bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regional Population-Based Workforce Shortages in General Surgery by Practicing Surgeon and Resident Trainee
Authors: Zagales Israel , Bourne Mitchell , Sutherland Mason , Pasarin Anthony , Zagales Ruth , Awan Muhammed , McKenney Mark , Elkbuli Adel 
Published: June 2021

Background The physician shortage in the United States (US) continues to become more apparent. We aimed to evaluate the relationship between the US physician distribution from 2012-2019 by specialty at the state/regional level relative to the corresponding population growth. Methods US matched residents and practicing physicians from 2012-2019 were extracted from the National Resident Matching Program and Association of American Medical College databases, respectively. Residents and practicing physicians were divided by geographic regions (West, Midwest, South, Northeast), states, and specialties (anesthesiology, emergency medicine, family medicine, general surgery (GS), internal medicine, obstetrics/gynecology and pediatrics). Results Entering residents and physicians increased across 7 specialties from 2012-2019 with the exception of GS, which showed .2% decrease in practicing physicians. GS experienced decreases in entering residents in all US regions except the South. All specialties showed a decrease in the people-per-physician (PPP) except GS and pediatrics, which had a 4.1% and 71.3% increase, respectively. EM showed the largest growth overall, both in entering residents and overall workforce. Conclusion GS experienced slow growth of residents, decreases in practicing physicians and workforce overall, and an increase in PPP from 2012-2019. Our findings suggest that current population growth rate is exceeding the rate of physicians entering the field of GS and highlights the need for interventions to promote the recruitment of GS residents and retainment of attending physicians, particularly for rural areas. Future research to measure surgeon distribution in relation to patient outcomes and the efficacy of recent policy to address shortages can help define additional interventions to address physician shortages moving forward.
The impact of social unrest and pandemic on mental health of young people in Hong Kong: The transdiagnostic role of event-based rumination
Authors: Wong Stephanie MY , Hui Christy LM , Suen Yi Nam , Wong Corine SM , Chan Sherry KW , Lee Edwin HM , Chang Wing Chung , Chen Eric YH 
Published: June 2021

Objective: Co-occurring population-level events, such as social unrest and coronavirus disease 2019, are observed in many societies today. Few studies have explored their combined mental health effects on young people. While self-focused rumination has been suggested to be a key mechanism underlying depression, the role of event-based rumination in mediating the impact of population stressors has yet to be elucidated. Methods: Data were collected from 6988 young people in a large-scale community online survey in Hong Kong. The survey assessed symptoms of post-traumatic stress disorder and depression, direct exposure to social unrest-related traumatic events, coronavirus disease 2019 pandemic-related events, personal stressful life events, event-based rumination and other individual risk factors. Results: High levels of comorbid post-traumatic stress disorder and depressive symptoms were observed. Logistic regression analysis revealed that probable post-traumatic stress disorder was associated with traumatic events (odds ratio = 1.73, 95% confidence interval = [1.64, 1.82]), pandemic-related events (odds ratio = 1.08, confidence interval = [1.01, 1.16]), stressful life events (odds ratio = 1.20, confidence interval = [1.21, 1.37]), high event-based rumination (odds ratio = 3.00, confidence interval = [2.58, 3.48]), lower resilience (odds ratio = 1.18, confidence interval = [1.15, 1.21]), higher smartphone reliance (odds ratio = 1.09, confidence interval = [1.05, 1.13]) and financial concerns (odds ratio = 1.25, confidence interval = [1.18, 1.33]). The odds for probable post-traumatic stress disorder was also significantly higher when two or more traumatic events were experienced (odds ratio = 4.03, confidence interval = [3.52, 4.62]). Factors associated with moderate-to-severe level depressive symptoms were similar. Event-based rumination significantly mediated between different types of external events (traumatic events, pandemic-related events, stressful life events) and both post-traumatic stress disorder and depressive symptoms. Conclusion: These findings suggest that diverse types of stressful events during population-level crises could add to personal stressors to affect mental health outcomes in young people. Among other protective and risk factors, event-based rumination presented as a prominent transdiagnostic mediator for different symptom dimensions which may be a potentially important target for early risk detection and intervention.
Ketamine’s effect on inflammation and kynurenine pathway in depression: A systematic review
Authors: Kopra Emma , Mondelli Valeria , Pariante Carmine , Nikkheslat Naghmeh 
Published: June 2021

Background: Ketamine is a novel rapid-acting antidepressant with high efficacy in treatment-resistant patients. Its exact therapeutic mechanisms of action are unclear; however, in recent years its anti-inflammatory properties and subsequent downstream effects on tryptophan (TRP) metabolism have sparked research interest. Aim: This systematic review examined the effect of ketamine on inflammatory markers and TRP–kynurenine (KYN) pathway metabolites in patients with unipolar and bipolar depression and in animal models of depression. Methods: MEDLINE, Embase, and PsycINFO databases were searched on October 2020 (1806 to 2020). Results: Out of 807 initial results, nine human studies and 22 animal studies on rodents met the inclusion criteria. Rodent studies provided strong support for ketamine-induced decreases in pro-inflammatory cytokines, namely in interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α and indicated anti-inflammatory effects on TRP metabolism, including decreases in the enzyme indoleamine 2,3-dioxygenase (IDO). Clinical evidence was less robust with high heterogeneity between sample characteristics, but most experiments demonstrated decreases in peripheral inflammation including in IL-1β, IL-6, and TNF-α. Preliminary support was also found for reduced activation of the neurotoxic arm of the KYN pathway. Conclusion: Ketamine appears to induce anti-inflammatory effects in at least a proportion of depressed patients. Suggestions for future research include investigation of markers in the central nervous system and examination of clinical relevance of inflammatory changes.
Evidence for the atherogenic index of plasma as a potential biomarker for cardiovascular disease in schizophrenia
Authors: Onen Sinay , Taymur Ibrahim 
Published: June 2021

Background: Schizophrenia is known to be accompanied with increased cardiovascular mortality, which causes reduced life expectancy. Aim: The aim of the current study was to investigate if atherogenic index of plasma (AIP) could be a good marker in assessing cardiovascular disease (CVD) risk in patients with schizophrenia. Methods: Patients with schizophrenia ( n = 328) and healthy controls ( n = 141) were recruited. Schizophrenia patients were evaluated according to the presence of antipsychotic (AP) drug use as AP(+)Sch group and AP(−)Sch group. Atherogenic indices, such as AIP, Castelli’s risk index-I (CRI-I), Castelli’s risk index-II (CRI-II), and atherogenic coefficient (AC), were calculated according to the laboratory examination of serum lipid parameters. Results: According to the comparison of serum lipid levels, triglyceride (TG) levels were found to be highest and high-density lipoprotein–cholesterol levels were lowest in AP(+)Sch group than AP(−)Sch group and control group (CG) ( p < 0.001). AIP, CRI-I, and CRI-II scores were found to be significantly higher in AP(+)Sch group than AP(−)Sch group, and in AP(−)Sch than healthy controls ( p < 0.001). Mean AC scores were higher in AP(+)Sch group than both AP(−)Sch and CG and were similar in AP(−)Sch and control subjects ( p < 0.001). According to the correlation analysis, AIP scores were positively correlated with duration of disease ( r = 0.235; p = 0.002) and age ( r = 0.226; p = 0.003) in AP(+)Sch group but not in drug-free subjects. In all groups, atherogenic indices of CRI-I, CRI-II, and AC scores were found to be positively correlated with AIP scores ( p < 0.001). Conclusion: Our results suggest that AIP is an easily calculable and reliable marker for determining the CVD risk in both drug-free schizophrenia patients and patients under AP treatment.
Randomised, controlled trial of erenumab for the prevention of episodic migraine in patients from Asia, the Middle East, and Latin America: The EMPOwER study
Authors: Wang Shuu-Jiun , Roxas Artemio A , Saravia Bibiana , Kim Byung-Kun , Chowdhury Debashish , Riachi Naji , Tai Mei-Ling Sharon , Tanprawate Surat , Ngoc Tai Tran , Zhao Yi Jing , Mikol Daniel D , Pandhi Shaloo , Wen Shihua , Mondal Subhayan , Tenenbaum Nadia , Hours-Zesiger Peggy 
Published: June 2021

Objective EMPOwER, a double-blind, randomised, phase 3 study, evaluated the efficacy and safety of erenumab in adults with episodic migraine from Asia, the Middle East, and Latin America. Methods Randomised patients (N = 900) received monthly subcutaneous injections of placebo, erenumab 70 mg, or 140 mg (3:3:2) for 3 months. Primary endpoint was change from baseline in monthly migraine days at Month 3. Other endpoints included achievement of ≥50%, ≥75%, and 100% reduction in monthly migraine days, change in monthly acute migraine-specific medication treatment days, patient-reported outcomes, and safety assessment. Results At baseline, mean (standard deviation) age was 37.5 (9.9) years, 81.9% were women, and monthly migraine days was 8.2 (2.8). At Month 3, change from baseline in monthly migraine days (primary endpoint) was −3.1, −4.2, and −4.8 days for placebo, erenumab 70 mg, and erenumab 140 mg, respectively, with a statistically significant difference for erenumab versus placebo (P = 0.002 [70 mg], P < 0.001 [140 mg]). Both erenumab doses were also significantly superior to placebo on all secondary endpoints, including the proportion of patients achieving ≥50% reduction from baseline in monthly migraine days, change from baseline in monthly acute migraine-specific medication treatment days and change from baseline in the Headache Impact Test-6™ scores. The safety profile of erenumab was comparable with placebo; no new safety signals were observed. Conclusions This study of erenumab in patients with episodic migraine from Asia, the Middle East, and Latin America met all primary and secondary endpoints. A consistent numerical benefit was observed with erenumab 140 mg versus erenumab 70 mg across all efficacy endpoints. These findings extend evidence of erenumab’s efficacy and safety to patients under-represented in previous trials. ClinicalTrials.gov identifier: NCT03333109
Self-reported camouflaging behaviours used by autistic adults during everyday social interactions
Authors: Cook Julia , Crane Laura , Hull Laura , Bourne Laura , Mandy William 
Published: June 2021

Autistic people may camouflage their innate autistic social behaviours to adapt to, cope within and/or influence the predominately neurotypical social landscape. This study describes behaviours exhibited, altered or avoided by autistic adults whilst camouflaging (i.e. camouflaging behaviours). Using Interpersonal Process Recall methodology, 17 autistic adults (8 women, 6 men and 3 agender/gender neutral individuals) participated in a brief social task designed to replicate a common day-to-day social situation. Participants then watched a video of their interaction with a researcher, actively identifying and describing camouflaging behaviours. Using qualitative content analysis, descriptions of 38 camouflaging behaviours described by participants were clustered into four main categories and seven subcategories: (1) masking, (2) innocuous engagement (subcategories: passive encouragement, centring social partner, deferential engagement and reducing social risk), (3) modelling neurotypical communication and (4) active self-presentation (subcategories: reciprocal social behaviours, risky social behaviours, and comfortable and familiar social behaviours). The novel use of Interpersonal Process Recall methodology addressed limitations in existing camouflaging research and facilitated the identification of previously unreported camouflaging behaviours. These camouflaging behaviours are discussed with reference to literature concerning interpersonal research and theory within and outside the field of autism. Lay abstract Camouflaging can be thought of as the process through which autistic people modify their natural social behaviours to adapt to, cope within or influence the largely neurotypical (non-autistic) social world. Many autistic people experience negative reactions to their natural or intuitive social behaviours when interacting with non-autistic people. Over time, in response to these negative reactions, autistic people’s social behaviour often changes. We refer to autistic people’s changed behaviours as ‘camouflaging behaviours’. Research exploring camouflaging behaviours is still at an early stage. This study investigated camouflaging behaviours used by autistic adults in everyday social interactions using a research method that was new to the field of autism. Specifically, 17 autistic adults were filmed taking part in a common everyday social situation – a conversation with a stranger. With the help of the video of this conversation, they then showed and described their camouflaging behaviours to a researcher. These autistic people identified and described a total of 38 different camouflaging behaviours. The detailed and specific information provided by autistic adults about camouflaging behaviours generated important new insights into the ways in which autistic people adapt to, cope within and influence the neurotypical (non-autistic) social world.
The feasibility and acceptability of a psychosocial intervention to support people with dementia with Lewy bodies and family care partners
Authors: Killen Alison , Flynn Darren , O’Brien Nicola , Taylor John-Paul 
Published: June 2021

Objectives Psychosocial support for people with dementia with Lewy bodies (DLB) and family care partners is frequently lacking, despite the need expressed by those with lived experience. Our objective was to examine the feasibility and acceptability of an intervention designed to build coping capability. Design The design was non-randomised with all participants receiving the intervention. Setting The setting was a Memory Assessment and Management Service in the Northeast of England. Participants Participants comprised 19 dyads consisting of a person with DLB and a family care partner. Intervention The intervention was group-based, with weekly sessions attended for up to four successive weeks. It was informed by Social Cognitive Theory. Measurements Data were collected on recruitment, attendance and attrition, self-efficacy, mood, stress and participant experience. Results Recruitment was achieved with minimal attrition and three successive groups were delivered. Care partners felt more in control and able to cope in at least 3 of 13 areas with 73% feeling this way in eight or more areas. Three themes were identified from post-intervention interviews: people like us, outcomes from being a group member and intervention design. Conclusions A DLB-specific group intervention is acceptable to people with DLB and family care partners, and recruitment is feasible within a specialist service. Participation may enhance understanding of this condition and reduce social isolation. It may improve care partners’ coping capability particularly if targeted towards those with low prior understanding of DLB and more stress. Means of evaluating outcomes for people with DLB need further development.
Forest Income and Rural Livelihoods in West Bengal, India
Authors: Ray Biswajit , Mukherjee Promita 
Published: June 2021

To what extent forests contribute to rural livelihoods in developing countries? To find a plausible answer for this, this article explores whether inclusion of forest income to rural households’ total income accounts reduces poverty and income inequality, and also enables rural households to cope with shocks. To this end, we conducted household surveys in eight forest-dependent villages in the Indian state of West Bengal between August 2016 and August 2017. Using data from 407 sample households, we measured forest income of a household as the aggregate monetary value of resources extracted solely from forest ecosystem and compared this with other economic activities of the households. We calculated poverty indices and Gini coefficient with and without forest income, and we employed regression and Gini decomposition techniques to assess the safety net role and relative contribution of forest income to reducing rural poverty and inequality when compared to other sources of income. We found that the addition of forest income to household accounts significantly reduces measured poverty and inequality. Besides, the sample households, especially the poor, extract more from forests to cope with severe covariate shocks due to greater income certainty and thus adopt forest-dominated coping strategy in time of shocks and crises. The implication is that forest income needs to sustainably flow to the poor along with the development of better safety nets in forested rural areas in order to improve the forest-based rural livelihoods in developing countries like India. JEL Codes: Q23, Q56, Q57
Ultimatum Game Bargaining Behaviour: A Classroom Experiment
Authors: Tetik Metin , Tetik Gamzegül 
Published: June 2021

This study aims to investigate the types of bargaining behaviour students have and the variables that affect these bargaining behaviours by designing an ultimatum bargaining game in the classroom environment (during the real exam). The experimental group consists of 202 students who took the spring term economics final exam. The strategic interaction between students was formulated as a two-person bargaining problem. A cooperative solution was based on the Nash solution also obtained for bargaining problem among students. The findings of this study show that the highest bargaining equilibrium in this game is the equilibrium status based on the Nash solution. Moreover, we concluded that the success of the economy course and the grade-level affect the students’ behaviour according to the equilibrium strategy based on the Nash solution. JEL Classifications: C90, C70, C78, C57
A comparison study of human examples vs. non-human examples in an evolution lesson leads to differential impacts on student learning experiences in an introductory biology course
Authors: Grunspan Daniel Z. , Dunk Ryan D. P. , Barnes M. Elizabeth , Wiles Jason R. , Brownell Sara E. 
Published: June 2021

Abstract
Background
Instructors can teach evolution using any number of species contexts. However, not all species contexts are equal, and taxa choice can alter both cognitive and affective elements of learning. This is particularly true when teaching evolution using human examples, a promising method for evolution instruction that nevertheless comes with unique challenges. In this study, we tested how an evolution lesson focused on a human example may impact students’ engagement, perceived content relevance, learning gains, and level of discomfort, when compared to the same lesson using a non-human mammal example. We use this isomorphic lesson and a pre-post study design administered in a split-section introductory biology classroom to isolate the importance of the species context.

Results
For two of the four measurements of interest, the effect of using human examples could not be understood without accounting for student background. For learning gains, students with greater pre-class content knowledge benefited more from the human examples, while those with low levels of knowledge benefited from the non-human example. For perceived relevance, students who were more accepting of human evolution indicated greater content relevance from the human example. Regardless of condition, students with lower evolution acceptance reported greater levels of discomfort with the lesson.

Conclusions
Our results illustrate the complexities of using human examples to teach evolution. While these examples were beneficial for many students, they resulted in worse outcomes for students that were less accepting of evolution and those who entered the course with less content knowledge. These findings demonstrate the need to consider diverse student backgrounds when establishing best practices for using human examples to teach evolution.
Scalable robust graph and feature extraction for arbitrary vessel networks in large volumetric datasets
Authors: Drees Dominik , Scherzinger Aaron , Hägerling René , Kiefer Friedemann , Jiang Xiaoyi 
Published: June 2021

AbstractBackgroundRecent advances in 3D imaging technologies provide novel insights to researchers and reveal finer and more detail of examined specimen, especially in the biomedical domain, but also impose huge challenges regarding scalability for automated analysis algorithms due to rapidly increasing dataset sizes. In particular, existing research towards automated vessel network analysis does not always consider memory requirements of proposed algorithms and often generates a large number of spurious branches for structures consisting of many voxels. Additionally, very often these algorithms have further restrictions such as the limitation to tree topologies or relying on the properties of specific image modalities.ResultsWe propose a scalable iterative pipeline (in terms of computational cost, required main memory and robustness) that extracts an annotated abstract graph representation from the foreground segmentation of vessel networks of arbitrary topology and vessel shape. The novel iterative refinement process is controlled by a single, dimensionless, a-priori determinable parameter.ConclusionsWe are able to, for the first time, analyze the topology of volumes of roughly 1 TB on commodity hardware, using the proposed pipeline. We demonstrate improved robustness in terms of surface noise, vessel shape deviation and anisotropic resolution compared to the state of the art. An implementation of the presented pipeline is publicly available in version 5.1 of the volume rendering and processing engine Voreen.
A novel nonlinear dimension reduction approach to infer population structure for low-coverage sequencing data
Authors: Zhang Miao , Liu Yiwen , Zhou Hua , Watkins Joseph , Zhou Jin 
Published: June 2021

AbstractBackgroundLow-depth sequencing allows researchers to increase sample size at the expense of lower accuracy. To incorporate uncertainties while maintaining statistical power, we introduce to analyze population structure of low-depth sequencing data.ResultsThe method optimizes the choice of nonlinear transformations of dosages to maximize the Ky Fan norm of the covariance matrix. The transformation incorporates the uncertainty in calling between heterozygotes and the common homozygotes for loci having a rare allele and is more linear when both variants are common.ConclusionsWe apply to samples from two indigenous Siberian populations and reveal hidden population structure accurately using only a single chromosome. The package is available onhttps://github.com/yiwenstat/MCPCA_PopGen.