and the bolometric luminosity, implying stronger shock activities are associated with more luminous protoclusters. The SiO clumps in associations with H ii regions were found to show a steeper feature in $L_{\rm{sio}}$/$L_{\rm{bol}}$. The SiO line luminosity and the fraction of shocked gas have no apparent evidence of correlation with the evolutionary stages traced by luminosity to mass ratio ($L_{\rm{bol}}/M$).
The effect of selection – a tale of cluster mass measurement bias induced by correlation and projection
Authors: Zhang Yuanyuan , Annis James
Published: January 2022

Cosmology analyses using galaxy clusters by the Dark Energy Survey have recently uncovered an issue of a previously unknown selection effect affecting weak-lensing mass estimates. In this letter, we use the Illustris-TNG simulation to demonstrate that selecting on galaxy counts induces a selection effect because of projection and correlation between different observables. We compute the weak-lensing-like projected mass estimations of dark matter haloes and examine their projected subhalo counts. In the two-dimensional (2D) projected space, haloes that are measured as more massive than truth have higher subhalo counts. Thus, projection along the line of sight creates cluster observables that are correlated with cluster mass measurement deviations, which in turn creates a mass measurement bias when the clusters are selected by this correlated observable. We demonstrate that the bias is predicted in a forward model using the observable-mass measurement correlation.
Long-Read Genome Sequencing Provides Molecular Insights into Scavenging and Societal Complexity in Spotted HyenaCrocuta crocuta
Authors: Shao Yong , Wang Xiao-Bo , Zhang Mei-Ling , Liu Yan , Wang Sheng , Zhang Bao-Lin , Yang Min-Min , Yang Ming-Hai , Jia Ting , Pu Tian-Chun , Lu Yan , Liu He , Xu Zhe , Li Bo , Liu Ning , Onsongo Violet Magoma , Wu Dong-Dong , Zhang Cheng-Lin , Ruan Jue , Li Yan
Published: January 2022

The spotted hyena (Crocuta crocuta) is a large and unique terrestrial carnivore. It is a particularly fascinating species due to its distinct phenotypic traits, especially its complex social structure and scavenging lifestyle, with associated high dietary exposure to microbial pathogens. However, the underlying molecular mechanisms related to these phenotypes remain elusive. Here, we sequenced and assembled a high-quality long-read genome of the spotted hyena, with a contig N50 length of ∼13.75 Mb. Based on comparative genomics, immunoglobulin family members (e.g., IGKV4-1) showed significant adaptive duplications in the spotted hyena and striped hyena. Furthermore, immune-related genes (e.g., CD8A, LAG3, and TLR3) experienced species-specific positive selection in the spotted hyena lineage. These results suggest that immune tolerance between the spotted hyena and closely related striped hyena has undergone adaptive divergence to cope with prolonged dietary exposure to microbial pathogens from scavenging. Furthermore, we provided the potential genetic insights underlying social complexity, hinting at social behavior and cognition. Specifically, the RECNE-associated genes (e.g., UGP2 and ACTR2) in the spotted hyena genome are involved in regulation of social communication. Taken together, our genomic analyses provide molecular insights into the scavenging lifestyle and societal complexity of spotted hyenas.
Activation of TRPV4 stimulates transepithelial K+ secretion in rat epididymal epithelium
Authors: Gao Dong-Dong , Huang Jun-Hao , Zhang Yi-Lin , Peng Lei , Deng Wei-Ji , Mai You-Nian , Wu Jia-Rui , Li Pei-Lun , Ding Nan , Huang Zi-Yang , Zhu Yun-Xin , Zhou Wen-Liang , Hu Min
Published: January 2022

The maturation of sperms is dependent on the coordinated interactions between sperm and the unique epididymal luminal milieu, which is characterized by high K+ content. This study investigated the involvement of transient receptor potential vanilloid 4 (TRPV4) in the K+ secretion of epididymal epithelium. The expression level and cellular localization of TRPV4 and Ca2+-activated K+ channels (KCa) were analyzed via RT–PCR, real-time quantitative PCR, western blot and immunofluorescence. The functional role of TRPV4 was investigated using short-circuit current (ISC) and intracellular Ca2+ imaging techniques. We found a predominant expression of TRPV4 in the corpus and cauda epididymal epithelium. Activation of TRPV4 with a selective agonist, GSK1016790A, stimulated a transient decrease in the ISC of the epididymal epithelium. The ISC response was abolished by either the TRPV4 antagonists, HC067047 and RN-1734, or the removal of basolateral K+. Simultaneously, the application of GSK1016790A triggered Ca2+ influx in epididymal epithelial cells. Our data also indicated that the big conductance KCa (BK), small conductance KCa (SK) and intermediate conductance KCa (IK) were all expressed in rat epididymis. Pharmacological studies revealed that BK, but not SK and IK, mediated TRPV4-elicited transepithelial K+ secretion. Finally, we demonstrated that TRPV4 and BK were localized in the epididymal epithelium, which showed an increased expression level from caput to cauda regions of rat epididymis. This study implicates that TRPV4 plays an important role in the formation of high K+ concentration in epididymal intraluminal fluid via promoting transepithelial K+ secretion mediated by BK.
Descriptive Epidemiology and Outcomes of Hospitalizations With Complicated Urinary Tract Infections in the United States, 2018
Authors: Zilberberg Marya D , Nathanson Brian H , Sulham Kate , Shorr Andrew F
Published: January 2022

Background

Hospitalizations with complicated urinary tract infection (cUTI) in the United States have increased. Though most often studied as a subset of cUTI, catheter-associated UTI (CAUTI) afflicts a different population of patients and carries outcomes distinct from non-CA cUTI (nCAcUTI). We examined the epidemiology and outcomes of hospitalizations in these groups.

Methods

We conducted a cross-sectional multicenter study within the 2018 National Inpatient Sample (NIS) database, a 20% stratified sample of discharges from US community hospitals, to explore characteristics and outcomes of patients discharged with a UTI diagnosis. We divided cUTI into mutually exclusive categories of nCAcUTI and CAUTI. We applied survey methods to develop national estimates.

Results

Among 2 837 385 discharges with a UTI code, 500 400 (17.6%, 19.8% principal diagnosis [PD]) were nCAcUTI and 126 120 (4.4%, 63.8% PD) were CAUTI. Though similar in age (CAUTI, 70.1 years; and nCAcUTI, 69.7 years), patients with nCAcUTI had lower comorbidity (mean Charlson, 4.3) than those with CAUTI (mean Charlson, 4.6). Median (interquartile range [IQR]) length of stay (LOS) was 5 (3–8) days in nCAcUTI and 5 (3–9) days in CAUTI. Overall median (IQR) hospital costs were similar in nCAcUTI ($9713 [$5923–$17 423]) and CAUTI ($9711 [$5969–$17 420]). Though low in both groups, hospital mortality was lower in nCAcUTI (2.8%) than in CAUTI (3.4%). Routine discharges home were higher in nCAcUTI (41.5%) than CAUTI (22.1%).

Conclusions

There are >626 000 hospital admissions with a cUTI, comprising ~1.8% of all annual admissions in the United States; 4/5 are nCAcUTI. Because CAUTI is frequently the reason for admission, preventive efforts are needed beyond the acute care setting.
Perspectives on the pervasive energy-systems transformations
Authors: Nakicenovic Nebojsa
Published: January 2022

Energy is central for the global decarbonization and the achievement of a sustainable future for all. This calls for a fundamental energy-systems transformation that would bring multiple co-benefits for health, climate and other challenges facing humanity and especially those without access to affordable and clean energy services. Pervasive transformation toward zero-carbon electricity and electrification of energy end use are central to achieving higher efficiencies, decarbonization and net-zero emissions. This is not merely a technical and economic issue. It is about people, about societies and about values and behaviors. Technology is an integral part of the society and an expression of collective intentionality through aggregation of sundry individual choices. The next disruptive transformation toward a sustainable future may indeed be powered by the digital revolution. It poses dangers for privacy, dissemination of alternative realities and erosion of evidence-based information but it also offers a great promise of catalyzing the emergence of a sustainable future by augmenting human capabilities by new, more convenient, more efficient and decarbonized goods and services. The key question is whether humanity will have the political will to collectively achieve the energy-systems transformation toward a sustainable future and net-zero emissions in merely three decades.
On the Adequacy of a Substructural Logic for Mathematics and Science
Authors: Tennant Neil
Published: January 2022

Williamson argues for the contention that substructural logics are ‘ill-suited to acting as background logics for science’. That contention, if true, would be very important, but it is refutable, given what is already known about certain substructural logics. Classical Core Logic is a substructural logic, for it eschews the structural rules of Thinning and Cut and has Reflexivity as its only structural rule. Yet it suffices for classical mathematics, and it furnishes all the proofs and disproofs one needs for the hypothetico-deductive method in science. We explain exactly what Classical Core Logic is, why it is a substructural logic par excellence, and what the basic requirements would be for a logic to be ‘suited to acting as [a] background logic for science’. We also explain how Classical Core Logic meets all these requirements. We end by examining Williamson’s argument in order to expose where its error lies.
APPLICABILITY OF A HANDHELD LaBr3(Ce) SPECTROMETER FOR INTERNAL RADIOACTIVE CONTAMINATION EXAMINATION IN RADIOLOGICAL EMERGENCY
Authors: Ji Yunlong , Li Dawei , Qu Decheng , Ning Jing
Published: January 2022

In case of a nuclear or radiological emergency, there may be a very large population of individuals being affected by radiation exposure. Rapid and on-site examinations of possible internal radioactive contaminations are required for early dose assessment and large-scale screening. With the appropriate methodology, early dose information of internal exposure can be instantly obtained by a handheld spectrometer only. In this study, we extended the use of a handheld LaBr3 spectrometer to rough internal dose assessment. A family of real source BOMAB phantoms was applied for efficiency calibration of different detecting geometries. Detecting limits of several nuclides of major concern was also investigated. The result of this study can be used for initial dose assessment and medical triage during the first response of nuclear and radiological emergencies.
Creating Conditions for Professional Development through a Trauma-Informed and Restorative Practice
Authors: Lauridsen Marlene Bruun , Munkejord Mai Camilla
Published: January 2022

Professionals in social work and nursing meet people who, due to trauma, struggle with self-regulation of emotions and social behavior. Caring for trauma survivors requires connection and compassion. Previous research has indicated that many professionals, some with their own trauma histories, do not feel sufficiently equipped to practice self-care or cope with challenging communication. To address how insecurity and trauma are rooted in deeper individual and structural causes of social injustice, social workers and nursing students (N = 29) were invited to participate in action research and a restorative circle process. The aim was to provide professionals the opportunity to challenge and reflect upon their own practices by introducing them to a trauma-informed and restorative practice based on the importance of building emotional safety and connection. The findings suggest that given time and space for reflection in a setting characterized by equality and safety, professionals can develop increased (a) self-awareness and compassion, (b) emotional safety and tolerance of stress in challenging communication, (c) trauma understanding, and (d) personal growth. A change to a more restorative and trauma-informed practice could lead to increased interpersonal competence and well-being among professionals and clients.
Negative effects of low root temperatures on water and carbon relations in temperate tree seedlings assessed by dual isotopic labelling
Authors: Wang Wenna , Hoch Günter
Published: January 2022

Low root zone temperatures restrict water and carbon (C) uptake and transport in plants and may contribute to the low temperature limits of tree growth. Here, we quantified the effects of low root temperatures on xylem conductance, photosynthetic C assimilation and phloem C transport in seedlings of four temperate tree species (two broad-leaved and two conifer species) by applying a simultaneous stable isotope labelling of 2H-enriched source water and 13C-enriched atmospheric CO2. Six days before the pulse labelling, the seedlings were transferred to hydroponic tubes and exposed to three different root temperatures (2, 7 and 15 °C), while all seedlings received the same, warm air temperatures (between 18 and 24 °C). Root cooling led to drought-like symptoms with reduced growth, leaf water potentials and stomatal conductance, indicating increasingly adverse conditions for water uptake and transport with decreasing root temperatures. Averaged across all four species, water transport to leaves was reduced by 40% at 7 °C and by 70% at 2 °C root temperature relative to the 15 °C treatment, while photosynthesis was reduced by 20 and 40% at 7 and 2 °C, respectively. The most severe effects were found on the phloem C transport to roots, which was reduced by 60% at 7 °C and almost ceased at 2 °C in comparison with the 15 °C root temperature treatment. This extreme effect on C transport was likely due to a combination of simultaneous reductions of phloem loading, phloem mass flow and root growth. Overall, the dual stable isotope labelling proved to be a useful method to quantify water and C relations in cold-stressed trees and highlighted the potentially important role of hydraulic constraints induced by low soil temperatures as a contributing factor for the climatic distribution limits of temperate tree species.
Fungicide Efficacy on Tar Spot and Yield of Corn in the Midwestern United States
Authors: Telenko Darcy E. P. , Chilvers Martin I. , Byrne Adam M. , Check Jill C. , Da Silva Camila R. , Kleczewski Nathan M. , Roggenkamp Emily E. , Ross Tiffanna J. , Smith Damon L.
Published: January 2022

Tar spot of corn caused by Phyllachora maydis has recently led to significant yield losses in the eastern corn belt of the Midwestern United States. Foliar fungicides containing quinone outside inhibitors (QoI), demethylation inhibitors (DMI), and succinate dehydrogenase inhibitors (SDHI) are commonly used to manage foliar diseases in corn. To mitigate the losses from tar spot, 13 foliar fungicides containing single or multiple modes of action (MOA/Fungicide Resistance Action Committee groups) were applied at their recommended rates in a single application at the standard VT/R1 (tassel/silk) growth stage timing to evaluate their efficacy against tar spot in a total of eight field trials in Illinois, Indiana, Michigan, and Wisconsin during 2019 and 2020. The single MOA fungicides included either a QoI or DMI. The dual MOA fungicides included a DMI with either a QoI or SDHI, and fungicides containing three MOAs included a QoI, DMI, and SDHI. Tar spot severity estimated as the percentage of leaf area covered by P. maydis stroma on the ear leaf of the nontreated control at dent growth stage ranged from 1.6 to 23.3% in the trials. Averaged across eight field trials all foliar fungicide treatments significantly reduced tar spot severity, but only Delaro 325SE (prothioconazole + trifloxystrobin), Revytek 3.33LC (mefentrifluconazole + pyraclostrobin + fluxapyroxad), and Veltyma 3.34S (mefentrifluconazole + pyraclostrobin) significantly increased yield over the nontreated control. When comparing groups of fungicide treatments by the number of MOAs, foliar fungicide products that had two or three MOAs decreased tar spot severity over not treating and products with one MOA. In addition, the fungicide group that contained all three MOAs significantly increased yield over not treating with a fungicide or using a single MOA group.
The Effect of Bedside Rounds on Learning Outcomes in Medical Education: A Systematic Review
Authors: Ratelle John T. , Gallagher Caitlyn N. , Sawatsky Adam P. , Kashiwagi Deanne T. , Schouten Will M. , Gonzalo Jed D. , Beckman Thomas J. , West Colin P.
Published: January 2022

Purpose

To determine if bedside rounds, compared with other forms of hospital ward rounds, improve learning outcomes in medical education.

Method

For this systematic review, the authors searched Ovid MEDLINE, Embase, and Scopus from inception through February 20, 2020. Experimental studies were included if they (1) compared bedside rounds to any other form of rounds in a hospital-based setting, and (2) reported a quantitative comparison of a learning outcome (e.g., learner reaction, knowledge, skills, behavior, health care delivery) among physicians-in-training (medical students, residents, fellows). Extraction elements were summarized using descriptive statistics and a narrative synthesis of design, implementation, and outcomes.

Results

Twenty studies met inclusion criteria, including 7 randomized trials. All studies involved resident physicians, and 11 also involved medical students. The design and implementation of bedside rounds varied widely, with most studies (n = 13) involving cointerventions (e.g., staff education, real-time order entry).

Of the 15 studies that reported learner satisfaction, 7 favored bedside rounds, 4 favored the control, and 4 were equivocal. Of the 4 studies reporting an outcome of learners’ knowledge and skills, 2 favored bedside rounds and 2 were equivocal. Of the 8 studies that reported on learner behavior (e.g., bedside communication with patients), 5 favored bedside rounds, 1 favored the control, and 2 were equivocal. Finally, of the 14 studies that reported a health care delivery outcome (e.g., teamwork, rounding time), 8 favored bedside rounds and 6 were equivocal. Due to the high risk of bias and unexplained heterogeneity across studies, the overall strength of evidence was low.

Conclusions

In hospital-based settings, learners’ satisfaction with bedside rounds is mixed. However, bedside rounds appear to have a positive effect on learner behavior and health care delivery. Given their potential value, additional research is needed to identify barriers to and facilitators of educationally successful bedside rounds.
Parental Leave Policies in Residency: A National Survey of Internal Medicine Program Directors
Authors: Stack Shobha W. , Finn Kathleen M. , Kisielewski Michael , Law Karen L. , Milne Caroline K. , Best Jennifer A.
Published: January 2022

Purpose

To characterize the existence, accessibility, and content of parental leave policies, as well as barriers to program-level policy implementation among internal medicine (IM) program directors (PDs) and to assess the willingness of PDs to implement a national standardized policy.

Method

In 2019, the Association of Program Directors in Internal Medicine conducted a survey of 422 IM PDs. Along with other content, 38 questions addressed 4 primary outcomes: parental leave policy existence, accessibility, content, and barriers. The authors compared programs with and without a program-level policy and applied qualitative content analysis to open-ended questions about barriers to policy implementation and openness to a national standard.

Results

The response rate was 69.4% (293/422). Of responding programs, 86% (250/290) reported a written parental leave policy with 43% (97/225) of these originating at the program level. Program-level policies, compared with policies at other levels, were more likely to address scheduling during pregnancy (38%, 36/95 vs 22%, 27/124; P = .018); peer coverage (24%, 21/89 vs 15%, 16/109; P = .037), how the duration of extended training is determined (81%, 72/89 vs 44%, 48/109; P < .001), and associated pay and benefits 61%, 54/89 vs 44%, 48/109; P = .009). PDs without program-level policy reported lacking guidance to develop policy, deferring upward to institutional policies, and wishing to retain flexibility. More than half of PDs (60%, 170/282) expressed agreement that a national standard for a residency program-level parental leave policy should exist. Those not in favor cited organization equity, lack of resources, implementation challenges, loss of flexibility, and potentially disadvantaging recruitment.

Conclusions

While existing program-level policies included important content, most PDs reported not having them. A national standard to guide the development of program-level parental leave policies could be embraced if it provided flexibility for programs with limited resources.
Adaptations to Opioid Use Disorder Care During the COVID-19 Pandemic: A National Survey of Prescribers
Authors: Sung Minhee L. , Black Anne C. , Blevins Derek , Henry Brandy F. , Cates-Wessel Kathryn , Dawes Michael A. , Drexler Karen , Hagle Holly , Molfenter Todd , Levin Frances R. , Becker William C. , Edelman E. Jennifer
Published: January 2022

Objectives

Among opioid use disorder (OUD)-treating providers, to characterize adaptations used to provide medications for OUD (MOUD) and factors associated with desire to continue virtual visits post-COVID-19 pandemic.

Methods

In a national electronic survey of OUD-treating prescribers (July-August 2020), analyses restricted to X-waivered buprenorphine prescribers providing outpatient, longitudinal care for adults with OUD, quantitative and qualitative analyses of survey items and free text responses were conducted.

Results

Among 797 respondents, 49% were men, 57% ≥50 years, 76% White, 68% physicians. Respondents widely used virtual visits to continue prescribing existing MOUD regimens (79%), provide behavioral healthcare (71%), and initiate new MOUD prescriptions (49%). Most prescribers preferred to continue/expand use of virtual visits after COVID-19. In multivariable models, factors associated with preference to continue/expand virtual visits to initiate MOUD postpandemic were treating a moderate number of patients prepandemic (aOR = 1.67; 95%[CI] = 1.06,2.62) and practicing in an urban setting (aOR = 2.17; 95%[CI] = 1.48,3.18). Prescribing buprenorphine prepandemic (aOR = 2.06; 95%[CI] = 1.11,3.82) and working in an academic medical center (aOR = 2.47; 95%[CI] = 1.30,4.68) were associated with preference to continue/expand use of virtual visits to continue MOUD postpandemic. Prescribing naltrexone extended-release injection prepandemic was associated with preference to continue/expand virtual visits to initiate and continue MOUD (aOR = 1.51; 95%[CI] = 1.10,2.07; aOR = 1.74; 95%[CI] = 1.19,2.54). Qualitative findings suggest that providers appreciated virtual visits due to convenience and patient accessibility, but were concerned about liability and technological barriers.

Conclusions

Surveyed prescribers widely used virtual visits to provide MOUD with overall positive experiences. Future studies should evaluate the impact of virtual visits on MOUD access and retention and clinical outcomes.
To a Centrality of Compassion
Authors: Constantinides Shannon M. , Georges Jane M.
Published: January 2022

The emancipatory theory of compassion, created by Dr Jane Georges, assumes the universality of suffering (physical, psychoemotional, socioeconomic, or biopolitical), and the means by which suffering can be alleviated: compassion. The theory also assumes that nurses can knowingly or unknowingly create environments in which suffering is perpetuated. Through critical review of Georges' work and major caring theories, an operationalized model was developed with which nurses may frame inquiry and practice focused on compassion, the alleviation of suffering through the deconstruction of power relations, and the promotion of health equity, social justice, and human rights.
Art Making as a Health Intervention
Authors: Kim Kyung Soo , Lor Maichou
Published: January 2022

Art making has been adopted across multiple disciplines as a health intervention. However, our understanding of art making as a health intervention and how it differs from art therapy is still limited. Therefore, we conducted a concept analysis to better understand art making as a health intervention guided by Walker and Avant's approach. We examined 85 studies in which we found 4 defining attributes, 4 antecedents, and physical, cognitive, emotional, and psychological consequences. We suggest several nursing research and practical implications for nurse researchers and clinicians to aid in designing and implementing art making health interventions.
Learning in the Third Room—A Way to Develop Praxis by Embracing Differences Between Theoretical and Practical Knowledge
Authors: Dahlborg Elisabeth
Published: January 2022

Contradictions between theory and practice are well known in nursing. To this end, this article discusses a learning strategy that might facilitate the capture of the dialectic between theory and practice, equally valid components of a nurse's competence, giving the 2 forms of knowledge equal relevance. Using a virtual platform (ie, the “third room”) decreases the power order between different forms of knowledge. Nurses, students, and teachers all contribute to a seminar using nonhierarchical structures and concepts to capture the knowledge that enables to learn the praxis of nursing.
Low-Density Pedicle Screw Constructs Are Associated with Lower Incidence of Proximal Junctional Failure in Adult Spinal Deformity Surgery
Authors: Durand Wesley M. , DiSilvestro Kevin J. , Kim Han Jo , Hamilton David K. , Lafage Renaud , Passias Peter G. , Protopsaltis Themistocles S. , Lafage Virginie , Smith Justin S. , Shaffrey Christopher I. , Gupta Munish C. , Klineberg Eric O. , Schwab Frank J. , Gum Jeffrey L. , Mundis Gregory M. , Eastlack Robert K. , Kebaish Khaled M. , Soroceanu Alexandra , Hostin Richard A. , Burton Douglas C. , Bess Shay , Ames Christopher P. , Hart Robert A. , Daniels Alan H.
Published: January 2022

Study Design.

Retrospective cohort study.

Objective.

Determine whether screws per level and rod material/diameter are associated with incidence of proximal junctional kyphosis (PJF).

Summary of Background Data.

PJF is a common and particularly adverse complication of adult spinal deformity (ASD) surgery. There is evidence that the rigidity of posterior spinal constructs may impact risk of PJF.

Methods.

Patients with ASD and 2-year minimum follow-up were included. Only patients undergoing primary fusion of more than or equal to five levels with lower instrumented vertebrae (LIV) at the sacro-pelvis were included. Screws per level fused was analyzed with a cutoff of 1.8 (determined by receiver operating characteristic curve (ROC) analysis). Multivariable logistic regression was utilized, controlling for age, body mass index (BMI), 6-week postoperative change from baseline in lumbar lordosis, number of posterior levels fused, sex, Charlson comorbidity index, approach, osteotomy, upper instrumented vertebra (UIV), osteoporosis, preoperative TPA, and pedicle screw at the UIV (as opposed to hook, wire, etc.).

Results.

In total, 504 patients were included. PJF occurred in 12.7%. The mean screws per level was 1.7, and 56.8% of patients had less than 1.8 screws per level. No differences were observed between low versus high screw density groups for T1-pelvic angle or magnitude of lordosis correction (both P > 0.15). PJF occurred in 17.0% versus 9.4% of patients with more than or equal to 1.8 versus less than 1.8 screws per level, respectively (P < 0.05). In multivariable analysis, patients with less than 1.8 screws per level exhibited lower odds of PJF (odds ratio (OR) 0.48, P < 0.05), and a continuous variable for screw density was significantly associated with PJF (OR 3.87 per 0.5 screws per level, P < 0.05). Rod material and diameter were not significantly associated with PJF (both P > 0.1).

Conclusion.

Among ASD patients undergoing long-segment primary fusion to the pelvis, the risk of PJF was lower among patients with less than 1.8 screws per level. This finding may be related to construct rigidity. Residual confounding by other patient and surgeon-specific characteristics may exist. Further biomechanical and clinical studies exploring this relationship are warranted.

Level of Evidence: 3
The Effect of a Stretch and Strength-Based Yoga Exercise Program on Patients with Neuropathic Pain due to Lumbar Disc Herniation
Authors: Yildirim Pelin , Gultekin Alper
Published: January 2022

Study Design.

Randomized controlled trial.

Objective.

To investigate the effect of a stretch and strengthbased yoga exercise program on neuropathic pain due to LDH.

Summary of Background Data.

LDH with neuropathic pain influences treatment outcomes negatively. Most yoga poses include the parameters of spinal training and help reduce pain and disability in patients with low back injuries. We hypothesized that yoga positively affects both LDH and neuropathic pain by increasing mobilization, core muscle strength, and spinal and hamstring flexibility.

Methods.

In total, 48 patients with neuropathic pain due to LDH were randomly assigned to a control group and a yoga group. All patients underwent a patient education program. In addition, the selected yoga exercise was taught and performed to the yoga group for one hour twice weekly for 12 weeks. Neuropathic pain (Douleur Neuropathique 4 for diagnosis; Leeds Assessment of Neuropathic Symptoms and Signs for severity), low back pain (the short-form of McGill Pain Questionnaire), disability (Oswestry Disability Index), and function (modified Schober and passive knee extension test) were measured blind before and at the one-, three-, and six-month follow-ups. The patient global assessment was applied at the six-month followup. The intention-to-treat analysis was performed in this study.

Results.

The intention-to-treat analysis showed a statistically significant difference in neuropathic pain, patient global assess ment, low back pain, disability, and function in favor of the yoga group at post-treatment. The between-group effect sizes were moderate at six-months follow-up.

Conclusion.

It was determined that the selected stretch and strength-based yoga exercise could be a promising treatment option for neuropathic pain due to LDH.

Level of Evidence.

2
Platelet Phenotype and Function Changes With Increasing Duration of Extracorporeal Membrane Oxygenation
Authors: Van Den Helm Suelyn , Yaw Hui Ping , Letunica Natasha , Barton Rebecca , Weaver Asami , Newall Fiona , Horton Stephen B. , Chiletti Roberto , Johansen Amy , Best Derek , McKittrick Joanne , Butt Warwick , d’Udekem Yves , MacLaren Graeme , Linden Matthew D. , Ignjatovic Vera , Monagle Paul
Published: January 2022

Objectives:

To investigate platelet pathophysiology associated with pediatric extracorporeal membrane oxygenation (ECMO).

Design:

Prospective observational study of neonatal and pediatric ECMO patients from September 1, 2016, to December 31, 2019.

Setting:

The PICU in a large tertiary referral pediatric ECMO center.

Patients:

Eighty-seven neonates and children (< 18 yr) supported by ECMO.

Interventions:

None.

Measurements and Main Results:

Arterial blood samples were collected on days 1, 2, and 5 of ECMO and were analyzed by whole blood flow cytometry. Corresponding clinical data for each patient was also recorded. A total of 87 patients were recruited (median age, 65 d; interquartile range [IQR], 7 d to 4 yr). The median duration of ECMO was 5 days (IQR, 3–8 d) with a median length of stay in PICU and hospital of 18 days (IQR, 10–29 d) and 35 days (IQR, 19–75 d), respectively. Forty-two patients (48%) had at least one major bleed according to a priori determined definitions, and 12 patients (14%) had at least one thrombotic event during ECMO. Platelet fibrinogen receptor expression decreased (median fluorescence intensity [MFI], 29,256 vs 26,544; p = 0.0005), while von Willebrand Factor expression increased (MFI: 7,620 vs 8,829; p = 0.0459) from day 2 to day 5 of ECMO. Platelet response to agonist, Thrombin Receptor Activator Peptide 6, also decreased from day 2 to day 5 of ECMO, as measured by binding with anti-P-selectin, PAC-1 (binds activated GPIIb/IIIa), and anti-CD63 monoclonal antibodies (P-selectin area under the curve [AUC]: 63.46 vs 42.82, respectively, p = 0.0022; PAC-1 AUC: 93.75 vs 74.46, p = 0.0191; CD63 AUC: 55.69 vs 41.76, p = 0.0020).

Conclusions:

The loss of platelet response over time may contribute to bleeding during ECMO. These novel insights may be useful in understanding mechanisms of bleeding in pediatric ECMO and monitoring platelet markers clinically could allow for prediction or early detection of bleeding and thrombosis.
Pseudoaneurysm and Arteriovenous Fistula in the Radial Artery after Cardiac Catheterization: A Case Report
Authors: Maeba Takahiro , Urata Hideki , Nagata Kahori , Haishi Shinya , Sugihara Kana , Shiozawa Kei , Nishimura Gozo
Published: January 2022

We report the case of a 71-year-old man who was experiencing a gradually worsening, dull pain and a cold sensation in his right hand. Three months earlier, he underwent a percutaneous coronary intervention for angina pectoris using a transradial approach in his right wrist and developed an arteriovenous fistula (AVF), a complication of percutaneous coronary intervention. Ultrasonography and computed tomography revealed a pseudoaneurysm and an AVF that were reducing the blood flow in his right hand. We observed that the pseudoaneurysm and the AVF were close to the bifurcation of the superficial palmar artery (SPA) and that the superficial palmar arch had radial artery superiority. Because we thought it was important to maintain the blood flow of the SPA branch, we excised the pseudoaneurysm, sutured the artery directly via microsurgery, and ligated the arteriovenous shunt. After the operation, the patient’s symptoms were alleviated. Computed tomography showed that the blood flow in his right hand was improved and that his right SPA branch from the radial artery was directly fed to the index finger. Because the blood circulation in the hand is dual dominant but with many anatomical variations, we believe that it is important to preserve the blood flow of the SPA in postcatheterization pseudoaneurysm and AVF repair.