bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hyper-realistic and immersive surgical simulation training environment will improve team performance
Authors: Hoang Tuan N , LaPorta Anthony J , Malone John D , Champagne Roland , Lavell Kit , De La Rosa Gabriel M , Gaul Lawrence , Dukovich Mitchell 
Published: March 2020

BackgroundSurgical trauma care requires excellent multidisciplinary team skills and communication to ensure the highest patient survival rate. This study investigated the effects of Hyper-realistic immersive surgical team training to improve individual and team performance. A Hyper-realistic surgical training environment is defined as having a high degree of fidelity in the replication of battlefield conditions in a training environment, so participants willingly suspend disbelief that they become totally immersed and eventually stress inoculated in a way that can be measured physiologically.MethodsSix multispecialty member US Navy Fleet Surgical/US Army Forward Surgical Teams (total n=99 evaluations) underwent a 6-day surgical training simulation using movie industry special effects and role players wearing the Human Worn Surgical Simulator (Cut Suit). The teams were immersed in trauma care scenarios requiring multiple complex interventions and decision making in a realistic, fast-paced, intensive combat trauma environment.ResultsHyper-realistic immersive simulation training enhanced performance between multidisciplinary healthcare team members. Key efficacy quantitative measurements for the same simulation presented on day 1 compared with day 6 showed a reduction in resuscitation time from 24 minutes to 14 minutes and critical error decrease from 5 to 1. Written test scores improved an average of 21% (Medical Doctors 11%, Registered Nurses 25%, and Corpsman/Medics 26%). Longitudinal psychometric survey results showed statistically significant increases in unit readiness (17%), combat readiness (12%), leadership quality (7%), vertical cohesion (7%), unit cohesion (5%), and team communication (3%). An analysis of salivary cortisol and amylase physiologic biomarkers indicated an adaptive response to the realistic environment and a reduction in overall team stress during performance evaluations.ConclusionsHyper-realistic immersive simulation training scenarios can be a basis for improved military and civilian trauma training.Level of evidenceLevel III.
HPGe detector field calculation methods demonstrated with an educational program, GeFiCa
Authors: Li Jianchen , Liu Jing , Kooi Kyler 
Published: March 2020

AbstractA review of tools and methods to calculate electrostatic potentials and fields inside high-purity germanium detectors in various configurations is given. The methods are illustrated concretely with a new educational program named GeFiCa - Germanium detector Field Calculator. Demonstrated in GeFiCa are generic numerical calculations based on the successive over-relaxation method as well as analytic ones whenever simplification is possible due to highly symmetric detector geometries. GeFiCa is written in C$$++$$++ and provided as an extension to the CERN ROOT libraries widely used in the particle physics community. Calculation codes for individual detectors, provided as ROOT macros and python scripts, are distributed along with the GeFiCa core library, serving as both examples showing the usage of GeFiCa and starting points for customized calculations. They can be run without compilation in a ROOT interactive session or directly from a Linux shell. The numerical results are saved in a ROOT tree, making full use of the I/O optimization and plotting functionalities in ROOT. The speed and precision of the calculation are comparable to other commonly used packages, which qualifies GeFiCa as a scientific research tool. However, the main focus of GeFiCa is to clearly explain and demonstrate the analytic and numeric methods to solve Poisson’s equation, practical coding considerations and visualization methods, with intensive documentation and example macros. It serves as a one-stop resource for people who want to understand the operating mechanism of such a package under the hood.
A study on the mechanical properties of forged high chrome steel heat resistant materials
Authors: Jeong Il Heon , Park Yeong Min , Yoo Jae Uk , Kim Tae Gyu 
Published: March 2020

High chrome steel (12 Cr-steel) is the material found in engine blade which required high durability and long service life at high temperatures. Therefore, it is important to produce durable and high strength 12 Cr-steel. In this study, effect of different tempering temperature on microstructure of 12 Cr-steel specimens were investigated. First, the specimens were heat treated to 1070[Formula: see text]C and quenched in an acidic solution. Then they were tempered at different temperature at 470[Formula: see text]C and 690[Formula: see text]C. Analyses on mechanical properties such as hardness, yield strength, tensile stress were performed. It is found that specimen at lower temperature (470[Formula: see text]C) has improved mechanical properties.
ENERGY COST FOR TARGET CONTROL OF COMPLEX NETWORKS
Authors: DUAN GAOPENG , LI AMING , MENG TAO , WANG LONG 
Published: March 2020

To promote the implementation of realistic control over various complex networks, recent work has been focusing on analyzing energy cost. Indeed, the energy cost quantifies how much effort is required to drive the system from one state to another when it is fully controllable. A fully controllable system means that the system can be driven by external inputs from any initial state to any final state in finite time. However, it is prohibitively expensive and unnecessary to confine that the system is fully controllable when we merely need to accomplish the so-called target control — controlling a subnet of nodes chosen from the entire network. Yet, when the system is partially controllable, the associated energy cost remains elusive. Here we present the minimum energy cost for controlling an arbitrary subset of nodes of a network. We show the scaling behavior of the precise upper and lower bounds of the minimum energy in terms of the time given to accomplish control. For controlling a given number of target nodes, we further show that the associated energy over different configurations can differ by several orders of magnitude. When the adjacency matrix of the network is nonsingular, we can simplify the framework by just considering the induced subgraph spanned by target nodes instead of the entire network. Importantly, we find that energy cost could be saved by orders of magnitude as we only need the partial controllability of the entire network. Our theoretical results are all corroborated by numerical calculations, and pave the way for estimating the energy cost to implement realistic target control in various applications.
Epigenome, Transcriptome, and Protection by Sulforaphane at Different Stages of UVB-Induced Skin Carcinogenesis
Authors: Li Shanyi , Yang Yuqing , Sargsyan Davit , Wu Renyi , Yin Ran , Kuo Hsiao-Chen Dina , Yang Irene , Wang Lujing , Cheng David , Ramirez Christina N. , Hudlikar Rasika , Lu Yaoping , Kong Ah-Ng 
Published: March 2020

AbstractSulforaphane (SFN), a potent antioxidant and antiinflammatory agent, has been shown to protect against cancers especially at early stages. However, how SFN affects UVB-mediated epigenome/DNA methylome and transcriptome changes in skin photodamage has not been fully assessed. Herein, we investigated the transcriptomic and DNA methylomic changes during tumor initiation, promotion, and progression and its impact and reversal by SFN using next-generation sequencing (NGS) technology. The results show that SFN reduced tumor incidence and tumor number. SFN's protective effects were more dramatic in the early stages than with later stages. Bioinformatic analysis of RNA sequencing (RNA-seq) data shows differential expressed genes and identifies the top canonical pathways related to SFN treatment of UVB-induced different stages of epidermal carcinogenesis. These pathways include p53 signaling, cell cycle: G2–M DNA damage checkpoint regulation, Th1, and Th2 activation pathway, and PTEN signaling pathways. The top upstream regulators related to UVB and SFN treatment as time progressed include dextran sulfate, TP53, NFE2L2 (Nrf2), IFNB1, and IL10RA. Bioinformatic analysis of Methyl-seq data shows several differential methylation regions induced by UVB were attenuated by SFN. These include Notch1, Smad6, Gnai3, and Apc2. Integrative analysis of RNA-seq and DNA-seq/CpG methylome yields a subgroup of genes associated with ultraviolet B (UVB) and SFN treatment. The changes in gene expression were inversely correlated with promoter CpG methylation status. These genes include Pik3cd, Matk, and Adm2. In conclusion, our study provides novel insights on the impact of SFN on the transcriptomic and DNA methylomic of UVB-induced different stages of skin cancer in mice.
IL1α Antagonizes IL1β and Promotes Adaptive Immune Rejection of Malignant Tumors
Authors: Tian Tian , Lofftus Serena , Pan Youdong , Stingley Claire A. , King Sandra L. , Zhao Jingxia , Pan Timothy Y. , Lock Rebecca , Marglous Jacob W. , Liu Kevin , Widlund Hans R. , Fuhlbrigge Robert C. , Cichowski Karen , Kupper Thomas S. 
Published: March 2020

AbstractWe assessed the contribution of IL1 signaling molecules to malignant tumor growth using IL1β−/−, IL1α−/−, and IL1R1−/− mice. Tumors grew progressively in IL1R−/− and IL1α−/− mice but were often absent in IL1β−/− mice. This was observed whether tumors were implanted intradermally or injected intravenously and was true across multiple distinct tumor lineages. Antibodies to IL1β prevented tumor growth in wild-type (WT) mice but not in IL1R1−/− or IL1α−/− mice. Antibodies to IL1α promoted tumor growth in IL1β−/− mice and reversed the tumor-suppressive effect of anti-IL1β in WT mice. Depletion of CD8+ T cells and blockade of lymphocyte mobilization abrogated the IL1β−/− tumor suppressive effect, as did crossing IL1β−/− mice to SCID or Rag1−/− mice. Finally, blockade of IL1β synergized with blockade of PD-1 to inhibit tumor growth in WT mice. These results suggest that IL1β promotes tumor growth, whereas IL1α inhibits tumor growth by enhancing T-cell–mediated antitumor immunity.
Primary Care of Opioid use Disorder: The End of “the French Model”?
Authors: Dupouy Julie , Maumus-Robert Sandy , Mansiaux Yohann , Pariente Antoine , Lapeyre-Mestre Maryse 
Published: March 2020

<b><i>Background:</i></b> In France, most patients with opioid use disorder (OUD) have been treated by buprenorphine, prescribed by general practitioners (GP) in private practice since 1996. This has contributed to building a ‘French model’ facilitating access to treatment based on the involvement of GPs in buprenorphine prescription. <b><i>Objectives:</i></b> Our study aimed to assess whether the involvement of primary care in OUD management has changed lately. <b><i>Materials and Methods:</i></b> Using data from the French National Health Insurance database, we conducted a yearly repeated cross-sectional study (2009–2015) and described proportion of opioid maintenance treatment (OMT)-prescribing GPs and OMT-dispensing community pharmacies (CP); and number of patients by GP or CP. <b><i>Results:</i></b> Whereas the number of buprenorphine-prescribing GPs in private practice remained quite stable (decrease of 3%), a substantial decrease in buprenorphine initial prescribers among private GPs was observed. In 2009, 10.3% of private GPs (6,297 from 61,301 French private GPs) prescribed buprenorphine for the initiation of a treatment, whereas they were 5.7% (<i>n</i> = 3,539 from 62,071 private GPs) in 2015 (43.8% decrease). GPs issuing initial prescriptions of buprenorphine tended to care for a higher number of patients treated by buprenorphine (14.6 ± 27.1 patients in 2009 to 16.0 ± 35.4 patients in 2015). The number of CPs dispensing buprenorphine remained quite stable (decrease of 2%), while there was a 7.5% decrease in the total number of French CPs across the study period. <b><i>Conclusions:</i></b> Our results suggest that primary care providers seem less engaged in buprenorphine initiation in OUD patients, while CPs have not modified their involvement towards these patients.
Aortic Stiffness and White Matter Microstructural Integrity Assessed by Diffusion Tensor Imaging: The ARIC‐NCS
Authors: Wei Jingkai , Palta Priya , Meyer Michelle L. , Kucharska‐Newton Anna , Pence Brian W. , Aiello Allison E. , Power Melinda C. , Walker Keenan A. , Sharrett A. Richey , Tanaka Hirofumi , Jack Clifford R. , Mosley Thomas H. , Reid Robert I. , Reyes Denise A. , Heiss Gerardo 
Published: March 2020

Background
Changes in white matter microstructural integrity are detectable before appearance of white matter lesions on magnetic resonance imaging as a manifestation of cerebral small‐vessel disease. The information relating poor white matter microstructural integrity to aortic stiffness, a hallmark of aging, is limited. We aimed to examine the association between aortic stiffness and white matter microstructural integrity among older adults.

Methods and Results

We conducted a cross‐sectional study to examine the association between aortic stiffness and white matter microstructural integrity among 1484 men and women (mean age, 76 years) at the 2011 to 2013 examination of the ARIC‐NCS (Atherosclerosis Risk in Communities Neurocognitive Study). Aortic stiffness was measured as carotid‐femoral pulse wave velocity. Cerebral white matter microstructural integrity was measured as fractional anisotropy and mean diffusivity using diffusion tensor imaging. Multivariable linear regression was used to examine the associations of carotid‐femoral pulse wave velocity with fractional anisotropy and mean diffusivity of the overall cerebrum and at regions of interest. Each 1‐m/s higher carotid‐femoral pulse wave velocity was associated with lower overall fractional anisotropy (β=−0.03; 95%
CI
, −0.05 to −0.02) and higher overall mean diffusivity (β=0.03; 95%
CI
, 0.02–0.04). High carotid‐femoral pulse wave velocity (upper 25th percentile) was associated with lower fractional anisotropy (β=−0.40; 95%
CI
, −0.61 to −0.20) and higher overall mean diffusivity (β=0.27; 95%
CI
, 0.10–0.43). Similar associations were observed at individual regions of interest.

Conclusions
High aortic stiffness is associated with low cerebral white matter microstructural integrity among older adults. Aortic stiffness may serve as a target for the prevention of poor cerebral white matter microstructural integrity.
Role of Moral Values in Evaluation of the Use of Nonhuman Animals in Research
Authors: Botero Maria , Desforges Donna 
Published: March 2020

Abstract
One requirement for the formation of an Institutional Animal Care and Use Committee (IACUC) is that they include a community member who embodies the values of the general population. This study’s aim is to investigate whether community members use moral arguments when deliberating a case of nonhuman animals used in experimentation. To this end, we tested the responses of community members in a situation similar to those confronting members of IACUC. The participants’ evaluation of the protocol was consistent with the mandates of IACUC. We also found that overall no moral argument played a significant role in their evaluation of a protocol. Only arguments based on loyalty to the human species played a moderate role in the evaluation of using animals in experimental research, in a way similar to using some moral arguments regarding the importance of human welfare to justify the use of animals in experimental research.
Précis of The Illusion of Doubt
Authors: Schönbaumsfeld Genia 
Published: March 2020

Abstract
The Illusion of Doubt shows that radical scepticism is an illusion generated by a Cartesian picture of our evidential situation—the view that my epistemic grounds in both the ‘good’ and the ‘bad’ cases must be the same. It is this picture which issues both a standing invitation to radical scepticism and ensures that there is no way of getting out of it while agreeing to the sceptic’s terms. The sceptical problem cannot, therefore, be answered ‘directly’. Rather, the assumptions that give rise to it, need to be undermined. These include the notion that radical scepticism can be motivated by the ‘closure’ principle for knowledge, that the ‘Indistinguishability Argument’ renders the Cartesian conception compulsory, that the ‘New Evil Genius Thesis’ is coherent, and the demand for a ‘global validation’ of our epistemic practices makes sense. Once these dogmas are undermined, the path is clear for a ‘realism without empiricism’ that allows us to re-establish unmediated contact with the objects and persons in our environment which an illusion of doubt had threatened to put forever beyond our cognitive grasp.
Impact of 24/7/365 Attending Radiologist Coverage on the Turnaround Time of Trauma-Related Imaging Studies Being Finalized Within 48 Hours in an Emergency Radiology Department, Offering a Perspective from a Tertiary Care Hospital
Authors: Jalal Sabeena , Ante Zharmaine , Ouellette Hugue , Peters Stephen , Munk Peter , Nicolaou Savvas 
Published: March 2020

Objective: To offer an evidence-based account of the effect of 24/7/365 attending radiologist coverage on the turnaround time (TAT) of trauma-related radiographs finalized within 48 hours of exam completion, drawing data from an emergency radiology department of a tertiary care hospital in Vancouver, British Columbia. Materials and Methods: This was a retrospective chart review, where TATs of imaging studies for a sample of trauma patients, who had visited the emergency department of the Vancouver General Hospital between two time periods, January 1 to September 30, 2013, and January 1 to September 30, 2017, were noted. Results: In models adjusted for patient’s age, sex, and seasonality, the 24/7/365 attending radiologist coverage was associated with an average of 19.1 (95% confidence interval [CI]: 18.7-19.4) hours of reduction in time from exam completion to report finalization by an attending radiologist. Approximately 11.3 (95% CI: 18.7-19.4) hours was due to reduction in time from exam completion to preliminary diagnosis of reports. When the impact of the increased number of radiology staff in 2017 was removed in the analysis, the overall TAT was reduced by 13.3 (95% CI: 13.0-13.6) hours and the time from exam completion to preliminary report was reduced by 7.8 (95% CI: 7.6-8.1) hours. Limitation: Since we have used a simple random sample (SRS) for this research, this study does not describe the burden of reports that are finalized in the emergency and trauma radiology department during the given time periods. Conclusion: Our pilot study demonstrates that the implementation of 24/7/365 attending radiology coverage significantly reduces TAT for finalized radiology reports of all modalities of trauma imaging studies in an emergency and trauma radiology department. Policy implication: This research serves the contemporary health-care administration, policymaking information needs by providing the evidence for significantly reduced TAT of finalized radiology reports from a Canadian perspective.
Percutaneous Image-Guided Biopsy of the Spleen: Experience at a Single Tertiary Care Center
Authors: John Susan , Shabana Wael , Salameh Jean-Paul , McInnes Matthew D. F. 
Published: March 2020

Purpose: The purpose of this study is to assess the complication rate of percutaneous image-guided biopsy of the spleen at our institution and to evaluate for variables associated with complication rate. Methods: This is a Research Ethics Board approved retrospective study of consecutive patients who underwent image-guided biopsy of the spleen at our institution from January 2010 to November 2019. Complications, imaging findings, and pathologic diagnosis were reviewed. Complications (major and minor) were classified per Society of Interventional Radiology Guidelines, and complication rate was calculated. Logistic regression was applied to determine factors associated with complications. Diagnostic yield was calculated. Results: In all, 55 patients (28 female) underwent splenic biopsy using ultrasound guidance. The most common indication was possible lymphoma in 41 (71.7%) patients followed by query metastasis 18 (31.5%) patients. Core biopsies (18 g/20 g) were done in 53 (92%) cases, and fine-needle aspiration (22 g) was performed in 4 (8%). The median number of samples collected was 4 (range: 2-9). The results were diagnostic in 54 cases (94.7%, 95% confidence interval [CI]: 88.7-100.0). There were 12 (21%, 95% CI: 10.1-31.9) patients with minor complications and 2 (3.5%, 95% CI: 0.0-8.4) with major complications (2 splenic bleeds requiring embolization, no splenectomy, or deaths). No variables (needle size, lesion size, and number of passes) were associated with complication rate. Conclusion: Percutaneous image-guided biopsy of the spleen at a single tertiary care institution demonstrates major complication rate comparable to that in the literature with no variables associated with complication rate; there were no cases of splenectomy or death.
The Role of Combined Diffusion-Weighted Imaging and Dynamic Contrast-Enhanced MRI for Differentiating Malignant From Benign Breast Lesions Presenting Washout Curve
Authors: Tezcan Sehnaz , Ozturk Funda Ulu , Uslu Nihal , Akcay Eda Yilmaz 
Published: March 2020

Purpose: The aim of this study is to evaluate the diagnostic performance of combined breast magnetic resonance imaging (MRI) protocol including dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging (DWI) in patients with enhancing lesions that demonstrated washout curve and to determine whether applying apparent diffusion coefficient (ADC) cutoff value could improve the diagnostic value of breast MRI. Methods: The retrospective study included 116 patients with 116 suspicious breast lesions, which showed washout curve on DCE-MRI, who underwent subsequent biopsy. Morphologic characteristics on DCE-MRI and ADC values on DWI were evaluated. Apparent diffusion coefficient values and morphologic features of benign and malignant lesions were compared. Diagnostic values of DCE-MRI and combined MRI, including DCE-MRI and DWI (applying an ADC cutoff value) for distinguishing malignancy from benign lesions, were calculated. Results: Of the 116 breast lesions, 79 were malignant and 37 were benign. The ADC value of malignant tumors (median ADC, 0.72 × 10−3 mm2/s) was significantly lower than that of benign lesions (median ADC, 1.03 × 10−3 mm2/s; P < .000). The sensitivity and specificity of an ADC cutoff value of 0.89 × 10−3 mm2/s were 92% and 95%, respectively. Dynamic contrast-enhanced MRI alone presented 100% sensitivity and 59.4% specificity. Adding an ADC cutoff value of 0.89 × 10−3 mm2/s provided 100% sensitivity and 81% specificity, which would have prevented biopsy for 21.6% of benign lesions without missing any malignancies. Conclusion: Applying an ADC cutoff value to DCE-MRI provides an improvement in the diagnostic value of breast MRI for differentiating among lesions presenting washout curve.
Pseudo-melancholia
Authors: Parker Gordon 
Published: March 2020

Objective: An incorrect false positive diagnosis of melancholia can lead to inappropriate treatment and illness prolongation. This paper therefore seeks to introduce the concept of ‘pseudo-melancholia’ to capture such instances and provide clinical examples of contributing at-risk scenarios. Methods: The author draws on clinical experience to provide exemplars of circumstances most risking a false positive diagnosis of melancholia. Results: Pseudo-melancholia can result from invalid measures of melancholia and from several functional and organic conditions presenting with suggested melancholic features. Conclusions: Recognising high-risk pseudo-melancholia scenarios has the potential to advance a change in diagnostic formulation, provide a more diagnosis-specific intervention and so avert a secondary diagnosis of ‘treatment resistant depression’.