bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Examination of Standardized Letters of Recommendation Rating Scales Among Neurosurgical Residency Candidates During the 2020-2021 Application Cycle
Authors: Feldman Michael J , Ortiz Alexander V , Roth Steven G , Dambrino Robert J , Yengo-Kahn Aaron M , Chitale Rohan V , Chambless Lola B 
Published: September 2021

Abstract

BACKGROUND
Letters of recommendation (LORs) are historically an important, though subjective, component of the neurosurgery residency application process. Standardized LORs (SLORs) were introduced during the 2020 to 2021 application cycle. The intent of SLORs is to allow objective comparison of applicants and to reduce bias.

OBJECTIVE
To examine the utility of SLORs during this application cycle. We hypothesized that “grade inflation” and poor inter-rater reliability, as described by other specialties using SLORs, would limit the utility of SLORs in their current form.

METHODS
This cross-sectional study analyzed all SLORs submitted to a single neurosurgery residency program over the 2020 to 2021 cycle. Data from 7 competency domains and the overall rating were recorded and stratified by academic category of letter writer. Inter-rater reliability was evaluated using Krippendorff's alpha.

RESULTS
One or more SLORs was submitted as part of 298 of 393 applications (76%). Approximately 58.3% of letters written by neurosurgery chairpersons rated a given applicant as being within the top 5% across all competencies. Approximately 44.4% of program director letters similarly rated applicants as amongst the top 5%, while 73.2% and 81.4% of letters by other neurosurgeons and general surgery evaluators, respectively, rated applicants in the top 5%. Inter-rater reliability was poor (<0.33) in all rating categories, including overall (α = 0.18).

CONCLUSION
The utility of the first iteration of SLORs in neurosurgery applications is undermined by significant “grade inflation” and poor inter-rater reliability. Improvements are necessary for SLORs if they are to provide meaningful information in future application cycles.
Systemic Immune-Inflammation Index Predicts Delayed Cerebral Vasospasm After Aneurysmal Subarachnoid Hemorrhage
Authors: Geraghty Joseph R , Lung Tyler J , Hirsch Yonatan , Katz Eitan A , Cheng Tiffany , Saini Neil S , Pandey Dilip K , Testai Fernando D 
Published: September 2021

Abstract

BACKGROUND
Delayed cerebral vasospasm is a feared complication of aneurysmal subarachnoid hemorrhage (SAH).

OBJECTIVE
To investigate the relationship of systemic inflammation, measured using the systemic immune-inflammation (SII) index, with delayed angiographic or sonographic vasospasm. We hypothesize that early elevations in SII index serve as an independent predictor of vasospasm.

METHODS
We retrospectively reviewed the medical records of 289 SAH patients for angiographic or sonographic evidence of delayed cerebral vasospasm. SII index [(neutrophils × platelets/lymphocytes)/1000] was calculated from laboratory data at admission and dichotomized based on whether or not the patient developed vasospasm. Multivariable logistic regression and receiver operating characteristic (ROC) analysis were performed to determine the ability of SII index to predict the development of vasospasm.

RESULTS
A total of 246 patients were included in our study, of which 166 (67.5%) developed angiographic or sonographic evidence of cerebral vasospasm. Admission SII index was elevated for SAH in patients with vasospasm compared to those without (P < .001). In univariate logistic regression, leukocytes, neutrophils, lymphocytes, neutrophil-lymphocyte ratio (NLR), and SII index were associated with vasospasm. After adjustment for age, aneurysm location, diabetes mellitus, hyperlipidemia, and modified Fisher scale, SII index remained an independent predictor of vasospasm (odds ratio 1.386, P = .003). ROC analysis revealed that SII index accurately distinguished between patients who develop vasospasm vs those who do not (area under the curve = 0.767, P < .001).

CONCLUSION
Early elevation in SII index can independently predict the development of delayed cerebral vasospasm in aneurysmal SAH.
Coagulopathy and Progression of Intracranial Hemorrhage in Traumatic Brain Injury: Mechanisms, Impact, and Therapeutic Considerations
Authors: Maegele Marc 
Published: September 2021

Abstract

BACKGROUND
Traumatic brain injury (TBI) remains one of the most challenging health and socioeconomic problems of our times. Clinical courses may be complicated by hemostatic abnormalities either pre-existing or developing with TBI.

OBJECTIVE
To review frequencies, patterns, mechanisms, novel approaches to diagnostics, treatment, and outcomes of hemorrhagic progression and coagulopathy after TBI.

METHODS
Selective review of the literature in the databases Medline (PubMed) and Cochrane Reviews using different combinations of the relevant search terms was conducted.

RESULTS
Of the patients, 20% with isolated TBI display laboratory coagulopathy upon hospital admission with profound effect on morbidity and mortality. Preinjury use of antithrombotic agents may be associated with higher rates of hemorrhagic progression and delayed traumatic intracranial hemorrhage. Further testing may display various changes affecting platelet function/numbers, pro- and/or anticoagulant factors, and fibrinolysis as well as interactions between brain tissues, vascular endothelium, mechanisms of inflammation, and blood flow dynamics. The nature of hemostatic disruptions after TBI remains elusive but current evidence suggests the presence of both a hyper- and hypocoagulable state with possible overlap and lack of distinction between phases and states. More “global” hemostatic assays, eg, viscoelastic and thrombin generation tests, may provide more detailed and timely information on the overall hemostatic potential thereby allowing early “goal-directed” therapies.

CONCLUSION
Whether timely and targeted management of hemostatic abnormalities after TBI can protect against secondary brain injury and thereby improve outcomes remains elusive. Innovative technologies for diagnostics and monitoring offer windows of opportunities for precision medicine approaches to managing TBI.
The Morbidity and Mortality of Surgery for Traumatic Brain Injury in Geriatric Patients: A Study of Over 100 000 Patient Cases
Authors: Haddad Alexander F , DiGiorgio Anthony M , Lee Young M , Lee Anthony T , Burke John F , Huang Michael C , Dhall Sanjay S , Manley Geoffrey T , Tarapore Phiroz E 
Published: September 2021

Abstract

BACKGROUND
Geriatric patients have the highest rates of Traumatic Brain Injury (TBI)-related hospitalization and death. This contributes to an assumption of futility in aggressive management in this population.

OBJECTIVE
To evaluate the effect of surgical intervention on the morbidity and mortality of geriatric patients with TBI.

METHODS
A retrospective analysis of patients ≥80 yr old with TBI from 2003 to 2016 was performed using the National Trauma Data Bank. Univariate and multivariate analyses were performed to compare outcomes between surgery and nonsurgery groups.

RESULTS
A total of 127 129 patient incidents were included: 121 185 (95.3%) without surgery and 5944 (4.7%) with surgery. The surgical group was slightly younger (84.0 vs 84.3, P < .001) and predominantly male (60.2% vs 44.4%, P < .001). Mean emergency department (ED) Glasgow Coma Scale (GCS) was lower in surgical patients (12.4 vs 13.7, P < .001). Complications (OR = 1.91, CI:1.80-2.02, P < .001) and hospital length of stay (LOS, ß = 5.25, CI:5.08-5.42, P < .001) were independently associated with surgery. Intensive care unit (ICU) LOS (ß = 3.19, CI:3.05-3.34, P < .001), ventilator days (ß = 1.57, CI:1.22-1.92, P < .001), and reduced discharge home (OR = 0.434, CI:0.400-0.470, P < .001) were also independently associated with surgery. However, surgery was not independently associated with mortality on multivariate analysis (OR = 1.03, CI:0.955-1.12, P = .423). Recursive partitioning analysis identified ED GCS and injury severity score (ISS) as prognosticators of mortality following surgical intervention.

CONCLUSION
Surgical treatment of geriatric patients with TBI is associated with increased complications, hospital LOS, ICU LOS, and ventilator days as well as reduced discharge to home. However, surgery is not associated with increased mortality. ISS and ED GCS are prognosticators of mortality following surgical intervention.
Artificially regulated synthesis of nanocrystals in live cells
Authors: Liu An-An , Sun En-Ze , Wang Zhi-Gang , Liu Shu-Lin , Pang Dai-Wen 
Published: September 2021

Abstract
Live cells, as reservoirs of biochemical reactions, can serve as amazing integrated chemical plants where precursor formation, nucleation and growth of nanocrystals, and functional assembly, can be carried out accurately following an artificial program. It is crucial but challenging to deliberately direct intracellular pathways to synthesize desired nanocrystals that cannot be produced naturally in cells, because the relevant reactions exist in different spatiotemporal dimensions and will never encounter each other spontaneously. This article summarizes the progress in the introduction of inorganic functional nanocrystals into live cells via the ‘artificially regulated space–time-coupled live-cell synthesis’ strategy. We also describe ingenious bio-applications of nanocrystal–cell systems, and quasi-biosynthesis strategies expanded from live-cell synthesis. Artificially regulated live-cell synthesis—which involves the interdisciplinary application of biology, chemistry, nanoscience and medicine—will enable researchers to better exploit the unanticipated potentialities of live cells and open up new directions in synthetic biology.
Reducing the Burden of Disease Through Tobacco Taxes in Mongolia: A Health Impact Analysis Using a Dynamic Public Health Model
Authors: Tuvdendorj Ariuntuya , Konings Stefan R A , Purevdorj Bolormaa , Buskens Erik , Feenstra Talitha L 
Published: September 2021

Abstract

Background/Objectives
Smoking is the leading risk factor for many chronic diseases. The quantitative analysis of potential health gains from reduced smoking is important for establishing priorities in Mongolia’s health policy. This study quantifies the effect of tobacco-tax increases on future smoking prevalence and the associated smoking-related burden of disease in Mongolia.

Methods
The dynamic model for health impact assessment (DYNAMO-HIA) tool was used. The most recent data were used as input for evaluating tobacco-taxation scenarios. Demographic data were taken from the Mongolian Statistical Information Services. Smoking data came from a representative population-based STEPS survey, and smoking-related disease data were obtained from the health-information database of Mongolia’s National Health Center. Simulation was used to evaluate various levels of one-time price increases on tobacco products (25% and 75%) in Mongolia. Conservative interpretation suggests that the population will eventually adjust to the higher tobacco price and return to baseline smoking behaviors.

Results
Over a three-year period, smoking prevalence would be reduced by 1.2% points, corresponding to almost 40 thousand smokers at the population level for a price increase of 75%, compared to the baseline scenario. Projected health benefits of this scenario suggest that more than 137 thousand quality adjusted of life years would be gained by avoiding smoking-related diseases within a population of three million over a 30-year period.

Discussion
Prevention through effective tobacco-control policy could yield considerable gains in population health in Mongolia. Compared to current policy, tax increases must be higher to have a significant effect on population health.

Implications
Tobacco taxation is an effective policy for reducing the harm of tobacco smoking, while benefiting population health in countries where the tobacco epidemic is still in an early stage. Smoking prevalence and smoking behaviors in these countries differ from those in Western countries. Reducing the uptake of smoking among young people could be a particularly worthwhile benefit of tobacco-tax increases.
Human Abuse Liability Assessment of Tobacco and Nicotine Products: Approaches for Meeting Current Regulatory Recommendations
Authors: Vansickel Andrea , Baxter Sarah , Sherwood Neil , Kong Michael , Campbell Leanne 
Published: September 2021

Abstract
Many regulatory bodies now recommend that tobacco product manufacturers provide information regarding new tobacco products’ abuse liability to inform regulatory authorization of currently marketed tobacco products or new product applications (including premarket tobacco product applications in the United States). In addition, the US Food and Drug Administration (FDA) recommends including this information as part of modified risk tobacco product applications. Regulators, including FDA, and many public health officials and researchers consider abuse liability assessment a model which predicts the likelihood that the use of the tobacco product would result in addiction and be used repeatedly or even sporadically resulting in undesirable effects. Abuse liability of a new, potentially reduced harm product can also inform its ability to substitute completely for more harmful tobacco products. While many methods exist, no standard tobacco product abuse liability assessment has been established. The purpose of this review is to provide background information and practical recommendations for human abuse liability testing methods to meet tobacco regulatory needs. A combination of nicotine test product pharmacokinetic, subjective effect and/or behavioral response, and physiological response data relative to comparator products with known abuse liability satisfies some regulatory requirements.
Implications: This review provides a practical inspection of the current, international regulatory recommendations for abuse liability assessment of tobacco and regulatory review of such information within the United States and also recommends study designs and methods for abuse liability testing of tobacco products based on scientific and regulatory knowledge. Given that tobacco product abuse liability testing is of increasing interest to regulatory bodies globally, especially with the emergence of novel tobacco products, this timely work provides background and functional recommendations for tobacco product abuse liability testing.
Shift work amongst older UK workers and job exit
Authors: Bevilacqua G , D’Angelo S , Ntani G , Stevens M , Linaker C H , Walker-Bone K 
Published: September 2021

Abstract

Background
Night/shift work may be increasing but there are few data about the prevalence amongst older workers. With governments encouraging people to work to older ages, it is important to know how feasible night/shift work is for them and whether there are any adverse health consequences.

Aims
Amongst current older workers (aged 50–64 years), to explore the prevalence of night/shift working and evaluate its health impacts and sustainability over 4 years of follow-up.

Methods
Data from the Health and Employment After Fifty cohort were used to describe the demographic, job and health characteristics of men and women undertaking night/shift work. Longitudinal data were used to examine the number and nature of exits annually thereafter.

Results
Amongst the 5409 working at baseline, 32% reported night/shift work in sectors which differed by sex. Night/shift workers were more likely to be: current smokers; doing physically demanding work; struggling to cope at work; dissatisfied with their hours; depressed; sleeping poorly; rating their health poorly. Women whose job involves night work were more likely to exit the workforce over 4 years.

Conclusions
Almost one in three contemporary UK older workers report night/shift work. We found some evidence of adverse impacts on health, sleep and well-being and higher rates of job exit amongst women. More research is needed but night/shift work may be challenging to sustain for older workers and could have health consequences.
Shift work, inflammation and musculoskeletal pain—The HUNT Study
Authors: Matre D , Christensen J O , Mork P J , Ferreira P , Sand T , Nilsen K B 
Published: September 2021

Abstract

Background
Studies have indicated that shift work, in particular night work, is associated with chronic musculoskeletal pain but the mechanisms are unclear. It has been suggested that sleep disturbance, a common complaint among shift and night workers, may induce low-grade inflammation as well as heightened pain sensitivity.

Aims
Firstly, this study was aimed to examine the cross-sectional associations between shift work, C-reactive protein (CRP) level and chronic musculoskeletal pain, and secondly, to analyse CRP as a mediator between shift work and chronic musculoskeletal pain.

Methods
The study included 23 223 vocationally active women and men who participated in the HUNT4 Survey of the Trøndelag Health Study (HUNT). Information was collected by questionnaires, interviews, biological samples and clinical examination.

Results
Regression analyses adjusted for sex, age and education revealed significant associations between shift work and odds of any chronic musculoskeletal pain (odd ratio [OR] 1.11, 95% confidence interval [CI] 1.04–1.19), between shift work and CRP level (OR 1.09, 95% CI 1.03–1.16) and between CRP level 3.00–10 mg/L and any chronic musculoskeletal pain (OR 1.38, 95% CI 1.27–1.51). Shift work and CRP were also associated with number of chronic pain sites. Mediation analysis indicated that shift work was indirectly associated with any chronic musculoskeletal pain through CRP (OR 1.03, 95% CI 1.01–1.06).

Conclusions
The results support the hypothesis that shift work is associated with chronic musculoskeletal pain, and that systemic inflammation may be a biological mechanism linking shift work to chronic pain.
Dworkin versus Hart Revisited: The Challenge of Non-lexical Determination
Authors: Berman Mitchell N 
Published: September 2021

Abstract
A fundamental task for legal philosophy is to explain what makes it the case that the law has the content that it does. Anti-positivists say that moral norms play an ineliminable role in the determination of legal content, while positivists say that they play no role, or only a contingent one. Increasingly, scholars report finding the debate stale. This article hopes to freshen it by, ironically, revisiting what might be thought its opening round: Dworkin’s challenge to Hartian positivism levelled in The Model of Rules I. It argues that the underappreciated significance of Dworkin’s distinction between rules and principles is not that Hart’s model cannot allow for the existence of legal principles, but that it cannot make sense of their operation. Hart’s model posits that legal rules are determined in a rule-like (‘lexical’) way, whereas legal principles contribute to rules in a manner that is at least partly non-lexical. The upshots of this reinterpretation are: first (against most positivists) that Dworkin’s challenge does require some reworking of Hart’s positivist theory; and second (against most anti-positivists) that the reworking required to meet Dworkin’s challenge does not necessitate positivism’s abandonment.
Now in the Network
Authors: Rofe Michael 
Published: September 2021

Abstract
Network technologies have played an increasingly prominent role in sound art practices over the last forty years. The consequent creative possibilities associated with space and locality are clearly apparent: networks enable connections between geographically remote locations, and allow the creation of new virtual spaces for sound art to inhabit. Less immediately apparent—though equally significant—are the ways in which network technologies have enabled artists to explore temporal relationships in their work. In particular, network technologies inevitably involve latency—a short time delay between the moment a signal is created at one location and the moment it is perceived at another. Taking traditional notated music practice as a point of reference, this chapter considers a number of case studies in which sound artists have explored new types of temporal relationships in their work, as a consequence of their use of network technologies. This investigation is framed in the context of Bergson’s concept of durée and Clarke’s concept of subject position.
Changing the purpose of the corporation to rebalance capitalism
Authors: Henderson Rebecca M 
Published: September 2021

AbstractSolving the great problems of our time will require reimagining capitalism by balancing the power of the free market with capable, democratically accountable government and strong civil society. Changing the purpose of the firm has the potential to make this process of rebalancing significantly easier. Purpose-driven firms could be catalysts in the drive for systemic change by supporting transformation within their own industries, supporting cooperation in the public interest and modelling public/private partnerships, and supporting the strengthening of global democracy. Transforming the purpose of the firm will require not only changing corporate law, but also changing the metrics used to control and measure firms and the social norms that constrain and guide corporate behavior.
Capitalism: what has gone wrong, what needs to change, and how it can be fixed
Authors: Collier Paul , Coyle Diane , Mayer Colin , Wolf Martin 
Published: September 2021

AbstractThe distinguished contributors to this issue of the Oxford Review of Economic Policy were asked to address the question of what has gone wrong with capitalism, what needs to change, and how can it be fixed. The objective behind the solutions discussed in these articles is to retain as far as possible the benefits of globalization, technology, and market processes, while addressing sources of disaffection and discontent by prioritizing convergence in attainable levels of earned incomes and wellbeing within and across countries. Three key ideas run through the articles. The first is the inadequate depiction of the individual in conventional economics as a person preoccupied with consumption and leisure. The second is widespread support for greater devolution to local decision-taking, and an emphasis on the importance of cooperation in communities. The third is the critique of economic orthodoxy implied by the concept of radical uncertainty. Together, these articles provide an inspiring assessment and reconceptualization of capitalism, and offer practical ways of addressing its deficiencies while preserving its merits.
Standing Up for the Nations? Devolution and the Changing Territorial Role of Backbench MPs with Constituencies in Northern Ireland, Scotland and Wales, 1992–2019
Authors: Sheldon Jack 
Published: September 2021

Abstract
At UK general elections, parties and candidates standing in Northern Ireland, Scotland and Wales give prominence to pledges to act on behalf of those territories. This article examines how far and in what ways MPs with constituencies in those parts of the UK actually seek to give representation to these territorial units once elected. A typology of forms of substantive parliamentary representation of sub-state units such as these is outlined, and results of a content analysis of Commons contributions by backbench MPs between 1992 and 2019 are presented. It is found that MPs from the parts of the UK with devolved legislatures focus extensively on the sub-state territorial level and that these MPs have adapted their representational styles to the changed institutional context following devolution. These findings have important implications for how we think about the roles of MPs from Northern Ireland, Scotland and Wales in the post-devolution context.