bluuebunny/crossref_metadata_2025_split huggingface dataset:
Visual chunking as a strategy for spatial thinking in STEM
Authors: Stieff Mike , Werner Stephanie , DeSutter Dane , Franconeri Steve , Hegarty Mary 
Published: April 2020

AbstractWorking memory capacity is known to predict the performance of novices and experts on a variety of tasks found in STEM (Science, Technology, Engineering, and Mathematics). A common feature of STEM tasks is that they require the problem solver to encode and transform complex spatial information depicted in disciplinary representations that seemingly exceed the known capacity limits of visuospatial working memory. Understanding these limits and how visuospatial information is encoded and transformed differently by STEM learners presents new avenues for addressing the challenges students face while navigating STEM classes and degree programs. Here, we describe two studies that explore student accuracy at detecting color changes in visual stimuli from the discipline of chemistry. We demonstrate that both naive and novice chemistry students’ encoding of visuospatial information is affected by how information is visually structured in “chunks” prevalent across chemistry representations. In both studies we show that students are more accurate at detecting color changes within chemistry-relevant chunks compared to changes that occur outside of them, but performance was not affected by the dimensionality of the structure (2D vs 3D) or the presence of redundancies in the visual representation. These studies support the hypothesis that strategies for chunking the spatial structure of information may be critical tools for transcending otherwise severely limited visuospatial capacity in the absence of expertise.
The Impact of Disuse and High-Fat Overfeeding on Forearm Muscle Amino Acid Metabolism in Humans
Authors: Wall Benjamin T , Cruz Ana M , Otten Britt , Dunlop Mandy V , Fulford Jonathan , Porter Craig , Abdelrahman Doaa Reda , Stephens Francis B , Dirks Marlou L 
Published: April 2020

Abstract

Context
Anabolic resistance is mechanistically implicated in muscle disuse atrophy.

Objective
The objective of this study is to assess whether anabolic resistance is associated with reduced postprandial amino acid uptake or exacerbated by excess lipid availability.

Design, Setting, Participants, and Interventions
Twenty men underwent 7 days of forearm immobilization while consuming a eucaloric (CON; n = 11) or high-fat overfeeding (HFD; n = 9; 50% excess energy as fat) diet (parallel design) within our Nutritional Physiology Research Unit.

Main Outcome Measures
Preimmobilization and postimmobilization we measured forearm muscle cross-sectional area (aCSA), and postabsorptive and postprandial (3-hour postingestion of a liquid, protein-rich, mixed meal) forearm amino acid metabolism using the arterialized venous-deep venous balance method and infusions of L-[ring-2H5]phenylalanine and L-[1-13C]leucine.

Results
Immobilization did not affect forearm muscle aCSA in either group, but tended to reduce postabsorptive phenylalanine (P = .07) and leucine (P = .05) net balances equivalently in CON and HFD. Mixed-meal ingestion switched phenylalanine and leucine net balances from negative to positive (P &lt; .05), an effect blunted by immobilization (P &lt; .05) and to a greater extent in HFD than CON (P &lt; .05). Preimmobilization, meal ingestion increased leucine rates of disappearance (Rd; P &lt; .05), with values peaking at 191% (from 87 ± 38 to 254 ± 60 µmol·min–1·100 mL forearm volume–1) and 183% (from 141 ± 24 to 339 ± 51 µmol·min–1·100 mL–1) above postabsorptive rates in CON and HFD, respectively, with meal-induced increases not evident postimmobilization in either group (P &gt; .05).

Conclusions
Disuse impairs the ability of a protein-rich meal to promote positive muscle amino acid balance, which is aggravated by dietary lipid oversupply. Moreover, disuse reduced postprandial forearm amino acid uptake; however, this is not worsened under high-fat conditions.
Retention and Migration of Rwandan Anesthesiologists: A Qualitative Study
Authors: Skelton Teresa , Irakoze Alain , Bould M. Dylan , Przybylak-Brouillard Antoine , Twagirumugabe Theogene , Livingston Patricia 
Published: April 2020

BACKGROUND:
Health care professional migration continues to challenge countries where the lack of surgical and anesthesia specialists results in being unable to address the global burden of surgical disease in their populations. Medical migration is particularly damaging to health care systems that are just beginning to scale up capacity building of human resources for health. Anesthesiologists are scarce in low-resource settings. Defining reasons why anesthesiologists leave their country of training through in-depth interviews may provide guidance to policy makers and academic organizations on how to retain valuable health professionals.

METHODS:
There were 24 anesthesiologists eligible to participate in this qualitative interview study, 15 of whom are currently practicing in Rwanda and 9 had left the country. From the eligible group, interviews were conducted with 13 currently practicing in Rwanda and 2 who had left to practice elsewhere. In-depth interviews of approximately 60 minutes were used to define themes influencing retention and migration among anesthesiologists in Rwanda. Interviews were conducted using a semistructured guide and continued until theoretical sufficiency was reached. Thematic analysis was done by 4 members of the research team using open coding to inductively identify themes.

RESULTS:
Interpretation of results used the framework categorizing themes into push, pull, stick, and stay to describe factors that influence migration, or the potential for migration, of anesthesiologists in Rwanda. While adequate salary is essential to retention of anesthesiologists in Rwanda, other factors such as lack of equipment and medication for safe anesthesia, isolation, and demoralization are strong push factors. Conversely, a rich academic life and optimism for the future encourage anesthesiologists to stay.

CONCLUSIONS:
Our study suggests that better clinical resources and equipment, a more supportive community of practice, and advocacy by mentors and academic partners could encourage more staff anesthesiologists to stay and work in Rwanda.
Blood Utilization and Clinical Outcomes in Extracorporeal Membrane Oxygenation Patients
Authors: Qin Caroline X. , Yesantharao Lekha V. , Merkel Kevin R. , Goswami Dheeraj K. , Garcia Alejandro V. , Whitman Glenn J. R. , Frank Steven M. , Bembea Melania M. 
Published: April 2020

BACKGROUND:
Patients requiring extracorporeal membrane oxygenation (ECMO) support are critically ill and have substantial transfusion requirements, which convey both risks and benefits. A retrospective analysis was conducted to assess the association between blood component administration and adverse outcomes in adult, pediatric, and neonatal ECMO patients.

METHODS:
We evaluated 217 ECMO patients at a single center hospitalized between January 2009 and June 2016. Three cohorts (88 adult, 57 pediatric, and 72 neonatal patients) were included for assessment of patient characteristics, blood utilization, and clinical outcomes. Univariable and multivariable analyses were used to assess the association between transfusions and clinical outcomes (primary outcome: mortality and secondary outcomes: morbid events). The analysis included the main exposure of interest (total number of blood component units transfused) and potential confounding variables (age group cohort, case mix index, sex, ECMO mode and duration, and primary ECMO indication).

RESULTS:
After adjustment for confounders, with each additional blood component unit transfused, there was an estimated increase in odds for mortality by 1% (odds ratio [OR] = 1.01; 95% confidence interval [CI], 1.00–1.02; P = .013) and an increase in odds for thrombotic events by 1% (OR = 1.01; 95% CI, 1.00–1.02; P = .007). Mortality was higher in the adult (57 of 88; 64.8%) and pediatric (37 of 57; 64.9%) than in the neonatal cohort (19 of 72; 26.4%) (P < .0001). Median total blood components transfused per day followed a similar pattern for the adult (2.3 units; interquartile range [IQR] = 0.8–7.0), pediatric (2.9 units; IQR = 1.1–10), and neonatal (1.0 units; IQR = 0.7–1.6) cohorts (P < .0001). Over the entire hospitalization, the total median blood components transfused was highest in the neonatal (41 units; IQR = 24–94) and pediatric (41 units; IQR = 17–113) compared to the adult (30 units; IQR = 9–58) cohort (P = .007). There was no significant interaction between total units transfused over the hospital stay and age cohort for mortality (P = .35).

CONCLUSIONS:
Given the association between transfusion and adverse outcomes, effective blood management strategies may be beneficial in ECMO patients.
Health Numeracy and Relative Risk Comprehension in Perioperative Patients and Physicians
Authors: Hayter Ryan R. , Hess Aaron S. 
Published: April 2020

BACKGROUND:
Helping patients to understand relative risks is challenging. In discussions with patients, physicians often use numbers to describe hazards, make comparisons, and establish relevance. Patients with a poor understanding of numbers—poor “health numeracy”—also have difficulty making decisions and coping with chronic conditions. Although the importance of “health literacy” in perioperative populations is recognized, health numeracy has not been well studied. Our aim was to compare understanding of numbers, risk, and risk modification between a patient population awaiting surgery under general anesthesia and attending physicians at the same center.

METHODS:
We performed a single-center cross-sectional survey study to compare patients’ and physicians’ health numeracy. The study instrument was based on the Schwartz–Lipkus survey and included 3 simple health numeracy questions and 2 risk reduction questions in the anesthesiology domain. The survey was mailed to patients over the age of 18 scheduled for elective surgery under general anesthesia between June and September 2019, as well as attending physicians at the study center.

RESULTS:
Two hundred thirteen of 502 (42%) patient surveys sent and 268 of 506 (53%) physician surveys sent were returned. Median patient score was 4 of 5, but 32% had a score of ≤3. Patients significantly overestimated their total scores by an average of 0.5 points (estimated [mean ± standard deviation (SD)] = 4.3 ± 1.2 vs actual 3.8 ± 1.3; P < .001). Health numeracy was significantly associated with higher educational level (gamma = 0.351; P < .001) and higher-income level (gamma = 0.397; P < .001). Physicians’ health numeracy was significantly higher than the patients’ (median [interquartile range {IQR}] = 5 [4–5] vs 4 [3–5]; P < .001). There was no significant difference between physicians’ self-estimated and actual total numeracy score (mean ± SD = 4.8 ± 0.6 vs 4.7 ± 0.6; P = .372). Simple health numeracy (questions 1–3) was predictive of correct risk reduction responses (questions 4, 5) for both patients (gamma = 0.586; P < .001) and physicians (gamma = 0.558; P = .006).

CONCLUSIONS:
Patients had poor health numeracy compared to physicians and tended to overrate their abilities. A small proportion of physicians also had poor numeracy. Poor health numeracy was associated with incomprehension of risk modification, suggesting that some patients may not understand treatment efficacy. These disparities suggest a need for further inquiry into how to improve patient comprehension of risk modification.
Rising Incidence of Colorectal Cancer in Young Adults Corresponds With Increasing Surgical Resections in Obese Patients
Authors: Hussan Hisham , Patel Arsheya , Le Roux Melissa , Cruz-Monserrate Zobeida , Porter Kyle , Clinton Steven K. , Carethers John M. , Courneya Kerry S. 
Published: April 2020

OBJECTIVES:
Strong evidence links obesity to esophageal cancer (EC), gastric cancer (GC), colorectal cancer (CRC), and pancreatic cancer (PC). However, national-level studies testing the link between obesity and recent temporal trends in the incidence of these cancers are lacking.

METHODS:
We queried the Surveillance, Epidemiology, and End Results (SEER) to identify the incidence of EC, GC, CRC, and PC. Cancer surgeries stratified by obesity (body mass index ≥30 kg/m2) were obtained from the National Inpatient Sample (NIS). We quantified trends in cancer incidence and resections in 2002–2013, across age groups, using the average annual percent change (AAPC).

RESULTS:
The incidence of CRC and GC increased in the 20–49 year age group (AAPC +1.5% and +0.7%, respectively, P < 0.001) and across all ages for PC. Conversely, the incidence of CRC and GC decreased in patients 50 years or older and all adults for EC. According to the NIS, the number of patients with obesity undergoing CRC resections increased in all ages (highest AAPC was +15.3% in the 18–49 year age group with rectal cancer, P = 0.047). This trend was opposite to a general decrease in nonobese patients undergoing CRC resections. Furthermore, EC, GC, and PC resections only increased in adults 50 years or older with obesity.

DISCUSSION:
Despite a temporal rise in young-onset CRC, GC, and PC, we only identify a corresponding increase in young adults with obesity undergoing CRC resections. These data support a hypothesis that the early onset of obesity may be shifting the risk of CRC to a younger age.
Characterization of Antimicrobial Edible Films with Single and Double Emulsions from Clove (Syzygium aromaticum) Oil
Authors: Natania Kam , Setiawan Giovani Fransisca 
Published: April 2020

Clove oil as a potent antimicrobial agent was added to enhance the properties of edible films. Clove oil was converted to single and double emulsion emulsions for homogenous dispersion in a starch based edible film suspension. Double emulsion was made with two steps emulsification with CaCl2 as inner water phase and guar gum as outer water phase. Single emulsion was prepared similarly without inner water phase. The physico-chemical characteristics and the antimicrobial activity of the of starch-based edible film added with the emulsion were observed. MBC/MFC of clove oil was determined against E. coli, S. aureus, R. stolonifer, and A. niger which gives value of 1.95, 1.46, 0.52, and 0.35 mg/ml respectively. Incorporation of different emulsions on starch-based edible films affect the properties of resulting edible films by increasing thickness, opacity, elongation at break, water vapor transmission rate, and swelling index. Both emulsions showed comparable physicochemical characteristics such as thickness, WVTR, and swelling index value. However, double emulsion produced more superior edible films in terms of tensile strength and antimicrobial activity. 15% addition of double emulsion were able to show strong antimicrobial activity with inhibition zone of more than 8.0 mm for E. coli and 24.0 mm for R. stolonifer.Keywords: clove oil; edible film; single and double emulsion
Intrarater Reliability and Agreement of Recommended Performance-Based Tests and Common Muscle Function Tests in Knee Osteoarthritis
Authors: Holm Pætur Mikal , Nyberg Mette , Wernbom Mathias , Schrøder Henrik Morville , Skou Søren Thorgaard 
Published: April 2020

Background and Purpose:
Some uncertainty persists regarding the reproducibility of the recommended core set of performance-based tests, as well as common muscle function tests, when applied in individuals with knee osteoarthritis (KOA). The purpose of this study was to investigate the intrarater reliability and agreement of the recommended core set of performance-based tests and common muscle function tests in KOA.

Methods:
Participants (N=40) with radiographic and/or symptomatic KOA were evaluated twice with a 3-day interval between test sessions using the following tests: Leg extensor (LE) maximal muscle power measured in a Nottingham Power Rig; knee extensor (KE) peak isometric strength measured with a handheld dynamometer; 40-m walk test; 30-second chair-stand test; and 9-step stair climb test. Reliability was assessed using a 2-way, mixed-effects, single-measures model (3,1), absolute agreement-type intraclass correlation coefficient (ICC). Agreement was assessed using 95% limits of agreement (LOA) and LOA relative to the mean score from test and retest (LOA-%).

Results:
Reliability for all tests was very high (ICC ≥ 0.97). LOA (LOA-%) was ±32.3 watt (W) (±22%) for LE power; ±22.7 N·m (±24%) for KE strength; ±0.2 m/s (±10%) for 40-m walk test; ±2.4 repetitions (±14%) for 30-second chair-stand test; and ±2 second (±20%) for stair climb test. A potential participant learning effect was found for all 3 performance-based tests, indicated by the significantly better scores at retest.

Discussion:
The very high reliability found for the performance-based tests supports findings from previous studies and confirms discriminate reliability of these tests on a group level. Also, very high reliability estimates were demonstrated for both muscle function tests. This study also provided estimates of agreement for both performance-based and muscle function tests, which are important to consider when using these tests on an individual level in clinical practice.

Conclusion:
When using these tests to monitor changes over time in the clinic, depending on the test, improvements of less than 10% to 24% could be a result of measurement error alone and therefore may not be considered an actual improvement after treatment.
Developing a Strength and Conditioning Technical Framework: An Example From a Canoe Slalom National Performance Program
Authors: Rawlley-Singh Ishan , King Ryan 
Published: April 2020

ABSTRACT
Canoe slalom requires technical ability, well-developed energetics, a high level of maximum force production, and range of movement to perform a variety of complex paddle stokes, while maneuvering through a challenging whitewater course. The strength and conditioning (S&C) coach should provide strategic direction across a network or department including S&C coaches working toward identified outcomes and measures. S&C coaches should collaborate with a multidisciplinary support team (i.e., sport coaches, physiotherapists, physiologists, etc.) to develop a technical framework. The technical framework may allow for development of training strategies that provide a clear breakdown of the outcomes, adaptations, exercises, and testing methods. The current article articulates this process related to a canoe slalom national performance program.
Experimental Response of Nonwoven Waste Cellulose Fabric–Reinforced Epoxy Composites for High Toughness and Coating Applications
Authors: Rastogi Shweta , Verma Akarsh , Singh V. K. 
Published: April 2020

Abstract
In this article, the authors have fabricated (using the manual hand lay-up method) and characterized in detail the nonwoven waste cellulose fabric (with varying weight percentages of 0, 7, 9, and 11) reinforced epoxy resin composites. The methodology to develop in conjunction with various physical (density, water absorption, and thickness swelling), mechanical (tensile, compression, flexural, hardness, and impact), thermal (differential thermal analysis, thermogravimetric analysis, and derivative thermogravimetric analysis), morphological (scanning electron microscopy and X-ray diffraction), and electrical characterization tests were performed to give complete insight into the mechanics of epoxy fabric laminates. It was predicted from these tests that with an increasing weight percentage of fabric, most of the mechanical properties improved and were complemented through the microstructural morphological tests. Enhanced mechanical strength and thermal stability of the developed composite (relative to the neat epoxy resin) pave its way for high toughness and coating applications in various engineering fields.
The Woman of Tomorrow
Authors: Ramirez Pablo A. 
Published: April 2020

Pablo A. Ramirez, “The Woman of Tomorrow: Gertrude Atherton and the Latina Foremother of the Californian New Woman” (pp. 502–534)
Throughout the 1890s, Gertrude Atherton employs the figure of the aristocratic Californiana (Mexican Californian woman) to extend classical liberalism’s economic model of individualism to include women. By joining the aristocratic Californiana with American liberalism, Atherton transforms California’s history of capitalist development into a romance in which the creation of new markets generates not only profits, but the New Woman as well. In Atherton’s stories of Alta California, which I call “tales of romantic liberalism,” the history and evolution of California and the New Woman is narrated through the promises (or contracts) that a Californiana character makes and the obligations she accepts or rejects. The Californiana in The Doomswoman (1893) and Before the Gringo Came (1894) becomes the foundation for the New Woman, whose personal development and advancement promises to perfect liberal capitalism through her consensual romantic unions. As the decade drew to a close and the war with Spain became imminent, however, one can see in Atherton’s The Californians (1898) her growing fear that the massification of politics and culture imperiled not only liberal capitalism and democracy, but the evolution of women’s individuality as well. As a result, the evolution of the Californiana character is no longer reliant on a union with a capitalist contractarian partner but on the reaffirmation of her aristocratic individualism. Through her Californiana heroines, Atherton engages the Californio past in order to imagine the evolution of women’s individuality as the United States undergoes a shift from classical liberalism to modern liberalism and from republic to overseas empire.
Assessment of Weed Flora Composition in Parthenium (Parthenium hysterophorus L.) Infested Area of East Shewa Zone, Ethiopia
Authors: Belachew Kifle , Tessema Taye 
Published: April 2020

Field survey on parthenium was conducted at East shewa Zone of Oromiya Regional State, Ethiopia during 2008 cropping season. The objectives of the study was to assess the weed flora composition and plant species that are growing in copetation with parthenium to use those plants as potential biological management options under field condition. Assessment of weed flora composition was carried out in five Kebeles (Farmers Association) of Boset District East Shewa Zone of Oromiya Regional State, Ethiopia. Data on the species composition were recorded and samples of weed flora compositions were collected. The result showed a total of eighty five different herbaceous plant species that were collected and recorded in 63 genera and 24 families. Poaceae (21), Asteraceae (11), Fabaceae (7) and Convolvulaceae (7) were by far the richest taxa and accounted together (55 %) of the entire flora of the study area. The major plant species having higher dominance value were Parthenium hysterophorus (25.6), Cassia tora (6.07), Argemone mexicana (5.83), Xanthium strumarium (4.53), Digitaria abyssinica (3.02) and Cyperus rotundus (2.86). Similarity index values of the species composition among different kebeles ranged from 65% to 78% which indicating that weed species compositions in these locations were similar. The diversity and evenness of species declined with increasing spread of parthenium which suggests negative influence that parthenium had on the status of species diversity in the studied area. In conclusion the selected plant species that were found competitive with parthenium based on their abundance and dominance values were Argemone mexicana, Cassia tora, and Xanthium strumarium which were suggested for detailed competition experiment in order to determine their competitiveness with P. hysterophorus and will be used for biological management of it.