bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical gender gap: a curriculum concordance and career vector perspective
Authors: Brown Chris , Harries Rhiannon L , Abdelrahman Tarig , Thomas Charlotte , Pollitt M John , Lewis Wyn G 
Published: October 2018

AbstractIntroductionWomen’s participation in medicine has increased dramatically during the last 50 years, yet Office for National Statistics data (2016) regarding annual pay continue to show an unequivocal 34% deficit in female doctors’ remuneration compared with their male counterparts. This study aimed to identify whether there are measurable differences in the training, career vectors and profiles of higher general surgical trainees (HSTs), related to gender.MethodThe Deanery roster supplemented with Intercollegiate Surgical Curriculum Programme and Scopus data was used to identify the profiles of 101 consecutive HSTs (38 women, 63 men, single UK deanery). Primary outcome measures were training programme attrition rate, time to completion of training and achievement of third level 4 competence (3L4C) in indicative operations. Secondary outcomes were publication number, citations and Hirsch Indices (HIs).ResultsAttrition rates were similar irrespective of gender (female n=3 (7.9%) vs male n=6 (9.5%), p=0.871). Training duration was on average 16 months longer in women (94 (72–134) months) than men (78 (72–112), p=0.002). Operative learning curve trajectories were similar; median operations required to achieve 3L4C was 380 (f) versus 410 (m, p=1.00). Academic profiles of men were stronger than women, specifically higher degrees; men (n=31, 83.8%), women (n=6, 16.2%, p=0.001); median (range) publication number 8 (0–57) versus 3 (0–38, p=0.003), citations 43 (0–1600) versus 9 (0–774, p=0.001), and HI 3 (0–26) versus 2 (0–12, p=0.002).ConclusionA complex variable gender gap was apparent related to time in training and academic profile, but not training attrition or operative learning curve trajectory.
Optimizing critical care of the trauma patient at the intermediate care unit: a cost-efficient approach
Authors: Plate Joost D J , Peelen Linda M , Leenen Luke P H , Hietbrink Falco 
Published: October 2018

BackgroundThe aim of this study was to describe the case load, safety, and cost savings of critical care of the trauma patient provided at the surgical intermediate care unit (IMCU).﻿MethodsThis cohort study included all trauma admissions between January 1, 2011 and January 7, 2015 at the general intensive care unit (ICU), stand-alone neuro(surgical) IMCU, and stand-alone (trauma) surgical IMCU. Trauma mechanism, Abbreviated Injury Scale score and Injury Severity Score (ISS), vital signs, laboratory parameters, admission duration, intubation duration, ICU transfer, and in-hospital mortality were prospectively collected. Hypothetical cost savings were calculated using the fixed cost price per IMCU (US$1500) and ICU (US$2500) admission day.ResultsA total of 1320 admissions were included, 675 (51.1%) at the IMCU and 645 (48.9%) at the ICU. Patients admitted at the IMCU had a median ISS of 17 (11, 22). Their median duration of admission was 32.8 hours (18.8, 62.5). At the IMCU, one patient died due to aneurogenic shock. A subsequent ICU transfer was required in 38 (5.6%) IMCU admissions. Of these transfers, four patients died due to neurological deterioration. At the ICU, the median ISS was 22 (14, 30). Nearly all (n=620, 96.3%) ICU trauma patients required mechanical ventilation. Expected total cost savings due to the presence of the IMCU were US$1 772 785.DiscussionA substantial amount of trauma patients in need of critical care can safely be admitted at the IMCU, without the need for further mechanical ventilation. Thereby, the IMCU could fulfill an essential cost-saving role in the management of severely injured trauma patients.Level of evidenceLevel IV.
Pressure effect on the mechanical and electronic properties of orthorhombic-C20
Authors: Ma Jian-Li , Fu Zhi-Fen , Wei Qun , Liu Peng , Zhou Jian-Ping 
Published: October 2018

A systematic investigation of structural, mechanical, elastic anisotropy and electronic properties of a recently reported novel superhard material orthorhombic [Formula: see text] ([Formula: see text]-[Formula: see text]) under pressure is performed utilizing the density functional theory in this work. The crystal structure parameters are obtained at zero as well as at high pressure. Pressure induced elastic constants [Formula: see text], polycrystalline aggregate elastic modulus [Formula: see text], [Formula: see text] ratio, and Debye temperature changes for [Formula: see text]-[Formula: see text] have been determined. The crystal elastic anisotropies of the ultra-incompressible [Formula: see text]-[Formula: see text] are investigated in the pressure range of 0–100 GPa. The Lyakhov–Oganov model is applied to predict the hardness as functions of pressure. The calculated results reveal that [Formula: see text]-[Formula: see text] possesses high elastic anisotropy under zero pressure and high pressure, and the hardness of [Formula: see text]-[Formula: see text] decreases with pressure, while the Debye temperature behaves with the opposite trend. The results of electronic structure indicate that [Formula: see text]-[Formula: see text] exhibits insulator characteristics, and the band gap increases with pressure. This work is expected to provide a useful guide for the future synthesis and application of [Formula: see text]-[Formula: see text].
Thread-safe reactive programming
Authors: Drechsler Joscha , Mogk Ragnar , Salvaneschi Guido , Mezini Mira 
Published: October 2018

The execution of an application written in a reactive language involves transfer of data and control flow between imperative and reactive abstractions at well-defined points. In a multi-threaded environment, multiple such interactions may execute concurrently, potentially causing data races and event ordering ambiguities. Existing RP languages either disable multi-threading or handle it at the cost of reducing expressiveness or weakening consistency. This paper proposes a model for thread-safe reactive programming (RP) that ensures abort-free strict serializability under concurrency while sacrificing neither expressiveness nor consistency. We also propose an architecture for integrating a corresponding scheduler into the RP language runtime, such that thread-safety is provided "out-of-the-box" to the applications.
We show the feasibility of our proposal by providing and evaluating a ready-to-use implementation integrated into the REScala programming language. The scheduling algorithm is formally proven correct. A thorough empirical evaluation shows that reactive applications build on top of it scale with multiple threads, while the scheduler incurs acceptable performance overhead in a single-threaded configuration. The scalability enabled by our scheduler is roughly on-par with that of hand-crafted application-specific locking and better than the scalability enabled by a scheduler using an off-the-shelf software transactional memory library.
A derivation framework for dependent security label inference
Authors: Li Peixuan , Zhang Danfeng 
Published: October 2018

Dependent security labels (security labels that depend on program states) in various forms have been introduced to express rich information flow policies. They are shown to be essential in the verification of real-world software and hardware systems such as conference management systems, Android Apps, a MIPS processor and a TrustZone-like architecture. However, most work assumes that all (complex) labels are provided manually, which can both be error-prone and time-consuming.
In this paper, we tackle the problem of automatic label inference for static information flow analyses with dependent security labels. In particular, we propose the first general framework to facilitate the design and validation (in terms of soundness and/or completeness) of inference algorithms. The framework models label inference as constraint solving and offers guidelines for sound and/or complete constraint solving. Under the framework, we propose novel constraint solving algorithms that are both sound and complete. Evaluation result on sets of constraints generated from secure and insecure variants of a MIPS processor suggests that the novel algorithms improve the performance of an existing algorithm by orders of magnitude and offers better scalability.
Distributed system development with ScalaLoci
Authors: Weisenburger Pascal , Köhler Mirko , Salvaneschi Guido 
Published: October 2018

Distributed applications are traditionally developed as separate modules, often in different languages, which react to events, like user input, and in turn produce new events for the other modules. Separation into components requires time-consuming integration. Manual implementation of communication forces programmers to deal with low-level details. The combination of the two results in obscure distributed data flows scattered among multiple modules, hindering reasoning about the system as a whole.
The ScalaLoci distributed programming language addresses these issues with a coherent model based on placement types that enables reasoning about distributed data flows, supporting multiple software architectures via dedicated language features and abstracting over low-level communication details and data conversions. As we show, ScalaLoci simplifies developing distributed systems, reduces error-prone communication code and favors early detection of bugs.
Collapsible contracts: fixing a pathology of gradual typing
Authors: Feltey Daniel , Greenman Ben , Scholliers Christophe , Findler Robert Bruce , St-Amour Vincent 
Published: October 2018

The promise of gradual typing is that programmers should get the best of both worlds: the static guarantees of static types, and the dynamic flexibility of untyped programming. This is an enticing benefit, but one that, in practice, may carry significant costs. Significant enough, in fact, to threaten the very practicality of gradual typing; slowdowns as high as 120x are reported as arising from gradual typing.
If one examines these results closely, though, it becomes clear that the costs of gradual typing are not evenly distributed. Indeed, while mixing typed and untyped code almost invariably carries non-trivial costs, many truly deal-breaking slowdowns exhibit pathological performance. Unfortunately, the very presence of these pathological cases---and therefore the possibility of hitting them during development---makes gradual typing a risky proposition in any setting that even remotely cares about performance.
This work attacks one source of large overheads in these pathological cases: an accumulation of contract wrappers that perform redundant checks. The work introduces a novel strategy for contract checking---collapsible contracts---which eliminates this redundancy for function and vector contracts and drastically reduces the overhead of contract wrappers.
We implemented this checking strategy as part of the Racket contract system, which is used in the Typed Racket gradual typing system. Our experiments show that our strategy successfully brings a class of pathological cases in line with normal cases, while not introducing an undue overhead to any of the other cases. Our results also show that the performance of gradual typing in Racket remains prohibitive for many programs, but that collapsible contracts are one essential ingredient in reducing the cost of gradual typing.
The root cause of blame: contracts for intersection and union types
Authors: Williams Jack , Morris J. Garrett , Wadler Philip 
Published: October 2018

Gradual typing has emerged as the tonic for programmers with a thirst for a blend of static and dynamic typing. Contracts provide a lightweight form of gradual typing as they can be implemented as a library, rather than requiring a gradual type system.
Intersection and union types are well suited to static and dynamic languages: intersection encodes overloaded functions; union encodes uncertain data arising from branching code. We extend the untyped lambda calculus with contracts for monitoring higher-order intersection and union types, for the first time giving a uniform treatment to both. Each operator requires a single reduction rule that does not depend on the constituent types or the context of the operator.
We present a new method for defining contract satisfaction based on blame behaviour. A value positively satisfies a type if applying a contract of that type can never elicit positive blame. A continuation negatively satisfies a type if applying a contract of that type can never elicit negative blame. We supplement our definition of satisfaction with a series of monitoring properties that satisfying values and continuations should have.
Identifying refactoring opportunities for replacing type code with subclass and state
Authors: Vedurada Jyothi , Nandivada V. Krishna 
Published: October 2018

Refactoring is a program transformation that restructures existing code without altering its behaviour and is a key practice in popular software design movements, such as Agile. Identification of potential refactoring opportunities is an important step in the refactoring process. In large systems, manual identification of useful refactoring opportunities requires a lot of effort and time. Hence, there is a need for automatic identification of refactoring opportunities. However, this problem has not been addressed well for many non-trivial refactorings. Two such non-trivial, yet popular refactorings are “Replace Type Code with Subclass” (SC) and “Replace Type Code with State” (ST) refactorings. In this paper, we present new approaches to identify SC and ST refactoring opportunities.

Our proposed approach is based around the notion of
control-fields
. A control-field is a field of a class that exposes the different underlying behaviors of the class. Each control-field can lead to a possible SC/ST refactoring of the associated/interacting classes. We first present a formal definition of control-fields and then present algorithms to identify and prune them; each of these pruned control-fields represents a refactoring opportunity. Further, we present a novel flow- and context-sensitive analysis to classify each of these refactoring opportunities into one of the SC and ST opportunities. We have implemented our proposed approach in a tool called Auto-SCST, and demonstrated its effectiveness by evaluating it against eight open-source Java applications.
Low‐Level Cumulative Lead and Resistant Hypertension: A Prospective Study of Men Participating in the Veterans Affairs Normative Aging Study
Authors: Zheutlin Alexander R. , Hu Howard , Weisskopf Marc G. , Sparrow David , Vokonas Pantel S. , Park Sung Kyun 
Published: October 2018

Background
Bone lead offers a better method over blood lead measurement to discern long‐term lead exposure and accumulation. We examined the risk of resistant hypertension based on bone lead levels in a prospective cohort study of NAS (Normative Aging Study).

Methods and Results

Participants had clinic data on hypertension (systolic blood pressure, diastolic blood pressure, and antihypertension medication), lead (blood, bone‐patella, bone‐tibia), and demographic and confounding variables. Cases of resistant hypertension were identified by meeting criteria for: (1) inadequate systolic blood pressure (>140 mm Hg) or diastolic blood pressure (>90 mm Hg) while taking 3 medications or (2) requiring >4 medications for blood pressure control. A modified Poisson regression was used for model analysis. Of the 475 participants, 97 cases of resistant hypertension (20.4%) were identified. Among the cases of resistant hypertension, the median tibia and patella lead levels were 20 μg/g and 25 μg/g, respectively, while median tibia and patella lead levels were 20 μg/g and 27.5 μg/g, respectively, in participants without resistant hypertension. Tibia lead demonstrated a significant association with resistant hypertension (relative risk, 1.19; 95% confidence interval, 1.01–1.41 [
P
=0.04]) per interquartile range increase in tibia lead (13–28.5 μg/g). Patella lead was not associated with resistant hypertension (relative risk, 1.10; 95% confidence interval, 0.92–1.31 [
P
=0.31]) per interquartile range increase in patella lead (18–40 μg/g). Blood lead levels were not significantly associated with resistant hypertension (relative risk, 1.11; 95% confidence interval, 0.88–1.40 [
P
=0.38]).

Conclusions
Tibia lead represents a novel risk factor for resistant hypertension. Our study demonstrates an increased association between tibia lead and resistant hypertension status, with an increased risk of 19% per 1 interquartile range increase in tibia lead.
Two macaw species can learn to solve an optimised two-trap problem, but without functional causal understanding
Authors: O’Neill Laurie , Picaud Anthony , Maehner Jana , Gahr Manfred , von Bayern Auguste M.P. 
Published: October 2018

Abstract
The trap-tube paradigm is a useful reference for judging whether a species is likely to use advanced physical causal cognition, however it does not have a standardised format. In this study, the design of an optimised two trap-table is described and is then tested on two species of macaw: Ara ambiguus and Ara glaucogularis. Multiple subjects of both species learned a successful method to solve an initial trap-problem and some transferred this success to other apparatus presented. However this transfer was likely achieved without a functional physical understanding of the task. The macaws probably have a preference to use learned rules based on arbitrary properties to solve the trap-problem. We conclude that this setup of the two-trap-problem is a viable benchmark that could be administered to a variety of species with very little modification, thus paving the way for more directly comparative studies.
Catastrophic High School and Collegiate Cheerleading Injuries in the United States: An Examination of the 2006-2007 Basket Toss Rule Change
Authors: Yau Rebecca K. , Dennis Savannah G. , Boden Barry P. , Cantu Robert C. , Lord James A. , Kucera Kristen L. 
Published: October 2018

Background: Cheerleading is a specialized athletic activity that can lead to catastrophic injuries. Cheerleading rules are in place to maximize safety of participants. The purpose of this study was to describe catastrophic cheerleading injuries among high school and collegiate-level participants in the United States and to explore whether the 2006-2007 basket toss rule change was effective at reducing the number of catastrophic injuries. Hypothesis: The 2006-2007 basket toss rule change contributed to a reduction in the number of catastrophic injuries among high school and collegiate cheerleaders. Study Design: Case series. Level of Evidence: Level 4. Methods: Data on catastrophic cheerleading injuries were collected by the National Center for Catastrophic Sport Injury Research from July 2002 to June 2017. Information collected included cheerleader, event, and injury characteristics. The impact of the 2006-2007 rule change banning the basket toss on any hard surfaces was assessed by comparing injury rates and 95% CIs before and after the rule change. Results: There were 54 catastrophic cheerleading injuries, or 3.6 injuries per year. From July 2002 through June 2017, the injury rate was 2.12 per 1,000,000 cheerleaders (95% CI, 1.56-2.69). Most cheerleaders sustained serious injuries (n = 27; 50%) during practice (n = 37; 69%) to the head (n = 28; 52%) and cervical spine (n = 17; 32%). From July 2002 through June 2017, basket tosses were the stunt that accounted for the highest proportion of injuries (n = 19; 35%). The basket toss injury rate decreased from 1.55 to 0.40 per 1,000,000 cheerleaders among both high school and collegiate cheerleaders after the rule change. Conclusion: Catastrophic injury rates in cheerleading decreased dramatically after the 2006-2007 rule change banning basket tosses from being performed on any hard surfaces. In particular, there was a nearly 4-fold reduction in the rate of catastrophic basket toss injuries.
Chronic Rhinosinusitis—Could Phenotyping or Endotyping Aid Therapy?
Authors: Bayar Muluk Nuray , Cingi Cemal , Scadding Glenis K. , Scadding Guy 
Published: October 2018

Objectives We reviewed the phenotyping and endotyping of chronic rhinosinusitis (CRS) and treatment options. Methods We searched PubMed, Google, Google Scholar, and the Proquest Central Database of the Kırıkkale University Library. Results Phenotypes are observable properties of an organism produced by the environment acting upon the genotype, that is, patients with a particular disorder are subgrouped according to common characteristics. Currently, CRS is usually phenotyped as being with (CRSwNP) or without (CRSsNP) nasal polyps. However, this is not immutable as some individuals progress from nonpolyp to polypoid CRS over time. Phenotypes of CRS are also based on inflammatory patterns, generally CRSwNP is eosinophilic, CRSsNP neutrophilic; but there is a spectrum, rather than a clear-cut division into 2 types. An endotype is a subtype of a condition defined by a distinct functional or pathobiological mechanism. Endotypes of CRS can be (1) nontype Th2, (2) moderate type Th2, and (3) severe type Th2 immune reactions, based on cytokines and mediators such as IL4, 5, 13. CRS endotyping can also include a (1) type 2 cytokine-based approach, (2) eosinophil-mediated approach, (3) immunoglobulin E-based approach, and (4) cysteinyl leukotriene-based approach. Subdivisions of CRSwNP can be made into nonsteroidal anti-inflammatory drug-exacerbated respiratory disease, allergic fungal sinusitis, and eosinophil pauci-granulomatous arteritis by testing. General treatment for all CRS is nasal douching. The place of surgery needs careful reconsideration. Endotype-directed therapies include glucocorticosteroids, antibiotics, aspirin, antifungals, anticytokines, and immunoglobulin replacement. The recognition of united airways and the co-occurrence of CRSwNPs and severe asthma should lead to common endotyping of both upper and lower airways in order to better direct therapy. Conclusion Endotyping can allow for the identification of groups of patients with CRS with a high likelihood of successful treatment, such as patients with a moderate type 2 immune reaction or those with acquired immune deficiency.
The Accolade TMZF stem fulfils the demands of modern stem design: Minimum 5-year survival in a cohort of 937 patients
Authors: van den Hout Joost AAM , Koenraadt Koen LM , Wagenmakers Robert , Bolder Stefan BT 
Published: October 2018

Purpose: Modern hip stem design includes a prosthesis that has a predictable outcome in all total hip arthroplasty (THA) patients, regardless of approach, surgeon or patient characteristics. Introduction without a learning curve and, in cases of problems, the possibility for a simple revision are other prerequisites. The purpose of this study is to evaluate whether the Accolade TMZF stem (Stryker Orthopedics, Mahwah, New Jersey, USA) is suitable to fulfil these demands. We report our mid-term survival of the Accolade TMZF hip stem in all patients from the first implantation at our institute. Methods: From the start of using the Accolade TMZF stem (March 2009) until February 2011, 937 THA were performed by 12 surgeons using a posterolateral or anterolateral approach. Survival of the stem was calculated using Kaplan–Meier analysis. Effect of approach, patient age and comorbidity were analysed with a Cox proportional hazards’ model. The learning effect was determined by comparing the number of revisions in the surgeons’ first 20 THAs with their next 30 THAs and the subsequent THAs. Results: At 5 years, cumulative stem survival was 97.9% based on revisions for all reasons and 98.8% with aseptic loosening as endpoint. We found no effect of surgical approach, patient age or comorbidity on stem survival. No learning effect was found. Conclusion: The Accolade TMZF stem fulfilled the demands of modern stem design.