bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical Trainee Performance and Alignment With Surgical Program Director Expectations
Authors: Abbott Kenneth L. , Krumm Andrew E. , Kelley Jesse K. , Kendrick Daniel E. , Clark Michael J. , Chen Xilin , Gupta Tanvi , Jones Andrew T. , Moreno Beatriz Ibaáñez , Kwakye Gifty , Zaidi Nikki L. Bibler , Swanson David B. , Bell Richard H. , George Brian C. ,   on behalf of the Society for Improving Medical Professional Learning
Published: June 2021

Objective:
To examine the alignment between graduating surgical trainee operative performance and a prior survey of surgical program director expectations.

Background:
Surgical trainee operative training is expected to prepare residents to independently perform clinically important surgical procedures.

Methods:
We conducted a cross-sectional observational study of US general surgery residents’ rated operative performance for Core general surgery procedures. Residents’ expected performance on those procedures at the time of graduation was compared to the current list of Core general surgery procedures ranked by their importance for clinical practice, as assessed via a previous national survey of general surgery program directors. We also examined the frequency of individual procedures logged by residents over the course of their training.

Results:
Operative performance ratings for 29,885 procedures performed by 1861 surgical residents in 54 general surgery programs were analyzed. For each Core general surgery procedure, adjusted mean probability of a graduating resident being deemed practice-ready ranged from 0.59 to 0.99 (mean 0.90, standard deviation 0.08). There was weak correlation between the readiness of trainees to independently perform a procedure at the time of graduation and that procedure’s historical importance to clinical practice (p = 0.22, 95% confidence interval 0.01–0.41, P = 0.06). Residents also continue to have limited opportunities to learn many procedures that are important for clinical practice.

Conclusion:
The operative performance of graduating general surgery residents may not be well aligned with surgical program director expectations.
The Recurrence of Motor Tics Mediated by Oral Prednisolone Use in Autistic Children: A Case Report
Authors: Figueiredo Tiago 
Published: June 2021

Objectives
This study aimed to report motor tics worsening by prednisolone acute treatment, despite the use of aripiprazole and clonidine. It was also aimed to discuss the mechanisms involved in neuropsychiatric adverse effects with the use of corticosteroids.

Methods
It was reported a 7-year-old boy patient with a history of autism spectrum disorder and motor tics. He has remitted motor tics with an association between aripiprazole and clonidine. However, was registered motor tics' recurrence with acute use of prednisolone.

Conclusions
The neuropsychiatric adverse effects mediated by corticosteroid use are low explored, mainly in pediatric clinical practice. The prednisolone prescription is widespread in childhood and, considering some vulnerable conditions to this type of adverse effects, is imperative.
DEEP LEARNING TISSUE ANALYSIS DIAGNOSES AND PREDICTS TREATMENT RESPONSE IN EOSINOPHILIC ESOPHAGITIS
Authors: Javaid Aamir , Fernandes Philip , Adorno William , Catalano Alexis , Ehsan Lubaina , von Eckstaedt Hans Vizthum , Barnes Barrett , Khan Marium , Raghavan Shyam S. , McGowan Emily , Collins Margaret H. , Rothenberg Marc E. , Moskaluk Christopher A , Brown Donald E. , Syed Sana 
Published: June 2021

ABSTRACTBackgroundEosinophilic Esophagitis (EoE) is a chronic inflammatory condition diagnosed by ≥15 eosinophils (Eos) per high-power field (HPF). There is no gold standard for clinical remission and Eo-associated metrics are poorly correlated with symptoms. Deep learning can be used to explore the relationships of tissue features with clinical response.ObjectivesTo determine if deep learning can elucidate tissue patterns in EoE that predict treatments or symptoms at remission.MethodsWe created two deep learning models using esophageal biopsies from histologically normal and EoE patients: one to identify Eos in esophageal biopsies and a second to broadly classify esophageal tissue as EoE vs. normal. We used these models to analyze biopsies at diagnosis and first remission timepoint, as defined by <15 Eos/HPF, in a subset of 19 treatment-naïve patients. Differences in deep learning metrics between patient groups were assessed using Wilcoxon Rank-Sum tests.ResultsAll initial patients were symptomatic at diagnosis and a majority were still suffering from dysphagia at remission. The Eo identification model had a low mean (SD) error of −0.3 (11.5) Eos/HPF. Higher peak and average Eo counts at diagnosis were associated with higher likelihood of being on a food-elimination diet at remission than steroids or proton-pump inhibitor (p<0.05). The EoE classification model had an F1-score of 0.97 for distinguishing normal tissue from EoE. There was a significant decrease from diagnosis in the percentage of EoE-classified tissue among asymptomatic remission patients (p<0.05).ConclusionsDeep learning may have utility in diagnosing EoE and predicting future treatment response at diagnosis and resolution of symptoms at follow-up.Clinical Implications or Key Messages (for mechanistic article)We developed two deep learning approaches for tissue analysis in eosinophilic esophagitis, which may improve histologic assessment of patients at diagnosis and predict treatment response and symptoms at remission.Capsule summaryTwo deep learning approaches for eosinophilic esophagitis (EoE): (1) Quantification of eosinophils throughout an entire biopsy, which predicted treatment at remission (2) Classifying esophageal tissue as EoE or normal, which predicted symptoms at remission.
Hospital saturation and risk of death without receiving mechanical ventilation in hospitalized COVID-19 patients: a city-wide analysis
Authors: Núñez Isaac , Soto-Mota Adrián 
Published: June 2021

AbstractBackgroundPneumonia is the hallmark of severe COVID-19, with supplemental oxygen requirement being the main indication for hospitalization. Refractory hypoxemia in these patients requires invasive mechanical ventilation (IMV) otherwise, death is imminent. In places with a high disease burden, availability of critical care experts, beds, or resources is challenged and many patients could die without receiving them.MethodsWe performed a retrospective cohort study using open databases from Mexico City about suspected or confirmed COVID-19 patients, health system saturation, and deaths between May 8th, 2020, and January 5th, 2021. After building a directed acyclic graph, we performed a binary logistic regression to identify the association between proposed causal variables and dying without receiving IMV (the outcome).ResultsWe included 33 805 hospitalized patients with suspected or confirmed COVID-19, of which 19 820 (58.6%) did not require IMV and survived, 5416 (16.1%) required and received IMV, and 8569 (25.3%) required IMV but died without receiving it. Saturation of IMV-capable beds did not increase the odds of the outcome (odds ratio 1.07, 95% confidence interval 0.94-1.22 of 90%vs50% occupancy), while general bed saturation (2, 1.86-2.14 of 90%vs50% occupancy) and IMV-capable to general bed ratio (1.64, 1.52-1.77 for a ratio of 2vs0.5) did. Private healthcare decreased the odds of the outcome (0.12, 0.08-0.17) and dyspnea increased them (1.33, 1.19-1.9).ConclusionsIn Mexico City, increased general hospital bed saturation and IMV-capable to general bed ratio were associated with a higher risk of dying without receiving IMV. Private healthcare was the most protective factor.Key messagesHospital saturation has been a central feature of public health messaging, but it is not known how outcomes relate to hospital saturation or capacity.In Mexico City, 90% of COVID-19 patients requiring mechanical ventilation died but less than half received it.Higher general bed saturation and an increased ratio of IMV-capable beds to general beds increased the probability of dying without being intubated while receiving private healthcare decreased this probability.Having available beds to intubate patients is possible thanks to the conversion of general beds, however, still yields suboptimal critical care.
Quantitative imaging of intracellular density with ratiometric stimulated Raman scattering microscopy
Authors: Figueroa Benjamin , Xu Fiona Xi , Hu Ruoqian , Men Shuaiqian , Fu Dan 
Published: June 2021

AbstractCell size and density impact a wide range of physiological functions, including tissue homeostasis, growth regulation, and osmoregulation. Both are tightly regulated in mammalian cells. In comparison, density variation of a given cell type is much smaller than cell size, indicating that maintenance of cell type-specific density is important for cell function. Despite this importance, little is known about how cell density affects cell function and how it is controlled. Current tools for intracellular cell density measurements are limited either to suspended cells or cells growing on 2D substrates, neither of which recapitulate the physiology of single cells in intact tissue. While optical measurements have the potential to measure cell density in situ and noninvasively, light scattering in multicellular systems prevents direct quantification. Here, we introduce an intracellular density imaging technique based on ratiometric stimulated Raman scattering microscopy (rSRS). It quantifies intracellular drymass density through vibrational imaging of macromolecules. Moreover, water is used as an internal standard to correct for aberration and light scattering. We demonstrate real-time measurement of intracellular density quantification and show that density is tightly regulated across different cell types and can be used to differentiate cell types as well as cell states. We further demonstrate dynamic imaging of density change in response to osmotic challenge as well as intracellular density imaging of a 3D tumor spheroid. Our technique has the potential for imaging intracellular density in intact tissue and understanding density regulation and its role in tissue homeostasis.
Moral injury and wellbeing in essential workers during the Covid-19 pandemic: Local survey findings
Authors: Guy Catherine , Kunonga Edward , Kennedy Angela , Patel Paras 
Published: June 2021

AbstractEssential workers have faced many difficult situations working during in the pandemic. Staff may feel that they, or other people, have acted wrongly and be distressed by this. This represents moral injury, which has been linked with significant mental ill health.This survey asked essential workers in County Durham and Darlington about their experiences during the first wave of the pandemic and anything they felt would help. Wellbeing and moral injury were rated using sliders.There were 566 responses. A majority of respondents reported feeling troubled by other people’s actions they felt were wrong (60% scored over 40, where 0 is “not at all troubled” and 100 “very troubled”, median score=52.5). Respondents were generally less troubled by their own actions (median score=3). Wellbeing and moral injury scores varied by employment sector (e.g. NHS staff were more troubled by the actions of others than non-NHS staff).Staff suggestions included regular supervisor check-ins, ensuring kindness from everyone, fair rules and enforcement and improving communication and processes. Respondents offered simple, practical actions that could be taken by leaders at team, organisation, societal and government policy levels to tackle moral injury and the underlying causes of moral injurious environments.Using these findings to develop a strategy to address moral injury is important, not only for staff wellbeing, but staff retention and continued delivery of vital services in these challenging times. Working together, we can seek to reduce and mitigate “moral injury” the same way we do for other physical “injuries” in the workplace.
Proinflammatory responses in SARS-CoV-2 infected and soluble spike glycoprotein S1 subunit activated human macrophages
Authors: Chiok Kim , Hutchison Kevin , Miller Lindsay Grace , Bose Santanu , Miura Tanya A. 
Published: June 2021

AbstractCritically ill COVID-19 patients infected with SARS-CoV-2 display signs of generalized hyperinflammation. Macrophages trigger inflammation to eliminate pathogens and repair tissue, but this process can also lead to hyperinflammation and resulting exaggerated disease. The role of macrophages in dysregulated inflammation during SARS-CoV-2 infection is poorly understood. We used SARS-CoV-2 infected and glycosylated soluble SARS-CoV-2 Spike S1 subunit (S1) treated THP-1 human-derived macrophage-like cell line to clarify the role of macrophages in pro-inflammatory responses. Soluble S1 upregulated TNF-α and CXCL10 mRNAs, and induced secretion of TNF-α from THP-1 macrophages. While THP-1 macrophages did not support productive SARS-CoV-2 replication, virus infection resulted in upregulation of both TNF-α and CXCL10 genes. Our study shows that S1 is a key viral component inducing inflammatory response in macrophages, independently of virus replication. Thus, virus-infected or soluble S1-activated macrophages may become sources of pro-inflammatory mediators contributing to hyperinflammation in COVID-19 patients.
Double-stranded RNA drives SARS-CoV-2 nucleocapsid protein to undergo phase separation at specific temperatures
Authors: Roden Christine A. , Dai Yifan , Seim Ian , Lee Myungwoon , Sealfon Rachel , McLaughlin Grace A. , Boerneke Mark A. , Iserman Christiane , Wey Samuel A. , Ekena Joanne L. , Troyanskaya Olga G. , Weeks Kevin M. , You Lingchong , Chilkoti Ashutosh , Gladfelter Amy S. 
Published: June 2021

SummaryBetacoronavirus SARS-CoV-2 infections caused the global Covid-19 pandemic. The nucleocapsid protein (N-protein) is required for multiple steps in the betacoronavirus replication cycle. SARS-CoV-2-N-protein is known to undergo liquid-liquid phase separation (LLPS) with specific RNAs at particular temperatures to form condensates. We show that N-protein recognizes at least two separate and distinct RNA motifs, both of which require double-stranded RNA (dsRNA) for LLPS. These motifs are separately recognized by N-protein’s two RNA binding domains (RBDs). Addition of dsRNA accelerates and modifies N-protein LLPS in vitro and in cells and controls the temperature condensates form. The abundance of dsRNA tunes N-protein-mediated translational repression and may confer a switch from translation to genome packaging. Thus, N-protein’s two RBDs interact with separate dsRNA motifs, and these interactions impart distinct droplet properties that can support multiple viral functions. These experiments demonstrate a paradigm of how RNA structure can control the properties of biomolecular condensates.
SARS-CoV-2 variant of concern B.1.1.7: diagnostic accuracy of three antigen-detecting rapid tests
Authors: Lindner Andreas K. , Krüger Lisa J. , Nikolai Olga , Klein Julian A.F. , Rössig Heike , Schnitzler Paul , Corman Victor M. , Jones Terry C. , Tobian Frank , Gaeddert Mary , Burock Susen , Sacks Jilian A. , Seybold Joachim , Mockenhaupt Frank P. , Denkinger Claudia M. 
Published: June 2021

AbstractVirus mutations have the potential to impact the accuracy of diagnostic tests. The SARS-CoV-2 B.1.1.7 lineage is defined by a large number of mutations in the spike gene and four in the nucleocapsid (N) gene. Most commercially available SARS-CoV-2 antigen-detecting rapid tests (Ag-RDTs) target the viral N-protein, encoded by the N-gene.We conducted a manufacturer-independent, prospective diagnostic accuracy study of three SARS-CoV-2 Ag-RDTs that are currently under review by the WHO Emergency Use Listing Procedure (Espline -Fujirebio Inc.; Sure Status -Premier Medical Corporation Private Limited; Mologic -Mologic Ltd.) and report here on an additional sub-analysis regarding the B.1.1.7 lineage. During the study, in Berlin and Heidelberg, Germany, from 20 January to 15 April 2021, B.1.1.7 rapidly became the dominant SARS-CoV-2 lineage at the testing sites and was detected in 220 (62%) of SARS-CoV-2 RT-PCR positive patients. All three Ag-RDTs yielded comparable sensitivities irrespective of an infection with the B.1.1.7 lineage or not.There is only limited data on how N-gene mutations in variants of concern may impact Ag-RDTs. Currently, no major changes to test performance are anticipated. However, test developers and health authorities should assess and monitor the impact of emerging variants on the accuracy of Ag-RDTs.
Relative precision of the sibship and LD methods for estimating effective population size with genomics-scale datasets
Authors: Waples Robin S. 
Published: June 2021

AbstractComputer simulations were used to compare relative precision of two widely-used single-sample methods for estimating effective population size (Ne)—the sibship method and the linkage-disequilibrium (LD) method. Emphasis is on performance when thousands of gene loci are used, which now can easily be achieved even for non-model species. Results show that unless Ne is very small, if at least 500-2000 diallelic loci are used, precision of the LD method is higher than the maximum possible precision for the sibship method, which occurs when all sibling relationships have been correctly identified. Results also show that when precision is high for both methods, their estimates of effective population size are high and positively correlated, which limits additional gains in precision that might be obtained by combining information from the two estimators.
Lake water volume calculation using time series LANDSAT satellite data: a geospatial analysis of Deepor Beel Lake, Guwahati
Authors: Ahmed Ishita Afreen , Shahfahad Shahfahad , Baig Mirza Razi Imam , Talukdar Swapan , Asgher Md Sarfaraz , Usmani Tariq Mahmood , Ahmed Shakeel , Rahman Atiqur 
Published: June 2021

PurposeDeepor Beel is one of the Ramsar Site and a wetland of great biodiversity, situated in the south-western part of Guwahati, Assam. With urban development at its forefront city of Guwahati, Deepor Beel is under constant threat. The study aims to calculate the lake water volume from the water surface area and the underwater terrain data using a triangulated irregular network (TIN) volume model.Design/methodology/approachThe lake water surface boundaries for each year were combined with field-observed water level data to generate a description of the underwater terrain. Time series LANDSAT images of 2001, 2011 and 2019 were used to extract the modified normalized difference water index (MNDWI) in GIS domain.FindingsThe MNDWI was 0.462 in 2001 which reduced to 0.240 in 2019. This shows that the lake water storage capacity shrank in the last 2 decades. This leads to a major problem, i.e. the storage capacity of the lake has been declining gradually from 20.95 million m3 in 2001 to 16.73 million m3 in 2011 and further declined to 15.35 million m3 in 2019. The fast decline in lake water volume is a serious concern in the age of rapid urbanization of big cities like Guwahati.Originality/valueNone of the studies have been done previously to analyze the decline in the volume of Deepor Beel lake. Therefore, this study will provide useful insights in the water resource management and the conservation of Deepor Beel lake.
More than lip service to internal market orientation: a multilevel investigation of the role of internal service quality
Authors: Mo Ziying , Liu Matthew Tingchi , Wong IpKin Anthony 
Published: June 2021

Purpose
Drawing on self-determination theory and the service-profit chain, this study aims to expand the current understanding of the internal processes of internal market orientation (IMO) on an organizational commitment by investigating the interactive effect between job (task) satisfaction and internal service quality in the field of hospitality and tourism.

Design/methodology/approach
This study examines the cross-level effects of internal service quality through a time-lagged field study with multilevel structural equation modeling analysis that involved 667 frontline employees from 40 casino hotels.

Findings
The results reveal the IMO has an indirect effect on affective and normative organizational commitments through the interaction of job (task) satisfaction with internal service quality, such that internal service quality compensates for relatively low levels of job (task) satisfaction. While no indirect effect is found on continuance organizational commitment.

Research limitations/implications
This study extends the service-profit chain by integrating self-determination theory and by investigating IMO’s indirect effects on commitment through the interaction between job (task) satisfaction and internal service quality.

Practical implications
The study provides practical solutions to the employee servicing and employee retention dilemmas faced by casino organizations.

Originality/value
This study advances the service-profit chain literature by proposing and theorizing an internal process of IMO, through the cross-level buffering effect of internal service quality on the relationship between job (task) satisfaction and organizational commitment. This study further presents the theoretical and managerial implications by understanding how employees’ perceptions and interpretations of IMO affect their commitment.
Functioning tourism interpretation on consumer products at the tourist generating region through tea tourism
Authors: Khaokhrueamuang Amnaj , Chueamchaitrakun Piyaporn , Kachendecha Warinthorn , Tamari Yuki , Nakakoji Kazuyoshi 
Published: June 2021

Purpose
This paper aims to clarify the functions of tourism interpretations of consumer products in a tourist-generating region (TGR) as a means of marketing the tourist destination region (TDR) through tea tourism.

Design/methodology/approach
This is a case study of the Thai Shizuoka Green Tea brand working to promote tea tourism in Shizuoka, Japan. It is used to identify the functions of tourism interpretations of consumer products in a TGR related to the concept of brand identity. This paper assessed Thai consumers’ opinions on the efficiency of tourism interpretation through a sample of 404 questionnaires and with interviews of ten young females, the primary respondents.

Findings
Tourism interpretations of the TGR’s consumer products are important for promoting the TDR through five premises: 1) motivating visitors to visit the destination, 2) communicating the place’s meaning, 3) targeting potential tourists, 4) differentiating the destination from other sites and 5) activating value co-creation. Premises 1 and 2 were assumed to stem from visitors’ enjoyment of the tea; the packaging motivated their visit to Shizuoka, its origin. Premise 3 concerns young women who view the product as a premium healthy drink. Premises 4 and 5 are based on the brand’s essence, implying the tea company’s partnership between Thailand and Japan.

Originality/value
Tourism interpretation plays a significant role in TDRs’ success; however, it can be implemented with other consumer products and an efficient brand identity, to create an image of a destination.