bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment in Neurologic Education
Authors: Jones Lyell 
Published: August 2018

AbstractNeurology trainee assessment is a required component of the education feedback loop, allowing programs and trainees to measure their progress toward established educational goals. In the era of competency-based medical education, assessment systems should be designed to inform decisions about each trainee's acquisition of the many competencies required for independent clinical neurology practice. In addition to the need to inform trainees and programs regarding trainee performance, assessment systems must be equipped to satisfy requirements established by accrediting bodies. Educational goals should be thoughtfully established prior to assessment system design to ensure that assessment priorities align with the overall goal of equipping graduates to deliver high-quality neurologic care. This article provides an overview of modern principles of medical education as they can be applied to neurologic education, complemented by practical recommendations for neurologic educators to develop or improve assessment systems within their own training programs.
Bedside Teaching in Neurology
Authors: Cho Tracey , Dewey Jeffrey 
Published: August 2018

AbstractThe patient's bedside offers an ideal venue for teaching the art of clinical neurology and modeling humanism and professionalism. However, bedside teaching is underutilized in modern medical education, despite evidence that learners desire more. Logistical challenges and lack of teacher confidence are commonly cited reasons, but both can be mitigated with a deliberate approach and sufficient experience. Well-executed bedside teaching can provide lasting lessons for learners while enhancing the patient experience, without affecting the efficiency or quality care delivery. In this review, we discuss the theory and evidence to support the use of bedside teaching, and subsequently delineate a framework for designing and executing effective bedside teaching in neurology.
Becker's Nevus Syndrome
Authors: Cucuzza Maria , Paternò Sara , Catanzaro Stefano , Polizzi Agata , Schepis Carmelo , Lacarrubba Francesco , Micali Giuseppe , Verzì Anna , Pirrone Concetta , Commodari Elena , Zanghì Antonio , Salafia Stefania , Praticò Elena , Pascual-Castroviejo Ignacio , Ruggieri Martino , Attardo Daniele , Praticò Andrea 
Published: August 2018

The simultaneous occurrence of a patch of light or dark brown hyperpigmentation with hypertrichosis (Becker's nevus) together with (usually ipsilateral) soft tissues hypoplasia (especially breast, in women) and underlying skeletal anomalies (i.e., vertebral hypoplasia, scoliosis, pectus carinatum or excavatum) represents the Becker's nevus syndrome (BNS) phenotype. It was first described (as a single cutaneous lesion) by Becker in 1949 and then associated with the surrounding musculoskeletal disorders. The syndrome has also been reported as pigmentary hairy epidermal nevus syndrome. Less than 100 cases have been reported in the literature, with a slightly higher incidence in females and only few familiar cases: paradominant postzygotic mutations and/or an androgen-dependent hyperactivation have been reported as the causes of the diseases.The extracutaneous lesions are congenital and nonprogressive, and the natural history of the Becker's nevus is the same as that of isolated nevi: in prepubertal boys, the pigmentation may be less intense and the hairiness may be absent or mild, as occurs in women, whereas in men, there is an increase of hairiness after puberty. The treatment is essentially cosmetic, and potential therapeutic options include electrolysis, waxing, makeup, or laser.
Viral genetic diversity and protective efficacy of a tetravalent dengue vaccine in two phase 3 trials
Authors: Juraska Michal , Magaret Craig A. , Shao Jason , Carpp Lindsay N. , Fiore-Gartland Andrew J. , Benkeser David , Girerd-Chambaz Yves , Langevin Edith , Frago Carina , Guy Bruno , Jackson Nicholas , Duong Thi Hue Kien , Simmons Cameron P. , Edlefsen Paul T. , Gilbert Peter B. 
Published: August 2018

SignificanceDengue virus (DENV) vaccine development is complicated by the existence of four genetically diverse DENV serotypes. A high degree of antigenic match between vaccine strains and circulating DENVs may be important to achieve high vaccine efficacy (VE). Using data from two phase 3 trials of the CYD-TDV vaccine, we assessed whether and how VE against virologically confirmed dengue varied with amino acid sequence characteristics and genotypes of the disease-causing DENVs. VE decreased with the degree of amino acid dissimilarity between the vaccine insert and disease-causing DENVs. After accounting for differential VE by serotype, this effect seemed to occur only for younger children, who also had lower baseline seropositivity and potentially a less broadly protective immune response.
Hack weeks as a model for data science education and collaboration
Authors: Huppenkothen Daniela , Arendt Anthony , Hogg David W. , Ram Karthik , VanderPlas Jacob T. , Rokem Ariel 
Published: August 2018

Significance
As scientific disciplines grapple with more datasets of rapidly increasing complexity and size, new approaches are urgently required to introduce new statistical and computational tools into research communities and improve the cross-disciplinary exchange of ideas. In this paper, we introduce a type of scientific workshop, called a hack week, which allows for fast dissemination of new methodologies into scientific communities and fosters exchange and collaboration within and between disciplines. We present implementations of this concept in astronomy, neuroscience, and geoscience and show that hack weeks produce positive learning outcomes, foster lasting collaborations, yield scientific results, and promote positive attitudes toward open science.
Multidecadally resolved polarity oscillations during a geomagnetic excursion
Authors: Chou Yu-Min , Jiang Xiuyang , Liu Qingsong , Hu Hsun-Ming , Wu Chung-Che , Liu Jianxing , Jiang Zhaoxia , Lee Teh-Quei , Wang Chun-Chieh , Song Yen-Fang , Chiang Cheng-Cheng , Tan Liangcheng , Lone Mahjoor A. , Pan Yongxin , Zhu Rixiang , He Yaoqi , Chou Yu-Chen , Tan An-Hung , Roberts Andrew P. , Zhao Xiang , Shen Chuan-Chou 
Published: August 2018

Significance
A stalagmite-based paleomagnetic record of the post-Blake excursion reveals details of repeated centennial–millennial interhemispheric polarity drifts and saw-tooth inclination oscillations during periods of low geomagnetic field intensity at 100 thousand years before present. One surprisingly abrupt centennial reversal transition occurred in 144 ± 58 years (2σ) and provides unprecedented evidence that raises fundamental questions about the speed of geomagnetic field shifts. Such rapid polarity changes could severely affect satellites and human society in the future if the current geomagnetic field intensity continues to decrease.
Inflammasome-derived cytokine IL18 suppresses amyloid-induced seizures in Alzheimer-prone mice
Authors: Tzeng Te-Chen , Hasegawa Yuto , Iguchi Risa , Cheung Amy , Caffrey Daniel R. , Thatcher Elizabeth Jeanne , Mao Wenjie , Germain Gail , Tamburro Nelsy DePaula , Okabe Shigeo , Heneka Michael T. , Latz Eicke , Futai Kensuke , Golenbock Douglas T. 
Published: August 2018

Significance
Alzheimer’s disease (AD) is a neurodegenerative disorder characterized by severe cognitive decline. The connection between neuroinflammation and the progressive loss of neurons is well known; however, the fact that most patients with AD suffer from concomitant seizure disorders is underappreciated. We have previously shown that the NLRP3 inflammasome, a major source of the proinflammatory cytokines IL1β and IL18, drives the pathology of AD in APP/PS1 mice. Here we report that surprisingly, IL18-deficient APP/PS1 mice develop a lethal seizure disorder due to an increase in neuronal network transmission. While targeting the NLRP3 inflammasome might be one potential method of halting AD progression, it should be recognized that specific cytokine inhibition in the brain may result in unintended deleterious consequences.
Militarization fails to enhance police safety or reduce crime but may harm police reputation
Authors: Mummolo Jonathan 
Published: August 2018

Significance
National debates over heavy-handed police tactics, including so-called “militarized” policing, are often framed as a trade-off between civil liberties and public safety, but the costs and benefits of controversial police practices remain unclear due to data limitations. Using an array of administrative data sources and original experiments I show that militarized “special weapons and tactics” (SWAT) teams are more often deployed in communities of color, and—contrary to claims by police administrators—provide no detectable benefits in terms of officer safety or violent crime reduction, on average. However, survey experiments suggest that seeing militarized police in news reports erodes opinion toward law enforcement. Taken together, these findings suggest that curtailing militarized policing may be in the interest of both police and citizens.
Nonpoint source pollution: experiments on the average Pigouvian tax under costly communication
Authors: Sarr H , Bchir M A , Cochard F , Rozan A 
Published: August 2018

AbstractThe ‘average Pigouvian tax’ (APT) was proposed to reduce the financial burden imposed by the standard ambient tax. This instrument consists of a standard ambient tax divided by the number of firms and it requires polluters to cooperate in order to achieve the social optimum. To enable polluters to cooperate, communication is allowed in most of the experimental treatments. We introduce different types of communication: cheap talk, exogenous costly communication and endogenous costly communication. Our experiment confirms that under cheap talk, the APT promotes a reduction in polluters’ emissions. In contrast, under costly communication, the APT reduces group emissions to a lesser extent.
UBS AG v. IRC, DB Group Services (UK) Ltd v. IRC: Fiscal Nullity and the Supreme Court*
Authors: Ohms Chris , Olesen Karin 
Published: August 2018

Abstract
In this article, the application of the UK doctrine of fiscal nullity by the Supreme Court is considered in light of the twin decisions in the cases of UBS AG v. IRC1 and DB Group Services (UK) Ltd v. IRC.2 This article argues that fiscal nullity is not a separate doctrine of taxation but can be explained in the way the facts are proven in a tax case, in the way that legal transactions are characterized and how the legislation is interpreted and applied. Using this as the conceptual framework of the paper, prior fiscal nullity cases have been analysed and decisions explained with a focus on different stages of the framework. UBS and DB Group Services findings relate to all three stages of the conceptual framework. Stage 1 requires that the court view the background ‘matrix of fact’ in a very objective manner. Stage 2 is the construction of the legal relations and the application of the statute particularly around the concept of ‘restricted security.’ Stage 3 concerns the purposive interpretation of ‘restricted security’ within the meaning of the legislation (section 425(2) ITEPA (UK)). Consequently, the decision in these two cases is not a departure from prior decisions.
Clinical research with adolescents: barriers and how to overcome them
Authors: Sokkary Nancy , Yoost Jennie 
Published: August 2018

Purpose of review
This review aims to emphasize the importance of including adolescents in research, outline current standards and evaluate barriers that prevent adolescent research. We also hope to provide some guidance and call for much needed additional direction in the field.

Recent findings
The absolute necessity for including adolescents in research has been an area of focus within the community of adolescent providers and care takers. Recent policy and support from major organizations has emphasized the importance of including this population in research but also pointed out many of the complexities.

Summary
Adolescent research is imperative to guiding policy and promoting evidence-based care. Current standards provide both guidance and barriers, yet more research is needed to further guide conduct of ethical research in this population.
Enterprise Cybersecurity: Building a Successful Defense Program
Authors: Reagin Michael J. , Gentry Michael V. 
Published: August 2018

SUMMARY
Cybersecurity is no longer an option or an afterthought—it is a strategic asset that every organization must address, especially in healthcare. The impact of modern cyberattacks extends well beyond privacy breaches and damage to brand or reputation; it can also affect the safe delivery of care. In 2017, a global security incident affected National Health Service hospitals in England and Scotland, preventing them from providing services to patients and causing thousands of appointments to be canceled. Such serious cyberattacks are becoming more prevalent, and their impact has dramatically changed from impeding back-office operations to threatening patient safety and the financial viability of healthcare organizations. This era of increased cybersecurity risks has compelled successful organizations to rapidly adapt their information security strategies and develop world-class cyber defense programs.
“THINK” Before You Order: Multidisciplinary Initiative to Reduce Unnecessary Lab Testing
Authors: Shinwa Masih , Bossert Adam , Chen Iris , Cushing Anna , Dunn Andrew S. , Poeran Jashvant , Weinstein Sally , Cho Hyung J. 
Published: August 2018

ABSTRACT
Inappropriate daily lab testing can have adverse effects on patients, including anemia, pain, and interruption of sleep. We implemented a student-led, multifaceted intervention featuring clinician education, publicity campaign, gamification, and system changes, including a novel nurse-driven protocol to reduce unnecessary daily lab testing in a teaching hospital. We applied a quasi-experimental interrupted time series design with a segmented regression analysis to estimate changes before and after our 14-month intervention with a comparison to a control surgical unit. There was an increasing trend in the baseline period, which was mitigated by the intervention (postintervention effect estimate −0.04 labs per patient day/month, p < .05), which was not seen in the control unit. Estimated cost savings was $94,269 ($6,734/month). A student-led, multidisciplinary campaign involving nurse-driven pathway, education, publicity, gamification, and system changes was effective in reducing daily lab testing.
Audiometric and cVEMP Thresholds Show Little Correlation With Symptoms in Superior Semicircular Canal Dehiscence Syndrome
Authors: Noij Kimberley S. , Wong Kevin , Duarte Maria J. , Masud Salwa , Dewyer Nicholas A. , Herrmann Barbara S. , Guinan John J. , Kozin Elliott D. , Jung David H. , Rauch Steven D. , Lee Daniel J. 
Published: August 2018

Objective:
Evaluate the relationship between objective audiometric and vestibular tests and patient symptoms in superior canal dehiscence (SCD) syndrome.

Study Design:
Retrospective chart review.

Setting:
Tertiary care center.

Patients:
Ninety-eight patients with SCD, preoperative threshold audiograms, cervical vestibular evoked myogenic potential (cVEMP) thresholds, and computed tomography (CT) imaging were included. Clinical reports were reviewed for self-reported SCD symptoms. Twenty-five patients completed the Hearing Handicap Inventory (HHI), Dizziness Handicap Inventory (DHI), Autophony Index (AI), and the 36-item Short Form Survey (SF-36).

Main Outcome Measures:
Correlations between preoperative low-frequency air-bone gap (ABG), cVEMP thresholds, and symptoms (including HHI, DHI, AI, and SF-36). Symptoms included hearing loss, aural fullness, autophony, hyperacusis, tinnitus, vertigo, imbalance and sound-, pressure and exercise provoked dizziness. Secondary outcome measure: Correlations between changes of objective and subjective measures before and after surgery.

Results:
Patients who reported hearing loss had larger ABGs at 250 Hz than patients without subjective hearing loss (p = 0.001). ABGs and cVEMP thresholds did not correlate with any other symptom. No significant correlation was found between ABG or cVEMP threshold and the HHI, DHI, AI or Health Utility Value (derived from the SF-36 quality of life score). Following SCD surgery, ABG decreased (p < 0.001), cVEMP thresholds increased (p < 0.001) and overall symptoms, handicap scores and quality-of-life improved; however, there was no significant relationship between these measures.

Conclusion:
While threshold audiometry and cVEMP are important tools to diagnose SCD and monitor surgical outcomes, these measures showed no significant correlation with vestibular and most auditory symptoms or their severity.
Dynamic coagulability after injury: Is delaying venous thromboembolism chemoprophylaxis worth the wait?
Authors: Sumislawski Joshua J. , Kornblith Lucy Z. , Conroy Amanda S. , Callcut Rachael A. , Cohen Mitchell Jay 
Published: August 2018

BACKGROUND
Severely injured patients often progress from early hypocoagulable to normal and eventually hypercoagulable states, developing increased risk for venous thromboembolism (VTE). Prophylactic anticoagulation can decrease this risk, but its initiation is frequently delayed for extended periods due to concerns for bleeding. To facilitate timely introduction of VTE chemoprophylaxis, we characterized the transition from hypo- to hypercoagulability and hypothesized that trauma-induced coagulopathy resolves within 24 hours after injury.

METHODS
Serial blood samples were collected prospectively from critically injured patients for 120 hours after arrival at an urban Level I trauma center. Extrinsic thromboelastometry maximum clot firmness was used to classify patients as hypocoagulable (HYPO, <49 mm), normocoagulable (NORM, 49–71 mm), or hypercoagulable (HYPER, >71 mm) at each time point. Changes in coagulability over hospital course, VTE occurrence, and timing of prophylaxis initiation were analyzed.

RESULTS
898 patients (median Injury Severity Score, 13; mortality, 12%; VTE, 8%) were enrolled. Upon arrival, 3% were HYPO (90% NORM, 7% HYPER), which increased to 9% at 6 hours before down-trending. Ninety-seven percent were NORM by 24 hours, and 53% were HYPER at 120 hours. Median maximum clot firmness began in the NORM range, up-trended gradually, and entered the HYPER range at 120 hours. Patients with traumatic brain injury (TBI) followed a similar course and were not more HYPO at any time point than those without TBI. Failure to initiate prophylaxis by 72 hours was predicted by TBI and associated with VTE development (27% vs 16%, p < 0.05).

CONCLUSIONS
Regardless of injury pattern, trauma-induced coagulopathy largely resolves within 24 hours, after which hypercoagulability becomes increasingly more prevalent. Deferring initiation of chemoprophylaxis, which is often biased toward patients with intracranial injuries, is associated with VTE development.

LEVEL OF EVIDENCE
Prognostic study, level III; Therapeutic, level IV.
A review of discrete element simulation of ice–structure interaction
Authors: Tuhkuri Jukka , Polojärvi Arttu 
Published: August 2018

Sea ice loads on marine structures are caused by the failure process of ice against the structure. The failure process is affected by both the structure and the ice, thus is called ice–structure interaction. Many ice failure processes, including ice failure against inclined or vertical offshore structures, are composed of large numbers of discrete failure events which lead to the formation of piles of ice blocks. Such failure processes have been successfully studied by using the discrete element method (DEM). In addition, ice appears in nature often as discrete floes; either as single floes, ice floe fields or as parts of ridges. DEM has also been successfully applied to study the formation and deformation of these ice features, and the interactions of ships and structures with them. This paper gives a review of the use of DEM in studying ice–structure interaction, with emphasis on the lessons learned about the behaviour of sea ice as a discontinuous medium.This article is part of the theme issue ‘Modelling of sea-ice phenomena’.
A fresh look at how ocean waves and sea ice interact
Authors: Squire Vernon A. 
Published: August 2018

Because of their capacity to alter floe size distribution and concentration and consequently to influence atmosphere-ocean fluxes, there is a compelling justification and demand to include waves in ice/ocean models and earth system models. Similarly, global wave forecasting models like WAVEWATCH III
®
need better parametrizations to capture the effects of a sea ice cover such as the marginal ice zone on incoming wave energy. Most parametrizations of wave propagation in sea ice assume without question that the frequency-dependent attenuation which is observed to occur with distance
x
travelled is exponential, i.e.
A
=
A
0
e

−
αx

. This is the solution of the simple first-order linear ordinary differential equation d
A
/d
x
= −
αA
, which follows from an Airy wave mode ansatz

. Yet, in point of fact, it now appears that exponential decay may not be observed consistently and a more general equation of the type d
A
/d
x
= −
αA

n

is proposed to allow for a broader range of attenuation behaviours should this be necessary to fit data.

This article is part of the theme issue ‘Modelling of sea-ice phenomena’.
Variational problems in the theory of hydroelastic waves
Authors: Plotnikov P. I. , Toland J. F. 
Published: August 2018

This paper outlines a mathematical approach to steady periodic waves which propagate with constant velocity and without change of form on the surface of a three-dimensional expanse of fluid which is at rest at infinite depth and moving irrotationally under gravity, bounded above by a frictionless elastic sheet. The elastic sheet is supposed to have gravitational potential energy, bending energy proportional to the square integral of its mean curvature (its Willmore functional), and stretching energy determined by the position of its particles relative to a reference configuration. The equations and boundary conditions governing the wave shape are derived by formulating the problem, in the language of geometry of surfaces, as one for critical points of a natural Lagrangian, and a proof of the existence of solutions is sketched.
This article is part of the theme issue ‘Modelling of sea-ice phenomena’.
Multiple-gene targeting and mismatch tolerance can confound analysis of genome-wide pooled CRISPR screens
Authors: Fortin Jean-Philippe , Gascoigne Karen E. , Haverty Peter M. , Forrest William F. , Costa Michael R. , Martin Scott E. 
Published: August 2018

AbstractGenome-wide loss-of-function screens using the CRISPR/Cas9 system allow the efficient discovery of cancer cell vulnerabilities. While several studies have focused on correcting for DNA cleavage toxicity biases associated with copy number alterations, the effects of sgRNAs co-targeting multiple genomic loci in CRISPR screens have not been discussed yet. In this work, we analyze CRISPR essentiality screen data from 391 cancer cell lines to characterize biases induced by multi-target sgRNAs. We investigate two types of multi-targets: on-targets predicted through perfect sequence complementarity, and off-targets predicted through sequence complementarity with up to two nucleotide mismatches. We found that the number of on-targets and off-targets both increase sgRNA activity in a cell line-specific manner, and that existing additive models of gene knockout effects fail at capturing genetic interactions that may occur between co-targeted genes. We use synthetic lethality between paralog genes to show that genetic interactions can introduce biases in essentiality scores estimated from multi-target sgRNAs. We further show that single-mismatch tolerant sgRNAs can confound the analysis of gene essentiality and lead to incorrect co-essentiality functional networks.