bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficient exploration and calibration of a semi-analytical model of galaxy formation with deep learning
Authors: Elliott Edward J , Baugh Carlton M , Lacey Cedric G
Published: June 2021

We implement a sample-efficient method for rapid and accurate emulation of semi-analytical galaxy formation models over a wide range of model outputs. We use ensembled deep learning algorithms to produce a fast emulator of an updated version of the galform model from a small number of training examples. We use the emulator to explore the model’s parameter space, and apply sensitivity analysis techniques to better understand the relative importance of the model parameters. We uncover key tensions between observational data sets by applying a heuristic weighting scheme in a Markov chain Monte Carlo framework and exploring the effects of requiring improved fits to certain data sets relative to others. Furthermore, we demonstrate that this method can be used to successfully calibrate the model parameters to a comprehensive list of observational constraints. In doing so, we re-discover previous galform fits in an automatic and transparent way, and discover an improved fit by applying a heavier weighting to the fit to the metallicities of early-type galaxies. The deep learning emulator requires a fraction of the model evaluations needed in similar emulation approaches, achieving an out-of-sample mean absolute error at the knee of the K-band luminosity function of 0.06 dex with less than 1000 model evaluations. We demonstrate that this is an extremely efficient, inexpensive, and transparent way to explore multidimensional parameter spaces, and can be applied more widely beyond semi-analytical galaxy formation models.
The ASKAP-EMU Early Science Project: 888 MHz radio continuum survey of the Large Magellanic Cloud
Authors: Pennock Clara M , van Loon Jacco Th , Filipović Miroslav D , Andernach Heinz , Haberl Frank , Kothes Roland , Lenc Emil , Rudnick Lawrence , White Sarah V , Agliozzo Claudia , Antón Sonia , Bojičić Ivan , Bomans Dominik J , Collier Jordan D , Crawford Evan J , Hopkins Andrew M , Jeganathan Kanapathippillai , Kavanagh Patrick J , Koribalski Bärbel S , Leahy Denis , Maggi Pierre , Maitra Chandreyee , Marvil Josh , Michałowski Michał J , Norris Ray P , Oliveira Joana M , Payne Jeffrey L , Sano Hidetoshi , Sasaki Manami , Staveley-Smith Lister , Vardoulaki Eleni
Published: June 2021

We present an analysis of a new 120 deg2 radio continuum image of the Large Magellanic Cloud (LMC) at 888 MHz with a bandwidth of 288 MHz and beam size of 13${_{.}^{\prime\prime}}$9 × 12${_{.}^{\prime\prime}}$1 from the Australian Square Kilometre Array Pathfinder processed as part of the Evolutionary Map of the Universe survey. The median root mean squared noise is 58 $\mu$Jy beam−1. We present a catalogue of 54 612 sources, divided over a Gold list (30 866 sources) complete down to 0.5 mJy uniformly across the field, a Silver list (22 080 sources) reaching down to <0.2 mJy, and a Bronze list (1666 sources) of visually inspected sources in areas of high noise and/or near bright complex emission. We discuss detections of planetary nebulae and their radio luminosity function, young stellar objects showing a correlation between radio luminosity and gas temperature, novae and X-ray binaries in the LMC, and active stars in the Galactic foreground that may become a significant population below this flux level. We present examples of diffuse emission in the LMC (H ii regions, supernova remnants, bubbles) and distant galaxies showcasing spectacular interaction between jets and intracluster medium. Among 14 333 infrared counterparts of the predominantly background radio source population, we find that star-forming galaxies become more prominent below 3 mJy compared to active galactic nuclei. We combine the new 888 MHz data with archival Australia Telescope Compact Array data at 1.4 GHz to determine spectral indices; the vast majority display synchrotron emission but flatter spectra occur too. We argue that the most extreme spectral index values are due to variability.
Do galaxies die? Different views from simulations and observations in the local Universe
Authors: Corcho-Caballero Pablo , Ascasibar Yago , Scannapieco Cecilia
Published: June 2021

For years, the extragalactic community has divided galaxies in two distinct populations. One of them, featuring blue colours, is actively forming stars, while the other is made up of ‘red-and-dead’ objects with negligible star formation. Yet, are these galaxies really dead? Here, we would like to highlight that, as previously reported by several independent groups, state-of-the-art cosmological numerical simulations (EAGLE, IllustrisTNG, MAGNETICUM, and SIMBA) predict the existence of a large number of quenched galaxies that have not formed any star over the last few Gyr. In contrast, observational measurements of large galaxy samples in the nearby Universe (GAMA, SDSS) suggest that even the most passive systems still form stars at some residual level close to sSFR ∼ 10−12 yr−1. Unfortunately, extremely low star formation poses a challenge for both approaches. We conclude that, at present, the fraction of truly dead galaxies is still an important open question that must be addressed in order to understand galaxy formation and evolution.
The stellar mass – physical effective radius relation for dwarf galaxies in low-density environments
Authors: Prole D J
Published: June 2021

The scaling relation between stellar mass (M*) and physical effective radius (re) has been well studied using wide spectroscopic surveys. However, these surveys suffer from severe surface brightness incompleteness in the dwarf galaxy regime, where the relation is poorly constrained. In this study, I use a Bayesian empirical model to constrain the power-law exponent β of the M*–re relation for late-type dwarfs ($10^{7} \le$M*/M⊙$\le 10^{9}$) using a sample of 188 isolated low surface brightness (LSB) galaxies, accounting for observational incompleteness. Surprisingly, the best-fitting model (β = 0.40 ± 0.07) indicates that the relation is significantly steeper than would be expected from extrapolating canonical models into the dwarf galaxy regime. Nevertheless, the best fitting M*–re relation closely follows the distribution of known dwarf galaxies. These results indicate that extrapolated canonical models overpredict the number of large dwarf (i.e. LSB) galaxies, including ultra-diffuse galaxies (UDGs), explaining why they are overproduced by some semi-analytic models. The best-fitting model also constrains the power-law exponent of the physical size distribution of UDGs to $n\mathrm{[dex^{-1}]}\propto r_{\mathrm{ e}}^{3.54\pm 0.33}$, consistent to within 1σ of the corresponding value in cluster environments and with the theoretical scenario in which UDGs occupy the high-spin tail of the normal dwarf galaxy population.
Monitoring Insect Transposable Elements in Large Double-Stranded DNA Viruses Reveals Host-to-Virus and Virus-to-Virus Transposition
Authors: Loiseau Vincent , Peccoud Jean , Bouzar Clémence , Guillier Sandra , Fan Jiangbin , Gueli Alletti Gianpiero , Meignin Carine , Herniou Elisabeth A , Federici Brian A , Wennmann Jörg T , Jehle Johannes A , Cordaux Richard , Gilbert Clément
Published: June 2021

The mechanisms by which transposable elements (TEs) can be horizontally transferred between animals are unknown, but viruses are possible candidate vectors. Here, we surveyed the presence of host-derived TEs in viral genomes in 35 deep sequencing data sets produced from 11 host–virus systems, encompassing nine arthropod host species (five lepidopterans, two dipterans, and two crustaceans) and six different double-stranded (ds) DNA viruses (four baculoviruses and two iridoviruses). We found evidence of viral-borne TEs in 14 data sets, with frequencies of viral genomes carrying a TE ranging from 0.01% to 26.33% for baculoviruses and from 0.45% to 7.36% for iridoviruses. The analysis of viral populations separated by a single replication cycle revealed that viral-borne TEs originating from an initial host species can be retrieved after viral replication in another host species, sometimes at higher frequencies. Furthermore, we detected a strong increase in the number of integrations in a viral population for a TE absent from the hosts’ genomes, indicating that this TE has undergone intense transposition within the viral population. Finally, we provide evidence that many TEs found integrated in viral genomes (15/41) have been horizontally transferred in insects. Altogether, our results indicate that multiple large dsDNA viruses have the capacity to shuttle TEs in insects and they underline the potential of viruses to act as vectors of horizontal transfer of TEs. Furthermore, the finding that TEs can transpose between viral genomes of a viral species sets viruses as possible new niches in which TEs can persist and evolve.
A small-molecule chemical interface for molecular programs
Authors: Shenshin Vasily A , Lescanne Camille , Gines Guillaume , Rondelez Yannick
Published: June 2021

In vitro molecular circuits, based on DNA-programmable chemistries, can perform an increasing range of high-level functions, such as molecular level computation, image or chemical pattern recognition and pattern generation. Most reported demonstrations, however, can only accept nucleic acids as input signals. Real-world applications of these programmable chemistries critically depend on strategies to interface them with a variety of non-DNA inputs, in particular small biologically relevant chemicals. We introduce here a general strategy to interface DNA-based circuits with non-DNA signals, based on input-translating modules. These translating modules contain a DNA response part and an allosteric protein sensing part, and use a simple design that renders them fully tunable and modular. They can be repurposed to either transmit or invert the response associated with the presence of a given input. By combining these translating-modules with robust and leak-free amplification motifs, we build sensing circuits that provide a fluorescent quantitative time-response to the concentration of their small-molecule input, with good specificity and sensitivity. The programmability of the DNA layer can be leveraged to perform DNA based signal processing operations, which we demonstrate here with logical inversion, signal modulation and a classification task on two inputs. The DNA circuits are also compatible with standard biochemical conditions, and we show the one-pot detection of an enzyme through its native metabolic activity. We anticipate that this sensitive small-molecule-to-DNA conversion strategy will play a critical role in the future applications of molecular-level circuitry.
iTARGEX analysis of yeast deletome reveals novel regulators of transcriptional buffering in S phase and protein turnover
Authors: Huang Jia-Hsin , Liao You-Rou , Lin Tzu-Chieh , Tsai Cheng-Hung , Lai Wei-Yun , Chou Yang-Kai , Leu Jun-Yi , Tsai Huai-Kuang , Kao Cheng-Fu
Published: June 2021

Integrating omics data with quantification of biological traits provides unparalleled opportunities for discovery of genetic regulators by in silico inference. However, current approaches to analyze genetic-perturbation screens are limited by their reliance on annotation libraries for prioritization of hits and subsequent targeted experimentation. Here, we present iTARGEX (identification of Trait-Associated Regulatory Genes via mixture regression using EXpectation maximization), an association framework with no requirement of a priori knowledge of gene function. After creating this tool, we used it to test associations between gene expression profiles and two biological traits in single-gene deletion budding yeast mutants, including transcription homeostasis during S phase and global protein turnover. For each trait, we discovered novel regulators without prior functional annotations. The functional effects of the novel candidates were then validated experimentally, providing solid evidence for their roles in the respective traits. Hence, we conclude that iTARGEX can reliably identify novel factors involved in given biological traits. As such, it is capable of converting genome-wide observations into causal gene function predictions. Further application of iTARGEX in other contexts is expected to facilitate the discovery of new regulators and provide observations for novel mechanistic hypotheses regarding different biological traits and phenotypes.
Distinct difference in tumor-infiltrating immune cells between Wilms’ tumor gene 1 peptide vaccine and anti-programmed cell death-1 antibody therapies
Authors: Yokota Chisato , Nakata Jun , Takano Koji , Nakajima Hiroko , Hayashibara Hiromu , Minagawa Hikaru , Chiba Yasuyoshi , Hirayama Ryuichi , Kijima Noriyuki , Kinoshita Manabu , Hashii Yoshiko , Tsuboi Akihiro , Oka Yoshihiro , Oji Yusuke , Kumanogoh Atsushi , Sugiyama Haruo , Kagawa Naoki , Kishima Haruhiko
Published: June 2021

Background

Wilms’ tumor gene 1 (WT1) peptide vaccine and anti-programmed cell death-1 (anti-PD-1) antibody are expected as immunotherapies to improve the clinical outcome of glioblastoma. The aims of this study were to clarify how each immunotherapy affects tumor-infiltrating immune cells (TIIs) and to determine whether the combination of these two therapies could synergistically work.

Methods

Mice were transplanted with WT1 and programmed cell death-ligand 1 doubly expressing glioblastoma cells into brain followed by treatment with WT1 peptide vaccine, anti-PD-1 antibody, or the combination of the two, and survival of each therapy was compared. CD45+ cells were positively selected as TIIs from the brains with tumors, and TIIs were compared between WT1 peptide vaccine and anti-PD-1 antibody therapies.

Results

Most mice seemed to be cured by the combination therapy with WT1 peptide vaccine and anti-PD-1 antibody, which was much better survival than each monotherapy. A large number of CD4+ T cells, CD8+ T cells, and NK cells including WT1-specific CD8+ and CD4+ T cells infiltrated into the glioblastoma in WT1 peptide vaccine-treated mice. On the other hand, the number of TIIs did not increase, but instead PD-1 molecule expression was decreased on the majority of the tumor-infiltrating CD8+ T cells in the anti-PD-1 antibody-treated mice.

Conclusion

Our results clearly demonstrated that WT1 peptide vaccine and anti-PD-1 antibody therapies worked in the different steps of cancer-immunity cycle and that the combination of the two therapies could work synergistically against glioblastoma.
Regulatory Approaches and Implementation of Minimally Addictive Combusted Products
Authors: Hatsukami Dorothy K , Xu Dongqun , Ferris Wayne Geoffrey
Published: June 2021

Introduction

A joint meeting was held by the World Health Organization (WHO) and the Convention Secretariat of the WHO Framework Convention on Tobacco Control to examine the potential effects of a regulatory policy to reduce nicotine in cigarettes to minimally addictive levels. This paper reviews the feasibility of and approaches to implementing a nicotine product standard.

Methods

Prior WHO reports on this topic were consulted and a systematic review of the scientific literature was conducted. The paper was reviewed by the participants at the aforementioned meeting and their feedback was incorporated.

Results

The nicotine dose most likely to consistently reduce smoking behavior and dependence is ≤0.4 mg nicotine/g tobacco. An immediate rather than a gradual nicotine reduction approach appears to be more beneficial. Smokers are likely to seek nicotine from alternate sources (e.g., nicotine replacement therapies, e-cigarettes) or potentially, the illegal market. As such, the availability of alternative products, as well as strong policies against illegal markets, can potentially mitigate unintended consequences. An effectively reduced nicotine regulation must be imbedded in a comprehensive and strong tobacco control program that includes public education and surveillance. Barriers and challenges to implementing a nicotine product standard exist, particularly in low-capacity countries.

Conclusions

Not all countries will have the capacity to implement a regulation to reduce nicotine in cigarettes (and preferably other combusted tobacco products) to minimally addictive levels. However, for the countries that choose to implement it, such a policy could potentially dramatically reduce the burden of tobacco use.

Implications for tobacco regulatory science

Article 9 of the Framework Convention on Tobacco Control provides signatory governments the authority to implement a product standard for reducing nicotine in tobacco products to minimally addictive levels. This product standard has the potential to result in a dramatic reduction in cigarette and other combusted tobacco use and therefore, smoking-caused mortality and morbidity. This article describes the growing scientific evidence to support nicotine regulation in cigarettes, potential regulatory approaches and describes the infrastructure and tobacco control policies needed to implement a reduced nicotine product standard.
Reporting Treatment Fidelity in Behavioral Tobacco Treatment Clinical Trials: Scoping Review and Measurement Recommendations
Authors: Salloum Ramzi G , Rojewski Alana M , Piper Megan E , Blalock Janice A , Borrelli Belinda , Boyce Lindsay M , Minnix Jennifer A , Dogar Omara , Tomko Rachel L , Jorenby Douglas E , Kotsen Chris , Ostroff Jamie S
Published: June 2021

Introduction

Adoption of rigorous standards for reporting treatment fidelity is essential for advancing discovery, validation, and implementation of behavioral treatments. Whereas the NIH Behavior Change Consortium (BCC) developed an assessment tool to assess the quality of reporting and monitoring of treatment fidelity across health behavior change interventions, it has not yet been applied specifically to treatment fidelity in behavioral tobacco treatment trials.

Aims and Methods

We conducted a scoping review of peer-reviewed, clinical trials of behavioral adult tobacco treatment interventions published in English between 2006 and 2018. Using the BCC treatment fidelity checklist, articles were coded for the presence or absence of various treatment fidelity strategies within each of 5 domains: Design, Training, Delivery, Receipt, and Enactment. Eligible articles (N = 755) were coded by two independent coders.

Results

The proportion of reporting strategies varied within the fidelity domains, ranging from 5.2% to 96.3% in Design, 1.9% to 24.9% in Training, 2.6% to 32.3% in Delivery, 5.2% to 44.3% in Receipt, and 6.7% to 43.2% in Enactment. The mean proportion of adherence to treatment fidelity strategies within each domain was: Design (68%), Training (14%), Delivery (15%), Receipt (16%), and Enactment (25%). Only 11 studies achieved ≥80% reporting across >1 fidelity domain. There was no evidence for improvement in fidelity reporting across the 13-year time frame from the initial BCC publication to the present.

Conclusions

These findings illustrate the lack of consistency in fidelity reporting in tobacco treatment trials and underscore the challenges faced in evaluating rigor and reproducibility, as well as interpretation and dissemination of findings. Recommendations are made for improving fidelity reporting in tobacco treatment trials.

Implications

The SRNT Treatment Research Network sponsored a scoping review to summarize the current state of reporting treatment fidelity and make recommendations for best practices in reporting fidelity in tobacco treatment trials. The review identified a lack of consistency in fidelity reporting, illustrating the challenges faced in evaluating rigor, and reproducibility, as well as interpretation and dissemination of findings.
Systematics and conservation of an endemic radiation ofAccipiterhawks in the Caribbean islands
Authors: Catanach Therese A , Halley Matthew R , Allen Julie M , Johnson Jeff A , Thorstrom Russell , Palhano Samantha , Poor Thunder Chyna , Gallardo Julio C , Weckstein Jason D
Published: June 2021

More than one-third of the bird species found in the Caribbean are endemic to a set of neighboring islands or a single island. However, we have little knowledge of the evolutionary history of the Caribbean avifauna, and the lack of phylogenetic studies limits our understanding of the extent of endemism in the region. The Sharp-shinned Hawk (Accipiter striatus) occurs widely across the Americas and includes 3 endemic Caribbean taxa: venator on Puerto Rico, striatus on Hispaniola, and fringilloides on Cuba. These island populations have undergone extreme declines presumably due to ecosystem changes caused by anthropogenic factors, as well as due to severe hurricanes. Sharp-shinned Hawks, in general, and Caribbean Sharp-shinned Hawks, in particular, have not been placed in a modern phylogenetic context. However, the island taxa have historically been presumed to have some ongoing gene flow with mainland populations. Here we sequenced ultraconserved elements (UCEs) and their flanking regions from 38 samples, focusing on Caribbean taxa. Using a combination of UCEs, mitochondrial genome sequences, and single-nucleotide polymorphisms, we investigated the phylogenetic relationships among Caribbean lineages and their relationships to mainland taxa. We found that Caribbean Sharp-shinned Hawks are reciprocally monophyletic in all datasets with regard to mainland populations and among island taxa (with no shared mtDNA haplotypes) and that divergence in the NADH dehydrogenase 2 gene (ND2) between these mainland and island groups averaged 1.83%. Furthermore, sparse non-negative matrix factorization (sNMF) analysis indicated that Hispaniola, Puerto Rico, and mainland samples each form separate populations with limited admixture. We argue that our findings are consistent with the recognition of the 3 resident Caribbean populations as species-level taxa because nuclear and mitochondrial genetic data indicate reciprocal monophyly and have species-level divergences, there is no sharing of mitochondrial haplotypes among or between island taxa and those on the mainland; and they are diagnosable by plumage.
Perioperative Intravenous Lidocaine Infusion for Postoperative Analgesia in Patients Undergoing Surgery of the Spine: Systematic Review and Meta-Analysis
Authors: Licina Ana , Silvers Andrew
Published: June 2021

Objective

We conducted a systematic review and meta-analysis to examine the impact of perioperative intravenous lidocaine infusion on pain management scores, opioid consumption, adverse events, and hospital length of stay in patients undergoing spinal surgery.

Methods

We included randomized controlled trials evaluating the use of perioperative intravenous lidocaine in adult and pediatric patients undergoing spinal surgery. Primary outcomes were postoperative pain scores at rest and at 2, 4–6, 24, and 48 hours and adverse events attributable to lidocaine administration. We searched electronic databases from their inception to the present. We used Cochrane’s standard methods. We used a random-effects model to synthetize data. We conducted three subgroup analyses: patients undergoing major surgery vs patients undergoing minor surgery, patients with chronic pain conditions vs patients without, and adult vs pediatric patients.

Results

A total of eight studies were included that compared patients having intravenous lidocaine (n = 349) with controls (n = 343). Intravenous lidocaine administration was associated with significantly reduced visual analog pain scores at 2 hours (mean difference [MD] = −1.13), 4–6 hours (MD = −0.79), and 24 hours (MD = −0.50) postoperatively. In the adults, efficacy of treatment was extended to 48 hours (MD = −0.72). Perioperative intravenous lidocaine administration was associated with reduced perioperative opioid consumption at 24 and 48 hours, as well as decreased hospital length of stay.

Conclusion

Perioperative intravenous lidocaine infusion consistently improves analgesic measures in adult and pediatric populations in the first 24 hours, with an effective decrease in opioid consumption noted to 48 hours. These results are most generalizable in the adult population in the first 4–6 to 24 postoperative hours.
Leadership Competencies for Knowledge Translation in Public Health: A consensus study
Authors: Rodríguez-Feria Pablo , Flórez Luis Jorge Hernández , Czabanowska Katarzyna
Published: June 2021

Background

In 2010, 240 billion US dollars was invested worldwide to conduct research for health; unfortunately, 200 billion was misused in the production and reporting of the evidence researched. Universities could facilitate students to acquire leadership competencies to move well-conducted research findings into practical use; this could be an essential move to reduce the misuse of investment.

Methods

A literature review was done based on the Equator Network and Cochrane guidelines, followed by three Delphi rounds to select competencies.

Results

Eleven papers were analysed out of 1121 items and 39/78 identified competencies were prioritized to be presented in the Delphi. Four out of 12 participants accepted to be involved in this project, and 22 competencies reached consensus and stability after three rounds. This framework conceptualizes competencies as the knowledge, skills, attitudes and values. The competencies were framed in four domains: knowledge management, engage diverse others in public health initiatives, training and capacity building/change management and communication.

Conclusion

This framework offers guidance to universities when instructing students with leadership competencies for KT. This project emphasizes that effective leadership should include personal conscience and self-determination values.
Morphometry of the lateral orbitofrontal cortex is associated with eating dispositions in early adolescence: findings from a large population-based study
Authors: Hall Peter A , Best John R , Danckert James , Beaton Elliott A , Lee Jessica A
Published: June 2021

Early adolescence is a critical period for eating behaviors as children gain autonomy around food choice and peer influences increase in potency. From a neurodevelopmental perspective, significant structural changes take place in the prefrontal cortex during this time, including the orbitofrontal cortex (OFC), which is involved in socially contextualized decision-making. We examined the morphological features of the OFC in relation to food choice in a sample of 10 309 early adolescent children from the Adolescent Brain and Cognitive Development Study. Structural parameters of the OFC and insula were examined for relationships with two important aspects of food choice: limiting the consumption of fast/fried food and maximizing the consumption of nutritious foods. Raw, partially adjusted and fully adjusted models were evaluated. Findings revealed that a larger surface area of the lateral OFC was associated with higher odds of limiting fast/fried food consumption in raw [odds ratio (OR) = 1.07, confidence interval (CI): 1.02, 1.12, P = 0.002, PFDR = 0.012], partially adjusted (OR = 1.11, CI: 1.03, 1.19, P = 0.004, PFDR = 0.024) and fully adjusted models (OR = 1.11, CI: 1.03, 1.19, P = 0.006, PFDR = 0.036). In contrast, a larger insula volume was associated with lower odds of maximizing healthy foods in raw (OR = 0.94, CI: 0.91, 0.97, P <0.001, PFDR = 0.003) and partially adjusted (OR = 0.93, CI: 0.88, 0.98, P = 0.008, PFDR = 0.048) models. These findings refine our understanding of the OFC as a network node implicated in socially mediated eating behaviors.
Pathways to Social Work Licensure: An Examination of Hawai′i’s Licensed Social Workers
Authors: Arndt Robin G , Kreif Theresa M , Stotzer Rebecca L
Published: June 2021

Few research studies have examined social work practitioners and their licensure practices and pathways, or how policies affect licensure choices. Pathways to licensure, particularly the process of movement from graduation to licensure, along with the type of license, and the length of time a license is held were analyzed using administrative data from a state agency responsible for professional licensure administration and two schools of social work in the same state. The analysis prioritized the review of individuals who have held or do hold multiple licenses. Results indicated (a) that the majority of people who pursue licensure do so shortly after graduation; (b) that once licensed, graduates maintain their licenses for long periods of time; (c) that the majority of graduates do not pursue licensure; and (d) that policy contexts and opportunities for licensure at different levels affect licensure decision making. The analysis resulted in detailed information regarding the decisions graduates are making to pursue their licenses, the impact of policy on licensure pathways, the intersection of jurisdictional policy and license mobility, and the process of how social workers move through various levels of licensure.
Phytophthora sojae Pathotype Distribution and Fungicide Sensitivity in Michigan
Authors: McCoy Austin G. , Noel Zachary A. , Jacobs Janette L. , Clouse Kayla M. , Chilvers Martin I.
Published: June 2021

Identifying the pathotype structure of a Phytophthora sojae population is crucial for the effective management of Phytophthora stem and root rot of soybean (PRR). P. sojae has been successfully managed with major resistance genes, partial resistance, and fungicide seed treatments. However, prolonged use of resistance genes or fungicides can cause pathogen populations to adapt over time, rendering resistance genes or fungicides ineffective. A statewide survey was conducted to characterize this pathotype structure and fungicide sensitivity of P. sojae within Michigan. Soil samples were collected from 69 fields with a history of PRR and fields having consistent plant stand establishment issues. Eighty-three isolates of P. sojae were obtained, and hypocotyl inoculations were performed on 14 differential soybean cultivars, all of which carry a single Rps gene or no resistance gene. The survey identified a loss of effectiveness of Rps genes 1b, 1k, 3b, and 6, compared with a previous survey conducted in Michigan from 1993 to 1997. Three effective resistance genes were identified for P. sojae management in Michigan; Rps 3a, 3c, and 4. Additionally, the effective concentration of common seed treatment fungicides to inhibit mycelial growth by 50% (EC50) was determined. No P. sojae isolates were insensitive to the tested chemistries with mean EC50 values of 2.60 × 10−2 μg/ml for ethaboxam, 3.03 × 10−2 μg/ml for mefenoxam, 2.88 × 10−4 μg/ml for oxathiapiprolin, and 5.08 × 10−2 μg/ml for pyraclostrobin. Results suggest that while there has been a significant shift in Rps gene effectiveness, seed treatments are still effective for early season management of this disease.
Distant and Hidden Figures: Foregrounding Patients in the Development, Content, and Implementation of Entrustable Professional Activities
Authors: Sebok-Syer Stefanie S. , Gingerich Andrea , Holmboe Eric S. , Lingard Lorelei , Turner David A. , Schumacher Daniel J.
Published: June 2021

Entrustable professional activities (EPAs) describe activities that qualified professionals must be able to perform to deliver safe and effective care to patients. The entrustable aspect of EPAs can be used to assess learners through documentation of entrustment decisions, while the professional activity aspect can be used to map curricula. When used as an assessment framework, the entrustment decisions reflect supervisory judgments that combine trainees’ relational autonomy and patient safety considerations. Thus, the design of EPAs incorporates the supervisor, trainee, and patient in a way that uniquely offers a link between educational outcomes and patient outcomes. However, achieving a patient-centered approach to education amidst both curricular and assessment obligations, educational and patient outcomes, and a supervisor–trainee–patient triad is not simple nor guaranteed. As medical educators continue to advance EPAs as part of their approach to competency-based medical education, the authors share a critical discussion of how patients are currently positioned in EPAs. In this article, the authors examine EPAs and discuss how their development, content, and implementation can result in emphasizing the trainee and/or supervisor while unintentionally distancing or hiding the patient. They consider creative possibilities for how EPAs might better integrate the patient as finding ways to better foreground the patient in EPAs holds promise for aligning educational outcomes and patient outcomes.
AI-ssessment: Towards Assessment As a Sociotechnical System for Learning
Authors: Lentz Alison , Siy J. Oliver , Carraccio Carol
Published: June 2021

Two decades ago, the advent of competency-based medical education (CBME) marked a paradigm shift in assessment. Now, medical education is on the cusp of another transformation driven by advances in the field of artificial intelligence (AI). In this article, the authors explore the potential value of AI in advancing CBME and entrustable professional activities by shifting the focus of education from assessment of learning to assessment for learning. The thoughtful integration of AI technologies in observation is proposed to aid in restructuring our current system around the goal of assessment for learning by creating continuous, tight feedback loops that were not before possible. The authors argued that this personalized and less judgmental relationship between learner and machine could shift today’s dominating mindset on grades and performance to one of growth and mastery learning that leads to expertise. However, because AI is neither objective nor value free, the authors stress the need for continuous co-production and evaluation of the technology with geographically and culturally diverse stakeholders to define desired behavior of the machine and assess its performance.
Choosing Surgery
Authors: Kim Elizabeth N.
Published: June 2021

This perspective piece describes changes in medical education and challenges in specialty discernment faced by medical students as a result of the COVID-19 pandemic. In particular, this narrative explains ways a father–daughter relationship before as well as during the global pandemic influenced a medical student’s decision to pursue a career in general surgery.
Spine Surgery Complications in the Ambulatory Surgical Center Setting
Authors: Cha Elliot D.K. , Lynch Conor P. , Hrynewycz Nadia M. , Geoghegan Cara E. , Mohan Shruthi , Jadczak Caroline N. , Parrish James M. , Jenkins Nathaniel W. , Singh Kern
Published: June 2021

Study Design:

This was a systematic review study.

Purpose:

This study aims to review current literature to determine the rates of complications in relation to spine surgery in ambulatory surgery centers (ASC).

Background:

Recent improvements in anesthesia, surgical techniques, and technological advances have facilitated a rise in the use of ASC. Despite the benefits and lower costs associated with ASCs, there is inconsistent reporting of complication rates.

Methods:

This systematic review was completed utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Pertinent studies were identified through Embase and PubMed databases using the search string (((“ambulatory surgery center”) AND “spine surgery”) AND “complications”). Articles were excluded if they did not report outpatient surgery in an ASC, did not define complications, were in a language other than English, were non-human studies, or if the articles were classified as reviews, book chapters, single case reports, or small case series (≤10 patients). The primary outcome was the frequency of complications with respect to various categories.

Results:

Our query identified 150 articles. After filtering relevance by title, abstract, and full text, 22 articles were included. After accounting for 2 studies that were conducted on the same study sample, a total of 11,245 patients were analyzed in this study. The most recent study reported results from May 2019. While 5 studies did not list their surgical technique, studies reported techniques including open (6), minimally invasive surgery (2), endoscopic (4), microsurgery (1), and combined techniques (4). The following rates of complications were determined: cardiac 0.29% (3/1027), vascular 0.25% (18/7116), pulmonary 0.60% (11/1839), gastrointestinal 1.12% (2/179), musculoskeletal/spine/operative 0.59% (24/4053), urologic 0.80% (2/250), transient neurological 0.67% (31/4616), persistent neurological 0.61% (9/1479), pain related 0.57% (20/3479), and wound site 0.68% (28/4092).

Conclusions:

After literature review, this is the first study to comprehensively analyze the current state of literature reporting on the complication profile of all ASC spine surgery procedures. The most common complications were gastrointestinal (1.12%) and the most infrequent were vascular (0.25%). Case reports varied significantly with regard to the type and rate of complications reported. This study provides complication profiles to assist surgeons in counseling patients on the most realistic expectations.
Soluble Suppression of Tumorigenicity-2 Associates With Ventilator Dependence in Coronavirus Disease 2019 Respiratory Failure
Authors: Alladina Jehan W. , Giacona Francesca L. , White Emma B. , Brait Kelsey L. , Abe Elizabeth A. , Michelhaugh Sam A. , Hibbert Kathryn A. , Januzzi James L. , Thompson B. Taylor , Cho Josalyn L. , Medoff Benjamin D.
Published: June 2021

OBJECTIVES:

We hypothesize that elevated soluble suppression of tumorigenicity-2 concentrations, a marker of pulmonary epithelial injury, reflect ongoing lung injury in acute hypoxemic respiratory failure due to coronavirus disease 2019 and associate with continued ventilator dependence.

DESIGN:

We associated serial plasma soluble suppression of tumorigenicity-2 levels and markers of systemic inflammation including d-dimer, C-reactive protein, and erythrocyte sedimentation rate with 30-day mortality and ventilator dependence.

SETTING:

Adult medical ICUs and general medicine wards at an academic teaching hospital in Boston, MA.

PATIENTS:

Adult patients with severe acute respiratory syndrome coronavirus 2 infection and acute hypoxemic respiratory failure admitted to the ICU (n = 72) and non-ICU patients managed with supplemental oxygen (n = 77).

INTERVENTIONS:

Observational study from April 25 to June 25, 2020.

MEASUREMENTS AND MAIN RESULTS:

ICU patients had a higher baseline body mass index and median soluble suppression of tumorigenicity-2, d-dimer, and C-reactive protein concentrations compared with non-ICU patients. Among ICU patients, elevated baseline modified Sequential Organ Failure Assessment score and log (soluble suppression of tumorigenicity-2) were associated with 30-day mortality, whereas initial Pao
2/Fio
2 and markers of systemic inflammation were similar between groups. Only log (soluble suppression of tumorigenicity-2) associated with ventilator dependence over time, with the last measured log (soluble suppression of tumorigenicity-2) concentration obtained on ICU day 11.5 (interquartile range [7–17]) higher in patients who required reintubation or tracheostomy placement compared with patients who were successfully extubated (2.10 [1.89–2.26] vs 1.87 ng/mL [1.72–2.13 ng/mL]; p = 0.03). Last measured systemic inflammatory markers, modified Sequential Organ Failure Assessment score, and Pao
2/Fio
2 were not different between patients who were successfully extubated compared with those with continued ventilator dependence.

CONCLUSIONS:

Plasma soluble suppression of tumorigenicity-2 is a biomarker readily measured in blood that can provide dynamic information about the degree of a patient’s lung injury and real-time assessment of the likelihood of extubation success. Measures of systemic inflammation, illness severity, and oxygenation did not associate with ventilator outcomes.
Life-course Psychological Distress and Total Mortality by Middle Age
Authors: Batty G. David , Hamer Mark , Gale Catharine R.
Published: June 2021

Background:

The onset of psychological distress most commonly occurs in adolescence and, in keeping with other exposures, is time-varying across the life course. Most studies of its association with mortality risk are, however, conducted in middle- and older-aged populations with a single baseline assessment. This may lead to an underestimation of the magnitude of distress–mortality relationship.

Methods:

We used data from the 1970 British Cohort Study, a prospective cohort study. Psychological distress and covariates were collected at ages 5, 10, and 26. Vital status was ascertained between ages 26 and 44 years.

Results:

Eighteen years of mortality surveillance of 5,901 individuals (3,221 women) gave rise to 74 deaths. After adjustment for a series of confounding factors which included early life socioeconomic status, birth characteristics, and cognition, relative to the unaffected group, distress in childhood only was associated with around a 50% elevation in mortality risk (hazard ratio = 1.45; 95% confidence interval = 0.84, 2.51), whereas distress in adulthood only was related to a doubling of risk (1.95; 0.90, 4.21). In study members with persistent distress symptoms (childhood and adulthood), there was a tripling of the death rate (3.10; 1.42, 6.74) (P value for trend across these categories: 0.002).

Conclusion:

The suggestion of a strong association between life-course distress and death warrants replication in a study with a greater number of events.
Obesity increases endometrial cancer risk in Chinese women with postmenopausal bleeding
Authors: Liu Fangzi , Cheung Eva C.W. , Lao Terence T.
Published: June 2021

Objective:

We examined the relationship between body mass index (BMI) at referral and subsequent diagnosis of endometrial cancer in a cohort of Chinese women presenting with postmenopausal bleeding, to determine whether BMI of 25 kg/m2 would serve to delineate women at increased risk of endometrial cancer.

Methods:

This cohort included 4,164 Chinese women referred for postmenopausal bleeding from 2002 to 2013. For all women, a medical history was taken, and physical examination, BMI measurement, transvaginal pelvic ultrasonography, and endometrial sampling were performed. Additional investigations were performed as indicated clinically. The presence of risk factors for endometrial cancer and histological diagnoses were compared among groups defined by the standard Asian BMI cut-off values.

Results:

Within the cohort, 868 (20.8%) were overweight (BMI 23-24.9 kg/m2) and 1,611 (38.7%) were obese (BMI ≥25 kg/m2), and 162 (3.9%) had endometrial cancer. The prevalence of endometrial cancer correlated with BMI category (P < 0.001). On multivariate analysis, BMI ≥25 kg/m2 was independently associated with 1.57 times risk of endometrial cancer (95% CI 1.13-2.20, P = 0.008) compared with BMI less than 25 kg/m2.

Conclusion:

When managing postmenopausal bleeding in Chinese women, the Asian BMI standard for obesity at 25 kg/m2 identified 51% of endometrial cancers in this group and denoted a 57% increased risk of endometrial cancer. Thus obesity could be used to triage women presenting with postmenopausal bleeding for prioritized investigations.
Drug-induced sarcoidosis-like reactions
Authors: Miedema Jelle , Nunes Hilario
Published: June 2021

Purpose of review

Sarcoidosis is a complex granulomatous disease of unknown cause. Several drug categories are able to induce a systemic granulomatous indistinguishable from sarcoidosis, known as drug-induced sarcoidosis-like reaction (DISR). This granulomatous inflammation can resolve if the medication is discontinued. In this review, we discuss recent literature on medication associated with DISR, possible pathophysiology, clinical features, and treatment.

Recent findings

Recently, increasing reports on DISR have expanded the list of drugs associated with the systemic granulomatous eruption. Most reported drugs can be categorized as combination antiretroviral therapy, tumor necrosis factor-α antagonist, interferons, and immune checkpoint inhibitors, but reports on other drugs are also published. The proposed mechanism is enhancement of the aberrant immune response which results in systemic granuloma formation. It is currently not possible to know whether DISR represents a separate entity or is a triggered but ‘true’ sarcoidosis.

As DISRs may cause minimal symptoms, treatment is not always necessary and the benefits of continuing the offending drug should be weighed against clinical symptoms and organ dysfunction. Treatment may involve immunosuppressive medication that is used for sarcoidosis treatment.

In this article, we review recent insights in DISR: associated drug categories, clinical presentation, diagnosis, and treatment. Additionally, we discuss possible mechanisms of DISR which can add to our knowledge of sarcoidosis pathophysiology.
Interstitial pneumonia with autoimmune features: from research classification to diagnosis
Authors: Glenn Laura M. , Pugashetti Janelle V. , Oldham Justin , Corte Tamera J.
Published: June 2021

Purpose of review

The term interstitial pneumonia with autoimmune features (IPAF) was first proposed by an international task force in 2015 as a research classification to standardise nomenclature regarding patients with idiopathic interstitial pneumonia and features of connective tissue disease. However, how the use of this term and its proposed definition translates to clinical practice remains uncertain. This review will provide a comprehensive overview of studies of IPAF cohorts to date, discuss the consideration of IPAF as a distinct diagnostic entity and outline a suggested approach to patient management.

Recent findings

Considerable heterogeneity exists between published IPAF cohorts, with some cohorts exhibiting similarities to those with connective tissue disease-associated interstitial lung disease (CTD-ILD), and others more similar to idiopathic interstitial pneumonias including idiopathic pulmonary fibrosis (IPF). Little data exist to inform the management of patients who fulfil the IPAF criteria. Preliminary data supports pragmatic management of these patients as having a working clinical diagnosis of either idiopathic interstitial pneumonia or CTD-ILD. Future research studies into this approach are required.

The term IPAF, and its definition, have been of fundamental benefit to facilitating research in this diverse patient group. However, to date, there remain many unanswered questions regarding their natural histories and response to treatment.