bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intraoperative dynamics of workflow disruptions and surgeons' technical performance failures: insights from a simulated operating room
Authors: Koch Amelie , Kullmann Aljoscha , Stefan Philipp , Weinmann Tobias , Baumbach Sebastian F. , Lazarovici Marc , Weigl Matthias 
Published: November 2021

Abstract
Introduction
Flow disruptions (FD) in the operating room (OR) have been found to adversely affect the levels of stress and cognitive workload of the surgical team. It has been concluded that frequent disruptions also lead to impaired technical performance and subsequently pose a risk to patient safety. However, respective studies are scarce. We therefore aimed to determine if surgical performance failures increase after disruptive events during a complete surgical intervention.

Methods
We set up a mixed-reality-based OR simulation study within a full-team scenario. Eleven orthopaedic surgeons performed a vertebroplasty procedure from incision to closure. Simulations were audio- and videotaped and key surgical instrument movements were automatically tracked to determine performance failures, i.e. injury of critical tissue. Flow disruptions were identified through retrospective video observation and evaluated according to duration, severity, source, and initiation. We applied a multilevel binary logistic regression model to determine the relationship between FDs and technical performance failures. For this purpose, we compared FDs in one-minute intervals before performance failures with intervals without subsequent performance failures.

Results
Average simulation duration was 30:02 min (SD = 10:48 min). In 11 simulated cases, 114 flow disruption events were observed with a mean hourly rate of 20.4 (SD = 5.6) and substantial variation across FD sources. Overall, 53 performance failures were recorded. We observed no relationship between FDs and likelihood of immediate performance failures: Adjusted odds ratio = 1.03 (95% CI 0.46–2.30). Likewise, no evidence could be found for different source types of FDs.

Conclusion
Our study advances previous methodological approaches through the utilisation of a mixed-reality simulation environment, automated surgical performance assessments, and expert-rated observations of FD events. Our data do not support the common assumption that FDs adversely affect technical performance. Yet, future studies should focus on the determining factors, mechanisms, and dynamics underlying our findings.
Neuroenhancement of surgeons during robotic suturing
Authors: Patel Ronak , Suwa Yusuke , Kinross James , von Roon Alexander , Woods Adam J. , Darzi Ara , Singh Harsimrat , Leff Daniel Richard 
Published: November 2021

AbstractBackgroundThe initial phases of robotic surgical skills acquisition are associated with poor technical performance, such as low knot-tensile strength (KTS). Transcranial direct-current stimulation (tDCS) can improve force and accuracy in motor tasks but research in surgery is limited to open and laparoscopic tasks in students. More recently, robotic surgery has gained traction and is now the most common approach for certain procedures (e.g. prostatectomy). Early-phase robotic suturing performance is dependent on prefrontal cortex (PFC) activation, and this study aimed to determine whether performance can be improved with prefrontal tDCS.MethodsFifteen surgical residents were randomized to either active then sham tDCS or sham then active tDCS, in two counterbalanced sessions in a double-blind crossover study. Within each session, participants performed a robotic suturing task repeated in three blocks: pre-, intra- and post-tDCS. During the intra-tDCS block, participants were randomized to either active tDCS (2 mA for 15 min) to the PFC or sham tDCS. Primary outcome measures of technical quality included KTS and error scores.ResultsSignificantly faster completion times were observed longitudinally, regardless of active (p < 0.001) or sham stimulation (p < 0.001). KTS was greater following active compared to sham stimulation (median: active = 44.35 N vs. sham = 27.12 N,p < 0.001). A significant reduction in error scores from “pre-” to “post-” (p = 0.029) were only observed in the active group.ConclusiontDCS could reduce error and enhance KTS during robotic suturing and warrants further exploration as an adjunct to robotic surgical training.
Cancer-associated fibroblasts-derived HAPLN1 promotes tumour invasion through extracellular matrix remodeling in gastric cancer
Authors: Zhang Tiancheng , Li Xiang , He Yani , Wang Yaohui , Shen Jiajia , Wang Shoulin , You Qiang , Zhai Jing , Shen Lizong 
Published: November 2021

Abstract
Background
Cancer-associated fibroblasts (CAFs) are the most principal cells of depositing and remodeling extracellular matrix (ECM) within solid tumours. Both CAFs and ECM have been demonstrated to play critical roles in tumour development. However, the functional roles of CAFs-associated ECM or ECM remodeling in the pathogenesis of gastric cancer remain unclear.

Methods
Bioinformatics analysis of the differentially expressed genes between CAFs and corresponding normal fibroblasts (NFs) in gastric cancer was performed. The clinical relevance of hyaluronan and proteoglycan link protein 1 (HAPLN1) was investigated using TCGA data and human gastric cancer specimens. Spheroid cell invasion assay and nude mouse xenograft model were introduced to assay cell invasion. Second harmonic generation (SHG) was used to image and analyze the changes of collagen fibers in ECM.

Results
HAPLN1 was identified as the most significantly up-regulated gene in CAFs of gastric cancer, and higher HAPLN1 levels were associated with shorter overall survival. HAPLN1 was prominently produced by CAFs, and its levels were correlated positively with tumor T staging (P < 0.0001), lymph node metastasis (P = 0.0006) and TNM stage (P = 0.0063). Mechanically, gastric cancer cells activate fibroblasts to up-regulate HAPLN1 expression via activation of TGF-β1/Smad2/3 signaling, which in turn promotes tumour migration and invasion. Importantly, SHG assays with mouse xenograft models and human samples further demonstrated CAFs-derived HAPLN1 increased tumour invasiveness through ECM remodeling.

Conclusions
This study sheds light on the role of CAFs-derived HAPLN1 in the pathogenesis of gastric cancer, and provides insights for the development of novel strategies for prevention and treatment of gastric carcinoma.
Graphic modeling in Distributed Autonomous and Asynchronous Automata (DA3)
Authors: Daszczuk Wiktor B. 
Published: November 2021

AbstractAutomated verification of distributed systems becomes very important in distributed computing. The graphical insight into the system in the early and late stages of the project is essential. In the design phase, the visual input helps to articulate the collaborative distributed components clearly. The formal verification gives evidence of correctness or malfunction, but in the latter case, graphical simulation of counterexample helps for better understanding design errors. For these purposes, we invented Distributed Autonomous and Asynchronous Automata (DA3), which have the same semantics as the formal verification base—Integrated Model of Distributed Systems (IMDS). The IMDS model reflects the natural characteristics of distributed systems: unicasting, locality, autonomy, and asynchrony. Distributed automata have all of these features because they share the same semantics as IMDS. In formalism, the unified system definition has two views: the server view of the cooperating distributed nodes and the agent view of the migrating agents performing distributed computations. The automata have two formally equivalent forms that reflect two views: Server DA3 for observing servers exchanging messages, and Agent DA3 for tracking agents, which visit individual servers in their progress of distributed calculations. We present the DA3 formulation based on the IMDS formalism and their application to design and verify distributed systems in the Dedan environment. DA3 formalism is compared with other concepts of distributed automata known from the literature.
Führen in der Krise – organisationales Krisenmanagement während der COVID-19-Pandemie („coronavirus disease 2019“) am Beispiel der Lebenshilfe Tirol
Authors: Riedel Priya-Lena , Kulcar Vanesse , Kreh Alexander , Reiter Martin , Juen Barbara 
Published: November 2021

ZusammenfassungHintergrundDie COVID-19-Pandemie („coronavirus disease 2019“) stellt im Gesundheitsbereich eine Herausforderung dar. Die Kenntnis organisationaler Schutz- und Risikofaktoren ist zentral zur Aufrechterhaltung des psychosozialen Wohlbefindens der Mitarbeitenden sowie der Versorgung von Klient:innen.ZielDas Ziel dieser qualitativen Untersuchung von Führungspersonal und Mitarbeiter:innen ist die Identifikation von spezifischen Schutz- und Belastungsfaktoren bei der Begleitung von Menschen mit Beeinträchtigung. Auf dieser Basis sollen Rückschlüsse auf notwendige Anpassungen der Führung in Krisensituationen möglich werden.MethodikZwischen Oktober und Dezember 2020 wurden online-basierte Expert:inneninterviews (n = 11) mit Mitarbeiter:innen der Lebenshilfe Tirol durchgeführt. Durch Anwendung der Grounded Theory wurde ein Modell zur Erklärung des Erlebens von Gesundheitspersonal sowie den Kontextfaktoren und Bewältigungsstrategien in der Behindertenbetreuung erstellt.ErgebnisseDas Stresserleben während der COVID-19-Pandemie war durch Unsicherheit und Überforderung charakterisiert, welche durch die Neuartigkeit der Situation, einem Übermaß an Informationen sowie veränderte Arbeitsbedingungen unter verringerter Partizipation hervorgerufen wurden. Positives Erleben war mit Sinnerfülltheit sowie flachen Hierarchien und der Identifikation mit der Organisation assoziiert. Durch eine Anpassung des Führungsverhaltens, der durch flache Hierarchien gekennzeichneten Organisation, hin zu direktiven Entscheidungen konnte erfolgreich auf die Pandemie reagiert werden.DiskussionDie Ergebnisse dieser Untersuchung weisen auf veränderte Anforderungen an das Führungsverhalten und einen Bedarf an verstärkter direktiver Führung während Krisen hin. Dabei erwiesen sich dezentrale Strukturen und ein laufender Dialog mit Mitarbeiter:innen, Klient:innen und Angehörigen als zentrale Resilienzfaktoren. Nur durch ausreichende Kommunikation und Inkludierung der Mitarbeiter:innen kann der Wechsel im Führungsstil akzeptiert werden.
A Perspective to Control Laser-Induced Periodic Surface Structure Formation at Glancing-Incident Femtosecond Laser-Processed Surfaces
Authors: Jelinek Alexander , Pfeifenberger Manuel J. , Pippan Reinhard , Kiener Daniel 
Published: November 2021

AbstractThe favorable combination of high material removal rate and low influence on the material beneath the ultra-short pulsed laser-processed surface are of particular advantage for sample preparation. This is especially true at the micrometer scale or for the pre-preparation for a subsequent focused ion beam milling process. Specific surface features, the laser-induced periodic surface structures, are generated on femtosecond laser-irradiated surfaces in most cases, which pose an issue for surface-sensitive mechanical testing or microstructural investigations. This work strives for an approach to enhance the surface quality of glancing-incident laser-processed surfaces on the model material copper with two distinctly different grain sizes. A new generalized perspective is presented, in which optimized parameter selection serves to counteract the formation of the laser-induced periodic surface structures, enabling, for example, grain orientation mapping directly on femtosecond laser processed surfaces.
People and Plants in Nunatsiavut (Labrador, Canada): Examining Plants as a Foundational Aspect of Culture in the Subarctic
Authors: Norton C. H. , Cuerrier A. , Hermanutz L. 
Published: November 2021

AbstractThis paper emphasizes the cultural value of plants in Nunatsiavut (Labrador, Canada), a self–governing Inuit region in the Subarctic. Via interviews with community members, we describe the links between plant usage and culture to understand the direct ways that plants are utilized for food, construction, gardening, and medicine, and to then link these uses to deeper cultural significance among three communities in Nunatsiavut (Hopedale, Postville, and Rigolet). Many plants were common amongst communities with a total of 66 taxa identified. About 75% of taxa were reported in at least two communities, corresponding to 95% of all responses. Edible plants were the most common reported usage, with emphasis on berry–producing taxa such as blueberry shrubs. Our study shows that a diversity of plants (i) support cultural activities; (ii) act as markers for historical events; (iii) highlight intergenerational exchange and valuing of plant knowledge; (iv) express the deep awareness that people have for their local environment; and (v) a medium for the expression of traditional values. The similarities in the plant responses among the communities suggest a shared body of plant knowledge. Our study supports the great cultural importance of plants in northern communities.
Coercive inequalities in higher-dimensional anisotropic heisenberg group
Authors: Bou Dagher Esther , Zegarliński Bogusław 
Published: November 2021

AbstractIn the setting of higher-dimensional anisotropic Heisenberg group, we compute the fundamental solution for the sub-Laplacian, and we prove Poincaré and $$\beta $$
β
-Logarithmic Sobolev inequalities for measures as a function of this fundamental solution.
Probabilistic screening and behavior of solar cells under Gaussian parametric uncertainty using polynomial chaos representation model
Authors: Samadhiya Akshit , Namrata Kumari 
Published: November 2021

AbstractThe paper presents a hierarchical polynomial chaos expansion-based probabilistic approach to analyze the single diode solar cell model under Gaussian parametric uncertainty. It is important to analyze single diode solar cell model response under random events or factors due to uncertainty propagation. The optimal values of five electrical parameters associated with the single diode model are estimated using six deterministic optimization techniques through the root-mean-square minimization approach. Values corresponding to the best objective function response are further utilized to describe the probabilistic design space of each random electrical parameter under uncertainty. Adequate samples of each parameter corresponding Gaussian uncertain distribution are generated using Latin hypercube sampling. Furthermore, a multistage probabilistic approach is adopted to evaluate the model response using low-cost polynomial chaos series expansion and perform global sensitivity analysis under specified Gaussian distribution. Coefficients of polynomial basis functions are calculated using least square and least angle regression techniques. Unlike the highly non-linear and complex single diode representation of solar cells, the polynomial chaos expansion model provides a low computational burden and reduced complexity. To ensure reproducibility, probabilistic output response computed using proposed polynomial chaos expansion model is compared with the true model response. Finally, a multidimensional sensitivity analysis is performed through Sobol decomposition of polynomial chaos series representation to quantify the contribution of each parameter to the variance of the probabilistic response. The validation and assessment result shows that the output probabilistic response of the solar cell under Gaussian parametric uncertainty correlates to a Rayleigh probability distribution function. Output response is characterized by a mean value of 0.0060 and 0.0760 for RTC France and Solarex MSX83 solar cells, respectively. The standard deviation of $$ \pm $$
±
0.0034 and $$ \pm $$
±
0.0052 was observed in the probabilistic response for RTC France and Solarex MSX83 solar cells, respectively.
Between colonial medicine and global health: protein malnutrition and UNICEF milk in the Belgian Congo
Authors: Coghe Samuël 
Published: November 2021

AbstractDuring the last decades of colonial rule, Belgian colonial authorities, health agencies and researchers intensely engaged with kwashiorkor, a severe syndrome that was deemed widespread among young children in some parts of the Belgian Congo and Ruanda-Urundi and chiefly attributed to protein malnutrition. To fight kwashiorkor, the Belgian government, in the early 1950s, set up a joint milk distribution campaign with the United Nations International Children’s Emergency Fund, Food and Agriculture Organization and World Health Organization, the first of its kind in colonial Africa. Placing this campaign in the context of mounting international and inter-imperial concern about kwashiorkor and other nutritional problems in Africa and across the globe, this article explores its rationales, mechanisms and consequences, and in particular, how the campaign was shaped and publicised by FORÉAMI, one of the main health providers on the ground. It not only contributes to the history of European colonial medicine and nutritional policies, but also opens new perspectives on international health collaboration during late colonialism. It argues that Belgian authorities were wary of international interference in colonial policies, but that especially FORÉAMI also viewed and used the campaign as an opportunity to display its ‘mastery’ in rural and infant healthcare and control the narrative on Belgium’s colonial medicine.
ADEQUATE ASSURANCE OF PERFORMANCE UNDER THE UN CONVENTION ON CONTRACTS FOR THE INTERNATIONAL SALE OF GOODS AND THE UNIFORM COMMERCIAL CODE
Authors: Kryla-Cudna Katarzyna 
Published: November 2021

AbstractThis article compares and contrasts the doctrine of adequate assurance of performance under the US Uniform Commercial Code (the UCC) and the UN Convention on Contracts for the International Sale of Goods (the CISG). The article argues that, in the context of the CISG, the mechanism of adequate assurance found in the UCC is a faux ami. Despite some similarities, the doctrine of adequate assurance regulated in the CISG is distinct and serves different functions to its UCC counterpart.
THE IMPLICATIONS OF THE WTO TOBACCO PLAIN PACKAGING DISPUTES FOR PUBLIC HEALTH MEASURES
Authors: Mitchell Andrew David , Samlidis Theodore 
Published: November 2021

AbstractAustralia became the first country to introduce standardised or plain packaging laws for tobacco products in 2011. However, they immediately came under direct and indirect challenge from the tobacco industry in various domestic and international fora, including at the World Trade Organization (WTO). The WTO-consistency of Australia's measures was not settled until June 2020, when the Appellate Body upheld two WTO panels’ earlier findings that Australia had acted consistently with its obligations under certain WTO agreements. This article critically analyses the Appellate Body's key findings and their implications for implementing other public health measures. It is shown that these implications are multifaceted, have political, practical and legal dimensions and are likely to reach beyond the WTO dispute resolution system's bounds into other international trade and investment law contexts.
Fine Structure of Microseismic Glacial Stick‐Slip
Authors: Gräff Dominik , Köpfli Manuela , Lipovsky Bradley Paul , Selvadurai Paul Antony , Farinotti Daniel , Walter Fabian 
Published: November 2021

AbstractFrictional instabilities exist in many geological settings, including glaciers and tectonic plate boundaries. However, investigations of suggested analogies between stick‐slip “icequakes” and earthquake faulting have been hampered by the noisy, melt‐prone and inaccessible nature of glacial environments. Here, we reveal details of stick‐slip events beneath an Alpine glacier using seismic sensors within a few meters of a seismically active bed region. We present evidence that widely detected stick‐slip events, which are measurable at the ice surface, are in fact dynamic ruptures over many smaller asperities, whose individual seismic failures are usually too small to be recorded at the surface. Characteristic recurrence times of such multi‐asperity ruptures and their sizes suggest an analogy to Parkfield earthquakes on the San Andreas Fault, questioning traditional glacier sliding theories. Although several trillion times smaller, glacial seismic sources presented here may therefore be ideal for studying earthquake faulting due to much higher event rates.
Zinc Isotopes of the Mariana and Ryukyu Arc‐Related Lavas Reveal Recycling of Forearc Serpentinites Into the Subarc Mantle
Authors: Chen Zuxing , Chen Jiubin , Zeng Zhigang , Soh Tamehe Landry , Zhang Ting , Zhang Yuxiang , Yin Xuebo , Wang Xiaoyuan , Chen Shuai , Shuai Wangcai 
Published: November 2021

AbstractMantle source heterogeneity of arc‐related magmas was traditionally thought to be predominantly affected by slab‐derived components. However, the role of forearc serpentinites in causing subarc mantle heterogeneity remains poorly constrained. Here, we present the first Zn isotope data for lavas from the Mariana and Ryukyu subduction zones. Notably, the δ66Zn values of basaltic lavas from the Mariana arc (0.16–0.18‰) and southern Okinawa Trough (0.15–0.17‰) are generally lower (∼0.10‰) than those of the mid‐ocean ridge basalts (MORB) (0.27 ± 0.05‰). Since mantle melting and magmatic differentiation respectively induce heavy Zn isotope enrichment in primary and evolved magmas, while melt extraction yields the limited Zn isotope fractionation in the mantle, lavas with low δ66Zn values thus potentially indicate the addition of subducted components. The negative correlation between the δ66Zn values and the Ba/La ratios of the basaltic lavas suggests the involvement of isotopically light fluids in their mantle sources. Forearc serpentinites are typically characterized by extremely light Zn isotope compositions. Such forearc materials were likely dragged downward to subarc depths and released isotopically light Zn in fluids to modify the overlying mantle wedge, thereby producing low δ66Zn values in arc‐related magmas. Beyond subarc depths, forearc serpentinites are broken down completely, so light Zn isotope fluids are absent. Accordingly, the basalts from the middle Mariana and Okinawa Trough display MORB‐like δ66Zn values. Collectively, Zn isotope provides new insights into the role of the recycling of forearc serpentinites in generating chemical heterogeneity in the mantle source of subduction‐related magmas.
Unusual Cross‐Shelf Transport Driven by the Changes of Wind Pattern in a Marginal Sea
Authors: Yao Zhigang , Chen Ke , Ding Yang , Lin Xiaopei , Bao Xianwen , Qiao Lulu 
Published: November 2021

AbstractThe traditional understanding of the regional circulation in the Northwest Pacific marginal seas is that the Korean Coastal Current flows southward, following the isobaths of 20–50 m. However, an unusual tongue‐shaped structure of cold water is observed in satellite SST data in January 2017, indicating a possible offshore spread of cold coastal water into the middle Southern Yellow Sea (SYS). Additional observations, including in situ hydrographic data as well as direct current measurement, also suggest this cross‐shelf transport of the Korean Coastal Water in January 2017. Our analysis shows that this flow breaks through the isobaths at ∼37°N, moves southward between 50–75 m, and eventually veers anti‐cyclonically at ∼35°N to join the western slope of the SYS. This circulation pattern is further supported by heat budget analysis. Diagnosis of potential vorticity (PV) reveals that the elevated negative PV anomaly imposed by surface wind stress favors this unusual cross‐shelf transport. The change of wind pattern, although under a deceasing wind speed condition, plays an important role. This work provides an alternative view of the wintertime circulation pattern and motivates future studies of the variability of the coastal currents over interannual and longer time scales in the SYS.