Multidisciplinary Questions Research Articles

Performance of ChatGPT on the India Undergraduate Community Medicine Examination: Cross-Sectional Study.

Medical students may increasingly use large language models (LLMs) in their learning. ChatGPT is an LLM at the forefront of this new development in medical education with the capacity to respond to multidisciplinary questions. The aim of this study was to evaluate the ability of ChatGPT 3.5 to complete the Indian undergraduate medical examination in the subject of community medicine. We further compared ChatGPT scores with the scores obtained by the students. The study was conducted at a publicly funded medical college in Hyderabad, India. The study was based on the internal assessment examination conducted in January 2023 for students in the Bachelor of Medicine and Bachelor of Surgery Final Year-Part I program; the examination of focus included 40 questions (divided between two papers) from the community medicine subject syllabus. Each paper had three sections with different weightage of marks for each section: section one had two long essay-type questions worth 15 marks each, section two had 8 short essay-type questions worth 5 marks each, and section three had 10 short-answer questions worth 3 marks each. The same questions were administered as prompts to ChatGPT 3.5 and the responses were recorded. Apart from scoring ChatGPT responses, two independent evaluators explored the responses to each question to further analyze their quality with regard to three subdomains: relevancy, coherence, and completeness. Each question was scored in these subdomains on a Likert scale of 1-5. The average of the two evaluators was taken as the subdomain score of the question. The proportion of questions with a score 50% of the maximum score (5) in each subdomain was calculated. ChatGPT 3.5 scored 72.3% on paper 1 and 61% on paper 2. The mean score of the 94 students was 43% on paper 1 and 45% on paper 2. The responses of ChatGPT 3.5 were also rated to be satisfactorily relevant, coherent, and complete for most of the questions (>80%). ChatGPT 3.5 appears to have substantial and sufficient knowledge to understand and answer the Indian medical undergraduate examination in the subject of community medicine. ChatGPT may be introduced to students to enable the self-directed learning of community medicine in pilot mode. However, faculty oversight will be required as ChatGPT is still in the initial stages of development, and thus its potential and reliability of medical content from the Indian context need to be further explored comprehensively.

Neuroaesthetics in Plastic and Reconstructive Surgery: Opportunities for Interdisciplinary Collaboration.

Neuroaesthetics is a burgeoning discipline concerned with the neural basis for the perception and creation of art1 and neuroscientific mechanisms of human aesthetic experiences.2 Research in this field has combined principles of neurology, neuroanatomy, psychology, and art history to answer questions about the experience of beauty.2 Vision has received particularly close attention, especially human perception of faces, paintings, landscapes, and architecture.3 Neuroaesthetics has made meaningful contributions to unraveling neurologic mechanisms underpinning the aesthetic experience, previously regarded as a philosophical concept. Research has demonstrated aesthetic evaluations are important for human activity in consumer behavior, mate selection, and determination of morality.4 The field has identified neuroanatomic structures implicated in the perception of beauty broadly, notably the medial orbital frontal cortex, as well as cortical and subcortical structures specific to certain visual or auditory experiences.2 Within plastic surgery, neuroaesthetics overlaps with the specialty’s goal of characterizing optimal aesthetic outcomes for people. Plastic surgery research on aesthetic preferences may be augmented through collaboration with our colleagues in neuroaesthetics, who offer valuable expertise in neuroscience and aesthetic principles. In return, plastic surgery offers clinical, anatomic, and human aesthetic perspectives that may broaden the neuroaesthetic scope of inquiry. The fields complement one another to enhance the sophistication of questions posed, data generated, and analyses of those data. One example of such a collaboration is the University of Pennsylvania’s Center for Human Appearance, in which neuroaesthetics, plastic surgery, oral surgery, dermatology, oculoplastic surgery, and ear, nose, and throat play key complementary roles in designing studies that enhance understanding of appearance and clinical outcomes. Examples of the center’s initiatives include employing crowdsourcing to compare layperson aesthetic preferences, applying eye-tracking technology to characterize gaze patterns toward visual stimuli, and leveraging face databases to associate character traits to those with facial anomalies.1 Such studies have had an effect on understanding clinical outcomes in aesthetics, craniofacial surgery, and breast surgery. These clinical studies may be augmented with techniques common to the neuroaesthetics toolbox, including functional magnetic resonance imaging or magnetoencephalography to characterize brain activity in response to visual stimuli or convolutional neural networks to learn image features from datasets.5 Other efforts to leverage architectural and artistic principles are also poised to improve health care infrastructure and optimize the patient experience. Plastic surgery has not been regarded as a subdomain of neuroaesthetics inquiry. Plastic surgery would be an asset to the evolution of neuroaesthetics and should seek opportunities to foster relationships with colleagues in this nascent field. This convergence of interests is an exciting opportunity to continue plastic surgery’s history of collaboration to answer unique, multidisciplinary questions with implications for the outcomes of our patients. Disclosure The authors have no financial interest to declare in relation to the content of this article.

Towards climate targets with cropland afforestation – effect of subsidies on profitability

Afforesting unutilized or low-productivity agricultural land is important for achieving ambitious climate targets, and subsidy schemes may incentivize this land-use change. To determine how subsidies affect the relative performance of afforestation, we analyze both carbon-flux-based and lump sum afforestation subsidies. Utilizing detailed empirically estimated ecological models based on Finnish conditions, combined with economic descriptions of agriculture and forestry, enables us to study this complex multidisciplinary question with minimal simplifications. We calculate the economic performance of both agriculture and forestry using different interest rates, afforestation costs, and subsidies to determine how each economic parameter affects the relative economic profitability of each land-use alternative. We show that afforestation can be more profitable than low-income (€70/ha) agriculture, even without subsidies. On high-income (€200/ha) cereal farms, forestry is more profitable than agriculture if carbon is subsidized at a medium level (€100/tC), and afforestation costs are less than €2000/ha. If afforestation costs are high (€2000 +/ha), additional afforestation subsidies are needed for the forestry to be competitive with agriculture. If agricultural income per hectare is very high (€600/ha), forestry remains less profitable unless carbon subsidies (€600/tC) or additional afforestation subsidies are very high.

Quantifying sediment connectivity: Moving toward a holistic assessment through a mixed methods approach

AbstractThe sediment connectivity concept is particularly suitable for tackling complex, multidisciplinary questions through systems thinking. However, it is unclear how to directly measure connectivity, and so proxy variables are often applied by indices to provide estimates. In this study, we critically evaluate a broad range of connectivity indices encompassing structural and functional connectivity as well as hillslope channel coupling. We then discuss their role in providing a more holistic estimation of connectivity within the Tahoma Creek Watershed, WA. Of the 14 km of channel below the glacier front, the upper 6 km (0–6 km) are coupled to the adjacent hillslopes. Coupled reaches correspond to regions with a high proportion of area contributing sediment and relatively high connectivity values, where all measures decrease in the downstream direction. A significant transition occurs near river kilometer 6. Here the valley bottom abruptly widens, deposition occurs, and the hillslopes become decoupled from the active channel. This transitional reach is also identified as a geomorphic hotspot based on the network structure. The lower 8 km of channel downstream of this reach are largely depositional and percent contributing area and connectivity values remain low, eventually reaching a minimum. Despite their limitations, we found each method to provide unique and useful information regarding connectivity. The effect of scale and event magnitude on connectivity is illustrated. We also found vegetation, topographic characteristics, and network structure to be important in high‐gradient glacio‐volcanic landscapes. The choice of an index will depend on the research objectives, data availability, and the proxy variables that best describe the variability within the defined area.

The Alzheimer patient from the dermatologist's point of view.

Alzheimer's disease (AD) is characterized by a cluster of signs and symptoms that include memory loss, language disturbances, psychological and psychiatric changes and difficulty in carrying out daily activities. Although it may seem to be far from a dermatologic competence, the ageing of populations in industrialized and developing countries has changed things, making AD a multidisciplinary question. Indeed, this neurodegenerative disorder is not exclusively neurological, but rather may involve multiple tissues and organs. The abnormalities in metabolic and biochemical processes described in affected brains are also present in the skin and may condition specific dermatological manifestations. In fact, although a history of non-melanoma skin cancer is linked to a significantly reduced risk of developing AD, this is not so for melanoma. Several biological, social and environmental hypotheses can be advanced to explain these correlations. AD patients' memory problems and the partial inability to express an informed consent, could make a simple tumor excision challenging for a dermatologic surgeon. Moreover, attention should also be paid to the possibility of pharmacological interactions with AD therapies and to surgery timing. Observational studies have provided evidence for a non-spurious correlation between bullous pemphigoid (BP) and dementia. The demonstration of neurological isoforms of both BP180 and BP230 in the central nervous system has provided partial explanations for these findings and raised the question as to whether AD patients should be given accurate screening for BP and vice versa. Some adverse skin reactions have been observed with AD drugs and although mainly localized others are diffuse. Importantly, some of these drugs are available for administration in a patch or systemic form. When dealing with bedridden patients, the skin examination should be as complete as possible, since ulcer location is not only influenced by pressure and paratonia but also by spasticity, conditioning wounds in atypical sites.

Practicing Democracy on Wicked Problems Through Deliberation: Essentials for Civic Learning and Student Development

Infusing the curriculum with deliberative practice transforms civic education from episodic moments to sustained practice. The capacities necessary for productive and meaningful democratic engagement— critical thinking, empathic listening, creative problem solving, ethical leadership, and collaboration—are not only essential for sustaining a vibrant democracy, they are the best preparation for our students-citizens to be successful in the 21st century. The practice of deliberation cultivates students thinking to explore enduring, and multidisciplinary questions and address persistent (and wicked) public problems. Students who engage in deliberative practice see politics differently and experience enhanced engagement in their democratic lives.

Aligning hearts and minds: creation of an integrated cardiovascular pharmacy course

BackgroundIn order to train pharmacy students to function within a large, complex healthcare system, the curriculum needs to integrate disciplines, theory and practice (1,2). Moreover, curricular integration is explicitly called for in the accreditation standards for pharmacy programs in the US(3).The UCSF School of Pharmacy launched a new, three‐year curriculum in 2018 that focuses on using pedagogic strategies that facilitate integrative learning, such as ability‐based outcomes to define learning expectations, case‐ and problem‐based learning, capstone courses, experiential learning, and comprehensive authentic assessment(4). Here we report on the design of and early outcomes from an integrated cardiovascular block.MethodsThe overall course objectives for the cardiovascular (CV) course were developed in a multidisciplinary team to address “what skills and knowledge does a PharmD student need to succeed in clinical rotations?” Anchor cases cover key conditions and serve as the springboard to basic science topics and to illustrate its relevance to clinical practice. Relevant session objectives were selected and modified in collaborative, multidisciplinary team meetings. An interactive process narrowed down the topics to fit in the template calendar. Instructors used session objectives to design online and in‐class learning materials and assessments.Weekly, required formative assessments included case‐based 10–12 constructed response questions with detailed answer keys. Summative exams followed a similar format as the formative assessments and contained MCQs.Pharmacology items on summative exams in the legacy and current CV courses were categorized by Blooms Level 1–4 (1: define/identify, 2: explain/recall, 3: apply, 4: evaluate), and an average Bloom’s score per exam was calculated. Student evaluations were collected using Evalue.ResultsWeekly anchor cases are acute coronary syndrome, chronic stable angina, dyslipidemia, heart failure, and arrhythmias. Each week, relevant disciplines (physio, biochem, anat pcol, therapeutics, biostats, etc.) focus on the cases, while the experiential arm provides relevant clinical skills and experiences. ○ Legacy curriculum: Blooms Level per exam: ave 2.2 SEM=0.06) ○ New curriculum: Blooms Level: ave 3.45 (SEM=0.14) ○ Student performance on PCOL questions, some of which are multidisciplinary ranged from 79 – 99% ○ Lower performance was associated with multidisciplinary questions ○ Passing rate on 3 exams ranged from 91–97% ○ Students listed integration, clinical cases and formative assessments as strengths, and high workload and integration of inquiry as areas for improvement.Discussion ○ Integration requires frequent meetings and adaptation of teaching materials driven by a list of essential knowledge and skills, per condition provided by therapeutics. ○ Centralized, administrative course support is essential in both design and implementation phases. ○ Lower student performance on multidisciplinary questions indicate that students are learning to apply knowledge to clinical scenarios.ConclusionFrequent, collaborative meetings are important in creating an integrated course.Evaluation and exam performance data show that this course teaches students to apply pharmacology knowledge to clinical cases.

Ross C. Puffer: Neurosurgery primary board review

Ross C. Puffer presents “Neurosurgery Primary Board Review,” a contemporary question and answer book of 170 pages (paperback), primarily intended for residents preparing their neurosurgical board examination. The book is divided into seven chapters, according to the structure of the American Board of Neurological Surgery (ABNS) primary written exam, as follows: neurosurgery, neurology, neuroanatomy, neurobiology, neuropathology, neuroimaging, and fundamental skills. The book’s key feature is the abundant and up-to-date question bank, comprising 1500 multidisciplinary questions. Of those, 600 multiple-choice questions can be found in the book, accompanied by corresponding answer keys that include short explanations for each answer. Those questions are also enriched by 217 illustrations, which are suitably placed within the text. The remaining 900 questions can be accessed online.

1636PD - Analysis of 105,000 cancer patients: Have they been discussed in oncologic multidisciplinary team meetings? A nationwide population-based study in the Netherlands

BackgroundFor optimal oncological care it is recommended to discuss every patient with cancer in a multidisciplinary team meeting (MDTM). Due to increasing incidence and prevalence of cancer and emergence of dedicated tumour specific MDTMs, the number of patients that needs to be discussed rises, and the time- and financial burden is growing. This leads to a growing demand to change the current workflow. We aimed to investigate the number of patients discussed in current daily practice of MDTMs and aimed to identify characteristics that associate with not being discussed. MethodsData of patients with a newly diagnosed solid malignant tumour in 2015 and 2016 were analyzed through the nationwide population-based Netherlands Cancer Registry (NCR). We clustered all different tumour types in 8 groups that were frequently discussed within a tumour specific MDTM; 1. upper gastro-intestinal- , 2. hepato-pancreatic-biliary- , 3. colorectal-, 4. gynaecological- , 5.central nervous system-, 6. head and neck-, 7. breast- and 8. prostate cancers. Tumour types without information about MDTMs in the NCR were excluded. Multivariable logistic regression analyses were used to analyze which factors were associated with not being discussed in a MDTM. ResultsOut of 105.305 patients, 91% were discussed in a MDTM; varying from 74%-99% between the different tumour groups. Significantly less frequently discussed were patients aged ≥ 75 years (OR=0.7, 95%CI=0.6-0.7), diagnosed with disease stage I (OR=0.5, 95%CI=0.5-0.6), IV (OR=0.4, 95%CI=0.4-0.4) or unknown (OR=0.2, 95%CI=0.2-0.2), and patients that received no treatment (OR=0.3, 95%CI=0.3-0.3). Patients that received a multidisciplinary treatment were more likely to be discussed compared to patients with a monodisciplinary treatment (OR=4.6, 95%CI=4.2-5.1). ConclusionsIn general most cancer patients are actually discussed in a MDTM in the Netherlands, although differences were observed between tumour groups. Factors associated with not being discussed may, at least partially, reflect the absence of a multidisciplinary question. These results form a starting point for debate towards a more durable and efficient new MDTM strategy. Legal entity responsible for the studyThe authors. FundingHas not received any funding. DisclosureV.E.P.P. Lemmens: Research grant / Funding (institution): Roche. R.H.A. Verhoeven: Research grant / Funding (self): Roche; Research grant / Funding (self): Bristol-Myers Squibb. All other authors have declared no conflicts of interest.

Analysis of 105.000 patients with cancer: have they been discussed in oncologic multidisciplinary team meetings? A nationwide population-based study in the Netherlands

IntroductionFor optimal oncological care, it is recommended to discuss every patient with cancer in a multidisciplinary team meeting (MDTM). This is a time consuming and expensive practice, leading to a growing demand to change the current workflow. We aimed to investigate the number of patients discussed in MDTMs and to identify characteristics associated with not being discussed. MethodsData of patients with a newly diagnosed solid malignant tumour in 2015 and 2016 were analysed through the nationwide population-based Netherlands Cancer Registry (NCR). We clustered tumour types in groups that were frequently discussed within a tumour-specific MDTM. Tumour types without information about MDTMs in the NCR were excluded. Multivariable logistic regression analyses were used to analyse factors associated with not being discussed. ResultsOut of 105.305 patients with cancer, 91% were discussed in a MDTM, varying from 74% to 99% between the different tumour groups. Significantly less frequently discussed were patients aged ≥75 years (odds ratio [OR] = 0.7, 95% confidence interval [CI] = 0.6–0.7), patients diagnosed with disease stage I (OR = 0.5, 95% CI = 0.5–0.6), IV (OR = 0.4, 95% CI = 0.4–0.4) or unknown (OR = 0.2, 95% CI = 0.2–0.2) and patients who received no treatment (OR = 0.3, 95% CI = 0.3–0.3). Patients who received a multidisciplinary treatment were more likely to be discussed in contrary to a monodisciplinary treatment (OR = 4.6, 95% CI = 4.2–5.1). ConclusionIn general, most patients with cancer were actually discussed in a MDTM, although differences were observed between tumour groups. Factors associated with not being discussed may, at least partially, reflect the absence of a multidisciplinary question. These results form a starting point for debate on a more durable and efficient new MDTM strategy.

A Practive Faeces Collection Protocol for Multidisciplinary Research in Wildlife Science

Faecal samples have become an important noninvasive source of information in wildlife biology and ecological research. Despite regular use of faeces, there is no universal protocol available for faeces collection and storage to answer various questions in wildlife biology. In this study we collected 1408 faeces from ten different species using a dry sampling approach, and achieved 77.49% and 75.25% success rate in mitochondrial and nuclear marker amplifications respectively. We suggest a universal framework to use the same samples to answer different questions. This protocol provides an easy, quick and cheap option to collect non-invasive samples from species living in different environmental conditions to answer multidisciplinary questions in wildlife biology.

Formation of the Universe and Some Multidisciplinary Questions of Connections

Formation of the Universe and Some Multidisciplinary Questions of Connections

Formation of the Universe and Some Multidisciplinary Questions of Connection

We see diversities among the contemporary theories, but proper explanation to the earth's atmosphere is absent. Actually, formation of the universe is a part of the history; we have a specific discipline for studying the past. If we go through the history to that edge just before the philosopher Aristotle's, geography of as a discipline will seem different. But, in that time too, questions about geography of the universe existed; thus this topic is amongst the oldest disciplines of knowledge. Therefore, reviewing literatures from the possible historical principal resources has the utmost demand of necessity towards this question. As the above stated logic, information has been gathered from the principal resource of history. Because of the author's limitations of knowledge; information has been highlighted only from Al-Quran and its related references (similar information could be found in other principal resources). It has been mentioned as the prime resource of knowledge in this article. As a result, this article shows explanation to the atmosphere of the earth and the geography of the universe with a comparison to the perspectives of outside. Again, it shows some connections among the disciplines through the inquiry; and the necessity of reviewing authentic historical documentations. This article, if considered as thought, has a flow like conversations because of the verbal mode of transmission. This is mainly an association of knowledge; questions presented are the part of this approach.

Salvage harvesting for bioenergy in Canada: From sustainable and integrated supply chain to climate change mitigation

Driven by the policy imperatives of mitigating greenhouse gas (GHG) emissions and improving energy security, an increasing proportion of global energy demand is being met by nonfossil energy sources. The socioeconomic and environmental benefits of replacing fossil fuels with bioenergy are complex; however, debate continues about issues such as best practices for biomass removal, stable supply chains, and GHG mitigation. With the greatest biomass per capita in the world, Canada could play an increasing role in the future of global bioenergy and the emerging bioeconomy. This paper reviews the utilization of feedstock salvaged after natural disturbances (fire and insect outbreaks) to supply wood‐based bioenergy, by addressing the following multidisciplinary questions: (1) How much salvaged feedstock is available, and what are the uncertainties around these estimates? (2) How can sustainable practices to support increased removal of biomass be implemented? (3) What are the constraints on development of an integrated supply chain and cost‐effective mobilization of the biomass? (4) Is the quality of biomass from salvaged trees suitable for conversion to bioenergy? (5) What is the potential for climate change mitigation? In average, salvaged feedstock from fire and insects could theoretically provide about 100 × 106 oven Dry ton (ODT) biomass per year, with high variability over time and space. Existing policies and guidelines for harvesting of woody biomass in Canadian jurisdictions could support sustainable biomass removal. However, uncertainties remain as to the development of competitive and profitable supply chains, because of the large distances between the locations of this feedstock and available processing sites. Another uncertainty lies in the time needed for a benefit in climate change mitigation to occur. A flexible supply chain, integrated with other sources of biomass residues, is needed to develop a cost‐efficient bioenergy sector.This article is categorized under: Bioenergy > Climate and Environment

Aspects of endocrine ophthalmopathy surgical treatment by ENT specialist

Актуальность. Лечение эндокринной офтальмопатии (ЭОП) является одной из чрезвычайно актуальных на сегодняшний день мультидисциплинарных проблем. Хирургическая помощь пациентам с ЭОП недостаточна именно вследствие недостаточного взаимодействия офтальмологов, эндокринологов и оториноларингологов. Возможности использования эндоназальной эндоскопической хирургии в смежных анатомических областях чрезвычайно актуальны в настоящее время. И приоритетной задачей оториноларингологов на сегодняшний день является изучение и разработка техники трансназальных, трансэтмоидальных, транссфеноидальных эндоскопических хирургических вмешательств на структурах основания черепа и орбиты с целью минимизации инвазивности и повышения эффективности лечения ряда патологий, в том числе эндокринной офтальмопатии.
 Цель. Оценить возможности хирургического лечения эндокринной офтальмопатии – трансэтмоидальной декомпрессии орбиты в отношении коррекции экзофтальма.
 Методы. В исследование были включены 64 пациента с эндокринной офтальмопатией при неэффективности медикаментозного лечения, хирургическое лечение которых было проведено с 2006 по 2016 год. Прооперировано 90 орбит. Пациентам выполнялась трансэтмоидальная декомпрессия орбиты (ТЭДО).
 Результаты. У всех пациентов в послеоперационном периоде отмечена стойкая положительная динамика, выражавшаяся в уменьшении экзофтальма, и улучшении качества жизни в связи с исчезновением косметического дефекта, однако у всех пациентов мы наблюдали разной степени выраженности транзиторную или стойкую послеоперационную диплопию. Ни у кого из пациентов не отмечено орбитальных инфекционных осложнений или других клинически значимых инфекций полости носа и околоносовых пазух.
 Заключение. В представленном нами исследовании продемонстрирована высокая клиническая эффективность ТЭДО в отношении регресса экзофтальма. Экзофтальм в среднем уменьшился у всех пациентов на 5,1 мм, а уровень послеоперационной диплопии составил менее чем 20% случаев.

Modeling the impacts of water transfer on water transport pattern in Lake Chao, China

Water transport pattern plays an important role in determining water and pollution transport, and is worth our investigation. In this study, a hydrological model (Xinanjiang) and a hydrodynamic model (Environmental Fluid Dynamics Code, EFDC) were coupled to investigate the impacts of a water transfer project on the water transport pattern of Lake Chao, China. The Xinanjiang model simulated the inflow discharges for the EFDC model. The validation results were acceptable with a Nash–Sutcliffe coefficient of 0.74 and 0.84 for the Xinanjiang and EFDC models. Based on the calibrated models, four simulations were implemented and compared to evaluate the impacts of the water transfer project on the water transport pattern, described by water age and residence time. The simulation results revealed that the water transfer project had the potential to shorten water age and residence time of the lake, however, should be carried out by considering the influences of wind conditions and water transfer route. This study demonstrated a successful adaption of water age and residence time for describing water transport pattern, and highlighted the importance of model coupling approach in addressing multidisciplinary questions from the complex natural ecosystem.

CanSAR: an updated cancer research and drug discovery knowledgebase.

canSAR (http://cansar.icr.ac.uk) is a publicly available, multidisciplinary, cancer-focused knowledgebase developed to support cancer translational research and drug discovery. canSAR integrates genomic, protein, pharmacological, drug and chemical data with structural biology, protein networks and druggability data. canSAR is widely used to rapidly access information and help interpret experimental data in a translational and drug discovery context. Here we describe major enhancements to canSAR including new data, improved search and browsing capabilities, new disease and cancer cell line summaries and new and enhanced batch analysis tools.

Advantages of concurrent use of multiple software frameworks in water quality modelling using a database approach

Water quality modelling deals with multidisciplinary questions ranging from fundamental to applied. Addressing this broad range of questions requires multiple analysis techniques and therefore multiple frameworks. Through the recently developed database approach to modelling (DATM), it has become possible to run a model in multiple software frameworks without much overhead. Here we apply DATM to the ecosystem model for ditches. PCDitch and its twin model for shallow lakes PCLake. Using DATM, we run these models in six frameworks (ACSL, DELWAQ, DUFLOW, GRIND for MATLAB, OSIRIS and R), and report on the possible model analyses with tools provided by each framework. We conclude that the dynamic link between frameworks and models resulting from DATM has the following main advantages: it allows one to use the framework one is familiar with for most model analyses and eases switching between frameworks for complementary model analyses, including the switch between a 0-D and 1-D to 3-D setting. Moreover, the strength of each framework – including runtime performance – can now be easily exploited. We envision that a community-based further development of the concept can contribute to the future development of water quality modelling, not only by addressing multidisciplinary questions but also by facilitating the exchange of models and process formulations within the community of water quality modellers.

CanSAR: updated cancer research and drug discovery knowledgebase

canSAR (http://cansar.icr.ac.uk) is a public integrative cancer-focused knowledgebase for the support of cancer translational research and drug discovery. Through the integration of biological, pharmacological, chemical, structural biology and protein network data, it provides a single information portal to answer complex multidisciplinary questions including—among many others—what is known about a protein, in which cancers is it expressed or mutated, and what chemical tools and cell line models can be used to experimentally probe its activity? What is known about a drug, its cellular sensitivity profile and what proteins is it known to bind that may explain unusual bioactivity? Here we describe major enhancements to canSAR including new data, improved search and browsing capabilities and new target, cancer cell line, protein family and 3D structure summaries and tools.

Le vieillissement traumatique

With the increase in life expectancy and dementia, the clinical question of post-traumatic stress disorder (PTSD) in the elderly is a major public health issue. PTSD is structured or restructured in old age according to several psychodynamic variants, which can be a reaction to a psychic trauma that is presented de novo; PTSD can also develop at a young age to later become chronic in old age. PTSD can thus be diagnosed very remotely, in time, from the event that was once the cause. The clinical presentation of PTSD is not constant but fluctuates over time: Following the apogee during the acute phase, the psychotraumatic symptoms decrease for a few years or even decades before increasing again at the start of old age. If traumatic or stressful life events that occur during old age can be isolated from a previously structured PTSD, the themes of the suffering experienced within the life history overlap. The symptoms of PTSD can evolve through absence, fluctuating over time to be updated in the elderly person through an organic pathology, sensory deficiency disorders, a cognitive decline or an institutionalization. Over time, the specific symptoms (reexperiencing, avoidance and hypervigilance) decrease in favor of nonspecific symptoms (asthenia, depression, use of psychoactive substances). The somatic presentation of PTSD is a fundamental aspect of the request for treatment in elderly patients: A somatic illness can lead to a PTSD de novo or cause old psychological psychotraumatic pain to reappear. With age the revivifications wane in favor of hypervigilance and avoidance strategies. The latter are at the forefront of “post-fall syndrome”, a syndrome considered as a psychotraumatic picture specific to the elderly person that develops into a normal aging process or dementia. In the face of a potentially traumatogenic situation, the integrity of the cognitive abilities is primordial to ensure a non-pathological psychological resolution. The difficulty in inhibiting traumatic memories will lead to their update. Likewise, PTSD is the locus of a decline in cognitive functions: recent or prolonged stress precedes the development of dementia in 80% of cases, playing the role of a triggering factor or facilitator. As revivifications are expressed more clinically due to neurocognitive disorders, it can be feared that the appearance or the exacerbation of a latent PTSD is the sign of the onset of dementia. Hypocampal atrophy with relative conservation of the amygdala is a biological support for dementia such as PTSD: pathological compensatory mnemic mechanisms could be at work here favoring productions that do not reflect real memories but thoughts guided by semantic knowledge. The absence of possibility of symbolizing death beyond life can fix thoughts on an ancient, unresolved confrontation where this death has already imposed itself. Far from a trivialization or a fatalistic vision of psychotraumatic disorders in elderly people, we wished to highlight research prospects, which open up the way to multidisciplinary questions notably including anthropological determinants. A dementia process can associate, at clinical level, hypo- and hypermnesic affections. It is thus fitting to assert the interest of considering dementia not only from a deficiency point of view but also according to its productive aspects. At an advanced stage of dementia it is difficult to establish a diagnosis of PTSD, all the more so as the emotional memory is affected.