bluuebunny/crossref_metadata_2025 huggingface dataset:
Mathematical model of assessing urban planning decisions based on capital construction facilities location under the city plan
Authors: Zedgenizov A V , Solodkiy A I , Seliangin K V
Published: July 2020

The article deals with the issues of placing large focal points over the city planning map. The topicality of this issue is described. The target function is determined; it takes into account the time losses of road users in the zone of the focal point influence and the amount of payments to budgets of different levels generated by the focal point functioning. The mathematical model that allows estimating time losses of road users is presented. The model has a special focus on the mechanism of transport demand development and on the assessment of crossing capacity based on the intensity of priority flows. The mathematical tools are developed; they allow calculating the financial consequences of the implementation of urban planning projects set out in the city plan, choosing focal points with the most beneficial influence on the municipal budget among the proposed ones, taking into account the minimum negative impact of the chosen focal points on the adjacent street-and-road network. Some particular cases of the transport demand development are discussed, for example, those of traffic management schemes that do not allow left-turn and through movements at uncontrolled intersections. The recommendations on the practical application of the target function when making urban transport decisions having regional and city significance are developed.
Overcoming information asymmetry in the construction industry based on open and closed contractor activity data
Authors: Anokhov I
Published: July 2020

The purpose of the research is to find measures to reduce information asymmetry which significantly affects the relationship between customer and contractor, leading to higher prices for construction work and enhanced opportunism. Information asymmetry can make contractor and customer move away from direct contractual relations to more and more costly ways of interaction: legal, law enforcement and ethical. In the long run, the most effective level of interaction is ethical, as it significantly reduces information asymmetry as well as attendant costs. The article proposes two approaches to analyse asymmetry of contractor’s information: in the situation of limited access to internal information of a construction company and in the situation of maximum access to information of the activities of construction company’s individual departments. In the first approach, an assessment of price discrimination and changes in the cost of construction due to a deliberate deterioration in its quality is used. In the second approach, a set of indicators is considered, grouped by the functional levels of the contractor: physical, procurement, economic, technological and design.
Analysis of the Filatov model of the construction industry in the Baikal region
Authors: Filatov E A , Rudykh L G
Published: July 2020

In recent years, due to the slowdown in industrial development and the decline in the economic growth of the Russian Federation in trade and services, many companies from these activities in order to minimize their costs stop expanding production through new construction and at the same time freeze what they have started. In these conditions, managing the profitability of construction companies is one of the most important tasks for all levels of management: operational, tactical and strategic. Return on assets is the most important indicator of the efficiency of a commercial company, the main standard or average value in a market economy, with which individual indicators of companies are correlated to justify their competitiveness. The article suggests a way to manage the return on assets by decomposing the Filatov model (return on assets) into factors that reflect various aspects of the company’s activities. The object of the study is construction companies (construction of residential and non-residential buildings) in the Baikal region of the Russian Federation (Irkutsk region, Republic of Buryatia, Zabaikalsky Krai). The article presents the method No. 2 of integral analysis developed by Filatov E. A. The article was carried out within the framework of the scientific project of the Inc SB RAS no. XI.174.1.4 ‘Activation of the internal development potential of regions of resource specialization (on the example of the Baikal region)‘.
Legal regulation of construction quality and control
Authors: Guseva I A
Published: July 2020

The Institute of State Construction Supervision of urban planning legislation system occupies a key place in the matter of quality assurance of construction, that is a necessary condition for the safety of buildings under construction. The article gives a brief analysis of state architectural-building supervision mechanism of the RSFSR/USSR of Soviet period and developed processes of that period of time. By Decree of the Council of People’s Commissars of August 16, 1944 No. 1110 “On the State architectural-building Supervision”, the authorities (organizations) of architectural-building supervision were created. The main activity of GASK authorities was control functions in construction process, the Construction Norms and Regulations compliance, quality assurance, project solutions relevance, the correctness of capital investments. Analyzing the legal regulation of construction quality and control of Soviet period, the author notes that the political regime of the state does not affect the essence of the state construction supervision, but defines forms and implementation methods of it.
Organization of work on the development of measures to ensure the survivability of buildings exposed to flooding
Authors: Peshkov V V
Published: July 2020

Nowadays the issue of ensuring the survivability of buildings in emergency situations is relevant. Floods are one of the most frequent and serious types of natural disasters. Therefore, flood protection becomes an important task for cities, regions and countries that are exposed to the threat of flooding. Because along with human tragedies and damage to the national economy, floods cause the failure of Central supply points, on which the population is particularly dependent in an emergency. A methodological analysis of the results of flood response in the Irkutsk region in the affected areas has shown that there are number of issues related to the design construction and restoration of residential buildings in areas subject to natural emergencies. In order to solve these problems, theoretical generalizations of domestic and foreign experience are required, as well as the development of principles techniques and models of urban development placement in conjunction with technological solutions. Together, emergency response measures should have the properties of mobility, urbanization, and efficient use of the environment and resources in the implementation of investment and construction projects.
Winter city: staff training features
Authors: Peshkov V V
Published: July 2020

The education system is one of the most important social institutions, the qualitative state and the result of which determines the level of development of the economy, science and culture of the country as a whole. The problem of training and retraining of workers for the construction industry and housing and communal services is becoming increasingly important for the economy of the country. It is obvious that the necessary volume of housing can be introduced only with appropriate quantitative and qualitative provision of human resources to the construction industry, especially in regions with harsh climatic conditions. Construction organizations need highly qualified personnel. Investment in construction has always been profitable, as this sphere is growing rapidly. Meanwhile, the increase in construction does not automatically entail a tide of human resources into this sector of the economy. However, the analysis shows that the shortage of specialized personnel reduces the pace of construction, especially in regions with severe climates, because for such regions it is necessary to provide a different approach to training, which should provide the necessary set of competences for specialists.
Construction company administration of intangible resources in the face of uncertainty
Authors: Peshkov A V
Published: July 2020

Management of intangible resources is an important component of a construction company’s business processes. The rapid development of information technology forces construction companies to change their usual activities and rebuild business processes in accordance with the challenges of the real market. It is digital technologies that are the object of the company’s intangible assets that can be used much more effectively to improve the current processes and information flows in the construction company. The advantages of the construction company’s intangible assets, such as Smart spaces, are that they provide increased efficiency and lower production costs, achieved through rational actions, the use of faster and more secure communication methods that guarantee the necessary flow of information. They also improve efficiency through rational and timely actions, with an emphasis on creating value and using new technologies. The economic effect of using information technologies, namely the introduction of Smart spaces, can be either direct, material in the form of achieved cost reduction and increased productivity of operations, or non-material, in the form of implemented patents and licenses, and improving the company’s image, as well as the potential of information technologies that can be used to make more effective decisions of a strategic nature.
Inefficiency of the current system of forming the initial maximum price of the contract of the state construction order
Authors: Pinchuk T O , Kazantseva I I
Published: July 2020

Management of the investment cycle of construction requires the development of adequate measures to the modern challenges of innovative forms and methods of state regulation in the field of construction. The existing mechanism for the placement and implementation of the state construction order allows us to conclude that the public procurement management system is insufficient and requires further improvement, based on the development priorities of the innovation environment and the investment attractiveness of construction investment projects. In particular, one of the main components for placing a state construction order is to determine the initial maximum contract price, which affects the conditions for the implementation of a state construction order. The existing approach to the formation of the initial maximum price does not meet modern realities. The methodological foundations of the formation of the initial maximum price of the contract by dividing it into basic and managed components are considered. The separation of controlled factors into qualitative and quantitative indicators is proposed. Based on the study, it follows that through controlled factors, it is possible to influence the initial maximum price of the contract by changing the quality factors in particular.
Numerical Investigation of the Aerodynamic Characteristics of a Missile
Authors: Meng Yu-shan , Yan Li , Huang Wei , Tong Xin-yu
Published: July 2020

During supersonic flight of supersonic missile, the missile configuration has great influence on the aerodynamic characteristics of the missile. This article evaluates the variation of the flow field results from the change of missile configuration by changing the shape of the head and the slenderness ratio of the body. The study is carried out by the CFD numerical method, and the structured grids are generated by ANSYS CFD software. We evaluate the aerodynamic characteristics of two-dimensional model and three-dimensional model by the flow solver FLUENT, and the standard Spalart-Allmaras one-equation is selected to simulate the flow around the missile, the results indicate that the drag coefficient of the oval head is less than parabolic head case and conical head case, and drag coefficient decreases with the increase of Mach number and slenderness ratio. With the increase of Mach number, the stagnation temperature increases correspondingly.
Method for Determining Takeoff Weight and Thrust-To-Weight Ratio of Aircraft Variants by Decision Speed with Engine Failed at Takeoff Run
Authors: Kapitanova L , Tiniakov D , Makarova L
Published: July 2020

In modern time the aircraft variants creation is main trend in the aviation industry. One the aspect of the aircraft safety is its safety take-off [1]. The aircraft parameters like relative take-off weight and thrust-to-weight ratio can determine many its performance include take-off. Their influence on decision speed during take-off of modified transport category airplanes are explored. The analytic model is simple and high efficiency way for the first approach of airplane`s safety analyses. The problem is solved by analytics modelling airplane motion on runway during take-off. Quantitative estimation of influence of the airplane weight and thrust-to-weight ratio variation on decision speed of continued or aborted take-off with critical engine failure is given on the base of example of heavy cargo airplane. The application of this way for the airplanes safety analysis is important for each types of aircraft. Estimation model is given in dimensionless parameters and so is applicable for any type of transport category airplanes.
Design and Simulation Analysis of Deployable Structure of a Single-unit Radar
Authors: Wang JinWei , Zhao XiFang , Tang BaoFu
Published: July 2020

The deployable structure has the characteristics of polymorphism, and it appears as the function of the mechanism during the deployment process, and as the function of the structure during the deployment and locking stage. Since the 21st century, it has been increasingly adopted by the military field. Based on the tactical requirements of individual radars for rapid withdrawal, off-road marching, rapid erection, and light weight in the war, a soldier radar with an expandable structure consisting of several active linear array antennas arranged uniformly on the circumference to form a cylindrical antenna array is designed. In order to ensure a smooth and reliable deployment of the deployable structure, a link mechanism design with hinge gap is used. According to the corresponding technical requirements,the rigidity of the single-armor radar’s cylindrical box and antenna unit panel was simulated and calculated. The results show that the single-armor radar can meet the technical requirements under the corresponding working conditions without damage.
Optimization Design of an Aircraft Wing Structure based on Response Surface Method
Authors: Hanif A A G , Li H S , Raza M A , Kamran M , Abdullah M
Published: July 2020

Wing is the most critical part of an aircraft whose structural weight holds prime importance. It is always desirable to reduce the weight of an aircraft. In this work, a detailed analysis of wing is carried out and results pertaining to stress distribution are recorded. Commercial software ANSYS is used to perform simulations related to stress, strain and displacement distributions. Moreover, the optimization design of an aircraft wing was conducted using design of experiments (DOE) and response surface method (RSM) technique for the reduction of computational cost. The aircraft wing is efficiently optimized by changing thickness under the same loading and flight conditions. Results show that this optimization technique is useful to reduce stresses as well as overall weight of the structure with minor variation in thickness of components.
Analysis of Gas State in Venus Surface Environment Simulation System
Authors: Wen Gao , Xiaoning Yang , Jing Wang , Qinliang Guo , Boying Lin , Yanqiang Bi , Yue Wu
Published: July 2020

Venus, as a terrestrial planet, not only has the closest distance to Earth in the solar system but also has similar size and mass to Earth, the detection on it has extremely high reference value for Earth and future research. While due to the high temperature, high pressure and weak acid environment on the surface of the planet, the landing detection is hindered. Based on comprehensive analysis and computation on the Venus surface environment simulation process and diffusion state of single-phase binary gas under high-temperature and high-pressure conditions, this article provides an optimization scheme, which would provide support for the establishment of future environmental simulation equipment.
Study on Unlocking Failure Mode for Mechanical Gyroscope in Spacecraft
Authors: Song Xiaohui , Guo Liang , Shan Ming , Zhang Qiang , Wei Lili , Wang Pei , Wang Xiaochen , Feng Tongchun
Published: July 2020

Mechanical gyroscope is a single-degree-of-freedom gyroscope used to measure the angular velocity of the carrier. In this paper, in accordance with the problem in the process of producing, based on the analysis of factors that influence the gyroscope’s assembly& debugging precision, through the experiment and analysis, the cause of in the process of producing is found, the technique to solving the problem is presented. The problem of unable to unlock normally is solved. This technique can be used in the producing of gyroscope and can increase passing rate of mechanical gyroscope. The experimentations result indicate that the scheme is in reason. The efficiency of gyroscope assembly is greatly enhanced.
Thermodynamic Investigation of Conventional and Alternative Rocket Fuels for Aerospace Propulsion
Authors: Ghedjatti Ilyes , Yuan Shiwei , Wang Haixing
Published: July 2020

The magnitude of the exhaust velocity is dependent on molecular and chemical properties of the propellant, and the expansion ratio of the engine. The main requirement for all propellant combinations is to maximize the energy release per kilogram; in other words, the lower the mass for a given energy release, the higher is the ultimate velocity of the vehicle. This also implies that the mass flow rate depends on the density, while the exhaust velocity depends on the energy contained in the hot gas. The main performance parameters can be defined as the thrust coefficient related to the nozzle performance, and the characteristic velocity related to the propellant and combustion performance. The first parameter reaches its optimum when the exhaust pressure is equal to the ambient pressure while the second parameter is defined by the choice of propellant combination. The objective of this work is to investigate, numerically and thermodynamically, different combinations of oxidizers with conventional and alternative fuels, for different rocket propulsion and energy generation systems. Based on the state-of-the-art and the analysis results on the most promising fuel-oxidizer combinations for the future of aerospace propulsion and space transportation, in a technically and environmentally sound manner, conclusions are made.
Dynamic Characteristics Analysis and Flight Test of Free Flight Model with Four Propellers
Authors: Wang Yalong , Yin Wenqiang , Qi Shenjun
Published: July 2020

Flight mode characteristics of free flight model with four propellers are analyzed, based on the results and flight test requirement, the control law is designed, then the simulation model is established and analyzed, finally, the control law is applied to free flight model test.The flight test results show: the propeller promoted the velocity stability and Dutch mode characteristic; level and turn flight stall test subjects were effectively accomplished based on the control law; the dynamic model built can simulate the free flight model test processand initially predict the stall characteristics; level stall angel is 10-12°, turn stall angel is 8-10°.
Research Status and Expectation of Intelligent Deformable Wing Aircraft
Authors: Ma Liangzheng , Huang Wei , Ao Yuntu , Yi Lin , Wang Ying
Published: July 2020

The performance requirements for military reconnaissance, military strikes, long-range transport and medical rescue are constantly increasing. The traditional wing has bottlenecks in terms of improving flight efficiency and mission adaptability, which restrict the performance of the aircraft. With the development of new intelligent materials and continuous pursue of aerodynamic performance, the concept of deformable wing emerges as the times require. This paper analyzes the advantages and disadvantages of deformable wing aircraft, summarizes the research results and current situation at home and abroad, and finally makes a prospect for the development of the technology.
Mechanism of visible-light-driven photocatalytic degradation of endosulfan pesticide by gold nanoparticles
Authors: Goel Puja , Arora Manju
Published: July 2020

Spherical shaped gold nanoparticles (GNPs) of size around ∼9 nm were successfully used for photocatalytic degradation of hazardous endosulfan (ES) pesticide. GNPs absorb sunlight at ambient condition in aqueous medium to enhance localized surface plasmon resonance (LSPR) which initiate hydrolysis, oxidation and reduction chemical reactions for the mineralization of ES molecules. Infrared transmittance spectra of GNPs treated ES solutions revealed formation of amorphous carbon and hydrocarbon as final reaction products indicating the nearly complete mineralization of ES as evidenced from their TEM images also. The disappearance of chloro carbon and sulphite functional groups peaks of ES in IR transmittance spectra confirmed their degradation. TEM images also support the optical absorption spectra consisting of inter-band and LSPR bands pertaining to individual and clustered GNPs ensembles. The redshift in LSPR absorption peak positions along minor and major axis of clustered GNPs ensembles is attributed to the change in GNPs polarizability on interaction with the electric component of visible light. The chemical reaction pathway for ES molecule degradation by the photocatalytic GNPs has been proposed in the light of inferences drawn from TEM images, IR transmittance and optical absorption spectra.
Atomic and close-to-atomic scale manufacturing: perspectives and measures
Authors: Fang Fengzhou
Published: July 2020

This article presents the three paradigms of manufacturing advancement: Manufacturing I, craft-based manufacturing by hand, as in the Stone, Bronze, and Iron Ages, in which
manufacturing precision was at the millimeter scale; Manufacturing II, precision-controllable
manufacturing using machinery whereby the scales of material removal, migration, and addition
were reduced from millimeters to micrometers and even nanometers; and Manufacturing III,
manufacturing objectives and processes are directly focused on atoms, spanning the macro through
the micro- to the nanoscale, whereby manufacturing is based on removal, migration, and
addition at the atomic scale, namely, atomic and close-to-atomic scale manufacturing (ACSM). A
typical characteristic of ACSM is that energy directly impacts the atom to be removed, migrated,
and added. ACSM, as the next generation of manufacturing technology, will be employed to
build atomic-scale features for required functions and performance with the capacity of mass
production. It will be the leading development trend in manufacturing technology and will play a significant role in the manufacture of high-end components and future products.
Synthesis of 2-phenyl-5,6,7,8-tetrahydroquinoxaline derivatives and screening for P2X1-purinoceptor antagonist activity in isolated preparations of rat vas deferens, for translation into a male contraceptive†
Authors: Mathiew Mitch , Dennis Belinda M , Bennetts Felix , Su N N Eunice , Nguyen Nghi , Botteon Antony , Baell Jonathan B , Ventura Sabatino
Published: July 2020

Sympathetically mediated contractions of smooth muscle cells in the vasa deferentia are mediated by neuronally released adenosine 5′-triphosphate (ATP) and noradrenaline, which stimulate P2X1-purinoceptors and α1A-adrenoceptors, respectively. This process is crucial for sperm transport, as demonstrated in knockout mouse studies where simultaneous genetic deletion of P2X1-purinoceptors and α1A-adrenoceptors resulted in male infertility. We hypothesize that dual pharmacological antagonism of these two receptors could inhibit sperm transport sufficiently to provide a novel nonhormonal method of male contraception. To generate a suitable P2X1-purinoceptor antagonist, substituents were introduced on the phenyl moiety of 2-phenyl-5,6,7,8-tetrahydroquinoxaline to create a series of analogues that were tested for P2X1-purinoceptor antagonism in isolated preparations of rat vas deferens. Novel compounds were initially screened for their ability to attenuate contractile responses to electrical field stimulation (EFS: 60 V, 0.5 ms, 0.2 Hz). The addition of polar substituents to the meta, but not ortho, position markedly increased the inhibition of contractions, as did the addition of both polar and aliphatic substituents to the para position. Di-substituted compounds were also synthesized and tested, resulting in a compound 31 (2-hydroxy, 4-fluoro), which exhibited the greatest potency, with an IC50 of 14 μM (95% confidence limits: 12–16 μM). Additionally, compound 31 noncompetitively antagonized contractions mediated by exogenously administered αß-methylene ATP (10 nM–30 μM) but had no inhibitory effect on contractions mediated by exogenously administered noradrenaline (30 nM–100 μM) or acetylcholine (30 nM–100 μM). These results have contributed to a structure–activity relationship profile for the P2X1-purinoceptor that will inform future designs of more potent antagonists.
Chromosome-level de novo assembly of the pig-tailed macaque genome using linked-read sequencing and HiC proximity scaffolding
Authors: Roodgar Morteza , Babveyh Afshin , Nguyen Lan H , Zhou Wenyu , Sinha Rahul , Lee Hayan , Hanks John B , Avula Mohan , Jiang Lihua , Jian Ruiqi , Lee Hoyong , Song Giltae , Chaib Hassan , Weissman Irv L , Batzoglou Serafim , Holmes Susan , Smith David G , Mankowski Joseph L , Prost Stefan , Snyder Michael P
Published: July 2020

Background

Macaque species share >93% genome homology with humans and develop many disease phenotypes similar to those of humans, making them valuable animal models for the study of human diseases (e.g., HIV and neurodegenerative diseases). However, the quality of genome assembly and annotation for several macaque species lags behind the human genome effort.

Results

To close this gap and enhance functional genomics approaches, we used a combination of de novo linked-read assembly and scaffolding using proximity ligation assay (HiC) to assemble the pig-tailed macaque (Macaca nemestrina) genome. This combinatorial method yielded large scaffolds at chromosome level with a scaffold N50 of 127.5 Mb; the 23 largest scaffolds covered 90% of the entire genome. This assembly revealed large-scale rearrangements between pig-tailed macaque chromosomes 7, 12, and 13 and human chromosomes 2, 14, and 15. We subsequently annotated the genome using transcriptome and proteomics data from personalized induced pluripotent stem cells derived from the same animal. Reconstruction of the evolutionary tree using whole-genome annotation and orthologous comparisons among 3 macaque species, human, and mouse genomes revealed extensive homology between human and pig-tailed macaques with regards to both pluripotent stem cell genes and innate immune gene pathways. Our results confirm that rhesus and cynomolgus macaques exhibit a closer evolutionary distance to each other than either species exhibits to humans or pig-tailed macaques.

Conclusions

These findings demonstrate that pig-tailed macaques can serve as an excellent animal model for the study of many human diseases particularly with regards to pluripotency and innate immune pathways.
LncRNA HCG18 contributes to the progression of hepatocellular carcinoma via miR-214-3p/CENPM axis
Authors: Zou Yuepei , Sun Zhonghua , Sun Shuangming
Published: July 2020

Long non-coding RNA (lnc) HCG18 has been reported to contribute progression of a variety of tumours. However, its roles in hepatocellular carcinoma (HCC) remains unknown. In the current study, we intended to uncover the biological functions of HCG18 in HCC. Quantitative real-time polymerase chain reaction (qRT-PCR) was conducted to detect the expression of HCG18, microRNA-214-3p (miR-214-3p) and centromere protein M (CENPM) messenger RNA (mRNA). The role of HCG18 in the growth and migration were assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, colony formation assay, wound healing assay and flow cytometry in vitro and animal experiments in vivo. The results showed that HCG18 was highly expressed in HCC tissues. HCG18 silencing inhibited the proliferation and migration while induced the apoptosis of HCC cells. Besides, miR-214-3p was down-regulated in HCC cells. Further experiments revealed that miR-214-3p could directly bind to HCG18 and exerted an anti-tumour role to counteracted siHCG18-1-mediated influence in HCC cells. Moreover, miR-214-3p could directly interact with CENPM mRNA and down-regulating the expression of CENPM. While HCG18 could up-regulate the expression of CENPM through acting as a sponge of miR-214-3p. Therefore, those results suggested HCG18 functioned as an oncogene to promote the proliferation and migration of HCC cells via miR-214-3p/CENPM axis.
Development of a miniaturized 3D organoid culture platform for ultra-high-throughput screening
Authors: Du Yuhong , Li Xingnan , Niu Qiankun , Mo Xiulei , Qui Min , Ma Tingxuan , Kuo Calvin J , Fu Haian
Published: July 2020

The recent advent of robust methods to grow human tissues as 3D organoids allows us to recapitulate the 3D architecture of tumors in an in vitro setting and offers a new orthogonal approach for drug discovery. However, organoid culturing with extracellular matrix to support 3D architecture has been challenging for high-throughput screening (HTS)-based drug discovery due to technical difficulties. Using genetically engineered human colon organoids as a model system, here we report our effort to miniaturize such 3D organoid culture with extracellular matrix support in high-density plates to enable HTS. We first established organoid culturing in a 384-well plate format and validated its application in a cell viability HTS assay by screening a 2036-compound library. We further miniaturized the 3D organoid culturing in a 1536-well ultra-HTS format and demonstrated its robust performance for large-scale primary compound screening. Our miniaturized organoid culturing method may be adapted to other types of organoids. By leveraging the power of 3D organoid culture in a high-density plate format, we provide a physiologically relevant screening platform to model tumors to accelerate organoid-based research and drug discovery.
A case of missed unstable cervical injury during the COVID-19 pandemic
Authors: Archer James E , Gardner Adrian
Published: July 2020

This case report discusses a patient with a significant, unstable, three-column injury of the cervical spine, which was not initially detected and was subsequently found on reassessment at 2 weeks post injury. The report discusses the imaging findings and the subsequent management of the injury. The report highlights the need for an individualized assessment of each presentation, taking into account the circumstances of injury and any pre-existing degenerative change in the spine.
Demographics and Career Intentions of Graduates of Combined Baccalaureate–MD Programs, 2010–2017: An Analysis of AAMC Graduation Questionnaire Data
Authors: Merritt Rory , Baird Janette , Clyne Brian
Published: July 2020

Purpose

Combined baccalaureate–MD programs exist to fulfill a variety of educational missions, including to promote the development of physician–scientists, increase workforce diversity, promote primary care careers, and meet the needs of underserved patients. The authors sought to determine the demographics of combined program graduates, as well as their intention to practice in primary care (IPPC) and intention to work with the medically underserved (IWMU), as compared with graduates of traditional MD programs.

Method

Data from the 2010–2017 Association of American Medical Colleges Graduation Questionnaire, a national survey of graduating medical students, were recategorized (e.g., as combined program or traditional program) before analysis. Logistic regression models on the 2 primary outcomes (IPPC and IWMU) were conducted to estimate odds ratios for the effects of covariates and predictors (e.g., gender, underrepresented in medicine [URM] group member, type of medical degree program).

Results

Data from a total of 109,028 respondents were included (3,182 from combined and 105,846 from traditional programs). Compared with students in traditional programs, those in combined programs were more likely to be younger (age at graduation ≤ 29: 3,143, 98.8% vs 89,688, 84.7%) and female (1,813, 57.0% vs 52,013, 49.1%) but less likely to identify as a URM group member (276, 8.7% vs 14,757, 13.9%). In an adjusted logistic regression model, graduating from a combined program, identifying as female, and IWMU predicted significantly greater odds of IPPC, while identifying as a URM, identifying as female, and having debt predicted significantly greater odds of IWMU. Graduating medical students who indicated family medicine as a career specialty were more likely to indicate an IWMU.

Conclusions

Medical students graduating from combined programs were more likely to indicate an IPPC but were no more likely to indicate an IWMU than traditional program graduates.
A Call for LGBTQ Content in Graduate Medical Education Program Requirements
Authors: Pregnall Andrew M. , Churchwell André L. , Ehrenfeld Jesse M.
Published: July 2020

A well-developed body of literature demonstrates that lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals experience poorer health outcomes and report worse health care experiences than straight/cisgender individuals. Many reforms since 2010 have addressed the LGBTQ-related education of future health care professionals at the undergraduate medical education (UME) level; however, reforms at the graduate medical education (GME) level are lagging, and new literature suggests that didactic education at the UME level is not enough to prepare future physicians to properly and compassionately care for LGBTQ patients. Recently, the Accreditation Council for Graduate Medical Education (ACGME) implemented a major revision of its Common Program Requirements that requires residents to demonstrate, as a competence, respect and responsiveness to diverse populations. Given these revisions and the ongoing failure of many GME training programs to adequately prepare future physicians to care for LGBTQ patients, the authors argue that now is the time for the ACGME to develop and implement LGBTQ health–related residency requirements. In addition, the authors outline a path by which the academic medical community may develop and implement these requirements.
Addressing Kentucky’s Physician Shortage While Securing a Network for a Research-Intensive, Referral Academic Medical Center: Where Public Policy Meets Effective Clinical Strategic Planning
Authors: Griffith Charles H. , de Beer Fred , Edwards Robert L. , Smith Connie , Colvin Garren , Karpf Michael
Published: July 2020

A critical shortage of physicians is looming in the United States. The situation in Kentucky is especially dire, especially in rural areas. Class size constraints have resulted in the University of Kentucky College of Medicine (UK COM) unable to admit over 100 qualified Kentuckians each year. This article describes how leadership at University of Kentucky committed to addressing the state physician shortage while simultaneously strengthening relationships with critical partners through the establishment of two 4-year UK COM regional medical campuses. Based on criteria (such as a commitment to educating physicians, ample patients, sufficient willing physician preceptors, etc.), partners selected were Med Center Health, the leading health care system in southwestern Kentucky, and St. Elizabeth Healthcare, the predominant health care system in northern Kentucky. These regional campuses allow UK COM to expand its class size to 201 and total enrollment to 804, increasing from historically 70 to currently 120 graduates per year expected to practice in Kentucky. Critical to the success of this expansion is the buy-in of leadership and the Admissions Committee to consider students with a wider range of Medical College Admission Test scores. The regional clinical partners have substantially increased their teaching opportunities, with a greater ability to attract physicians. Both partners have made substantial financial contributions in support of the regional campuses. These relationships have energized UK COM engagement with its area alumni and have resulted in fewer Kentuckians referred out of state for advanced specialty care. Partnerships are also occurring with UK COM to increase graduate medical education offerings at the regional sites, fulfilling the vision of “training Kentuckians in Kentucky to practice in Kentucky.”
Can titanium elastic nail be safely used for paediatric subtrochanteric femur fractures?
Authors: Basa Can Doruk , Kacmaz Ismail Eralp , Zhamilov Vadym , Reisoglu Ali , Agus Haluk
Published: July 2020

In this study, we aimed to show that subtrochanteric femur fractures, an uncommon type of fracture in the paediatric age group, can be treated with titanium elastic nailing (TEN). We reviewed the patients treated with TEN in the paediatric age group with subtrochanteric femur fractures who had been treated at the Orthopaedics and Traumatology Clinic of Izmir Tepecik Research and Training Hospital between January 2011 and December 2016 retrospectively. All fractures were fixed by retrograde nailing with supracondylar entry following reduction. Patients’ demographics as well as data such as fracture type, fracture level, time of operation, reduction type, time to union, shortness, additional fixation, duration of additional fixation, Flynn scores and reduction loss were evaluated. The 20 patients included in our study were followed up for at least 1 year, had an age range of 54–173 months (mean, 104 ± 31.82 months) and were operated within 2–11 days after fracture. All patients had fracture union and only three patients had union with an angulation of less than 5°. None of the patients had limb length inequality. Fourteen patients underwent reoperation, all of these were routine operations for implant removal and no patients required reoperation for complications. We think that paediatric subtrochanteric femur fractures can be treated by TEN fixation using the proper technique, with a limited invasive intervention.
Influence of local anesthesia on the outcomes of non-surgical periodontal treatment
Authors: Shi Shu-Wen , Jiao Jian , Zhang Li , Lu Rui-Fang , Meng Huan-Xin , Cao Zhan-Qiang , Shi Dong , Song Yi
Published: July 2020

Background

There is limited evidence of the effects of local anesthesia (LA) on outcomes of non-surgical periodontal treatment (NSPT), in particular among the Chinese. This retrospective cohort study aimed to evaluate the effects of LA on short-term treatment outcomes of NSPT and to determine under what circumstances LA should be prescribed to improve these outcomes.

Methods

Data from periodontal examinations of 3980 patients were used. The data were from 3-month re-evaluation records of an electronic periodontal charting record system in the Department of Periodontology of Peking University School and Hospital of Stomatology from June 2008 to January 2015. Descriptive analyses included changes in probing depth (PD) and the Mazza bleeding index (BI). Two-level (patient and tooth) logistic regression models and three-level (patient, tooth, and site) linear regression models were constructed to analyze the influence of LA on PD for all teeth/sites and teeth/sites with an initial PD ≥ 5 mm. Decreases in PD and BI at sites under LA using the initial PD were also compared.

Results

A significantly higher mean decrease in PD after NSPT was found in the LA group than in the no local anesthesia (NLA) group (0.98 vs. 0.54 mm, t = 24.12, P < 0.001). A significantly higher probability of decreases was found in the LA group in BI (percentages of teeth with BI > 1 and BI > 2) for all teeth (16.7% vs. 13.8%, t = 3.75, P < 0.001; 34.7% vs. 28.1%, t = 6.73, P < 0.001) and PD for teeth with PD ≥ 5 mm (32.3% vs. 17.3%, t = 28.48, P < 0.001). The difference in PD between the LA and NLA groups increased as the initial PD increased. The difference between the two groups was 0.12 to 0.22 mm for sites with a baseline PD < 7 mm; however, it increased to 0.41 to 1.37 mm for sites with a baseline PD ≥ 7 mm.

Conclusions

LA improved the decrease in PD after NSPT. Root debridement at sites with initial PD ≥ 7 mm should be performed under routine LA.
Single-nucleotide polymorphism biomarkers of adjuvant anastrozole-induced estrogen suppression in early breast cancer
Authors: Ingle James N. , Kalari Krishna R. , Barman Poulami , Shepherd Lois E. , Ellis Matthew J. , Goss Paul E. , Buzdar Aman U. , Robson Mark E. , Cairns Junmei , Carlson Erin E. , Eyman Casey Abraham , Hoskin Tanya L. , Goodnature Barbara A. , Haddad Tufia C. , Goetz Matthew P. , Weinshilboum Richard M. , Wang Liewei
Published: July 2020

Objectives

Based on our previous findings that postmenopausal women with estrone (E1) and estradiol (E2) concentrations at or above 1.3 pg/ml and 0.5 pg/ml, respectively, after 6 months of adjuvant anastrozole therapy had a three-fold risk of recurrence, we aimed to identify a single-nucleotide polymorphism (SNP)-based model that would predict elevated E1 and E2 and then validate it in an independent dataset.

Patients and methods

The test set consisted of 322 women from the M3 study and the validation set consisted of 152 patients from MA.27. All patients were treated with adjuvant anastrozole, had on-anastrozole E1 and E2 concentrations and genome-wide genotyping.

Results

SNPs were identified from the M3 genome-wide association study. The best model to predict the E1-E2 phenotype with high balanced accuracy was a support vector machine model using clinical factors plus 46 SNPs. We did not have an independent cohort that is similar to the M3 study with clinical, E1-E2 phenotypes and genotype data to test our model. Hence, we chose a nested matched case-control cohort (MA.27 study) for testing. Our E1-E2 model was not validated but we found the MA.27 validation cohort was both clinically and genomically different.

Conclusions

We identified a SNP-based model that had excellent performance characteristics for predicting the phenotype of elevated E1 and E2 in women treated with anastrozole. This model was not validated in an independent dataset but that dataset was clinically and genomically substantially different. The model will need validation in a prospective study.
The COMPASS trial: practical considerations for application after coronary artery bypass surgery
Authors: Eikelboom Rachel , Muller Moran Hellmuth R. , Lodewyks Carly , Yan Weiang , Zelentsov Ivan , Arora Rakesh C.
Published: July 2020

Purpose of review

We review the cardiovascular outcomes for people using anticoagulation strategies (COMPASS) trial with particular emphasis on patients with a history of remote coronary artery bypass grafting (CABG) and those who were enrolled 4–14 days after CABG. We provide practical guidance for selecting patients with the greatest potential to benefit who have acceptable bleeding risk. In particular, we address concerns about postoperative bleeding and discuss the relative merits of rivaroxaban and aspirin versus P2Y12 inhibition and aspirin.

Recent findings

The COMPASS trial demonstrated that rivaroxaban and aspirin reduce myocardial infarction, stroke, and cardiovascular death in patients with coronary artery disease, without a demonstrated effect on bypass graft patency in the first postoperative year.

After CABG, cardiac surgeons should consider using the COMPASS regimen in patients at high risk of thrombosis whose risk of bleeding is acceptable. If used, the COMPASS regimen should be continued indefinitely in conjunction with other pharmacological risk reduction therapies to prevent long-term atherothrombotic events.
Positive relationship of hypertensive retinopathy with carotid intima--media thickness in hypertensive patients
Authors: Zhang Wenbo , Li Jun , Zhao Liang , Zhang Jing , She Haicheng , Meng Ying , Peng Yuan , Shang Kun , Zhang Yadi , Gu Xiaopeng , Chen Xuling , Zhang Yan , Yang Ying , Sun Pengfei , Qin Xianhui , Wang Binyan , Xu Xiping , Hou Fanfan , Tang Genfu , Liao Rongfeng , Lin Tengfei , Jiang Chongfei , Huo Yong , Yang Liu
Published: July 2020

Objectives:

We aimed to explore the relationship of hypertensive retinopathy with carotid intima--media thickness (CIMT), and to examine the possible effect modifiers in Chinese adults with hypertension.

Methods:

We conducted a cross-sectional study of 12 342 hypertensive patients with complete exit site visit data from the China Stroke Primary Prevention Trial. CIMT was measured by carotid ultrasonography. Hypertensive retinopathy was diagnosed according to the Keith--Wagener--Barker classification.

Results:

The mean (SD) CIMT among study participants was 739.9 (111.4) μm. Compared with patients with grade 1 hypertensive retinopathy or without hypertensive retinopathy, a significantly higher CIMT level (β, 7.63, 95% CI: 2.54--12.73) was observed in patients with grade 2–4 hypertensive retinopathy. Moreover, the association between hypertensive retinopathy (grade 2–4 versus grade 1 or normal) and CIMT was stronger in participants of younger age (<60 years; β, 13.70, 95% CI: 5.65--21.75; versus ≥60 years; β, 1.03, 95% CI: −5.58 to 7.63; P interaction = 0.006); or with lower total homocysteine levels [<12.1 μmol/l (median); β, 12.70, 95% CI: 5.98--19.42; versus ≥12.1 μmol/l; β, 2.07, 95% CI: −5.63 to 9.78; P interaction = 0.030). None of the other variables, including sex, BMI, study centers, treatment group, SBP, triglycerides, total cholesterol, fasting blood glucose, folate, serum creatinine, current smoking and alcohol drinking, significantly modified the relation of hypertensive retinopathy with CIMT levels.

Conclusion:

Hypertensive retinopathy (grade 2 and higher) was significantly associated with increased CIMT in hypertensive patients. The association was stronger in those of younger age or with lower total homocysteine levels.