bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving sodium laser guide star brightness by polarization switching
Authors: Fan Tingwei , Zhou Tianhua , Feng Yan 
Published: January 2016

AbstractOptical pumping with circularly polarized light has been used to enhance the brightness of sodium laser guide star. But the benefit is reduced substantially due to the precession of sodium atoms in geomagnetic field. Switching the laser between left and right circular polarization at the Larmor frequency is proposed to improve the return. With ESO’s laser guide star system at Paranal as example, numerical simulation shows that the return flux is increased when the angle between geomagnetic field and laser beam is larger than 60°, as much as 50% at 90°. The proposal is significant since most astronomical observation is at angle between 60° and 90° and it only requires a minor addition to the delivery optics of present laser system.
Liver sinusoidal endothelial cells induce tolerance of autoreactive CD4+ recent thymic emigrants
Authors: Xu Xi , Jin Rong , Li Mingyang , Wang Ke , Zhang Shusong , Hao Jie , Sun Xiuyuan , Zhang Yu , Wu Hounan , Zhang Jun , Ge Qing 
Published: January 2016

AbstractThe liver is a unique lymphoid organ whose microenvironment is biased towards tolerance induction. We previously found that a proportion of CD4+ autoreactive recent thymic emigrants (RTEs) retained in the liver after thymic egress and acquired IL-10 producing capability. To investigate the tolerance of these liver persisting CD4+ RTEs in more detail and to study the liver stromal cell types that facilitate the tolerogenic changes in young T cells, the phenotype and function of liver RTEs were further characterized and the impact of liver sinusoidal endothelial cells (LSECs) and Kupffer cells on RTEs were examined using an in vitro co-culture system. More than 70% of CD4+ CD44hi RTEs in the liver acquired Foxp3-LAG3+ CD49b− regulatory phenotype and function. But higher ratio of apoptosis with enhanced FasL and Bim expression was also found in these CD4+ liver RTEs when compared to those in the lymph nodes and spleen. LSECs played an important role in RTEs’ acquisition of tolerogenic and regulatory phenotype. These results indicate an important role of liver microenvironment in enforcing peripheral tolerance to CD4+ thymic emigrants against self- and gut-derived antigens.
IL-10-produced by human transitional B-cells down-regulates CD86 expression on B-cells leading to inhibition of CD4+T-cell responses
Authors: Nova-Lamperti Estefania , Fanelli Giorgia , Becker Pablo D. , Chana Prabhjoat , Elgueta Raul , Dodd Philippa C. , Lord Graham M. , Lombardi Giovanna , Hernandez-Fuentes Maria P. 
Published: January 2016

AbstractA novel subset of human regulatory B-cells has recently been described. They arise from within the transitional B-cell subpopulation and are characterised by the production of IL-10. They appear to be of significant importance in regulating T-cell immunity in vivo. Despite this important function, the molecular mechanisms by which they control T-cell activation are incompletely defined. Here we show that transitional B-cells produced more IL-10 and expressed higher levels of IL-10 receptor after CD40 engagement compared to other B-cell subsets. Furthermore, under this stimulatory condition, CD86 expressed by transitional B-cells was down regulated and T-cell proliferation was reduced. We provide evidence to demonstrate that the down-regulation of CD86 expression by transitional B-cells was due to the autocrine effect of IL-10, which in turn leads to decreased T-cell proliferation and TNF-α production. This analysis was further extended to peripheral B-cells in kidney transplant recipients. We observed that B-cells from patients tolerant to the graft maintained higher IL-10 production after CD40 ligation, which correlates with lower CD86 expression compared to patients with chronic rejection. Hence, the results obtained in this study shed light on a new alternative mechanism by which transitional B-cells inhibit T-cell proliferation and cytokine production.
The asymmetry of pectoralis muscles is greater in male prepubertal than in professional tennis players
Authors: Sanchis‐Moysi Joaquin , Dorado Cecilia , Idoate Fernando , González‐Henríquez Juan J. , Serrano‐Sanchez Jose A. , Calbet Jose A. L. 
Published: January 2016

AbstractIt is generally accepted that preadolescents have a limited capacity to develop muscle hypertrophy in response to exercise compared with older populations; however, studies are scarce and conflicting. The main aim of the present study was to assess if playing tennis is associated with the hypertrophy of dominant pectoralis muscles (PM) in professional (PRO) and in prepubescent tennis players (PRE). A secondary aim was to assess if the degree of asymmetry of PM is greater in PRO than PRE. The volume of PM of both sides was determined using magnetic resonance imaging in 8 male PRO (21.9 years), 6 male PRE (11 years, Tanner 1–2) and 12 male non‐active controls (6 adults: 23.5 years; and 6 prepubescents: 10.7 years, Tanner 1–2). PRO and PRE had 15 and 30% greater volume, respectively, in the dominant than in the contralateral PM (P < .01). No significant side‐to‐side differences in PM volume were observed in the non‐active controls (3%, P = .34 in adults and 5%, P = .17 in children). The degree of side‐to‐side asymmetry in PM volume was greater in PRE than in PRO (P < .05). In conclusion, tennis practice is associated with marked hypertrophy of dominant PM in tennis players, even at prepubertal age, whilst non‐active age‐matched control subjects display similar volumes in both sides. The larger asymmetry observed in PRE than in PRO may indicate a greater relative loading in the children or increased contralateral hypertrophy in the professionals. This study demonstrates that prepubertal children respond with marked hypertrophy to loading by tennis.
Biomechanical aspects of incisor action of beavers ( Castor fiber L.)
Authors: Stefen Clara , Habersetzer Jörg , Witzel Ulrich 
Published: January 2016

AbstractBeavers are known for their gnawing performance, e.g., felling trees. Even though this is well known, the biomechanics of it are not, and so this is the focus of this study. The lower incisors work as main cutting tools so that their technical parameters were studied. There are 3 angles (adding to 90°) of importance in cutting: 1) the wedge angle, the angle of the incisor tip; 2) the clearance angle between tooth and material (tree trunk); and 3) the chip angle between incisor tip and the perpendicular to the surface of the trunk. Cutting is usually oblique to the wood fibers. For technical wood cutting tools, an optimal wedge angle of 27° is known under certain conditions, and for the incisor of Castor fiber the wedge angle was determined using micro-Computed Tomography (µCT) scans to be 26.95°. Potential cutting forces of beavers were estimated for wood chips (2mm in thickness) of 3 sample tree species. For plum trees hardness forces ranged from 246 to 328N, and for maples from 190 to 254N. Finite element analyses were performed to determine stresses in the incisor under different loads on the incisor tip. Three hypotheses concerning gnawing were posed and are supported by the data: 1) The shape of the cutting blade of the incisor determines the geometry of wood chips and ultimately the maximum wood hardness that can be cut. 2) Clearance angle and maximum gape determine the maximum diameter of a tree that can be cut (if rough bark is neglected). 3) Functionally most importantly the lower incisors are optimized in shape and supporting tissue for compression stress with all forces being transmitted along the locations of the center of gravity in theoretical cross sections within the tooth, so that only compression occurs under load.
Cancer prevention and control: alarming challenges in China
Authors: Bode Ann M. , Dong Zigang , Wang Hongyang 
Published: January 2016

AbstractChina is geographically the third largest country in the world and the most populated low-to-middle-income country. Cancer incidence and mortality rates for some cancers in the USA and European countries have steadily decreased over the last decades, whereas the incidence and mortality of certain cancers in China have been increasing at an alarming speed. Rapid industrialization and urbanization in China have been accompanied by incredible changes in lifestyle and environment combined with an aging population. Mortality caused by lung, colorectal and breast cancers has been steadily increasing, whereas cancer mortality from gastric, esophageal and cervical tumors has tended to decrease. Similar to what has occurred in the United States, unhealthy lifestyles in China, including heavy smoking and poor diet combined with pollution, have contributed to increased cancer risk. China is facing many challenges in cancer treatment and prevention for the general population. The major areas that need to be addressed in the control of cancer in China include cancers associated with environmental pollution, tobacco use, occupational carcinogens, infection, excessive alcohol consumption, dietary deficiencies and obesity. In this perspective, we review the problems in each area and suggest ideas for future directions in cancer research and strategies and actions to reduce the incidence of cancer in China.
High-performance computing environment: a review of twenty years of experiments in China
Authors: Xu Zhiwei , Chi Xuebin , Xiao Nong 
Published: January 2016

AbstractA high-performance computing environment, also known as a supercomputing environment, e-Science environment or cyberinfrastructure, is a crucial system that connects users’ applications to supercomputers, and provides usability, efficiency, sharing, and collaboration capabilities. This review presents important lessons drawn from China's nationwide efforts to build and use a high-performance computing environment over the past 20 years (1995–2015), including three observations and two open problems. We present evidence that such an environment helps to grow China's nationwide supercomputing ecosystem by orders of magnitude, where a loosely coupled architecture accommodates diversity. An important open problem is why technology for global networked supercomputing has not yet become as widespread as the Internet or Web. In the next 20 years, high-performance computing environments will need to provide zettaflops computing capability and 10 000 times better energy efficiency, and support seamless human-cyber-physical ternary computing.
An Innovative Blended Preclinical Curriculum in Clinical Epidemiology and Biostatistics: Impact on Student Satisfaction and Performance
Authors: Evans Kambria H. , Thompson Atalie C. , O’Brien Colin , Bryant Madika , Basaviah Preetha , Prober Charles , Popat Rita A. 
Published: January 2016

Problem
There is little understanding of the impact of teaching clinical epidemiology and biostatistics in a flipped or blended format. At Stanford University School of Medicine, the quantitative medicine (QM) curriculum for first-year students was redesigned to use a blended format, in response to student feedback.

Approach
The blended QM curriculum introduced in 2013 integrated self-paced, online learning with small-group collaborative learning. The authors analyzed the blended format’s impact on student satisfaction and performance, comparing the pilot cohort of students (n = 101) with students who took the traditional curriculum in 2011 and 2012 (n = 178). They also analyzed QM resource utilization in 2013.

Outcomes
The blended curriculum had a positive impact on satisfaction and mastery of core material. Comparing the 2013 blended cohort with the 2011–2012 traditional cohort, there were significant improvements in student satisfaction ratings (overall, P < .0001; organization, P < .0001; logical sequence, P = .008; value of content, P < .0001). The mean (SD) overall satisfaction rating for small-group sessions increased: 3.40 (1.03) in 2013 versus 2.79 (1.00) in 2011 and 2.83 (1.06) in 2012. Performance on the QM final exam showed no significant changes in 2013 versus 2011 and 2012. The majority of students in 2013 reported using the QM online videos as their primary learning resource (69%–85% across modules).

Next Steps
The positive impact of the curricular elements studied will inform continued development of the QM curriculum. Features of the curriculum could serve as a model for future blended courses.
U.S. Medical Schools’ Compliance With the Americans With Disabilities Act: Findings From a National Study
Authors: Zazove Philip , Case Benjamin , Moreland Christopher , Plegue Melissa A. , Hoekstra Anne , Ouellette Alicia , Sen Ananda , Fetters Michael D. 
Published: January 2016

Purpose
Physician diversity improves care for underserved populations, yet there are few physicians with disabilities. The authors examined the availability of technical standards (TSs) from U.S. medical schools (MD- and DO-granting) and evaluated these relative to intent to comply with the Americans with Disabilities Act (ADA).

Method
Document analysis was conducted (2012–2014) on U.S. medical schools’ TSs for hearing, visual, and mobility disabilities. Primary outcome measures were ease of obtaining TSs, willingness to provide reasonable accommodations, responsibility for accommodations, and acceptability of intermediaries or auxiliary aids.

Results
TSs were available for 161/173 (93%) schools. While 146 (84%) posted these on their Web sites, 100 (58%) were located easily. Few schools, 53 (33%), had TSs specifically supporting accommodating disabilities; 79 (49%) did not clearly state policies, 6 (4%) were unsupportive, and 23 (14%) provided no information. Most schools, 98 (61%), lacked information on responsibility for providing accommodations, 33 (27%) provided accommodations, and 10 (6%) had students assume some responsibility. Approximately 40% allowed auxiliary aids (e.g., motorized scooter), but < 10% allowed intermediaries (e.g., sign language interpreter). Supportive schools were more likely to allow accommodations (P < .001), assume responsibility for accommodations (P < .001), and accept intermediaries (P < .002). DO-granting schools were more supportive for students with mobility disabilities.

Conclusions
Most medical school TSs do not support provision of reasonable accommodations for students with disabilities as intended by the ADA. Further study is needed to understand how schools operationalize TSs and barriers to achieving ADA standards.
Tools to Assess Behavioral and Social Science Competencies in Medical Education: A Systematic Review
Authors: Carney Patricia A. , Palmer Ryan T. , Fuqua Miller Marissa , Thayer Erin K. , Estroff Sue E. , Litzelman Debra K. , Biagioli Frances E. , Teal Cayla R. , Lambros Ann , Hatt William J. , Satterfield Jason M. 
Published: January 2016

Purpose
Behavioral and social science (BSS) competencies are needed to provide quality health care, but psychometrically validated measures to assess these competencies are difficult to find. Moreover, they have not been mapped to existing frameworks, like those from the Liaison Committee on Medical Education (LCME) and Accreditation Council for Graduate Medical Education (ACGME). This systematic review aimed to identify and evaluate the quality of assessment tools used to measure BSS competencies.

Method
The authors searched the literature published between January 2002 and March 2014 for articles reporting psychometric or other validity/reliability testing, using OVID, CINAHL, PubMed, ERIC, Research and Development Resource Base, SOCIOFILE, and PsycINFO. They reviewed 5,104 potentially relevant titles and abstracts. To guide their review, they mapped BSS competencies to existing LCME and ACGME frameworks. The final included articles fell into three categories: instrument development, which were of the highest quality; educational research, which were of the second highest quality; and curriculum evaluation, which were of lower quality.

Results
Of the 114 included articles, 33 (29%) yielded strong evidence supporting tools to assess communication skills, cultural competence, empathy/compassion, behavioral health counseling, professionalism, and teamwork. Sixty-two (54%) articles yielded moderate evidence and 19 (17%) weak evidence. Articles mapped to all LCME standards and ACGME core competencies; the most common was communication skills.

Conclusions
These findings serve as a valuable resource for medical educators and researchers. More rigorous measurement validation and testing and more robust study designs are needed to understand how educational strategies contribute to BSS competency development.
Is There a Consensus on Consensus Methodology? Descriptions and Recommendations for Future Consensus Research
Authors: Waggoner Jane , Carline Jan D. , Durning Steven J. 
Published: January 2016

The authors of this article reviewed the methodology of three common consensus methods: nominal group process, consensus development panels, and the Delphi technique. The authors set out to determine how a majority of researchers are conducting these studies, how they are analyzing results, and subsequently the manner in which they are reporting their findings. The authors conclude with a set of guidelines and suggestions designed to aid researchers who choose to use the consensus methodology in their work.
Overall, researchers need to describe their inclusion criteria. In addition to this, on the basis of the current literature the authors found that a panel size of 5 to 11 members was most beneficial across all consensus methods described. Lastly, the authors agreed that the statistical analyses done in consensus method studies should be as rigorous as possible and that the predetermined definition of consensus must be included in the ultimate manuscript. More specific recommendations are given for each of the three consensus methods described in the article.
Professional Formation in the Gross Anatomy Lab and Narrative Medicine: An Exploration
Authors: Kissler Mark J. , Saxton Ben , Nuila Ricardo , Balmer Dorene F. 
Published: January 2016

As an early and important experience in medical education, dissection in the gross anatomy lab is a locus of professional formation. Because students often think of their professional development in evolving, narrative terms, the authors propose that close attention to these narratives might add to understanding of professional formation in progress. They solicited written reflections from students, to explore ways that both the content and form of written reflections might illuminate themes relevant to professional formation, and to describe some elements of professional formation in the context of one institution (Baylor College of Medicine, Houston, Texas). Seventeen students participated in writing sessions and wrote in response to an oral interview transcript and to a poem. Using a reading approach that grew out of the narrative medicine movement, the authors collaboratively engaged the content and form of these written reflections.Students’ collection of written reflections was a rich source of information about their experiences in the anatomy lab. Through both content (e.g., expressions of gratitude, transitions, self-awareness) and form (e.g., from less detailed writing to literary playfulness), their writings gave a glimpse into the tensions, disappointments, and satisfactions of the practice of gross anatomy.This project models one way that educators can read and respond to the reflective writing that students generate. The authors go on to propose ways that interactions around reflective writing can be part of a broader goal of forming narrative-minded physicians, who become increasingly self- and other-aware as they progress in their education and practice.
Are Low Patient Satisfaction Scores Always Due to the Provider?
Authors: Bible Jesse E. , Shau David N. , Kay Harrison F. , Cheng Joseph S. , Aaronson Oran S. , Devin Clinton J. 
Published: January 2016

Study Design.
A prospective study.

Objective.
The aim of this study was to investigate the impact of various components on patient satisfaction scores

Summary of Background Data.
Patient satisfaction has become an important component of quality assessments. However, with many of these sources collecting satisfaction data reluctant to disclose detailed information, little remains known about the potential determinants of patient satisfaction.

Methods.
Two hundred patients were contacted via phone within 3 weeks of new patient encounter with 11 spine providers. Standardized patient satisfaction phone survey consisting of 25 questions (1–10 rating scale) was administered. Questions inquired about scheduling, parking, office staff, teamwork, wait-time, radiology, provider interactions/behavior, treatment, and follow-up communication. Potential associations between these factors and three main outcome measures were investigated: (1) provider satisfaction, (2) overall clinic visit satisfaction, and (3) quality of care.

Results.
Significant associations (P < 0.0001) with provider satisfaction, overall clinic visit satisfaction, and perceived overall quality of care were found with appointment scheduling, parking, office staff, teamwork, wait time, radiology, provider interactions/behavior, treatment, and follow-up communication. Nurse-practitioner/resident involvement was positively associated with scores (P ≤ 0.03). A “candy-man” effect was not noted, as pain medication prescribing did not play a significant role in satisfaction (P > 0.05).
In multivariate regression analysis, explanation of medical condition/treatment (P = 0.002) and provider empathy (P = 0.04) were significantly associated with provider satisfaction scores, while the amount of time spent with the provider was not. Conversely, teamwork of staff/provider and follow-up communication were significantly associated with both overall clinic visit satisfaction and quality of care (P ≤ 0.03), while provider behaviors or satisfaction were not.

Conclusion.
Satisfaction with the provider was associated with better explanations of the spine condition/treatment plan and provider empathy, but was not a significant factor in either overall clinic visit satisfaction or perceived quality of care. Patients’ perception of teamwork between staff and providers along with reliable follow-up communication were found to be significant determinants of overall patient satisfaction and perceived quality of care.

Level of Evidence: 3