bluuebunny/crossref_metadata_2025_split huggingface dataset:
A National Survey of Motor Vehicle Crashes Among General Surgery Residents
Authors: Schlick Cary Jo R. , Hewitt Daniel Brock , Quinn Christopher M. , Ellis Ryan J. , Shapiro Katherine E. , Jones Andrew , Bilimoria Karl Y. , Yang Anthony D. 
Published: June 2020

Objectives:
Evaluate the frequency of self-reported, post-call hazardous driving events in a national cohort of general surgery residents and determine the associations between duty hour policy violations, psychiatric well-being, and hazardous driving events.

Summary of Background Data:
MVCs are a leading cause of resident mortality. Extended work shifts and poor psychiatric well-being are risk factors for MVCs, placing general surgery residents at risk.

Methods:
General surgery residents from US programs were surveyed after the 2017 American Board of Surgery In-Training Examination. Outcomes included self-reported nodding off while driving, near-miss MVCs, and MVCs. Group-adjusted cluster Chi-square and hierarchical regression models with program-level intercepts measured associations between resident- and program-level factors and outcomes.

Results:
Among 7391 general surgery residents from 260 programs (response rate 99.3%), 34.7% reported nodding off while driving, 26.6% a near-miss MVC, and 5.0% an MVC over the preceding 6 months. More frequent 80-hour rule violations were associated with all hazardous driving events: nodding off while driving {59.8% with ≥5 months with violations vs 27.2% with 0, adjusted odds ratio (AOR) 2.86 [95% confidence interval (CI) 2.21–3.69]}, near-miss MVCs, [53.6% vs 19.2%, AOR 3.28 (95% CI 2.53–4.24)], and MVCs [14.0% vs 3.5%, AOR 2.46 (95% CI 1.65–3.67)]. Similarly, poor psychiatric well-being was associated with all 3 outcomes [eg, 8.0% with poor psychiatric well-being reported MVCs vs 2.6% without, odds ratio 2.55 (95% CI 2.00–3.24)].

Conclusions:
Hazardous driving events are prevalent among general surgery residents and associated with frequent duty hour violations and poor psychiatric well-being. Greater adherence to duty hour standards and efforts to improve well-being may improve driving safety.
Mental Health Burden After Injury
Authors: Herrera-Escobar Juan P. , Seshadri Anupamaa J. , Stanek Ewelina , Lu Kaye , Han Kelsey , Sanchez Sabrina , Kaafarani Haytham M. A. , Salim Ali , Levy-Carrick Nomi C. , Nehra Deepika 
Published: June 2020

Objective:
Assess the prevalence of anxiety, depression, and posttraumatic stress disorder (PTSD) after injury and their association with long-term functional outcomes.

Background:
Mental health disorders (MHD) after injury have been associated with worse long-term outcomes. However, prior studies almost exclusively focused on PTSD.

Methods:
Trauma patients with an injury severity score ≥9 treated at 3 Level-I trauma centers were contacted 6–12 months post-injury to screen for anxiety (generalized anxiety disorder-7), depression (patient health questionnaire-8), PTSD (8Q-PCL-5), pain, and functional outcomes (trauma quality of life instrument, and short-form health survey)). Associations between mental and physical outcomes were established using adjusted multivariable logistic regression models.

Results:
Of the 531 patients followed, 108 (20%) screened positive for any MHD: of those who screened positive for PTSD (7.9%, N = 42), all had co-morbid depression and/or anxiety. In contrast, 66 patients (12.4%) screened negative for PTSD but positive for depression and/or anxiety. Compared to patients with no MHD, patients who screened positive for PTSD were more likely to have chronic pain {odds ratio (OR): 8.79 [95% confidence interval (CI): 3.21, 24.08]}, functional limitations [OR: 7.99 (95% CI: 3.50, 18.25)] and reduced physical health [β: −9.3 (95% CI: −13.2, −5.3)]. Similarly, patients who screened positive for depression/anxiety (without PTSD) were more likely to have chronic pain [OR: 5.06 (95% CI: 2.49, 10.46)], functional limitations [OR: 2.20 (95% CI: 1.12, 4.32)] and reduced physical health [β: −5.1 (95% CI: −8.2, −2.0)] compared to those with no MHD.

Conclusions:
The mental health burden after injury is significant and not limited to PTSD. Distinguishing among MHD and identifying symptom-clusters that overlap among these diagnoses, may help stratify risk of poor outcomes, and provide opportunities for more focused screening and treatment interventions.
Latency-associated Peptide Identifies Immunoevasive Subtype Gastric Cancer With Poor Prognosis and Inferior Chemotherapeutic Responsiveness
Authors: Cao Yifan , He Hongyong , Li Ruochen , Liu Xin , Chen Yifan , Qi Yangyang , Yu Kuan , Wang Jieti , Lin Chao , Liu Hao , Zhang Heng , Li He , Chen Lingli , Zhang Peipei , Shen Zhenbin , Huang Hua , Sun Yihong , Zhang Weijuan , Qin Jing , Xu Jiejie 
Published: June 2020

Objective:
To examine the clinical significance of LAP to predict survival outcomes and chemotherapeutic responsiveness in gastric cancer.

Background:
LAP has been shown to possess significant immunoregulatory roles in several malignancies. However, the role and clinical significance of LAP in gastric cancer still remains unknown.

Methods:
Four hundred and fifty-six tumor tissue microarray specimens, 80 fresh tumor tissue samples of gastric cancer patients from Zhongshan Hospital, Fudan University and transcriptomic and clinical data of 328 gastric cancer patients from the Cancer Genome Atlas were analyzed. LAP expression and immune contexture were examined by immunohistochemistry, CIBERSORT, and flow cytometry. Clinical outcomes of patient subgroups were compared by Kaplan-Meier curves, Cox model and interaction test.

Results:
High LAP expression predicted poor overall survival (P < 0.001, P < 0.001, and P = 0.022) and inferior therapeutic responsiveness to fluorouracil-based adjuvant chemotherapy (P = 0.008 for interaction) in gastric cancer. LAP was associated with immunoevasive tumor microenvironment featured by dysfunctional CD8+ T cells infiltration (P < 0.001). The LAP-associated dysfunctional CD8+ T cells had an exhausted phenotype with decreased effector molecules such as interferon-γ, granzyme B, and perforin, but also elevated programmed cell death protein-1, which resulted in poor prognosis and inferior therapeutic responsiveness.

Conclusions:
This study revealed that LAP could identify immunoevasive subtype gastric cancer, indicating LAP might be a potential immunotherapeutic target and facilitate patient counseling on individualized adjuvant therapy and follow-up scheduling in gastric cancer.
The Quality of Operative Performance Narrative Feedback
Authors: Ahle Samantha L. , Eskender Mickyas , Schuller Mary , Carnes Emily , Chen Xilin , Koehler Jeanne , Willey Gabrielle , Latif Ahmed , Doyle Jennifer , Wnuk Gregory , Fryer Jonathan P. , Mellinger John D. , George Brian C. 
Published: June 2020

Objective:
To describe the quality of operative performance feedback using evaluation tools commonly used by general surgery residency training programs.

Summary of Background Data:
The majority of surgical training programs administer an evaluation through which faculty members may rate and comment on trainee operative performance at the end of the rotation (EOR). Many programs have also implemented the system for improving and measuring procedural learning (SIMPL), a workplace-based assessment tool with which faculty can rate and comment on a trainee's operative performance immediately after a case. It is unknown how the quality of narrative operative performance feedback delivered with these tools compares.

Methods:
The authors collected EOR evaluations and SIMPL narrative comments on trainees’ operative performance from 3 university-based surgery training programs during the 2016–2017 academic year. Two surgeon raters categorized comments relating to operative skills as being specific or general and as encouraging and/or corrective. Comments were then classified as effective, mediocre, ineffective, or irrelevant. The frequencies with which comments were rated as effective were compared using Chi-square analysis.

Results:
The authors analyzed a total of 600 comments. 10.7% of EOR and 58.3% of SIMPL operative performance evaluation comments were deemed effective (P < 0.0001).

Conclusions:
Evaluators give significantly higher quality operative performance feedback when using workplace-based assessment tools rather than EOR evaluations.
Development and Validation of a Modified Eighth AJCC Staging System for Primary Pancreatic Neuroendocrine Tumors
Authors: Zhang Xu-Feng , Xue Feng , Wu Zheng , Lopez-Aguiar Alexandra G. , Poultsides George , Makris Eleftherios , Rocha Flavio , Kanji Zaheer , Weber Sharon , Fisher Alexander , Fields Ryan , Krasnick Bradley A. , Idrees Kamran , Smith Paula M. , Cho Cliff , Beems Megan , Lyu Yi , Maithel Shishir K. , Pawlik Timothy M. 
Published: June 2020

Objective:
To improve the prognostic accuracy of the eighth edition of AJCC staging system for pNETs with establishment and validation of a new staging system.

Background:
Validation of the updated eighth AJCC staging system for pNETs has been limited and controversial.

Methods:
Data from the SEER registry (1975–2016) (n = 3303) and a multi-institutional database (2000–2016) (n = 825) was used as development and validation cohorts, respectively. A mTNM was proposed by maintaining the eighth AJCC T and M definitions, and the recently proposed N status as N0 (no LNM), N1 (1–3 LNM), and N2 (≥4 LNM), but adopting a new stage classification.

Results:
The eighth TNM staging system failed to stratify patients with stage I versus IIA, stage IIB versus IIIA, and overall stage I versus II relative to long-term OS in both database. There was a monotonic decrement in survival based on the proposed mTNM staging classification among patients derived from both the SEER (5-year OS, stage I 87.0% vs stage II 80.3% vs stage III 72.9% vs stage IV 57.2%, all P < 0.001), and multi-institutional (5-year OS, stage I 97.6% vs stage II 82.7% vs stage III 78.4% vs stage IV 50.0%, all P < 0.05) datasets. On multivariable analysis, mTNM staging remained strongly associated with prognosis, as the hazard of death incrementally increased with each stage among patients in the 2 cohorts.

Conclusion:
A mTNM pNETs clinical staging system using N0, N1, N2 nodal categories was better at stratifying patients relative to long-term OS than the eighth AJCC staging.
Timing for Introduction of Total Laparoscopic Living Donor Right Hepatectomy; Initial Experience Based on the Data of Laparoscopic Major Hepatectomy
Authors: Lee Boram , Choi YoungRok , Lee Woohyung , Park Youngmi , Kim Kil Hwan , Hyun In Gun , Han Sun Jong , Cho Jai Young , Yoon Yoo-Seok , Han Ho-Seong 
Published: June 2020

Background.
This study evaluated the timing of safe introduction of total laparoscopic donor right hepatectomy (TLDRH) based on outcomes of laparoscopic major hepatectomy (LMH).

Methods.
The data of 1013 consecutive patients who underwent laparoscopic liver resection from 2003 to 2017 were reviewed; the cumulative sum method was used to evaluate the learning curve of LMH. Patients were divided into 3 groups according to the timing of introduction of TLDRH (since 2010) and learning curve of LMH. Surgical outcomes of LMH and TLDRH were evaluated.

Results.
Cumulative sum analysis demonstrated a learning curve of approximately 73 cases of LMH. In phase I (before the introduction of TLDRH, 2003–2009), 38 cases of LMH were performed. Phase II (after the introduction of TLDRH until learning curve of LMH, 2010–2014), 35 and 15 cases of LMH and TLDRH were performed, respectively. Phase III (after learning curve of LMH until 2017, 2014–2017), 59 and 20 cases of LMH and TLDRH were performed, respectively. In cases of LMH, there was significant improvement in the operation time 398.9 ± 140.9 versus 403.7 ± 165.2 versus 265.5 ± 91.7; P < 0.001), estimated blood loss (1122.9 ± 1460.2 versus 1209.3 ± 1409.1 versus 359.8 ± 268.8; P < 0.001), and open conversion rate (26.3% versus 22.9% versus 13.6%; P = 0.026) between phases I versus II versus III. In cases of TLDRH, the operation time (567.8 ± 117.9 versus 344.2 ± 71.8; P < 0.001), estimated blood loss (800.7 ± 514.8 versus 439.4 ± 347.0; P = 0.004), and hospital stay (12.5 ± 4.36 versus 9.15 ± 4.84; P = 0.025) significantly improved in phase III.

Conclusions.
Overcoming the learning curve of LMH before starting TLDRH is advisable to ensure donor’s surgical outcomes.
Stokes' mathematical education
Authors: Barrow-Green June 
Published: June 2020

George Gabriel Stokes won the coveted title of Senior Wrangler in 1841, a year in which the examination papers for the Cambridge Mathematical Tripos were notoriously difficult. Coming top in the Mathematical Tripos was a notable achievement, but for Stokes it was a prize hard won after several years of preparation, and not only years spent at Cambridge. When Stokes arrived at Pembroke College, he had spent the previous two years at Bristol College, a school which prided itself on its success in preparing students for Oxford and Cambridge. This article follows Stokes' path to the senior wranglership, tracing his mathematical journey from his arrival in Bristol to the end of his final year of undergraduate study at Cambridge.This article is part of the theme issue ‘Stokes at 200 (Part 1)’.
Use of Stokes’ theorem for plasma confinement
Authors: MacKay R. S. 
Published: June 2020

Stokes’ theorem, in its original form and Cartan’s generalization, is crucial for designing magnetic fields to confine plasma (ionized gas). The paper illustrates its use, in particular to address the question whether quasi-symmetric fields, those for which guiding-centre motion is integrable, can be made with little or no toroidal current.This article is part of the theme issue ‘Stokes at 200 (Part 1)’.
The Navier–Stokes regularity problem
Authors: Robinson James C. 
Published: June 2020

There is currently no proof guaranteeing that, given a smooth initial condition, the three-dimensional Navier–Stokes equations have a unique solution that exists for all positive times. This paper reviews the key rigorous results concerning the existence and uniqueness of solutions for this model. In particular, the link between the regularity of solutions and their uniqueness is highlighted.
This article is part of the theme issue ‘Stokes at 200 (Part 1)’.
Viscous flow and collapse of macroscopic cavities in a granular material in terms of a Darcylet
Authors: Sano Osamu 
Published: June 2020

Viscous flow through a granular material that has a macroscopic cavity is obtained on the basis of the Stokes and the generalized Darcy’s equation. A new singularity termed ‘Darcylet’, a fundamental flow in the granular material that acts like a point force with negative direction, is proposed, which is applied to elucidate the interaction of two cavities. Depending on the configuration of the latter, the volume flux into the cavity increases, which enhances the local stresses on the boundary, causes the collapse of cavities and triggers landslides.
This article is part of the theme issue ‘Stokes at 200 (Part 1)’.
Nonlinear dynamics determines the thermodynamic instability of condensed matter
in vacuo
Authors: Cartwright Julyan H. E. 
Published: June 2020

Condensed matter is thermodynamically unstable in a vacuum. That is what thermodynamics tells us through the relation showing that condensed matter at temperatures above absolute zero always has non-zero vapour pressure. This instability implies that at low temperatures energy must not be distributed equally among atoms in the crystal lattice but must be concentrated. In dynamical systems such concentrations of energy in localized excitations are well known in the form of discrete breathers, solitons and related nonlinear phenomena. It follows that to satisfy thermodynamics such localized excitations must exist in systems of condensed matter at arbitrarily low temperature and as such the nonlinear dynamics of condensed matter is crucial for its thermodynamics.
This article is part of the theme issue ‘Stokes at 200 (Part 1)’.
Minimal transmission in an influenza A (H3N2) human challenge-transmission model within a controlled exposure environment
Authors: Nguyen-Van-Tam Jonathan S. , Killingley Ben , Enstone Joanne , Hewitt Michael , Pantelic Jovan , Grantham Michael L. , de Mesquita P. Jacob Bueno , Lambkin-Williams Robert , Gilbert Anthony , Mann Alexander , Forni John , Noakes Catherine J. , Levine Min Z. , Berman LaShondra , Lindstrom Stephen , Cauchemez Simon , Bischoff Werner , Tellier Raymond , Milton Donald K. ,   for the EMIT Consortium.
Published: June 2020

AbstractUncertainty about the importance of influenza transmission by airborne droplet nuclei generates controversy for infection control. Human challenge-transmission studies have been supported as the most promising approach to fill this knowledge gap. Healthy, seronegative volunteer ‘Donors’ (n=52) were randomly selected for intranasal challenge with influenza A/Wisconsin/67/2005 (H3N2). ‘Recipients’ randomized to Intervention (IR, n=40) or Control (CR, n=35) groups were exposed to Donors for four days. IRs wore face shields and hand sanitized frequently to limit large droplet and contact transmission. One transmitted infection was confirmed by serology in a CR, yielding a secondary attack rate of 2.9% among CR, 0% in IR (p=0.47 for group difference), and 1.3% overall, significantly less than 16% (p<0.001) expected based on a proof-of-concept study secondary attack rate and considering that there were twice as many Donors and days of exposure. The main difference between these studies was mechanical building ventilation in the follow-on study, suggesting a possible role for aerosols.Author summaryUnderstanding the relative importance of influenza modes of transmission informs strategic use of preventive measures to reduce influenza risk in high-risk settings such as hospitals and is important for pandemic preparedness. Given the increasing evidence from epidemiological modelling, exhaled viral aerosol, and aerobiological survival studies supporting a role for airborne transmission and the potential benefit of respirators (and other precautions designed to prevent inhalation of aerosols) versus surgical masks (mainly effective for reducing exposure to large droplets) to protect healthcare workers, more studies are needed to evaluate the extent of risk posed airborne versus contact and large droplet spray transmission modes. New human challenge-transmission studies should be carefully designed to overcome limitations encountered in the current study. The low secondary attack rate reported herein also suggests that the current challenge-transmission model may no longer be a more promising approach to resolving questions about transmission modes than community-based studies employing environmental monitoring and newer, state-of-the-art deep sequencing-based molecular epidemiological methods.
Cremation based estimates suggest significant under- and delayed reporting of COVID-19 epidemic data in Wuhan and China
Authors: He Mai , Li Li , Dehner Louis P. , Dunn Lucia F. 
Published: June 2020

AbstractBackgroundChina’s COVID-19 statistics fall outside of recognized and accepted medical norms. Here we estimated the incidence, death and starting time of the COVID-19 outbreak in Wuhan and China based on cremation related information.MethodsData sources included literature on COVID-19 in China, official Chinese government figures, state-run and non state-run media reports. Our estimates are based on investigative media reports of crematory operations in Wuhan, which is considered as a common data end point to life. A range of estimates is presented by an exponential growth rate model from lockdown (Jan 23,2020) until the intervention started to show effects, which was estimated 14.5 days after lockdown.ResultsFor the cumulative infections and total deaths, under different assumptions of case fatality rates (from 2.5% to 10%) and doubling time 6.4 days, the estimates projected on February 7, 2020 in Wuhan range from 305,000 to 1,272,000 for infections and from 6,811 to 7,223 for deaths - on the order of at least 10 times the official figures (13,603 and 545). The implied starting time of the outbreak is October 2019. The estimates of cumulative deaths, based on both funeral urns distribution and continuous full capacity operation of cremation services up to March 23, 2020, give results around 36,000, more than 10 times of the official death toll of 2,524.ConclusionsOur study indicates a significant under-reporting in Chinese official data on the COVID-19 epidemic in Wuhan in early February, the critical time for response to the COVID-19 pandemic.
A partial C4photosynthetic biochemical pathway in rice
Authors: Lin Hsiang-Chun , Arrivault Stéphanie , Coe Robert A , Karki Shanta , Covshoff Sarah , Bagunu Efren , Lunn John E. , Stitt Mark , Furbank Robert T. , Hibberd Julian M. , Quick W Paul 
Published: June 2020

AbstractIntroduction of a C4photosynthetic pathway into C3rice (Oryza sativa) requires installation of a biochemical pump that concentrates CO2at the site of carboxylation in modified bundle sheath cells. To investigate the feasibility of this, we generated a quadruple line that simultaneously expresses four of the core C4photosynthetic enzymes from the NADP-malic enzyme subtype, phosphoenolpyruvate carboxylase (ZmPEPC), NADP-malate dehydrogenase (ZmNADP-MDH), NADP-malic enzyme (ZmNADP-ME) and pyruvate phosphate dikinase (ZmPPDK), in a cell-specific manner. This led to enhanced enzyme activity but was largely neutral in its effects on photosynthetic rate and growth. Measurements of the flux of13CO2through photosynthetic metabolism revealed a significant increase in the incorporation of13C into malate, consistent with increased fixation of13CO2via PEP carboxylase in lines expressing the maize PEPC enzyme. We also showed13C labelling of aspartate indicating additional13CO2fixation into oxaloacetate by PEPC and conversion to aspartate by the endogenous aspartate aminotransferase activity. However, there were no significant differences in labelling of 3-phosphoglycerate (3PGA) or phosphoenolpyruvate (PEP) indicating limited carbon flux through C4enzymes into the Calvin-Benson cycle. Crossing the quadruple line with a line with reduced glycine decarboxylase H-protein (OsGDCH) abundance led to a photosynthetic phenotype characteristic of the reducedOsGDCH line and higher labelling of malate, aspartate and citrate. While Kranz anatomy or other anatomical modifications have not yet been installed in these plants to enable a fully functional C4cycle, these results demonstrate for the first-time flux through the carboxylation phase of C4metabolism in transgenic rice containing the key metabolic steps in the C4pathway.