bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Harvard Medical School Pathways Curriculum: Reimagining Developmentally Appropriate Medical Education for Contemporary Learners
Authors: Schwartzstein Richard M. , Dienstag Jules L. , King Randall W. , Chang Bernard S. , Flanagan John G. , Besche Henrike C. , Hoenig Melanie P. , Miloslavsky Eli M. , Atkins K. Meredith , Puig Alberto , Cockrill Barbara A. , Wittels Kathleen A. , Dalrymple John L. , Gooding Holly , Hirsh David A. , Alexander Erik K. , Fazio Sara B. , Hundert Edward M. ,   for the Pathways Writing Group
Published: March 2020

As the U.S. health care system changes and technology alters how doctors work and learn, medical schools and their faculty are compelled to modify their curricula and teaching methods. In this article, educational leaders and key faculty describe how the Pathways curriculum was conceived, designed, and implemented at Harvard Medical School. Faculty were committed to the principle that educators should focus on how students learn and their ability to apply what they learn in the evaluation and care of patients. Using the best evidence from the cognitive sciences about adult learning, they made major changes in the pedagogical approach employed in the classroom and clinic. The curriculum was built upon 4 foundational principles: to enhance critical thinking and provide developmentally appropriate content; to ensure both horizontal integration between courses and vertical integration between phases of the curriculum; to engage learners, foster curiosity, and reinforce the importance of student ownership and responsibility for their learning; and to support students’ transformation to a professional dedicated to the care of their patients and to their obligations for lifelong, self-directed learning.
The practice of medicine is rapidly evolving and will undoubtedly change in multiple ways over the career of a physician. By emphasizing personal responsibility, professionalism, and thinking skills over content transfer, the authors believe this curriculum will prepare students not only for the first day of practice but also for an uncertain future in the biological sciences, health and disease, and the nation’s health care system, which they will encounter in the decades to come.
Problematic Child Mealtime Behavior and Caregiver Mobile Phone Use
Authors: Milkovich Libby Matile , Sherman Ashley , Dreyer Gillette Meredith , Sweeney Brooke , Nyp Sarah , Black Benjamin 
Published: March 2020

ABSTRACT:

Objective:
To evaluate the associations of caregiver mobile phone problematic use and child problematic mealtime behaviors (PMBs) to improve understanding of the possible implications of caregiver mobile phone problematic use.

Methods:
Surveys were administered to caregivers of children aged 3 to 8 years. The survey included demographics, a validated measure for caregiver mobile phone problematic use (Mobile Phone Problematic Use Scale-10 [MPPUS-10]), and a validated measure for the perception of child PMB (Meals in our Household [MIOH]). The bivariate associations between child and caregiver characteristics, mobile phone problematic use, and PMBs of children were analyzed. Partial correlations examined these relations while controlling for significant (p ≤ 0.05) covariates.

Results:
Eighty-four caregivers (mean age 32.6 years, 63% white, 21% ≤ high school completion) participated. The correlation of MIOH problematic behavior total with MPPUS-10 was significant (r = 0.33, p ≤ 0.01). Significantly correlated caregiver variables with MPPUS-10 included age (r = −0.25, p = 0.02) and female sex (p = 0.01). No significant caregiver variables were noted for PMB. Child’s age was significantly correlated with PMB (r = −0.27, p = 0.01). MPPUS-10 and PMB correlation remained significant when controlling for significant covariates.

Conclusion:
A positive correlation existed between MPPUS-10 and PMB. Understanding the potential association between caregiver mobile phone problematic use and child PMB strengthens the pediatricians' ability to counsel about the implications of caregiver mobile phone problematic use when discussing child PMB.
Predictors of Aspirin Nonadherence in Adults With Prior Myocardial Infarction
Authors: Bhasin Varun , Mehta Aayushi , Skopicki Hal A. , Parikh Puja B. 
Published: March 2020

Background:
Medication nonadherence is an alarming public health concern due to its effect on both individual treatment success and overall health care costs. This study sought to identify the predictors of aspirin nonadherence in adults with prior myocardial infarction (MI).

Methods:
The 2017 Centers for Disease Control’s Behavioral Risk Factor Surveillance Survey, a nationally representative, cross-sectional survey, was utilized to identify a cohort of community-dwelling adults (age ≥ 18 years) with prior MI (n = 2173). The primary outcome of interest was presence of self-reported aspirin nonadherence.

Results:
Among 2173 participants with prior MI studied, a total of 550 participants (25.3%) reported aspirin nonadherence, whereas 1623 participants (74.7%) reported adherence to aspirin. Adults with aspirin nonadherence were younger and more likely to be female, Black, and of Hispanic ethnicity. They also had lower annual income and were less likely to have health insurance or own a home. Participants with aspirin nonadherence had less frequent medical checkups and lower rates of multiple comorbidities including diabetes mellitus, hypertension, hyperlipidemia, and obesity. In multivariable analysis, independent predictors of aspirin nonadherence included female sex [odds ratio (OR), 1.42; 95% confidence interval (CI), 1.14–1.83], Black race (OR, 1.64; 95% CI, 1.19–2.26), Hispanic ethnicity (OR, 2.27; 95% CI, 1.60–3.21), current employment (OR, 1.74; 95% CI, 1.28–2.36), and absence of homeowner status (OR, 0.71; 95% CI, 0.55–0.93).

Conclusions:
In this observational contemporary study of adults with prior MI, predictors of aspirin nonadherence included female sex, Black race, Hispanic ethnicity, currently employed status, and absence of homeowner status.
Ventricular Arrhythmias in Patients with Spontaneous Coronary Artery Dissection
Authors: Daoulah Amin , Al-Faifi Salem M. , Alsheikh-Ali Alawi A. , Hersi Ahmad S. , Lotfi Amir 
Published: March 2020

Background:
Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute coronary syndrome in young women, with a wide clinical spectrum of severity. Ventricular arrhythmia (VA) can occur and worsen prognosis. The current study compared in-hospital and follow-up adverse cardiovascular events in patients with and without VA at presentation.

Methods:
Eighty-three cases of SCAD were collected retrospectively from 4 Gulf countries (KSA, UAE, Kuwait, and Bahrain) during the period from January 2011 to December 2017. We divided the patients into 2 groups: those with and without VA at presentation. VA was defined as ventricular tachycardia and/or ventricular fibrillation. In-hospital (recurrent VA, cardiogenic shock, death, implantable cardioverter-defibrillator placement, dissection extension) and follow-up (MI, de novo SCAD, death, spontaneous superior mesenteric artery dissection) events were compared among the 2 groups.

Results:
The median age of patients in the study was 44 (37–55) years. Forty-two (51%) were women. VA occurred in 10 (12%) patients in the first 24-hour of hospitalization, and 5 (50%) of those patients had recurrent in-hospital VA. Among those with recurrent VA, 1 died during hospitalization and 1 died within the first year following hospital discharge.

Conclusions:
In-hospital adverse cardiovascular events were significantly more frequent for patients with SCAD who presented with VA. However, follow-up events were not statistically significant between those with and without VA at presentation.
Approach to Evaluating and Managing Adult Attention-Deficit/Hyperactivity Disorder in Primary Care
Authors: Huang Hsiang , Huang Heather , Spottswood Margaret , Ghaemi Nassir 
Published: March 2020

Abstract
Requests for the evaluation of potential adult attention-deficit/hyperactivity disorder (ADHD) is on the rise across primary care clinics. Many health care providers, however, may feel ill equipped to diagnose and manage adults presenting with inattention and impulsivity. The diagnosis of ADHD is often complicated by medical and psychiatric conditions that can contribute to inattention symptoms. In this article, the authors provide a pragmatic clinical approach for evaluating and managing adult ADHD in the primary care setting.
The Safety and Effectiveness of High-Dose Propranolol as a Treatment for Challenging Behaviors in Individuals With Autism Spectrum Disorders
Authors: London Eric B. , Yoo J. Helen , Fethke Eric D. , Zimmerman-Bier Barbie 
Published: March 2020

Abstract

Purpose/Background
Individuals with autism spectrum disorders present with social communication deficits and a rigid adherence to sameness. Along with these symptoms, many individuals also present with severe challenging behaviors that place themselves as well as their families and communities at risk for injury. For these individuals, new and effective treatments are acutely needed. Propranolol has been used worldwide for over 50 years. Its primary indication is for hypertension, but there is evidence that, at higher doses, propranolol inhibits rage and anger through its effects on the central nervous system. This effect has been demonstrated in a variety of neuropsychiatric disorders.

Methods/Procedures
Here, we present 46 retrospective analyses of clinical cases that were followed by a psychiatrist. Propranolol was prescribed as an add-on to the patients' existing medications. The doses ranged from 120 to 960 mg per day (mean = 462 mg).

Findings/Results
Thirty-nine (85%) of 46 patients were found to be much improved or very much improved on the physician-rated Clinical Global Impression Improvement scale. There were few side effects noted, with only 2 subjects unable to tolerate the propranolol.

Implications/Conclusions
It appears that high-dose propranolol can be given safely with minimal adverse cardiovascular problems, provided that close clinical monitoring is maintained. A more rigorous clinical trial is needed to elucidate and verify its clinical utility, clinical practice parameters, and the effects of propranolol as a monotherapy versus as an add-on to the patient's existing medication regimen.
Does Treatment Response With Antidementia Drugs After 6 Months in Alzheimer's Disease Predict Long-term Treatment Outcome?
Authors: Horikoshi Sho , Kunii Yasuto , Matsumoto Junya , Gotoh Daisuke , Miura Itaru , Yabe Hirooki 
Published: March 2020

Abstract

Background
Alzheimer's disease (AD) is a chronic, progressive disorder that causes declines in cognitive and physical functions. This condition places severe burdens on families and caregivers. Delaying progressive declines in cognitive function and reducing their burden are thus important. Relationships between early treatment response and subsequent outcomes of schizophrenia and major depressive disorder have been reported. We thus aimed to investigate the relationships between treatment response to antidementia drugs in AD after 6 months (M) and subsequent outcomes.

Methods
Eligible individuals comprised 194 patients diagnosed with presumed AD. Of these, 110 patients who received antidementia drugs for the first time and were assessed using the Mini-Mental State Examination (MMSE) at 6 M, 12 M, and 24 M were categorized as responders (n = 84) or nonresponders (n = 26). Responders were defined as showing a change in MMSE after 6 M the same as or lower than that in the natural course according to previously reported data.

Results
No significant differences in baseline characteristics (age, sex, education, or comorbidities) were seen between groups. Mean MMSE score at baseline was significantly lower in responders (18.0) than in nonresponders (20.7; P = 0.008). Mean change from baseline MMSE was significantly smaller in responders than in nonresponders at both 12 M (−0.46 vs −2.5; P = 0.04) and 24 M (−0.78 vs −4.4; P = 0.001).

Conclusions
Treatment response with antidementia drugs after 6 M predicted better outcomes at 12 M and 24 M. Treatment response should be assessed every 6 M, and treatment should be reconsidered accordingly.
Pharmacokinetics and Pharmacodynamics of the Dual Orexin Receptor Antagonist Daridorexant in Japanese and Caucasian Subjects
Authors: Muehlan Clemens , Zuiker Rob , Peeters Pierre , Rowles Racheal , Dingemanse Jasper 
Published: March 2020

Abstract

Purpose/Background
Daridorexant is a dual orexin receptor antagonist in development for the treatment of sleep disorders. Thus far, it has not yet been studied in Japanese subjects. Study objectives were to evaluate the pharmacokinetics (PK), pharmacodynamics (PD), and safety of single- and multiple-dose administration of daridorexant in healthy Caucasian and Japanese subjects.

Methods/Procedures
This was a double-blind, placebo-controlled, randomized study. Subjects received once-daily doses of daridorexant (25 or 50 mg) or placebo for 5 days. Pharmacokinetics and safety were investigated using standard assessments. To assess PD effects, a battery of tests (saccadic peak velocity, body sway, adaptive tracking performance, and visual analog scales for alertness, mood, and calmness), known to be sensitive to sleep-promoting drugs was used.

Findings/Results
On day 1, PK variables were similar between Caucasian and Japanese subjects. On day 5, slight accumulation occurred in Japanese but not in Caucasian subjects, resulting in a higher maximum concentration (1403 vs 1006 ng/mL) and area under the curve (8256 vs 6306 ng·h/mL) at a dose of 50 mg, whereas values for time to maximum concentration and half-life were similar. Daridorexant dose-dependently reduced vigilance, attention, visuomotor coordination, and postural stability. Pharmacokinetic effects were detectable within 1 hour after drug administration and returned to baseline 4 to 8 hours postdose. Overall, Japanese showed slightly larger PD effects and reported more adverse events than Caucasians. The most frequently reported were somnolence, fatigue, and headache. Changes in other safety assessments were unremarkable.

Implications/Conclusions
The PK, PD, and safety profile of daridorexant were similar in Japanese and Caucasian subjects.
Antarcticimicrobium sediminis gen. nov., sp. nov., isolated from Antarctic intertidal sediment, transfer of Ruegeria lutea to Antarcticimicrobium gen. nov. as Antarcticimicrobium luteum comb. nov.
Authors: Zhang Shan , Liu Wei-Xiong , Liu Ning-Hua , He Xiao-Yan , Su Hai-Nan , Li Chun-Yang , Zhang Yu-Zhong , Song Xiao-Yan , Zhang Xi-Ying 
Published: March 2020

A Gram-stain-negative, aerobic, non-flagellated and rod- or ovoid-shaped bacterium, designated as strain S4J41T, was isolated from Antarctic intertidal sediment. The isolate grew at 0–37 °C and with 0.5–10 % (w/v) NaCl. It reduced nitrate to nitrite and hydrolysed Tween 80 and gelatin. Phylogenetic analysis based on 16S rRNA gene sequences revealed that strain S4J41T constituted a distinct phylogenetic line within the family

Rhodobacteraceae

and was closely related with some species in the genera

Ruegeria

,

Phaeobacter

,

Pseudopuniceibacterium

,

Sulfitobacter

,

Puniceibacterium

and

Poseidonocella

with 98.6–95.7 % 16S rRNA gene sequence similarities. The major cellular fatty acids were C16 : 0, summed feature 8 (C18 : 1
ω7c and/or C18 : 1
ω6c) and C18 : 0 and the major polar lipids were phosphatidylglycerol, phosphatidylcholine, diphosphatidylglycerol, phosphatidylethanolamine and one unidentified aminolipid. The sole respiratory quinone was Q-10. The genomic DNA G+C content of strain S4J41T was 60.3 mol%. Based on the phylogenetic, chemotaxonomic and phenotypic data obtained in this study, strain S4J41T is considered to represent a novel species in a new genus within the family

Rhodobacteraceae

, for which the name Antarcticimicrobium sediminis gen. nov., sp. nov. is proposed. The type strain is S4J41T (=MCCC 1K03508T=KCTC 62793T). Moreover, the transfer of

Ruegeria lutea

Kim et al. 2019 to Antarcticimicrobium gen. nov. as Antarcticimicrobium luteum comb. nov. (type strain 318-1T=JCM 30927T=KCTC 72105T) is also proposed.
Efficient Dual-Negative Selection for Bacterial Genome Editing
Authors: Cianfanelli Francesca Romana , Cunrath Olivier , Bumann Dirk 
Published: March 2020

AbstractWe describe a versatile method for chromosomal gene editing based on classical consecutive single-crossovers. The method exploits rapid plasmid construction using Gibson assembly, a convenientE. colidonor strain, and efficient dual-negative selection for improved suicide vector resolution. We used this method to generatein framedeletions, insertions and point mutations inSalmonella entericawith limited hands-on time. Similar strategies allowed efficient gene editing also inPseudomonas aeruginosaand multi-drug-resistant (MDR)Escherichia coliclinical isolates.
Brain gene co-expression networks link complement signaling with convergent synaptic pathology in schizophrenia
Authors: Kim Minsoo , Haney Jillian R. , Zhang Pan , Hernandez Leanna M. , Wang Lee-kai , Perez-Cano Laura , Loohuis Loes M. Olde , de la Torre-Ubieta Luis , Gandal Michael J. 
Published: March 2020

AbstractThe most significant common variant association for schizophrenia (SCZ) reflects increased expression of the complement component 4A (C4A). Yet, it remains unclear howC4Ainteracts with other SCZ risk genes and whether the complement system is more broadly implicated in SCZ pathogenesis. Here, we integrate several existing, large-scale genetic and transcriptomic datasets to interrogate the functional role of the complement system andC4Ain the human brain. Surprisingly, we find no significant genetic enrichment among known complement system genes for SCZ. Conversely, brain co-expression network analyses usingC4Aas a seed gene revealed that genes down-regulated whenC4Aexpression increased exhibit strong and specific genetic enrichment for SCZ risk. This convergent genomic signal reflected neuronal, synaptic processes and was sexually dimorphic and most prominent in frontal cortical brain regions. Overall, these results indicate that synaptic pathways—rather than the complement system—are the driving force conferring SCZ risk.
Multimodal mapping of neural activity and cerebral blood flow reveals long-lasting neurovascular dissociations after small-scale strokes
Authors: He Fei , Sullender Colin , Zhu Hanlin , Williamson Michael R. , Li Xue , Zhao Zhengtuo , Jones Theresa A. , Xie Chong , Dunn Andrew K. , Luan Lan 
Published: March 2020

AbstractNeurovascular coupling, the close spatial and temporal relationship between neural activity and hemodynamics, is disrupted in pathological brain states. To understand the altered neurovascular relationship in brain disorders, longitudinal, simultaneous mapping of neural activity and hemodynamics is critical yet challenging to achieve. Here, we employ a multimodal neural platform in a mouse model of stroke and realize long-term, spatially-resolved tracking of intracortical neural activity and cerebral blood flow in the same brain regions. We observe a pronounced neurovascular dissociation that occurs immediately after small-scale strokes, becomes the most severe a few days after, lasts into chronic periods, and varies with the level of ischemia. Neuronal deficits extend spatiotemporally whereas restoration of cerebral blood flow occurs sooner and reaches a higher relative value. Our findings reveal the neurovascular impact of mini-strokes and inform the limitation of neuroimaging techniques that infer neural activity from hemodynamic responses.
An associated evaluation methodology of initial stress level of coal-rock masses in steeply inclined coal seams, Urumchi coal field, China
Authors: Shan Pengfei , Lai Xingping 
Published: March 2020

Purpose
This paper aims to present an associated methodology to evaluate the initial stress of coal-rock masses in steeply inclined coal seams.

Design/methodology/approach
On the basis of the real-time monitoring data in the field, the corresponding analytical analysis is carried out in consideration of the characteristics of topography and geology, so as to deduce the value of the initial stress in the study area and also give the analytical model of the initial stress field.

Findings
The authors identified feasibility of the initial stress level of coal-rock masses in steeply inclined coal seams, and revealed that exact acquisition on the displacement of surrounding rock was feasible to analyze the initial stress level of coal-rock masses by the back analytical method in the steeply inclined coal seams as a two-dimensional plane problem.

Originality/value
The calculation results including vertical stress, minimum horizontal principal stress and shearing stress were 7.057, 8.085 and 0.057 MPa, respectively. The KJ743 coal mine initial stress monitoring system was used to collect real-time initial stress data, which were used to check the accuracy of the analytical back results. The value of the vertical stress varied from 6.8 to 7.0 MPa, which is slightly smaller than the result of the back calculation. The minimum principal horizontal stress varied from 7.6 to 8.4 MPa, which is similar to the result of the back calculation.
Career adaptability of South Korean engineering students
Authors: Park Sunyoung , Park Su Yeong 
Published: March 2020

Purpose
The purpose of this study is to examine the role of mastery goal orientation, support for career development, career decision-making self-efficacy and engineering interest in career adaptability for engineering students.

Design/methodology/approach
Data were collected from 307 Korean engineering students from two universities. Structural equation modeling was used to analyze data and examine the relationships among the variables.

Findings
The results indicated that the level of mastery of goal orientation and support for career development significantly affected career decision-making self-efficacy. Engineering students’ career decision-making self-efficacy also positively influenced their engineering interests and career adaptability. Finally, the students’ engineering interest positively affected their career adaptability.

Originality/value
This study demonstrated that important factors for career planning and development need to be successively considered during the career choice process by linking it to career decision-making self-efficacy, engineering interest and career adaptability (career choice action), in consecutive order.