bluuebunny/crossref_metadata_2025 huggingface dataset:
Network Theory and Intergroup Approaches
Authors: Stohl Cynthia
Published: February 2018

A social network consists of interactive patterns among individuals and groups that are created by transmitting and exchanging messages through time and space. A central feature of intergroup settings is that group members are embedded in multiple, previously established, as well as emerging, communication networks that vary in their structure, the nature of the relationships, and the diversity of the links.

A network perspective extends and complements traditional social scientific approaches to intergroup communication. Rather than focusing on the attributes of individuals, a network perspective focuses on the causes and consequences of relations and connections between and among sets of people and groups. A network approach invigorates intergroup theory by focusing on the dynamic structures of connectedness, treating identity, social categorization, and representativeness as fluid rather than fixed factors within interactions.

A basic principle of network theory is that behavior can best be understood socially; every social unit stands at the nexus of a multitude of constraining and enabling alignments. Structural network dynamics include, but are not limited to, density, diversity, clustering, equivalence, and centrality of the network. These structural configurations combined with the strength and multiplexity of specific network linkages strongly influence social identities, values, attitudes, experiences, and behavior. Using graph-theoretic models, network analysts are able to identify specific types of structures that are highly effective in predicting ingroup and intergroup attitudes and behaviors above and beyond individual-level characteristics. Structural dynamics can further amplify intergroup principles through exploring the degree to which ingroup boundaries are loosely or tightly connected and the types and nature of linkages and communication exchanges within and between groups. For example, network theory suggests that the greater ingroup overlap across social contexts, the more likely group members perceive higher status for that particular ingroup than for other social categories to which they belong. It is also more likely the boundary between groups will be linguistically marked. In organizations, intergroup conflict and the capacity for successful adaptation and intergroup cooperation are strongly related to the extent and the alignment of intergroup “weak” ties across traditional communication channels and online. Identifying network structures can help explain a large set of multilevel intergroup outcomes such as linguistic accommodation and stereotyping, group level conflict, organizational productivity and innovation, political attitudes, and community resilience.
Climate Dynamics of ENSO Modoki Phenomena
Authors: Behera Swadhin , Yamagata Toshio
Published: February 2018

The El Niño Modoki/La Niña Modoki (ENSO Modoki) is a newly acknowledged face of ocean-atmosphere coupled variability in the tropical Pacific Ocean. The oceanic and atmospheric conditions associated with the El Niño Modoki are different from that of canonical El Niño, which is extensively studied for its dynamics and worldwide impacts. A typical El Niño event is marked by a warm anomaly of sea surface temperature (SST) in the equatorial eastern Pacific. Because of the associated changes in the surface winds and the weakening of coastal upwelling, the coasts of South America suffer from widespread fish mortality during the event. Quite opposite of this characteristic change in the ocean condition, cold SST anomalies prevail in the eastern equatorial Pacific during the El Niño Modoki events, but with the warm anomalies intensified in the central Pacific. The boreal winter condition of 2004 is a typical example of such an event, when a tripole pattern is noticed in the SST anomalies; warm central Pacific flanked by cold eastern and western regions. The SST anomalies are coupled to a double cell in anomalous Walker circulation with rising motion in the central parts and sinking motion on both sides of the basin. This is again a different feature compared to the well-known single-cell anomalous Walker circulation during El Niños. La Niña Modoki is the opposite phase of the El Niño Modoki, when a cold central Pacific is flanked by warm anomalies on both sides.

The Modoki events are seen to peak in both boreal summer and winter and hence are not seasonally phase-locked to a single seasonal cycle like El Niño/La Niña events. Because of this distinction in the seasonality, the teleconnection arising from these events will vary between the seasons as teleconnection path will vary depending on the prevailing seasonal mean conditions in the atmosphere. Moreover, the Modoki El Niño/La Niña impacts over regions such as the western coast of the United States, the Far East including Japan, Australia, and southern Africa, etc., are opposite to those of the canonical El Niño/La Niña. For example, the western coasts of the United States suffer from severe droughts during El Niño Modoki, whereas those regions are quite wet during El Niño. The influences of Modoki events are also seen in tropical cyclogenesis, stratosphere warming of the Southern Hemisphere, ocean primary productivity, river discharges, sea level variations, etc. A remarkable feature associated with Modoki events is the decadal flattening of the equatorial thermocline and weakening of zonal thermal gradient. The associated ocean-atmosphere conditions have caused frequent and persistent developments of Modoki events in recent decades.
The Politics of International Trade
Authors: Madeira Mary Anne
Published: February 2018

International trade and state efforts to liberalize or restrict trade generate very contentious politics. Trade creates winners and losers at the individual level, firm level, industry level, national level, and even regional level. It also generates conflict among transnational social groups, such as environmental advocacy organizations, human rights organizations, and transnational business alliances. Because of this complexity of the politics of international trade, scholars of international political economy (IPE) can focus on different levels of analysis and a variety of stages of the political decision-making process. Scholars agree that not only societal preferences but collective action problems, domestic institutions, and international factors all affect trade politics and policy outcomes. These aspects of trade politics together form the key influences on trade policy and whether it is liberal or protectionist in nature.

Societal preferences constitute the initial inputs into the trade policy-making process. Understanding how different groups of economic actors within society win or lose from trade liberalization or protection is the first step toward understanding trade politics and trade policy outcomes. Once societal trade preferences are formed, they must be aggregated into cohesive pressure groups or grass-roots movements whose purpose is to influence trade policy. This is easier for some groups of actors to achieve than others. In lobbying government actors on policy, interest groups find that domestic institutions play an important role translating societal inputs into policy outputs. Policy-making institutions vary in the degree to which they are susceptible to special-interest lobbying versus the preferences of broader societal coalitions, and electoral rules and party structures also affect policy outcomes, with certain configurations creating a bias toward more protectionism or liberalization.

In addition to these domestic-level influences on trade policy, IPE scholars have extensively studied the ways that international factors also affect trade policy outcomes such as the extent of liberalization and the content of what is liberalized (e.g., manufactures versus agricultural goods versus services). International factors such as the distribution of power, the character of international institutions and trade agreements (e.g., multilateral versus bilateral), transnational civil society and diffusion processes may be thought of as inputs into the policy-making process as well. Systemic conditions may constrain the types of policies that governments can adopt, or they may open the door to a range of possible policy outcomes that are nevertheless limited by the preferences of domestic societal actors.
Harold Lasswell and the Study of Public Policy
Authors: Dunn William N.
Published: February 2018

Over seventy-five years ago, the social sciences were irrevocably transformed by the rise of the policy sciences. The policy sciences, an ambitious multidisciplinary movement founded by the preeminent political scientist, Harold D. Lasswell, offered an unprecedented approach to public policy based primarily on an adaptation of the work of John Dewey and other pragmatists. Although parts of this new approach may be traced to the 19th century, the policy sciences were distinctive. Not only did they mandate the creation of knowledge about the process of policymaking; they also required that the knowledge so created be used to improve that process.
Covert Ethnography in Criminal Justice and Criminology: The Controversial Tradition of Doing Undercover Fieldwork
Authors: Calvey David
Published: February 2018

The role and value of covert ethnography in the fields of criminal justice and criminology, a controversial and somewhat marginalized tradition due to its association with deception. It is a transgressive approach with ethical baggage that runs counter to the received wisdom on informed consent. Despite this, it is a creative and innovative approach which can yield rich types of insider data and lived experience leading to nuanced analyses and understanding of crime and deviance in society. There is a classic fear and fascination with covert research. It is a methodological pariah, which has been routinely demonized, particularly in the current climate of ethical regimentation. It is typically associated with harm and risk to both the researched and the researched. The covert researcher has been seen as a belligerent figure in the criminological landscape, which marginalizes its worth.

My exploration and unpacking of this controversial tradition shall be undertaken in several ways: Firstly, by outlining the controversy surrounding deception, which covert ethnography is squarely associated with. This association is partly related to how the understanding of covert observation is deeply embedded in popular culture. Secondly, by exploring the rich diversity of covert ethnography in criminology and criminal justice, both classic and contemporary. Part of the logic here is to rehabilitate and celebrate the sociological aspects of criminology and criminal justice, partly by examining some heartland topics in the field as well as studying deviance across different settings and subcultures. Thirdly, by drawing on some of my own field experiences from a covert study of bouncers in the night-time economy of Manchester, which I compare to others in the field. Fourthly, by offering some brief reflections on the future directions of covert ethnography via a discussion of the revival in covert research. Lastly, by providing some concluding sentiments on covert ethnography.
Population Changes at Place: Immigration, Gentrification, and Crime
Authors: Ousey Graham C.
Published: February 2018

Immigration and gentrification are two sources of population change that occur in geographic communities. Immigration refers to the inflow of foreign-born residents, while gentrification involves middle- and upper-income residents moving into poor urban communities. Scholars have speculated that both types of population change may be related to crime rates. The nature of those relationships, however, is debated. Classic criminological perspectives, such as Social Disorganization Theory, suggest that these population changes are likely to result in increased crime rates. More recent perspectives proffer an opposing viewpoint: that immigration and gentrification may lower crime rates. Some research suggests that these opposing arguments may each draw empirical support but under differing social conditions or circumstances. Regarding the effects of immigration on crime, one theory is that immigration is most likely to be a crime-protective factor when it occurs in places where there is a well-established immigrant population base and institutional supports. And immigration may contribute to higher crime rates in places that lack the strong preexisting immigrant population and institutions. Study design variations also appear to impact the findings that researchers investigating the immigration-crime relationship have found, with longitudinal studies more consistently reporting the immigration works to reduce (rather than increase) crime. With respect to gentrification, scholars suggest that its effects on crime are likely to hinge on factors such as the racial composition of the place, the timing or stage at which the gentrification process is observed, or the degree to which gentrifying neighborhoods are surrounded by poor non-gentrifying neighborhoods or by other communities that have already progressed through the gentrification process.
Laws of Geography
Authors: Leitner Michael , Glasner Philip , Kounadi Ourania
Published: February 2018

The most prominent law in geography is Tobler’s first law (TFL) of geography, which states that “everything is related to everything else, but near things are more related than distant things.” No other law in geography has received more attention than TFL. It is important because many spatial statistical methods have been developed since its publication and, especially since the advent of geographic information system (GIS) and geospatial technology, have been conceptually based on it. These methods include global and local indicators of spatial autocorrelation (SA), spatial and spatial-temporal hotspots and cold spots, and spatial interpolation. All of these are highly relevant to spatial crime analysis, modeling, and mapping and will be discussed in the main part of this text.
Cephalochordate Nervous System
Authors: Candiani Simona , Pestarino Mario
Published: February 2018

The central and peripheral nervous systems of amphioxus adults and larvae are characterized by morphofunctional features relevant to understanding the origins and evolutionary history of the vertebrate CNS. Classical neuroanatomical studies are mainly on adult amphioxus, but there has been a recent focus, both by TEM and molecular methods, on the larval CNS. The latter is small and remarkably simple, and new data on the localization of glutamatergic, GABAergic/glycinergic, cholinergic, dopaminergic, and serotonergic neurons within the larval CNS are now available. In consequence, it has been possible begin the process of identifying specific neuronal circuits, including those involved in controlling larval locomotion. This is especially useful for the insights it provides into the organization of comparable circuits in the midbrain and hindbrain of vertebrates. A much better understanding of basic chordate CNS organization will eventually be possible when further experimental data will emerge.
The Regional Centrality of Vietnam’s Central Highlands
Authors: Salemink Oscar
Published: February 2018

Vietnam’s Central Highlands—or Tây Nguyên—area is usually described as remote, backward, and primitive, but this region has played a central role in the history of the surrounding states and the wider East and Southeast Asia region. Far from isolated, the Central Highlands engaged in trade in precious forest products with lowland states and beyond since at least the emergence of the Hinduized Cham states from the first centuries ce onward. Lowland and coastal states needed the support of local leaders and traders in order to boost their trade and tax revenues. In addition, as a buffer between various rivalrous polities now known as Vietnam, Champa, Cambodia, Laos, and Thailand, the area occupied a strategic position in the wider mainland Southeast Asia region. With the emergence of a unified, neo-Confucianist Vietnamese state the region lost its centrality until the late colonial era, when its strategic value turned it into a battleground among various Vietnamese parties, France, and the United States. It was here that the outcome of the Indochina wars was determined, but at a terrible price for the local population. After the adoption of economic reforms in reunified Vietnam the Central highlands regained its economic centrality, predicated on the global prominence of its valuable cash crops such as coffee, tea, rubber, pepper, and cashew. This coffee boom was based on the labor of lowlander in-migrants, who displaced and dispossessed the highlanders in the process, turning the national and international integration of the Central Highlands and its renewed centrality into a tragic experience for the Central Highlanders. By taking the centrality of the Central Highlands seriously, I arrive at an alternative historical periodization.
Atmospheric Electricity in the Solar System
Authors: Aplin Karen , Fischer Georg
Published: February 2018

Electricity occurs in atmospheres across the Solar System planets and beyond, spanning spectacular lightning displays in clouds of water or dust, to more subtle effects of charge and electric fields. On Earth, lightning is likely to have existed for a long time, on the basis of evidence from fossilized lightning strikes in ancient rocks, but observations of planetary lightning are necessarily much more recent. The generation and observations of lightning and other atmospheric electrical processes, both from within-atmosphere measurements, and spacecraft remote sensing, can be readily studied using a comparative planetology approach, with the Earth as a model.

All atmospheres contain charged molecules, electrons, and/or molecular clusters created by ionization from cosmic rays and other processes, which may affect an atmosphere’s energy balance both through aerosol and cloud formation and direct absorption of radiation. Several planets are anticipated to host a “global electric circuit” by analogy with the circuit occurring on the Earth, where thunderstorms drive the current of ions or electrons through weakly conductive parts of the atmosphere. This current flow may further modulate an atmosphere’s radiative properties through cloud and aerosol effects.

Lightning could potentially have implications for life through its effects on atmospheric chemistry and particle transport. It has been observed on many of the Solar System planets (Earth, Jupiter, Saturn, Uranus, and Neptune), and it may also be present on Venus and Mars. On Earth, Jupiter, and Saturn, lightning is thought to be generated in deep water and ice clouds, but discharges can be generated in dust, as for terrestrial volcanic lightning, and on Mars. Other, less well-understood mechanisms causing discharges in non-water clouds also seem likely. The discovery of thousands of exoplanets has recently led to a range of further exotic possibilities for atmospheric electricity, though lightning detection beyond our Solar System remains a technical challenge to be solved.
The Lumbee Tribe of North Carolina
Authors: Lowery Malinda Maynor
Published: February 2018

The Lumbee tribe of North Carolina, including approximately 55,000 enrolled members, is the largest Indian community east of the Mississippi River. Lumbee history serves as a window into the roles that Native people have played in the struggle to implement the founding principles of the United States, not just as “the First Americans,” but as members of their own nations, operating in their own communities’ interests. When we see US history through the perspectives of Native nations, we see that the United States is not only on a quest to expand rights for individuals. Surviving Native nations like the Lumbees, who have their own unique claims on this land and its ruling government, are forcing Americans to confront the ways in which their stories, their defining moments, and their founding principles are flawed and inadequate. We know the forced removals, the massacres, the protests that Native people have lodged against injustice, yet such knowledge is not sufficient to understand American history. Lumbee history provides a way to honor, and complicate, American history by focusing not just on the dispossession and injustice visited upon Native peoples, but on how and why Native survival matters. Native nations are doing the same work as the American nation—reconstituting communities, thriving, and finding a shared identity with which to achieve justice and self-determination.

Since the late 19th century, Lumbee Indians have used segregation, war, and civil rights to maintain a distinct identity in the biracial South. The Lumbees’ survival as a people, a race, and a tribal nation shows that their struggle has revolved around autonomy, or the ability to govern their own affairs. They have sought local, state, and federal recognition to support that autonomy, but doing so has entangled the processes of survival with outsiders’ ideas about what constitutes a legitimate Lumbee identity. Lumbees continue to adapt to the constraints imposed on them by outsiders, strengthening their community ties through the process of adaptation itself. Lumbee people find their cohesion in the relentless fight for self-determination. Always, that struggle has mattered more than winning or losing a single battle.
Regulating America’s Natural Environment
Authors: Elmore Bart
Published: February 2018

From the founding of the American republic through the 19th century, the nation’s environmental policy mostly centered on promoting American settlers’ conquest of the frontier. Early federal interventions, whether railroad and canal subsidies or land grant acts, led to rapid transformations of the natural environment that inspired a conservation movement by the end of the 19th century. Led by activists and policymakers, this movement sought to protect America’s resources now jeopardized by expansive industrial infrastructure. During the Gilded Age, the federal government established the world’s first national parks, and in the Progressive Era, politicians such as President Theodore Roosevelt called for the federal government to play a central role in ensuring the efficient utilization of the nation’s ecological bounty. By the early 1900s, conservationists established new government agencies, such as the U.S. Forest Service and the Bureau of Reclamation, to regulate the consumption of trees, water, and other valuable natural assets. Wise-use was the watchword of the day, with environmental managers in DC’s bureaucracy focused mainly on protecting the economic value latent in America’s ecosystems. However, other groups, such as the Wilderness Society, proved successful at redirecting policy prescriptions toward preserving beautiful and wild spaces, not just conserving resources central to capitalist enterprise. In the 1960s and 1970s, suburban and urban environmental activists attracted federal regulators’ attention to contaminated soil and water under their feet. The era of ecology had arrived, and the federal government now had broad powers through the Environmental Protection Agency (EPA) to manage ecosystems that stretched across the continent. But from the 1980s to the 2010s, the federal government’s authority to regulate the environment waxed and waned as economic crises, often exacerbated by oil shortages, brought environmental agencies under fire. The Rooseveltian logic of the Progressive Era, which said that America’s economic growth depended on federal oversight of the environment, came under assault from neoliberal disciples of Ronald Reagan, who argued that environmental regulations were in fact the root cause of economic stagnation in America, not a powerful prescription against it. What the country needed, according to the reformers of the New Right, was unregulated expansion into new frontiers. By the 2010s, the contours of these new frontiers were clear: deep-water oil drilling, Bakken shale exploration, and tar-sand excavation in Alberta, Canada. In many ways, the frontier conquest doctrine of colonial Americans found new life in deregulatory U.S. environmental policy pitched by conservatives in the wake of the Reagan Revolution. Never wholly dominant, this ethos carried on into the era of Donald Trump’s presidency.
Overpopulation Debates in Latin America during the Cold War
Authors: Buckley Eve
Published: February 2018

From the 1950s to the 1970s, numerous academics and non-governmental organizations based in the United States generated alarm about political and ecological threats posed by human population growth. During the first half of the 20th century, improvements in nutrition, sanitation, and medical therapies had dramatically reduced infant mortality and contributed to increased life expectancy in many parts of the world. In the context of the Cold War, many leaders of Western industrialized nations viewed the rapid growth of poor Asian, African, and Latin American populations as a potential source of political instability. They feared that these poor masses would become fodder for revolutionary political movements, particularly communism. Combined with eugenicist views rooted in colonial racism, new understanding of ecological systems, and growing concern about overtaxing earth’s resources, these fears led many American and European scholars and activists to promote population reduction in the newly designated “Third World.” In Latin America, such efforts to curb human increase were met with skepticism or outright opposition by both Catholic Church leaders and many left-wing nationalists who saw the promotion of birth control as a form of racist imperialism. Although some physicians and even liberal priests viewed decreasing family size as important for public health and family welfare, the involvement of North American capitalists (such as the Rockefellers), U.S. government agencies, and former eugenicists in efforts to distribute contraceptive technologies made them deeply suspect in the eyes of many Latin Americans.
Livestock, Livelihood, and Agrarian Change in Andean Peru
Authors: Puente Javier
Published: February 2018

Agrarian transformations in Andean Peru, subject to larger sociopolitical and economic processes, entailed major material, environmental, and biological changes. The long history of sheep introduction in Andean environments, its specific impact on the central highlands, and the making of an Andean breed of sheep—the oveja Junín—illustrate how such transformations shaped rural Peru as a societal space. Following larger environmental patters in Latin America, sheep became the dominant animal of the upper Andean regions, populating depleted landscapes and refashioning otherwise hostile environments as areas of agrarian productivity. Many of the transformations that occurred during colonial times, particularly the consolidation of the hacienda system and the rise of sheepherding as a form of peonage, served manifold purposes in the transition to the national period. While the 19th-century liberal obliteration of corporate identities and property obscured the legacy of indigenous communities, sheep continued to thrive and set the conditions for the incorporation of the Peruvian countryside into the global world economy. In the 20th century, with the parallel arrival of state and capital governance, transforming sheep and sheepherding from vernacular expressions of livelihood into advanced forms of modern agrarian industrialism merged together scientific and veterinarian knowledge with local understandings, producing the oveja Junín as the ultimate result. As sheepherding modernized based on efficient husbandry, sheep modernity efficiently nurtured rural developmentalism, bringing together communal and capitalist interests in unprecedented ways. The state-sponsored project of granjas comunales devoted to capital-intensive grazing economies reveals how husbandry and modern grazing activities both reinforced and transformed societal organization within indigenous communities, sanctioning existing differences while providing a vocabulary of capital for recasting their internal social relations of production. When the state envisioned the centralization of otherwise profitable communal grazing economies, through the allegedly empowering language of agrarian reform, the cooperativization of land, labor, and animals led to communal, family, and individual disenfranchisement. Indigenous community members, turned into campesinos, sought new battlegrounds for resisting state intromission. Eventually, the very biology of the oveja Junín as an exclusive domain of state and capital became the target of campesino sabotage. As the agrarian reform collapsed and revolution engulfed the countryside, rural livelihoods—sheep included—faced their ultimate demise, often with severe degrees of violence. In this entire trajectory, sheep—and the oveja Junín—ruled the upper regions of the Andes like no political power ever did.
Natural Hazards Governance in the Philippines
Authors: Iuchi Kanako , Jibiki Yasuhito , Solidum Renato , Santiago Ramon
Published: February 2018

Located in the Pacific Ring of Fire and the typhoon belt, the Philippines is one of the most hazard prone countries in the world. The country faces different types of natural hazards including geophysical disturbances such as earthquakes and volcanic eruptions, meteorological and hydrological events such as typhoons and floods, and slow-onset disasters such as droughts. Together with rapidly increasing population growth and urbanization, large-scale natural phenomena have resulted in unprecedented scales of devastation. In the early 21st century alone, the country experienced some of the most destructive and costliest disasters in its history including Typhoon Yolanda (2013), Typhoon Pablo (2012), and the Bohol Earthquake (2013).

Recurrent natural disasters have prompted the Philippine government to develop disaster risk reduction and management (DRRM) strategies to better prepare, respond, and recover, as well as to be more resilient in the face of natural disasters. Since the early 1940s, the governing structure has undergone several revisions through legal and institutional arrangements. Historical natural disasters and seismic risks have affected and continue to threaten the National Capital Region (NCR) and the surrounding administrative areas; these were key factors in advancing DRRM laws and regulations, as well as in restructuring its governing bodies. The current DRRM structure was instituted under Republic Act no. 10121 (RA10121) in 2010 and was implemented to shift from responsive to proactive governance by better engaging local governments (LGUs), communities, and the private sector to reduce long-term disaster risk. This Republic Act established a national disaster risk reduction and management council (NDRRMC) to develop strategies that manage and reduce risk.

Typhoon Yolanda in 2013 was the most significant test of this revised governance structure and related strategies. The typhoon revealed drawbacks of the current council-led governing structure to advancing resilience. Salient topics include how to respond better to disaster realities, how to efficiently coordinate among relevant agencies, and how to be more inclusive of relevant actors. Together with other issues, such as the way to co-exist with climate change efforts, a thorough examination of RA 10121 by the national government and advocates for DRRM is underway. Some of the most important discourse to date focuses on ways to institute a powerful governing body that enables more efficient DRRM with administrative and financial power. The hope is that by instituting a governing system that can thoroughly lead all phases of preparedness, mitigation, response, and recovery, the country can withstand future—and likely more frequent—mega-disasters.
MIRA: an R package for DNA methylation-based inference of regulatory activity
Authors: Lawson John T , Tomazou Eleni M , Bock Christoph , Sheffield Nathan C
Published: February 2018

DNA methylation contains information about the regulatory state of the cell. MIRA aggregates genome-scale DNA methylation data into a DNA methylation profile for a given region set with shared biological annotation. Using this profile, MIRA infers and scores the collective regulatory activity for the region set. MIRA facilitates regulatory analysis in situations where classical regulatory assays would be difficult and allows public sources of region sets to be leveraged for novel insight into the regulatory state of DNA methylation datasets.

Availability and implementation

http://bioconductor.org/packages/MIRA.
Flucytosine resistance in Cryptococcus gattii is indirectly mediated by the FCY2-FCY1-FUR1 pathway
Authors: Vu Kiem , Thompson George R , Roe Chandler C , Sykes Jane E , Dreibe Elizabeth M , Lockhart Shawn R , Meyer Wieland , Engelthaler David M , Gelli Angie
Published: February 2018

Cryptococcosis is an opportunistic fungal infection caused by members of the two sibling species complexes: Cryptococcus neoformans and Cryptococcus gattii. Flucytosine (5FC) is one of the most widely used antifungals against Cryptococcus spp., yet very few studies have looked at the molecular mechanisms responsible for 5FC resistance in this pathogen. In this study, we examined 11 C. gattii clinical isolates of the major molecular type VGIII based on differential 5FC susceptibility and asked whether there were genomic changes in the key genes involved in flucytosine metabolism. Susceptibility assays and sequencing analysis revealed an association between a point mutation in the cytosine deaminase gene (FCY1) and 5FC resistance in two of the studied 5FC resistant C. gattii VGIII clinical isolates, B9322 and JS5. This mutation results in the replacement of arginine for histidine at position 29 and occurs within a variable stretch of amino acids. Heterologous expression of FCY1 and spot sensitivity assays, however, demonstrated that this point mutation did not have any effect on FCY1 activities and was not responsible for 5FC resistance. Comparative sequence analysis further showed that no changes in the amino acid sequence and no genomic alterations were observed within 1 kb of the upstream and downstream sequences of either cytosine permeases (FCY2-4) or uracil phosphoribosyltransferase (FUR1) genes in 5FC resistant and 5FC susceptible C. gattii VGIII isolates. The herein obtained results suggest that the observed 5FC resistance in the isolates B9322 and JS5 is due to changes in unknown protein(s) or pathway(s) that regulate flucytosine metabolism.
Enhanced Requirements for Assessment in a Competency-Based, Time-Variable Medical Education System
Authors: Gruppen Larry D. , ten Cate Olle , Lingard Lorelei A. , Teunissen Pim W. , Kogan Jennifer R.
Published: February 2018

Competency-based, time-variable medical education has reshaped the perceptions and practices of teachers, curriculum designers, faculty developers, clinician educators, and program administrators. This increasingly popular approach highlights the fact that learning among different individuals varies in duration, foundation, and goal. Time variability places particular demands on the assessment data that are so necessary for making decisions about learner progress. These decisions may be formative (e.g., feedback for improvement) or summative (e.g., decisions about advancing a student). This article identifies challenges to collecting assessment data and to making assessment decisions in a time-variable system. These challenges include managing assessment data, defining and making valid assessment decisions, innovating in assessment, and modeling the considerable complexity of assessment in real-world settings and richly interconnected social systems. There are hopeful signs of creativity in assessment both from researchers and practitioners, but the transition from a traditional to a competency-based medical education system will likely continue to create much controversy and offer opportunities for originality and innovation in assessment.
Learning in Practice: A Valuation of Context in Time-Variable Medical Training
Authors: Teunissen Pim W. , Kogan Jennifer R. , ten Cate Olle , Gruppen Larry D. , Lingard Lorelei A.
Published: February 2018

The logical consequence of implementing competency-based education is moving to time-variable training. Competency-based, time-variable training (CBTVT) requires an understanding of how learners interact with their learning context and how that leads to competence. In this article, the authors discuss this relationship. They first explain that the time required to achieve competence in clinical practice depends on the availability of clinical experiences that are conducive to ongoing competence development. This requires both curricular flexibility in light of the differences in individual learners’ development and a balance between longitudinal placements and transitions to different environments.

Along with the deliberate use of the opportunities that learning environments offer, there is value for learners in spending ample time-in-context. For instance, guided independence is possible when trainees do not progress immediately after meeting curricular learning objectives. Next, the potential implications of CBTVT can be illustrated by two learning perspectives—Sfard’s acquisition and participation metaphors—which leads to the assertion that competence is both an individual characteristic and a quality that emerges from a purposeful social interaction between individuals and their context. This theory recognizes that the deliberate use of context could be used to approach learning as acquiring collective competence.

Based on this relationship between learner, context, and competence, the authors propose an approach to CBTVT that recognizes that all learners will have to meet a number of standard preset learning targets in their workplace, while still having room for further context-specific competence development and personal growth within strategically organized learning environments.
Competency-Based, Time-Variable Education in the Health Professions: Crossroads
Authors: Lucey Catherine R. , Thibault George E. , ten Cate Olle
Published: February 2018

Health care systems around the world are transforming to align with the needs of 21st-century patients and populations. Transformation must also occur in the educational systems that prepare the health professionals who deliver care, advance discovery, and educate the next generation of physicians in these evolving systems. Competency-based, time-variable education, a comprehensive educational strategy guided by the roles and responsibilities that health professionals must assume to meet the needs of contemporary patients and communities, has the potential to catalyze optimization of educational and health care delivery systems. By designing educational and assessment programs that require learners to meet specific competencies before transitioning between the stages of formal education and into practice, this framework assures the public that every physician is capable of providing high-quality care. By engaging learners as partners in assessment, competency-based, time-variable education prepares graduates for careers as lifelong learners. While the medical education community has embraced the notion of competencies as a guiding framework for educational institutions, the structure and conduct of formal educational programs remain more aligned with a time-based, competency-variable paradigm.

The authors outline the rationale behind this recommended shift to a competency-based, time-variable education system. They then introduce the other articles included in this supplement to Academic Medicine, which summarize the history of, theories behind, examples demonstrating, and challenges associated with competency-based, time-variable education in the health professions.
Influence of Cardiac Output on the Pharmacokinetics of Sufentanil in Anesthetized Pigs
Authors: Birkholz Torsten , Leuthold Christian , Schmidt Joachim , Ihmsen Harald , Schüttler Jürgen , Jeleazcov Christian
Published: February 2018

Background

Sufentanil is used for general anesthesia and analgesia. The study aim was to determine the effect of pharmacologically induced changes in cardiac output on the pharmacokinetics of sufentanil in anesthetized pigs.

Methods

Twenty-four pigs were randomly assigned to low, high, and control cardiac output groups. Cardiac output was decreased or increased from baseline by at least 40%, or maintained within ± 10% of baseline, respectively. Sufentanil was administered as a bolus followed by a continuous infusion for 120 min. Timed arterial samples were drawn for sufentanil concentration measurements.

Results

Data from 20 animals were analyzed. The cardiac outputs (means ± SD) were 2.9 ± 0.7, 5.4 ± 0.7, and 9.6 ± 1.6 l/min in the low, control, and high cardiac output groups, respectively. The parameters of the two-compartment pharmacokinetic model for these cardiac outputs were: CL1: 0.9, 1.2, and 1.7 l/min; CL2: 0.9, 3.1, and 6.9 l/min; V1: 1.6, 2.9, and 5.2 l; and V2: 27.5, 47.0, and 79.8 l, respectively. Simulated sufentanil doses to maintain a target plasma concentration of 0.5 ng/ml for 3 h were 99.5, 128.6, and 157.6 μg for cardiac outputs of 3, 5, and 7 l/min, respectively. The context-sensitive half-times for these cardiac outputs increased from 3.1 to 19.9 and 25.9 min, respectively.

Conclusions

Cardiac output influences the pharmacokinetics of sufentanil. Simulations suggest that in the case of increased cardiac output, the dose should be increased to avoid inadequate drug effect at the expense of prolonged recovery, whereas for low cardiac output the dose should be reduced, and a faster recovery may be expected.
Survival and Safety Outcomes of ICU Patients Discharged Directly Home—A Direct From ICU Sent Home Study*
Authors: Lau Vincent I. , Lam Joyce N. H. , Basmaji John , Priestap Fran A. , Ball Ian M.
Published: February 2018

Objectives:

Evaluate outcomes (mortality, morbidity, unplanned return visits) of patients who are discharged directly to home from the ICU.

Design:

Prospective cohort study.

Setting:

Two tertiary care medical-surgical-trauma ICUs at Canadian hospitals over 1 year (February 2016–2017).

Subjects:

All adult patients who were either discharged directly to home (Recruited and Nonrecruited cohorts) from ICU or discharged home within 24 hours after ward transfer (Ward Transfer cohort).

Interventions:

Direct discharge home from ICU or discharge home within 24 hours of ward transfer from ICU.

Measurements and Main Results:

One-hundred ninety-eight patients were in the study, 100 patients in the discharged directly to home Recruited arm, 37 patients in the discharged directly to home Nonrecruited arm, and 61 patients in the Ward cohort. All three patient cohorts had 0% mortality at 8 weeks post discharge. The unplanned return visit rate for the Recruited cohort was 24% (emergency department 18%, Ward 4%, ICU 1%), whereas the rate for the Nonrecruited cohort was 52% (emergency department 34%, Ward 14%, ICU 3%) and the Ward Transfer cohort was 46% (emergency department 17%, Ward 26%, ICU 3%) (p = 0.005). No home support was available for 7% of the discharged directly to home Recruited cohort. Twenty-four percent of patients had funded home care nursing, but the majority of patients (81%) relied on help from friends/family.

Conclusions:

Recruited discharged directly to home patients experienced very good 8-week postdischarge outcomes with 0% mortality and a low rate of ICU readmission (1%) or ward readmission (4%), but not an insignificant rate of emergency department visits (18%). Recruited discharged directly to home patients had better outcomes compared with nonrecruited discharged directly to home patients and patients transferred briefly to the ward prior to discharge home. Future work should include derivation of a clinical prediction tool to identify patient characteristics that make discharged directly to home safe and a randomized control trial to compare discharged directly to home with short stay ward transfers.
A Hospital Bed Allocation Hybrid Model Based on Situation Awareness
Authors: Grübler Murillo da Silveira , da Costa Cristiano André , Righi Rodrigo da Rosa , Rigo Sandro José , Chiwiacowsky Leonardo Dagnino
Published: February 2018

Bed management is an important area of planning and control for hospitals, as it has the important role of maintaining the balance between patients from the emergency department, patients who have elective surgery or scheduled treatment, and patients who are discharged from the hospital, while maintaining high bed occupancy rates. Effective management of these resources has always been a challenge for managers. In the 1980s and 1990s, thousands of patients had operations canceled due to nonmedical reasons. Due to the constant uncertainty experienced by hospitals today, use of the cognitive model known as situation awareness has been increasing in healthcare. Situation awareness seeks to understand environmental context to design the future, using artificial intelligence techniques. In this context, this article contributes the use of situation awareness in bed management using a hybrid system that combines known techniques of artificial neural networks and multiattribute value theory for decision-making by automating the process of bed allocation. The system was evaluated in a hospital in Porto Alegre, Brazil, yielding a result of 93.5% similarity between the beds determined by the proposed model and those chosen by the hospital manager.
Effects of Multimethod Intervention on Bedside Report Compliance and Patient Satisfaction
Authors: Faloon Daniela N. , Hampe Holly , Cline Thomas
Published: February 2018

Miscommunication is a large contributing factor to hospital sentinel events. Communication with nurses is a component of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. The HCAHPS survey not only assesses patient satisfaction but also impacts how hospitals are reimbursed. A literature review reveals that nursing bedside shift positively impacts patient satisfaction and nurse communication. There is limited research on how to implement bedside report as well as what to include during report. A pilot study evaluated an educational intervention and its impact on nurses' compliance with bedside report. The study also evaluated whether bedside report compliance affected HCAHPS scores. A test of independent proportions showed that overall compliance scores increased significantly from period 1 (46%) to period 3 (81%), z = 2.23, P = −.017, one-tailed. HCAHPS scores for nursing communication went from 69.9% in quarter 1 of 2015 to 73.8% in quarter 4 of 2016, but there was no statistically significant change.