bluuebunny/crossref_metadata_2025 huggingface dataset:
Formation of Nanoporous Gold Film on Ti by Anodization in Oxalic Acid
Authors: Nishio Kazuyuki , Udagawa Yuta
Published: June 2021

A nanoporous gold (NPG) film was formed on a Ti sheet or sputter-deposited thin Ti film by the anodization of a thin gold film on the Ti substrates in oxalic acid. A remarkably low anodic current of the Ti sheet compared with that of the Al sheet indicates that Ti is a stable substrate for the NPG film formed by the anodization. It is also confirmed that the preanodization of the Ti sheet significantly improves the adhesion of the NPG film to Ti. By increasing the anodic potential, NPG film was formed on sputter-deposited thin Ti film with a thickness of 130 nm.
Unwatched Pollution: The Effect of Intermittent Monitoring on Air Quality
Authors: Zou Eric Yongchen
Published: June 2021

Intermittent monitoring of environmental standards may induce strategic changes in polluting activities. This paper documents local strategic responses to a cyclical, once-every-six-day air quality monitoring schedule under the federal Clean Air Act. Using satellite data of monitored areas, I show that air quality is significantly worse on unmonitored days. This effect is explained by short-term suppression of pollution on monitored days, especially during high-pollution periods when the city’s noncompliance risk is high. Cities’ use of air quality warnings increases on monitored days, which suggests local governments’ role in coordinating emission reductions. (JEL K32, Q35, Q58, R11)
A first radiotherapy application of functional bulboclitoris anatomy, a novel female sexual organ-at-risk, and organ-sparing feasibility study
Authors: Marshall Deborah C , Ghiassi-Nejad Zahra , Powers Allison , Reidenberg Joy S , Argiriadi Pamela , Ru Meng , Dumane Vishruta , Buckstein Michael , Goodman Karyn , Blank Stephanie V , Schnur Julie , Rosenstein Barry
Published: June 2021

Objective:

The bulboclitoris (clitoris and vestibular bulbs) is the primary organ responsible for female sexual arousal and orgasm. Effects of radiotherapy on the bulboclitoris are unknown, as its structure/function has yet to be described in radiotherapy, and it overlaps only partially with the external genitalia structure. Our aim was to: describe bulboclitoris structure, function and delineation; compare volume of and dose delivered to the bulboclitoris vs external genitalia; and, compare bulboclitoris-sparing IMRT (BCS-IMRT) to standard IMRT (S-IMRT) to determine reoptimization feasibility.

Methods:

Our expert team (anatomist, pelvic radiologist, radiation oncologist) reviewed bulboclitoris anatomy and developed contouring guidance for radiotherapy. 20 female patients with anal cancer treated with chemoradiation were analyzed. Sexual organs at risk (OARs) included the external genitalia and the bulboclitoris. Volumes, dice similarity coefficients (DSCs) and dose received using S-IMRT were compared. Plans were reoptimized using BCS-IMRT. Dose–volume histograms (DVHs) for PTVs and all OARs were compared for BCS-IMRT vs S-IMRT.

Results:

Bulboclitoris structure, function and delineation are described herein. The bulboclitoris occupies 20cc (IQR:12–24), largely distinct from the external genitalia (DSC <0.05). BCS-IMRT was superior to S-IMRT in reducing the dose to the bulboclitoris, with the greatest reductions in V30 and V40, with no significant changes in dose to other OARs or PTV 1/V95.

Conclusion:

The bulboclitoris can be contoured on planning imaging, largely distinct from the external genitalia. Compared with S-IMRT, BCS-IMRT dramatically reduced dose to the bulboclitoris in anal cancer planning. BCS-IMRT might safely reduce sexual toxicity compared with standard approaches.

Advances in knowledge:

The structure and function of the bulboclitoris, the critical primary organ responsible for female sexual arousal and orgasm, has yet to be described in the radiotherapy literature. Structure, function and delineation of the bulboclitoris are detailed, delineation and bulboclitoris-sparing IMRT were feasible, and sparing reduces the dose to the bulboclitoris nearly in half in female patients receiving IMRT for anal cancer, warranting further clinical study.
The association of meniscal body height with knee structural changes in middle-aged and elderly patients with symptomatic knee osteoarthritis
Authors: Liu Yao , Du Guiying
Published: June 2021

Objectives:

To investigate whether and how meniscal height is associated with osteoarthritis (OA)-related knee structural changes in symptomatic knee OA.

Methods:

We studied 106 patients (61 female, aged 40–73 years) with symptomatic knee OA. X-ray was used for Kellgren-Lawrence score. Meniscal body heights and extrusion were measured on coronal sections of intermediate-weighted MRI sequence. Knee structural changes were assessed using the modified whole-organ magnetic resonance imaging score (WORMS). Associations between meniscal body height and knee structural changes were assessed using linear regression analysis.

Results:

Higher medial meniscal body height was significantly associated with severe medial meniscal lesions (p = 0.001–0.023), medial compartmental cartilage lesions (p = 0.045), patellofemoral compartmental and medial compartmental bone marrow edema patterns (p = 0.001–0.037), anterior cruciate ligament and patellar ligament abnormalities (p = 0.020–0.023), and loose bodies (p = 0.017). However, lateral meniscal body height was negatively correlated with WORMS scores for lateral meniscal lesions (p ≤ 0.018), lateral compartmental cartilage lesions (p ≤ 0.011), and lateral compartmental bone marrow edema patterns (p = 0.038).

Conclusion:

Higher medial meniscal body height was associated with more severe medial compartment structural abnormalities and patellofemoral bone marrow edema patterns, while lateral meniscal body height was inversely correlated with the severity of lateral compartment structural abnormalities.

Advances in knowledge:

Our study revealed that meniscal body height was associated with multiple OA-related knee structural changes, which would be beneficial in identifying patients with or at risks for knee OA.
A Utopian Way of Thinking about Work: Tracing William Morris’ Ideas on the Concept of Work
Authors: Peksan Selcan
Published: June 2021

Social theories present a wide range of criticism regarding the modern organization of work, yet little on the nature of humans and what an ideal concept of work would be. Favoring a utopian way of thinking about work, this paper inspects William Morris’ understanding of work and the basic dynamics of work organization in his vision of the society of the future. This article has chosen to perform an in-depth analysis of his utopian novel News from Nowhere due to the transformation of work laying at the core of the book. By tracing the key patterns of work in Morris’ future utopia which he called Nowhere, this paper proposes the concept of work that articulated in Morris’thought as a means of gaining an alternative model regarding the recent debates about the future of work. In particular, the paper scans Morris’ arguments on labor to demonstrate how Morris’ view presents an inspiring approach for our era. This hopefully opens up the prospect of thinking about the ideal work of the future one wants to achieve.
Differentiation and Individualization of Primary School Education Abroad
Authors: Artyuhova Irina
Published: June 2021

The article presents the main results of a critical analysis of the global trend, which is aimed at implementing an individual approach to teaching younger students. The characteristics of the features of primary education in the leading countries, whose primary school students demonstrate a high level of educational achievements in the course of international monitoring studies and occupy corresponding places (Finland and Singapore) are given. Attention is paid to the approach to selection, current forms of work and encouragement of especially gifted children in the US primary education system, which may turn out to be interesting and useful for domestic teachers. Methods of organizing the process of individually differentiated education of primary school children based on proven experience of working with them are considered.
The Problem of Teaching Children of Immigrants in the Russian Federation
Authors: Vinogradova Natalya
Published: June 2021

The publication proposes to discuss the problem of teaching children of immigrants who have arrived in our country and need to adapt to the new social, linguistic and cultural environment. The principles underlying the organization of education for children of immigrants in the Russian Federation, and the conditions for their education in educational institutions of our country, which were formulated at a meeting of the Council under the President of the Russian Federation for Interethnic Relations on March 30, 2021, are given. The content of the state order of the Ministry of Education of the Russian Federation to the Federal State the budgetary scientific institution “Institute of Education Development

Strategy of the Russian Academy of Education” to study the difficulties faced by children of immigrants in the process of adaptation. The result of the study should be the creation of a set of guidelines for teachers organizing the work of classes in which children of immigrants study.
Rory Loughnane and Andrew Power, eds. Early Shakespeare 1588-1594. Cambridge: Cambridge University Press, 2020. Pp 336.
Authors: Blyth Benjamin
Published: June 2021

Benjamin Blyth review of Early Shakespeare 1588-1594, edited by Rory Loughnane and Andrew Power.
¿QUIÉN VIGILA AL ALGORITMO?: LOS DERECHOS DE INFORMACIÓN DE LOS REPRESENTANTES DE LOS REPARTIDORES EN LA EMPRESA SOBRE LOS ALGORITMOS DE LAS PLATAFORMAS DE REPARTO.
Authors: Pérez Amorós Francisco
Published: June 2021

Se presentan unas reflexiones sobre el derecho de información de los representantes en la empresa en materia de algoritmos, regulado en el reciente Real Decreto-ley 9/2021, de 11 de mayo, en favor de las personas dedicadas al reparto en el ámbito de plataformas digitales. Al respecto se parte del “Acuerdo de la Mesa de Diálogo Social”, adoptado, el 10 de marzo 2021, entre el Gobierno, CC.OO., UGT y CEOE y CEPYME, y se tiene presente la STS de 25 de septiembre de 2020 sobre la laboralidad de los repartidores. Se comentan los elementos clásicos del nuevo derecho de información: sujetos (emisor y receptor) objeto (tiempo, forma y contenido) y finalidad.
EL ARDUO CAMINO HACIA LA UNIVERSALIDAD DE LA ASISTENCIA SANITARIA DE LOS INMIGRANTES IRREGULARES EN ESPAÑA.
Authors: Rubio Velasco Fuencisla
Published: June 2021

El Real Decreto-ley 7/2018, de 27 de julio, sobre el acceso universal al Sistema Nacional de Salud, supone un cambio radical en lo que se refiere al derecho a la asistencia sanitaria. El acceso al Sistema Nacional de Salud en condiciones de equidad y de universalidad es un derecho primordial de toda persona. La garantía del ejercicio de este derecho y la protección efectiva de la salud de la ciudadanía cobra aún mayor importancia cuando quienes se ven privados de una asistencia sanitaria normalizada son colectivos de una especial vulnerabilidad, amenazados por la exclusión social, como es el caso de la población extranjera no registrada ni autorizada a residir en España. La reforma que instauró el ya derogado Real Decreto-ley de 2012, desvirtuó el derecho a la protección de la salud al anular su vocación universal y eliminar la titularidad del derecho establecida.
EL IMPACTO DE LAS TECNOLOGÍAS DIGITALES SOBRE LA ORGANIZACIÓN DEL TRABAJO.
Authors: Villa Fombuena María
Published: June 2021

El vertiginoso avance tecnológico-digital que viene produciéndose desde hace relativamente poco tiempo ha transformado la configuración clásica de las relaciones laborales. Analizar la forma y el alcance que su impacto está teniendo en el ámbito laboral deviene en consecuencia una cuestión fundamental para poder encontrar aquellas medidas que permitan minimizar los inconvenientes a los que se enfrentan tanto las personas trabajadoras como las empresas. Con el presente trabajo se busca, por un lado, ofrecer una visión panorámica sobre dicha repercusión y, por otro, analizar la forma en la que las empresas interiorizan estos avances.
CONFIGURACIÓN DEL DAÑO AL PROYECTO DE VIDA EN EL DERECHO DEL TRABAJO: APORTES DESDE LA JURISPRUDENCIA DE LA CORTE INTERAMERICANA DE DERECHOS HUMANOS Y LA DOCTRINA Y JURISPRUDENCIA PERUANA.
Authors: Quintana García Luis Alberto
Published: June 2021

En el presente artículo se establecen los elementos para configurar el daño al proyecto de vida en el Derecho del Trabajo, para lo cual, partimos de revisar críticamente los aportes desarrollados tanto por la jurisprudencia de la Corte Interamericana de Derechos Humanos como por la doctrina, sistemática y concepción establecida por el profesor Carlos Fernández Sessarego relativa al daño al proyecto de vida. Con dichos elementos, bajo un análisis crítico y teniendo en cuenta la jurisprudencia de la Corte Suprema de Justicia del Perú, desarrollamos una propuesta sobre la configuración del daño al proyecto laboral considerando: 1) Concepto, criterios de reconocimiento, evaluación del monto y las medidas de reparación, y 2) Aplicación en el ámbito de la responsabilidad patronal como categoría de resarcimiento, estableciendo su concepto, forma de sistematización y su ubicación dentro de la sistemática de los daños.
Inteligencia Artificial y derecho. Ni dioses ni bestias ni cíborgs: homo juridicus.
Authors: R. Juan Gabriel
Published: June 2021

El presente trabajo parte de una defensa del Derecho de los sistemas jurídicos constitucionalizados, por el lugar central que otorga a los derechos humanos, cuya base es la dignidad de la persona humana. Destaca asimismo que la aspiración de realización del valor justicia nos caracteriza como Homo Juridicus. Todo lo cual encuentra justificación en una ética humanista que, en tanto integrante de una cultura jurídica, concuerda con el objeto de estudio del Bioderecho Internacional. En ese marco, luego de identificar los problemas y riesgos de la Inteligencia Artificial, de conceptualizar y caracterizar la posición transhumanista, mediante un abordaje ético se contrapone esta última visión con aquella biojurídica. La conclusión es que esta última es la única que proporciona una adecuada justificación a las acciones y límites normativos.
Identidad digital Blockchain e Inteligencia Artificial: aspectos jurídicos de presente y futuro a debate.
Authors: Merchán Murillo Antonio
Published: June 2021

La identidad digital se presenta como un elemento esencial para cualquier transacción, especialmente, con el surgimiento del Blockchain como innovación tecnológica. Por ello, en este trabajo se pretende realizar un estudio de la identidad y su incidencia en el Blockchain, asimismo se plantea su reconocimiento entre Estados. Por otro lado, debe prestarse atención a la Inteligencia Artificial que va a plantear retos en su aplicación, junto a la tecnología Blockchain; pues ésta va a tener la misión de generar confianza, transparencia y actuar de mediador. Por ello, va a tener el desafío de hacer posible que actúen y se conecten entre sí. Este hecho va a plantear la necesidad de proteger la identidad digital.
La inteligencia artificial (IA) como aplicación jurídica y razonable: la cuestión sanitaria.
Authors: Cárcar Benito Jesús Esteban
Published: June 2021

La IA llevará a cambios sustanciales en la sociedad; en breve, esperamos ver a los robots desempeñar todo tipo de tareas en el mundo sanitario, interconectados e inteligentes. Habrá grandes dilemas para la consolidación, calidad y cohesión de la aplicación de la IA. Por ello, el Derecho tendrá que ocuparse de esta tecnología disruptiva que revolucionará la asistencia sanitaria. Hay además grandes interrogantes. Una regulación eficaz creará confianza en el uso de los dispositivos y aplicaciones, así como garantías éticas y jurídicas, lo cual es esencial para los ciudadanos, los pacientes y los proveedores de servicios sanitarios, instituciones y autoridades. Ahora bien, este trabajo pretende profundizar, también, sobre el concepto de razonabilidad en un mundo como la IA, que refleja lo indefinido, lo atípico, producto, en buena parte, de la superación de un formalismo estéril, que nunca se ha dejado encorsetar en el mundo de la tecnología.
Inteligencia Artificial, derecho administrativo y protección de datos personales. Entre la dignidad de la persona y la eficacia administrativa.
Authors: Domínguez Álvarez José Luis
Published: June 2021

Es un lugar común referirse sistemáticamente a las transformaciones del Derecho público, circunstancia esta que, como insiste en señalar buena parte de la doctrina, se encuentra agravada en el caso del Derecho administrativo. El avance tecnológico y los crecientes procesos de modernización de las diferentes Administraciones públicas, las cuales no son ajenas en forma alguna al actual tsunami digital, ha permitido evidenciar la necesidad de contar con un ordenamiento jurídico-administrativo adaptado a la realidad en red, capaz de combatir el pernicioso alcance que el impulso de la digitalización y datificación de la sociedad posee en la esfera vital de la ciudadanía. En efecto, el transcurso del tiempo y el progreso digital no han hecho más que acentuar la preeminencia del Derecho administrativo, entendido como dique de contención capaz de preservar la dignidad de la persona ante las tribulaciones propiciadas por la (r)evolución tecnológica. Dificultosa travesía que encuentra en la tutela jurídica de la protección de datos de carácter personal uno de sus principales desafíos, y a cuyo estudio se dedican las próximas páginas.
Para una genealogía del oficio de “figurinista” en Portugal. Una lucha de género en curso.
Authors: Cucinotta Caterina
Published: June 2021

Analizar el cine y citar solamente el trabajo de dirección resulta ser la metodología elegida en más ocasiones por los investigadores y científicos de Film studies. Este método de análisis, de hecho, está tan aceptado en la academia que hasta se despliega con absoluta normalidad por la mayoría de los artistas hombres que trabajan o han trabajado en el cine (Chaplin, Rossellini, Fellini, Hitchcock, Godard, Truffaut, De Oliveira, entre algunos ejemplos). La “Big history” del cine, tal como se aprende, se construyó a partir de la mirada de los grandes directores. Estos han construido un discurso en el que se hacen responsables absolutos de la creación, la materialización y la ordenación de las imágenes en movimiento que constituyeron las grandes obras del séptimo arte que conocemos y analizamos. Sin embargo, existe toda una serie de artesanías y artes que, a pesar de sufrir un absoluto olvido, cuentan con una abrumadora mayoría de trabajadoras y artistas. Por ejemplo, en los principios del cine, el trabajo de las montadoras quedó relegado a la simple técnica de corta y pega y, en 2020 (Schultz en Cordero-Hoyo et al.) ya estábamos seguros de que el departamento cinematográfico que en España y Portugal tiene el mayor número de mujeres, es el de diseño de vestuario (figurinos o guarda-ropa). En particular, en Portugal este arte se reduce a una mera función técnica con consecuencias salariales y de descrédito también reflejado en su terminología técnica. A través de algunos study-cases abarcados durante el proyecto posdoctoral (en curso), financiado por FCT, centraremos nuestra atención en cuestiones de género que en sus historias, las diseñadoras de vestuario, las jefas de guarda-ropa y las costureras del cine portugués, abordaran en entrevistas realizadas en 2017 y analizadas a través de la metodología de la historia oral.
Technical Note—Approximating Systems Fed by Poisson Processes with Rapidly Changing Arrival Rates
Authors: Zheng Zeyu , Honnappa Harsha , Glynn Peter W.
Published: June 2021

In many operations management settings, the arrival process to the system exhibits clear nonstationarities. These nonstationarities may arise as a consequence of time-of-day effects, day-of-week effects, seasonalities, or stochastic fluctuations in the arrival rate. Tools that are developed for performance prediction and decision making when systems are stationary may not be valid in the nonstationary environment. This paper provides a generic, closed-form, and simple approximation tool for when the nonstationarities are caused by rapid fluctuations in the arrival processes.
Schedule-Constrained Demand Management in Two-Region Urban Networks
Authors: Kumarage Sakitha , Yildirimoglu Mehmet , Ramezani Mohsen , Zheng Zuduo
Published: June 2021

Demand management aiming to optimize system cost while ensuring user compliance in an urban traffic network is a challenging task. This paper introduces a cooperative demand redistribution strategy to optimize network performance through the retiming of departure times within a limited time window. The proposed model minimizes the total time spent in a two-region urban network by incurring minimal disruption to travelers’ departure schedules. Two traffic models based on the macroscopic fundamental diagram (MFD) are jointly implemented to redistribute demand and analyze travelers’ reaction. First, we establish equilibrium conditions via a day-to-day assignment process, which allows travelers to find their preferred departure times. The trip-based MFD model that incorporates individual traveler attributes is implemented in the day-to-day assignment, and it is conjugated with a network-level detour ratio model to incorporate the effect of congestion in individual traveler route choice. This allows us to consider travelers with individual preferences on departure times influenced by desired arrival times, trip lengths, and earliness and lateness costs. Second, we develop a nonlinear optimization problem to minimize the total time spent considering both observed and unobserved demand—that is, travelers opting in and out of the demand management platform. The accumulation-based MFD model that builds on aggregated system representation is implemented as part of the constraints in the nonlinear optimization problem. The results confirm the resourcefulness of the model to address complex two-region traffic dynamics and to increase overall performance by reaching a constrained system optimum scenario while ensuring the applicability at both full and partial user compliance conditions.
Glass half full
Authors: Cummings Ellen
Published: June 2021

Ellen Cummings talks to Barry Cockcroft about his optimism for the future of water fluoridation in the UK
Shout about infection control
Authors: Nixon Jenny
Published: June 2021

Jenny Nixon explains why informing your patients about infection control procedures will reassure them it's safe to visit
Inhalation sedation in the spotlight
Authors: Pickles Janet
Published: June 2021

Janet Pickles discusses the effects of Covid-19 on the provision of inhalation sedation
Tips from a dental sedation nurse
Authors: Silver Rebecca
Published: June 2021

Rebecca Silver advises on assisting with IV conscious sedation
Smiles for health
Authors: Whiteley Jackie
Published: June 2021

Jackie Whiteley talks about starting her own oral health promotion project
Management of non-traumatic epistaxis in adults in the emergency department
Authors: Reed Ashley , Barnes Martyn , Howard Caroline
Published: June 2021

Background/aims

Despite epistaxis being a common presentation to emergency departments there is a lack of guidelines, both nationally and internationally, for its management. The authors reviewed the current management of epistaxis and then introduced a new pathway for management to see if care could be improved. The aims were to evaluate the impact of the pathway on reduction of emergency department breaches, emergency ambulance transfers and hospital admissions.

Methods

The study was an interrupted time series analysis over 29 months and included 903 participants. A pathway for the management of adults with non-traumatic epistaxis was designed and implemented in a university teaching hospital with an emergency department annual attendance rate of 105 495 in 2019–20.

Results

The pathway led to a 14-minute longer stay in the emergency department, a 5% increase in emergency department breaches, an 8.2% reduction in admissions, a 3.6% reduction in emergency ambulance transfers, a 14.1% increase in nasal cautery and a 3.2% reduction in nasal packing.

Conclusions

The authors calculate that these results equate to roughly 56 hospital bed days saved, providing better care closer to home for patients, in addition to beneficial knock-on effects for other emergency department and admitted patients.
Adapted Exponential Type Estimator in the Presence of Non-response
Authors: Ünal Ceren , Kadilar Cem
Published: June 2021

In this article, we propose an estimator using the exponential function for the population mean in the case of non-response on both the study and the auxiliary variables. The equations for the Bias and Mean Square Error (MSE) are derived to the first order of approximation and theoretical comparisons are made with existing estimators in literature. Besides, we examine the efficiency of the proposed estimator according to the classical ratio and regression estimator, Hansen-Hurwitz unbiased estimator, and the estimator of Singh et al. (2009). Following theoretical comparisons, we infer that the proposed estimator is more efficient than compared estimators under the obtained conditions in theory. Moreover, these theoretical results are supported numerically by providing an empirical study on five different data sets.
Reliability Test Plan for an Extended Birnbaum-Saunders Distribution
Authors: Gillariose Jiju , Tomy Lishamol
Published: June 2021

Birnbaum-Saunders distribution has been widely studied in statistical literature because this distribution accommodates several interesting properties. The purpose of this paper is to introduce a new parametric distribution based on the Birnbaum-Saunders model and develop a new acceptance sampling plans for derived extended Birnbaum-Saunders distribution when the mean lifetime test is truncated at a predetermined time. For various acceptance numbers, confidence levels and values of the ratio of the fixed experimental time to the specified mean life, the minimum sample size necessary to assure a specified mean lifetime worked out. The results are illustrated by a numerical example. The operating characteristic functions of the sampling plans and producer’s risk and the ratio of true mean life to a specified mean life that ensures acceptance with a pre-assigned probability are tabulated. This paper presents relevant characteristics of the new distribution and a new acceptance sampling plans when the lifetime of a product adopts an extended Birnbaum-Saunders distribution. Based on this study, the optimal number of testers demanded is decreases as test termination time increases. Moreover, the operating characteristic values increases as the mean life ratio increases, which indicate that items with increased mean life will be accepted with higher probability compared with items with lower mean life ratio.
Burnout within UK surgical specialties: a systematic review
Authors: Balendran B , Bath MF , Awopetu AI , Kreckler SM
Published: June 2021

Introduction

Burnout is of growing concern within the surgical workforce, having been shown to result in reduced job satisfaction, decreased patient satisfaction and higher rates of medical errors. Determining the extent of burnout and identifying its risk factors within UK surgical practice is essential to ensure appropriate interventions can be implemented to improve mental wellbeing.

Materials

A systematic search of PubMed, Medline, Embase, PsychINFO and Cochrane databases was performed, following PRISMA guidelines. Studies published between January 2000 and October 2019 that reported prevalence data or risk factors on burnout for surgeons working within the UK and/or the Republic of Ireland were included.

Findings

Ten papers met the inclusion criteria. The overall prevalence of burnout amongst surgeons in the UK was 32.0% (IQR 28.9–41.0%), with surgical trainees having the highest prevalence (59.0%) of burnout documented for any subgroup. The most common risk factors identified for burnout were younger surgeon age and lower clinical grade. Being married or living with a partner was found to be protective.

Conclusions

Burnout is highly prevalent in UK surgical specialties, mostly amongst surgical trainees. Targeted pre-emptive interventions based upon relevant risk factors for burnout should be prioritised, at both individual and institutional levels.
Appraisal of the current guidelines for the management of diverticular disease using the Appraisal of Guidelines Research and Evaluation II (AGREE II) instrument
Authors: Gavriilidis P , Askari A , Gavriilidis E , de’Angelis N , Di Saverio S , Wheeler J , Davies RJ
Published: June 2021

Introduction

Diverticular disease is one of the most frequent reasons for attending emergency departments and surgical causes of hospital admission. In the past decade, many surgical and gastroenterological societies have published guidelines for the management of diverticular disease. The aim of the present study was to appraise the methodological quality of these guidelines using the Appraisal of Guidelines Research and Evaluation II (AGREE II) tool.

Methods

PubMed, Embase, Cochrane Library and Google Scholar databases were searched systematically. The methodological quality of the guidelines was appraised independently by five appraisers using the AGREE II instrument.

Findings

A systematic search of the literature identified 12 guidelines. The median overall score of all guidelines was 68%. Across all guidelines, the highest score of 85% was demonstrated in the domain ‘Scope and purpose’. The domains ‘Clarity and presentation’ and ‘Editorial independence’ both scored a median of 72%. The lowest scores were demonstrated in the domains ‘Stakeholder involvement’ and ‘Applicability’ at 46% and 40%, respectively. Overall, the National Institute for Health and Care Excellence (NICE) guidelines performed consistently well, scoring 100% in five of six domains; NICE was one of the few guidelines that specifically reported stakeholder involvement, scoring 97%. Generally, the domain of ‘Stakeholder involvement’ ranked poorly with seven of twelve guidelines scoring below 50%, with the worst score in this domain demonstrated by Danish guidelines at 25%.

Conclusion

Six of twelve guidelines (NICE, American Society of Colon & Rectal Surgeons (ASCRS), European Society of Coloproctology (ESCP), American Gastroenterological Association, German Society of Gastroenterology/German Society for General and Visceral Surgery (German), Netherlands Society of Surgery) scored above 70%. Only three, NICE, ASCRS and ESCP, scored above 75% and were voted unanimously by the appraisers for use as they are. Therefore, use of AGREE II may help improve the methodological quality of guidelines and their future updates.
Emergency hip disarticulations for severe necrotising fasciitis of the lower limb: a series of rare cases from a rural district general hospital
Authors: Korambayil SM , Iyer S , Williams DJ
Published: June 2021

Hip disarticulation is the removal of the entire lower limb through the hip joint by detaching the femur from the acetabulum. This major ablative procedure is rarely performed for infection but may be required in severe necrotising fasciitis. We present a single centre retrospective review of all cases of emergency hip disarticulations in patients with necrotising fasciitis between 2010 and 2020. All five patients included in the review presented with acute lower limb pain and sepsis. Three patients had comorbidities predisposing them to necrotising fasciitis. Three were deemed to be high risk and two were at intermediate risk of developing necrotising fasciitis. There were two deaths in the postoperative period. Of the three survivors, two required revision surgery for a completion hindquarter amputation and one for flap closure. All three survivors had good functional outcomes after discharge from hospital. Despite its associated morbidity, emergency amputation of the entire lower limb is a life-saving treatment in cases of rapidly progressing necrotising fasciitis and should be considered as a first-line option in managing this condition.
Regenerative terahertz wave parametric amplifier based on four-wave mixing in asynchronously pumped graphene oxide integrated TOPAS
Authors: Amini Tahereh , Jahangiri Fazel
Published: June 2021

A widely tunable regenerative terahertz parametric amplifier is proposed based on degenerate four-wave mixing in an asynchronously pumped highly nonlinear medium. To enhance the Kerr nonlinearity, a hybrid structure of cyclic olefin co/polymer (COC/P) TOPAS integrated by a graphene oxide film is utilized as the gain medium and embedded into a cavity. A low-power terahertz seed wave is injected inside the cavity and sequentially pumped by four asynchronous coupled beams of identical powers. Our results reveal that the output power, the tuning frequency range and the power conversion efficiency of terahertz waves could be considerably improved in the proposed design. Terahertz waves with maximum peak power of 641 W, the accumulated conversion efficiency of 3.8% and amplification gain of 320.5 are obtained at a frequency of 9.61 THz, which could be tuned over a range of 1.17 − 19.736 THz.
Ronchi-Hartmann type null screens for testing a plano-freeform surface with a detection plane inside a caustic surface
Authors: DelOlmo-Márquez Jesús , Castillo-Santiago Gabriel , Avendaño-Alejo Maximino , Moreno Ivan , Román-Hernández Edwin , López-Bautista María C.
Published: June 2021

We have implemented an exact ray trace through a plano-freeform surface for an incident plane wavefront. We obtain two caustic surfaces and provide the critical points related to the ray tracing process. Additionally, we study the propagation of the refracted wavefronts through the plane-curved surface. Finally, by using the Ronchi-Hartmann type null screen and placing the detection plane within the caustic region, we have evaluated the shape of a plano-freeform optical surface under test, obtaining an RMS difference in sagitta value of 6.3 μm.
Development of a handheld compression optical coherence elastography probe with a disposable stress sensor
Authors: Wang Xiwen , Wu Qian , Chen Jiewen , Mo Jianhua
Published: June 2021

Optical coherence elastography (OCE) is a functional extension of optical coherence tomography (OCT). OCE measures a sample’s deformation under force stimuli. Compression is often used to generate the force stimuli in OCE. In this Letter, we report the development of a handheld quantitative compression OCE probe with a novel stress senor, dedicated to measuring the force. The stress sensor consists of a circular glass window and a metal ring which are connected with polyurethane spokes. This sensor is mounted on the tip of the OCT sample arm as an imaging window, so that the force applied to the sample through the window can be measured by detecting the window displacement from the OCT image. The force-displacement function was first developed through simulation on COMSOL Multiphysics and eventually calibrated experimentally. A phase-sensitive OCT technique was employed to measure both the window displacement and the sample deformation. The performance of an OCE probe with this stress sensor was evaluated on a two-layer phantom. The results show that it is extremely capable of measuring the sample Young’s modulus. Finally, we successfully measured the elasticity of the human fingertip, indicating a good potential of this OCE probe for in vivo elastogram measurement on human skin.
W-type normal dispersion thulium-doped fiber-based high-energy all-fiber femtosecond laser at 1.7  µm
Authors: Chen Shaoxiang , Chen Yuhao , Liu Kun , Sidharthan Raghuraman , Li Huizi , Chang Chen Jian , Wang Qi Jie , Tang Dingyuan , Yoo Seongwoo
Published: June 2021

We propose a parabolic W-type thulium-doped fiber for the 1.7 µm high-energy femtosecond pulsed laser. Despite its attractive normal dispersion, the fiber offers high gain in 1.7 µm region thanks to its distributed short-pass filtering effect. With a proper dispersion management in an all-fiber chirped pulse amplification (CPA) scheme, we demonstrate so far the highest pulse energy of 128.0 nJ in a stable pulse of 174 fs in the 1.7–1.8 µm region, which marks above an order of magnitude improvement in pulse energy while exhibiting the shortest pulse duration among fiber-based CPA works at 1.7 µm. Hence, we provide a pathway to an energy scalable and efficient femtosecond laser at 1.7 µm via a compact and elegant all-fiber solution.
High dynamic defocus response method for binary defocusing fringe projection profilometry
Authors: Zheng Zhuojun , Gao Jian , Zhuang Yizhong , Zhang Lanyu , Chen Xin
Published: June 2021

The measurement accuracy of high-speed binary defocusing fringe projection profilometry depends on the fringe pitch and defocus degree. During the measurement process, the degree of defocus changes with the measurement depth of the scenes. This makes it difficult to obtain a suitable defocus degree and achieve high-precision measurement owing to dynamic changes in the measurement object or environment. To address this problem, we propose a highly dynamic defocus response method to adaptively adjust fringe pitches for binary defocusing fringe projection profilometry. As the defocus degree changes significantly, the proposed method can respond quickly and adjust the fringe pitches adaptively to the scenes. Therefore, a high-precision dynamic measurement can be achieved for the current measuring scene. In this study, considering the effect of random error and nonlinear error, we established a complete phase-error model and used it as an optimization function. Based on this function, we obtained the optimal fringe pitch expression with the defocus degree and harmonic response parameters as variables. With the proposed method, we can obtain the defocus degree and harmonic response parameters during the measurement process and calculate the optimal fringe pitches for the current scenes. Thus, the proposed method can dynamically adapt to the measuring depth change and achieve an accurate measurement without modifying any hardware parameters.
Genome-wide identification, phylogenetic, and expression analysis under abiotic stress conditions of LIM gene family in Medicago sativa L.
Authors: Nian Lili , Liu Xuelu , Yang Yingbo , Zhu Xiaolin , Yi Xianfeng , Haider Fasih Ullah
Published: June 2021

The LIM (Lin-11, Isl-1 and Mec-3 domains) family is a key transcription factor widely distributed in animals and plants. The LIM proteins in plants are involved in the regulation of a variety of biological processes, including cytoskeletal organization, the development of secondary cell walls, and cell differentiation. It has been identified and analyzed in many species. However, the systematic identification and analysis of the LIM genes family have not yet been reported in alfalfa (Medicago sativaL.). Based on the genome-wide data of alfalfa, a total of 21 LIM genes were identified and named MsLIM01-MsLIM21. Comprehensive analysis of the chromosome location, physicochemical properties of the protein, evolutionary relationship, conserved motifs, and responses to abiotic stresses of the LIM gene family in alfalfa using bioinformatics methods. The results showed that these MsLIM genes were distributed unequally on 21 of the 32 chromosomes in alfalfa. Gene duplication analysis showed that segmental duplications were the major contributors to the expansion of the alfalfa LIM family. Based on phylogenetic analyses, the LIM gene family of alfalfa can be divided into four subfamilies: αLIM subfamily, βLIM subfamily, γLIM subfamily, and δLIM subfamily, and approximately all the LIM genes within the same subfamily shared similar gene structure. The 21 MsLIM genes of alfalfa contain 10 Motifs, of which Motif1 and Motif3 are the conserved motifs shared by these genes. Furthermore, the analysis of cis-regulatory elements indicated that regulatory elements related to transcription, cell cycle, development, hormone, and stress response are abundant in the promoter sequence of MsLIM genes. Real-time quantitative PCR demonstrated that MsLIM gene expression is induced by low temperature and salt. The present study serves as a basic foundation for future functional studies on the alfalfa LIM family.
Early social distancing policies in Europe, changes in mobility & COVID-19 case trajectories: Insights from Spring 2020
Authors: Woskie Liana R. , Hennessy Jonathan , Espinosa Valeria , Tsai Thomas C. , Vispute Swapnil , Jacobson Benjamin H. , Cattuto Ciro , Gauvin Laetitia , Tizzoni Michele , Fabrikant Alex , Gadepalli Krishna , Boulanger Adam , Pearce Adam , Kamath Chaitanya , Schlosberg Arran , Stanton Charlotte , Bavadekar Shailesh , Abueg Matthew , Hogue Michael , Oplinger Andrew , Chou Katherine , Corrado Greg , Shekel Tomer , Jha Ashish K. , Wellenius Gregory A. , Gabrilovich Evgeniy
Published: June 2021

Background

Social distancing have been widely used to mitigate community spread of SARS-CoV-2. We sought to quantify the impact of COVID-19 social distancing policies across 27 European counties in spring 2020 on population mobility and the subsequent trajectory of disease.

Methods

We obtained data on national social distancing policies from the Oxford COVID-19 Government Response Tracker and aggregated and anonymized mobility data from Google. We used a pre-post comparison and two linear mixed-effects models to first assess the relationship between implementation of national policies and observed changes in mobility, and then to assess the relationship between changes in mobility and rates of COVID-19 infections in subsequent weeks.

Results

Compared to a pre-COVID baseline, Spain saw the largest decrease in aggregate population mobility (~70%), as measured by the time spent away from residence, while Sweden saw the smallest decrease (~20%). The largest declines in mobility were associated with mandatory stay-at-home orders, followed by mandatory workplace closures, school closures, and non-mandatory workplace closures. While mandatory shelter-in-place orders were associated with 16.7% less mobility (95% CI: -23.7% to -9.7%), non-mandatory orders were only associated with an 8.4% decrease (95% CI: -14.9% to -1.8%). Large-gathering bans were associated with the smallest change in mobility compared with other policy types. Changes in mobility were in turn associated with changes in COVID-19 case growth. For example, a 10% decrease in time spent away from places of residence was associated with 11.8% (95% CI: 3.8%, 19.1%) fewer new COVID-19 cases.

Discussion

This comprehensive evaluation across Europe suggests that mandatory stay-at-home orders and workplace closures had the largest impacts on population mobility and subsequent COVID-19 cases at the onset of the pandemic. With a better understanding of policies’ relative performance, countries can more effectively invest in, and target, early nonpharmacological interventions.
Acromioplasty reduces critical shoulder angle in patients with rotator cuff tear
Authors: Lin Che-Li , Lin Li-Fong , Hsu Tzu-Herng , Lin Lien-Chieh , Lin Chueh-Ho , Huang Shih-Wei
Published: June 2021

Critical shoulder angle (CSA) is the angle between the superior and inferior bone margins of the glenoid and the most lateral border of the acromion and is potentially affected during a rotator cuff tear (RCT). Acromioplasty is generally performed to rectify the anatomy of the acromion during RCT repair surgery. However, limited information is available regarding the changes in the CSA after anterolateral acromioplasty. We hypothesized that CSA can be decreased after anterolateral acromioplasty. Data were retrospectively collected from 712 patients with RCTs and underwent arthroscopic rotator cuff repair between January 2012 and December 2018, of which 337 patients were included in the study. The presurgical and postsurgical CSA were then determined and compared using a paired samples t test. Because previous study mentioned CSA more than 38 degrees were at risk of rotator cuff re-tear, patients were segregated into two groups: CSA < 38° and CSA ≥ 38°; these groups were compared using an independent-samples t test. These 337 participants (160 male and 177 female) presented a CSA of 38.4° ± 6.0° before anterolateral acromioplasty, which significantly decreased to 35.8° ± 5.9° after surgery (P < .05). Before surgery, 172 patients were present in the CSA ≥ 38° group and 57 were preset in the CSA < 38° group after surgery. The CSA decreased significantly in the CSA ≥ 38° group rather than in the CSA < 38° group (P < .05). In conclusion, the CSA can be effectively decreased through anterolateral acromioplasty, and this reduction in the CSA is more significant among individuals with CSA ≥ 38° than among those with CSA < 38°, indicating that acromioplasty is recommended along with RCT repair especially among individuals with a wide presurgical CSA.
Association of CYP24A1 gene polymorphism with colorectal cancer in the Jiamusi population
Authors: Chai Lin , Ni Jian , Ni Xiaolin , Zhang Nan , Liu Yang , Ji Zhiwu , Zhao Xingwang , Zhu Xiaowen , Zhao Bin , Xin Guorong , Wang Yu , Yang Fan , Sun Liang , Zhu Xiaoquan , Bao Wenhua , Shui Xiaofang , Wang Fengling , Chen Fujun , Yang Ze
Published: June 2021

Background

The population in Jiamusi has been reported to have the highest prevalence of colorectal cancer (CRC) in China. The genetic causal-effect for this occurrence among the residents remains unclear. Given the long cold seasons with people wearing more clothes and reduced UV exposure, we aimed to study the association between the vitamin D metabolism-related gene CYP24A1 polymorphism and CRC susceptibility.

Method

A case-control study was conducted that included 168 patients with CRC and 710 age-matched healthy individuals as the control group. Plausible susceptible variations were sought and clinical phenotypic-genotype association analysis was performed.

Results

Overall, two CYP24A1 polymorphisms, rs6013905 AX (P = 0.02, OR = 1.89, 95%CI: 1.09–3.29) and rs2762939 GX (P = 0.02, OR = 1.52, 95%CI: 1.08–2.13) were significantly associated with CRC in the Jiamusi population. In the female group, three CYP24A1 polymorphisms, rs6013905 AX (P = 0.04, OR = 2.59, 95%CI: 1.03–6.49), rs2762939 GX (P = 0.01, OR = 2.35, 95%CI: 1.25–4.42), and rs6068816 GG (P = 0.05, OR = 1.89, 95%CI: 0.99–3.59) carriers were significantly associated with CRC. In clinical phenotypic-genotype analysis, rs6013905 GG (P = 0.05, OR = 4.00, 95%CI: 0.92–17.48) and rs2762939 GX (P = 0.03, OR = 4.87, 95%CI: 1.00–23.69) carriers were significantly associated with poorly differentiated CRC, while CYP24A1 rs6068816 AX was significantly associated with the tumor type (P = 0.02, OR = 2.08, 95%CI: 1.10–3.96) and location (P = 0.04, OR = 2.24, 95%CI: 1.05–4.77).

Conclusion

CYP24A1 gene polymorphism may be a genetic risk factor attributable to the highest prevalence of CRC in Jiamusi people. Individuals with CYP24A1 gene polymorphism may have an increased barrier for vitamin D absorption, thus contributing to the risk of CRC development.