bluuebunny/crossref_metadata_2025_split huggingface dataset:
Addressing the physician burnout epidemic with resilience curricula in medical education: a systematic review
Authors: Seo Chanhee , Corrado Mario , Fournier Karine , Bailey Tayler , Haykal Kay-Anne 
Published: February 2021

Abstract
Background
A variety of stressors throughout medical education have contributed to a burnout epidemic at both the undergraduate medical education (UGME) and postgraduate medical education (PGME) levels. In response, UGME and PGME programs have recently begun to explore resilience-based interventions. As these interventions are in their infancy, little is known about their efficacy in promoting trainee resilience. This systematic review aims to synthesize the available research evidence on the efficacy of resilience curricula in UGME and PGME.

Methods
We performed a comprehensive search of the literature using MEDLINE, EMBASE, PsycINFO, Educational Resources Information Centre (ERIC), and Education Source from their inception to June 2020. Studies reporting the effect of resilience curricula in UGME and PGME settings were included. A qualitative analysis of the available studies was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Risk of bias was assessed using the ROBINS-I Tool.

Results
Twenty-one studies met the inclusion criteria. Thirteen were single-arm studies, 6 quasi-experiments, and 2 RCTs. Thirty-eight percent (8/21; n = 598) were implemented in UGME, while 62 % (13/21, n = 778) were in PGME. There was significant heterogeneity in the duration, delivery, and curricular topics and only two studies implemented the same training model. Similarly, there was considerable variation in curricula outcome measures, with the majority reporting modest improvement in resilience, while three studies reported worsening of resilience upon completion of training. Overall assessment of risk of bias was moderate and only few curricula were previously validated by other research groups.

Conclusions
Findings suggest that resilience curricula may be of benefit to medical trainees. Resilience training is an emerging area of medical education that merits further investigation. Additional research is needed to construct optimal methods to foster resilience in medical education.
Automated detection of colorectal tumors based on artificial intelligence
Authors: Lee Kwang-Sig , Son Sang-Hyuk , Park Sang-Hyun , Kim Eun Sun 
Published: February 2021

Abstract
Background
This study developed a diagnostic tool to automatically detect normal, unclear and tumor images from colonoscopy videos using artificial intelligence.

Methods
For the creation of training and validation sets, 47,555 images in the jpg format were extracted from colonoscopy videos for 24 patients in Korea University Anam Hospital. A gastroenterologist with the clinical experience of 15 years divided the 47,555 images into three classes of Normal (25,895), Unclear (2038) and Tumor (19,622). A single shot detector, a deep learning framework designed for object detection, was trained using the 47,255 images and validated with two sets of 300 images—each validation set included 150 images (50 normal, 50 unclear and 50 tumor cases). Half of the 47,255 images were used for building the model and the other half were used for testing the model. The learning rate of the model was 0.0001 during 250 epochs (training cycles).

Results
The average accuracy, precision, recall, and F1 score over the category were 0.9067, 0.9744, 0.9067 and 0.9393, respectively. These performance measures had no change with respect to the intersection-over-union threshold (0.45, 0.50, and 0.55). This finding suggests the stability of the model.

Conclusion
Automated detection of normal, unclear and tumor images from colonoscopy videos is possible by using a deep learning framework. This is expected to provide an invaluable decision supporting system for clinical experts.
Physical accessibility of primary care facilities for people with disabilities: a cross-sectional survey in 31 countries
Authors: Groenewegen Peter P. , Kroneman Madelon , Spreeuwenberg Peter 
Published: February 2021

Abstract
Background
Primary care is the first point of care, also for people with disabilities. The accessibility of primary care facilities is therefore very important. In this study we analysed comparative data on physical accessibility of general practices (GP practices) in 31 (mainly) European countries.

Methods
We used data from the QUALICOPC study, conducted in 2011 among GPs in 34 (mainly European) countries and constructed a physical accessibility scale. We applied multilevel analysis to assess the differences between and within countries and to test hypotheses, related to characteristics of the practices and of the countries.

Results
We found large differences between countries and a strong clustering of physical accessibility within countries. Physical accessibility was negatively related to the age of the GPs, and was less in single-handed and in inner city practices. Of the country variables only the length of the period of social democratic government participation during the previous decades was positively related to physical accessibility.

Conclusion
A large share of the variation in physical accessibility of GP practices was on the level of countries. This means that national policies can be used to increase physical accessibility of GP practices.
Tunable expression rate control of a growth-decoupled T7 expression system by l-arabinose only
Authors: Stargardt Patrick , Striedner Gerald , Mairhofer Juergen 
Published: February 2021

Abstract
Background
Precise regulation of gene expression is of utmost importance for the production of complex membrane proteins (MP), enzymes or other proteins toxic to the host cell. In this article we show that genes under control of a normally Isopropyl β-d-1-thiogalactopyranoside (IPTG)-inducible PT7-lacO promoter can be induced solely with l-arabinose in a newly constructed Escherichia coli expression host BL21-AI<gp2>, a strain based on the recently published approach of bacteriophage inspired growth-decoupled recombinant protein production.

Results
Here, we show that BL21-AI<gp2> is able to precisely regulate protein production rates on a cellular level in an l-arabinose concentration-dependent manner and simultaneously allows for reallocation of metabolic resources due to l-arabinose induced growth decoupling by the phage derived inhibitor peptide Gp2. We have successfully characterized the system under relevant fed-batch like conditions in microscale cultivation (800 µL) and generated data proofing a relevant increase in specific yields for 6 different Escherichia coli derived MP-GFP fusion proteins by using online-GFP signals, FACS analysis, SDS-PAGE and western blotting.

Conclusions
In all cases tested, BL21-AI<gp2> outperformed the parental strain BL21-AI, operated in growth-associated production mode. Specific MP-GFP fusion proteins yields have been improved up to 2.7-fold. Therefore, this approach allows for fine tuning of MP production or expression of multi-enzyme pathways where e.g. particular stoichiometries have to be met to optimize product flux.
Monoclonal antibodies and chimeric antigen receptor (CAR) T cells in the treatment of colorectal cancer
Authors: Jin Ke-Tao , Chen Bo , Liu Yu-Yao , Lan H uan-Rong , Yan Jie-Ping 
Published: February 2021

AbstractColorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer deaths worldwide. Besides common therapeutic approaches, such as surgery, chemotherapy, and radiotherapy, novel therapeutic approaches, including immunotherapy, have been an advent in CRC treatment. The immunotherapy approaches try to elicit patients` immune responses against tumor cells to eradicate the tumor. Monoclonal antibodies (mAbs) and chimeric antigen receptor (CAR) T cells are two branches of cancer immunotherapy. MAbs demonstrate the great ability to completely recognize cancer cell-surface receptors and blockade proliferative or inhibitory pathways. On the other hand, T cell activation by genetically engineered CAR receptor via the TCR/CD3 and costimulatory domains can induce potent immune responses against specific tumor-associated antigens (TAAs). Both of these approaches have beneficial anti-tumor effects on CRC. Herein, we review the different mAbs against various pathways and their applications in clinical trials, the different types of CAR-T cells, various specific CAR-T cells against TAAs, and their clinical use in CRC treatment.
Smartphone-based dispatch of community first responders to out-of-hospital cardiac arrest - statements from an international consensus conference
Authors: Metelmann Camilla , Metelmann Bibiana , Kohnen Dorothea , Brinkrolf Peter , Andelius Linn , Böttiger Bernd W. , Burkart Roman , Hahnenkamp Klaus , Krammel Mario , Marks Tore , Müller Michael P. , Prasse Stefan , Stieglis Remy , Strickmann Bernd , Thies Karl Christian 
Published: February 2021

Abstract
Background
Over the past decade Smartphone-based activation (SBA) of Community First Responders (CFR) to out-of-hospital cardiac arrests (OHCA) has gained much attention and popularity throughout Europe. Various programmes have been established, and interestingly there are considerable differences in technology, responder spectrum and the degree of integration into the prehospital emergency services. It is unclear whether these dissimilarities affect outcome. This paper reviews the current state in five European countries, reveals similarities and controversies, and presents consensus statements generated in an international conference with the intention to support public decision making on future strategies for SBA of CFR.

Methods
In a consensus conference a three-step approach was used: (i) presentation of current research from five European countries; (ii) workshops discussing evidence amongst the audience to generate consensus statements; (iii) anonymous real-time voting applying the modified RAND-UCLA Appropriateness method to adopt or reject the statements. The consensus panel aimed to represent all stakeholders involved in this topic.

Results
While 21 of 25 generated statements gained approval, consensus was only found for 5 of them. One statement was rejected but without consensus. Members of the consensus conference confirmed that CFR save lives. They further acknowledged the crucial role of emergency medical control centres and called for nationwide strategies.

Conclusions
Members of the consensus conference acknowledged that smartphone-based activation of CFR to OHCA saves lives. The statements generated by the consensus conference may assist the public, healthcare services and governments to utilise these systems to their full potential, and direct the research community towards fields that still need to be addressed.
Changes in the proportion of clinical clusters contribute to the phenotypic evolution of Behçet’s disease in Japan
Authors: Soejima Yutaro , Kirino Yohei , Takeno Mitsuhiro , Kurosawa Michiko , Takeuchi Masaki , Yoshimi Ryusuke , Sugiyama Yumiko , Ohno Shigeru , Asami Yukiko , Sekiguchi Akiko , Igarashi Toshihisa , Nagaoka Shohei , Ishigatsubo Yoshiaki , Nakajima Hideaki , Mizuki Nobuhisa 
Published: February 2021

AbstractBackgroundWe hypothesized that Behçet’s disease (BD) consists of several clinical subtypes with different severity, resulting in heterogeneity of the disease. Here, we conducted a study to identify clinical clusters of BD.MethodsA total of 657 patients registered in the Yokohama City University (YCU) regional BD registry between 1990 and 2018, as well as 6754 patients who were initially registered in the Japanese Ministry of Health, Labour and Welfare (MHLW) database between 2003 and 2014, were investigated. The YCU registry data regarding the clinical manifestations of BD, human leukocyte antigen (HLA) status, treatments, and hospitalizations were analyzed first, followed by similar analyses of the MHLW for validation. A hierarchical cluster analysis was independently performed in both patient groups.ResultsA hierarchical cluster analysis determined five independent clinical clusters in the YCU cohort. Individual counterparts of the YCU clusters were confirmed in the MHLW registry. Recent phenotypical evolutions of BD in Japan, such as increased gastrointestinal (GI) involvement, reduced complete type according to the Japan Criteria, and reduced HLA-B51 positivity were associated with chronologically changing proportions of the clinical clusters.ConclusionsIn this study, we identified independent clinical clusters among BD patients in Japan and found that the proportion of each cluster varied over time. We propose five independent clusters namely “mucocutaneous”, “mucocutaneous with arthritis”, “neuro”, “GI”, and “eye.”
Molecule Set Comparator (MSC): a CDK-based open rich‐client tool for molecule set similarity evaluations
Authors: Rajan Kohulan , Hein Jan-Mathis , Steinbeck Christoph , Zielesny Achim 
Published: February 2021

AbstractThe open rich-client Molecule Set Comparator (MSC) application enables a versatile and fast comparison of large molecule sets with a unique inter-set molecule-to-molecule mapping obtained e.g. by molecular-recognition-oriented machine learning approaches. The molecule-to-molecule comparison is based on chemical descriptors obtained with the Chemistry Development Kit (CDK), such as Tanimoto similarities, atom/bond/ring counts or physicochemical properties like logP. The results are summarized and presented graphically by interactive histogram charts that can be examined in detail and exported in publication quality.
Random attractor for second-order stochastic delay lattice sine-Gordon equation
Authors: Li Xintao , She Lianbing , Shan Zhenpei 
Published: February 2021

AbstractIn this paper, we prove the existence of random $\mathcal{D}$
D
-attractor for the second-order stochastic delay sine-Gordon equation on infinite lattice with certain dissipative conditions, and then establish the upper bound of Kolmogorov ε-entropy for the random $\mathcal{D}$
D
-attractor.
On an SE(Is)(Ih)AR epidemic model with combined vaccination and antiviral controls for COVID-19 pandemic
Authors: De la Sen M. , Ibeas A. 
Published: February 2021

AbstractIn this paper, we study the nonnegativity and stability properties of the solutions of a newly proposed extended SEIR epidemic model, the so-called SE(Is)(Ih)AR epidemic model which might be of potential interest in the characterization and control of the COVID-19 pandemic evolution. The proposed model incorporates both asymptomatic infectious and hospitalized infectious subpopulations to the standard infectious subpopulation of the classical SEIR model. In parallel, it also incorporates feedback vaccination and antiviral treatment controls. The exposed subpopulation has three different transitions to the three kinds of infectious subpopulations under eventually different proportionality parameters. The existence of a unique disease-free equilibrium point and a unique endemic one is proved together with the calculation of their explicit components. Their local asymptotic stability properties and the attainability of the endemic equilibrium point are investigated based on the next generation matrix properties, the value of the basic reproduction number, and nonnegativity properties of the solution and its equilibrium states. The reproduction numbers in the presence of one or both controls is linked to the control-free reproduction number to emphasize that such a number decreases with the control gains. We also prove that, depending on the value of the basic reproduction number, only one of them is a global asymptotic attractor and that the solution has no limit cycles.
COVID-19-associated coagulopathy: thromboembolism prophylaxis and poor prognosis in ICU
Authors: Zheng Runhui , Zhou Jing , Song Bin , Zheng Xia , Zhong Ming , Jiang Li , Pan Chun , Zhang Wei , Xia Jiaan , Chen Nanshan , Wu Wenjuan , Zhang Dingyu , Xi Yin , Lin Zhimin , Pan Ying , Liu Xiaoqing , Li Shiyue , Xu Yuanda , Li Yimin , Tan Huo , Zhong Nanshan , Luo Xiaodan , Sang Ling 
Published: February 2021

Abstract
Background
Coronavirus disease 2019 (COVID-19) is associated with coagulation abnormalities which are indicators of higher mortality especially in severe cases.

Methods
We studied patients with proven COVID-19 disease in the intensive care unit of Jinyintan Hospital, Wuhan, China from 30 to 2019 to 31 March 2020.

Results
Of 180 patients, 89 (49.44 %) had died, 85 (47.22 %) had been discharged alive, and 6 (3.33 %) were still hospitalised by the end of data collection. A D-dimer concentration of > 0.5 mg/L on admission was significantly associated with 30 day mortality, and a D-dimer concentration of > 5 mg/L was found in a much higher proportion of non-survivors than survivors. Sepsis-induced coagulopathy (SIC) and disseminated intravascular coagulation (DIC) scoring systems were dichotomised as < 4 or ≥ 4 and < 5 or ≥ 5, respectively, and the mortality rate was significantly different between the two stratifications in both scoring systems. Enoxaparin was administered to 68 (37.78 %) patients for thromboembolic prophylaxis, and stratification by the D-dimer concentration and DIC score confirmed lower mortality in patients who received enoxaparin when the D-dimer concentration was > 2 than < 2 mg/L or DIC score was ≥ 5 than < 5. A low platelet count and low serum calcium concentration were also related to mortality.

Conclusions
A D-dimer concentration of > 0.5 mg/L on admission is a risk factor for severe disease. A SIC score of > 4 and DIC score of > 5 may be used to predict mortality. Thromboembolic prophylaxis can reduce mortality only in patients with a D-dimer concentration of > 2 mg/L or DIC score of ≥ 5.
Validation study of the Italian version of Temporal Focus Scale: psychometric properties and convergent validity
Authors: Diotaiuti Pierluigi , Valente Giuseppe , Mancone Stefania 
Published: February 2021

Abstract
Background
Over the last decade, international research has produced a large number of studies that have stressed the importance of temporal focus in various aspects of the lives of individuals, groups and organizations. This first Italian validation study of the Temporal Focus Scale (TFS) has shown a reliable measurement to assess the tendency of individuals to characteristically think about different periods of their lives.

Methods
TFS/I was administered to a sample of 1458 participants, while three other convenience samples (N1 = 453; N2 = 544; N3 = 168) were used for convergent validity testing.

Results
Confirmatory factor analysis confirmed a three-factor solution (including 10 items) with good indices of fit to data, e.g., χ2 = 49.533, CFI = 0.992, TLI = 0.986, RMSEA = 0.034, RMSEA 90% CI .018–.048. Convergent validity assessment confirmed predictive indications with variables such as life satisfaction, optimistic/pessimistic orientation, perceived general self-efficacy, self-regulatory modes, anxiety, depression.

Conclusion
The temporal focus has proven to be a significant feature associated with various aspects of both well-being and personal discomfort. By virtue of its good psychometric properties, the TFS can be an integrative tool along with others for a better evaluation of the person’s profile in different contexts such as education, coaching, psychotherapy, counseling and career guidance.
Altered identity: fleeting colors and obscured surfaces in Van Gogh’s Landscapes in Paris, Arles, and Saint-Rémy
Authors: Pozzi Federica , Basso Elena , Centeno Silvia A. , Smieska Louisa M. , Shibayama Nobuko , Berns Roy , Fontanella Megan , Stringari Lena 
Published: February 2021

Abstract
The Thannhauser Collection of the Solomon R. Guggenheim Museum, New York, represents an important survey of European avant-garde art production during the late 19th and early 20th centuries. Among the works included in this collection are three paintings by Vincent van Gogh, namely Roadway with Underpass (1887), Landscape with Snow (1888), and Mountains at Saint-Rémy (1889). These examples each exhibit some degree of surface alteration, including fading of specific pigments and, in one case, a non-original, discolored varnish, resulting in obscured color and spatial relationships, as well as being the subject of questions regarding authenticity in the case of the two earlier pictures. Initial examination involved documentation of the brushwork, paint quality, and distribution of colors under magnification. Infrared (IR) and ultraviolet (UV) photography, as well as X-radiography, provided additional information on the surface coatings, the structure of the works, and their supports. Subsequently, an in-depth scientific investigation of the ground and paint layers, with a special focus on fading colors and altered surfaces, was carried out non-invasively with point and macro-X-ray fluorescence (XRF) spectroscopy, visible reflection spectroscopy, and multi-channel visible spectrum four-light imaging, followed by the analysis of cross sections and dispersed pigment samples by means of optical microscopy, transmission Fourier-transform infrared (FTIR) and Raman spectroscopies, and scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy (SEM/EDS), as well as high-performance liquid chromatography with photodiode array detection (HPLC-PDA) and pyrolysis-gas chromatography/mass spectrometry (Py-GC/MS). Results indicated that both the brushwork and artist's palette of all three paintings are consistent with data previously reported for other Van Gogh works and with pigments described in the artist’s letters to his friends and his brother Theo. Most notably, evidence of biodeterioration and paint alteration phenomena was found on Roadway with Underpass, while specific pigments such as eosin red—historically sold as geranium lake—were detected in areas of Landscape with Snow and Mountains at Saint-Rémy that display severe fading. In addition to assisting the development of a suitable plan for the conservation of the 1887 painting, this study traces the progression of Van Gogh’s practice over three years critical to his artistic development, discusses the historical context in which each masterpiece was created, identifies the range of materials and techniques used, and addresses authenticity questions by providing a comparison with results of scientific analysis from other similar works.