bluuebunny/crossref_metadata_2025_split huggingface dataset:
Famous Barriers Within the Bowtie Levels Analysis: Creating Middle and Senior Management Understanding About the Relative Importance of Management Activities. Providing Mathematical Methods
Authors: Hudson Timothy , Hudson Peter 
Published: July 2020

Abstract
The paper discusses extending the use of the Frequency Adjusted Measured Effectiveness (FAME) methodology (SPE-190633)(SPE-197793) to the operational, organisational and cultural levels in bowties. The method enables risk management functions to steer senior management toward effective management actions at the middle management level, allows greater understanding of the cultural and regulatory factors impacting those management activities, and provides a clearer understanding of where the most important impact can be achieved through organisational change.
This paper develops Bowtie concepts by applying FAME (SPE-190633)(SPE-197793) to the bowtie ‘levels analysis’ (SPE 127180). The ‘levels analysis’ defines the barriers at the levels of a bowtie as the workplace (Level 1, L1), organisational (Level 2, L2), and cultural and regulatory factors (Level 3, L3). FAME quantifies the relative importance of barriers within bowtie systems as a whole. The paper uses these concepts to provide simple ways of providing middle and senior managers with understanding about how well their risks are being managed.
The disconnect between what management does and what actually needs to be done has been shown to contribute strongly to accidents. Without the support of analytical tools to steer decision-making, management activities are generally prioritised on an ad-hoc basis, usually guided by an individual manager's experience as well as senior management pressures. This can lead to important management activities not being conducted as rigorously as they require. The Levels Analysis improves understanding of the middle and senior management roles involved in the management of the risks of the operation, while the FAME methodology supports the understanding of the relative importance of those activities, allowing prioritisation. When applied this allows risk-based decision-making to be applied not only to frontline tasks but also to higher-level management functions. This approach, by looking at all the management functions controlling barriers, allows risk managers to communicate clearly the priority safety critical management functions require to senior managers.
This allows the conversation to change from "why wasn't he wearing his gloves?" to "how did we not have a start-up audit on this contract?" The emphasis is moved from immediate causes that are hard to control to factors that are within the span of control of middle and senior managers. This paper introduces a method for clearly communicating to middle and senior management what their own critical management functions are, which are most important and what they can and should be held accountable for.
Needs assessment for a curriculum for difficult conversations -A survey from 5 Chinese accredited neurology residency training programs
Authors: Zhou Lixin , Wu Bo , Wu Liyong , Cheng Xin , Hu Bo , Yao Ming , Zhu Yicheng , Peng Bin , Cui Liying , Ni Jun 
Published: July 2020

Abstract
Background: Communication skill is a core competency in neurology residency training. Specific training in this area at the residency level is often lacking, especially regarding difficult conversations. The aim of this study is to evaluate the current state in teaching residents about difficult conversations in 5 Chinese accredit neurology residency training programs and determine whether there is a perceived need for a formalized curriculum in this field. Methods: An anonymous, 27-question, cross-sectional online survey addressing difficult conversations for neurological residents were distributed to five grade-A, class-3 hospitals selected from the affiliated teaching hospitals of medical schools qualified to provide neurology residency training in China. Results: A total of 182 residents responded to the survey, and the response rate was 67.16% (182/271). Of the participants, 84.6% were female and the average age was 26.8 years. The majority of respondent residents (n=168; 92.31%) reported being exposed to at least one difficult conversation in their medical careers. Only 43 (23.63%) participants reported having previously received formal communication skills training. In comparison with residents without previous training, those with previous training indicated significantly more confidence（P=0.003）and were under lower pressure（P=0.037）in managing difficult conversations. Only 97 (53.3%) residents indicated interest in receiving formal training. Time, lack of enthusiasm, lack of educational materials and faculty expertise were commonly cited barriers to formalized training. Conclusion: This survey provides a preliminary assessment of the current status of education on the topic of difficult conversations in five accredit Chinese neurology residency training programs. Our results suggest that there is an unmet need to further develop and implement educational activities by teaching residents to lead difficult conversations. Future efforts should be made to establish and promote standard and targeted communication curriculum in difficult conversation for Chinese neurological residents.
Allo-HSCT compared with immunosuppressive therapy for acquired aplastic anemia: Is superiority a one-sided understanding?
Authors: Zhu Yangmin , Gao Qingyan , Hu Jing , Guan Dongrui , Liu Xu , Zhang Fengkui 
Published: July 2020

Abstract
Acquired aplastic anemia (AA) is a rare hematologic disease characterized by a profound pancytopenia and hypocellular bone marrow. To comprehensively compare the efﬁcacy and safety of allogeneic hematopoietic stem cell transplantation (allo-HSCT) with immunosuppressive therapy (IST) as a front-line treatment for patients with AA. We searched the Medline, Embase, and Cochrane Registry of Controlled Trials databases from January 2000 to March 2019. Studies comparing allo-HSCT with IST as a first-line therapy for patients with AA were included. Fifteen studies including a total of 5336 patients were included in the meta-analysis. The pooled hazard ratio (HR) for overall survival (OS) was 0.4 (95% CI 0.074–0.733, P = 0.016, I2 = 58.8%) and the pooled HR for failure-free survival (FFS) was 1.962 (95% CI 1.43–2.493, P = 0.000, I2 = 0%). The pooled relative risk (RR) for overall response rate (ORR) was 1.691 (95% CI 1.433–1.996, P = 0.000, I2 = 11.6%). Although survival was significantly longer among AA patients undergoing first-line allo-HSCT compared to those undergoing first-line IST, the selection of initial treatment for patients with newly diagnosed AA still requires comprehensive evaluation of donor availability, patient age, expected quality of life, risk of disease relapse or clonal evolution after IST, and potential use of adjunctive eltrombopag.
Cost-effective joint Optimisation of BBU Placement and Fronthaul Deployment in Brown-field Scenarios
Authors: Marotta Andrea , Correia Luis Manuel 
Published: July 2020

Abstract
In this work , one proposes a model to evaluate the optimal deployment of Centralised Radio Access Network (C- RAN ) architecture elements , i.e. Base Band processing Units ( BBUs ) and fronthaul links , in a brown- field scenario, in which traditional base stations are already deployed and a physical network is present. The proposed optimisation framework jointly optimises BBU placement and access network infrastructures deployment . It clusterises the Remote Radio Heads in the scenario through a Multicommodity Flow approach , and solves the minimum cost fronthaul network deployment through a Rooted Delay - Constrained Minimum Spanning Tree approach . Optical fibre and microwave links are considered as fronthaul infrastructures . The proposed optimisation framework is validated through a comparison with a theoretical output for a canonical scenario, being afterwards applied to a real scenario. A cost analysis for different scenario configurations is presented , and trade - offs and guidelines for a cost optimal deployment of C- RAN are provided . The analysis of results for the real scenario of the city of Lisbon and its surrounding areas shows that the delay budget in the fronthaul network highly impacts on capital expenditures as well as on operational ones . It is shown that a larger delay budget enables an annual cost reduction up to 72 % in urban areas and 54 % in rural ones .
A knowledge-based intensity-modulated radiation therapy treatment planning technique for locally advanced nasopharyngeal carcinoma radiotherapy
Authors: Bai Penggang , Weng Xing , Quan Kerun , Chen Jihong , Dai Yitao , Xu Yuanji , Lin Fasheng , Zhong Jing , Wu Tianming , Chen Chuanben 
Published: July 2020

Abstract
BackgroundTo investigate the feasibility of a knowledge-based automated intensity-modulated radiation therapy (IMRT) planning technique for locally advanced nasopharyngeal carcinoma (NPC) radiotherapy.Methods140 NPC patients treated with definitive radiation therapy with the step-and-shoot IMRT techniques were retrospectively selected and separated into a knowledge library (n=115) and a test library (n=25). For each patient in the knowledge library, the overlap volume histogram (OVH), target volume histogram (TVH) and dose objectives were extracted from the manually generated plan. 5-fold cross validation was performed to divide the patients in the knowledge library into 5 groups before validating one group by using the other 4 groups to train each neural network (NN) machine learning models. For patients in the test library, their OVH and TVH were then used by the trained models to predict a corresponding set of mean dose objectives, which were subsequently used to generate automated plans (APs) in Pinnacle planning system via an in-house developed automated scripting system. All APs were obtained after a single step of optimization. Manual plans (MPs) for the test patients were generated by an experienced medical physicist strictly following the established clinical protocols. The qualities of the APs and MPs were evaluated by an attending radiation oncologist. The dosimetric parameters for planning target volume (PTV) coverage and the organs-at-risk (OAR) sparing were also quantitatively measured and compared using Mann-Whitney U test and Bonferroni correction.ResultsAPs and MPs had the same rating for more than 80% of the patients (19 out of 25) in the test group. Both AP and MP achieved PTV coverage criteria for no less than 80% of the patients. For each OAR, the number of APs achieving its criterion was similar to that in the MPs. The AP approach improved planning efficiency by greatly reducing the planning duration to about 17% of the MP (9.85±1.13 min vs. 57.10±6.35 min).ConclusionA robust and effective knowledge-based IMRT treatment planning technique for locally advanced NPC is developed. Patient specific dose objectives can be predicted by trained NN models based on the individual’s OVH and clinical TVH goals. The automated planning scripts can use these dose objectives to efficiently generate APs with largely shortened planning time. These APs had comparable dosimetric qualities when compared to our clinic’s manual plans.
Impairment-driven cancer rehabilitation in patients with neoplastic spinal cord compression using minimally invasive spine stabilization
Authors: Ishida Yukako , Shigematsu Hideki , Tsukamoto Shinji , Morimoto Yasuhiko , Iwata Eiichiro , Okuda Akinori , Kawasaki Sachiko , Tanaka Masato , Fujii Hiromasa , Tanaka Yasuhito , Kido Akira 
Published: July 2020

Abstract
Background: Neoplastic spinal cord compression is a cause of severe disability in cancer patients. To prevent irreversible paraplegia, a structured strategy is required to address the various impairments present in cancer patients. In this study, we aimed to identify the status where rehabilitation with minimally invasive spine stabilization (MISt) effectively improves ADL.Methods: We retrospectively reviewed 27 consecutive patients with neoplastic spinal compression who were treated with MISt. We classified the impairments of patients through our multidisciplinary tumor board based on spine-specific factors, skeletal instability and tumor growth. The neurological deficits, progress of pathological fracture, incidence of vertebral collapse, postoperative implant failure were examined. Changes of the Barthel index (BI) scores before and after surgery were investigated throughout the clinical courses.Results: The average duration to ambulation was 7.19±11 days, and we observed no collapse or progression of paralysis except in four cases of complete motor paraplegia before the surgery. Neurological deficiency was improved to or maintained at Frankel’s grade E in 16 patients, remained unchanged in 6 patients (in grades B, C, D), and worsened in 5 patients. BI score comparisons before and after surgery in all patients showed statistically significant increments (p < 0.05). On further analysis, we noted good functional prognosis in patients capable of ambulation within seven days (p < 0.05) and in patients who could survive longer than three months after the surgery (p < 0.05).Conclusions: In various cancer patients with neoplastic spinal cord compression, skeletal instability as the primary impairment is a good indication for MISt, as the patients showed early ambulation with improved BI scores.
Digital Crowdsourcing in Promoting HIV testing Among MSM in China: Study Protocol for A Cluster-Randomized Controlled Trial
Authors: Ren Ci , Tucker Joseph David , Tang Weiming , Tao Xiaorun , Liao Meizhen , Wang Guoyong , Jiao Kedi , Xu Zece , Zhao Zhe , Yan Yu , Lin Yuxi , Li Chuanxi , Wang Lin , Li Yijun , Kang Dianmin , Ma Wei 
Published: July 2020

Abstract
Background: Men who have sex with men (MSM) are an important key population in China. However, HIV testing rates among MSM remain suboptimal. Digital crowdsourcing may be a useful tool to reach this marginalized population. The proposed cluster randomized controlled trial (RCT) study aims to assess the effectiveness of digital crowdsourcing in improving HIV testing and sexual behaviors change among Chinese MSM. Methods: A two-arm, cluster-randomized controlled trial will be implemented in eleven cities (ten clusters) in Shandong Province, China. Target study enrollment will be 250 participants per arm and 50 participants per cluster. MSM who are 18 years old or above, live in the study city, have not been tested for HIV in the past 3 months, are not living with HIV or have never been tested for HIV, and are willing to provide informed consent, will be enrolled. MSM will be recruited through banner advertisements on Blued, the largest gay dating app in China, and in-person at community-based organizations (CBOs). Participants will be followed-up quarterly during the 12-month period. The primary outcome will be the self-reported uptake of HIV testing. Secondary outcomes will include change in condomless sex, self-test efficacy, social network engagement, HIV testing social norms, and testing stigma.Discussion: Innovative approaches to HIV testing among marginalized population are urgently needed. Through this cluster randomized controlled trial, we expected that we can evaluate effectiveness of a digital crowdsourcing approach, improve the HIV testing rate among MSM and provide a resource in related public health fields.Trial Registration: ChiCTR1900024350. Registered on 6 July 2019, identifier http:// chictr.org.cn/.
Precarious working conditions and psychosocial work stress act as a risk factor for symptoms of postpartum depression during maternity leave: results from a longitudinal cohort study
Authors: Karl Marlene , Schaber Ronja , Kress Victoria , Kopp Marie , Martini Julia , Weidner Kerstin , Garthus-Niegel Susan 
Published: July 2020

Abstract
Introduction: Most Western women work during their reproductive years, but past research has often neglected the influence of work-related factors on postpartum health. Especially postpartum depression (PPD) puts an enormous psychological burden on mothers. Therefore, this study aims to investigate the prospective impact of precarious working conditions and psychosocial work stress (such as work-privacy conflict and effort-reward imbalance at the job) during pregnancy on symptoms of maternal PPD. Methods: In the prospective-longitudinal cohort study DREAM ( DR esdner Studie zu E lternschaft, A rbeit und M entaler Gesundheit), N = 587 employed women were questioned about their work during pregnancy and mental health 8 weeks after delivery. Results: Multiple regression analyses revealed that work-privacy conflict, low reward at work, and precarious working conditions significantly predicted symptoms of PPD, even when controlling for lifetime depression, anxiety, education, parity, and age. Conclusion: Our results indicate that psychosocial work stress and precarious working conditions have important implications for maternal peripartum mental health and might act as prospective risk factors for PPD even during the period of maternal leave. Hence, preventative measures targeting work life need to be investigated in more detail.
Three-dimensional length from the center of the liver is a prognostic factor of colorectal cancer with liver metastasis: a retrospective analysis
Authors: Bong Jun Woo , Ju Yeonuk , Seo Jihyun , Kang Sang Hee , Park Pyoung-Jae , Choi Sae-Byeol , Lee Sun Il , Oh Sang Cheul , Min Byung Wook 
Published: July 2020

Abstract
Background Resectability of liver metastasis is important to establish a treatment strategy for colorectal cancer patients. We aimed to evaluate the effect of distance from metastasis to the center of the liver on the resectability and patient outcomes after hepatectomy.Methods Clinical data of a total of 124 patients who underwent hepatectomy for colorectal cancer with liver metastasis were retrospectively reviewed. We measured the minimal length from metastasis to the bifurcation of the portal vein at the primary branch of the Glissonean tree and defined it as “Centrality”. Predictive effects on positive resection margin and overall survival of centrality were statistically analyzed.Results The value as a predictive factor for the positive resection margin of centrality was analyzed by the receiver operating characteristic curve (area under the curve = 0.72, P<0.001) and centrality ≤ 1.5 cm was an independent risk factor the positive resection margin in multivariate analysis. Total number of metastases ≥ 3 and centrality ≤ 1.5 cm were significant risk factors of overall survival after Cox regression analysis. Patients with these two risk factors (n=21) had worse 5-year overall survival (10.7%) than patients with one (n=35, 58.3%) or no risk factor (n=68, 69.2%).Conclusion Centrality was related with the positive resection margin of deeply located liver metastasis. Centrality should be considered to establish the surgical strategy for patients with advanced colorectal cancer with liver metastasis.
Metadichol ® a novel nano lipid that inhibits In Vitro, SARS-COV-2 and a multitude of pathological viruses
Authors: Raghavan Palayakotai R 
Published: July 2020

Abstract

New pathogenic virus outbreaks, occurring with increasing regularity, are leading us to explore novel approaches, which will reduce the reliance on time-consuming vaccine modes to halt the outbreaks. The requirement is to find a universal approach to disarm any new and as yet unknown viruses as they appear. A promising approach could be targeting lipid membranes, which are common to all viruses and bacteria.The ongoing pandemic of severe acute respiratory syndrome-coronavirus 2 (SARS-COV-2) has reaffirmed the importance of interactions between components of the host cell plasma membrane and the virus envelope as a critical mechanism of infection. Metadichol®, a nano lipid emulsion, has been examined and shown to be a strong candidate to help stop the proliferation of SARS-COV-2.Naturally derived substances, such as long-chain saturated lipid alcohols, reduce the infectivity of various types of viruses, including coronaviruses such as SARS-COV-2, by modifying lipid-dependent attachment to human host cells. SARS-COV-2 uses the receptor ACE2 for entry and the serine protease TMPRSS2 for S protein priming.Metadichol®, a nano lipid formulation of long-chain alcohols, has been shown to inhibit TMPRSS2 (EC50 96 ng/ml). Compared to the inhibitor camostat mesylate (EC50 26000 ng/ml), it is 270 times more potent. Additionally, Metadichol® is also a weak inhibitor of ACE2 at 31 µg/ml. Further a live virus assay in Caco2 cells, Metadichol® inhibited SARS-CoV-2 replication with an EC90 of 0.16 µg/ml.
Targeted deletions of complement lectin pathway genes improve outcome in traumatic brain injury
Authors: Mercurio Domenico , Oggioni Marco , Fumagalli Stefano , Lynch Nicholas , Roscher Silke , Minuta Denise , Perego Carlo , Ippati Stefania , Wallis Russell , Schwaeble Wilhelm , Simoni Maria-Grazia De 
Published: July 2020

Abstract
The complement system is believed to contribute to inflammation in acute brain injury. This work defines the neurobehavioral response to traumatic brain injury (TBI) modeled by controlled cortical impact in wild-type mice and in mice carrying gene-targeted deficiencies of individual components of the lectin pathway of complement activation to identify the key components contributing to pathology. Targeted gene deletions include: the recognition subcomponents ficolin-A, CL-11, MBL-C and MBL-A, both individually and combined, and the serine proteases MASP-1, MASP-2 and MASP-3. Our results demonstrate that MASP-2 deficiency brings the highest protective phenotype, countering long-term neuroinflammatory injury following TBI, as shown by reduced neuronal deficits and neuronal cell loss compared to wild-type mice. This study highlights MASP-2 as a promising pharmacological target in patients suffering from TBI, a leading cause of death and disability.
MULocDeep: A deep-learning framework for protein subcellular and suborganellar localization prediction with residue-level interpretation
Authors: Jiang Yuexu , Wang Duolin , Yao Yifu , Eubel Holger , Künzler Patrick , Møller Ian , Xu Dong 
Published: July 2020

Abstract
Prediction of protein localization plays an important role in understanding protein function and mechanism. In this paper, we propose a general deep learning-based localization prediction framework, MULocDeep, which can predict multiple localizations of a protein at both subcellular and suborganellar levels. We collected a dataset with 45 suborganellar localization annotations in 10 major subcellular compartments, the most comprehensive suborganelle localization dataset to date. We also experimentally generated an independent dataset of mitochondrial proteins in Arabidopsis thaliana cell cultures, Solanum tuberosum tubers, and Vicia faba roots and made this dataset publicly available. Evaluations using the above datasets show that overall MULocDeep outperforms other major methods at both subcellular and suborganellar levels. Furthermore, MULocDeep assesses each amino acid’s contribution to localization, which provides insights into the mechanism of protein sorting and localization motifs. A web server can be accessed at http://mu-loc.org/.