bluuebunny/crossref_metadata_2025 huggingface dataset:
Review and new concepts for neutron-capture measurements of astrophysical interest
Authors: Domingo-Pardo C. , Babiano-Suarez V. , Balibrea-Correa J. , Caballero L. , Ladarescu I. , Lerendegui-Marco J. , Tain J. L. , Calviño F. , Casanovas A. , Segarra A. , Tarifeño-Saldivia A. E. , Guerrero C. , Millán-Callado M. A. , Quesada J. M. , Rodríguez-González M.T. , Aberle O. , Alcayne V. , Amaducci S. , Andrzejewski J. , Audouin L. , Bacak M. , Barbagallo M. , Bennett S. , Berthoumieux E. , Bosnar D. , Brown A. S. , Busso M. , Caamaño M. , Calviani M. , Cano-Ott D. , Cerutti F. , Chiaveri E. , Colonna N. , Cortés G. P. , Cortés-Giraldo M. A. , Cosentino L. , Cristallo S. , Damone L. A. , Davies P. J. , Diakaki M. , Dietz M. , Dressler R. , Ducasse Q. , Dupont E. , Durán I. , Eleme Z. , Fernández-Domíngez B. , Ferrari A. , Ferro-Gonçalves I. , Finocchiaro P. , Furman V. , Garg R. , Gawlik A. , Gilardoni S. , Göbel K. , González-Romero E. , Gunsing F. , Heyse J. , Jenkins D. G. , Jericha E. , Jiri U. , Junghans A. , Kadi Y. , Käppeler F. , Kimura A. , Knapová I. , Kokkoris M. , Kopatch Y. , Krticka M. , Kurtulgil D. , Lederer-Woods C. , Lonsdale S.-J. , Macina D. , Manna A. , Martínez T. , Masi A. , Massimi C. , Mastinu P. F. , Mastromarco M. , Maugeri E. , Mazzone A. , Mendoza E. , Mengoni A. , Michalopoulou V. , Milazzo P. M. , Mingrone F. , Moreno-Soto J. , Musumarra A. , Negret A. , Ogállar F. , Oprea A. , Patronis N. , Pavlik A. , Perkowski J. , Petrone C. , Piersanti L. , Pirovano E. , Porras I. , Praena J. , Ramos Doval D. , Reifarth R. , Rochman D. , Rubbia C. , Sabaté-Gilarte M. , Saxena A. , Schillebeeckx P. , Schumann D. , Sekhar A. , Smith A. G. , Sosnin N. , Sprung P. , Stamatopoulos A. , Tagliente G. , Tassan-Got L. , Thomas B. , Torres-Sánchez P. , Tsinganis A. , Urlass S. , Valenta S. , Vannini G. , Variale V. , Vaz P. , Ventura A. , Vescovi D. , Vlachoudis V. , Vlastou R. , Wallner A. , Woods P. J. , Wright T. J. , Žugec P.
Published: November 2020

The idea of slow-neutron capture nucleosynthesis formulated in 1957 triggered a tremendous experimental effort in different laboratories worldwide to measure the relevant nuclear physics input quantities, namely (n, γ) cross sections over the stellar temperature range (from few eV up to several hundred keV) for most of the isotopes involved from Fe up to Bi. A brief historical review focused on total energy detectors will be presented to illustrate how advances in instrumentation have led to the assessment of new aspects of s-process nucleosynthesis and to the progressive refinement of stellar models. A summary will be presented on current efforts to develop new detection concepts, such as the Total-Energy Detector with γ-ray imaging capability (i-TED). The latter is based on the simultaneous combination of Compton imaging with neutron time-of-flight (TOF) techniques, in order to achieve a superior level of sensitivity and selectivity in the measurement of stellar neutron capture rates.
GeoGebra as learning tool for the search of the roots of functions in numerical methods
Authors: Arceo-Díaz S , Bricio Barrios E E , Aréchiga Maravillas J , Salazar-Torres J
Published: November 2020

Physics is capable of describing, through equations, phenomena on a micro and macroscopic scale. However, most of these equations are non-linear and the identification of their roots requires the use of approximation methods, with numerical methods being a proposal based on a systematic and iterative process, that conclude only when a pre-established tolerance is satisfied. Traditional teaching of numerical methods involves the memorization of algorithms. However, this hinders student’s ability to understand the important aspects and then apply them for solving applied problems in subjects such as kinematics, dynamics, electromagnetism, etc. Therefore, this work proposes the use of GeoGebra, as a didactic tool to illustrate the functioning of single root searching algorithms. By using the dynamical graphic’s view of GeoGebra, a series of abstract and applied problems where solved by engineering students taking a numerical methods course. The scores of this test group was then compared to a test group, taught trough algorithm memorization. Results show can improve their understanding of how the bisection, false position, secant, and Newton-Raphson methods are able to find approximated solutions to polynomial and trigonometric equations. The results are compared against traditional learning, based on memorizing the steps of the algorithm for each method and the representation of the convergence of successive roots by numerical tables.
Analysis on the mechanic resistance and water absorption capacity of prototype mortar with residual coconut mesocarp and fiber aggregates
Authors: Pérez Valdovinos A S , Ramirez Rivera M , Correa Fuentes D A , Moreno Peña J R , Arceo Díaz S
Published: November 2020

Material physics has traditionally been used in the area of mechatronics and aeronautical engineering. However, in recent years, bioclimatic architecture has used physical principles and conservation of matter to evaluate the performance of buildings where the comfort and safety of its inhabitants are sought, with the mortar being an adequate alternative in minimizing heat transfer. However, this material is fragile and has a high risk of fragmentation. This problem has been addressed through the incorporation of inorganic aggregates to maximize their mechanical properties but the cost of production is high compared to the traditional process. This work proposes the analysis of cement-sand modules with coconut endocarp and mesocarp (coconut fiber) aggregates, by evaluating their mechanical resistance, under a compressing force, and permeability and comparing to current regulations. The results showed that coconut fiber has a large impact on the mechanical resistance of the prototypes: a proportion of fiber greater than 3% compromises the mechanical resistance of the prototypes due to the water adsorption capacity of coconut fiber. Whereas, the prototypes identified under the endocarp to fiber ratio of 10% to 1% showed the highest performance in the deformation tests under compression with respect to the modules without the presence of this waste material. The resulting mixture meets the Mexican standard for mortar and could be an alternative for avoiding the burning of plant residues in regions with an active coconut industry.
Descriptive analysis of storytelling concepts in physics
Authors: Rojas-Suarez J P , Gallardo Pérez H J , Vergel-Ortega M
Published: November 2020

The research identifies storytelling concepts in Physics from university professors. The research follows a qualitative approach applied to 250 participants from universities in the department Norte de Santander, Colombia. The design implements as an interview technique the Socratic dialogue and as a quantitative support used elements of the correlational design. Interview and virtual survey instruments had a kappa index equal to 0.8 and α = 0.78. The results identify three categories associated with the application of science, the function of the history of Physics and scientific production. It is concluded that participant’s concept storytelling is the art of telling a story in motion and a didactic resource associated with approaches, the development of skills, useful to analyse the development of discoveries in Physics, its actors, its application in scientific advances and its contribution to innovation and community development. Classical mechanics, electricity and magnetism with storytelling, identifies in physical science axiological aspects associated with tradition; epistemological aspects associated with experimental physics; and critical aspects.
Beliefs of students around the study of physics in basic secondary and technical education
Authors: Prada-Núñez R , Gamboa-Suárez A A , Hernández-Suárez C A
Published: November 2020

This research is part of a line of research in education that aims to determine the degree of influence that affects have on the study of basic sciences that usually generate high rates of academic loss or repetition in school environments. The aim of this research was to analyze the system of beliefs that a group of students had about themselves as physics students, about physics as a discipline, about the physics teacher and his or her teaching practices, and about the importance of this area of knowledge in their social environment. To achieve this objective, a private educational institution is intentionally selected, with a home in San José de Cúcuta, Colombia, characterized by good results in the Saber 11 state tests. The informants were all students enrolled in 2019 in grades nine and eleven. A questionnaire was designed consisting of 36 items evaluated by means of a Likert scale with five levels of response. The results attested to the internal consistency and validity of the questionnaire. Subsequently, a complete characterization of the informants was carried out, allowing us to discover that the women in the sample have a better attitude and abilities in the study of physics. Finally, a factorial analysis was carried out in order to verify whether the opinions of the respondents fit into the four categories of beliefs considered by the researchers. Six factors were identified that explain 80% of the common variance, highlighting within them the beliefs that the student has about himself and his relationship with the teacher as the main factor explaining 41% of the variance.
Differential Alcohol Use Disparities by Sexual Identity and Behavior Among High School Students
Authors: Phillips II Gregory , Wang Xinzi , Ruprecht Megan M , Felt Dylan , McCuskey David , Stephens Reno , Perez-Bill Esrea , Beach Lauren B
Published: November 2020

Aims

Sexual minority youth (SMY) use alcohol at disproportionate rates compared to their heterosexual peers. However, sexual orientation is multidimensional. Analyzing alcohol use disparities only by one dimension of sexual orientation may result in critical disparities being obscured.

Methods

Data from state and local versions of the Youth Risk Behavior Survey were pooled (2009–2017), resulting in a large, diverse sample (n = 201,671). Multivariable logistic regression models were used to analyze associations between sexual identity/sexual behavior and three alcohol use outcomes among sexually active youth: age at first drink, binge drinking and current drinking.

Results

SMY, when categorized by sexual identity and sexual behavior, reported greater alcohol use than their heterosexual peers, though the magnitude of these disparities varied by subgroup. Both those who identified as bisexual and those who reported sexual behavior with both males and females reported the greatest levels of alcohol use. Decomposition analysis revealed that youth whose reported sexual behavior was not aligned with stereotypical behavioral expectations based on their sexual identity had higher odds of current drinking and drinking before 13 years as compared to other youth.

Conclusions

Results highlight the need to incorporate multiple methods of sexual orientation measurement into substance use research. Interventions based solely on identity, rather than both identity and behavior, may not be sufficient; targeted research into the causes of alcohol use disparities is needed, especially for bisexual youth, youth whose sexual behavior and sexual identity are not stereotypically aligned, and youth who report a sexual identity of ‘not sure.’
Analysis of Aspirin, Prasugrel and Clopidogrel in Counterfeit Pharmaceutical and Herbal Products: Plackett–Burman Screening and Box–Behnken Optimization
Authors: Mohammad Mohammad Abdul-Azim , Elkady Ehab Farouk , Fouad Marwa Ahmed , Salem Wadhah Atef
Published: November 2020

An isocratic reversed-phase high-performance liquid chromatographic method has been developed and validated for the simultaneous determination of aspirin, prasugrel HCl and clopidogrel bisulfate in the presence of clopidogrel-related compound (impurity-A) in focus on counterfeit. This method was used to determine counterfeited antiplatelet drugs in two substandard Indian pharmaceutical products sold on the market in Yemen and two traditional herbal medicines sold on the market in China. Thin layer chromatography and mass spectrometry of counterfeit herbal medicines have additionally been carried out to verify the identification of adulterants. Chromatographic separation was performed on Inertsil ® ODS-3 C18 (4.6 × 250 mm, 5 μm) with isocratic mobile phase elution containing a mixture of acetonitrile: (25 mM) potassium dihydrogen phosphate buffer, pH 2.7 adjusted with 0.1 M o-phosphoric acid (79: 21, v/v), at a flow rate of 1 mL/min and UV detection at 220 nm. Designs of experiment methodology, Plackett–Burman and Box–Behnken designs were used for the screening and optimization of the mobile phase composition. The method validation was also performed in accordance with the International Council on Harmonization (ICH) guidelines. The method developed for routine analysis was found to be sensitive, simple, accurate and highly robust. The results were statistically compared to reference methods using Student’s t-test and variance ratio F-test at P < 0.05.
Enhanced Detection of Genitourinary Cancers Using Fragmentation and Copy Number Profiles Obtained from Urinary Cell-Free DNA
Authors: Han Yang , Li Xinxin , Zhang Mingxin , Yang Yang , Ge Guangzhe , Wang Kunxiang , Gong Yanqing , Liang Yuan , Niu Haitao , Ci Weimin
Published: November 2020

Background

Recent studies have reported that examining the fragmentation profiles (FP) of plasma cell-free DNA (cfDNA) further improves the clinical sensitivity of tumor detection. We hypothesized that considering the differences of the FP of urinary cfDNA would increase the clinical sensitivity of genitourinary (GU) cancer detection.

Methods

177 patients with GU cancer and 94 individuals without tumors were enrolled in the discovery cohort. An independent validation dataset comprising 30 patients without tumors and 66 patients with GU cancer was also collected. We constructed an ensemble classifier, GUIDER, to detect and localize GU cancers using fragmentation and copy number profiles obtained from shallow whole-genome sequencing of urinary cfDNA.

Results

Urinary cfDNA of patients with GU cancer had a higher proportion of long fragments (209–280 bp) and a lower proportion of short fragments (140–208 bp) compared to controls. The overall mean classification accuracy of the FP was 74.62%–85.39% for different algorithms, and integration of the FP and copy number alteration (CNA) features further enhanced the classification of samples from patients with GU cancer. The mean diagnostic accuracy was further improved by the ensemble classifier GUIDER, which integrated the FP and CNA profiles and resulted in a higher mean accuracy (87.52%) compared to the analysis performed without FP features (74.62%). GUIDER performed well in an independent validation dataset.

Conclusions

The lengthening and shortening of urinary cfDNA within specific size ranges were identified in patients with GU cancer. Integration of the FP should further enhance the ability to use urinary cfDNA as a molecular diagnostic tool.
Sovereign Default, Domestic Banks and Exclusion from International Capital Markets
Authors: Thaler Dominik
Published: November 2020

Why do governments borrow internationally? Why do they temporarily remain out of international financial markets after default? This paper develops a quantitative model of sovereign default to propose a unified answer to these questions. In the model, the government has an incentive to borrow internationally since the domestic return on capital exceeds the world interest rate, due to a friction in the banking sector. Since banks are exposed to sovereign debt, sovereign default causes a financial crisis. After default, the government chooses to reaccess international capital markets only once banks have recovered and efficiently allocate investment again. Exclusion hence arises endogenously.
Types of grocery stores and demographic and household factors in Japanese provincial area
Authors: Kiyohara A , Daimon H , Yamaguchi M , Ueda Y
Published: November 2020

Background

Neighborhood grocery stores, such as supermarkets (SM) and convenience stores (CVS), have received attention as a determinant of a food purchase behavior. Previous studies reported that grocery store entry or closure was associated with regional populations. This study examines the association of types of SM (i.e. cross-regional, local, or small chain stores), CVS, and household demographics in the cities, towns and villages (having its own incorporated government) in Hiroshima and Okayama Prefectures, Japan.

Methods

We hypothesized that the entry and closure of SM, CVS are associated with the regional population and type of family household from interview surveys with supermarket and wholesale operators. We collected data on SM and CVS from Large-Scale Retail Store Data in Japan, while data on demographics and households were collected from the census. Data sets from 59 municipalities (city, town, ward, and village) and 49 SM chains (498 stores) and 8 CVS chains (1235 stores) were analyzed using multiple regression analysis.

Results

Some household factors showed significant associations with the number of SM and CVS at the municipality level. Those municipalities with a greater number of extended families and single households had significantly more “cross-regional” as well as “local chain SM” stores. Those municipalities with more nuclear families had significantly more “small chain SM” and fewer “local chain SM” stores. Those municipalities with more single households had significantly fewer SM stores.

Conclusions

In these prefectures, population declining and single household increasing are expected over the coming decades. If no political interventions are allowed on this issue, some of “food desert” may emerge for the hundreds of thousands people living in these areas; elderly people may not get fresh vegetables in their neighborhood, and young parents will have to drive for hours to “cross-regional SM” to buy fresh milk for their children.

Key messages

Supermarkets and convenience stores are determinant of a food purchase behavior. The association of the number of types of SM, CVS, and demographic and household factors.
Embryo implantation in the laboratory: an update on current techniques
Authors: Ojosnegros Samuel , Seriola Anna , Godeau Amélie L , Veiga Anna
Published: November 2020

BACKGROUND

The embryo implantation process is crucial for the correct establishment and progress of pregnancy. During implantation, the blastocyst trophectoderm cells attach to the epithelium of the endometrium, triggering intense cell-to-cell crosstalk that leads to trophoblast outgrowth, invasion of the endometrial tissue, and formation of the placenta. However, this process, which is vital for embryo and foetal development in utero, is still elusive to experimentation because of its inaccessibility. Experimental implantation is cumbersome and impractical in adult animal models and is inconceivable in humans.

OBJECTIVE AND RATIONALE

A number of custom experimental solutions have been proposed to recreate different stages of the implantation process in vitro, by combining a human embryo (or a human embryo surrogate) and endometrial cells (or a surrogate for the endometrial tissue). In vitro models allow rapid high-throughput interrogation of embryos and cells, and efficient screening of molecules, such as cytokines, drugs, or transcription factors, that control embryo implantation and the receptivity of the endometrium. However, the broad selection of available in vitro systems makes it complicated to decide which system best fits the needs of a specific experiment or scientific question. To orient the reader, this review will explore the experimental options proposed in the literature, and classify them into amenable categories based on the embryo/cell pairs employed.

The goal is to give an overview of the tools available to study the complex process of human embryo implantation, and explain the differences between them, including the advantages and disadvantages of each system.

SEARCH METHODS

We performed a comprehensive review of the literature to come up with different categories that mimic the different stages of embryo implantation in vitro, ranging from initial blastocyst apposition to later stages of trophoblast invasion or gastrulation. We will also review recent breakthrough advances on stem cells and organoids, assembling embryo-like structures and endometrial tissues.

OUTCOMES

We highlight the most relevant systems and describe the most significant experiments. We focus on in vitro systems that have contributed to the study of human reproduction by discovering molecules that control implantation, including hormones, signalling molecules, transcription factors and cytokines.

WIDER IMPLICATIONS

The momentum of this field is growing thanks to the use of stem cells to build embryo-like structures and endometrial tissues, and the use of bioengineering to extend the life of embryos in culture. We propose to merge bioengineering methods derived from the fields of stem cells and reproduction to develop new systems covering a wider window of the implantation process.
Trawl and eDNA assessment of marine fish diversity, seasonality, and relative abundance in coastal New Jersey, USA
Authors: Stoeckle Mark Y , Adolf Jason , Charlop-Powers Zachary , Dunton Keith J , Hinks Gregory , VanMorter Stacy M
Published: November 2020

Environmental DNA (eDNA) technology potentially improves the monitoring of marine fish populations. Realizing this promise awaits better understanding of how eDNA relates to fish presence and abundance. Here, we evaluate performance by comparing bottom trawl catches to eDNA from concurrent water samples. In conjunction with New Jersey Ocean Trawl Survey, 1-l water samples were collected at surface and depth prior to tows at about one-fourth of Survey sites in January, June, August, and November 2019. eDNA fish diversity from 1 l was same as or higher than trawl fish diversity from 66 M litres swept by one tow. Most (70–87%) species detected by trawl in a given month were also detected by eDNA, and vice versa, including nearly all (92–100%) abundant species. Trawl and eDNA peak seasonal abundance agreed for ∼70% of fish species. In log-scale comparisons by month, eDNA species reads correlated with species biomass, and more strongly with an allometric index calculated from biomass. In this 1-year study, eDNA reporting largely concorded with monthly trawl estimates of marine fish species richness, composition, seasonality, and relative abundance. Piggybacking eDNA onto an existing survey provided a relatively low-cost approach to better understand eDNA for marine fish stock assessment.
Mindset First, Strategy Second: Finding the Savings and Performance in Changing Culture
Authors: Gibson David R
Published: November 2020

Resolving major challenges for health care organizations is a constant challenge. Each military service provides its leaders with superb education and training to lead the constant needs and changes of the mission requirements. The primary trap we leaders may fall into, though, is when we mistake our own expertise and perspectives as the solutions to our organizational challenges. To fully unleash the potential of our people and organizations, we must be deliberate in setting a culture that leverages all the diversity within our organization. At the Carl R. Darnall Army Medical Center, Fort Hood, TX, our leadership team initiated an effort to shift the organizational mindset to create this cultural soil. The seeds of our education, training and strategic initiatives then were able to flourish and address our organizational challenges, but only after we addressed our own leadership mindset gap. By establishing and modeling a foundational outward mindset to ensure our team focused on the impact of our actions, we nurtured a culture that was inquisitive, collaborative, and without blame. In doing so, we eliminated negative financial and safety outcomes that threatened our institution and transformed it into a leading Army Medical Center.
IDH-wildtype lower-grade diffuse gliomas: the importance of histological grade and molecular assessment for prognostic stratification
Authors: Berzero Giulia , Di Stefano Anna Luisa , Ronchi Susanna , Bielle Franck , Villa Chiara , Guillerm Erell , Capelle Laurent , Mathon Bertrand , Laurenge Alice , Giry Marine , Schmitt Yohann , Marie Yannick , Idbaih Ahmed , Hoang-Xuan Khe , Delattre Jean-Yves , Mokhtari Karima , Sanson Marc
Published: November 2020

Background

Isocitrate dehydrogenase (IDH) wildtype (wt) grade II gliomas are a rare and heterogeneous entity. Survival and prognostic factors are poorly defined.

Methods

We searched retrospectively all patients diagnosed with diffuse World Health Organization (WHO) grades II and III gliomas at our center (1989–2020).

Results

Out of 517 grade II gliomas, 47 were “diffuse astrocytomas, IDHwt.” Tumors frequently had fronto-temporo-insular location (28/47, 60%) and infiltrative behavior. We found telomerase reverse transcriptase (TERT) promoter mutations (23/45, 51%), whole chromosome 7 gains (10/37, 27%), whole chromosome 10 losses (10/41, 24%), and EGFR amplifications (4/43, 9%), but no TP53 mutations (0/22, 0%). Median overall survival (OS) was 59 months (vs 19 mo for IDHwt grade III gliomas) (P < 0.0001). Twenty-nine patients (29/43, 67%) met the definition of molecular glioblastoma according to cIMPACT-NOW update 3. Median OS in this subset was 42 months, which was shorter compared with patients with IDHwt grade II gliomas not meeting this definition (median OS: 57 mo), but substantially longer compared with IDHwt grade III gliomas meeting the definition for molecular glioblastoma (median OS: 17 mo, P < 0.0001). Most patients with IDHwt grade II gliomas met cIMPACT criteria because of isolated TERT promoter mutations (16/26, 62%), which were not predictive of poor outcome (median OS: 88 mo). Actionable targets, including 5 gene fusions involving FGFR3, were found in 7 patients (24%).

Conclusions

Our findings highlight the importance of histological grading and molecular profiling for the prognostic stratification of IDHwt gliomas and suggest some caution when assimilating IDHwt grade II gliomas to molecular glioblastomas, especially those with isolated TERT promoter mutation.
Kyasanur forest disease: a state-of-the-art review
Authors: Gupta N , Wilson W , Neumayr A , Saravu K
Published: November 2020

Kyasanur forest disease (KFD) virus is a flavivirus that can be transmitted to humans from monkeys or other mammals through hard ticks (Haemaphysalis spinigera). The disease is endemic to 16 districts in 5 states of Southern India and is reported in the dry season, most commonly in humans travelling to the forests in these areas. The aim of this systematic review is to raise awareness of the clinical and laboratory manifestation of KFD among physicians and travel medicine practitioners. A total of 153 articles were screened of which 16 articles that met the inclusion and exclusion criteria were included for qualitative analysis. KFD is an acute haemorrhagic fever with a biphasic component in some individuals. The second phase is usually marked by neurological symptoms. Leucopoenia, thrombocytopenia and elevated transaminases are the hallmarks of the first phase of KFD. The diagnostic modality of choice in the first few days of illness is polymerase chain reaction assay, whereas serology is used in the late phase. In the absence of a specific antiviral treatment, the clinical management of patients is limited to supportive care. Avoidance of exposure and vaccination is recommended to prevent this infection.
Radiologic Manifestations of Recreational Drug Abuse
Authors: Chaudhry Ammar A. , Gul Maryam , Baker Kevin S. , Gould Elaine S.
Published: November 2020

Recreational drug abuse (RDA) is a commonly encountered clinical problem that, according to the Centers for Disease Control and Prevention (CDC), has resulted in a continuous steady increase in usage, morbidity, and mortality over the last two decades. The clinical picture of RDA is often opaque due to its extensive range of clinical presentation. As the problem becomes more widespread and many patients withhold a history of RDA, the radiologist frequently is first to note and suggest the possibility of RDA. Familiarity with the radiologic manifestations of RDA is critical to provide accurate diagnosis with a succinct differential diagnosis and to allow for prompt treatment of patients with this potentially fatal condition.
Wood’s and Guedel’s Legacies Return to the Heartland
Authors: Bause George S.
Published: November 2020

Pioneering anesthesiologists Paul Wood, M.D., and Arthur Guedel, M.D., were Hoosiers who migrated from America’s Heartland to opposite coasts. Dr. Wood moved east to New York in 1913; Dr. Guedel, west to California in 1928. By 1962, each pioneer had been honored with a namesake anesthesia museum. Fast-forwarding 55 yr, two young anesthesia historians, California’s Jane Moon, M.D., and Pennsylvania’s Melissa Coleman, M.D., met at the 2017 International Symposium of the History of Anesthesia in Boston. Today, these women are chairs of the Wood Library-Museum’s Archives and Museum Committees, respectively. As the newest authors of “Anesthesiology Reflections,” Drs. Coleman and Moon leave their coastal states semiannually for board meetings at the Wood Library-Museum of Anesthesiology, returning as legacies of Drs. Wood and Guedel…back to the American Heartland.
Depression as a Risk Factor for Developing Heart Failure
Authors: Cao Lihuan , Sheng Chun , Luo Guo , Ou Jinnan
Published: November 2020

Background

The associations of depression with incident heart failure (HF) risk based on epidemiological studies have been inconsistent.

Objective

We aimed to quantitatively estimate the relative effect of depression on the development of HF.

Methods

We performed a systematic review and meta-analysis of cohort studies published between January 1, 1950, and August 31, 2019, from PubMed, Embase, and the Science Citation Index databases. We selected prospective cohort studies reporting the relationship between depression and incident HF. Maximally adjusted hazard ratios and their 95% confidence intervals were combined using a random-effects model. The heterogeneity across studies was calculated by the I
2 statistic. This meta-analysis was registered in PROSPERO (number CRD42020149274).

Results

Six population-based, prospective cohort studies with 4727 HF events among 131 282 participants were eligible for meta-analysis. Compared with participants reporting no depression, those with depression had a 23% increased risk of developing HF (pooled hazard ratio, 1.23; 95% confidence interval, 1.08–1.41). There was no significant heterogeneity across studies (χ
2 = 7.75, df = 5, P = .17, I
2 = 35.5%).

Conclusion

Published literature supports a significant association of depression with an increased incidence of HF in the general population.
Ixazomib-associated tumor lysis syndrome in multiple myeloma
Authors: Jin Fengbo , Yang Mingzhen , Chen Yingying , Jiang Lei , Liu Lixia
Published: November 2020

Rationale:

Tumor lysis syndrome (TLS) is an oncologic emergency, but its incidence in MM is rare. To our knowledge, ixazomib has not been associated with TLS in MM.

Patient concerns:

The patient developed TLS after 10 days of treatment with ixazomib, accompanied by renal failure of hyperuricemia, hyperkalemia, and hyperphosphatemia.

Diagnoses:

MM (type IgG λ) was diagnosed according to the diagnostic criteria established by the International Myeloma Working Group and classified stage IIA by the International Staging System. TLS was diagnosed after the patient met all three criteria of the Cairo-Bishop TLS scoring system.

Interventions:

From April 8, 2017, the patient was treated with 3 courses of bortezomib, cyclophosphamide, and dexamethasone chemotherapy. From August 18, she received five courses of bortezomib combined with DCEP chemotherapy. On May 21, 2018 treatment was switched to lenalidomide, bortezomib, and dexamethasone for four courses. Ixazomib was started on October 10, 2018 with cyclophosphamide and dexamethasone. On October 19, 2018 vigorous intravenous hydration with sodium bicarbonate was initiated and peroral febuxostat was administered.

Outcomes:

On October 19, changes in hematological indicators raised concern for TLS worsening kidney function and decreasing urine output. She refused renal replacement treatment for TLS-induced acute kidney injury. On October 26th, the patient died of respiratory failure.

Lessons:

This case highlights the need to vigilant for the occurrence of TLS in patients undergoing MM treatment with ixazomib. Higher baseline uric acid or creatinine, rapidly progressive anemia, and raised lactate dehydrogenase (LDH) and β2-microglobulin may be surrogate markers of TLS.
Airway invasion in non-neurologically ill patients with dysphagia
Authors: Kim Kang Lip , Park Gi-Young , Kwon Dong Rak , Kwon Do Yun , Kwak Sang Gyu , Cho Hee Kyung
Published: November 2020

Dysphagia can occur among patients receiving medical care despite having no history of neurologic disease. The current study aimed to investigate factors contributing to airway invasion among non-neurologically ill patients with dysphagia.

This retrospective study included 52 non-neurologically ill patients who complained of swallowing difficulty and consulted the Department of Rehabilitation Medicine for videofluoroscopic swallowing studies between January 2018 and June 2019. Patients were then divided into 2 groups according to the presence of airway invasion (penetration or aspiration) based on videofluoroscopic swallowing study findings, with group 1 (n = 26) consisting of patients with airway invasion and group 2 (n = 26) consisting of those without airway invasion. Demographic information, functional ambulation ability within the past 3 months, presence of community acquired pneumonia (CAP), nutritional status, degree of dehydration, history of intensive care unit stay, history of endotracheal intubation, and videofluoroscopic dysphagia scale were reviewed.

Patients with airway invasion exhibited decreased functional ambulation ability, greater incidence of CAP, and lower serum albumin concentration than patients without airway invasion (P < .05). Airway invasion among non-neurologically ill patients was significantly associated with functional ambulation ability [odds ratio (OR), 3.57; 95% confidence interval (CI), 1.14–11.19;P = .03], serum albumin concentration under 3.5 g/dL (OR, 4.90; 95% CI, 1.39–17.32;P = .01), and presence of CAP (OR, 5.06; 95% CI, 1.56–16.44;P = .01). Groups 1 and 2 had a videofluoroscopic dysphagia scale score of 37.18 and 16.17, respectively (P < .05). Moreover, bolus formation, tongue-to-palate contact, premature bolus loss, vallecular residue, coating of pharyngeal wall, and aspiration score differed significantly between both groups (P < .05).

Airway invasion among non-neurologically ill patients was related to decreased functional ambulation ability, lower serum albumin concentration, and presence of CAP. The results presented herein can help guide clinical management aimed at preventing airway invasion among non-neurologically ill patients.
Long‐term Outcomes of Children With Pediatric Feeding Disorders Treated in an Inpatient Multidisciplinary Program
Authors: Kim Cindy , Brown Shonda , Brown Jessica , Ornelas Elisa
Published: November 2020

The purpose of this longitudinal observational study was to evaluate the effectiveness of a multidisciplinary inpatient treatment model for feeding disorders by analyzing long‐term nutritional and health outcomes 12 months following discharge. Fifty patients completed the study. Average caloric intake by mouth as a percentage of goal for gastrostomy tube (GT)‐dependent patients (n = 31) increased from pre‐admit, week 1, and week 2 of the inpatient program (30%, 70%, and 84%, respectively), and was sustained from week 3 to 12‐month follow‐up (85% and 86%, respectively). Eighty‐one percentage were discharged without GT support and 65% remained off GT support at 12 months. Oral supplement dependence for non‐GT patients (n = 19) decreased from pre‐admit, discharge, and 12‐month follow‐up (51%, 31%, and 19% of caloric intake, respectively). BMI z‐scores improved during and after treatment. The present study demonstrated an effective approach for treatment of pediatric feeding disorders, including decreased reliance on oral supplementation and GT dependence.
Substance Use, Mental Health Problems, and Physical and Sexual Violence Additively Increase HIV Risk Between Male Sex Workers and Their Male Clients in Northeastern United States
Authors: Mimiaga Matthew J. , Hughto Jaclyn M. W. , Klasko-Foster Lynne , Jin Harry , Mayer Kenneth H. , Safren Steven A. , Biello Katie B.
Published: November 2020

Background:

Male sex workers (MSW) are disproportionately affected by HIV/AIDS, with an estimated HIV prevalence in the United States of 19.3%. Existing research suggests that MSW are also at risk of adverse psychosocial problems. Cross-sectional studies of MSW have suggested that co-occurring epidemics or a “syndemic” of psychosocial problems may increase vulnerability to HIV acquisition/transmission by elevated sexual risk. To the best of our knowledge, there are no published studies examining this relationship longitudinally among MSW. This study examined how a syndemic of 6 psychosocial problems result in additive risk for condomless anal sex (CAS) with male clients among a multicity, longitudinal cohort of MSW.

Setting:

Community-based organization and health center in 2 Northeastern US cities.

Methods:

Between 2015 and 2017, 100 MSW from Boston, MA and Providence, RI completed behavioral/psychosocial surveys at baseline, 6 months, and 12months. Generalized estimating equation modeling was used to examine the prospective relationship of additive psychosocial problems and subsequent CAS with male clients, adjusting for age, site, race/ethnicity, MSW-type, and HIV serostatus.

Results:

Mean age = 34.7 (SD = 11.8); 62% racial/ethnic minority; and 20% HIV+. The prevalence of 6 psychosocial syndemic problems was substantial at baseline and remained high at each time point (all within the past 6 months): 74% problematic depressive symptoms, 27% polydrug use (3+ drugs, not including stimulants), 57% stimulant (methamphetamine/cocaine/crack) use, 44% hazardous drinking, 15% experienced client-specific physical/sexual violence, and 57% childhood sexual abuse. Looking at the number of psychosocial problems experienced, 7% had zero, 27% had 1, 24% had 2, 27% had 3, and 15% had 4 or more. We identified a statistically significant positive “dose-response” relationship between the number of psychosocial problems and CAS with male clients over time, with the greatest odds of engaging in CAS with a male client over follow-up among those with 4 or more psychosocial problems (adjusted odds ratio = 5.18, 95% CI: 1.61 to 16.62).

Conclusions:

Internet escorts and street-based MSW are likely to experience psychosocial problems and engaging in HIV sexual risk with male clients. The accumulation of psychosocial problems additively predicted CAS with male clients in a prospective cohort of MSW. The specification of psychosocial problems presents distinct treatment targets for HIV prevention among MSW in the United States.
Effect of Emotional Response on the Performance of a Simulated Laparoscopic Task
Authors: Yang Jin , Zheng Bin , Cai Xiujun , Wang Zhifei , Yu Hong , Cheng Yun , Yu Xiaojun
Published: November 2020

Introduction

An emotional state impacts task performance and cognition. However, evidence of the effect of an induced emotional state on laparoscopic performance has not yet been documented. We investigated whether surgical residents in whom a positive emotion had been induced would produce a better laparoscopic task performance than residents in whom a negative emotional state had been induced.

Methods

This controlled laboratory study recruited a total of 53 junior surgical residents who were divided into 3 groups. Each group was required to watch 1 of 3 ten-minute videos designed to evoke a positive, neutral, or negative emotion before performing a laparoscopic cholecystectomy on a virtual simulation model. Task performances, as evaluated by a global assessment form and psychomotor metrics that included task time, errors, and path lengths, were compared between the 3 groups.

Results

Video watching induced different emotions, as measured by a Visual Analog Scale on feelings. The task time was significantly shorter in the positive (13.7 ± 2.5 minutes) than in the neutrally (17.7 ± 3.9 minutes) and the negatively (18.5 ± 3.8 minutes) induced-emotion groups (P < 0.001).

Participants in the positive emotion group completed a laparoscopic cholecystectomy with a significantly lower error rate (2 vs. 4 vs. 7, P = 0.036) and shorter right-handed path length (1089.6 ± 250.6 cm vs. 1287.2 ± 355.5 cm vs. 1410.3 ± 304.1 cm, P = 0.010) than the participants in the neutral and negative emotion groups.

Conclusions

A positive emotion can enhance a simulated laparoscopic task performance as assessed by task time and path length. The results indicate that we might improve surgical task performance by adjusting the surgeon's emotional state. We plan a future study that will continue to investigate whether positive emotions can facilitate skill learning.
Psychometric Validation of Central Venous Catheter Insertion Mastery Learning Checklist Data and Decisions
Authors: McGaghie William C. , Adams William H. , Cohen Elaine R. , Wayne Diane B. , Barsuk Jeffrey H.
Published: November 2020

Introduction

Resident physicians are expected to acquire competence at central venous catheter (CVC) insertion to a mastery standard. Valid competence decisions about resident physicians' CVC performance rely on reliable data and rigorous achievement standards. This study used data from 3 CVC simulation-based mastery learning studies involving internal medicine (IM) and emergency medicine (EM) residents to address 2 questions: What is the effectiveness of a CVC mastery learning education intervention? Are minimum passing standards (MPSs) set by faculty supported by item response theory (IRT) analyses?

Methods

Pretraining and posttraining skills checklist data were drawn from 3 simulation-based mastery learning research reports about CVC internal jugular (IJ) and subclavian (SC) insertion skill acquisition. Residents were required to meet or exceed a posttest skills MPS. Generalized linear mixed effect models compared checklist performance from pre to postintervention. Minimum passing standards were determined by Angoff and Hofstee standard setting methods. Item response theory models were used for cut-score evaluation.

Results

Internal medicine and EM residents improved significantly on every IJ and SC checklist item after mastery learning. Item response theory analyses support the IJ and SC MPSs.

Conclusions

Mastery learning is an effective education intervention to achieve clinical skill acquisition among IM and EM residents. Item response theory analyses reveal desirable measurement properties for the MPSs previously set by expert faculty panels. Item response theory analysis is useful for evaluating standards for mastery learning interventions. The CVC mastery learning curriculum, reliable outcome data, and high achievement standards together contribute to reaching valid decisions about the competence of resident physicians to perform the clinical procedure.
Rapid Cycle Deliberate Practice Simulation Curriculum Improves Pediatric Trauma Performance
Authors: Yan Diana Hou , Slidell Mark B. , McQueen Alisa
Published: November 2020

Introduction

Simulation-based medical education allows learners to refine and maintain clinical skills especially for high-stake situations such as trauma resuscitation. Despite the primary and secondary survey being its foundation, literature shows poor adherence with overall rates as low as 13%. This study evaluates the impact of rapid cycle deliberate practice (RCDP) on primary and secondary survey skill retention. We hypothesized that RCDP-trained surgery residents will have real-world clinical improvement in their survey completion in pediatric trauma resuscitations.

Methods

We developed an RCDP trauma resuscitation curriculum. Videos of trauma resuscitations before and after curriculum implementation were scored by 2 blinded reviewers using a modified Pediatric Trauma Assessment Scoring Tool. Actual trauma care by residents who had received the curriculum (study group) was compared with care provided by residents who had not received the curriculum (precurriculum historical control group and a concurrent control group who provided care without receiving the curriculum).

Results

One hundred eighty-eight videos were scored with 98 in study group, 33 in concurrent control group, and 57 in historical control group. There was a significant improvement in primary survey performance between study group and historical control group (P < 0.001), but no difference between study group and concurrent control group. There was a significant improvement between study group and 2 control groups in secondary survey performance (both P < 0.001).

Conclusions

The RCDP curriculum led to significant improvement in surgical residents' trauma survey performance and had clinical impact on actual patients, which is rare in pediatric trauma simulation literature.
A comparison of treatment regimens for autoimmune hemolytic anemia: A network meta-analysis protocol
Authors: Deng Jiawen
Published: November 2020

Autoimmune hemolytic anemia (AIHA) is a rare blood disorder that result in the hemolysis of red blood cells (RBCs) due to the presence of autoantibodies in the serum. There are a variety of treatment regimens available for AIHA, including glucocorticoids, monoclonal antibody rituximab and splenectomy. We propose a network meta-analysis that investigates whether the use of different regimens can decrease adverse events, increase remission rate and improve lab results, including hemoglobin, RBC, reticulocyte counts, hematocrit and total bilirubin.
Response to neoadjuvant chemoradiotherapy in rectal cancer is associated with RAS/AKT pathway dysregulation and high tumour mutational burden
Authors: Stockton Joanne D , Tee Louise , Whalley Celina , James Jonathan , Dilworth Mark , Wheat Rachel , Nieto Thomas , Geh Ian , Beggs Andrew D
Published: November 2020

Purpose

Pathological complete response (pathCR) in rectal cancer, seen in examination of the pathological specimen post-surgery is the phenomenon whereby a tumour completely regresses under treatment with chemoradiotherapy. This is beneficial as up to 75% of patients do not experience regrowth of the primary tumour, allowing organ preservation and is poorly understood. We aimed to characterise the processes involved in pathCR.

Materials & Methods

Two groups of patients were identified with either complete response (pathCR group) or no response (poor response group) and biopsy and/or resection specimen blocks were retrieved. These underwent high read depth amplicon sequencing, exome sequencing, methylation arrays and immunohistochemistry for DNA repair pathway proteins. Sequencing data underwent analysis and the two cohorts were compared.

Results

Seven patients who underwent pathological complete response and twenty four who underwent poor response (to act as opposite “extreme phenotypes”) underwent molecular characterisation. Patients in the complete response group had significantly higher tumour mutational burden, neoantigen load and enrichments for mutations in the PI3K/AKT/mTOR signalling pathway as well as significantly lower numbers of structural variants. There were no differences in copy number variants or tumour heterogeneity. Methylation analysis demonstrated enrichment for changes in the PI3K/AKT/mTOR signalling pathway.

Conclusions

The phenomenon of pathCR in rectal cancer appears to be related to immunovisibility caused by a high tumour mutational burden phenotype. Resistance mechanisms seem to involve the PI3K/AKT/mTOR signalling pathway and tumour heterogeneity does not seem to play a role in resistance.