bluuebunny/crossref_metadata_2025 huggingface dataset:
ASSESSMENT OF ANIMAL WELFARE STATUS DURING TRANSPORTATION AND SLAUGHTERING OF RUMINANT ANIMALS AT LOCAL SLAUGHTER HOUSES IN BANGLADESH
Authors: Rudra K. C.
Published: August 2019

Background: Most of the developing countries including Bangladesh where humane treatment of slaughter animals is not satisfactorily practiced mainly due to poorly developed and implemented animal welfare legislation resulting in stress conditions and excessive suffering of animals. Objectives: The objective of this study was to assess the animal welfare knowledge and attitudes of animal transporters and butchers during transportation and slaughtering animals in local slaughter houses in Bangladesh Materials and Methods: This study was carried out from July to October 2017 at 40 local slaughter houses of 10 Upazilas in Mymensingh district. A pre-structured questionnaire was used to collect information from butchers at pre- and during slaughtering animals. The welfare data of 123 ruminant animals (84 cattle, 31 goats and 8 sheep) which were subjected to slaughter was collected by direct observation and examination. Results: Meat animals are usually purchased from the local market, some from farms and even from imported Indian cattle are usually transported from far away to slaughter houses. Significantly (p < 0.01) highest percentage of animals were transported by walking (42.28%), followed by truck (22.76%), pick-up van (20.33%), local vehicle (11.38%) and lowest by auto-rickshaw (3.25%). Small ruminants were kept in a lair-age for 1 to 2 days but most of the cattle were slaughtered upon arrival. Out of 123 animals investigated, 0.81 to 4.07% had lameness, 0.81 to 10.57% had skin lesions and 4.06 to 18.69% had dirty conditions in the different body regions. Diarrhea was recorded in 4.88% animals whereas 7.32% had nasal and 4.07% had ocular discharges. Lair-age was found in 85% slaughter houses with pacca (15.0%), kaccha (45.0%) and semi-pacca (40.0%) conditions but 80% had no bedding materials and 92.5% dirty floor condition. Mostly jute rope (89.43%) and halal method (100%) were used for casting and slaughtering of animals respectively without regular veterinary inspection. The stress caused by transportation and slaughtering of animals were not minimized due to lack of practice of animal welfare legislation in Bangladesh. Conclusions: The insufficient knowledge of animal transporters and butchers about animal behavior and animal welfare suggests that there is a need to improve animal welfare situation through training to the concerned people. Humane slaughter of animals may reduce the incidence of injury to the animals and less bruise to the carcasses that improve the meat quality. Keywords: Transportation, Slaughter house, Animal welfare, Animal handling, Butchers
Templates of Binary-induced Spiral-shell Patterns around Mass-losing Post-main-sequence Stars
Authors: Kim Hyosun , Liu Sheng-Yuan , Taam Ronald E.
Published: August 2019

The morphological properties of the outflowing circumstellar envelopes surrounding mass-losing stars in eccentric binary systems are presented based upon the results from a set of three-dimensional hydrodynamical model simulations. Making use of four template models of the envelope viewed for a range of inclination angles of the systems, we implement interpretative tools for observations at high spectral/angular resolutions (as illustrated via velocity-channel maps as well as position–velocity, radius–velocity, and angle–radius diagrams). Within this framework, the image and kinematical structures can be used to place constraints on the orbital parameters of the system. Specifically, three unique characteristic patterns in the envelopes are found that distinguish these systems from those in binary systems in circular orbits. Bifurcation of the spiral pattern, asymmetry in the interarm density depression, and a concurrent spiral/ring appearance all point to a binary system with an eccentric orbit. The methodology presented in this paper is illustrated in an analysis of recent radio observations of several asymptotic giant branch stars.
Surveying the Bright Stars by Optical Interferometry. II. A Volume-limited Multiplicity Survey of Main-sequence F Stars
Authors: Hutter D. J. , Tycner C. , Zavala R. T. , Benson J. A. , Hummel C. A. , Sanborn J.
Published: August 2019

We present the results of a multiplicity survey for a volume-limited sample of 29 main-sequence F0–G0 stars within 17 pc conducted with the Navy Precision Optical Interferometer (NPOI). Four companions were detected in previously known binary systems. The results for these stars show good agreement with previously published orbits. For one of these sources, ι Peg, the modeling of our data, which includes closure phase information, confirms the quadrant of the orbit. No new companions were detected in the sample (within separations of 3–860 mas and contrasts down to 3.5 mag at 700 nm). Combined with an extensive literature search, we provide a detailed listing of companions known around each star in the sample from prior spectroscopic and imaging/speckle observations, and we discuss the multiplicity frequency in the sample. We also discuss the prospects for future stellar multiplicity studies with the NPOI.
T2 Mapping as a New Method for Quantitative Assessment of Cartilage Damage in Rheumatoid Arthritis
Authors: Renner Nina , Kleyer Arnd , Krönke Gerhard , Simon David , Söllner Stefan , Rech Jürgen , Uder Michael , Janka Rolf , Schett Georg , Welsch Goetz H. , Pachowsky Milena L.
Published: August 2019

Objective.

Rheumatoid arthritis (RA) is associated with damage of the articular cartilage and the periarticular bone. While imaging of bone damage has substantially improved in recent years, direct imaging of the articular cartilage of the hand joints in patients with RA is still challenging. The study used T2 mapping of the finger joints to assess cartilage damage in RA.

Methods.

Magnetic resonance imaging (MRI) at 3 Tesla was done in 30 patients with RA, and T2 relaxation times visualizing alteration in the collagen network and hydration of articular cartilage were mapped in 6 cartilage regions of the metacarpophalangeal (MCP) joints 2 and 3. Values were related to autoantibody status [anticitrullinated protein antibodies (ACPA), rheumatoid factor (RF)], disease duration, and disease activity as well as sex and age of the patients.

Results.

T2 relaxation times could be reliably measured in the 6 regions of the MCP joints. Significantly higher relaxation times indicating more advanced cartilage alterations were observed in the metacarpal heads of ACPA-positive (p = 0.001–0.010) and RF-positive patients (p = 0.013–0.025) as well as those with longer disease duration (> 3 yrs; p = 0.028–0.043). Current disease activity, sex, and age did not influence T2 relaxation times.

Conclusion.

These data show that cartilage damage can be localized and quantified in the hand joints of patients with RA by T2 mapping. Further, ACPA and RF positivity as well as disease duration appear to be the crucial factors influencing cartilage damage.
Factors Influencing the Effectiveness of Allopurinol in Achieving and Sustaining Target Serum Urate in a US Veterans Affairs Gout Cohort
Authors: Singh Jasvinder A. , Yang Shuo , Saag Kenneth G.
Published: August 2019

Objective.

To assess factors associated with the ability to achieve and maintain target serum urate (SU) with allopurinol in patients with gout.

Methods.

We used US Veterans Affairs (VA) databases from 2002–2012. Eligible patients had ≥ 1 inpatient or ≥ 2 outpatient visits with a diagnostic code for gout, filled a new index allopurinol prescription, had at least 1 posttreatment SU level measured, and met the 12-month observability rule. Treatment successes were defined as the achievement of postindex SU < 6 mg/dl (success 1) and postindex SU < 6 mg/dl that was sustained (success 2).

Results.

Of the 198,839 unique patients with allopurinol use, 41,153 unique patients (with 47,072 episodes) and 17,402 unique patients (with 18,323 episodes) were eligible for analyses for success 1 and success 2; 42% each achieved (success 1) or achieved and maintained postindex SU < 6 mg/dl (success 2). In multivariable-adjusted models, factors associated with significantly higher odds of both outcomes were older age, normal body mass index, Deyo-Charlson index score of 0, rheumatologist as the main provider rather than non-rheumatologist, midwestern US location for the healthcare facility, a lower hospital bed size, military service connection for medical conditions of 50% or more (a measure of healthcare access priority), longer distance to the nearest VA facility, and lower preindex SU.

Conclusion.

We identified novel factors associated with maintaining SU < 6 mg/dl based on a theoretical model. Several potentially modifiable factors can be targeted by individual/provider/systems interventions for improving successful achievement and maintenance of target SU in patients with gout.
Optical Coherence Tomography Angiography in Monitoring Proliferative Macular Telangiectasia Type 2 Treatment Response
Authors: Estawro Rania G. , Embabi Sherif N.
Published: August 2019

BACKGROUND AND OBJECTIVE:

Difficulty exists in the follow-up of proliferative macular telangiectasia type 2 (MacTel 2) cases after anti-vascular endothelial growth factor (VEGF) treatment due to staining in fluorescein angiography (FA) and alteration in retinal layers by optical coherence tomography (OCT). Herein, the authors report three cases in which OCT angiography (OCTA) could resolve this issue.

PATIENTS AND METHODS:

In this retrospective, observational case series, diagnosis of MacTel 2 was made based on clinical examination, FA, OCT, and OCTA at presentation. Regression of neovessels was monitored by OCT and OCTA.

RESULTS:

OCTA could delineate neovessels before treatment in all cases and facilitate differentiation between active and regressed lesions after treatment. Simultaneous OCT images were less easily appreciated due to altered retinal structure secondary to degenerative nature of the disease.

CONCLUSION:

OCTA could be the tool of choice to monitor neovascular response to anti-VEGF treatment in proliferative MacTel 2.

[
Ophthalmic Surg Lasers Imaging Retina
. 2019;50:485–491.]
Persistent Plus Disease Subsequent to Panretinal Photocoagulation in an Infant With Retinopathy of Prematurity
Authors: Shah Saumya M. , Callaway Natalia F. , Moshfeghi Darius M.
Published: August 2019

Plus disease, or the presence of vascular dilation and tortuosity, is the most reliable predictor of the progression of retinopathy of prematurity (ROP), making resolution of plus disease one of the earliest signs of ROP regression. Patients with certain comorbid conditions such as anemia and cardiovascular disease may have persistent plus-like disease following successful resolution of ROP. The authors present a case of a 24-week premature infant who was treated with panretinal photocoagulation for stage 3, zone II.

[
Ophthalmic Surg Lasers Imaging Retina
. 2019;50:520–521.]
External Choroidal Drainage Using Direct Visualization
Authors: Snyder Laura L. , Patel Shriji N. , Kitchens John W.
Published: August 2019

Laura L. Snyder

Shriji N. Patel

A woman in her 60s with a functional glaucoma tube shunt presented after vitrectomy for epiretinal membrane peeling with symptomatic choroidal effusions not responsive to medical therapy. She underwent a minimally invasive, transconjunctival choroidal drainage procedure, which was directly visualized under a widefield viewing system to prevent intraocular hemorrhage or retinal penetration of the needle. This allowed for preservation of her conjunctiva, restoration of normal intraocular pressure by temporary blockage of her tube shunt with a viscoelastic, and resolution of her choroidal effusions.
Diagnosis of Peripheral Retinoschisis Using Ultrasound Biomicroscopy
Authors: Leshno Ari , Barak Adiel , Barzelay Aya , Zloto Ofira , Neudorfer Meira
Published: August 2019

BACKGROUND AND OBJECTIVE:

Retinal imaging can help differentiate retinoschisis (RS) from retinal detachment (RD). This study describes new sonographic features of RS using ultrasound biomicroscopy (UBM) and evaluates their diagnostic value.

PATIENTS AND METHODS:

Medical records of subjects diagnosed with RS and RD who underwent imaging prior to intervention were reviewed. Images were evaluated for detachment shape ultrasound (US) B-mode, as well as presence of intraretinal pillars, retinal layers split, and intraretinal cysts on UBM.

RESULTS:

Of 48 eyes from 48 patients in the study, 25 were diagnosed as RS and 23 as RD. “Retinal layers split” was the most common UBM finding in the RS group (72%), followed by intraretinal pillars (64%) and intraretinal cysts (36%). No RD case exhibited these findings (
P
< .001).

CONCLUSIONS:

UBM might assist in difficult cases to differentiate between RS and RD by detection of the unique sonographic features of RS described herein.

[
Ophthalmic Surg Lasers Imaging Retina
. 2019;50:e196–e202.]
Optical Coherence Tomography in Knobloch Syndrome
Authors: Thau Avrey , Tsukikawa Mai , Wangtiraumnuay Nutsuchar , Capasso Jenina , Affel Elizabeth , Alnabi Waleed Abed , Adam Murtaza , Alsulaiman Sulaiman M. , Spirn Marc , Levin Alex V.
Published: August 2019

BACKGROUND AND OBJECTIVE:

Knobloch syndrome is a genetic disorder defined by occipital defect, high myopia, and vitreoretinal degeneration. The authors studied retinal changes in patients with Knobloch syndrome using optical coherence tomography (OCT).

PATIENTS AND METHODS:

The authors report patients with Knobloch syndrome who received OCT testing during their care from 2011 to 2016. Diagnosis was based on high myopia, characteristic fundus, and occipital scalp or skull abnormalities with/without featureless irides and/or ectopia lentis. When available, diagnosis was confirmed by the detection of
COL18A1
mutations.

RESULTS:

The authors studied eight eyes from five patients. Two eyes were excluded due to chronic retinal detachment. OCT findings included epiretinal membrane, peripapillary vitreoretinal traction with retinoschisis, absent or rudimentary foveal pits, mean macular thickness of 113.4 μm, poor lamination, retinal pigment epithelium (RPE) atrophy, photoreceptor depletion, and mean choroidal thickness of 168.5 μm with enlarged choroidal vessels.

CONCLUSION:

OCT findings in Knobloch syndrome include abnormal vitreoretinal traction, poor foveal differentiation, poor retinal lamination, retinal thinning, RPE attenuation, myopic choroidal thinning, and pachychoroid.

[
Ophthalmic Surg Lasers Imaging Retina
. 2019;50:e203–e210.]
Retinal Defects Three Months After Intravitreal Dexamethasone Implant
Authors: Farber Nicholas C. , Ulrich J. Niklas
Published: August 2019

Intravitreal dexamethasone implants are commonly used to treat macular edema and noninfectious uveitis, and side effects including glaucoma and cataract formation are frequently managed. Rarely, the implant can cause an impact injury. However, this case shows peripheral retinal defects in a vitrectomized eye with abutting dexamethasone intravitreal implant without a flap, operculum, or other evidence of traction, developing 3 months after insertion, excluding the chance of injury from impact. The presence of an intravitreal dexamethasone implant appeared to cause destruction of juxtaposed retinal tissue. This report describes evaluation and management of this previously unreported complication.

[Ophthalmic Surg Lasers Imaging Retina. 2019;50:e211–e214.]
Editorial
Authors: Yasawardene Surangi G.
Published: August 2019

No abstract available
Revisiting the anatomical basis of varicocele
Authors: Samaranayake U. M. J. E. , Mathangasinghe Y. , Malalasekera A. P.
Published: August 2019

Objective: We intended to revisit aetiology and pathogenesis of varicocele. Results: Several theories were proposed as for the aetiology of left sided varicoceles being commoner than right sided varicoceles such as compression of the left testicular vein by the sigmoid colon, high concentration of adrenaline in the left renal vein causing vasospasms of the left testicular vein, presence of a right angle between the left testicular vein and the renal vein, “nutcracker effect” secondary to a compression of the left renal vein between the superior mesenteric artery and the aorta distal to its confluence with left testicular vein, and the presence of incompetent venous valves of the internal spermatic vein draining the left renal vein causing back flow of the blood. However, these theories were challenged in subsequent studies. Recent studies explored the ultrastructural changes of the pampiniform venous plexus in patients with varicoceles. Histological studies identified changes in the connective tissue density, endothelium and smooth muscle arrangement in these veins. However, the causality of these changes is not yet studied extensively. Genetic studies looking at matrix metalloproteinases synthesis and degradation, inflammation, immune dysregulation or alterations of metabolic pathways are necessary to understand pathogenesis of this clinical entity.
Minimal access oesophagectomy; review of out come
Authors: Galketiya K. B. , Pinto V.
Published: August 2019

Minimal access oesophagectomy may be performed by thoraco-laparoscopic or laparoscopic transhiatal techniques. Thoracoscopy gives a better visualization of intra-thorasic anatomy than trashiatal approach but has the disadvantage of making lung collapse during surgery a requirement. A comparison was done of both techniques. Surgery was completed safely by both methods. Thoracoscopy took more time and patients were electively ventilated for one day whereas transhiatal group were extubated in the immediate post operative period. Two patients of thoracoscopy group required re-intubation for lung infections and one of them died. If post operative Pulmonary care is improved thoracoscopy may be the better technique as it allows more precise oncologically acceptable dissection.
Thoracoscopic sympathectomy for chronic ischaemic pain in the upper extremity
Authors: Samarasinghe T. , Galketiya K. B. , Pinto V.
Published: August 2019

No abstract available
Cochylis hospes (Lepidoptera: Tortricidae) damage to male lines varies significantly and inbred susceptibility predicts damage to hybrids
Authors: Prasifka Jarrad R.
Published: August 2019

Larvae of Cochylis hospes (Walsingham) (Lepidoptera: Tortricidae) (banded sunflower moth) are a primary source of insect damage to seeds of cultivated sunflower, Helianthus annuus Linnaeus (Asteraceae), in North America. Field trials were used to evaluate seed damage under natural infestations for panels of publicly released male lines, publicly derived hybrids (females crossed to one common male parent), and commercial hybrids over a total of four years. For trials in 2013–2014 including 17 male lines, seed damage ranged from 3% to 19%. The least damaged male, RHA 266, was statistically similar to one other male, RHA 455. Three commercial hybrids used as checks also received very little seed damage (< 5%). In trials during 2016–2017, hybrids created by pollinating 15 different female lines with RHA 266 showed 4–14% damage. Data from female parents explained about 28% of variation in seed damage for the hybrids. Results confirm cultivated sunflower has greater variation in susceptibility to C. hospes than previously believed, and that seed damage to inbred lines provides some predictive power for hybrids. Though breeding for resistance to C. hospes seems possible, it may be too labour-intensive without relating resistance to more easily measurable traits or genetic markers.
Engaging Athletic Trainers in Concussion Detection: Overview of the National Football League ATC Spotter Program, 2011–2017
Authors: Mack Christina , Myers Emily , Barnes Ronnie , Solomon Gary , Sills Allen
Published: August 2019

Objective

To assist sideline medical staff and to augment detection of concussion in National Football League (NFL) players during preseason and regular season games via the use of certified athletic trainer (ATC) spotters.

Background

Detecting concussive injuries in contact-sport athletes can be a challenging task for health care providers on the sideline. Over the past 8 years, professional sport leagues have begun to use additional sets of eyes (medical spotters along with video review) to help identify athletes with possible concussive injuries.

Description

The NFL first began a program using spotters in 2011, and the ATC Spotter Program has undergone systematic enhancements each year. This article describes the evolution of the ATC Spotter Program, the requirements and training of its participants, and the program data available to date. Directions for future improvement and research are addressed.

Clinical Advantages

The use of ATC spotters stationed in the broadcast booth has enhanced the real-time detection of concussed players in the NFL.
Obstetric Physiotherapists and breastfeeding
Authors: Bergh A. M. , Grimbeek R. J. , Kachelhoffer P. M.
Published: August 2019

This study determined the perceptions of obstetric physiotherapists on the state of breast-feeding in South Africa and their contribution to breast-feeding education. A questionnaire to the 134 members of the Obstetric Association of the South African Society of Physiotherapy was completed by 36 practising respondents and 23 non-practitioners. The total response rate was 44%. A significantly larger group of practising respondents who had completed their training in the seventies returned the questionnaire. About 93% of respondents felt their basic training in breast-feeding had been inadequate. Almost 56% has received further training in breast-feeding during the previous five years. Regarding the impact of the South African national breast-feeding week campaign, 47% of respondents perceived a change in attitudes toward breastfeeding and 22% a change in breast-feeding practices. It is concluded that the perceptions of other groups of health professionals, the educational needs of parents and effective educational strategies also need investigation.
The conservative treatment of pain in the sacroiliac region during pregnancy: A case study
Authors: Paulsen T. E.
Published: August 2019

A case study of a pregnant woman complaining of pain in the left sacroiliac area is presented. In a field where differences of opinion between authorities are common, the importance of clinical presentation and assessment is stressed. The selection of techniques is discussed highlighting some of the implications of treating the sacroiliac joint (SIJ) during pregnancy.
Opinion Mining for the Tweets in Healthcare Sector using Fuzzy Association Rule
Authors: Mittal Mamta , Kaur Iqbaldeep , Chandra Pandey Subhash , Verma Amit , Mohan Goyal Lalit
Published: August 2019

Communication among several internet users has become more convenient through social networking sites to where each user sharing his own opinions on different matters, such as Healthcare, Education, marketing etc. The Objective of this paper is to present a method to make it easier for even a layman to predict and analyze one’s health issues on his own by making use of tweets on the social website twitter.com. As far as methodology or techniques is concerned, an algorithm has been framed for the same to perform the analysis on health care tweets with association rules to classify the ailments and their symptoms using a corpus through fuzzy set and two step approach for Document Term Matrix & Term Document Matrix. The results demonstrate the comparison of different terms over the WordCloud which concludes that in this novel approach of two step authentication the average accuracy of association between the hiv ailments is 98% through correlation table and association between the HIV ailments with 98% correlation.
Development and Pilot Testing of a Novel Tool for Evaluating Practical Skills in Hematopathology Residents in Pakistan
Authors: Moiz Bushra , Ali Syeda Kauser , Rashid Anila , Shariq Muhammad , Karim Farheen
Published: August 2019

Background

The mini-Clinical Evaluation Exercise (mini-CEX) and direct observation of procedural skills (DOPS) are reliable tools for work-based assessment of medical trainees. Tools of this type do not yet exist for evaluation of practical laboratory skills of pathology residents.

Objective

We developed and piloted a 9-item instrument for direct observation of laboratory skills (DOLS).

Methods

We used the DOLS tool with 10 hematopathology residents (PGY-1 to PGY-5) from Aga Khan University. Each resident was evaluated by 3 faculty members in the laboratory during 4 separate encounters using the DOLS instrument. We assessed construct validity, interrater reliability and G coefficient, feasibility of using DOLS, and learner satisfaction.

Results

A total of 120 encounters were observed with a mean score (±1 SD) of 56.7% (±12.44). Assessment scores moderately correlated with the number of laboratory procedures previously performed by participants (r = 0.658 and 0.641; P = .0001) and with PGY level. Interrater reliability ranged between 0.47 and 0.96. Cohen's d was 1.64. Residents accounted for a large component of estimated variance (73%), suggesting DOLS can differentiate residents' laboratory skills; variance associated with assessors was small (0.01%). Residents reported being satisfied with the tool. Mean time (±1 SD) taken for observing and feedback was 17.89 ± 5.89 minutes.

Conclusions

The new DOLS instrument could provide reliable scores for observing laboratory skills. Residents were satisfied with the tool, and rating times make the tool feasible for formative assessments.
Trait Emotional Intelligence and Its Correlates in Oman Medical Specialty Board Residents
Authors: Huseini Salim Al , Alawi Mohammed Al , Sinawi Hamed Al , Al-Balushi Naser , Jose Sachin , Al-Adawi Samir
Published: August 2019

Background

As part of the globalization of medical education, residency programs in Oman have adopted competency-based standards by the Accreditation Council for Graduate Medical Education International (ACGME-I). Correctly perceiving the emotions of others and managing one's own emotions are essential to high-quality patient care.

Objective

We tested the reliability and construct validity of the Trait Emotional Intelligence Questionnaire–Short Form (TEIQue-SF), and assessed trait Emotional Intelligence (EI) in Oman Medical Specialty Board (OMSB) residents in multiple specialties. We explored for correlations with trainees' sociodemographic background data.

Methods

We conducted a cross-sectional, observational study between February and August 2017. Participants were OMSB residents. We administered the TEIQue-SF and collected sociodemographic data from participants. Multiple linear regression analysis was conducted to identify independent predictors of trait EI.

Results

The present cohort scored high in the trait EI subscale of Well-being, followed by Sociability, Self-control, and Emotionality. Among sociodemographic factors, female gender and high income were significant predictors of TEIQue-SF's Well-being subscale and high income and living in a rented home were significant predictors of the Sociability subscale.

Conclusions

This is the first study conducted among medical residents in Oman regarding trait EI and its correlates. Our findings of overall high EI and several socioeconomic predictors echo the literature on the assessment of EI in trainees. The findings add to the evidence of cross-cultural applicability of instruments to measure trait EI, and use assessments of EI in resident selection and education.
Putting Time in Perspective: An Integrated Graduate Medical Education Institutional Dashboard and Report Card
Authors: Andrada Jillian , Teo Joyce , Neo Joel , Yeo Helen , Leng Lim Boon
Published: August 2019

Background

ACGME-I requires sponsoring institutions (SIs) to have systematic oversight of program performance. This was initially carried out through annual review, however, maintaining compliance became a challenge for a large SI like Singapore Health Services (SingHealth) as the number of residency programs grew from 5 to 34 in 3 years.

Objective

We assessed the impact of quarterly monitoring using a dashboard on graduate medical education (GME) program performance and institutional oversight.

Methods

In 2014, the SingHealth GME Committee (GMEC) approved the dashboard covering 13 indicators with implication on program performance, resident/faculty performance, and finance. Indicators were given color-coded scoring for compliance, borderline compliance, or concern. From annual reporting, periodicity was increased quarterly with reports distributed to program directors, head of department, and academic clinical programs.

Results

Since implementation, programs consistently met or exceeded compliance standards in 11 of 13 indicators (84%), with 7 indicators (63%) showing upward trends. Programs with borderline scores in particular quarters showed improvement in subsequent quarters. By 2015, percentage compliance for the 3 dimensions of residents' perspectives were 1 to 2 points higher than the national compliance average. Of 19 programs undergoing ACGME-I accreditation in 2014, only 4 had citations in the foundational requirement. Institutional citations were resolved, with 0 citations in the reaccreditation site visit in 2015.

Conclusions

For a large SI, increased periodicity of program performance reporting from annual to quarterly effectively addressed the gaps in a timely fashion. Institutional performance also improved through the use of quantitative data aligned with institution and national performance indicators.
Perceptions of the Learning Environment on the Relationship Between Stress and Burnout for Residents in an ACGME-I Accredited National Psychiatry Residency Program
Authors: Sum Min Yi , Chew Qian Hui , Sim Kang
Published: August 2019

Background

High rates of burnout have been reported in physicians in training, with contributing factors including stress, lack of coping skills, and attributes of the learning environment. The interrelationships among these factors and how they affect versus mitigate burnout in an international cohort of residents have not been studied.

Objective

We examined the interrelationships between stress, perceptions of the learning environment, and coping strategies used in a cohort of psychiatry residents in Singapore, using burnout as the dependent variable. We hypothesized that perceptions of the learning environment and coping strategies influence the relationship between residency-related stress and burnout in psychiatry residents.

Methods

From June 2016 to September 2017, 67 of 75 (89%) psychiatry residents from a single program in Singapore were assessed on their levels of stress and burnout, perceptions of their learning environment (including role autonomy, teaching, and social support), and the coping mechanisms they used.

Results

Psychiatry residents in this Singaporean program perceived their overall learning environment to be positive. Perceptions of the learning environment, not coping strategies, significantly mediated the relationship between stress and burnout.

Conclusions

Findings from this study suggest that perceptions of the learning environment mediate the relationship between stress and burnout. Approaches to evaluate and improve resident perceptions of aspects of their learning environment may be an effective strategy to manage burnout in psychiatry residency programs.
An Internal Medicine Intern Retreat to Facilitate Transition to PGME and Promote Peer Interaction
Authors: Ghazal Nisrine , Akl Imad Bou , Aoun Roni , Ziadeh Nathalie , Houranieh Renee , Khalil Pierre Bou
Published: August 2019

Background

Interns in the internal medicine program at American University of Beirut Medical Center (AUBMC) come from diverse educational backgrounds based on American, French, and Egyptian systems, similar to other settings in the Middle East. To help this diverse group of trainees integrate into their new role, the institution launched an intern retreat in 2014 and repeated the event 3 times to date.

Objective

We describe the experience with the AUBMC intern retreat and discuss the format and interns' perceptions of the benefits of the event.

Methods

The retreat was divided into workshops and team-building sessions. Workshop topics focused on communication, teamwork, time management, survival tips, patient-physician interaction, and resident well-being. Fun activities were meant to strengthen peer-to-peer relationship and included a treasure hunt, Jeopardy game, and basketball.

Results

Retreats took place in 2014, 2016, and 2017, and involved 72 of 102 interns (71%), as participation was optional. The 2015 retreat had to be canceled due to logistical problems. Of 72 eligible interns, 61 (85%) responded to the evaluation survey. The majority rated the activity as fun or interesting; sessions with the highest ratings included communication, patient-physician interaction, and resident well-being. There was unanimous agreement to make the retreat a yearly tradition. Each year, we collected feedback and made changes to further improve the retreat experience.

Conclusions

The retreat is now an established activity. In an institution that accepts interns from different backgrounds, the retreat has strengthened peer-to-peer relations, improved communication, and contributed to a collegial and supportive work environment.
Medical Careers and Motherhood: A Cross-Sectional Study of Hispanic Female Physicians
Authors: Lopez-Leon Sandra , Del Valle Cipatli Ayuzo , Salceda Alejandra Huante , Villegas-Pichardo Luz Odette , Scosyrev Emil
Published: August 2019

Background

One factor many women consider when choosing a medical specialty is the plan to have children and the compatibility of their chosen specialty with motherhood.

Objective

We surveyed Hispanic female physicians who are mothers to collect demographic information, specialty choice, childbearing, and professional and personal life characteristics, along with respondents' suggestions for female physicians who want to start a family, and how hospitals and medical institutions could enhance their support of female medical staff members with children.

Methods

The questionnaire was fielded on an online forum for Hispanic female physicians who are mothers. We summarized data by frequency and percentages, and means and standard deviations.

Results

Common medical specialties of respondents included pediatrics, family medicine, and obstetrics and gynecology, and 19% did not report a medical specialty. Most respondents were married (72%), had 1 or 2 children (89%), and worked at a public hospital 5 days a week (51%). Forty-four percent reported they slept 6 or more hours a night. Differences among specialties included dermatologists, radiologists, and gynecologists reporting working more than other specialties (6 to 7 days a week), psychiatrists reporting greater use of psychiatric medications, and anesthesiologists reporting lower rates of marriage. Female surgeons and emergency medicine physicians reported the highest consumption of alcohol.

Conclusions

The results offer initial insights into how medical specialty choice may affect female physicians' work-life balance and can be used to provide guidance to female learners who plan to have a family.
A hermeneutic approach to the problem of illusion in sense perception
Authors: Odozor Uche S. , Akintona Emmanuel O.
Published: August 2019

This paper is a hermeneutic exposition of the problem of illusion in sense perception, using the methods of critical and content analysis as tool of engagement. For decades, post-modern epistemology was steeped in the murky waters of the brilliant, sceptic argument from illusion, according to which the senses could not be relied upon for knowledge of the external world of reality, due to problems believed to be inherent in sensory perception. Why was the argument from illusion so important to epistemologists as to elicit enormous interest for such a long time? What are the implications of the argument for science? Did the argument from illusion portend any real danger for the foundations of empirical knowledge claims, as supposed by many frontline epistemologists? Exploring the concept and science of perceptual illusion, and the implications of the argument from illusion for science and epistemology, the paper found that the argument failed as a refutation of direct realism because it views illusion as the norm rather than an exception, and portrays human knowing process as an automatic, rather than a procedural, gradual phenomenon.Keywords: Argument from Illusion, Empiricism, Epistemology, Science, Scepticism
Sea cliff at Wissower Bach (Pleistocene stripe 5) – microstructural evidence of large-scale glacitectonism and glacier kinematics
Authors: Gehrmann Anna , Hüneke Heiko , Meschede Martin , Phillips Emrys
Published: August 2019

Abstract. Soft-sediment thin sections from a SW-dipping thrust
fault at the south-western limb of the Wissower Bach syncline (NE Rügen)
give rise to the complicated glacitectonic environment in the south-western
Baltic Sea region. Micromorphology, microstructural mapping, and
macroscale information have led to the development of a detailed model for
the evolution of the syncline during late Weichselian glacitectonism.
Coastal cliff at Lenzer Bach on Jasmund Peninsula, Rügen Island (Pleistocene Stripe 4): reconstructed history of glacitectonic deformation based on fold geometry and microstructural mapping
Authors: Mehlhorn Paul , Winkler Laura , Grabbe Franziska-Charlotte , Kenzler Michael , Gehrmann Anna , Hüneke Heiko , Rother Henrik
Published: August 2019

Abstract. A thrust-bound footwall syncline located within the
proximal part of the southern Jasmund Glacitectonic Complex is investigated,
exploring the spatio-temporal relationship between glacitectonic macro- and
microstructures. Orientation and geometry of macroscale folds and thrust
faults reveal a two-phased deformation history recorded by the sedimentary
sequence. The deformation is a result of glacitectonic imbrication and
subsequent ice flow across Jasmund Peninsula during the late Weichselian.
Clast microfabrics preserved within the folded glacial diamicts reveal that
till-internal deformation is mainly related to subglacial shearing within
the glacier bed, which predates large-scale imbrication and folding.
Micromorphology and clast microfabrics of subglacial traction tills at the sea cliff Dwasieden: evidence of polyphase syn- and post-depositional deformation
Authors: Brumme Johannes , Hüneke Heiko , Phillips Emrys
Published: August 2019

Abstract. A detailed thin-section-based micromorphological and
microstructural study of the glacial diamicts exposed at the sea cliff of
Dwasieden (M1, M2, M2) has revealed that all units can be related, in their entirety or in several parts, to subglacial conditions during the repeated readvance
of the Scandinavian Ice Sheet. These readvances are characterised by
polyphase deformation of the diamicts resulting in the development of
ductile and brittle structures and localised water-escape structures.
Subsequent alteration under periglacial conditions has been documented for
the chalk and till units M1 and M2.
The sea cliff at Dwasieden: soft-sediment deformation structures triggered by glacial isostatic adjustment in front of the advancing Scandinavian Ice Sheet
Authors: Pisarska-Jamroży Małgorzata , Belzyt Szymon , Börner Andreas , Hoffmann Gösta , Hüneke Heiko , Kenzler Michael , Obst Karsten , Rother Henrik , Steffen Holger , Steffen Rebekka , van Loon Tom
Published: August 2019

Abstract. Isostatic response of the Earth's crust as a consequence of the fluctuating extent of ice-sheet masses was accompanied by earthquakes probably due to local reactivation of pre-existing faults. Our study of a glacilacustrine and glacifluvial succession exposed on Rügen Island (SW Baltic Sea) indicates that some of the soft-sediment deformation structures within the succession must have formed shortly before the front of the Pleistocene Scandinavian Ice Sheet reached the study area (during the Last Glacial Maximum), thus during a stage of ice advance. Based on analysis of the textural and structural features of the soft-sediment deformation structures, the deformed layers under investigation are interpreted as seismites which formed as a result of seismically induced liquefaction and fluidisation.
The Bronze Age battlefield in the Tollense Valley – conflict archaeology and Holocene landscape reconstruction
Authors: Lidke Gundula , Lorenz Sebastian
Published: August 2019

Abstract. Archaeological discoveries in the Tollense Valley represent remains of a Bronze Age battle of ca. 1300–1250 BCE, documenting a violent group conflict hitherto unimagined for this period of time in Europe, changing the perception of the Bronze Age. Geoscientific, geoarchaeological and palaeobotanical investigations have reconstructed a tree- and shrubless mire characterised by sedges, reed and semiaquatic conditions with a shallow but wide river Tollense for the Bronze Age. The exact river course cannot be reconstructed, but the distribution of fluvial deposits traces only a narrow corridor, in which the Tollense meandered close to the current riverbed. The initial formation of the valley mire dates to the transition from the Weichselian Late Glacial to the early Holocene.
The accuracy of weather radar in heavy rain: a comparative study for Denmark, the Netherlands, Finland and Sweden
Authors: Schleiss Marc , Olsson Jonas , Berg Peter , Niemi Tero , Kokkonen Teemu , Thorndahl Søren , Nielsen Rasmus , Nielsen Jesper Ellerbæk , Bozhinova Denica , Pulkkinen Seppo
Published: August 2019

Abstract. Weather radar has become an invaluable tool for monitoring rainfall and studying its link to hydrological response. However, when it comes to accurately measuring small-scale rainfall extremes responsible for urban flooding, many challenges remain. The most important of them is that radar tends to underestimate rainfall compared to gauges. The hope is that by moving to higher resolution and making use of dual-polarization, these mismatches can be reduced. Each country has developed its own strategy for addressing this issue. But since there is no common benchmark, improvements are hard to quantify objectively. This study sheds new light on current performances by conducting a multinational assessment of radar's ability to capture heavy rain events at scales of 5 min up to 2 hours. The work is performed within the context of the joint experiment framework of project MUFFIN (Multiscale Urban Flood Forecasting), which aims at better understanding the link between rainfall and urban pluvial flooding across scales. In total, 6 different radar products in Denmark, the Netherlands, Finland and Sweden were considered. The top 50 events for each country were used to quantify the overall agreement between radar and gauges and the errors affecting the peaks. Results show that the overall agreement between radar and gauges in heavy rain is fair, with multiplicative biases in the order of 1.41–1.66 (i.e., radar underestimates by 29–39.8 %) and correlation coefficients of 0.71–0.83 across countries. However, the bias increases with intensity, reaching 45.9 %–66.2 % during the peaks. Only part of the bias (i.e., roughly 13 %–30 % depending on the radar product) can be explained by differences in measurement areas between gauges and radar. Radar products with higher spatial and temporal resolutions agreed better with the gauges, highlighting the importance of high-resolution radar for urban hydrology. However, for capturing peak intensity and reducing the bias during the most intense part of a storm, the ability to combine measurements from multiple overlapping radars to help mitigate attenuation seemed to play a more important role than resolution. The use of dual-polarization and phase information (e.g., Kdp) in the experimental Finnish OSAPOL product also seemed to provide a slight advantage in heavy rain. But improvements were hard to quantify and similarly good results were achieved in the Netherlands by applying a simple Z–R relation together with a mean field bias-correction.
Uncertainty quantification of floodplain friction in hydrodynamic models
Authors: Dalledonne Guilherme Luiz , Kopmann Rebekka , Brudy-Zippelius Thomas
Published: August 2019

Abstract. This study proposes a framework to estimate the uncertainty of hydrodynamic models on floodplains.
The traditional floodplain resistance formula of Pasche (1984) (based on Lindner, 1982) used for river modelling as well as the approaches of Baptist et al. (2007), Järvelä (2004), and Battiato and Rubol (2014) was considered for carrying out an uncertainty quantification (UQ).
The analysis was performed by means of three different methods: traditional Monte Carlo (MC), first-order second-moment (FOSM) and metamodelling.
Using a two-dimensional hydrodynamic model, a 10 km reach of the River Rhine was simulated.
The model was calibrated with water level measurements under steady flow conditions and then the analysis was carried out based on flow velocity results.
The compared floodplain friction formulae produced qualitatively similar results, in which uncertainties in flow velocity were most significant on the floodplains.
Among the tested resistance formulae the approach from Järvelä (2004) presented on average the smallest prediction intervals, i.e. the smallest variance.
It is important to keep in mind that UQ results are not only dependent on the defined input parameter deviations, but also on the number of parameters considered in the analysis.
In that sense, the approach from Battiato and Rubol (2014) is still attractive for it reduces the current analysis to a single parameter, the canopy permeability.
The three UQ methods compared gave similar results, which means that FOSM is the less expensive one.
Nevertheless it should be used with caution as it is a first-order method (linear approximation).
In studies involving dominant non-linear processes, one is advised to carry out further comparisons.
Evaluation of Leaf Properties of Eight Cherry Cultivars Grafted onto Maxma 14 Rootstock
Authors: Aras Servet , Keles Hakan
Published: August 2019

The study was conducted in order to assess the leaf properties of different sweet cherry varieties grafted onto MaxMa 14 rootstock. The experiment was arranged in a randomized plot desing with three replicates of five plants per replication. The soil analyses showed that the soil properties of experiment site were found as moderate alkaline, low amount of organic material, N, P, Zn and Mn. The soil characteristics may be sub-optimum for cherry growing. According to our results, Kordia had the highest SPAD value (37.86) among the cultivars. Samba, Regina, Kordia and 0900 Ziraat cultivars had the highest anthocyanin contents. The highest stomatal conductance was in 0900 Ziraat cv followed by Sweetheart. Samba had greater leaf area (53.25 cm2) compared to other cultivars. The highest LRWC was obtained with Lorry Bloom. Epicuticular was content of Regina leaves was higher among the cultivars. The results of the present study provide useful informations about how the cherry scions grafted onto MaxMa 14 response to environmental challenges in nature. The identified leaf properties are valuable targets for physiological studies related with environmental stresses.