bluuebunny/crossref_metadata_2025_split huggingface dataset:
High Thermal Gradient in Thermo-electrochemical Cells by Insertion of a Poly(Vinylidene Fluoride) Membrane
Authors: Hasan Syed Waqar , Said Suhana Mohd , Sabri Mohd Faizul Mohd , Bakar Ahmad Shuhaimi Abu , Hashim Nur Awanis , Hasnan Megat Muhammad Ikhsan Megat , Pringle Jennifer M. , MacFarlane Douglas R. 
Published: July 2016

AbstractThermo-Electrochemical cells (Thermocells/TECs) transform thermal energy into electricity by means of electrochemical potential disequilibrium between electrodes induced by a temperature gradient (ΔT). Heat conduction across the terminals of the cell is one of the primary reasons for device inefficiency. Herein, we embed Poly(Vinylidene Fluoride) (PVDF) membrane in thermocells to mitigate the heat transfer effects - we refer to these membrane-thermocells as MTECs. At a ΔT of 12 K, an improvement in the open circuit voltage (Voc) of the TEC from 1.3 mV to 2.8 mV is obtained by employment of the membrane. The PVDF membrane is employed at three different locations between the electrodes i.e. x = 2 mm, 5 mm, and 8 mm where ‘x’ defines the distance between the cathode and PVDF membrane. We found that the membrane position at x = 5 mm achieves the closest internal ∆T (i.e. 8.8 K) to the externally applied ΔT of 10 K and corresponding power density is 254 nWcm−2; 78% higher than the conventional TEC. Finally, a thermal resistivity model based on infrared thermography explains mass and heat transfer within the thermocells.
Rapid and label-free microfluidic neutrophil purification and phenotyping in diabetes mellitus
Authors: Hou Han Wei , Petchakup Chayakorn , Tay Hui Min , Tam Zhi Yang , Dalan Rinkoo , Chew Daniel Ek Kwang , Li King Ho Holden , Boehm Bernhard O. 
Published: July 2016

AbstractAdvanced management of dysmetabolic syndromes such as diabetes will benefit from a timely mechanistic insight enabling personalized medicine approaches. Herein, we present a rapid microfluidic neutrophil sorting and functional phenotyping strategy for type 2 diabetes mellitus (T2DM) patients using small blood volumes (fingerprick ~100 μL). The developed inertial microfluidics technology enables single-step neutrophil isolation (>90% purity) without immuno-labeling and sorted neutrophils are used to characterize their rolling behavior on E-selectin, a critical step in leukocyte recruitment during inflammation. The integrated microfluidics testing methodology facilitates high throughput single-cell quantification of neutrophil rolling to detect subtle differences in speed distribution. Higher rolling speed was observed in T2DM patients (P < 0.01) which strongly correlated with neutrophil activation, rolling ligand P-selectin glycoprotein ligand 1 (PSGL-1) expression, as well as established cardiovascular risk factors (cholesterol, high-sensitive C-reactive protein (CRP) and HbA1c). Rolling phenotype can be modulated by common disease risk modifiers (metformin and pravastatin). Receiver operating characteristics (ROC) and principal component analysis (PCA) revealed neutrophil rolling as an important functional phenotype in T2DM diagnostics. These results suggest a new point-of-care testing methodology and neutrophil rolling speed as a functional biomarker for rapid profiling of dysmetabolic subjects in clinical and patient-oriented settings.
Pronounced genetic differentiation and recent secondary contact in the mangrove tree Lumnitzera racemosa revealed by population genomic analyses
Authors: Li Jianfang , Yang Yuchen , Chen Qipian , Fang Lu , He Ziwen , Guo Wuxia , Qiao Sitan , Wang Zhengzhen , Guo Miaomiao , Zhong Cairong , Zhou Renchao , Shi Suhua 
Published: July 2016

AbstractSystematically investigating the impacts of Pleistocene sea-level fluctuations on mangrove plants may provide a better understanding of their demographic history and useful information for their conservation. Therefore, we conducted population genomic analyses of 88 nuclear genes to explore the population dynamics of a mangrove treeLumnitzera racemosaacross the Indo-West Pacific region. Our results revealed pronounced genetic differentiation in this species between the populations from the Indian Ocean and the Pacific Ocean, which may be attributable to the long-term isolation between the western and eastern coasts of the Malay Peninsula during sea-level drops in the Pleistocene glacial periods. The mixing of haplotypes from the two highly divergent groups was identified in a Cambodian population at almost all 88 nuclear genes, suggesting genetic admixture of the two lineages at the boundary region. Similar genetic admixture was also found in other populations from Southeast Asia based on the Bayesian clustering analysis of six nuclear genes, which suggests extensive and recent secondary contact of the two divergent lineages in Southeast Asia. Computer simulations indicated substantial migration from the Indian Ocean towards the South China Sea, which likely results in the genetic admixture in Southeast Asia.
Resistance mutations generate divergent antibiotic susceptibility profiles against translation inhibitors
Authors: Cocozaki Alexis I. , Altman Roger B. , Huang Jian , Buurman Ed T. , Kazmirski Steven L. , Doig Peter , Prince D. Bryan , Blanchard Scott C. , Cate Jamie H. D. , Ferguson Andrew D. 
Published: July 2016

Significance
The ribosome is a large and complex RNA–protein complex that synthesizes proteins in all kingdoms of life. The sequences of bacterial ribosomes differ, and antibiotics exploit these differences to inhibit the ribosome and stop cell growth. Mutations in the ribosome can interfere with antibiotic binding and render the bacteria resistant to the antibiotic. Using a combination of structural, biophysical, and biochemical experiments, we show how rRNA mutations alter the structure of the ribosome at the antibiotic binding site and result in divergent antibiotic susceptibility profiles.
Polymorphism and electronic structure of polyimine and its potential significance for prebiotic chemistry on Titan
Authors: Rahm Martin , Lunine Jonathan I. , Usher David A. , Shalloway David 
Published: July 2016

SignificanceTitan is the only place in the solar system, except Earth, where rainfall and seasonally flowing liquids erode the landscape. Whereas the surface pressure is similar to that of Earth, the temperature is extremely low and the dominant liquids are methane and ethane. This makes Titan a test case for exploring the environmental limits of prebiotic chemistry and addressing the question of whether life can develop without water. Experimental and observational data suggest that hydrogen cyanide, the most abundant hydrogen-bonding molecule in Titan’s atmosphere, may polymerize on the surface to polyimine. Using quantum mechanical calculations, we show that polyimine has interesting electronic and structural properties that could potentially facilitate prebiotic chemistry under cryogenic conditions akin to those on Titan.
Probe for the measurement of cell surface pH in vivo and ex vivo
Authors: Anderson Michael , Moshnikova Anna , Engelman Donald M. , Reshetnyak Yana K. , Andreev Oleg A. 
Published: July 2016

Significance
In acidic, diseased tissues, such as tumors, cell surfaces are expected to be more acidic than the surroundings, but no means have been available to measure surface acidity specifically in such tissues. We have developed a probe that uses a pH low insertion peptide to locate a pH-sensing dye, seminaphtharhodafluor, at acidic cell surfaces and find that the probe can measure surface pH, which is correlated with tumor aggressiveness. Even an individual cancer cell maintains acidity at its surface and can be detected in a well-perfused area. The new probe can be used in vivo and ex vivo on tissue specimens and opens a path to both medical utility and exploration of other functions of acidity on cell surfaces.
The performance of subject positions, power, and identity: a case of refugee recognition
Authors: Dagg Jennifer , Haugaard Mark 
Published: July 2016

ABSTRACT
This article explores the negotiation of subject positions, identities, and their recognition. It develops a theoretical model of identity and recognition, which is applied to the exemplar of a young Palestinian woman negotiating the refugee recognition process in Ireland. The paper is divided into five parts, as follows: (1) methodology; (2) a theorisation of subject positions, identity, and recognition based upon the work of Austin, Barnes, Davies and Harré, Butler, Foucault, Giddens, Goffman, Heidegger, Jenkins, and Searle; (3) the application of these perspectives to the complex performance of identity in a cross-cultural context; (4) the negotiation of the subject position asylum seeker; and (5) short conclusion-cum-epilogue. What emerges is that social actors occupy multiple conflicting subject positions; they are structurally constrained by others’ perceptions and refusals of recognition, thus frequently affirming subject positions that are contrary to their own desired identity-construction.
Is Canada Ready for Nationwide Collaboration on Medical School Admissions Practices and Policies?
Authors: Hanson Mark D. , Moineau Geneviève , Kulasegaram Kulamakan (Mahan) , Hammond Robert 
Published: July 2016

The report by the Association of Faculties of Medicine of Canada (AFMC) entitled “The Future of Medical Education in Canada: A Collective Vision for MD Education” includes recommendations to enhance admissions processes and increase national collaboration. To achieve these goals, the AFMC conducted a nationwide environmental scan appraising medical schools’ readiness for national collaboration and progress toward establishing “made-in-Canada” admissions processes. A critical narrative review of the academic and gray literature was conducted as part of this environmental scan. Four core admissions practice and policy domains were identified: (1) social accountability strategies, (2) standardized admissions testing, (3) interviewing procedures, and (4) application procedures.
In this article, the authors summarize and discuss the findings of this narrative review with regard to the four domains. They provide documentation of historical and present-day admissions factors relevant to Canadian medical schools’ readiness for nationwide collaboration and a descriptive analysis of the facilitators and barriers to establishing “made-in-Canada” admissions processes.
All four domains had facilitators and barriers. One barrier, however, cut across multiple domains—medical schools’ pursuit of prestige and its potential to conflict with the goals of the other domains. The authors recommend holding a national forum to debate these issues and to advance the AFMC’s goals, a process that will not be straightforward. Yet, national collaboration holds promise for applicants, medical schools, and Canada’s diverse population of patients, so efforts toward this end must continue.
Measuring Moral Courage for Interns and Residents: Scale Development and Initial Psychometrics
Authors: Martinez William , Bell Sigall K. , Etchegaray Jason M. , Lehmann Lisa Soleymani 
Published: July 2016

PurposeTo develop a practical and psychometrically sound set of survey items that measures moral courage for physicians in the context of patient care.MethodIn 2013, the 731 internal medicine and surgical interns and residents from two northeastern U.S. academic medical centers were invited to anonymously complete a survey about moral courage, empathy, and speaking up about patient safety breaches.ResultsOf the eligible participants, 352 (48%) responded. Principal components analysis of the moral courage items demonstrated a single, meaningful, nine-item factor labeled the Moral Courage Scale for Physicians (MCSP). All item–total score correlations were significant (P< .001) and ranged from 0.57 to 0.76. The Cronbach alpha for the MCSP was 0.90. Consistent with expectations based on theory, MCSP scores were negatively associated with being an intern versus resident (B = −4.17,P< .001), suggesting discriminant validity. MCSP scores were positively associated with respondents’ Jefferson Scale of Physician Empathy perspective-taking score (B = 0.53,P< .001), a construct conceptually relevant to moral courage, suggesting convergent validity. Finally, MCSP scores were positively correlated with self-reported speaking up about patient safety breaches (r= 0.19,P= .008), an action that involves moral courage, suggesting concurrent validity.ConclusionsThe authors provided initial evidence for the reliability and validity of a measure of moral courage for physicians. The MCSP may help researchers and educators to tangibly measure physician moral courage as a concept, and track progress on a set of desired behaviors in response to curricular interventions.
Neighborhood Variation in the Utilization of Laparoscopy for the Treatment of Colon Cancer
Authors: Doumouras Aristithes G. , Saleh Fady , Eskicioglu Cagla , Amin Nalin , Cadeddu Margherita , Hong Dennis 
Published: July 2016

BACKGROUND:
The rates of laparoscopic colectomy for colon cancer have steadily increased since its inception. Laparoscopic colectomy currently accounts for a third of colectomy procedures in the United States, but little is known regarding the spatial pattern of the utilization of laparoscopy for colon cancer.

OBJECTIVE:
This study evaluated the utilization of laparoscopy for colon cancer at the neighborhood level in Ontario.

DESIGN:
Retrospective analysis of prospectively collected data was performed.

SETTING:
This study was conducted at all hospitals in the province of Ontario.

PATIENTS:
This population-based study included all patients aged ≥18 who received an elective colectomy for colon cancer from April 2008 until March 2012 in the province of Ontario.

MAIN OUTCOME MEASURES:
The primary outcome measure was the neighborhood rates of laparoscopy.

RESULTS:
Overall, 9,969 patients underwent surgery, and the cluster analysis identified 74 cold-spot neighborhoods, representing 1.8 million people, or 14% of the population. In the multivariate analysis, patients from rural neighborhoods were less than half as likely to receive laparoscopy, OR 0.44 (95% CI, 0.24–0.84; p = 0.012). Additionally, having a minimally invasive surgery fellowship training facility within the same administrative health region as the neighborhood made it more than 23 times as likely to be a hot spot, OR 25.88 (95% CI, 12.15–55.11; p < 0.001). Neighborhood socioeconomic status was not associated with variation in the utilization of laparoscopy.

LIMITATIONS:
Patient case mix could affect laparoscopy use.

CONCLUSION AND RELEVANCE:
This study identified an unequal utilization of laparoscopy for colon cancer within Ontario with rural neighborhoods experiencing low rates of laparoscopic colectomy, whereas neighborhoods in the same administrative region as minimally invasive surgery training centers experienced increased utilization. Further study into the causes of this variation in resource allocation is needed to identify ways to improve more efficient spread of knowledge and technical skills advancement.
Diagnostic Accuracy of MRI for Assessment of T Category and Circumferential Resection Margin Involvement in Patients With Rectal Cancer
Authors: Zhang Ge , Cai Yu-zhe , Xu Guo-hui 
Published: July 2016

BACKGROUND:
The prognosis of rectal cancer is directly related to the stage of the tumor at diagnosis. Accurate preoperative staging is essential for selecting patients to receive optimal treatment.

OBJECTIVE:
The purpose of this study was to evaluate the diagnostic performance of MRI in tumor staging and circumferential resection margin involvement in rectal cancer.

DATA SOURCES:
A systematic literature search was performed in MEDLINE, EMBASE, PubMed, Cochrane Database of Systematic Reviews, and Web of Science database.

STUDY SELECTION:
Original articles from 2000 to 2016 on the diagnostic performance of MRI in the staging of rectal cancer and/or assessment of mesorectal fascia status were eligible.

MAIN OUTCOME MEASURES:
Pooled diagnostic statistics including sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio were calculated for invasion of muscularis propria, perirectal tissue, and adjacent organs and for circumferential resection margin involvement through bivariate random-effects modeling. Summary receiver operating characteristic curves were fitted, and areas under summary receiver operating characteristic curves were counted to evaluate the diagnostic performance of MRI for each outcome.

RESULTS:
Thirty-five studies were eligible for this meta-analysis. Preoperative MRI revealed the highest sensitivity of 0.97 (95% CI, 0.96–0.98) and specificity of 0.97 (95% CI, 0.96–0.98) for muscularis propria invasion and adjacent organ invasion. Areas under summary receiver operating characteristic curves indicated good diagnostic accuracy for each outcome, with the highest of 0.9515 for the assessment of adjacent organ invasion. Significant heterogeneity existed among studies. There was no notable publication bias for each outcome.

LIMITATIONS:
This meta-analysis revealed relatively high diagnostic accuracy for preoperative MRI, although significant heterogeneity existed. Therefore, exploration should be focused on standardized interpretation criteria and optimal MRI protocols for future studies.

CONCLUSIONS:
MRI showed relatively high diagnostic accuracy for preoperative T staging and circumferential resection margin assessment and should be reliable for clinical decision making.
Clinical Significance of 2 Deep Posterior Perianal Spaces to Complex Cryptoglandular Fistulas
Authors: Zhang Heng , Zhou Zhi-yang , Hu Bang , Liu De-chao , Peng Hui , Xie Shang-kui , Su Dan , Ren Dong-lin 
Published: July 2016

BACKGROUND:
Confusion exists regarding the clinical significance of the deep posterior intersphincteric space and deep postanal space to complex perianal fistulas.

OBJECTIVE:
The purpose of this study was to assess the clinical significance of the 2 deep posterior perianal spaces and to describe in detail the courses of posterior complex cryptoglandular fistula extensions.

DESIGN:
This was a retrospective study. MRI-based characteristics of selected perianal fistulas were independently evaluated by examiners who focused on lesions in these 2 spaces and were blinded to each other’s findings.

SETTINGS:
This study was conducted in the colorectal surgery and radiology departments of a large university teaching hospital in China.

PATIENTS:
Included in the study were patients who underwent pelvic MRI for posterior perianal fistula between October 2012 and December 2014.

MAIN OUTCOME MEASURES:
The occurrence rates of these 2 deep perianal space lesions in posterior cryptoglandular fistulas were determined.

RESULTS:
A total of 513 primary posterior cryptoglandular fistulas were identified in 508 patients, including 167 deep posterior intersphincteric space lesions (32.6%) and 23 deep postanal space lesions (4.5%). Of those, 173 fistulas (33.7%) were evaluated as complex. The former and latter spaces were involved in 79.2% (137/173) and 13.3% (23/173) of posterior complex fistulas. Compared with deep postanal space lesions, deep posterior intersphincteric space lesions were more common in cases with high transsphincteric or suprasphincteric fistulas (80.1% vs 15.8%), synchronous multiple transsphincteric fistulas (82.4% vs 20.6%), horseshoe-like fistulas (85.5% vs 14.5%), and supralevator fistulas (93.5% vs 16.1%). Similar incidences were also seen in cases with ischioanal-involved horseshoe-like fistulas (75.0% vs 25.0%).

LIMITATIONS:
This study was limited by its retrospective nature.

CONCLUSIONS:
The deep posterior intersphincteric space is more likely than the deep postanal space to be involved in complex cryptoglandular fistulas and is likely to play a more important role in the management of complex cryptoglandular fistulas.
Impact of the Specific Extraction-Site Location on the Risk of Incisional Hernia After Laparoscopic Colorectal Resection
Authors: Benlice Cigdem , Stocchi Luca , Costedio Meagan M. , Gorgun Emre , Kessler Hermann 
Published: July 2016

BACKGROUND:
The impact of the specific incision used for specimen extraction during laparoscopic colorectal surgery on incisional hernia rates relative to other contributing factors remains unclear.

OBJECTIVE:
This study aimed to assess the relationship between extraction-site location and incisional hernia after laparoscopic colorectal surgery.

DESIGN:
This was a retrospective cohort study (January 2000 through December 2011).

SETTINGS:
The study was conducted at a high-volume, specialized colorectal surgery department.

PATIENTS:
All of the patients undergoing elective laparoscopic colorectal resection were identified from our prospectively maintained institutional database.

MAIN OUTCOME MEASURES:
Extraction-site and port-site incisional hernias clinically detected by physician or detected on CT scan were collected. Converted cases, defined as the use of a midline incision to perform the operation, were kept in the intent-to-treat analysis. Specific extraction-site groups were compared, and other relevant factors associated with incisional hernia rates were also evaluated with univariate and multivariate analyses.

RESULTS:
A total of 2148 patients (54.0% with abdominal and 46.0% with pelvic operations) with a mean age of 51.7 ± 18.2 years (52% women) were reviewed. Used extraction sites were infraumbilical midline (23.7%), stoma site/right or left lower quadrant (15%), periumbilical midline (22.5%), and Pfannenstiel (29.6%) and midline converted (9.2%). Overall crude extraction site incisional hernia rate during a mean follow-up of 5.9 ± 3.0 years was 7.2% (n = 155). Extraction-site incisional hernia crude rates were highest after periumbilical midline (12.6%) and a midline incision used for conversion to open surgery (12.0%). Independent factors associated with extraction-site incisional hernia were any extraction sites compared with Pfannenstiel (periumbilical midline HR = 12.7; midline converted HR = 13.1; stoma site HR = 28.4; p < 0.001 for each), increased BMI (HR = 1.23; p = 0.002), synchronous port-site hernias (HR = 3.66; p < 0.001), and postoperative superficial surgical-site infection (HR = 2.11; p < 0.001).

LIMITATIONS:
This study was limited by its retrospective nature, incisional hernia diagnoses based on clinical examination, and heterogeneous surgical population.

CONCLUSIONS:
Preferential extraction sites to minimize incisional hernia rates should be Pfannenstiel or incisions off the midline. Midline incisions should be avoided when possible.