bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modifiable factors to improve work-life balance for trauma surgeons
Authors: Brown Carlos V.R. , Joseph Bellal A. , Davis Kimberly , Jurkovich Gregory J. 
Published: September 2020

INTRODUCTION
A balance between work and life outside of work can be difficult for practicing physicians to achieve, especially for trauma surgeons. Work-life balance (WLB) has been associated with burnout and career changes. The specific aim of this study was to investigate factors associated with WLB for trauma surgeons. We hypothesized that trauma surgeons are dissatisfied with their WLB, and there are modifiable factors that can be adjusted to improve and maintain WLB.

METHODS
Survey study of AAST members including detailed questions regarding demographics, clinical practice, family, lifestyle, and emotional support. Primary outcome was WLB, while the secondary outcome was surgeon burnout.

RESULTS
A total of 1,383 American Association for the Surgery of Trauma members received an email with the survey, and 291 (21%) completed the survey. There was a total of 125 members (43%) satisfied with their WLB, and 166 (57%) were not. Factors independently associated with satisfying WLB included hobbies (2.3 [1.1–4.7], p = 0.03), healthy diet (2.6 [1.2–4.4], p = 0.02), exercise (2.6 [1.3–5.1], p = 0.006), vacation weeks off (1.3 [1.0–1.6], p = 0.02), and fair compensation (2.6 [1.3–5.3], p = 0.008). Conversely, factors independently associated with a poor WLB included being midcareer (0.3 [0.2–0.7], p = 0.002), more work hours (0.4 [0.2–0.7], p = 0.006), fewer awake hours at home (0.2 [0.1–0.6], p = 0.002), and feeling that there is a better job (0.4 [0.2–0.9], p = 0.02]. Risk factors for burnout were the same as those for poor WLB.

CONCLUSION
Only 43% of trauma surgeons surveyed were satisfied with their WLB, and 61% reported burnout. Modifiable factors independently associated with a satisfying WLB were related to lifestyle and fair compensation. Factors independently associated with poor WLB and suffering burnout were being midcareer, increased hours at work, decreased awake hours at home, and feeling that there was a better job for yourself. Many factors associated with trauma surgeon WLB are modifiable. Trauma surgeons, as well as trauma leaders, should focus on these modifiable factors to optimize WLB and minimize burnout.

LEVEL OF EVIDENCE
Care management, Level III.
Predicting Mental Decline Rates in Mild Cognitive Impairment From Baseline MRI Volumetric Data
Authors: Nguyen Xuan V. , Candemir Sema , Erdal Barbaros Selnur , White Richard D. , Prevedello Luciano M. 
Published: September 2020

Purpose:
In mild cognitive impairment (MCI), identifying individuals at high risk for progressive cognitive deterioration can be useful for prognostication and intervention. This study quantitatively characterizes cognitive decline rates in MCI and tests whether volumetric data from baseline magnetic resonance imaging (MRI) can predict accelerated cognitive decline.

Methods:
The authors retrospectively examined Alzheimer Disease Neuroimaging Initiative data to obtain serial Mini-Mental Status Exam (MMSE) scores, diagnoses, and the following baseline MRI volumes: total intracranial volume, whole-brain and ventricular volumes, and volumes of the hippocampus, entorhinal cortex, fusiform gyrus, and medial temporal lobe. Subjects with <24 months or <4 measurements of MMSE data were excluded. Predictive modeling of fast cognitive decline (defined as >0.6/year) from baseline volumetric data was performed on subjects with MCI using a single hidden layer neural network.

Results:
Among 698 baseline MCI subjects, the median annual decline in the MMSE score was 1.3 for converters to dementia versus 0.11 for stable MCI (P<0.001). A 0.6/year threshold captured dementia conversion with 82% accuracy (sensitivity 79%, specificity 85%, area under the receiver operating characteristic curve 0.88). Regional volumes on baseline MRI predicted fast cognitive decline with a test accuracy of 71%.

Discussion:
An MMSE score decrease of >0.6/year is associated with MCI-to-dementia conversion and can be predicted from baseline MRI.
Clinical Profiles of Arteriolosclerosis and Alzheimer Disease at Mild Cognitive Impairment and Mild Dementia in a National Neuropathology Cohort
Authors: Yang Dixon , Masurkar Arjun V. 
Published: September 2020

Objective:
We sought to evaluate early clinical differences between cerebral arteriolosclerosis (pARTE), Alzheimer disease (pAD), and AD with arteriolosclerosis (ADARTE).

Methods:
Using National Alzheimer’s Coordinating Center neuropathology diagnoses, we defined pARTE (n=21), pAD (n=203), and ADARTE (n=158) groups. We compared demographics, medical history, psychometrics, neuropsychiatric symptoms, and apolipoprotein E (APOE) allele variants across neuropathology groups. Retrospective timepoints were first evaluation with Global Clinical Dementia Rating (CDR) score of 0.5 and 1.0, via the CDR Dementia Staging Instrument, corresponding to mild cognitive impairment (MCI) and mild dementia, respectively.

Results:
In MCI, clinical differences were minimal but pARTE subjects were older, had later onset cognitive decline, and progressed less severely than pAD. In mild dementia, pAD subjects were younger and had earlier onset of decline. Neuropsychiatric (depression) and psychometric (Logical Memory Delayed Recall, Trails B) differences also emerged between the groups. In MCI, APOE4 associated with worse Logical Memory Delayed Recall in pAD and ADARTE. In mild dementia, APOE4 associated with better animal fluency in pAD, but with better Trails A performance and more neuropsychiatric symptoms (Neuropsychiatric Inventory Questionnaire) in ADARTE.

Conclusions:
Differences between pARTE, pAD, and ADARTE emerge at mild dementia rather than MCI. APOE4 has varied cognitive and psychiatric impact dependent on neuropathology group and stage.
Sertraline for Trypophobia: Report of an Adolescent Case
Authors: Akinci Mehmet Akif , Uzun Necati 
Published: September 2020

Abstract
Trypophobia is a clinical entity that is characterized by unpleasant feelings related to or an aversion to irregular patterns of small holes or bumps. There are insufficient data about the etiological factors underlying trypophobia. It has been associated with anxiety disorders because it shows comorbidity and symptom similarity with anxiety disorders. Literature on the treatment strategies of trypophobia is somewhat limited. In this case report, we present an adolescent girl with trypophobia that is successfully treated with sertraline.
Intracranial EEG Validation of Single-Channel Subgaleal EEG for Seizure Identification
Authors: Pacia Steven V. , Doyle Werner K. , Friedman Daniel , Bacher Daniel H. , Kuzniecky Ruben I. 
Published: September 2020

Purpose:
A device that provides continuous, long-term, accurate seizure detection information to providers and patients could fundamentally alter epilepsy care. Subgaleal (SG) EEG is a promising modality that offers a minimally invasive, safe, and accurate means of long-term seizure monitoring.

Methods:
Subgaleal EEG electrodes were placed, at or near the cranial vertex, simultaneously with intracranial EEG electrodes in 21 epilepsy patients undergoing intracranial EEG studies for up to 13 days. A total of 219, 10-minute single-channel SGEEG samples, including 138 interictal awake or sleep segments and 81 seizures (36 temporal lobe, 32 extra-temporal, and 13 simultaneous temporal/extra-emporal onsets) were reviewed by 3 expert readers blinded to the intracranial EEG results, then analyzed for accuracy and interrater reliability.

Results:
Using a single-channel of SGEEG, reviewers accurately identified 98% of temporal and extratemporal onset, intracranial, EEG-verified seizures with a sensitivity of 98% and specificity of 99%. All focal to bilateral tonic-–clonic seizures were correctly identified.

Conclusions:
Single-channel SGEEG, placed at or near the vertex, reliably identifies focal and secondarily generalized seizures. These findings demonstrate that the SG space at the cranial vertex may be an appropriate site for long-term ambulatory seizure monitoring.
Hospital-Acquired Pressure Injury Development Among Surgical Critical Care Patients Admitted With Community-Acquired Pressure Injury
Authors: Alderden Jenny , Cummins Mollie , Zaratkiewicz Sunniva , ‘Lucy’ Zhao Yunchuan , Drake Kathryn , Yap Tracey L. 
Published: September 2020

PURPOSE:
Community-acquired pressure injuries (CAPIs) are present among approximately 3% to 8% of patients admitted to acute care hospitals. In the critical care population, little is known about hospital-acquired pressure injury (HAPI) development among patients with CAPIs because most studies exclude patients with CAPIs. The purpose of our study was to determine the incidence of HAPI development and the associated risk factors among surgical critical care patients with CAPIs.

DESIGN:
Retrospective cohort study.

SUBJECTS AND SETTING:
We used electronic health record data from adult critical care patients admitted to the surgical and cardiovascular surgical intensive care units (ICUs) at a level 1 trauma center and academic medical center between 2014 and 2018.

METHODS:
Univariate analysis was used to compare patients with CAPIs who developed a HAPI and those who did not, as well as logistic regression analysis to identify independent risk factors for HAPIs among patients with CAPIs.

RESULTS:
Among 5101 patients admitted to 2 surgical critical care units, 167 (3%) patients were admitted with CAPIs. Hospital-acquired pressure injuries were 4 times more common among patients with CAPIs compared to patients without CAPIs. Among the 167 patients with CAPIs, 47 patients (28%) went on to also develop a HAPI, whereas in the 4934 patients without CAPIs, 352 patients (7%) went on to develop a HAPI. Findings from the multivariate logistic regression analysis (n = 151) showed that decreased serum albumin (odds ratio [OR] = 0.47; 95% confidence interval [CI], 0.25-0.85; P = .02) and excessively dry skin (OR = 2.6; 95% CI, 1.1-6.22; P = .03) were independent predictors of HAPI development among patients admitted with CAPIs.

CONCLUSIONS:
Results from our study show that patients with CAPIs are at high risk for developing a HAPI, particularly among patients with decreased serum albumin or excessively dry skin. Patients with excessively dry skin may benefit from the application of skin moisturizers.
Telehealth for Wound Management During the COVID-19 Pandemic
Authors: Ratliff Catherine R. , Shifflett Robbin , Howell April , Kennedy Cindy 
Published: September 2020

BACKGROUND:
Prior to the COVID-19 pandemic, the Cardiovascular Surgery (CV) service of an academic medical center conducted a quality improvement project to decrease readmissions to the hospital from 2 rehabilitation facilities using telehealth via video calling. This initiative became of great importance with the COVID-19 pandemic because it helped the CV service better navigate and more efficiently meet the patient care needs associated with patient care restrictions. The CV service had to quickly evaluate and implement measures to reduce the rate of transmission of the coronavirus, which included adapting the clinic workflow to comply with state and federal recommendations. To minimize the interruption of clinical services and the associated revenue, a rapid transition from outpatient clinic visits to telehealth visits was implemented.

CASES:
Two cases reports of patients with wounds managed with 2 different telehealth platforms are described. Doxy.me platform allows the provider to e-mail or text a link to their personal waiting room for patients to join the video call. The second platform is Cisco Jabber platform to connect directly to the nursing unit at a skilled nursing or rehabilitation facility.

CONCLUSION:
Health care systems have had to adjust the manner in which they triage, evaluate, and care for patients using telehealth platforms that do not rely on in-person clinic visits during the COVID-19 pandemic. There are multiple telehealth platforms that require careful planning and treatment implementation. Each health care agency needs to choose the one or ones that function the best in their care setting.
The Lived Experiences of Persons With Ostomies Attending a Support Group
Authors: Byfield Donna 
Published: September 2020

PURPOSE:
The purpose of this study was to describe the lived experiences of patients with ostomies participating in a support group.

DESIGN:
Qualitative, descriptive, phenomenological study.

SUBJECT AND SETTING:
Fifteen adults with different types of ostomies were recruited from support groups in the state of Georgia.

METHODS:
Semistructured interviews were digitally audio-recorded and transcribed verbatim. Analyses of data were performed using Parse's 5-step thematic analysis.

RESULTS:
Four major themes and 10 subthemes emerged from the interviews: (1) theme 1—support group gives hope and changes lives, with 2 subthemes of increased knowledge and provided new knowledge and allows open communication; (2) theme 2—changes in body image had 2 subthemes, some things are different and everyone is the same; (3) theme 3—I am not alone resulted in 4 subthemes of feeling of belonging, willingness to be helped, being supported, and developing lifelong relationships; and (4) theme 4—being independent manifested 2 subthemes including confidence in rejoining society, and building confidence and decreased shame.

CONCLUSION:
We found that participation in an ostomy support group allowed individuals with ostomies to function at more advanced levels than they were before participating in the support group. The lived experiences were characterized by hope, willingness to live fully again, participating in different activities, and making new friends. Participants shared their positive experiences with others who were experiencing the same problems they once experienced. These findings add to and support the body of knowledge related to the interactions between nurses and individuals with ostomies as well as the care needed to ensure a safe discharge from the acute care facility. New knowledge gained may help in the improvement of the education provided during hospitalization. Providing this information will equip patients and families with a better understanding of and methods to care for their new ostomies and develop an acceptance of their new health status.
Telehealth Management of Urostomy Postoperative Complications
Authors: Sims Terran W. , Wilson Karie 
Published: September 2020

BACKGROUND:
Surgical creation of a urostomy with or without radical cystectomy is a common urologic procedure. Despite advances in techniques, ostomy and surgical-related postoperative complications are prevalent and may impair physical recovery and health quality of life. Restrictions in face-to-face clinic visits created by the coronavirus disease-2019 (COVID-19) pandemic have dramatically altered care for patients with a new urostomy.

CASE:
This case report describes our management approaches using telemedicine and complementary communication strategies during the recent COVID-19 pandemic for a patient with multiple complex chronic conditions and multiple stoma and related postoperative complications.

CONCLUSIONS:
Despite challenges imposed during the COVID-19 pandemic, we were able to manage multiple surgical- and ostomy-related complications using a combination of telecommunication techniques that mitigated the need for routine and urgent postoperative clinic visits, hospital readmission, or unplanned visits to an emergency department. The new onset use of telemedicine approaches (telephone, televideo, and direct telemedicine) and various Health Insurance and Portability and Accountability Act-secure platforms due to pandemic conditions can improve access to care.
Medical management of eating disorders: an update
Authors: Voderholzer Ulrich , Haas Verena , Correll Christoph U. , Körner Thorsten 
Published: September 2020

Purpose of review
Eating disorders are associated with numerous medical complications. The aim of this study was to review recent progress in improving the medical management of patients with eating disorders.

Recent findings
With close medical monitoring and electrolyte supplementation, accelerated refeeding protocols improve weight restoration without increasing the risk of refeeding syndrome. Olanzapine improves weight restoration better than placebo, without leading to adverse metabolic effects seen in individuals not in starvation. Alterations of the gut microbiome in anorexia nervosa have been demonstrated, but their clinical relevance remains unclear.

Summary
Medical complications of eating disorders may facilitate the first contact with health professionals and treatment initiation. Medical complications of anorexia nervosa generally occur due to starvation, malnutrition and their associated physiological effects, whereas medical complications of bulimia nervosa are generally due to purging behaviors. Most medical complications in patients with binge eating disorder are secondary to obesity. Most medical complications of eating disorders can be effectively treated with nutritional management, weight normalization and the termination of purging behaviors. In summary, eating disorders are associated with many medical complications that have to be carefully assessed and managed as early as possible to improve long-term outcomes.
Lithium Is Likely to Persist in the Brain
Authors: Augustin Marc , Karakavuz Rahsan , Riester Luise , Grözinger Michael 
Published: September 2020

Abstract
Electroconvulsive therapy and concomitant lithium therapy remain a matter of debate because of increased rates of adverse events. Current recommendations include monitoring lithium levels and reducing lithium to minimally effective dose. We present a report on protracted effects of lithium intoxication as electroconvulsive therapy 8 days after intoxication and under normal lithium serum levels resulted in a prolonged seizure. Electroencephalogram recordings before stimulation showed electroencephalogram correlates of subsiding lithium intoxication most likely due to protracted lithium influx and efflux of the central nervous system.
Automatic Contact Tracing for Outbreak Detection Using Hospital Electronic Medical Record Data
Authors: DeWitt Michael 
Published: September 2020

AbstractContact tracing is a well-known tool for public health professionals to trace and isolate contacts of known infectious persons. During a pandemic contact tracing is critical to ending an outbreak, but the volume of cases makes tracing difficult without adequate staffing tools. Hospitals equipped with electronic medical records can utilize these databases to automatically link cases into possible transmission chains and surface potential new outbreaks. While this automatic contact tracing does not have the richness of contact tracing interviews, it does provide a way for health systems to highlight potential super-spreader events and support their local health departments. Additionally, these data provide insight into how a given infection is spreading locally. These insights can be used to inform policy at the local level.
Disruption of RFX family transcription factors causes autism, attention deficit/hyperactivity disorder, intellectual disability, and dysregulated behavior
Authors: Harris Holly K. , Nakayama Tojo , Lai Jenny , Zhao Boxun , Argyrou Nikoleta , Gubbels Cynthia S. , Soucy Aubrie , Genetti Casie A. , Rodan Lance H. , Tiller George E. , Lesca Gaetan , Gripp Karen W. , Asadollahi Reza , Hamosh Ada , Applegate Carolyn D. , Turnpenny Peter D. , Simon Marleen E.H. , Volker-Touw Catharina (Nienke) M.L. , van Gassen Koen L.I. , van Binsbergen Ellen , Pfundt Rolph , Gardeitchik Thatjana , de Vries Bert B.A. , Imken Ladonna L. , Buchanan Catherine , Willing Marcia , Toler Tomi L. , Fassi Emily , Baker Laura , Vansenne Fleur , Wang Xiadong , Ambrus Julian L. , Fannemel Madeleine , Posey Jennifer E. , Agolini Emanuele , Novelli Antonio , Rauch Anita , Boonsawat Paranchai , Fagerberg Christina R. , Larsen Martin J. , Kibaek Maria , Labalme Audrey , Poisson Alice , Payne Katelyn K. , Walsh Laurence E. , Aldinger Kimberly , Balciuniene Jorune , Skraban Cara , Gray Christopher , Murrell Jill , Bupp Caleb P. , Pascolini Giulia , Grammatico Paola , Broly Martin , Küry Sébastien , Nizon Mathilde , Rasool Iqra Ghulam , Zahoor Muhammad Yasir , Kraus Cornelia , Reis André , Iqbal Muhammad , Uguen Kevin , Audebert-Bellanger Severine , Ferec Claude , Redon Sylvia , Baker Janice , Wu Yunhong , Zampino Guiseppe , Syrbe Steffan , Brosse Ines , Jamra Rami Abou , Dobyns William B. , Cohen Lilian L. , Agrawal Pankaj B. , Beggs Alan , Yu Timothy W. 
Published: September 2020

ABSTRACTPurposeWe describe a novel neurobehavioral syndrome of autism spectrum disorder, intellectual disability, and attention deficit/hyperactivity disorder associated withde novoor inherited deleterious variants in members of theRFXfamily of genes.RFXgenes are evolutionarily conserved transcription factors that act as master regulators of central nervous system development and ciliogenesis.MethodsWe assembled a cohort of 36 individuals (from 31 unrelated families) withde novomutations inRFX3, RFX4, andRFX7. We describe their common clinical phenotypes and present bioinformatic analyses of expression patterns and downstream targets of these genes as they relate to other neurodevelopmental risk genes.ResultsThese individuals share neurobehavioral features including autism spectrum disorder (ASD), intellectual disability, and attention-deficit/hyperactivity disorder (ADHD); other frequent features include hypersensitivity to sensory stimuli and sleep problems.RFX3, RFX4, andRFX7are strongly expressed in developing and adult human brain, and X-box binding motifs as well asRFXChIP-seq peaks are enriched in the cis-regulatory regions of known ASD risk genes.ConclusionThese results establish deleterious variation inRFX3, RFX4, andRFX7as important causes of monogenic intellectual disability, ADHD and ASD, and position these genes as potentially critical transcriptional regulators of neurobiological pathways associated with neurodevelopmental disease pathogenesis.
Covid-19 epidemic curve in Brazil: A sum of multiple epidemics, whose income inequality and population density in the states are correlated with growth rate and daily acceleration
Authors: de Sousa Pinto Airandes , Rodrigues Carlos Alberto , Sobrinho Carlito Lopes Nascimento , Santos Edval Gomes dos , Cruz Lívia Almeida da , Nunes Paulo Cesar , Costa Matheus Gomes Reis , da Costa Rocha Manoel Otávio 
Published: September 2020

ABSTRACTIntroductionRecently, we demonstrated that the polynomial interpolation method can be used to accurately calculate the daily acceleration of cases and deaths by Covid-19. The acceleration of new cases is important for the characterization and comparison of epidemic curves. The objective of this work is to measure the diversity of epidemic curves and understand the importance of socioeconomic variables in the acceleration, peak cases and deaths by Covid-19 in Brazilian states.MethodsThis is an ecological study with time series analysis of new cases and deaths by Covid-19 in Brazil and its 27 federation units. Using the polynomial interpolation method, we calculated the daily cases and deaths with the measurement of the respective acceleration. We calculated the correlation coefficient between the epidemic curve data and socioeconomic data.ResultsThe combination of daily data and acceleration determined that the states of Brazil are in different stages of the epidemic. Maximum acceleration of peak cases, peak of cases, maximum acceleration of deaths and peak of deaths are associated with the Gini index and population density, but did not correlate with HDI and per capita income.ConclusionBrazilian states showed heterogeneous data curves. Density population and socioeconomic inequality are associated with worse control of the epidemic.