bluuebunny/crossref_metadata_2025_split huggingface dataset:
Levels of burnout and its association with resilience and coping mechanisms among orthopaedic surgery residents: a single institution experience from Singapore
Authors: Ho Sean WL , Kwek Ernest BK 
Published: January 2021

Abstract

Introduction:
Burnout has implications for surgeon wellbeing and patient care. We aimed to: (a) describe burnout levels among orthopaedic surgery residents in an Accreditation Council for Graduate Medical Education-International (ACGME-I) accredited programme; and (b) determine associations between burnout levels and resident characteristics, resilience and coping mechanisms.

Methods:
This is a grant-funded, cross-sectional questionnaire-based study that included 44 orthopaedic surgery residents. Burnout was measured using Maslach Burnout Inventory and resilience was determined using the Short Grit Scale. Coping mechanisms were determined using the Brief Coping Orientation to Problems Experienced scale.

Results:
20 (45.5%) residents fulfilled the criteria for burnout. High levels of emotional exhaustion (EE) and depersonalisation (DP) correlated with stressors, such as inadequate sleep (EE: r = 0.43, P <0.01; DP: r = 0.33, P <0.05), conflict between family and work (EE: r = 0.40, P <0.01; DP: r = 0.40, P <0.01), financial pressure (DP: r = 0.46, P <0.01), and conflict with residents (EE: r = 0.35, P <0.05; DP: r = 0.34, P <0.05) and faculty (EE: r = 0.44, P <0.01; DP: r = 0.35, P<0.05). Severe burnout was associated with lower grit scores (p <0.05). Coping mechanisms, such as planning and positive reframing, were protective while behavioural disengagement and substance use may increase burnout risk.

Conclusion:
Burnout was high in our ACGME-I accredited programme. Stressors associated with higher burnout included feeling of inadequate sleep, poor work-life balance, poor relationships with fellow residents/faculty and financial pressures. Residents should be educated on protective coping mechanisms and regular screening to detect burnout should be performed.
The Jamesonian Impersonal; or, Person as Allegory
Authors: Hartley Daniel 
Published: January 2021

Abstract
This article locates Fredric Jameson’s Allegory and Ideology (2019) in the context of the broader trajectory of his career-long critique of the bourgeois centred subject. It argues that, for Jameson, the project of critique requires systematic depersonalisation at the level of thought. Contrary to negative liberal humanist interpretations of depersonalisation, Jameson stresses its hidden, revolutionary potential. Where his earlier work eschewed metanarratives of modernity premised upon shifts in subjectivity, preferring conjunctural or situational analyses, his more recent work – Antinomies of Realism (2013) and Allegory and Ideology in particular – develops a materialist version of just such metanarratives. The article concludes with a detailed application of Jameson’s allegorical method to the figure of the ‘person’ under capitalism, which can be sub-divided into the four levels of: individual, citizen/juridical person, infrastructural personifications, and the realm of social reproduction.
The Long and Winding Road
Authors: Simons Peter 
Published: January 2021

Abstract
Following its welcome revival in the late twentieth century, metaphysics in the analytic tradition has succumbed to decadence, with an astonishing variety of outlandish and extreme positions or “metaphysical follies” being taken seriously. This has caused an inevitable backlash among more scientifically-minded philosophers and incurred the scorn of scientists. Much of the reason for this is the blithe ignoring of empirical science by armchair metaphysicians. The roles of empirical knowledge in good, scientific metaphysics are however unclear. In virtue of its maximal generality, metaphysics is remote from straightforward empirical checks. This article explores, with historical and contemporary examples, the ways in which empirical information may inform and be fed back into metaphysics, the disputed role of common sense, and the delicate balance to be maintained, within a fallibilist, scientific metaphysics, between speculative, categorial and empirical elements.
The Role of Horizontal Temperature Advection in Arctic Amplification
Authors: Clark Joseph P. , Shenoy Vivek , Feldstein Steven B. , Lee Sukyoung , Goss Michael 
Published: January 2021

AbstractThe wintertime (December–February) 1990–2016 Arctic surface air temperature (SAT) trend is examined using self-organizing maps (SOMs). The high-dimensional SAT dataset is reduced into nine representative SOM patterns, with each pattern exhibiting a decorrelation time scale of about 10 days and having about 85% of its variance coming from intraseasonal time scales. The trend in the frequency of occurrence of each SOM pattern is used to estimate the interdecadal Arctic winter warming trend associated with the SOM patterns. It is found that trends in the SOM patterns explain about one-half of the SAT trend in the Barents and Kara Seas, one-third of the SAT trend around Baffin Bay, and two-thirds of the SAT trend in the Chukchi Sea. A composite calculation of each term in the thermodynamic energy equation for each SOM pattern shows that the SAT anomalies grow primarily through the advection of the climatological temperature by the anomalous wind. This implies that a substantial fraction of Arctic amplification is due to horizontal temperature advection that is driven by changes in the atmospheric circulation. An analysis of the surface energy budget indicates that the skin temperature anomalies as well as the trend, although very similar to that of the SAT, are produced primarily by downward longwave radiation.
Improved SSM/I Thin Ice Algorithm with Ice Type Discrimination in Coastal Polynyas
Authors: Kashiwase Haruhiko , Ohshima Kay I. , Nakata Kazuki , Tamura Takeshi 
Published: January 2021

AbstractLong-term quantification of sea ice production in coastal polynyas (thin sea ice areas) is an important issue to understand the global overturning circulation and its changes. The Special Sensor Microwave Imager (SSM/I), which has nearly 30 years of observation, is a powerful tool for that purpose owing to its ability to detect thin ice areas. However, previous SSM/I thin ice thickness algorithms differ between regions, probably due to the difference in dominant type of thin sea ice in each region. In this study, we developed an SSM/I thin ice thickness algorithm that accounts for three types of thin sea ice (active frazil, thin solid ice, and a mixture of two types), using the polarization and gradient ratios. The algorithm is based on comparison with the ice thickness derived from the Moderate Resolution Imaging Spectroradiometer (MODIS) for 22 polynya events off the Ross Ice Shelf, off Cape Darnley, and off the Ronne Ice Shelf in the Southern Ocean. The algorithm can properly discriminate the ice type in coastal polynyas and estimate the thickness of thin sea ice (≤20 cm) with an error range of less than 6 cm. We also confirmed that the algorithm can be applied to other passive microwave radiometers with higher spatial resolution to obtain more accurate and detailed distributions of ice type and thickness. The validation of this algorithm in the Arctic Ocean suggests its applicability to the global oceans.
The Moral Economy of Drug Trafficking: Armed Civilians and Mexico’s Violence and Crime
Authors: Álvarez-Rodríguez Irene María 
Published: January 2021

The consolidation of armed civilian collectives in the Mexican state of Michoacán arose in a setting in which the illegal regional economy no longer focused on drug smuggling but had turned to a variety of criminal activities and in which the perspective of a moral economy had been restored. This restructuring of the criminal economy was a strong factor in the emergence of the armed collectives. La consolidación de colectivos civiles armados en el estado mexicano de Michoacán surgió en un entorno en el que la economía regional ilegal ya no se centraba en el contrabando de drogas, sino una variedad de actividades delictivas y el restablecimiento de la perspectiva de una economía moral. Esta reestructuración de la economía criminal se convirtió en un factor importante en el surgimiento de los colectivos armados.
Web-based Oral Reading for Language in Aphasia (Web ORLA®): A pilot randomized control trial
Authors: Cherney Leora R , Lee Jaime B , Kim Kwang-Youn A , van Vuuren Sarel 
Published: January 2021

Objective: To investigate an intensive asynchronous computer-based treatment delivered remotely with clinician oversight to people with aphasia. Design: Single-blind, randomized placebo-controlled trial. Setting: Free-standing urban rehabilitation hospital. Participants: Adults with aphasia (at least six months post-onset). Interventions: Experimental treatment was Web ORLA® (Oral Reading for Language in Aphasia) which provides repeated choral and independent reading aloud of sentences with a virtual therapist. Placebo was a commercially available computer game. Participants were instructed to practice 90 minutes/day, six days/week for six weeks. Main measures: Change in Language Quotient of the Western Aphasia Battery-Revised from pre-treatment to post-treatment and pre-treatment to six weeks following the end of treatment. Results: 32 participants (19 Web ORLA®, 13 Control) completed the intervention and post-treatment assessment; 27 participants (16 Web ORLA®, 11 Control) completed the follow-up assessment six weeks after treatment had ended. Web ORLA® treatment resulted in significant improvements in language performance from pre-treatment to immediately post-treatment ( X = 2.96; SD = 4.32; P < 0.01; ES = 0.68) and from pre-treatment to six weeks following the end of treatment ( X = 4.53; SD = 3.16; P < 0.001; ES = 1.43). There was no significant difference in the gain from pre-treatment to post-treatment for the Web ORLA® versus Control groups. However, the Web ORLA® group showed significantly greater gains at the six-week follow-up than the control group ( X = 2.70; SD = 1.01; P = 0.013; ES = 1.92). Conclusion: Results provide evidence for improved language outcomes following intensive, web-based delivery of ORLA® to individuals with chronic aphasia. Findings underscore the value of combining clinician oversight with the flexibility of asynchronous practice.
Differences in initial versus recurrent diabetic foot ulcers at a specialized tertiary diabetic foot care center in China
Authors: Cheng Yuxia , Zu Ping , Zhao Jie , Shi Lintao , Shi Hongyan , Zhang Mei , Wang Aihong 
Published: January 2021

Objective To investigate the characteristics of diabetic foot ulcer (DFU) recurrence. Methods A total of 573 patients with DFUs were recruited and divided into an initial group (395 patients) and a recurrence group (178 patients). The factors related to recurrence were analyzed using multivariate regression. Results The recurrence group had longer diabetes duration (odds ratio [OR] 192; 95% confidence interval 120, 252 vs. 156; 96, 240); lower glycated hemoglobin levels (OR 8.1; 95% CI 6.8, 9.6 vs. 9.1; 7.4, 10.5), and higher rates than the initial group of amputation (37.5% vs. 2.0%), history of vascular intervention (21.3% vs. 3.9%), retinopathy (77.7% vs. 64.7%), callus (44.4% vs. 20.8%), foot deformity (51.2% vs. 24.6%), and outdoor sports shoe wearing (34.0% vs. 21.2%). Multiple factor logistic regression analysis showed that diabetes duration (OR 1.004), callus (OR 2.769), vascular intervention (OR 2.824) and amputation (OR 22.256) were independent risk factors for DFU recurrence. Conclusion Diabetes duration, callus, history of vascular intervention, and amputation were independent risk factors for recurrent DFUs in a cohort of Chinese patients with active DFU. The prevention and treatment of DFUs, especially callus treatment, foot care, and blood glucose control, should be improved in China.
A survey on the conceptual design of hypersonic aircraft powered by RBCC engine
Authors: Rui Xue , Xin He , Feixing Liu , Xiaogang Ma , Xing Zheng , Jianxun Du , Chao Weng 
Published: January 2021

Rocket-based combined-cycle (RBCC) powered vehicles have been widely recognized as the most promising aircraft solution that could dramatically reduce the cost of space transportation. Researchers and scientists worldwide have conducted considerable overall design researches to cope with the challenges in RBCC development including mode transition, thermal protection and thrust enhancement. According to the way to orbit and the configuration characteristics, the hypersonic aircraft powered by RBCC engine are classified as four categories: single-stage-to-orbit (SSTO) two-dimensional configuration, SSTO axisymmetric configuration, two-stage-to-orbit (TSTO) two-dimensional configuration, and TSTO axisymmetric configuration. This paper systematically presents the development of the conceptual design of RBCC-powered vehicles. Both the structural and operating key parameters like the weight distribution, the RBCC propulsion performance and take-off mode, et al. are introduced in detail. On this basis, a comparative analysis of the advantages and disadvantages of the orbit model, the configuration selection and takeoff modes are conducted. In addition, the application prospect and technology development direction for hypersonic aircraft are also discussed. At the same time, the lessons that can be drew from previous hypersonic vehicle concept design are explored.
Temporal and area-level variation in prevalence of high-grade histologically confirmed cervical abnormalities among Indigenous and non-Indigenous women, Queensland, Australia, 2008–2017
Authors: Dasgupta Paramita , Aitken Joanne F , Condon John , Garvey Gail , Whop Lisa J , DeBats Claire , Baade Peter D 
Published: January 2021

Objective Despite Australia’s National Cervical Screening Program, Indigenous women have a disproportionately high burden of cervical cancer. We describe temporal and area-level patterns in prevalence of histologically conformed high-grade cervical abnormalities (hHGA) among cytologically screened women by Indigenous status. Methods This was a population-based study of 2,132,925 women, aged 20–69, who underwent cervical screening between 2008 and 2017, in Queensland, Australia. Of these, 47,136 were identified as Indigenous from linked hospital records. Overall patterns in hHGA prevalence by Indigenous status were quantified using prevalence rate ratios (PrRR) from negative binomial models. Bayesian spatial models were used to obtain smoothed prevalence estimates of hHGA across 528 small areas compared to the state average. Results are presented as maps and graphs showing the associated uncertainty of the estimates. Results Overall, screened Indigenous women had significantly higher hHGA prevalence than non-Indigenous women. However, the magnitude of the difference reduced over time ( p < 0.001). Adjusted for age and area-level variables, Indigenous women had 36% higher hHGA prevalence (PrRR 1.36, 95% confidence interval [1.21–1.52]) than non-Indigenous women between 2013 and 2017. The overall effect of age decreased over time ( p = 0.021). Although there was evidence of moderate spatial variation in 10-year prevalence estimates for both groups of women, the high levels of uncertainty for many estimates, particularly for Indigenous women, limited our ability to draw definitive conclusions about the spatial patterns. Conclusions While the temporal reduction in Indigenous: non-Indigenous differential in hHGA prevalence is encouraging, further research into the key drivers of the continuing higher risk among Indigenous women is warranted.
Endothelial cell density change in fully dislocated XEN Gel IMPLANT after trabeculectomy: A case report
Authors: Menchini Martina , Sartini Francesco , Tatti Filippo , Peiretti Enrico , Figus Michele 
Published: January 2021

Purpose: To report a case of fully dislocated XEN Gel Implant device into the anterior chamber, 18 months after its implantation and its impact on endothelial cell density. Result: A 75-year-old man with a history of multiple glaucoma surgeries during the last three years presented with an entirely dislocated XEN Gel implant into the anterior chamber. An endothelial cell density reduction was observed over 18 months. Thus, the implant was removed. In the short-term after surgery, the endothelial cell loss rate reduced. Conclusion: XEN Gel Implant can dislocate into the anterior chamber, increasing endothelial cell loss in an eye already underwent multiple surgical procedures with subsequent adverse events. Therefore, if the implant seems displaced, the endothelial cell density should be monitored, and the length of the free-tube segment within the anterior chamber should be measured, during the patient’s follow-up.
Evaluation of Functional and Symptomatic Outcomes After Vitamin D3 Administration in Carpal Tunnel Syndrome With Hypovitaminosis D
Authors: Samant Prakash D. , Sane Rohit M. 
Published: January 2021

Background Vitamin D deficiency is now recognized as an independent risk factor and is involved in the pathogenesis of carpal tunnel syndrome (CTS). The purpose of this study was to evaluate the effects of vitamin D3 supplementation on functional and symptomatic outcomes in CTS patients with vitamin D deficiency. Methods This was a prospective, single-arm study with a pretreatment or posttreatment quasi-experimental design. Carpal tunnel syndrome patients with vitamin D deficiency were treated with vitamin D3 (60 000 IU/week) plus standard treatment for a period of 3 months. Carpal tunnel syndrome–related pain and functional and symptomatic outcomes were assessed at baseline and at 3 months posttreatment using the Visual Analogue Scale (VAS) and the Boston Carpal Tunnel Questionnaire, respectively, along with serum vitamin D. Results A total of 42 patients were analyzed. At 3 months posttreatment, there was a significant reduction in the severity of pain (VAS score) from baseline ( Z = −5.71, P < .001). Similarly, the functional and symptomatic outcomes (Boston symptoms severity scale [SSS] and Boston functional status scale [FSS] score) at 3 months posttreatment significantly improved in comparison with baseline (Boston SSS: Z = −5.66, P < .001; Boston FSS: Z = −5.68, P < .001). Conclusions Vitamin D3 supplementation was associated with improvement in functional and symptomatic outcomes and CTS-related pain in CTS with vitamin deficiency. However, further robust randomized controlled trials are warranted to validate the results.
Use of Artificial Intelligence to understand adults’ thoughts and behaviours relating to COVID-19
Authors: Flint SW , Piotrkowicz A , Watts K 
Published: January 2021

Aims: The outbreak of severe acute respiratory syndrome coronavirus 2 (COVID-19) is a global pandemic that has had substantial impact across societies. An attempt to reduce infection and spread of the disease, for most nations, has led to a lockdown period, where people’s movement has been restricted resulting in a consequential impact on employment, lifestyle behaviours and wellbeing. As such, this study aimed to explore adults’ thoughts and behaviours in response to the outbreak and resulting lockdown measures. Methods: Using an online survey, 1126 adults responded to invitations to participate in the study. Participants, all aged 18 years or older, were recruited using social media, email distribution lists, website advertisement and word of mouth. Sentiment and personality features extracted from free-text responses using Artificial Intelligence methods were used to cluster participants. Results: Findings demonstrated that there was varied knowledge of the symptoms of COVID-19 and high concern about infection, severe illness and death, spread to others, the impact on the health service and on the economy. Higher concerns about infection, illness and death were reported by people identified at high risk of severe illness from COVID-19. Behavioural clusters, identified using Artificial Intelligence methods, differed significantly in sentiment and personality traits, as well as concerns about COVID-19, actions, lifestyle behaviours and wellbeing during the COVID-19 lockdown. Conclusions: This time-sensitive study provides important insights into adults’ perceptions and behaviours in response to the COVID-19 pandemic and associated lockdown. The use of Artificial Intelligence has identified that there are two behavioural clusters that can predict people’s responses during the COVID-19 pandemic, which goes beyond simple demographic groupings. Considering these insights may improve the effectiveness of communication, actions to reduce the direct and indirect impact of the COVID-19 pandemic and to support community recovery.
Clinical outcomes and structural integrity rate of arthroscopic augmented rotator cuff repairs using extracellular porcine matrix patch
Authors: Consigliere Paolo , Bernasconi Alessio , Dimock Richard , Narvani A Ali 
Published: January 2021

Background Structural failure rate in rotator cuff repairs is still high. The purpose of the study is to assess the structural integrity of a series of augmented rotator cuff repairs with porcine matrix patch and report the functional outcomes. Methods Between 2014 and 2017, 44 consecutive patients underwent arthroscopic double-row repair of medium to massive rotator cuff tears with extracellular porcine dermal matrix augmentation. At one-year follow-up, magnetic resonance imaging scan was performed to assess the integrity of the repair. Oxford Shoulder Score (OSS), Constant Score (CS) and Visual Analogue Scale pain score, together with range of motion were used to assess patients. Results Patients mean age was 68 (53–82); mean follow-up was 17.2 (12–24) months. On magnetic resonance imaging scans, seven rotator cuff repair failures (15.9%) were observed: tear size was an independent predictor of re-rupture at one-year follow-up. Clinical scores showed a statistically significant improvement at three months and until final follow-up ( p< 0.001). No complications occurred. Conclusion Observed structural failure rate of 15.9% is lower than those reported in the literature for standard rotator cuff repair of medium to massive tears in similar cohorts to ours. Extracellular matrix augmentation for rotator cuff repair was shown to be a safe and reliable support to the repairs and patients recovered good shoulder function. Level of Evidence: Level IV.