bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lung Function in Royal Naval Firefighting Instructors
Authors: Searing Caroline S. M. , Smith D. J. , Pethybridge R. J. , Goad R. F. , Legg S. J. 
Published: October 2021

AbstractA four phase investigation into the effects of Royal Naval firefighting training on pulmonary function was carried out between 1979 and 1984. Phases I and II, reported elsewhere, failed to demonstrate changes in the lung function either in instructors, as measured by forced spirometry and transfer factor, over a one month period, or trainees, as measured by forced spirometry, during a one day fire-fighting course.This paper describes the results of phase III in which further lung function data was gathered from the instructors, at six monthly intervals, over two years. Multiple regression analysis of the data indicated that smoke exposure had a significant effect on the transfer factor (T1), flow at 75% of the forced vital capacity (FEF75), and the ratio of the forced expiratory volume in one second to the forced vital capacity (FEV1/FVC%). The decrements observed were many times those predicted for normal ageing.Analysis of data collected on instructors who had left the school in the previous twelve months failed to reveal any significant improvement in these three measurements. A later follow up study conducted 3 to 5 years after instructors had left the school (Phase IV) showed significant improvements in T1 and FEF75 when related to the first readings after leaving the school.The changes observed are confounded by the high incidence of cigarette smokers amongst the instructors.
Hyperbaric Oxygen in Osteoradionecrosis of the Mandible
Authors: Daum R. E. O. , Negus T. W. 
Published: October 2021

SummaryA case of recurrent osteoradionecrosis of the mandible, presenting 15 years after radiation therapy, is treated by a combination of surgery, antibiotics and exposure to hyperbaric oxygen. Mucosal cover of bone that had been exposed for six years was obtained after 18 days treatment. Osteoradionecrosis and the rationale behind its treatment with hyperbaric oxygen is discussed.
Lighting in Submarines
Authors: Brown D. C. 
Published: October 2021

AbstractSince the Second World War, the standard night-time illumination in RN submarine control rooms and adjacent spaces has been red lighting, because of its perceived advantage in dark adaption. Red light is, however, unpopular and has been shown to be detrimental to the performance of other control room tasks. In recent years evidence has emerged from the United States and other Navies that the advantage of red lighting over white lighting in terms of dark adaptation is insignificant at very low intensities. In this paper the research literature is reviewed and the findings related to current lighting practice in RN submarines. At the low levels of control room night illumination, there is minimal practical difference in the time taken for the periscope operator to dark adapt between red and white lighting. In view of the benefits to morale and performance offered by low level white lighting, it should replace red lighting for night use in submarine control rooms.
Motivations of medical students and doctors leaving the NHS explored in a residency training application webinar series
Authors: Ooi Setthasorn Zhi Yang , Ooi Rucira , Godoi Amanda , Foo Eu Fang , Woo Timothy , Li Chunhei , Ganesananthan Sashiananthan ,   Cardiff Healthcare International Perspectives Society (CHIPS), Ban Vin Shen , Chidowe Moses , Chiu Ka Ho Oscar , Fong Elizabeth , Goldenberg Mitchell , Janardanan Kuhanesh , Leow Tze Hao , Ng Ka Ting , Ooi Krisada Shen Yang , Raudaschl Lucinda , Syed Usama , Tam Johnson Pok Him , Tan Kimberly , Tan Nicholas , Tan Qi Jun , Tan Yi Chuen , Tan-Loh Joash , Yung David 
Published: October 2021

AbstractBackgroundRecent reports show that about 10% of UK-graduate doctors leave the country to pursue specialty training elsewhere. Our article aims to evaluate the motivating factors for UK graduates to leave the National Health Service (NHS), especially during the COVID-19 pandemic and Brexit.Study designCross-sectional study.MethodA novel 22-item questionnaire was disseminated at a webinar series regarding the application process to pursue residency training in six different countries/regions from 2 August 2020 to 13 September 2020. The data was analysed using Kruskal-Wallis rank-sum with post-hoc Wilcoxon test to compare the difference in significance among the motivating factors.Results1118 responses from the UK medical students and doctors were collected; of which, 1001 (89.5%) were medical students, and 88 (7.9%) were junior doctors. There was a higher propensity for leaving after the Foundation Programme compared with other periods (p&lt;0.0001 for all comparisons). There was no difference between desire for leaving after core surgical/medical training and specialty training (p=0.549). However, both were significantly higher than leaving the NHS after medical school (p&lt;0.0001). Quality of life and financial prospects (both p&lt;0.0001) were the most agreed reasons to leave the NHS, followed by clinical and academic opportunities and, subsequently, family reasons.ConclusionFuture work on the quality of life for doctors in the UK should be explored, especially among those considering leaving the NHS. Policymakers should focus on assessing the difference in working hours, on-call hours and wages that may differ among healthcare systems.
Image features of spinning regular black holes based on a locality principle
Authors: Eichhorn Astrid , Held Aaron 
Published: October 2021

AbstractTo understand the true nature of black holes, fundamental theoretical developments should be linked all the way to observational features of black holes in their natural astrophysical environments. Here, we take several steps to establish such a link. We construct a family of spinning, regular black-hole spacetimes based on a locality principle for new physics and analyze their shadow images. We identify characteristic image features associated to regularity (increased compactness and relative stretching) and to the locality principle (cusps and asymmetry) that persist in the presence of a simple analytical disk model. We conjecture that these occur as universal features of distinct classes of regular black holes based on different sets of construction principles for the corresponding spacetimes.
Neutrino pair annihilation ($$\nu {\bar{\nu }}\rightarrow e^-e^+$$) in the presence of quintessence surrounding a black hole
Authors: Lambiase G. , Mastrototaro L. 
Published: October 2021

AbstractQuintessence fields, introduced to explain the speed-up of the Universe, might affect the geometry of spacetime surrounding black holes, as compared to the standard Schwarzschild and Kerr geometries. In this framework, we study the neutrino pairs annihilation into electron-positron pairs ($$\nu {\bar{\nu }}\rightarrow e^-e^+$$

ν

ν

¯

→

e
-

e
+

) near the surface of a neutron star, focusing, in particular, on the Schwarzschild-like geometry in presence of quintessence fields. The effect of the latter is to increase the photon-sphere radius ($$R_{ph}$$

R

ph

), increasing in such a way the maximum energy deposition rate near to $$R_{ph}$$

R

ph

. The rate turns out to be several orders of magnitude greater than the rate computed in the framework of General Relativity. These results might provide a rising in the GRBs energy emitted from a close binary neutron star system and might be used to constraints the parameters of the quintessence model. Finally we theoretically study the effects of rotation on the neutrino energy deposition.
Implications of the Muon g-2 result on the flavour structure of the lepton mass matrix
Authors: Calibbi Lorenzo , López-Ibáñez M. L. , Melis Aurora , Vives Oscar 
Published: October 2021

AbstractThe confirmation of the discrepancy with the Standard Model predictions in the anomalous magnetic moment by the Muon g-2 experiment at Fermilab points to a low scale of new physics. Flavour symmetries broken at low energies can account for this discrepancy but these models are much more restricted, as they would also generate off-diagonal entries in the dipole moment matrix. Therefore, if we assume that the observed discrepancy in the muon $$g-2$$

g
-
2

is explained by the contributions of a low-energy flavor symmetry, lepton flavour violating processes can constrain the structure of the lepton mass matrices and therefore the flavour symmetries themselves predicting these structures. We apply these ideas to several discrete flavour symmetries popular in the leptonic sector, such as $$\Delta (27)$$

Δ
(
27
)

, $$A_4$$

A
4

, and $$A_5 < imes \mathrm{CP}$$

A
5

⋉
CP

.
Novel Redirected T–Cell Immunotherapies for Advanced Prostate Cancer
Authors: Dorff Tanya B. , Narayan Vivek , Forman Stephen J. , Zang Peter D. , Fraietta Joseph A. , June Carl H. , Haas Naomi B. , Priceman Saul J. 
Published: October 2021

Abstract
Immunotherapy has failed to achieve durable remissions in advanced prostate cancer patients. More potent T-cell–redirecting strategies may be needed to overcome the immunologically exclusive and suppressive tumor microenvironment. Clinical trials are underway, seeking to define the optimal target for T-cell redirection, such as PSMA, PSCA, or STEAP-1, as well as the optimal strategy, with CAR or bispecific antibodies. As results continue to emerge from these trials, understanding differential toxicity and efficacy of these therapies based on their targets and functional modifications will be key to advancing these promising therapies toward clinical practice. This review provides a unique depth and breadth of perspective regarding the diverse immunotherapy strategies currently under clinical investigation for men with advanced prostate cancer.
AXL Inhibitor TP-0903 Reduces Metastasis and Therapy Resistance in Pancreatic Cancer
Authors: Zhang Yuqing , Arner Emily N. , Rizvi Ali , Toombs Jason E. , Huang Huocong , Warner Steven L. , Foulks Jason M. , Brekken Rolf A. 
Published: October 2021

Abstract
Pancreatic cancer is the third leading cause of cancer-related deaths in the United States with a 5-year survival less than 5%. Resistance to standard therapy and limited response to immune checkpoint blockade due to the immunosuppressive and stroma-rich microenvironment remain major challenges in the treatment of pancreatic cancer. A key cellular program involved in therapy resistance is epithelial plasticity, which is also associated with invasion, metastasis, and evasion of immune surveillance. The receptor tyrosine kinase AXL is a key driver of tumor cell epithelial plasticity. High expression and activity of AXL is associated with poor prognosis, metastasis, and therapy resistance in multiple types of cancer including pancreatic. Here, we show that an AXL inhibitor (TP-0903), has antitumor and therapy sensitizing effects in preclinical models of pancreatic ductal adenocarcinoma (PDA). We demonstrate that TP-0903 as a single agent or in combination with gemcitabine and/or anti-programmed cell death protein 1 (PD1) antibody has anti-metastatic and anti-tumor effects in PDA tumor bearing mice, leading to increased survival. In addition, gene expression analysis of tumors demonstrated upregulation of pro-inflammatory and immune activation genes in tumors from TP-0903-treated animals compared with the vehicle, indicating pharmacologic inhibition of AXL activation leads to an immunostimulatory microenvironment. This effect was augmented when TP-0903 was combined with gemcitabine and anti-PD1 antibody. These results provide clear rationale for evaluating TP-0903 in the treatment of pancreatic cancer.
Clinical and Functional Significance of TP53 Exon 4–Intron 4 Splice Junction Variants
Authors: Pinto Emilia M. , Maxwell Kara N. , Halalsheh Hadeel , Phillips Aaron , Powers Jacquelyn , MacFarland Suzanne , Walsh Michael F. , Breen Kelsey , Formiga Maria N. , Kriwacki Richard , Nichols Kim E. , Mostafavi Roya , Wang Jinling , Clay Michael R. , Rodriguez-Galindo Carlos , Ribeiro Raul C. , Zambetti Gerard P. 
Published: October 2021

Abstract

Germline TP53 splicing variants are uncommon, and their clinical relevance is unknown. However, splice-altering variants at exon 4–intron 4 junctions are relatively enriched in pediatric adrenocortical tumors (ACT). Nevertheless, family histories of cancer compatible with classic Li-Fraumeni syndrome are rarely seen in these patients. We used conventional and in silico assays to determine protein stability, splicing, and transcriptional activity of 10 TP53 variants at exon 4–intron 4 junctions and analyzed their clinical correlates. We reviewed public databases that report the impact of TP53 variants in human cancer and examined individual reports, focusing on family history of cancer. TP53 exon 4–intron 4 junction germline variants were identified in 9 of 75 pediatric ACTs enrolled in the International Pediatric Adrenocortical Tumor Registry and Children's Oncology Group ARAR0332 study. An additional eight independent TP53 variants involving exon 4 splicing were identified in the Pediatric Cancer Genome Project (n = 5,213). These variants resulted in improper expression due to ineffective splicing, protein instability, altered subcellular localization, and loss of function. Clinical case review of carriers of TP53 exon 4–intron 4 junction variants revealed a high incidence of pediatric ACTs and atypical tumor types not consistent with classic Li-Fraumeni syndrome. Germline variants involving TP53 exon 4–intron 4 junctions are frequent in ACT and rare in other pediatric tumors. The collective impact of these germline TP53 variants on the fidelity of splicing, protein structure, and function must be considered in evaluating cancer susceptibility.

Implications:
Taken together, the data indicate that splice variants at TP53 codon 125 and surrounding bases differentially impacted p53 gene expression and function.
Genotype-Guided P2Y
12
Inhibitor Therapy After Percutaneous Coronary Intervention: A Bayesian Analysis
Authors: Parcha Vibhu , Heindl Brittain F. , Li Peng , Kalra Rajat , Limdi Nita A. , Pereira Naveen L. , Arora Garima , Arora Pankaj 
Published: October 2021

Background:
Among patients receiving percutaneous coronary intervention (PCI), the role of a genotype-guided approach for antiplatelet therapy compared with usual care is unclear. We conducted a Bayesian analysis of the entire TAILOR-PCI (Tailored Antiplatelet Initiation to Lessen Outcomes Due to Decreased Clopidogrel Response After Percutaneous Coronary Intervention) randomized clinical trial population to evaluate the effect of the genotype-guided antiplatelet therapy post-PCI compared with the usual care on the risk of major adverse cardiovascular events (MACE).

Methods:
The primary outcome for our study was the composite of MACE (myocardial infarction, stroke, and cardiovascular death). Secondary outcomes included cardiovascular death, stroke, myocardial infarction, stent thrombosis, and major/minor bleeding. Bayesian modeling was used to estimate the probability of clinical benefit of genotype-guided therapy using (1) noninformative priors (ie, analyzing the TAILOR-PCI trial) and (2) informative priors derived from the ADAPT, POPular Genetics, IAC-PCI, and PHARMCLO trials (ie, analyzing TAILOR-PCI trial in the context of prior evidence). Risk ratio (RR: ratio of cumulative outcome incidence between genotype-guided and conventional therapy group) and 95% credible interval (CrI) were estimated for the study outcomes, and probability estimates for RR <1 were computed.

Results:
Using noninformative priors, in TAILOR-PCI the RR for MACE was 0.78 (95% CrI, 0.55–1.07) in genotype-guided therapy after PCI, and the probability of RR <1 was 94%. Using noninformative priors, the probability of RR <1 for cardiovascular death (RR, 0.95 [95% CrI, 0.52–1.74]), stroke (RR, 0.68 [95% CrI, 0.44–1.06]), myocardial infarction (RR, 0.84 [95% CrI, 0.37–1.89]), stent thrombosis (RR, 0.75 [95% CrI, 0.37–1.45]), and major or minor bleeding (RR, 1.22 [95% CrI, 0.84–1.77]) were 57%, 96%, 67%, 81%, and 15%, respectively. Using informative priors, the posterior probability of RR <1 for MACE, from genotype-guided therapy, was 99% (RR, 0.69 [95% CrI, 0.57–0.84]). Using informative priors, the posterior probability of RR <1 for cardiovascular death (RR, 0.86 [95% CrI, 0.61–1.19]), stroke (RR, 0.69 [95% CrI, 0.48–0.99]), myocardial infarction (RR:0.56 [95% CrI, 0.40–0.78]), stent thrombosis (RR, 0.59 [95% CrI, 0.38–0.94]), and major or minor bleeding (RR, 0.84 [95% CrI, 0.70–0.99]) were 81%, 99%, 99%, 99%, and 99%, respectively.

Conclusions:

Bayesian analysis of the TAILOR-PCI trial provides clinically meaningful data on the posterior probability of reducing MACE using genotype-guided P2Y
12
inhibitor therapy after PCI.
Local Similarity Theory of Convective Turbulent Layer Using “Spectral” Prandtl Mixing Length and Second Moment of Vertical Velocity
Authors: Vulfson Alexander , Nikolaev Petr 
Published: October 2021

Abstract
Approximations of the turbulent moments of the atmospheric convective boundary layer are constructed based on a variant of the local similarity theory. As the basic parameters of this theory, the second moment of vertical velocity and the “spectral” Prandtl mixing length are used. This specific choice of the basic parameters allows us to consider the coefficient of turbulent transfer and the dissipation of kinetic energy of the Prandtl turbulence theory as the forms of the local similarity. Therefore, the obtained approximations of the turbulent moments should be considered as natural complementation to the semiempirical turbulence theory. Moreover, within the atmospheric surface layer, the approximations of the new local similarity theory are identical to the relations of the Monin–Obukhov similarity theory (MOST). Therefore, the proposed approximations should be considered as a direct generalization of the MOST under free-convection conditions. The new approximations are compared with the relations of the known local similarity theories. The advantages and limitations of the new theory are discussed. The comparison of the approximations of the new local similarity theory with the field and laboratory experimental data indicates the high effectiveness of the proposed approach.
A systematic review of the current management approaches in leiomyosarcoma of inferior vena cava—Results from analysis of 118 cases
Authors: Saikia Jyoutishman , Rastogi Sameer , Barwad Adarsh , Dhamija Ekta , Pandey Rambha , Bhoriwal Sandeep , Deo Suryanarayana , Kumar Sunil 
Published: October 2021

Introduction Primary intravenous leiomyosarcomas are rare vascular tumors with aggressive disease biology. The diagnosis and management have been challenging as little data exist from large databases. Methods A literature search was done to identify all cases of primary leiomyosarcomas in the last five years. Clinicopathological features and management strategies were evaluated. Results The median age was 53 years, predominantly females (2.5:1), presenting as metastases in up to 12.1% cases. Most tumors were locally advanced with a median size of 10cm. Inferior vena cava involvement from renal veins to infrahepatic veins remains the most frequent site (57.1%cases) while nearly half (52.8%) proceeded for surgery without histological proof. Most patients could undergo upfront resection (88.0%) with few patients receiving neoadjuvant chemotherapy (4.3%) or neoadjuvant radiotherapy (2.2%). Significant multivisceral resections included right nephrectomy (41.3%), liver resection (25.7%) and left nephrectomy (2.2%). Most patients (91.8%) needed an inferior vena cava graft placement with remarkable microscopically negative margins (85.5% cases). Doxorubicin and ifosfamide were the most frequently used combination chemotherapy regimens in both pre and postoperative settings with partial responses. The median overall and disease free survival among operated patients was 60 months and 28 months respectively. In multivariate analysis large tumor, extensive inferior vena cava involvement, and need for adjuvant chemotherapy appeared significant predictors for overall survival. Conclusions Aggressive upfront surgical resection with clear margin remains the key for long-term survival. Doxorubicin-based regimens were preferred as neoadjuvant chemotherapy while adjuvant treatment with chemotherapy, radiotherapy, or both may be considered in high-risk patients.
Analysis of outpatient expenditure trends using Korean Health Panel Survey data of patients diagnosed with lumbar intervertebral disc herniation
Authors: Lee Won-Jun , Han Chang-Hyun , Yang Changsop , Lee Sook-Hyun , Kim Doori , Ha Inhyuk , Song Hyun Jin , Lee Yoon Jae 
Published: October 2021

Objective In this study, we aimed to analyze cost trends for the outpatient treatment of lumbar intervertebral disc herniation (LDH). Methods We used cross-sectional data obtained from the Korea Health Panel Survey from 2011 to 2015. We compared outpatient medical expenses for conservative treatment of LDH using traditional Korean medicine (TKM) or Western medicine (WM). Results This analysis revealed that the total medical expenses for outpatient treatment of LDH using WM treatment methods increased by 30% from 2011 to 2015, and self-payment expenses increased by 50%. The total medical expenses for outpatient treatment of LDH using TKM methods increased by 8%, and self-payment expenses decreased by 33%. The National Health Insurance Service (NHIS) expenditure for WM increased by 7%, and non-covered costs increased by 83%. The NHIS expenditure for TKM increased by 41%, and non-covered costs decreased by 66%. Conclusions The total medical expenses for WM treatments are increasing in Korea, especially for non-covered treatments. The non-covered costs for TKM treatments are decreasing, suggesting a change in medical cost trends according to whether Korea’s actual medical expense insurance scheme is applied.