bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing Exposures from the Deepwater Horizon Oil Spill Response and Clean-up
Authors: Stewart Patricia , Groth Caroline P , Huynh Tran B , Gorman Ng Melanie , Pratt Gregory C , Arnold Susan F , Ramachandran Gurumurthy , Banerjee Sudipto , Cherrie John W , Christenbury Kate , Kwok Richard K , Blair Aaron , Engel Lawrence S , Sandler Dale P , Stenzel Mark R 
Published: November 2021

Abstract
The GuLF Study is investigating adverse health effects from work on the response and clean-up after the Deepwater Horizon explosion and oil release. An essential and necessary component of that study was the exposure assessment. Bayesian statistical methods and over 135 000 measurements of total hydrocarbons (THC), benzene, ethylbenzene, toluene, xylene, and n-hexane (BTEX-H) were used to estimate inhalation exposures to these chemicals for &gt;3400 exposure groups (EGs) formed from three exposure determinants: job/activity/task, location, and time period. Recognized deterministic models were used to estimate airborne exposures to particulate matter sized 2.5 µm or less (PM2.5) and dispersant aerosols and vapors. Dermal exposures were estimated for these same oil-related substances using a model modified especially for this study from a previously published model. Exposures to oil mist were assessed using professional judgment. Estimated daily THC arithmetic means (AMs) were in the low ppm range (&lt;25 ppm), whereas BTEX-H exposures estimates were generally &lt;1000 ppb. Potential 1-h PM2.5 air concentrations experienced by some workers may have been as high as 550 µg m−3. Dispersant aerosol air concentrations were very low (maximum predicted 1-h concentrations were generally &lt;50 µg m−3), but vapor concentrations may have exceeded occupational exposure excursion guidelines for 2-butoxyethanol under certain circumstances. The daily AMs of dermal exposure estimates showed large contrasts among the study participants. The estimates are being used to evaluate exposure–response relationships in the GuLF Study.
Economic cost–utility analysis of stage-directed gastric cancer treatment
Authors: Powell Arfon G , Wheat Jennifer R , Eley Catherine , Robinson David , Roberts Stuart A , Lewis Wyn 
Published: November 2021

Abstract

Background
Gastric cancer (GC) treatment levies substantial financial burden on health services. Potentially curative surgery with or without chemotherapy is offered to patients with locoregional disease. This study aimed to examine treatment costs related to life-years gained in patients having potentially curative treatment (gastrectomy) and those receiving best supportive care (BSC).

Methods
Some 398 consecutive patients with GC were classified according to treatment modality (116 BSC, 282 gastrectomy). Cost calculations for 1 year’s treatment from referral were made according to network diagnostic, staging and treatment algorithms. Primary outcome was overall survival (OS).

Results
GC median survival after BSC was 8 months, costing €5413, compared with gastrectomy median survival of 34 months, costing €22 753 for 1 year’s treatment: cost per life-year gained €9319. Cost incurred for stage I GC was €22 434, stage II €23 498, stage III €22 445, and stage IV €22 032. Based on these values, the cost per quality adjusted life-year (QALY) for BSC for stage I GC was –€8335 stage II –€8952, stage III –€11 317, and stage IV –€25 669.

Conclusion
Potentially curative treatment that included gastrectomy improved OS four-fold compared with BSC and was cost-effective at national thresholds of readiness to pay per QALY.
Outcomes of leadless pacemaker implantation in patients with mechanical heart valves
Authors: Loughlin G , Pachon M , Martinez-Sande J.L , Ibanez J.L , Bastante T , Osca J , Arias M.A 
Published: November 2021

Abstract

Introduction
Device-related infections constitute a major complication of transvenous pacemaker implantation. Mechanical heart valves (MHV) increase the risk of infective endocarditis (IE) and pacemaker infection, worsening their outcomes.Leadless pacemakers (LP) have been associated with low infection rates and thus pose an attractive option in MHV patients requiring permanent pacing.

Methods and results
This is a multicenter, observational, retrospective study including all consecutive patients implanted with an LP at 5 tertiary referral centers between June 2015 and January 2020.Procedural outcomes, complications, performance during follow-up and episodes of bacteremia and IE were recorded and compared between patients with and without a MHV (MHV and non-MHV groups).Four hundred fifty-nine patients were included (74 in the MHV group, 16.1%, and 385 in the non-MHV group, 83.9%).Implantation success, procedural outcomes and acute electrical performance were comparable between groups.Vascular complications and cardiac perforation occurred in 2.7 vs. 2.3% (p=1) and 0% vs. 0.8% (p=1) in the MHV group and non-MHV group, respectively.During a median post-implant follow-up of 308 days for the MHV group and 416 days for non-MHV patients (p=0.029), one case of IE was reported in the MHV group and 2 in the non-MHV group. All three occurred in patients with abandoned transvenous leads.

Conclusion
LP implantation is feasible and safe in patients with MHV, with procedural outcomes and electrical performance comparable to the general LP population. Device-related infections, including IE, are rare in patients receiving an LP, including those with an MHV. LP implantation should be considered in MHV patients with an indication for pacing.

Funding Acknowledgement
Type of funding sources: None. Procedural outcomes and complicationsBaseline and follow-up parameters
Hidden Curriculum and Politicization of Medical Students in the Late Ottoman Empire
Authors: İlikan Rasimoğlu Ceren Gülser 
Published: November 2021

Abstract
This article discusses the effect of medical education on politicization during the late Ottoman period. The article focuses on the nineteenth-century emergence of the epistemological and etiological shift in medicine on a global scale, which led to the dominance of the modernization paradigm in the environment of the Military School of Medicine in Istanbul. The ideas favoring modernization and progressivism became widespread through partnerships and differences between the two generations of physicians represented by the periods of Tanzimat (1839-1876) and Abdülhamid II (1876-1909). Based on the narratives of prominent physicians of the late Ottoman and Early Republican Turkey, the article aims to illustrate that all the activities in the school resulted in the gradual transformation of the perspective of the students in contrast to their professors, interpreting the concept of progress as an effective basis to assist the modern aspirations of the administrative elites, composing the hidden curriculum of modern medical education in the Ottoman context. The younger generation began to equate materialism with solidarity, political activism, and insurgency, which would finally enable them to lead the movement against the monarchy or sultan. This generation would also occupy leading administrative positions in the first decades of the new Turkish Republic.
Galleria mellonella (Lepidoptera: Pyralidae) Hemocytes Release Extracellular Traps That Confer Protection Against Bacterial Infection in the Hemocoel
Authors: Chen Robin Y , Keddie B Andrew 
Published: November 2021

Abstract
Extracellular traps (ETs) released from vertebrate and invertebrate immune cells consist of chromatin and toxic granule contents that are capable of immobilizing and killing microbes. This recently described innate immune response is not well documented in insects. The present study found that ETs were released by hemocytes of Galleria mellonella (Linnaeus) (Lepidoptera: Pyralidae) in vivo and ex vivo after bacterial stimulation. ET release (ETosis), hemolymph coagulation, and melanization likely contributed to the immobilization and killing of the bacteria. The injection of G. mellonella hemocyte deoxyribonucleic acid (DNA) in the presence of bacteria increased bacterial clearance rate and prolonged insect survival. Taken together, these results indicate the presence of insect hemocyte extracellular traps (IHETs) that protect the insect against microbial infection in the hemocoel and represent the first documentation of ETs in insects in vivo.
Forty years in cryoEM of membrane proteins
Authors: Kühlbrandt Werner 
Published: November 2021

Abstract
In a surprisingly short time, electron cryo-microscopy (cryoEM) has developed from a niche technique in structural biology to a mainstream method practiced in a rapidly growing number of laboratories around the world. From its beginnings about 40 years ago, cryoEM has had a major impact on the study of membrane proteins, in particular the energy-converting systems from bacterial, mitochondrial and chloroplast membranes. Early work on two-dimensional crystals attained resolutions ∼3.5 Å, but at present, single-particle cryoEM delivers much more detailed structures without crystals. Electron cryo-tomography of membranes and membrane-associated proteins adds valuable context, usually at lower resolution. The review ends with a brief outlook on future prospects.
Immigration and the UK economy after Brexit
Authors: Portes Jonathan 
Published: November 2021

Abstract:
I review trends in migration to the UK since the Brexit referendum, examining first the sharp fall in net migration from the EU that resulted, and then the recent more dramatic exodus of foreign-born residents during the covid-19 pandemic. I describe the new post-Brexit system, and review studies which attempt to estimate both the impact on future migration flows and on GDP and GDP per capita. Finally, I discuss the wider economic impact of the new system and some of the policy implications.
The Arabidopsis ATR-SOG1 signaling module regulates pleiotropic developmental adjustments in response to 3'-blocked DNA repair intermediates
Authors: Li Jinchao , Liang Wenjie , Liu Yi , Ren Zhitong , Ci Dong , Chang Jinjie , Qian Weiqiang 
Published: November 2021

Abstract
Base excision repair and active DNA demethylation produce repair intermediates with DNA molecules blocked at the 3′-OH end by an aldehyde or phosphate group. However, both the physiological consequences of these accumulated single-strand DNAs break with 3′-blocked ends (DNA 3′-blocks) and the signaling pathways responding to unrepaired DNA 3′-blocks remain unclear in plants. Here, we investigated the effects of DNA 3′-blocks on plant development using the zinc finger DNA 3'-phosphoesterase (zdp) AP endonuclease2 (ape2) double mutant, in which 3′-blocking residues are poorly repaired. The accumulation of DNA 3′-blocked triggered diverse developmental defects that were dependent on the ATM and RAD3-related (ATR)-suppressor of gamma response 1 (SOG1) signaling module. SOG1 mutation rescued the developmental defects of zdp ape2 leaves by preventing cell endoreplication and promoting cell proliferation. However, SOG1 mutation caused intensive meristematic cell death in the radicle of zdp ape2 following germination, resulting in rapid termination of radicle growth. Notably, mutating FORMAMIDOPYRIMIDINE DNA GLYCOSYLASE (FPG) in zdp ape2 sog1 partially recovered its radicle growth, demonstrating that DNA 3′-blocks generated by FPG caused the meristematic defects. Surprisingly, despite lacking a functional radicle, zdp ape2 sog1 mutants compensated the lack of root growth by generating anchor roots having low levels of DNA damage response. Our results reveal dual roles of SOG1 in regulating root establishment when seeds germinate with excess DNA 3′-blocks.
How Do Individual Politicians Affect Privatization? Evidence from China
Authors: Ru Hong , Zou Kunru 
Published: November 2021

Abstract
This paper examines the role of local politicians’ patronage connections to top political leaders (i.e., the Central Committee of the Communist Party of China) in privatization outcomes. We find that connected local politicians are more likely to sell state-owned enterprises (SOEs) to corrupt buyers at substantially discounted prices. The SOEs purchased by corrupt buyers engage in significantly more fraudulent and corrupt activities following privatization and thus perform worse. For identification, we use the mandatory retirement ages of Central Committee members in a fuzzy regression discontinuity design. When local politicians lose their connections because Central Committee members step down after reaching mandatory retirement ages, we find a 14.4 percentage point drop in the likelihood of choosing corrupt buyers and a 90.13% drop in price discounts for privatization sales. Consequently, the privatized SOEs experience jumps in efficiency gains after the age cut-offs for mandatory retirement.
Trust Thy Neighbour? Compliance and Proximity to the EU through the Lens of Extradition
Authors: Mancano Leandro 
Published: November 2021

Abstract
The principle of mutual trust between Member States is key to the functioning of European Union (EU) law. Rooted in sincere cooperation and equality of the Union’s States, that principle is premised on compliance with shared values, interests, and rules. This fosters close cooperation in many areas, such as law enforcement, as exemplified by the European Arrest Warrant Framework Decision (EAW FD). Outside the Union, the presumption is that the principle of mutual trust does not apply. This seems confirmed by the case law on the extradition of EU citizens, with the EU Court of Justice (ECJ) prioritizing intra-EU cooperation over forced transfer of Union nationals to the requesting third countries. As the EU has developed a sophisticated network of relationships with its partners, and neighbours especially, the question arises as to when, if at all, third countries can be trusted, and when that trust can be challenged. By using the benchmark of EU membership as the standard of legal proximity, this article analyses the EU’s relationship with some of its neighbours in cases of extradition. The article creates an analytical framework to tackle unanswered questions around mutual trust and cooperation in criminal matters, and to read into the future of the legal relationship between the EU and some third countries.
Performance Nutrition for Physician Trainees Working Overnight Shifts: A Randomized Controlled Trial
Authors: Makowski Maryam S. , Trockel Mickey T. , Menon Nikitha K. , Wang Hanhan , Katznelson Laurence , Shanafelt Tait D. 
Published: November 2021

Purpose
To compare acute effects of 2 dietary interventions with usual dietary habits on physician trainees’ alertness during overnight shifts.

Method
This registered, controlled, block randomized crossover trial (NCT03698123) was conducted between October 2018 and May 2019 at Stanford Medicine. Physician trainees working at least 3 overnight shifts during a 1-week period were recruited. During the first night, participants followed their usual dietary habits. During the intervention nights (low carbohydrate-to-protein ratio and high carbohydrate-to-protein ratio interventions), participants received healthy dinners, snacks, water, and, upon request, caffeinated beverages, at the beginning of their shifts and were instructed to eat meals before 10 pm. The sequence of interventions on the second and third nights were block randomized across study weeks. Outcome measures (a priori) were overnight changes in validated measures of specific neurobehavioral dimensions: psychomotor vigilance, sensory–motor speed, working memory, and risk decision making, as well as self-reported sleepiness and work exhaustion.

Results
Sixty-one physician trainees participated in this study. Compared with usual dietary habits, overnight changes in psychomotor vigilance scores (scale 0–1,000) improved by 51.02 points (95% CI: 12.08, 89.96) and sleepiness (scale 1–7) improved by 0.69 points (95% CI: 0.33, 1.05) under the low carbohydrate-to-protein ratio intervention. Compared with usual dietary habits, overnight changes in sleepiness (scale 1–7) improved by 0.61 points (95% CI: 0.25, 0.96) under the high carbohydrate-to-protein ratio intervention. Neither intervention had beneficial effects relative to usual dietary habits with respect to sensory–motor speed, working memory, risk decision making, or work exhaustion. There were no differences in outcomes between low carbohydrate-to-protein ratio and high carbohydrate-to-protein ratio interventions.

Conclusions
Dietary interventions may mitigate negative effects of physician trainee sleep deprivation during overnight shifts. Future studies are warranted to further examine the effectiveness of nutritional strategies on physician alertness during overnight shifts.
Cardiac Rehabilitation in Patients With Ventricular Assist Device
Authors: Amstad Tabea , Taeymans Jan , Englberger Lars , Mohacsi Paul , Steiner Dieter , Wilhelm Markus J. , Hermann Matthias 
Published: November 2021

Purpose:
The aim of this study was to investigate changes in exercise capacity (EC) and quality of life (QoL) of patients with ventricular assist devices (VADs) during cardiac rehabilitation (CR).

Methods:
Data from patients with VAD implantation and subsequent CR between 2007 and 2017 were analyzed retrospectively. Measures of the 6-min walk test [6MWT] distance, Functional Independence Measure [FIM], ergometry, MacNew Heart Disease Questionnaire [MNH], and Hospital Anxiety and Depression Scale [HADS] at entry and discharge were examined.

Results:
Data from 110 patients (age 53 ± 12 yr; male 82%) were analyzed. Patients improved during CR significantly in the 6MWT (114 ± 85 m, P < .001), ergometry (20 ± 17 W, P = .002), FIM (8 ± 7 points, P < .001), and MNH (0.8 ± 0.7 points, P < .001). Initial HADS levels were high with a mean value of 9 and did not improve during CR (−0.4 ± 5 points, P = .637). Significant differences of improvements in the 6MWT were observed between left and biventricular VAD (129 ± 90 m vs 85 ± 67 m, P = .043) as well as destination therapy and bridge-to-transplant (184 ± 88 m vs 102 ± 82 m, P = .005).

Conclusions:
Patients with VAD implantation had statistically and clinically significant improvements in EC and QoL as assessed with the MNH during CR. Patients on destination therapy showed a larger benefit from CR than bridge-to-transplant patients and patients with left VAD improved more than biventricular VAD patients.
Acanthamoeba and staphylococcal keratitis with epithelial ingrowth after laser in situ keratomileusis
Authors: Wang Xiaorui , McAlinden Colm , Wang Xiaodong , Shen Di , Wei Wei 
Published: November 2021

Introduction:
A rare case of Acanthamoeba and staphylococcal keratitis after femtosecond laser–assisted laser in situ keratomileusis (LASIK), managed medically and surgically (with flap lift, scraping, and povidone–iodine 5% application) is reported.

Patient and clinical findings:
A 25-year-old woman presented 30 months after myopic LASIK with a painless loss of vision in the right eye. Visual acuity was 20/32, and a focal stromal opacity was observed.

Diagnosis, intervention, and outcomes:
The patient underwent flap lift, scraping, and application of povidone–iodine 5% to the flap interface. Samples were sent to the microbiology department for microscopic, culture, and sensitivity, and the patient was commenced with topical fluconazole, levofloxacin, and fusidic acid. Giemsa staining demonstrated 2 Acanthamoeba cysts. Microscopic examination revealed gram-positive cocci and pyogenic cells. Culture on a nonnutrient agar with a lawn of Escherichia coli identified the gram-positive organism Staphylococcus aureus. The clinical situation improved, and topical steroids were added. Mild epithelial ingrowth was noted at 4 months after flap lift; however, the growth remained stable and was under observation. The final visual outcome was good (visual acuity 20/25).

Conclusions:
This case emphasized the importance of precise microbiological diagnosis and consideration of early flap lift in post-LASIK infectious keratitis.
Survival After Liver Transplantation: An International Comparison Between the United States and the United Kingdom in the Years 2008–2016
Authors: Ivanics Tommy , Wallace David , Abreu Phillipe , Claasen Marco P.A.W. , Callaghan Chris , Cowling Thomas , Walker Kate , Heaton Nigel , Mehta Neil , Sapisochin Gonzalo , van der Meulen Jan 
Published: November 2021

Background.
Compared with the United States, risk-adjusted mortality in the United Kingdom has historically been worse in the first 90 d following liver transplantation (LT) and better thereafter. In the last decade, there has been considerable change in the practice of LT internationally, but no contemporary large-scale international comparison of posttransplant outcomes has been conducted. This study aimed to determine disease-specific short- and long-term mortality of LT recipients in the United States and the United Kingdom.

Methods.
This retrospective international multicenter cohort study analyzed adult (≥18 y) first-time LT recipients between January 2, 2008, and December 31, 2016, using the Organ Procurement and Transplantation Network/United Network for Organ Sharing and the UK Transplant Registry databases. Time-dependent Cox regression estimated hazard ratios (HRs) comparing disease-specific risk-adjusted mortality in the first 90 d post-LT, between 90 d and 1 y, and between 1 and 5 y.

Results.
Forty-two thousand eight hundred seventy-four US and 4950 UK LT recipients were included. The main LT indications in the United States and the United Kingdom were hepatocellular carcinoma (25.4% and 24.9%, respectively) and alcohol-related liver disease (20.3% and 27.1%, respectively). There were no differences in mortality during the first 90 d post-LT (reference: United States; HR, 0.96; 95% confidence interval [CI], 0.82–1.12). However, between 90 d and 1 y (HR, 0.71; 95% CI, 0.59–0.85) and 1 and 5 y (HR, 0.71; 95% CI, 0.63–0.81]) the United Kingdom had lower mortality. The mortality differences between 1 and 5 y were most marked in hepatocellular carcinoma (HR, 0.71; 95% CI, 0.58–0.88) and alcohol-related liver disease patients (HR, 0.64; 95% CI, 0.45–0.89).

Conclusions.
Risk-adjusted mortality in the United States and the United Kingdom was similar in the first 90 d post-LT but better in the United Kingdom thereafter. International comparisons of LT may highlight differences in healthcare delivery and help benchmarking by identifying modifiable factors that can facilitate improved global outcomes in LT.
Large-scale conformational changes of FhaC provide insights into the two-partner secretion mechanism
Authors: Sicoli G. , Konijnenberg A. , Guerin J. , Hessmann S. , Nero E. Del , Hernandez-Alba O. , Lecher S. , Rouaut G. , Müggenburg L. , Vezin H. , Cianférani S. , Sobott F. , Schneider R. , Jacob-Dubuisson F. 
Published: November 2021

AbstractThe Two-Partner secretion pathway mediates protein transport across the outer membrane of Gram-negative bacteria. TpsB transporters belong to the Omp85 superfamily, whose members catalyze protein insertion into, or translocation across membranes without external energy sources. They are composed of a transmembrane β barrel preceded by two periplasmic POTRA domains that bind the incoming protein substrate. Here we used an integrative approach combining in vivo assays, mass spectrometry, nuclear magnetic resonance and electron paramagnetic resonance techniques suitable to detect minor states in heterogeneous populations, to explore transient conformers of the TpsB transporter FhaC. This revealed substantial, spontaneous conformational changes with a portion of the POTRA2 domain coming close to the lipid bilayer and surface loops. Specifically, the amphipathic β hairpin immediately preceding the first barrel strand can insert into the β barrel. We propose that these motions enlarge the channel and hoist the substrate into it for secretion. An anchor region at the interface of the β barrel and the POTRA2 domain stabilizes the transporter in the course of secretion. Our data propose a solution to the conundrum how these transporters mediate protein secretion without the need for cofactors, by utilizing intrinsic protein dynamics.