bluuebunny/crossref_metadata_2025_split huggingface dataset:
Salt-Laden Winter Runoff and Freshwater Mussels; Assessing the Effect on Early Life Stages in the Laboratory and Wild Mussel Populations in Receiving Waters
Authors: Gillis Patricia L. , Salerno Joseph , McKay Vicki L. , Bennett C. James , Lemon Karen L. K. , Rochfort Quintin J. , Prosser Ryan S. 
Published: January 2021

AbstractThe widespread use of road salt for winter road maintenance has led to an increase in the salinity of surface water in many seasonally cold areas. Freshwater mussels have a heightened sensitivity to salt, which is a concern, because many Canadian mussel species at risk have ranges limited to southern Ontario, Canada’s most road-dense region. This study examined the effect of winter road runoff on freshwater mussels. The impact of two bridges that span mussel habitat in the Thames River watershed (Ontario, Canada), the second most species-rich watershed for mussels in Canada, were studied. During a winter melt event, bridge runoff, as well as creek surface water surrounding the bridges were collected. Chloride concentrations in samples from bridge deck and tile drains varied (99–8250 mg/L). In general, survival of Lampsilis fasciola glochidia exposed to those samples reflected chloride levels (e.g. 84% at 99 mg/L; 0% at 8250 mg/L), although potassium (60 mg/L) may have at least contributed to toxicity in one sample. Serial dilution exposures with the two most toxic runoff samples revealed 48-h glochidia EC50s of 44% (McGregor Creek Tile Drain) and 26% (Baptiste Creek Deck Drain). During the melt event, the chloride concentrations in creek surface waters downstream of the bridges ranged from 69 to 179 mg Cl−/L; effects on glochidia (viability 77–91%) exposed to those waters was minimal. There were no live mussels surrounding one bridge (Baptiste Creek), likely due to poor habitat. At the other targeted bridge (McGregor Creek), fewer mussels were found close (< 100 m up- or downstream) to the bridge than further (> 200 m) away. However, other contributing factors, including agriculture, were present at both study areas.
APX005M, a CD40 agonist antibody with unique epitope specificity and Fc receptor binding profile for optimal therapeutic application
Authors: Filbert Erin L. , Björck Pia K. , Srivastava Minu K. , Bahjat Frances R. , Yang Xiaodong 
Published: January 2021

AbstractTargeting CD40 with agonist antibodies is a promising approach to cancer immunotherapy. CD40 acts as a master regulator of immunity by mobilizing multiple arms of the immune system to initiate highly effective CD8 + T-cell-mediated responses against foreign pathogens and tumors. The clinical development of CD40 agonist antibodies requires careful optimization of the antibody to maximize therapeutic efficacy while minimizing adverse effects. Both epitope specificity and isotype are critical for CD40 agonist antibody mechanism of action and potency. We developed a novel antibody, APX005M, which binds with high affinity to the CD40 ligand-binding site on CD40 and is optimized for selective interaction with Fcγ receptors to enhance agonistic potency while limiting less desirable Fc-effector functions like antibody-dependent cellular cytotoxicity of CD40-expressing immune cells. APX005M is a highly potent inducer of innate and adaptive immune effector responses and represents a promising CD40 agonist antibody for induction of an effective anti-tumor immune response with a favorable safety profile.
Identification of Glisson's Capsule Invasion During Hepatectomy for Colorectal Liver Metastasis by Contrast‐Enhanced Ultrasonography Using Perflubutane
Authors: Hiroyoshi Junko , Ishizawa Takeaki , Abe Hiroyuki , Arita Junichi , Akamatsu Nobuhisa , Kaneko Junichi , Ushiku Tetsuo , Hasegawa Kiyoshi 
Published: January 2021

AbstractBackgroundGlisson invasion by CLM is associated with a risk of margin‐positive resection, leading to poor long‐term outcomes after hepatectomy. This study was performed to evaluate the efficacy of intraoperative ultrasonography (IOUS) for the diagnosis of Glisson's capsule invasion by colorectal liver metastasis (CLM).MethodsThis prospective study involved 50 consecutive patients undergoing hepatectomy for CLM. Preoperatively, all patients had undergone gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid‐enhanced magnetic resonance imaging (EOB‐MRI). During hepatectomy, a contrast agent (perflubutane) was intravenously injected and Glisson invasion was estimated based on three characteristic findings: a tumor thrombus, peripheral dilatation, and border irregularity/caliber change. The diagnostic abilities of the preoperative and intraoperative imaging studies were evaluated based on pathological examinations of resected specimens.ResultsAmong 187 CLMs resected, pathological examinations proved Glisson invasion in 24 tumors (13%). IOUS revealed a tumor thrombus in 3 tumors (1.6%), peripheral dilatation in 4 (2.1%), and border irregularity and/or caliber change in 24 (12.8%). The sensitivity and specificity of IOUS with any of the above three findings for diagnosis of Glisson invasion was 79% and 96%, respectively, while preoperative EOB‐MRI detected Glisson invasion in only four tumors (sensitivity/specificity, 17%/100%). The cutoff value of caliber change for diagnosis of Glisson invasion was set at 140% by receiver operating characteristic analysis. The R0 resection rates were not significantly different between patients with (82%) and without (85%) Glisson invasion.ConclusionsIdentification of characteristic findings (tumor thrombus, peripheral dilatation, and border irregularity/caliber change) by contrast‐enhanced IOUS is useful for the prediction of Glisson invasion by CLM.
If in Doubt Don't Act Out! Exploring Behaviours in Clinical Decision Making by General Surgeons Towards Surgical Procedures
Authors: Whelehan Dale F. , Conlon Kevin C. , Ridgway Paul F. 
Published: January 2021

AbstractBackgroundClinical decision‐making (CDM) plays an integral role to surgeons work and has ramifications for patient outcomes and experience. The factors influencing a surgeons decision‐making and the utility of cognitive decisional short cuts used in CDM known as ‘heuristics’ remains unknown. The aim of this paper is to explore how general surgeons make decisions in high‐stake biliary tract clinical scenarios.MethodsThis was a cross sectional survey comprising of two sections—a ‘demographics section’ and a ‘clinical vignettes section’. Participants were recruited by an email distributed by the Royal College of Surgeons in Ireland. Non‐parametric testing examined relationships and content analysis was applied for clinical reasoning.Results73 participants or 37.6% of the overall population completed the survey. 71.4% of these were male. Most (50%) were higher trainees with moderate levels of overall reflective practice in decision‐making. A majority of participants chose conservatively in high‐stake biliary tract clinical cases with disease factors (43.5%) weighted highest, followed by personal factors (41.1%) and patient factors (15.4%) in clinical reasoning. The presence of a ‘hook’ associated with commonly used heuristics did not significantly change decision‐making behaviour.ConclusionIn high‐stake scenarios, surgeons make conservative clinical decisions, predominantly dominated by disease and personal justifications. The utility of heuristics in lower‐stake scenarios should be explored regarding clinical decision‐making rationale and outcomes. Practitioners should consider use of patient factors in high‐stake decisions to enable shared decision‐making when appropriate which can reduce post‐decisional regret and support the vision of patient‐centred care.
Enhanced Training Benefits of Video Recording Surgery With Automated Hand Motion Analysis
Authors: Mackenzie Colin F. , Yang Shiming , Garofalo Evan , Hu Peter Fu‐Ming , Watts Darcy , Patel Rajan , Puche Adam , Hagegeorge George , Shalin Valerie , Pugh Kristy , Granite Guinevere , Stansbury Lynn G. , Shackelford Stacy , Tisherman Samuel 
Published: January 2021

AbstractBackgroundHand motion analysis by video recording during surgery has potential for evaluation of surgical performance. The aim was to identify how technical skill during open surgery can be measured unobtrusively by video recording during a surgical procedure. We hypothesized that procedural‐step timing, hand movements, instrument use and Shannon entropy differ with expertise and training and are concordant with a performance‐based validated individual procedure score.MethodsSurgeon and non‐surgeon participants with varying training and levels of expertise were video recorded performing axillary artery exposure and control (AA) on un‐preserved cadavers. Color‐coded gloves permitted motion‐tracking and automated extraction of entropy data from recordings. Timing and instrument‐use metrics were obtained through observational video reviews. Shannon entropy measured speed, acceleration and direction by computer‐vision algorithms. Findings were compared with individual procedure score for AA performanceResultsExperts had lowest entropy values, idle time, active time and shorter time to divide pectoralis minor, using fewer instruments. Residents improved with training, without reaching expert levels, and showed deterioration 12–18 months later. Individual procedure scores mirrored these results. Non‐surgeons differed substantially.ConclusionsHand motion entropy and timing metrics discriminate levels of surgical skill and training, and these findings are congruent with individual procedure score evaluations. These measures can be collected using consumer‐level cameras and analyzed automatically with free software. Hand motion with video timing data may have widespread application to evaluate resident performance and can contribute to the range of evaluation and testing modalities available to educators, training course designers and surgical quality assurance programs.
The leading modes of NH extratropical tropopause variability and their connection with stratosphere-troposphere variability
Authors: Kim Jinju , Kim Kwang-Yul 
Published: January 2021

AbstractThe leading modes of Northern Hemisphere tropopause variability for November–April (1979/1980–2018/2019) and the associated stratosphere-troposphere variability were analyzed based on the NCEP and ERA interim reanalysis products. For this, cyclostationary empirical orthogonal function technique is employed. The first two modes feature the intraseasonal evolution of tropopause pressure anomalies over the Arctic, which respond directly to stratospheric temperature fluctuations in association with stratospheric polar vortex variations. These two modes reflect the link between stratospheric polar vortex strength and high-latitude tropospheric circulation. The first mode represents a single-phase fluctuation of the stratospheric polar vortex from winter to early spring. The second mode describes a two-phase fluctuation of the stratospheric vortex with opposite signs in winter and in spring. Tropopause pressure anomalies near the mid-latitude tropospheric jet regions exhibit significant zonal variation. In the first mode, in particular, these mid-latitude tropopause anomalies are linked to asymmetric jet variations in the Atlantic and the Pacific regions. In regard to the Northern Annular mode, distinct vertical evolution structures of the two modes are practically related to the varying evolutionary structure of extreme vortex events with relatively long persistence.
Is a diluted seawater-based solution safe and effective on human nasal epithelium?
Authors: Huang Song , Constant Samuel , De Servi Barbara , Meloni Marisa , Saaid Amina , Culig Josip , Bertini Marco 
Published: January 2021

Abstract
Purpose
Nasal irrigation is an effective method for alleviating several nasal symptoms and regular seawater-based nasal irrigation is useful for maintaining nasal hygiene which is essential for appropriate functioning of the nose and for preventing airborne particles including some pollutants, pathogens, and allergens from moving further in the respiratory system. However, safety studies on seawater-based nasal irrigation are scarce. In this study, the safety and efficacy of a diluted isotonic seawater solution (Stérimar Nasal Hygiene, SNH) in maintaining nasal homeostasis were evaluated in vitro.

Methods
Safety was assessed by measuring tissue integrity via transepithelial electrical resistance (TEER). Efficacy was measured by mucociliary clearance (MCC), mucin secretion, and tissue re-epithelization (wound repair) assays. All assays were performed using a 3D reconstituted human nasal epithelium model.

Results
In SNH-treated tissues, TEER values were statistically significantly lower than the untreated tissues; however, the values were above the tissue integrity limit. SNH treatment significantly increased MCC (88 vs. 36 µm/s, p < 0.001) and mucin secretion (1717 vs. 1280 µg/ml, p < 0.001) as compared to untreated cultures. Faster wound closure profile was noted upon pre-SNH treatment as compared to classical isotonic saline solution pre-treatment (90.5 vs. 50.7% wound closure 22 h after wound generation).

Conclusion
SNH did not compromise the integrity of the nasal epithelium in vitro. Furthermore, SNH was effective for removal of foreign particles through MCC increase and for enhancing wound repair on nasal mucosa.
The usefulness of a trauma probability of survival model for forensic life-threatening danger assessments
Authors: Jakobsen Lykke Schrøder , Lynnerup Niels , Steinmetz Jacob , Banner Jytte 
Published: January 2021

AbstractClinical forensic medical examinations constitute an increasing proportion of our institution’s tasks, and, concomitantly, the authorities are now requesting forensic life-threatening danger assessments based on our examinations. The aim of this retrospective study was to assess if a probability of survival (PS) trauma score could be useful for these forensic life-threatening danger assessments and to identify a cut-off PS score as a supporting tool for the forensic practice of assessing life-threatening danger. We compared a forensic database and a trauma database and identified 161 individuals (aged 15 years or older) who had both a forensic life-threatening danger assessment and a PS score. The life-threatening danger assessments comprised the following statements: was not in life-threatening danger (NLD); could have been in life-threatening danger (CLD); or was in life-threatening danger (LD). The inclusion period was 2012–2016. A statistically significant difference was found in the PS scores between NLD, CLD and LD (chi-square test: p < 0.0001). The usefulness of the PS score for categorizing life-threatening danger assessments was determined by a receiver-operator characteristic (ROC) curve. The area under the curve was 0.76 (95% CI, 0.69 to 0.84) and the ROC curve revealed that a cut-off PS score of 95.8 would appropriately identify LD. Therefore, a PS score below 95.8 would indicate life-threatening danger. We propose a further exploration of how the evidence-based PS score, including a cut-off value, might be implemented in clinical forensic medical statements to add to the scientific strength of these statements.
Involuntary sustained firing of plantar flexor motor neurones: effect of electrical stimulation parameters during tendon vibration
Authors: Mesquita Ricardo N. O. , Taylor Janet L. , Kirk Benjamin , Blazevich Anthony J. 
Published: January 2021

Abstract
Purpose
Simultaneous application of tendon vibration and neuromuscular electrical stimulation (NMES) induces an involuntary sustained torque. We examined the effect of different NMES parameters (intensity, pattern of stimulation and pulse width) on the magnitude of the evoked involuntary torque.

Methods
Plantar flexor torque was recorded during 33-s Achilles tendon vibration with simultaneous 20-Hz NMES bouts on triceps surae (n = 20; 13 women). Intensity was set to elicit 10, 20 or 30% of maximal voluntary contraction torque (MVC), pulse width was narrow (0.2 ms) or wide (1 ms), and the stimulus pattern varied (5 × 2-s or 10 × 1-s). Up to 12 different trials were performed in a randomized order, and then repeated in those who produced a sustained involuntary torque after the cessation of vibration.

Results
Six of 7 men and 5 of 13 women produced a post-vibration sustained torque. Eight of 20 participants did not complete the 30% trials, as they were perceived as painful. Torque during vibration at the end of NMES and the increase in torque throughout the trial were significantly higher in 20 than 10% trials (n = 11; 9.7 ± 9.0 vs 7.1 ± 6.1% MVC and 4.3 ± 4.5 vs 3.6 ± 3.5% MVC, respectively). Post-vibration sustained torque was higher in wide pulse-width trials (5.4 ± 5.9 vs 4.1 ± 4.3% MVC). Measures of involuntary torque were not different between 20 and 30% trials (n = 8).

Conclusion
Bouts of 5 × 2-s NMES with wide pulse width eliciting 20% MVC provides the most robust responses and could be used to maximise the production of involuntary torque in triceps surae.
Significance of indeterminate pulmonary nodules in resectable pancreatic adenocarcinoma—a review
Authors: Kuan Li Lian , Dennison Ashley R. , Garcea Giuseppe 
Published: January 2021

Abstract
Background
The clinical significance of indeterminate pulmonary nodules (IPN) in patients with resectable pancreatic adenocarcinoma (PDAC) is unknown. The rate of detection on IPN has risen due to enhanced staging investigations to determine resectability. IPNs detected on preoperative imaging represent a clinical dilemma and complicate decision-making. Currently, there are no recommendations on the management of IPN. This review provides a comprehensive overview of the current knowledge on the natural history of IPN detected among patients with resectable PDAC.

Methods
A systematic review based on a search in Medline and Embase databases was performed. All clinical studies evaluating the significance of IPN in patients with resectable PDAC were included. PRISMA guidelines were followed.

Results
Five studies met the inclusion criteria. The total patient population was 761. The prevalence of IPN reported ranged from 18 to 71%. The median follow-up duration was 17 months. The median overall survival was 19 months. Patients with pre-operative IPN which subsequently progressed to clinically recognizable pulmonary metastases, ranged from 1.5 to 16%. Four studies found that there was no significant difference in median overall survival in patients with or without IPNs.

Conclusion
This is a first review on the significance of IPN in patients with resectable PDAC. The preoperative presence of IPN does not demonstrate an association with overall survival after surgery. The identification of IPN is a significant finding however it should not preclude patients with resectable PDAC from undergoing curative resection.
Cabozantinib in Japanese patients with advanced hepatocellular carcinoma: a phase 2 multicenter study
Authors: Kudo Masatoshi , Tsuchiya Kaoru , Kato Naoya , Hagihara Atsushi , Numata Kazushi , Aikata Hiroshi , Inaba Yoshitaka , Kondo Shunsuke , Motomura Kenta , Furuse Junji , Ikeda Masafumi , Morimoto Manabu , Achira Meguru , Kuroda Shingo , Kimura Akiko 
Published: January 2021

Abstract
Background
To evaluate the efficacy and safety of cabozantinib in Japanese patients with advanced hepatocellular carcinoma (HCC) who had progressed following one or two lines of systemic therapy including sorafenib. An exploratory evaluation in sorafenib-naïve patients was performed.

Methods
In this open-label, single-arm, phase 2 trial, patients received oral cabozantinib 60 mg once daily. The primary endpoint was progression-free survival (PFS) rate at Week 24. Secondary endpoints included PFS, overall survival (OS), objective response rate (ORR, best response of complete/partial response), disease control rate (DCR, objective response or stable disease) and safety.

Results
Thirty-four patients received cabozantinib across 17 centers (prior sorafenib cohort, n = 20; sorafenib-naïve cohort, n = 14). PFS rate at 24 weeks was 59.8% [90% confidence interval (CI) 36.1–77.2%] in the prior sorafenib cohort, 16.7% (90% CI 4.0–36.8%) in the sorafenib-naïve cohort and 40.1% (90% CI 24.8–55.0%) overall. Median PFS was 7.4 months for the prior sorafenib cohort, 3.6 months for the sorafenib-naïve cohort, and 5.6 months overall. OS rate at 6 months was 100.0%, 78.6% and 91.1%, respectively; DCR was 85.0%, 64.3% and 76.5%, respectively. The ORR was 0.0% for both cohorts. All patients required dose modifications due to adverse events, the most common of these were palmar–plantar erythrodysesthesia syndrome and diarrhea. Three patients (8.8%) discontinued due to adverse events other than disease progression.

Conclusions
Cabozantinib 60 mg/day has a favorable benefit/risk profile for Japanese patients with advanced HCC who have previously received one or two lines of systemic anticancer therapy including sorafenib. (Clinical trial registration: NCT03586973)
Performance and Reuse of Steel Shot in Abrasive Waterjet Cutting of Granite
Authors: Cha Yohan , Oh Tae-Min , Joo Gun-Wook , Cho Gye-Chun 
Published: January 2021

AbstractSteel shots are suitable for abrasive waterjet rock cutting and recycling because of the high hardness and magnetic properties of steel. This study evaluated the rock-cutting performance and recycling characteristics of steel shot waterjet. The rock-cutting responses of steel shot and garnet were compared at the same waterjet conditions. The used steel shot was collected and the particle-size changes were evaluated before reuse, and its cutting performance was re-evaluated. Overall, the steel shot waterjet yielded improvements in performance in the range of 30–50% compared with the garnet waterjet. Moreover, the recycled steel shot yielded a 50% reduction in cutting performance. Rust was observed on the surface of the used steel shot, the used steel shots were partially destroyed, and the debris on the abrasive surface needed to be removed by drying. The reusable steel shot left on the 80th sieve converged to 60% in each recycling run. The results of this study can be used to reduce the cost of abrasive waterjet and industrial waste.
Towards 5G-based IoT security analysis against Vo5G eavesdropping
Authors: Kwon Sungmoon , Park Seongmin , Cho HyungJin , Park Youngkwon , Kim Dowon , Yim Kangbin 
Published: January 2021

AbstractWith the advent of 5G technology, the enhanced Mobile Broadband technology is translating 5G-based Internet of Things (IoT) such as smart home/building into reality. With such advances, security must mitigate greater risks associated with faster and more accessible technology. The 5G-based IoT security analysis is crucial to IoT Technology, which will eventually expand extensively into massive machine-type communications and Ultra-Reliable Low Latency Communications. This paper analyses the countermeasures and verification methods of eavesdropping vulnerabilities within IoT devices that use the current 5G Non-Standalone (NSA) network system. The network hierarchical structure of 5G-based IoT was evaluated for vulnerability analysis, performed separately for 5G Access Stratum (AS), Non-Access Stratum (NAS), and Internet Protocol (IP) Multimedia Subsystem (IMS). AS keystream reuse, NAS null-ciphering, and IMS IPsec off vulnerabilities were tested on mobile carrier networks to validate it on the 5G NSA network as well. A countermeasure against each vulnerability was presented, and our Intrusion Detection System based on these countermeasures successfully detected the presented controlled attacks.