bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of burnout and its relationship to health status and social support in more than 1000 subspecialty anesthesiologists
Authors: Hyman Steve A , Card Elizabeth Borg , De Leon-Casasola Oscar , Shotwell Matthew S , Shi Yaping , Weinger Matthew B 
Published: February 2021

BackgroundPhysician burnout may be at ‘epidemic’ proportions due to factors associated with modern healthcare practice and technology. Practice attributes vary appreciably among subspecialists. Understanding burnout incidence and its associated factors could illuminate potential causes and interventions. We evaluated burnFout, mental and physical health, and social support and coping skills in acute and chronic pain physicians and pediatric and cardiac anesthesiologists.MethodsWe administered the Maslach Burnout Inventory Human Services Survey (MBI-HSS), a two-item self-identified burnout measure, the Veterans RAND 12-item Health Survey and the Social Support and Personal Coping Survey to subspecialty society members practicing acute and chronic pain management, pediatric anesthesiology and cardiac anesthesiology. Multivariable regression analysis compared the groups, and adjusted burnout prevalence was compared with an all-physician and an employed general population sample.ResultsAmong 1303 participants (response rates 21.6%–35.6% among the subspecialty groups), 43.4% met established burnout criteria (range 30.0%–62.3%). Chronic pain physicians had significantly worse scores (unadjusted) than the other three groups of subspecialty anesthesiologists, the all-physician comparator group and the general population comparator group. Mental health inversely correlated with emotional exhaustion and depersonalization in all groups. Self-identified burnout correlated with the full MBI-HSS (R=0.54; positive predictive value of 0.939 (0.917, 0.955)). Physicians’ scores for personal accomplishment were higher than population norms.ConclusionsThis study provides data on burnout prevalence and associated demographic, health and social factors in subspecialist anesthesiologists. Chronic pain anesthesiologists had significantly greater burnout than the other groups. The self-identified burnout metric performed well and may be an attractive alternative to the full MBI-HSS.
Respiratory exacerbations are associated with muscle loss in current and former smokers
Authors: Mason Stefanie Elizabeth , Moreta-Martinez Rafael , Labaki Wassim W , Strand Matthew , Baraghoshi David , Regan Elizabeth A , Bon Jessica , San Jose Estepar Ruben , Casaburi Richard , McDonald Merry-Lynn N , Rossiter Harry , Make Barry J , Dransfield Mark T , Han MeiLan K , Young Kendra A , Kinney Greg , Hokanson John E , San Jose Estepar Raul , Washko George R 
Published: February 2021

Objectives
Muscle wasting is a recognised extra-pulmonary complication in chronic obstructive pulmonary disease and has been associated with increased risk of death. Acute respiratory exacerbations are associated with reduction of muscle function, but there is a paucity of data on their long-term effect. This study explores the relationship between acute respiratory exacerbations and long-term muscle loss using serial measurements of CT derived pectoralis muscle area (PMA).

Design and setting
Participants were included from two prospective, longitudinal, observational, multicentre cohorts of ever-smokers with at least 10 pack-year history.

Participants
The primary analysis included 1332 (of 2501) participants from Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) and 4384 (of 10 198) participants from Genetic Epidemiology of COPD (COPDGene) who had complete data from their baseline and follow-up visits.

Interventions
PMA was measured on chest CT scans at two timepoints. Self-reported exacerbation data were collected from participants in both studies through the use of periodic longitudinal surveys.

Main outcome measures
Age-related and excess muscle loss over time.

Results
Age, sex, race and body mass index were associated with baseline PMA. Participants experienced age-related decline at the upper end of reported normal ranges. In ECLIPSE, the exacerbation rate over time was associated with an excess muscle area loss of 1.3% (95% CI 0.6 to 1.9, p<0.001) over 3 years and in COPDGene with an excess muscle area loss of 2.1% (95% CI 1.2 to 2.8, p<0.001) over 5 years. Excess muscle area decline was absent in 273 individuals who participated in pulmonary rehabilitation.

Conclusions
Exacerbations are associated with accelerated skeletal muscle loss. Each annual exacerbation was associated with the equivalent of 6 months of age-expected decline in muscle mass. Ameliorating exacerbation-associated muscle loss represents an important therapeutic target.
Age of thawed plasma does not affect clinical outcomes or biomarker expression in patients receiving prehospital thawed plasma: a PAMPer secondary analysis
Authors: Reitz Katherine M , Gruen Danielle S , Guyette Frances , Brown Joshua B , Yazer Mark H , Vodovotz Yoram , Johanssen Pär I , Stensballe Jakob , Daley Brian , Miller Richard S , Harbrecht Brian G , Claridge Jeffrey , Phelan Herb A , Neal Matthew D , Zuckerbraun Brian S , Sperry Jason L 
Published: February 2021

BackgroundPrehospital plasma administration during air medical transport reduces the endotheliopathy of trauma, circulating pro-inflammatory cytokines, and 30-day mortality among traumatically injured patients at risk of hemorrhagic shock. No clinical data currently exists evaluating the age of thawed plasma and its association with clinical outcomes and biomarker expression post-injury.MethodsWe performed a secondary analysis from the prehospital plasma administration randomized controlled trial, PAMPer. We dichotomized the age of thawed plasma creating three groups: standard-care, YOUNG (day 0–1) plasma, and OLD (day 2–5) plasma. We generated HRs and 95% CIs for mortality. Among all patients randomized to plasma, we compared predicted biomarker values at hospital admission (T0) and 24 hours later (T24) controlling for key difference between groups with a multivariable linear regression. Analyses were repeated in a severely injured subgroup.ResultsTwo hundred and seventy-one patients were randomized to standard-care and 230 to plasma (40% YOUNG, 60% OLD). There were no clinically or statistically significant differences in demographics, injury, admission vital signs, or laboratory values including thromboelastography between YOUNG and OLD. Compared with standard-care, YOUNG (HR 0.66 (95% CI 0.41 to 1.07), p=0.09) and OLD (HR 0.64 (95% CI 0.42 to 0.96), p=0.03) plasma demonstrated reduced 30-day mortality. Among those randomized to plasma, plasma age did not affect mortality (HR 1.04 (95% CI 0.60 to 1.82), p=0.90) and/or adjusted serum markers by plasma age at T0 or T24 (p>0.05). However, among the severely injured subgroup, OLD plasma was significantly associated with increased adjusted inflammatory and decreased adjusted endothelial biomarkers at T0.DiscussionAge of thawed plasma does not result in clinical outcome or biomarker expression differences in the overall PAMPer study cohort. There were biomarker expression differences in those patients with severe injury. Definitive investigation is needed to determine if the age of thawed plasma is associated with biomarker expression and outcome differences following traumatic injury.Level of evidenceII.
From 95 to 59 millimetres: a new active acoustic tag size guideline for salmon
Authors: Liss Stephanie A. , Znotinas Katherine R. , Blackburn Shannon E. , Fischer Eric S. , Hughes James S. , Harnish Ryan A. , Li Huidong , Deng Zhiqun Daniel 
Published: February 2021

Two laboratory studies evaluated small Chinook salmon (Oncorhynchus tshawytscha) (36–99 mm fork length (FL), 0.7%–26.7% tag burden) survival, tag retention, and growth (n = 539) and critical swimming speed (Ucrit; n = 241). Fish were implanted with a new active acoustic tag and compared with untagged controls at 12 and 17 °C. Across studies, no temperature differences were detected. All control fish survived. All tagged fish ≥58 mm FL survived and retained their tags. Regression models predicted ≥98.6% survival and retention for tagged fish ≥58.6 mm FL or ≥1.9 g (4.2% tag burden). No growth differences among treatments were identified. Spline regression analysis indicated Ucrit was similar for control and tagged fish that measured ≥57.3 mm FL. We recommend tagging salmon ≥59 mm FL or ≥1.9 g (≤4.2% tag burden), although the guideline should be confirmed in a field setting. Study results represent an important step towards using the new active tag in acoustic telemetry field studies that estimate short-term (30-day) survival of small salmonids.
Nucleon and dinucleon decays to leptonic final states in a left-right symmetric model with large extra dimensions
Authors: Girmohanta Sudhakantha 
Published: February 2021

AbstractWe consider baryon-number-violating nucleon and dinucleon decays to leptonic final states in the context of a left-right symmetric (LRS) model with large extra dimensions. Specifically, we study (a) nucleon to trilepton decays with $$\varDelta B=-1$$

Δ
B
=
-
1

and $$\varDelta L=-3$$

Δ
L
=
-
3

, and (b) dinucleon to dilepton decays with $$\varDelta B=-2$$

Δ
B
=
-
2

and $$\varDelta L=-2$$

Δ
L
=
-
2

. In the LRS model, $$B-L$$

B
-
L

is gauged and is spontaneously broken by a Higgs vacuum expectation value $$v_R$$

v
R

, which characterizes the scale at which processes violating $$B-L$$

B
-
L

occur. We show that together with the lower bound on $$v_R$$

v
R

from experimental limits on n-$${\bar{n}}$$

n

¯

oscillations, constraints from searches for other nucleon decay modes imply sufficient suppression of these nucleon to trilepton and dinucleon to dilepton decay modes in this model to agree with experimental bounds.
HiggsSignals-2: probing new physics with precision Higgs measurements in the LHC 13 TeV era
Authors: Bechtle Philip , Heinemeyer Sven , Klingl Tobias , Stefaniak Tim , Weiglein Georg , Wittbrodt Jonas 
Published: February 2021

AbstractThe program confronts the predictions of models with arbitrary Higgs sectors with the available Higgs signal rate and mass measurements, resulting in a likelihood estimate. A new version of the program, , is presented that contains various improvements in its functionality and applicability. In particular, the new features comprise improvements in the theoretical input framework and the handling of possible complexities of beyond-the-SM Higgs sectors, as well as the incorporation of experimental results in the form of simplified template cross section (STXS) measurements. The new functionalities are explained, and a thorough discussion of the possible statistical interpretations of the results is provided. The performance of is illustrated for some example analyses. In this context the importance of public information on certain experimental details like efficiencies and uncertainty correlations is pointed out. is continuously updated to the latest experimental results and can be obtained at https://gitlab.com/higgsbounds/higgssignals.
Double-Diffusive of a Nanofluid in a Rectangle-Shape Mounted on a Cavity Saturated by Heterogeneous Porous Media
Authors: Aly Abdelraheem M. , Mahmoud Ehab Mohamed , Ahmad Hijaz , Yao Shao-Wen 
Published: February 2021

This study presents numerical simulations on double-diffusive flow of a nanofluid in two cavities connected with four vertical gates. Novel shape of an outer square shape mounted on a square cavity by four gates was used. Heterogeneous porous media and

Al

2

O

3

-water nanofluid are filled in an inner cavity. Outer rectangle shape is filled with a nanofluid only, and its left walls carry high temperature

T

h

and high concentration

C

h

. The right walls of a rectangle shape carry low temperature

T

c

and low concentration

C

c

and the other walls are adiabatic. An incompressible smoothed particle hydrodynamics (ISPH) method is applied for solving the governing equations of velocities, temperature, and concentration. Results are introduced for the effects of a buoyancy ratio

−
2
≤
N
≤
2

, Darcy parameter

10

−
3

≤
Da
≤

10

−
5

, solid volume fraction

0
≤
ϕ
≤
0.05

, and porous levels. Main results are indicated in which the buoyancy ratio parameter adjusts the directions of double-diffusive convection flow in an outer shape and inner cavity. Adding more concentration of nanoparticles reduces the flow speed and maximum of the velocity field. Due to the presence of a porous medium layer in an inner cavity, the Darcy parameter has slight changes inside the rectangle shape.
Identifying Stage II Colorectal Cancer Recurrence Associated Genes by Microarray Meta-Analysis and Building Predictive Models with Machine Learning Algorithms
Authors: Lu Wei , Pan Xiang , Dai Siqi , Fu Dongliang , Hwang Maxwell , Zhu Yingshuang , Zhang Lina , Wei Jingsun , Kong Xiangxing , Li Jun , Xiao Qian , Ding Kefeng 
Published: February 2021

Background. Stage II colorectal cancer patients had heterogeneous prognosis, and patients with recurrent events had poor survival. In this study, we aimed to identify stage II colorectal cancer recurrence associated genes by microarray meta-analysis and build predictive models to stratify patients’ recurrence-free survival. Methods. We searched the GEO database to retrieve eligible microarray datasets. The microarray meta-analysis was used to identify universal recurrence associated genes. Total samples were randomly divided into the training set and the test set. Two survival models (lasso Cox model and random survival forest model) were trained in the training set, and AUC values of the time-dependent receiver operating characteristic (ROC) curves were calculated. Survival analysis was performed to determine whether there was significant difference between the predicted high and low risk groups in the test set. Results. Six datasets containing 651 stage II colorectal cancer patients were included in this study. The microarray meta-analysis identified 479 recurrence associated genes. KEGG and GO enrichment analysis showed that G protein-coupled glutamate receptor binding and Hedgehog signaling were significantly enriched. AUC values of the lasso Cox model and the random survival forest model were 0.815 and 0.993 at 60 months, respectively. In addition, the random survival forest model demonstrated that the effects of gene expression on the recurrence-free survival probability were nonlinear. According to the risk scores computed by the random survival forest model, the high risk group had significantly higher recurrence risk than the low risk group (HR = 1.824, 95% CI: 1.079–3.084,

p

= 0.025). Conclusions. We identified 479 stage II colorectal cancer recurrence associated genes by microarray meta-analysis. The random survival forest model which was based on the recurrence associated gene signature could strongly predict the recurrence risk of stage II colorectal cancer patients.
Numerical Study on the Tandem Submerged Hydrofoils Using RANS Solver
Authors: Maram Moloud Arian , Ghafari Hamid Reza , Ghassemi Hassan , Ghiasi Mahmoud 
Published: February 2021

This paper is presented on the tandem two-dimensional hydrofoils with profiles NACA4412 in single-phase and two-phase flow domains for different submergence depths and different distances in a various angle of attack (AoA). Also, supercavitation is studied at

σ
=
0.34

by the Zwart cavitation model. Reynolds-averaged Navier–Stokes (RANS) with the shear stress transport (SST) K-ω is employed as a turbulence model in transient analysis of Ansys FLUENT software. The numerical results show that, by increasing depth, the drag coefficient increases for both hydrofoils 1 and 2 as well as the lift coefficient. The drag coefficient of hydrofoil 2 is bigger than hydrofoil 1 for all depths; moreover, it was found that the flow pressure behind the hydrofoil 1 had affected the upper and the lower surface of the hydrofoil 2 at each distance or AoA. These effects are observed in the hydrofoil 2 lift coefficient as well as the flow separation. However, the maximum lift-to-drag ratio is observed at AoA =

8

°

and 3.5c distance. Also, single-phase results reveal that the value of pressure and the hydrodynamic coefficient are very different from the two-phase flow results, due to the elimination of the free surface. So, a two-phase flow domain is recommended for increasing the accuracy of results. In addition, the investigation of supercavitation shows a growth in cavity occurrence on the surface by raising AoA.
Exploiting Allosteric Properties of RAF and MEK Inhibitors to Target Therapy-Resistant Tumors Driven by Oncogenic BRAF Signaling
Authors: Adamopoulos Christos , Ahmed Tamer A. , Tucker Maxwell R. , Ung Peter M.U. , Xiao Min , Karoulia Zoi , Amabile Angelo , Wu Xuewei , Aaronson Stuart A. , Ang Celina , Rebecca Vito W. , Brown Brian D. , Schlessinger Avner , Herlyn Meenhard , Wang Qi , Shaw David E. , Poulikakos Poulikos I. 
Published: February 2021

Abstract

Current clinical RAF inhibitors (RAFi) inhibit monomeric BRAF (mBRAF) but are less potent against dimeric BRAF (dBRAF). RAFi equipotent for mBRAF and dBRAF have been developed but are predicted to have lower therapeutic index. Here we identify a third class of RAFi that selectively inhibits dBRAF over mBRAF. Molecular dynamic simulations reveal restriction of the movement of the BRAF αC-helix as the basis of inhibitor selectivity. Combination of inhibitors based on their conformation selectivity (mBRAF- plus dBRAF-selective plus the most potent BRAF–MEK disruptor MEK inhibitor) promoted suppression of tumor growth in BRAFV600E therapy–resistant models. Strikingly, the triple combination showed no toxicities, whereas dBRAF-selective plus MEK inhibitor treatment caused weight loss in mice. Finally, the triple combination achieved durable response and improved clinical well-being in a patient with stage IV colorectal cancer. Thus, exploiting allosteric properties of RAF and MEK inhibitors enables the design of effective and well-tolerated therapies for BRAFV600E tumors.

Significance:
This work identifies a new class of RAFi that are selective for dBRAF over mBRAF and determines the basis of their selectivity. A rationally designed combination of RAF and MEK inhibitors based on their conformation selectivity achieved increased efficacy and a high therapeutic index when used to target BRAFV600E tumors.
See related commentary by Zhang and Bollag, p. 1620.
This article is highlighted in the In This Issue feature, p. 1601
Policy Characteristics, Electoral Cycles, and the Partisan Politics of Climate Change
Authors: Schulze Kai 
Published: February 2021

Abstract
Domestic policies are the cornerstone of the new global climate governance architecture. However, what motivates vote-seeking politicians to pursue climate policies remains remarkably unclear, as the climate politics literature suggests that climate policies are usually not perceived as a vote winner. The present article revisits this issue and argues that a better understanding of the relationship between electoral competition and climate policy making requires taking into account differences both in party ideologies and in policy characteristics. Studying twenty-nine democracies between 1990 and 2016, the analysis finds that climate policy production overall tends to increase as the election approaches due to increases in “soft” policies, such as subsidies, research grants, and information instruments, and relatively stable production rates of “hard” policies like taxes and regulations over the electoral term. Regarding partisan politics, left governments are found to produce more hard, but not more soft, climate policies than center and right governments, especially before elections. This suggests that partisan and electoral incentives are important reference points in the fight against climate change.
Drivers and Subseasonal Predictability of Heavy Rainfall in Equatorial East Africa and Relationship with Flood Risk
Authors: MacLeod David A , Dankers Rutger , Graham Richard , Guigma Kiswendsida , Jenkins Luke , Todd Martin C. , Kiptum Augustine , Kilavi Mary , Njogu Andrew , Mwangi Emmah 
Published: February 2021

AbstractEquatorial East Africa (EEA) suffers from significant flood risks. These can be mitigated with preemptive action; however, currently available early warnings are limited to a few days’ lead time. Extending warnings using subseasonal climate forecasts could open a window for more extensive preparedness activity. However, before these forecasts can be used, the basis of their skill and relevance for flood risk must be established. Here we demonstrate that subseasonal forecasts are particularly skillful over EEA. Forecasts can skillfully anticipate weekly upper-quintile rainfall within a season, at lead times of 2 weeks and beyond. We demonstrate the link between the Madden–Julian oscillation (MJO) and extreme rainfall events in the region, and confirm that leading forecast models accurately represent the EEA teleconnection to the MJO. The relevance of weekly rainfall totals for fluvial flood risk in the region is investigated using a long record of streamflow from the Nzoia River in western Kenya. Both heavy rainfall and high antecedent rainfall conditions are identified as key drivers of flood risk, with upper-quintile weekly rainfall shown to skillfully discriminate flood events. We additionally evaluate GloFAS global flood forecasts for the Nzoia basin. Though these are able to anticipate some flooding events with several weeks lead time, analysis suggests action based on these would result in a false alarm more than 50% of the time. Overall, these results build on the scientific evidence base that supports the use of subseasonal forecasts in EEA, and activities to advance their use are discussed.
Autoantibodies to Annexin A2 and cerebral thrombosis: Insights from a mouse model
Authors: Weiss Ronen , Bushi Doron , Mindel Ekaterina , Bitton Almog , Diesendruck Yael , Gera Orna , Drori Tali , Zmira Ofir , Aharoni Shay Anat , Agmon-Levin Nancy , Kashi Oren , Benhar Itai , Golderman Valery , Orion David , Chapman Joab , Shavit-Stein Efrat 
Published: February 2021

Introduction Antiphospholipid syndrome (APS) is an autoimmune disorder manifested by thromboembolic events, recurrent spontaneous abortions and elevated titers of circulating antiphospholipid antibodies. In addition, the presence of antiphospholipid antibodies seems to confer a fivefold higher risk for stroke or transient ischemic attack. Although the major antigen of APS is β2 glycoprotein I, it is now well established that antiphospholipid antibodies are heterogeneous and bind to various targets. Recently, antibodies to Annexin A2 (ANXA2) have been reported in APS. This is of special interest since data indicated ANXA2 as a key player in fibrinolysis. Therefore, in the present study we assessed whether anti-ANXA2 antibodies play a pathological role in thrombosis associated disease. Materials and Methods Mice were induced to produce anti-ANXA2 antibodies by immunization with ANXA2 (iANXA2) and control mice were immunized with adjuvant only. A middle cerebral artery occlusion stroke model was applied to the mice. The outcome of stroke severity was assessed and compared between the two groups. Results Our results indicate that antibodies to ANXA2 lead to a more severe stroke as demonstrated by a significant larger stroke infarct volume (iANXA2 133.9 ± 3.3 mm3 and control 113.7 ± 7.4 mm3; p = 0.017) and a more severe neurological outcome (iANXA2 2.2 ± 0.2, and control 1.5 ± 0.18; p = 0.03). Conclusions This study supports the hypothesis that auto-antibodies to ANXA2 are an independent risk factor for cerebral thrombosis. Consequently, we propose screening for anti-ANXA2 antibodies should be more widely used and patients that exhibit the manifestations of APS should be closely monitored by physicians.