bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors for Weight Gain during Methadone Maintenance Treatment
Authors: Peles Einat , Schreiber Shaul , Sason Anat , Adelson Miriam 
Published: April 2016

Background: Weight gain was reported during methadone maintenance treatment (MMT). However, its relation to eating habits and specific risk factors, including methadone dose or serum level, was limited. The aims of this study were to characterize risk factors for weight gain and to study current eating habits, food preferences, and nutrition knowledge. Methods: Patients with available measures of weight and height (body mass index [BMI]) at admission to MMT and at follow-up, when methadone serum levels were determined (after 1 year or when stabilized) ( N = 114), were studied (using the Addiction Severity Index [ASI], drugs in urine, methadone doses, and serum levels). In addition, 109 current patients with available earlier (5.8 ± 2.6 years earlier) BMI completed eating behavior rating and nutrition knowledge questionnaires, and their current and earlier BMI were compared. Results: The BMI of 114 newly admitted patients increased from 22.5 ± 3.8 to 24.4 ± 4.3 ( P < .0005). Once stabilized on methadone, BMI increased further (24.3 ± 4.5 to 25.6 ± 5.0; P < .0005; n = 74), with no change in methadone doses (125.6 ± 32.5 to 128.0 ± 34.1; F = 1.4, P = .2) or serum levels (495.6 ± 263.7 to 539.8 ± 306.2; F = 1.3, P = .2). Repeated-measures analyses revealed that BMI elevation was higher among 45 hepatitis C virus seronegative and 46 non–benzodiazepine-abusing on-admission patients. Those who scored lower on knowledge about healthy diet and showed a higher sweet-foods preference had a higher BMI. Conclusion: BMI increased over time, but independent of methadone dosage and blood levels. As expected, worse diet habits and a desire for sweet foods are related to higher BMI. Paradoxically, healthier status (i.e., hepatitis C seronegative, no benzodiazepine abuse) at admission is predictive of greater weight gain during MMT. Education about nutrition habits is recommended.
Jung’s Answer to Job: a modern myth for the times
Authors: Doran Christine 
Published: April 2016

ABSTRACTJung’sAnswer to Jobwas one of the most allusive, and yet elusive, texts he ever wrote. This article offers an interpretation of what Jung was intending to accomplish in writing this strange book. It places it in historical context in the aftermath of World War II, a time of widespread public shock at the Holocaust and fear of imminent global destruction. By outlining some notable theories about the nature of myth, the true significance of Jung’s achievement can be better understood. In this regard the insightful concepts of the Italian philosopher, Giambattista Vico, are particularly helpful. The myth that almost immediately began to grow up surrounding the writing of the book and its controversial public reception is also discussed.
Multi-scale study of the isotope effect in ISTTOK
Authors: Liu B. , Silva C. , Figueiredo H. , Pedrosa M.A. , van Milligen B.Ph. , Pereira T. , Losada U. , Hidalgo C. 
Published: April 2016

Abstract
The isotope effect, namely the isotope dependence of plasma confinement, is still one of the principal scientific conundrums facing the magnetic fusion community. We have investigated the impact of isotope mass on multi-scale mechanisms, including the characterization of radial correlation lengths (

L

r

) and long-range correlations (LRC) of plasma fluctuations using multi-array Langmuir probe system, in hydrogen (H) and deuterium (D) plasmas in the ISTTOK tokamak. We found that when changing plasma composition from the H dominated to D dominated, the LRC amplitude increased markedly (10–30%) and the

L

r

increased slightly (~10%). The particle confinement also improved by about 50%. The changes of LRC and

L

r

are congruent with previous findings in the TEXTOR tokamak (Xu et al 2013 Phys. Rev. Lett. 110
265005). In addition, using biorthogonal decomposition, both geodesic acoustic modes and very low frequency (<5 kHz) coherent modes were found to be contributing to LRC.
Study on the L–H transition power threshold with RF heating and lithium-wall coating on EAST
Authors: Chen L. , Xu G.S. , Nielsen A.H. , Gao W. , Duan Y.M. , Liu H.Q. , Wang L. , Li M.H. , Wang M. , Zhang X.J. , Chen R. , Wang H.Q. , Sun Z. , Ding S.Y. , Yan N. , Liu S.C. , Shao L.M. , Zhang W. , Hu G.H. , Li J. , Zhang L. , Wan B.N. 
Published: April 2016

Abstract
The power threshold for low (L) to high (H) confinement mode transition achieved by radio-frequency (RF) heating and lithium-wall coating is investigated experimentally on EAST for two sets of walls: an all carbon wall (C) and molybdenum chamber and a carbon divertor (Mo/C). For both sets of walls, a minimum power threshold P
thr of ~0.6 MW was found when the EAST operates in a double null (DN) divertor configuration with intensive lithium-wall coating. When operating in upper single null (USN) or lower single null (LSN), the power threshold depends on the ion  ∇B drift direction. The low density dependence of the L–H power threshold, namely an increase below a minimum density, was identified in the Mo/C wall for the first time. For the C wall only the single-step L–H transition with limited injection power is observed whereas also the so-called dithering L–H transition is observed in the Mo/C wall. The dithering behaves distinctively in a USN, DN and LSN configuration, suggesting the divertor pumping capability is an important ingredient in this transition since the internal cryopump is located underneath the lower divertor. Depending on the chosen divertor configuration, the power across the separatrix P
loss increases with neutral density near the lower X-point in EAST with the Mo/C wall, consistent with previous results in the C wall (Xu et al 2011 Nucl. Fusion
51 072001). These findings suggest that the edge neutral density, the ion  ∇B drift as well as the divertor pumping capability play important roles in the L–H power threshold and transition behaviour.
The Library in Twelfth- and Thirteenth-Century French Literature: Benoît de Sainte-Maure's
Roman de Troie
, Chrétien de Troyes's
Cligès
, and Adenet le Roi's
Berte as grans piés
Authors: Campbell Emma 
Published: April 2016

Abstract
The allusion to a real or imaginary source is a commonplace in medieval literature; however, some writers take this reference to sources a stage further and speak about the discovery of a work in a library or book collection, occasionally evoking particular place names or locations. If the library's depiction in such instances elaborates upon a common motif, it also raises the issue of the imaginative work that this elaboration might perform, inviting reflection on the historical conceptualization of book collections and the relationship to knowledge they connote. To the extent that it features in more modern discussions, the library as a figure or metaphor has usually been thought about in connection with periods subsequent to the Middle Ages, often being associated with the organization or throwing into chaos of systems of knowledge. This article considers how the library as it appears in twelfth- and thirteenth-century francophone literature offers alternative ways of imagining hierarchies of knowledge from those associated with modernity and post-modernity, ways that are less concerned with systems of classification or notions of ordered space than with relationships among writers, readers, and texts.
Amazonian Forests and Trees: Multiplicity and Objectivity in Studies of Online Consumer-Generated Ratings and Reviews, A Commentary on de Langhe, Fernbach, and Lichtenstein
Authors: Kozinets Robert V. 
Published: April 2016

Abstract
Consumer-generated ratings and reviews play an important role in people’s experiences of online search and shopping. This article applauds and extends the thought-provoking response of de Langhe, Fernbach, and Lichtenstein (2016, in this issue) to Simonson’s (2015) assertions about the topic and suggests an agenda for future research. Follow-up research into the topic should emphasize the diversity of consumers and the multiplicity of their needs. It should recognize that reviews and ratings are complex social conversations embedded in consumers’ multifaceted communicational repertoires. It should be cautious when using terms such as objective and rational when describing consumers and consumption. Being aware of the risks to external validity of studying average ratings may lead to frameworks with greater contextual integrity, and encourage collaborative communication between scholars from different perspectives working in this field.
Feasibility and Outcomes of Implementing a Portfolio Assessment System Alongside a Traditional Grading System
Authors: O’Brien Celia Laird , Sanguino Sandra M. , Thomas John X. , Green Marianne M. 
Published: April 2016

Purpose
Portfolios are a powerful tool to collect and evaluate evidence of medical students’ competence across time. However, comprehensive portfolio assessment systems that are implemented alongside traditional graded curricula at medical schools in the United States have not been described in the literature. This study describes the development and implementation of a longitudinal competency-based electronic portfolio system alongside a graded curriculum at a relatively large U.S. medical school.

Method
In 2009, the authors developed a portfolio system that served as a repository for all student assessments organized by competency domain. Five competencies were selected for a preclerkship summative portfolio review. Students submitted reflections on their performance. In 2014, four clinical faculty members participated in standard-setting activities and used expert judgment and holistic review to rate students’ competency achievement as “progressing toward competence,” “progressing toward competence with some concern,” or “progressing toward competence pending remediation.” Follow-up surveys measured students’ and faculty members’ perceptions of the process.

Results
Faculty evaluated 156 portfolios and showed high levels of agreement in their ratings. The majority of students achieved the “progressing toward competence” benchmark in all competency areas. However, 31 students received at least one concerning rating, which was not reflected in their course grades. Students’ perceptions of the system’s ability to foster self-assessment were mixed.

Conclusions
The portfolio review process allowed faculty to identify students with a concerning rating in a behavioral competency who would not have been identified in a traditional grading system. Identification of these students allows for intervention and early remediation.
When Assessment Data Are Words: Validity Evidence for Qualitative Educational Assessments
Authors: Cook David A. , Kuper Ayelet , Hatala Rose , Ginsburg Shiphra 
Published: April 2016

Quantitative scores fail to capture all important features of learner performance. This awareness has led to increased use of qualitative data when assessing health professionals. Yet the use of qualitative assessments is hampered by incomplete understanding of their role in forming judgments, and lack of consensus in how to appraise the rigor of judgments therein derived. The authors articulate the role of qualitative assessment as part of a comprehensive program of assessment, and translate the concept of validity to apply to judgments arising from qualitative assessments. They first identify standards for rigor in qualitative research, and then use two contemporary assessment validity frameworks to reorganize these standards for application to qualitative assessment.
Standards for rigor in qualitative research include responsiveness, reflexivity, purposive sampling, thick description, triangulation, transparency, and transferability. These standards can be reframed using Messick’s five sources of validity evidence (content, response process, internal structure, relationships with other variables, and consequences) and Kane’s four inferences in validation (scoring, generalization, extrapolation, and implications). Evidence can be collected and evaluated for each evidence source or inference. The authors illustrate this approach using published research on learning portfolios.
The authors advocate a “methods-neutral” approach to assessment, in which a clearly stated purpose determines the nature of and approach to data collection and analysis. Increased use of qualitative assessments will necessitate more rigorous judgments of the defensibility (validity) of inferences and decisions. Evidence should be strategically sought to inform a coherent validity argument.
How Prevalent Are Potentially Illegal Questions During Residency Interviews? A Follow-up Study of Applicants to All Specialties in the National Resident Matching Program
Authors: Hern H. Gene , Trivedi Tarak , Alter Harrison J. , Wills Charlotte P. 
Published: April 2016

Purpose
To describe the prevalence and effects on applicants of being asked potentially illegal questions during the residency interview process by surveying all residency applicants to all specialties.

Method
The authors surveyed all applicants from U.S. medical schools to residency programs in all specialties in 2012–2013. The survey included questions about the prevalence of potentially illegal questions, applicants’ level of comfort with such questions, and whether such questions affected how applicants ranked programs. Descriptive statistics, tests of proportions, t tests, and logistic regression modeling were used to analyze the data.

Results
Of 21,457 eligible applicants, 10,976 (51.1%) responded to the survey. Overall, 65.9% (7,219/10,967) reported receiving at least one potentially illegal question. More female respondents reported being asked questions about gender (513/5,357 [9.6%] vs. 148/5,098 [2.9%]), marital status (2,895/5,283 [54.8%] vs. 2,592/4,990 [51.9%]), or plans for having children (889/5,241 [17.0%] vs. 521/4,931 [10.6%]) than male respondents (P < .001). Those in surgical specialties were more likely to have received a potentially illegal question than those in nonsurgical specialties (1,908/2,330 [81.9%] vs. 5,311/8,281 [64.1%]). Questions regarding their commitment to the program were reported by 15.5% (1,608/10,378) of respondents. Such potentially illegal questions negatively affected how respondents ranked programs.

Conclusions
Two-thirds of applicants reported being asked potentially illegal questions. More women than men reported receiving questions about marital status or family planning. Potentially illegal questions negatively influence how applicants perceive and rank programs. A formal interview code of conduct or interviewer training could help to address these issues.
Toward Defining the Foundation of the MD Degree: Core Entrustable Professional Activities for Entering Residency
Authors: Englander Robert , Flynn Timothy , Call Stephanie , Carraccio Carol , Cleary Lynn , Fulton Tracy B. , Garrity Maureen J. , Lieberman Steven A. , Lindeman Brenessa , Lypson Monica L. , Minter Rebecca M. , Rosenfield Jay , Thomas Joe , Wilson Mark C. , Aschenbrener Carol A. 
Published: April 2016

Currently, no standard defines the clinical skills that medical students must demonstrate upon graduation. The Liaison Committee on Medical Education bases its standards on required subject matter and student experiences rather than on observable educational outcomes. The absence of such established outcomes for MD graduates contributes to the gap between program directors’ expectations and new residents’ performance.
In response, in 2013, the Association of American Medical Colleges convened a panel of experts from undergraduate and graduate medical education to define the professional activities that every resident should be able to do without direct supervision on day one of residency, regardless of specialty. Using a conceptual framework of entrustable professional activities (EPAs), this Drafting Panel reviewed the literature and sought input from the health professions education community. The result of this process was the publication of 13 core EPAs for entering residency in 2014. Each EPA includes a description, a list of key functions, links to critical competencies and milestones, and narrative descriptions of expected behaviors and clinical vignettes for both novice learners and learners ready for entrustment.
The medical education community has already begun to develop the curricula, assessment tools, faculty development resources, and pathways to entrustment for each of the 13 EPAs. Adoption of these core EPAs could significantly narrow the gap between program directors’ expectations and new residents’ performance, enhancing patient safety and increasing residents’, educators’, and patients’ confidence in the care these learners provide in the first months of their residency training.
Convergent Validity of Three Methods for Measuring Postoperative Complications
Authors: Fritz Bradley A. , Escallier Krisztina E. , Ben Abdallah Arbi , Oberhaus Jordan , Becker Jennifer , Geczi Kristin , McKinnon Sherry , Helsten Dan L. , Sharma Anshuman , Wildes Troy S. , Avidan Michael S. 
Published: April 2016

AbstractAbstract
In a study of over 1,500 subjects more than 30 days after surgery, patient-reported outcomes, compared to automated or manual chart review, demonstrated poor-to-moderate positive agreement (0 to 58%) and excellent negative agreement (82 to 100%). Discrepancies frequently reflected patients reporting events that occurred outside the time period of interest, suggesting that more effective in-hospital communication and thoughtful survey design may improve the value of patient-reported outcomes.
Supplemental Digital Content is available in the text.

Background
Anesthesiologists need tools to accurately track postoperative outcomes. The accuracy of patient report in identifying a wide variety of postoperative complications after diverse surgical procedures has not previously been investigated.

Methods
In this cohort study, 1,578 adult surgical patients completed a survey at least 30 days after their procedure asking if they had experienced any of 18 complications while in the hospital after surgery. Patient responses were compared to the results of an automated electronic chart review and (for a random subset of 750 patients) to a manual chart review. Results from automated chart review were also compared to those from manual chart review. Forty-two randomly selected patients were contacted by telephone to explore reasons for discrepancies between patient report and manual chart review.

Results
Comparisons between patient report, automated chart review, and manual chart review demonstrated poor-to-moderate positive agreement (range, 0 to 58%) and excellent negative agreement (range, 82 to 100%). Discordance between patient report and manual chart review was frequently explicable by patients reporting events that happened outside the time period of interest.

Conclusions
Patient report can provide information about subjective experiences or events that happen after hospital discharge, but often yields different results from chart review for specific in-hospital complications. Effective in-hospital communication with patients and thoughtful survey design may increase the quality of patient-reported complication data.
General Anesthesia Causes Epigenetic Histone Modulation of c-Fos and Brain-derived Neurotrophic Factor, Target Genes Important for Neuronal Development in the Immature Rat Hippocampus
Authors: Dalla Massara Lorenza , Osuru Hari Prasad , Oklopcic Azra , Milanovic Desanka , Joksimovic Srdjan Milan , Caputo Valentina , DiGruccio Michael Robert , Ori Carlo , Wang Guangfu , Todorovic Slobodan Milenko , Jevtovic-Todorovic Vesna 
Published: April 2016

AbstractAbstract
Exposure to general anesthesia during critical stages of synaptogenesis modulated expression and function of the key transcription factors, cAMP-responsive element-binding protein (CREB) and CREB-binding protein. CREB-binding protein and CREB modulation may, in turn, cause epigenetic changes manifested as histone hypoacetylation, leading to down-regulated transcription of the target genes cellular Finkel-Biskis-Jinkins murine sarcoma virus osteosarcoma oncogene and brain-derived neurotrophic factor, which play an important role in neuronal development.

Background
Early postnatal exposure to general anesthesia (GA) may be detrimental to brain development, resulting in long-term cognitive impairments. Older literature suggests that in utero exposure of rodents to GA causes cognitive impairments in the first-generation as well as in the second-generation offspring never exposed to GA. Thus, the authors hypothesize that transient exposure to GA during critical stages of synaptogenesis causes epigenetic changes in chromatin with deleterious effects on transcription of target genes crucial for proper synapse formation and cognitive development. They focus on the effects of GA on histone acetyltransferase activity of cAMP-responsive element-binding protein and the histone-3 acetylation status in the promoters of the target genes brain-derived neurotrophic factor and cellular Finkel-Biskis-Jinkins murine sarcoma virus osteosarcoma oncogene (c-Fos) known to regulate the development of neuronal morphology and function.

Methods
Seven-day-old rat pups were exposed to a sedative dose of midazolam followed by combined nitrous oxide and isoflurane anesthesia for 6 h. Hippocampal neurons and organotypic hippocampal slices were cultured in vitro and exposed to GA for 24 h.

Results
GA caused epigenetic modulations manifested as histone-3 hypoacetylation (decrease of 25 to 30%, n = 7 to 9) and fragmentation of cAMP-responsive element-binding protein (two-fold increase, n = 6) with 25% decrease in its histone acetyltransferase activity, which resulted in down-regulated transcription of brain-derived neurotrophic factor (0.2- to 0.4-fold, n = 7 to 8) and cellular Finkel-Biskis-Jinkins murine sarcoma virus osteosarcoma oncogene (about 0.2-fold, n = 10 to 12). Reversal of histone hypoacetylation with sodium butyrate blocked GA-induced morphological and functional impairments of neuronal development and synaptic communication.

Conclusion
Long-term impairments of neuronal development and synaptic communication could be caused by GA-induced epigenetic phenomena.