bluuebunny/crossref_metadata_2025_split huggingface dataset:
The number and composition of work hours for attending physicians in Taiwan
Authors: Chang Ray-E. , Yu Tsung-Hsien , Shih Chung-Liang 
Published: September 2020

AbstractLong work hours among physicians is a worldwide issue in the healthcare arena. Previous studies have largely focused on the work hours of resident physicians rather than those of attending physicians. The purpose of this study was to investigate total work hours and the composition of those work hours for attending physicians across different hospital settings and across different medical specialties through a nationwide survey. This included examining differences in physician workload and its composition with respect to different hospital characteristics, and grouping medical specialties according to the work similarities. A cross-sectional self-reported nationwide survey was conducted from June to September of 2018, and the two questionnaires were distributed to all accredited hospitals in Taiwan. The number of physician work hours in different types of duty shifts were answered by medical specialty in each surveyed hospital. Each medical specialty in a hospital filled only one response for its attending physicians. The findings reveal that the average total work hours per week of an attending physician is around 69.1 h, but the total work hours and their composition of different duty shifts varied among hospital accreditation levels, geographic locations, emergency care responsibilities, and medical specialties. Because of the variance in the number and composition of attending physicians’ work hours, adjusting physician work hours to a reasonable level will be a major challenge for health authority and hospital managers.
Enhanced decontamination of levofloxacin as toxic pharmaceutical residuals from water using CaO/MgO nanorods as a promising adsorbent
Authors: AbuKhadra Mostafa R. , Basyouny Mohamed Gameel , AlHammadi Ali A. , El-Sherbeeny Ahmed M. , Salam Mohamed Abdel 
Published: September 2020

AbstractNovel MgO/CaO nanocomposite (MgO/CaO NRs) was synthesized by the hydrothermal method using diatomite porous frustules as a substrate under the microwave irradiation. The composite appeared as well crystalline rod-like nanoparticles with 52.3 nm as average particle size and 112.8 m2/g as BET surface area. The synthetic MgO/CaO NRs were addressed as a novel adsorbent for promising removal of levofloxacin (LVX) as pharmaceutical residuals. The adsorption studies revealed effective uptake of levofloxacin by MgO/CaO NRs with theoretical qmax of 106.7 mg/g and the equilibrium time of 720 min considering the best pH value (pH 7). The equilibrium studies highly fitted with the Langmuir model of monolayer adsorption considering the values of Chi-squared (χ2) and determination coefficient. The estimated adsorption energy from Dubinin–Radushkevich (0.2 kJ/mol) signifies physisorption mechanisms that might be coulombic attractive forces considering the kinetic studies. The thermodynamic addressing for the reactions verified their spontaneous and exothermic nature within a temperature range from 303 to 333 K. Additionally, the prepared MgO/CaO NRs show significant recyclability properties to be used in realistic remediation process and its uptake capacity is higher than several studied adsorbents in literature.
Surgical outcomes analysis in patients with uncomplicated acute type A aortic dissection: a 13-year institutional experience
Authors: Lin Chun-Yu , See Lai-Chu , Tseng Chi-Nan , Wu Meng-Yu , Han Yi , Lu Cheng-Hui , Tsai Feng-Chun 
Published: September 2020

AbstractThis retrospective study aimed to clarify the short-term and mid-term outcomes of and prognostic factors for patients who underwent surgical repair for uncomplicated acute type A aortic dissection (ATAAD). Between January 2007 and June 2019, 603 consecutive patients underwent ATAAD repair at our institution. According to patients’ preoperative presentations and imaging studies, uncomplicated ATAAD was found in 276 (45.8%) patients by excluding preoperative complicated factors. Patients with uncomplicated ATAAD were classified into the survivor (n = 243) and non-survivor (n = 33) groups. Clinical features, surgical information, and postoperative complications were compared. Three-year survival and freedom from reoperation rates for survivors were analyzed using the Kaplan–Meier actuarial method. The in-hospital surgical mortality rate of uncomplicated ATAAD patients was 11.9%. The non-survivor group had a higher rate of postoperative malperfusion-related complications, and a multivariate analysis revealed that repeat surgery, retrograde cerebral perfusion, and intraoperative extracorporeal membrane oxygenation support were predictors of in-hospital mortality. In the survivor group, 3-year cumulative survival and freedom from aortic reoperation rates were 89.6% (95% confidence interval [CI] 84.8–92.9%) and 83.1% (95% CI 76.8–87.7%), respectively. In conclusion, uncomplicated and complicated ATAAD rates were similar; the short-term and mid-term surgical outcomes in patients with uncomplicated ATAAD were generally acceptable.
Ultrathin single‐crystalline LiNbO3 film bulk acoustic resonator for 5G communication
Authors: Fang Zijing , Jin Hao , Dong Shurong , Lu Leihe , Xuan Weipeng , Luo Jikui 
Published: September 2020

This Letter reports a high‐performance film bulk acoustic resonator (FBAR) that can be applied in 5G wireless communication. The FBAR has a back‐etched free‐standing structure using an ultra‐thin single‐crystalline lithium niobate (LiNbO3 ) as the piezoelectric film. The thin LiNbO3 was obtained by the smart cut method and FBARs were fabricated by a standard MEMS process. Owing to the superior bulk‐like properties of the single‐crystal thin film, the fabricated FBARs have a resonant frequency of 5.0 GHz, a quality factor above 1800 and an electromechanical coupling coefficient of 2.66%, demonstrating a promising potential of FBAR filters in 5G and future 6G applications.
Fragmentation of star-forming filaments in the X-shaped nebula of the California molecular cloud
Authors: Zhang Guo-Yin , André Ph. , Men’shchikov A. , Wang Ke 
Published: September 2020

Context. Dense molecular filaments are central to the star formation process, but the detailed manner in which they fragment into prestellar cores is not well understood yet.
Aims. Here, we investigate the fragmentation properties and dynamical state of several star-forming filaments in the X-shaped nebula region of the California molecular cloud in an effort to shed some light on this issue.
Methods. We used multiwavelength far-infrared images from Herschel as well as the getsources and getfilaments extraction methods to identify dense cores and filaments in the region and derive their basic properties. We also used a map of 13CO(2−1) emission from the Arizona 10m Submillimeter Telescope (SMT) to constrain the dynamical state of the filaments.
Results. We identified ten filaments with aspect ratios of AR > 4 and column density contrasts of C > 0.5, as well as 57 dense cores, including two protostellar cores, 20 robust prestellar cores, 11 candidate prestellar cores, and 24 unbound starless cores. All ten filaments have roughly the same deconvolved full width at half maximum (FWHM), with a median value of 0.12 ± 0.03 pc, which is independent of their column densities ranging from <1021 cm−2 to >1022 cm−2. Two star-forming filaments (# 8 and # 10) stand out since they harbor quasi-periodic chains of dense cores with a typical projected core spacing of ~0.15 pc. These two filaments have thermally supercritical line masses and are not static. Filament 8 exhibits a prominent transverse velocity gradient, suggesting that it is accreting gas from the parent cloud gas reservoir at an estimated rate of ~40 ± 10 M⊙ Myr−1 pc−1. Filament 10 includes two embedded protostars with outflows and it is likely at a somewhat later evolutionary stage than filament 8. In both cases, the observed (projected) core spacing is similar to the filament width and significantly shorter than the canonical separation of ~4 times the filament width predicted by classical cylinder fragmentation theory. It is unlikely that projection effects can explain this discrepancy. We suggest that the continuous accretion of gas onto the two star-forming filaments, as well as the geometrical bending of the filaments, may account for the observed core spacing.
Conclusions. Our findings suggest that the characteristic fragmentation lengthscale of molecular filaments is quite sensitive to external perturbations from the parent cloud, such as the gravitational accretion of ambient material.
The New Generation Planetary Population Synthesis (NGPPS)
Authors: Schlecker M. , Mordasini C. , Emsenhuber A. , Klahr H. , Henning Th. , Burn R. , Alibert Y. , Benz W. 
Published: September 2020

Context. Recent observational findings have suggested a positive correlation between the occurrence rates of inner super-Earths and outer giant planets. These results raise the question of whether this trend can be reproduced and explained by planet formation theory.
Aims. Here, we investigate the properties of inner super-Earths and outer giant planets that form according to a core accretion scenario. We study the mutual relations between these planet species in synthetic planetary systems and compare them to the observed exoplanet population.
Methods. We invoked the Generation 3 Bern model of planet formation and evolution to simulate 1000 multi-planet systems. We then confronted these synthetic systems with the observed sample, taking into account the detection bias that distorts the observed demographics.
Results. The formation of warm super-Earths and cold Jupiters in the same system is enhanced compared to the individual appearances, although it is weaker than what has been proposed through observations. We attribute the discrepancy to warm and dynamically active giant planets that frequently disrupt the inner systems, particularly in high-metallicity environments. In general, a joint occurrence of the two planet types requires intermediate solid reservoirs in the originating protoplanetary disk. Furthermore, we find differences in the volatile content of planets in different system architectures and predict that high-density super-Earths are more likely to host an outer giant. This correlation can be tested observationally.
Improvement in Hemorrhoidal Disease Surgery Outcomes Using a New Anatomical/Clinical–Therapeutic Classification (A/CTC)
Authors: Naldini Gabriele , Caminati Filippo , Sturiale Alessandro , Fabiani Bernardina , Cafaro Danilo , Menconi Claudia , Mascagni Domenico , Celedon Porzio Felipe 
Published: September 2020

Abstract
Introduction The introduction and diffusion of new techniques for hemorrhoidal surgery have made it clear how much Goligher classification is inadequate in the modern times, lacking in any correlation between anatomical and clinical features to a surgical procedure. The aim of the study was to evaluate if the application of a new classification of hemorrhoidal diseases might lead to an improvement in the postoperative surgical outcomes.
Methods From January 2014 to December 2015, all patients undergoing surgery for hemorrhoidal disease were enrolled. The procedures performed were based upon a new anatomical/clinical–therapeutic classification (A/CTC) considering these items: anatomical presentation, symptom types and frequency, associated diseases, and available surgical treatments and their related contraindications. The new classification identified four groups: A (outpatient), B, C, and D (surgical approaches). The overall outcomes were assessed and then stratified by surgical groups. These data were then analyzed in comparison with the published data about all the surgical procedures performed.
Results A total of 381 patients underwent surgery and they were stratified as follows: Group B (39), C (202), and D (140). Group B underwent Doppler-guided dearterialization with mucopexies or tissue selective therapy, Group C stapled procedures, and Group D hemorrhoidectomy. The mean follow-up was 30 months. The overall outcomes were: success rate 92.4%, recurrences 7.6%, postoperative complications 4.8%, long-term complications 5.4%, and reoperation rate 2.7%. The success rates stratified by groups were: B, 85%); C, 91.4%; and D, 95.7%.
Conclusion The A/CTC proved to be useful in stratifying the patients and choosing the proper treatment for each case. This classification seems to improve the outcome of different surgical procedures if compared with those already published.
Acute Sensory and Autonomic Neuronopathy: A Devastating Disorder Affecting Sensory and Autonomic Ganglia
Authors: Gutierrez Joel , Palma Jose-Alberto , Kaufmann Horacio 
Published: September 2020

AbstractAcute-onset and severe sensory and autonomic deficits with no motor dysfunction, typically preceded by a febrile illness, with poor recovery, and often fatal outcome are the hallmark features of acute sensory and autonomic neuronopathy (ASANN). Pathologically and electrophysiologically, ASANN is characterized by an extensive ganglionopathy affecting sensory and autonomic ganglia with preservation of motor neurons. Consequently, patients, usually children or young adult, develop acute-onset profound widespread loss of all sensory modalities resulting in automutilations, as well as autonomic failure causing neurogenic orthostatic hypotension, neurogenic underactive bladder, and gastroparesis and constipation. The diagnosis is clinical with support of nerve conduction studies and autonomic testing, as well as spinal cord magnetic resonance imaging showing characteristic posterior cord hyperintensities. Although the presumed etiology is immune-mediated, further studies are required to clarify the physiopathology of the disease. We here performed a systematic review of the epidemiology, pathophysiology, diagnosis, and management of ASANN, with three representative cases that recently presented at our clinic. All three patients had the typical clinical manifestations of ASANN but in different combinations, illustrating the variable phenotype of the disorder. Immunosuppression is seldom effective. Management options are limited to supportive and symptomatic care with the goal of minimizing complications and preventing death.
Autonomic Dysfunction in the Synucleinopathies
Authors: Coon Elizabeth A. 
Published: September 2020

AbstractAutonomic dysfunction is a characteristic feature in the synucleinopathies. Differences in cellular deposition and neuronal populations affected by α-synuclein aggregation influence the manifestations and severity of autonomic failure in the different synucleinopathy disorders. The Lewy body disorders (Parkinson's disease, dementia with Lewy bodies, and pure autonomic failure) have predominantly peripheral involvement, whereas multiple system atrophy chiefly manifests as central autonomic failure. Clinical and laboratory features may be useful in distinguishing the different synucleinopathies based on the pattern and severity of autonomic failure. Treatment recommendations are aimed at the underlying pathophysiology and utilize non-pharmacologic and pharmacologic approaches. This review will focus on pathophysiology, clinical manifestations, and management recommendations for autonomic failure including neurogenic orthostatic hypotension, thermoregulatory dysfunction, genitourinary dysfunction, and gastrointestinal dysfunction in the synucleinopathies.
Sudomotor Dysfunction
Authors: Cheshire William P. 
Published: September 2020

AbstractDisorders of sudomotor function are common and diverse in their presentations. Hyperhidrosis or hypohidrosis in generalized or regional neuroanatomical patterns can provide clues to neurologic localization and inform neurologic diagnosis. Conditions that impair sudomotor function include small fiber peripheral neuropathy, sudomotor neuropathy, myelopathy, α-synucleinopathies, autoimmune autonomic ganglionopathy, antibody-mediated hyperexcitability syndromes, and a host of medications. Particularly relevant to neurologic practice is the detection of postganglionic sudomotor deficits as a diagnostic marker of small fiber neuropathies. Extensive anhidrosis is important to recognize, as it not only correlates with symptoms of heat intolerance but may also place the patient at risk for heat stroke when under conditions of heat stress. Methods for assessing sudomotor dysfunction include the thermoregulatory sweat test, the quantitative sudomotor axon reflex test, silicone impressions, and the sympathetic skin response.
Endoscopic Transnasal Resection of Midline Skull Base Meningiomas: Tumor Consistency and Surgical Outcomes
Authors: Al Abdulsalam Hissah K. , Aldahish Aljohara K. , Albakr Abdulrahman , Hussain Sajjad , Alroqi Ahmad , Alromaih Saud , Alsaleh Saad , Ajlan Abdulrazag M. 
Published: September 2020

Abstract
Background The endoscopic transnasal approach (ETA) has proven to be of great value in the resection of midline skull base meningiomas when compared with traditional approaches. Our objective was to assess tumor consistency in relation to surgical outcomes for midline meningiomas (MMs) resected using ETA.
Methods Radiological preoperative features, including the tumor to cerebellar peduncle T2-weighted magnetic resonance imaging (MRI) ratio (TCTI), were evaluated. The intraoperative consistency assessment was performed by the surgeon, which determined if the tumor was soft (resectable by suction) or firm (required a cavitation ultrasonic aspirator). Surgical resection and postoperative complications were evaluated in relation to tumor consistency.
Results Twenty patients were evaluated; 6 were classified as firm and 14 were classified as soft. The mean TCTI ratio was 1.7 and the median was 1.7 (range: 1.3–2.4). Three firm tumors had a ratio of <1.6. All soft tumors had a ratio of ≥1.6 with three outliers. Additionally, 66.7% of patients with firm tumors had complications compared with 35.7% of patients with soft tumors. Only 33.3% of firm tumors underwent gross total resection (GTR) in comparison to 79.0% of tumors with a soft consistency.
Conclusion In our analysis, we found that tumor consistency was significantly related to short-term surgical outcomes in MMs resected using the ETA. The TCTI ratio was found to be the most reliable predictor with a sensitivity of 76.9% and a specificity of 40.0%. Our findings suggest that traditional cranial approaches should be considered as the first surgical option for managing firm MMs.
Neuroendoscopy-Assisted Evacuation of Chronic Subdural Hematoma with Mixed CT Density Through A Novel Small Bone Flap
Authors: Huang Chuan Jun , Liu Xing , Zhou Xiao Ting , Qian Wei , Li Chen Hong , Wang Jin Hui , Zhang Wei , Zou Yu 
Published: September 2020

Abstract
Objective Chronic subdural hematoma (CSDH) is a common neurosurgical condition with an increasing incidence and favorable prognosis. Surgery is the standard treatment for CSDH, and bur hole evacuation is the most widely employed technique. However, if mixed computed tomography (CT) density is found, burr hole hematoma evacuation is prone to recurrence. Endoscopic examination of the hematoma cavity provides a novel strategy. Here, we present a modification of burr hole evacuation by using neuroendoscopy through a novel small trapezoid bone flap and assess the advantages and risks of the procedure.
Methods Twenty-five patients diagnosed with CSDH of mixed CT density were included in this study. Radiographic, epidemiologic, and clinical data were collected and analyzed. In all procedures the burr hole was replaced by a small trapezoidal cross-sectional bone flap, ∼2 cm in diameter. Neuroendoscopy was employed after the subdural cavity was cleaned and drained. The CSDH cavity was inspected thoroughly. If a blood clot, septa, stretching of cortical vessels, or intraluminal trabecular structures with active bleeding were found, the surgeon aspirated the region with a syringe pipe and/or used bipolar electrocoagulation.
Results All 25 patients who received 26 neuroendoscopy-assisted operations achieved favorable clinical outcomes. The recurrence rate was 4%. The average operation time was slightly increased compared with the traditional burr hole evacuation due to the use of the neuroendoscope and eventual subsequent treatment.
Conclusion Neuroendoscopy provides excellent illumination and vision when a small bone flap is employed. The main advantages of this technique include the precise treatment of structures which are related with progression and recurrence of CSDH, and the minimally invasive nature of the procedure.
Infective Endocarditis: A Case Series
Authors: Singh Sarvesh Pal , Singh Dharmraj 
Published: September 2020

AbstractInfective endocarditis (IE) is an infection of the endocardial surface of the heart. The incidence of IE worldwide is approximately 3 to 10 per 100,000 people annually. Twenty percent of patients die during the hospital stay, and the mortality may reach 25 to 30% six months postinfection. We hereby present our experience of six patients, of whom five survived. The cause of one death was late presentation and lack of coverage for Burkholderia in the prescribed empirical antibiotic therapy. One of our patients, with culture-negative endocarditis, responded to doxycycline and did not require any surgery. Five out of six patients who underwent surgery had vegetations more than 10 mm in size, and one patient had an aortic valve abscess (caused by Staphylococcus haemolyticus). Both prosthetic endocarditis and native valve endocarditis can be treated successfully with antimicrobial agents and surgery (when indicated). A high index of suspicion is required to diagnose IE caused by fungus and atypical bacteria.
Spatially dependent H-bond dynamics at interfaces of water/biomimetic self-assembled lattice materials
Authors: Wang Haoyuan , Wagner Jackson C. , Chen Wenfan , Wang Chenglai , Xiong Wei 
Published: September 2020

Significance
It is challenging to develop biomimetic lattice self-assemblies because such materials need to resemble the flexibility and crystallinity of their biological analog. We show that these materials exhibit unique micro- and mesoscopic-ordered ultrafast hydrogen-bond dynamics, which could be a key feature in the lattice self-assembly: the ultrafast dynamics ensure flexibility, whereas the domain-level ordering reflects crystallinity. This scientific insight cannot be revealed without the ultrafast transient vibrational sum-frequency generation microscope, which integrates ultrafast interfacial spectroscopy with interfacial molecular vibrational imaging––a state-of-the-art development.
Gravitational collapse in cubic Horndeski theories
Authors: Figueras Pau , França Tiago 
Published: September 2020

Abstract
We study spherically symmetric gravitational collapse in cubic Horndeski theories of gravity. By varying the coupling constants and the initial amplitude of the scalar field, we determine the region in the space of couplings and amplitudes for which it is possible to construct global solutions to the Horndeski theories. Furthermore, we identify the regime of validity of effective field theory as the sub-region for which a certain weak field condition remains small at all times. We evolve the initial data using the CCZ4 formulation of the Einstein equations and horizon penetrating coordinates without assuming spherical symmetry.