bluuebunny/crossref_metadata_2025_split huggingface dataset:
What is the state of complexity science in medical education research?
Authors: Cristancho Sayra , Field Emily , Lingard Lorelei 
Published: October 2018

Context‘Complexity’ is fast becoming a ‘god term’ in medical education, but little is known about how scholars in the field apply complexity science to the exploration of education phenomena. Complexity science presents both opportunities and challenges to those wishing to adopt its approaches in their research, and debates about its application in the field have emerged. However, these debates have tended towards a reductive characterisation of complexity versus simplicity. We argue that a more productive discussion centres on the multiplicity of complexity orientations, with their diverse disciplinary roots, concepts and terminologies. We discuss this multiplicity and use it to explore how medical education researchers have taken up complexity science in prominent journals in the field.MethodsWe synthesised the health sciences and medical education literature based on 46 papers published in the last 18 years (2000–2017) to describe the patterns of use of complexity science in medical education and to consider the consequences of those patterns for our ability to advance scholarly conversations about ‘complex’ phenomena in our field.ResultsWe identified four patterns in the use of complexity science in medical education research. Firstly, complexity science is described in a variety of ways. Secondly, multiple approaches to complexity are used in combination in single papers. Thirdly, the type of complexity science used tends to be left implicit. Fourthly, the complexity orientation used is much more commonly located using secondary source citation rather than primary source citation.ConclusionsThe presence of these four patterns begs the question: Do medical education scholars understand that there are multiple legitimate orientations to complexity science, deriving from distinct disciplinary origins, drawing on different metaphors and serving distinct purposes? If we do not understand this, a cascade of potential consequences awaits. We may assume that complexity science is singular in that there is only one way to do it. This assumption may cause us to perceive our way as the ‘right’ way and to disregard other approaches as illegitimate. However, this perception of illegitimacy may limit our ability to enter into productive dialogue about our complexity science‐inspired research.
Factors underlying suboptimal diagnostic performance in physicians under time pressure
Authors: ALQahtani Dalal A , Rotgans Jerome I , Mamede Silvia , Mahzari Moeber M , Al‐Ghamdi Ghassan A , Schmidt Henk G 
Published: October 2018

ContextTime pressure has been implicated in the suboptimal diagnostic performance of doctors and in increases in diagnostic errors. However, the reasons underlying these effects are not clear. The aim of this study was to investigate the influence of time pressure on physicians’ diagnostic accuracy and to explore the mediating effects of perceived stress (emotional pathway) and number of plausible diagnostic hypotheses (cognitive pathway) on the proposed relationship.MethodsWe conducted a randomised controlled experiment. A total of 75 senior internal medicine residents completed eight written clinical cases under conditions with (n = 40) or without (n = 35) time pressure. They were then asked to: (i) rate the overall stress experienced, and (ii) write down any alternative hypotheses they had thought of when diagnosing the cases. In a post hoc analysis, a mediation path analysis was performed to test the causal relationships between time pressure, perceived stress and number of alternative diagnoses.ResultsParticipants who were under time pressure spent less time diagnosing the cases (85.54 seconds versus 181.81 seconds; p< 0.001) and had a lower mean diagnostic accuracy score (0.44 versus 0.53; p = 0.01). In addition, they reported more stress (5.80 versus 4.69; p = 0.01) and generated fewer plausible tentative hypotheses (0.37 versus 0.51; p = 0.01). Two path coefficients were found to be statistically significant; the first path coefficient referred to the relationship between time pressure and perceived stress (standardised β = 0.25, p = 0.029), and the second negative path coefficient referred to the relationship between time pressure and number of plausible alternative hypotheses (standardised β = −0.32, p< 0.01).ConclusionsTime pressure adversely influences physicians’ diagnostic accuracy by increasing their stress response and reducing the number of plausible hypotheses as mediators.
Quantitative phosphoproteomic analysis reveals common regulatory mechanisms between effector‐ and PAMP‐triggered immunity in plants
Authors: Kadota Yasuhiro , Liebrand Thomas W. H. , Goto Yukihisa , Sklenar Jan , Derbyshire Paul , Menke Frank L. H. , Torres Miguel‐Angel , Molina Antonio , Zipfel Cyril , Coaker Gitta , Shirasu Ken 
Published: October 2018

Summary

Plant immunity consists of two arms: pathogen‐associated molecular pattern (PAMP)‐triggered immunity (PTI), induced by surface‐localized receptors, and effector‐triggered immunity (ETI), induced by intracellular receptors. Despite the little structural similarity, both receptor types activate similar responses with different dynamics.

To better understand phosphorylation events during ETI, we employed a phosphoproteomic screen using an inducible expression system of the bacterial effector avrRpt2 in Arabidopsis thaliana, and identified 109 differentially phosphorylated residues of membrane‐associated proteins on activation of the intracellular RPS2 receptor.

Interestingly, several RPS2‐regulated phosphosites overlap with sites that are regulated during PTI, suggesting that these phosphosites may be convergent points of both signaling arms. Moreover, some of these sites are residues of important defense components, including the NADPH oxidase RBOHD, ABC‐transporter PEN3, calcium‐ATPase ACA8, noncanonical Gα protein XLG2 and H+‐ATPases. In particular, we found that S343 and S347 of RBOHD are common phosphorylation targets during PTI and ETI. Our mutational analyses showed that these sites are required for the production of reactive oxygen species during both PTI and ETI, and immunity against avirulent bacteria and a virulent necrotrophic fungus.

We provide, for the first time, large‐scale phosphoproteomic data of ETI, thereby suggesting crucial roles of common phosphosites in plant immunity.
Comparison of bleach, acetic acid, and other topical anti‐infective treatments in pediatric atopic dermatitis: A retrospective cohort study on antibiotic exposure
Authors: Asch Sarah , Vork Diana L. , Joseph Josiane , Major‐Elechi Brittny , Tollefson Megha M. 
Published: October 2018

AbstractBackground/ObjectivesSkin infection is common in atopic dermatitis (AD), often necessitating treatment with systemic antibiotics. Topical adjunctive therapies such as dilute bleach baths are increasingly recommended, and topical dilute acetic acid (AA) has not been widely studied. The objective of this study was to evaluate whether various topical anti‐infective bathing recommendations were associated with decreased systemic antibiotic exposure in pediatric AD, as well as evaluate topical anti‐infective recommendations over time within our institution.MethodsClinical data were extracted from charts of pediatric patients from 1/1/2000 to 12/31/2005 and 1/1/2009 to 12/31/2014 who visited outpatient dermatology clinics at Mayo Clinic, Rochester, a tertiary referral center. Recommendations for topical anti‐infectives (dilute AA, dilute bleach, other, or none) at any time after patient had clinically proven or suspected AD superinfection were recorded as exposures to topical anti‐infective. Primary outcome was the number of systemic antibiotic courses in a 1‐year period.ResultsOf 1111 patients with AD, 753 met inclusion criteria (303 in 2000‐2005; 450 in 2009‐2014). Of these, 351 (46.6%) had culture‐proven or clinically suspected superinfection. Topical anti‐infective recommendations increased between the time periods (23.3% to 79.2%; P < 0.001) and number of courses of systemic antibiotics decreased (1.9 per year vs 1.5 per year, P = 0.010). Number of systemic antibiotic courses did not differ between those who received bathing recommendations and those who did not, nor between different anti‐infective groups (P = 0.398).ConclusionsPractice behaviors have changed, and topical anti‐infectives are now commonly recommended. Neither dilute AA nor bleach baths were associated with fewer subsequent exposures to systemic antibiotics in the treatment of pediatric AD.
Detection of bacterial contamination in platelet concentrates from Brazilian donors by molecular amplification of the ribosomal 16S gene
Authors: Viana J. D. , Ferreira S. C. , Matana S. R. , Rossi F. , Patel P. , Garson J. A. , Rocha V. , Tedder R. , Mendrone‐Júnior A. , Levi J. E. 
Published: October 2018

SummaryObjectiveThe aim of our work was to establish a semi‐automated high‐throughput DNA amplification method for the universal screening of bacteria in platelet concentrates (PCs).BackgroundAmong cases of transfusion transmission of infectious agents, bacterial contamination ranks first in the number of events, morbidity and mortality. Transmission occurs mainly by transfused PCs. Automated culture is adopted by some blood banks for screening of bacterial contamination, but this procedure is expensive and has a relatively long turnaround time.MethodsPCs were spiked with suspensions of five different bacterial species in a final concentration of 1 and 10 colony‐forming units (CFU) per millilitre. After incubation, the presence of bacteria was investigated by real‐time polymerase chain reaction (PCR) and by the Enhanced Bacterial Detection System (eBDS, Pall) assay as a reference method. Real‐time PCR amplification was performed with a set of universal primers and probes targeting the 16S rRNA gene. Co‐amplification of human mitochondrial DNA served as an internal control.ResultsUsing the real‐time PCR method, it was possible to detect the presence of all bacterial species tested with an initial concentration of 10 CFU mL−1 24 h after contamination, except for Staphylococcus hominis. The PCR assay also detected, at 24 h, the presence of Serratia marcescens and Enterobacter cloacae with an initial concentration of 1 CFU mL−1.ConclusionsThe real‐time PCR assay may be a reliable alternative to conventional culture methods in the screening of bacterial contamination of PCs, enabling bacterial detection even with a low initial concentration of microorganisms.
Lung lobe torsion in dogs: 52 cases (2005–2017)
Authors: Park Karen M. , Grimes Janet A. , Wallace Mandy L. , Sterman Allyson A. , Thieman Mankin Kelley M. , Campbell Bonnie G. , Flannery Erin E. , Milovancev Milan , Mathews Kyle G. , Schmiedt Chad W. 
Published: October 2018

AbstractObjectiveTo report outcomes and risk factors for mortality in dogs that underwent surgical management of lung lobe torsion.Study designRetrospective case series from 5 veterinary teaching hospitals (2005–2017).AnimalsFifty dogs with 52 instances of lung lobe torsion.MethodsData collected from medical records included signalment, clinical findings, results of clinicopathologic testing and diagnostic imaging, surgical treatment, lung lobe affected, intraoperative and postoperative complications, histopathologic and microbiologic findings, and outcome. Follow‐up was obtained from medical records and telephone contact with primary care veterinarians.ResultsFifty‐two instances of lung lobe torsion were identified in 50 dogs, with a median follow‐up of 453 days (range, 0–3075). Forty‐six (92%) dogs survived to discharge. Dogs with concurrent torsion of the right cranial and middle lung lobes were less likely to survive (2/4) than those with torsion of the left cranial lung lobe (22/22). No other risk factors for mortality prior to hospital discharge were identified. Overall median survival time after hospital discharge was 1369 days. Four dogs had >1 episode of lung lobe torsion.ConclusionThe percentage of dogs surviving to discharge after surgical treatment of lung lobe torsion was higher than previously reported. The short‐ and long‐term prognosis was excellent with surgical treatment of lung lobe torsion.Clinical significanceSurgery should be recommended when lung lobe torsion is suspected because of the high survival to discharge rate and excellent long‐term prognosis.
Faba bean as green manure for field weed control in maize
Authors: Álvarez‐Iglesias L , Puig C G , Revilla P , Reigosa M J , Pedrol N 
Published: October 2018

SummaryField observations on crop rotations with maize in temperate areas suggest that faba bean (Vicia faba) could exert some weed control when used as a green manure. To test this hypothesis, two glasshouse pot experiments and two field experiments were conducted on the weeding effects over time of faba bean incorporated into the soil. In the pots, faba bean concentrations of 1% and 2% of soil dry weight reduced the germination, root and shoot elongation and aerial biomass of Echinochloa crus galli and Amaranthus retroflexus by ca. 70% when the seeds were sown at the time of faba bean incorporation. These inhibitory effects declined with the delay in sowing. From ca. 21 days after incorporation, fertilising effects became evident in both the maize and the two weeds. In the two field experiments, on land with a history of maize growing in which faba bean biomasses of 6700 and 12 100 kg ha−1 were soil‐incorporated, residue‐mediated reductions of the density and biomass of naturally occurring dominant dicotyledon (A. retroflexus, Chenopodium album and Solanum nigrum) and monocotyledon weeds (Digitaria sanguinalis and Cyperus rotundus) were observed. At emergence, mean differences with respect to control plots ranged from −14.8% to −69.8% for density and from −46.9 to −78.5% for biomass. Impacts were visible at the flowering time, and still statistically significant for some dicotyledons, leading to mean differences of total weed biomass up to −67.2% compared with control plots. Our results indicate that faba bean has potential as green manure for weed control in maize cropping systems.
TEMPORAL RAINFALL DISAGGREGATION BY A SIMPLE RANDOM CASCADE MODEL
Authors: Saad Siti Mariam , Jemain Abdul Aziz , Ismail Noriszura 
Published: October 2018

This study evaluates the utility and suitability of a simple discrete multiplicative random cascade model for temporal rainfall disaggregation. Two of a simple random cascade model, namely log-Poisson and log-Normal models are applied to simulate hourly rainfall from daily rainfall at seven rain gauge stations in Peninsular Malaysia. The cascade models are evaluated based on the capability to simulate data that preserve three important properties of observed rainfall: rainfall variability, intermittency and extreme events. The results show that both cascade models are able to simulate reasonably well the commonly used statistical measures for rainfall variability (e.g. mean and standard deviation) of hourly rainfall. With respect to rainfall intermittency, even though both models are underestimated, the observed dry proportion, log-Normal model is likely to simulate number of dry spells better than log-Poisson model. In terms of rainfall extremes, it is demonstrated that log-Poisson and log-Normal models gave a satisfactory performance for most of the studied stations herein, except for Dungun and Kuala Krai stations, which both located in the east part of Peninsula.
NOVEL PALM OIL BASED POLYOLS WITH AMINE FUNCTIONALITY SYNTHESIS VIA RING OPENING REACTION OF EPOXIDIZED PALM OIL
Authors: Soloi Sabrina , Abdul Majid Rohah , Rahmat Abdul Razak 
Published: October 2018

In polymer chemistry, polyol usually used as starting materials for polyurethane (PU) production in which upon reacted with isocyanate will affect the physical and chemical properties of the obtained PU. Polyols that are mostly derived from petrochemical resources are facing issues such as depletion of petroleum sources as well as the increasing in market price. Ring opening reaction (ROR) of epoxidized palm oil (EPO) had been carried out using isopropanolamine (IPA) to impart polyol with amine functionality. The effect of reaction time on the opening of oxirane ring was investigated. FTIR spectra showed that the oxirane ring opening of EPO can occur at 6 hours reaction time, corresponding to the deacreasing intensity of oxirane COO twin band at 824-830 cm-1. The OH value of the amine- functionalized-polyol was calculated at around 240-253 mg KOH/g. By prolonging the reaction time the OH value has slightly reduced. Mass spectroscopy analysis revealed that the polyol has a molecular weight in the range of oligo-polyols (400 – 500 Da).
Ferrohydrodynamic Capillary Convection
Authors: Arias Francisco J. , De Las Heras Salvador A. 
Published: October 2018

Abstract
In this work, consideration is given to capillary convection on ferrofluids from the concentration gradient induced when a nonhomogeneous magnetic field is applied. It is known that mass transfer along an interface between two fluids can appear due to a gradient of the surface tension in the so-called Marangoni effect (or Gibbs–Marangoni effect). Because the surface tension is both thermal and concentration dependent, Marangoni convection can be induced by either a thermal or a concentration gradient, where in the former case, it is generally referred as thermocapillary convection. Now, it has been theoretically and experimentally demonstrated that a ferrofluid under the action of a non-homogeneous magnetic field can induce a concentration gradient of suspended magnetic nanoparticles, and also the effect of Fe3O4 nanoparticles on the surface tension has been measured. Therefore, by deductive reasoning and taking into account the above mentioned facts, it is permissible to infer ferrohydrodynamic capillary convection on magnetic fluids under the presence of a magnetic gradient field. Utilizing a simplified physical model, the phenomenon was investigated and it was found that ferrohydrodynamic-Marangoni convection could be induced with particle size in the range up to 10 nm, which is the range of magnetic fluids to escape magnetic agglomeration.
CFD Based Lock-in Modeling of Cavity-Pipe Line Systems
Authors: Bagwell Ted G. , Cody Kristin L. 
Published: October 2018

Flow over shallow cavities is a noise concern due to the possibility of flow tone lock-in with acoustic resonators. The principal aim of this work is to understand the factors that contribute to the onset of lock-in using Computational Fluid Dynamics (CFD) models.
CFD models of shallow cavity lock-in to longitudinal acoustic resonators are developed and validated against existing test data from Lehigh University. All simulations are performed using AcuSolve™. A key technical contribution is the development of admittance inflow and impedance outflow boundary conditions to model the effects of the pipe resonator. The general trends predicted by the CFD models agree with the test data. In particular, the resonator response at the strong interaction point is well represented.
Comparison of patient-reported outcomes during acute exacerbations of chronic obstructive pulmonary disease
Authors: Nishimura Koichi , Nakamura Saya , Kusunose Masaaki , Nakayasu Kazuhito , Sanda Ryo , Hasegawa Yoshinori , Oga Toru 
Published: October 2018

IntroductionThe aim of this study was to investigate which patient-reported outcome measure was the best during the recovery phase from severe exacerbation of chronic obstructive pulmonary disease (COPD).MethodsThe Exacerbations of Chronic Pulmonary Disease Tool (EXACT), the COPD Assessment Test (CAT), the St George’s Respiratory Questionnaire (SGRQ), the Dyspnoea-12 (D-12) and the Hyland Scale (global scale) were recorded every week for the first month and at 2 and 3 months in 33 hospitalised subjects with acute exacerbation of COPD (AECOPD).ResultsOn the day of admission (day 1), the internal consistency of the EXACT total score was high (Cronbach’s alpha coefficient=0.89). The EXACT total, CAT, SGRQ total and Hyland Scale scores obtained on day 1 appeared to be normally distributed. Neither floor nor ceiling effects were observed for the EXACT total and SGRQ total scores. The EXACT total score improved from 50.5±12.4 to 32.5±14.3, and the CAT score also improved from 24.4±8.5 to 13.5±8.4 during the first 2 weeks, and the effect sizes (ES) of the EXACT total and CAT score were −1.40 and −1.36, respectively. The SGRQ, Hyland Scale and D-12 were less responsive, with ES of −0.59, 0.96 and −0.90, respectively.DiscussionThe EXACT total and CAT scores are shown to be more responsive measures during the recovery phase from severe exacerbation. Considering the conceptual framework, it is recommended that the EXACT total score may be the best measure during the recovery phase from AECOPD. The reasons for the outstanding responsiveness of the CAT are still unknown.
Acute exacerbation of idiopathic pulmonary fibrosis: a 10-year single-centre retrospective study
Authors: Yamazoe Masatoshi , Tomioka Hiromi 
Published: October 2018

IntroductionIn 2016, an international working group proposed a revised definition and new diagnostic criteria for the acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF). Based on these criteria, AE-IPF was diagnosed regardless of the presence or absence of a known trigger and categorised as triggered (T-AE) or idiopathic (I-AE) AE-IPF. However, the clinical characteristics of the newly defined AE-IPF and clinical differences between T-AE and I-AE are unresolved.MethodsWe retrospectively analysed 64 patients with AE-IPF (I-AE (42), T-AE (22)) admitted to our hospital over a 10- year period.ResultsI-AE and T-AE cases did not show differences in in-hospital and long-term outcomes (in-hospital mortality: I-AE 52.4%, T-AE 59.1%, p=0.61; long-term mortality: p=0.68). In the I-AE group, significantly more patients received corticosteroid therapy before an AE (I-AE 35.7%, T-AE 4.5%; p=0.01). Significantly more patients in the T-AE group had lung cancer (I-AE 7.1%, T-AE 59.1%, p<0.001). I-AE occurred more frequently in winter while T-AE did not show seasonality. The white blood cell (WBC) count and haemoglobin (Hb) level were independent predictors of in-hospital deaths in I-AE (WBC: OR 1.87; 95% CI 1.09 to 4.95, p=0.01; Hb: OR 0.26, 95%  CI 0.04 to 0.78, p=0.01) but not T-AE.DiscussionWith the introduction of new criteria for AE-IPF, a retrospective study over a 10-year period showed a lack of prognostic difference between I-AE and T-AE. The WBC count and Hb level predicted in-hospital outcome in I-AE cases.