bluuebunny/crossref_metadata_2025_split huggingface dataset:
“I Don’t Have Time to Die”
Authors: Abzug Robert H. 
Published: December 2020

Abstract
In moving to California, May became a major force in the ongoing establishment of training programs and other aspects of humanistic psychology. He mentored a number of students who came to have important careers and developed an important friendship with Irvin Yalom. Within AHP, he engaged in a battle with advocates of “transpersonal psychology” because he thought they confused religion with psychology. He published two more major books, Freedom and Destiny and The Cry for Myth. And, after a problematic period in the wake of his divorce from Ingrid, he met and married Georgia Johnson, now Georgia Lee May. After two strokes, he begins to fail and, in 1994, dies a peaceful death in the company of his wife and Irvin Yalom.
The Language of Pain: Is There a Relationship Between Metaphor Use and Adjustment to Chronic Pain?
Authors: Munday Imogene , Kneebone Ian , Rogers Kris , Newton-John Toby 
Published: December 2020

Abstract

Objective
Metaphor, frequently used in chronic pain, can function as a communicative tool, facilitating understanding and empathy from others. Previous research has demonstrated that specific linguistic markers exist for areas such as pain catastrophizing, mood, as well as diagnostic categories. The current study sought to examine potential associations between the types of pain metaphors used and diagnostic category, disability, and mood.

Design
Online cross-sectional survey in Sydney, Australia.

Subjects
People with chronic pain (n = 247, age 19–78 years, M = 43.69).

Methods
The data collected included demographics, pain metaphors, the Brief Pain Inventory (BPI) and the Depression, Anxiety, and Stress Scales (DASS-21). Associations between metaphor source domains, obtained via Systematic Metaphor Analysis, and scores on the BPI, DASS-21, as well as diagnostic group were considered using binary logistic analysis.

Results
Use of different pain metaphors was not associated with pain intensity, however the extent to which pain interfered with daily life did have a relationship with use of metaphorical language. Preliminary support was found for an association between the use of certain pain metaphors and self-reported diagnostic categories, notably Endometriosis, Complex Regional Pain Syndrome, and Neuropathic pain.

Conclusions
There may be specific linguistic metaphorical markers to indicate pain interference and for particular diagnoses. Appreciation of pain metaphors has potential to facilitate communication and enhance understanding in interactions between clinicians and people with chronic pain.
The Asymptotic Behavior of Bootstrap Support Values in Molecular Phylogenetics
Authors: Huang Jun , Liu Yuting , Zhu Tianqi , Yang Ziheng 
Published: December 2020

Abstract
The phylogenetic bootstrap is the most commonly used method for assessing statistical confidence in estimated phylogenies by non-Bayesian methods such as maximum parsimony and maximum likelihood (ML). It is observed that bootstrap support tends to be high in large genomic data sets whether or not the inferred trees and clades are correct. Here, we study the asymptotic behavior of bootstrap support for the ML tree in large data sets when the competing phylogenetic trees are equally right or equally wrong. We consider phylogenetic reconstruction as a problem of statistical model selection when the compared models are nonnested and misspecified. The bootstrap is found to have qualitatively different dynamics from Bayesian inference and does not exhibit the polarized behavior of posterior model probabilities, consistent with the empirical observation that the bootstrap is more conservative than Bayesian probabilities. Nevertheless, bootstrap support similarly shows fluctuations among large data sets, with no convergence to a point value, when the compared models are equally right or equally wrong. Thus, in large data sets strong support for wrong trees or models is likely to occur. Our analysis provides a partial explanation for the high bootstrap support values for incorrect clades observed in empirical data analysis. [Bootstrap; model selection; star-tree paradox; support value.]
The Accelerating Change in Medical Education Consortium: Key Drivers of Transformative Change
Authors: Lomis Kimberly D. , Santen Sally A. , Dekhtyar Michael , Elliott Victoria Stagg , Richardson Judee , Hammoud Maya M. , Hawkins Richard , Skochelak Susan E. 
Published: December 2020

The American Medical Association’s (AMA’s) Accelerating Change in Medical Education (ACE) initiative, launched in 2013 to foster advancements in undergraduate medical education, has led to the development and scaling of innovations influencing the full continuum of medical training. Initial grants of $1 million were awarded to 11 U.S. medical schools, with 21 schools joining the consortium in 2016 at a lower funding level. Almost one-fifth of all U.S. MD- and DO-granting medical schools are represented in the 32-member consortium. In the first 5 years, the consortium medical schools have delivered innovative educational experiences to approximately 19,000 medical students, who will provide a potential 33 million patient care visits annually. The core initiative objectives focus on competency-based approaches to medical education and individualized pathways for students, training in health systems science, and enhancing the learning environment.
At the close of the initial 5-year grant period, AMA leadership sought to catalogue outputs and understand how the structure of the consortium may have influenced its outcomes. Themes from qualitative analysis of stakeholder interviews as well as other sources of evidence aligned with the 4 elements of the transformational leadership model (inspirational motivation, intellectual stimulation, individualized consideration, and idealized influence) and can be used to inform future innovation interventions. For example, the ACE initiative has been successful in stimulating change at the consortium schools and propagating those innovations broadly, with outputs involving medical students, faculty, medical schools, affiliated health systems, and the broader educational landscape. In summary, the ACE initiative has fostered a far-reaching community of innovation that will continue to drive change across the continuum of medical education.
Perspectives in Evaluating Selective Androgen Receptor Modulators in Human Hair: A Short Communication
Authors: Kintz Pascal , Gheddar Laurie , Ameline Alice , Raul Jean-Sébastien 
Published: December 2020

Background:
As hair testing increases the window of drug detection and permits the differentiation of long-term use from a single exposure when performing segmental analyses (which also allows establishing the pattern of use), this matrix should be considered as a suitable complement to standard investigations in clinical, forensic, and sport toxicology. The authors were recently involved in 3 cases where hair analysis was used to demonstrate the use of selective androgen receptor modulators (SARMs), including ligandrol (LGD-4033), andarine (S-4), and ostarine (S-22). SARMs are increasingly being abused as “safe” alternatives to steroids.

Methods:
After decontamination using dichloromethane, hair specimens were segmented, cut into very small segments (<1 mm), incubated overnight in a buffer, and extracted using a mixture of organic solvents. Drugs were tested using liquid chromatography–tandem mass spectrometry and confirmed using liquid chromatography/HRMS.

Results:
The determined concentrations were as follows: ligandrol, 14–42 pg/mg; andarine, 0.1–0.7 pg/mg; and ostarine, 3–21 pg/mg.

Conclusions:
To enhance performance, SARMs must be used on a long-term basis, which can have serious clinical consequences, including liver damage, myocardial infarction, and blood clots. Hair testing for SARMs has additional benefits versus urine analysis as it can detect the parent compound and numerous metabolites.
Pneumatic Dissection for Large-Diameter (9-mm) Deep Anterior Lamellar Keratoplasty in Eyes With Previous Anterior Lamellar Keratoplasty
Authors: Yu Angeli Christy , Myerscough James , Galante Giuditta , Furiosi Luca , Socea Sergiu , Bovone Cristina , Busin Massimo 
Published: December 2020

Purpose:
To evaluate the surgical and 3-year clinical outcomes of modified big-bubble 9-mm deep anterior lamellar keratoplasty (DALK) in eyes with previous ALK (ALK).

Methods:
In this interventional case series, 21 consecutive eyes with unsatisfactory vision after ALK (superficial ALK n = 9; laser-assisted ALK n = 7; and epikeratophakia n = 5) underwent large-diameter (9-mm) DALK. The surgery involved deep trephination based on the anterior segment optical coherence tomography pachymetry measurement at 9-mm diameter, pneumatic dissection from the base of the trephination and limited stromal clearance of the optical zone (6 mm). Main outcome measures were success rates of pneumatic dissection, best spectacle-corrected visual acuity, and complication rates.

Results:
Pneumatic dissection with type 1 bubble formation succeeded in 19 (90%) eyes. In the 2 remaining cases, the 6-mm optical zone was cleared by manual dissection. Perforation occurred in one of the latter cases; no procedure was converted to penetrating keratoplasty. One month after complete suture removal, the preoperative mean best spectacle-corrected visual acuity (0.75 ± 0.23 logMAR) improved to 0.09 ± 0.10 logMAR (P < 0.001) and remained stable up to 3 years after surgery. At the final follow-up, refractive astigmatism was ≤4.5 and <6 D in 20 (95%) and 21 (100%) eyes, respectively. Stromal rejection was observed in 2 eyes (10%) and was treated successfully with steroids.

Conclusions:
Even in eyes with previous ALK, pneumatic dissection can be achieved through a modified DALK technique with a low risk of complications and excellent visual and refractive outcomes.
Conjunctival Vessels in Diabetes Using Functional Slit Lamp Biomicroscopy
Authors: Hwang Jodi , Karanam Veena , Wang Jianhua , Feuer William J. , Garg Rajesh K. , Tamariz Leonardo , Galor Anat 
Published: December 2020

Purpose:
This study used functional slit lamp biomicroscopy (FSLB) to quantify conjunctival microvessel parameters in individuals with and without diabetes and examined whether these metrics could be used as surrogate markers of diabetes-related complications.

Methods:
A cross-sectional study of 98 controls (C), 13 individuals with diabetes without complications (D–C), and 21 with diabetes and related complications (D+C), which included retinopathy, nephropathy, neuropathy, and cardiovascular-, peripheral vascular-, and cerebrovascular diseases, was performed. Bulbar conjunctival metrics (venule diameter, length, axial velocity [Va], cross-sectional velocity [Vs], flow [Q], and branching complexity) were measured using FSLB (digital camera mounted on traditional slit lamp).

Results:
The mean age was 60 ± 11 years, and demographics were similar across the groups. Va and Vs significantly differed between groups. Va was 0.51 ± 0.17 mm/s, 0.62 ± 0.17 mm/s, and 0.45 ± 0.17 mm/s in the C, D–C, and D+C groups, respectively (P = 0.025). Similarly, Vs was 0.35 ± 01.12, 0.43 ± 0.13, and 0.32 ± 0.13 mm/s in the C, D–C, and D+C groups, respectively (P = 0.031). Black individuals had increased Va, Vs, and Q compared with White individuals (P < 0.05), but differences in velocities persisted after accounting for race. Among patients with diabetes, Va and Vs correlated with number of organ systems affected (Va: ρ = −0.42, P = 0.016; Vs: ρ = −0.41, P = 0.021). Va, Vs, and Q significantly (P ≤ 0.005) discriminated between diabetic patients with and without complications (area under the receiver operating curve for Va = 0.81, Vs = 0.79, Q = 0.81).

Conclusions:
Bulbar conjunctival blood flow metrics measured by FSLB differed between controls, diabetic patients without complications, and diabetic patients with complications. FSLB is a quick, easily accessible, and noninvasive alternative that might estimate the burden of vascular complications in diabetes.
Rehabilitation Outcomes for Patients With Severe Presentation of COVID-19: A Case Series
Authors: Solon Kathryn , Larson Allison , Ronnebaum Julie , Stevermer Catherine 
Published: December 2020

Purpose:
To provide an outline of the timeline from acute care admission to inpatient rehabilitation facility discharge and describe the functional progress and tolerance of 2 individuals who were hospitalized but not intubated because of COVID-19.

Method:
Retrospective data were collected from the electronic medical record to describe the rehabilitation course of the first 2 consecutive patients admitted to the rehabilitation facility who were recovering from COVID-19. Both patients were octogenarian men who experienced functional decline while hospitalized for symptoms of COVID-19 and were recommended for further inpatient rehabilitation services. Progress during inpatient rehabilitation was tracked using the following outcome measures: Centers for Medicare & Medicaid Services Quality Indicators (QI), 6-Minute Walk Test, 10-Meter Walk Test, Timed Up and Go, and Berg Balance Scale.

Results:
Patient 1 had an 18-day acute care stay, a 13-day inpatient rehabilitation facility stay, and was discharged to home. Patient 2 had an interrupted 19-day acute care stay, a 15-day inpatient rehabilitation facility stay, and was discharged to a skilled nursing facility. Patient 1 improved 160.98 m in the 6-Minute Walk Test, 0.08 m/s in self-selected walking speed, and 85 points in the total Quality Indicators score. Patient 2 improved 115.22 m in the 6-Minute Walk Test, 0.14 m/s in self-selected walking speed, and 39 points in the total Quality Indicators score.

Conclusion:
The patients made clinically meaningful improvements in each outcome measure during their length of stay for inpatient rehabilitation. This reveals the positive rehabilitation potential of 2 older adult patients with COVID-19 and demonstrates the patients' ability to maintain inpatient rehabilitation facility level of activity. With individualized care and discharge planning, similar patients may make significant gains in function despite advanced age and comorbid conditions.
Comparison of Cochlear Implant Device Fixation—Well Drilling Versus Subperiosteal Pocket. A Cost Effectiveness, Case–Control Study
Authors: Stern Shavit Sagit , Weinstein Emery P. , Drusin Madeleine A. , Elkin Elena B. , Lustig Lawrence R. , Alexiades George 
Published: December 2020

Objective:
To compare surgical characteristics and complications between well drilling (WD) and subperiosteal pocket techniques (SPT) for receiver/stimulator (R/S) fixation of cochlear implant (CI), and conduct cost-effectiveness analysis.

Study Design:
Retrospective clinical study, decision-analysis model.

Setting:
Tertiary referral center.

Patients:
Three-hundred and eighty-eight CI recipients with a minimum of 6-months follow-up.

Interventions:
CI surgery using either WD or SPT for R/S fixation. A decision-analysis model was designed using data from a systematic literature review.

Main Outcome Measures:
Surgical operation time, rates of major and minor long-term complications were compared. Incremental cost-effectiveness was also estimated, comparing the two methods of fixation.

Results:
We compared 179 WD with 209 SPT. Surgery time was significantly shorter in SPT (148 versus 169 min, p = 0.001) and remained significant after adjustment for possible confounders. Higher rates of major complications requiring surgical intervention were found with SPT (10.5% versus 4.5%, p = 0.042), however, the difference was not significant after adjusting for follow-up time (47.8 versus 32.5 months for SPT, WD respectively; p < 0.001). The incremental cost-effectiveness ratio for WD (compared with SPT) was $48,795 per major complication avoided, which was higher than the willingness-to-pay threshold of $47,700 (average cost of 2 h revision surgery).

Conclusions:
SPT was found to be faster but potentially risks more complications, particularly relating to device failure. Further long-term studies are required to validate these differences. Based on data from the current literature, neither of the methods is compellingly cost-effective over the other, and surgeons can base their choice on personal preference, comfort, and previous training.
Job Strain, Overweight, and Diabetes: A 13-Year Prospective Study Among 12,896 Men and Women in Ontario
Authors: Gilbert-Ouimet Mahée , Glazier Richard H. , Brisson Chantal , Mustard Cameron , Smith Peter M. 
Published: December 2020

ABSTRACT

Objective
The American Diabetes Association recently called for research on social and environmental determinants of diabetes to intensify primary prevention. Recent epidemiological evidence suggests that frequent and modifiable psychosocial stressors at work might contribute to the development of diabetes, but more prospective studies are needed. We evaluated the relationship between job strain and diabetes incidence in 12,896 workers followed up over a 13-year period in Ontario, Canada. We also examined the modifying effect of body mass index in this relationship.

Methods
Data from Ontario respondents (35–74 years of age) to the 2000–2001, 2002, and 2003 cycles of the Canadian Community Health Survey were prospectively linked to the Ontario Health Insurance Plan database for physician services and the Canadian Institute for Health Information Discharge Abstract Database for hospital admissions. The sample consisted of actively employed participants with no previous diagnosis for diabetes. Cox proportional hazard regression models were performed to evaluate the relationship between job strain, obesity, and the incidence of diabetes.

Results
Overall, job strain was not associated with the incidence of diabetes (hazard ratio [HR] = 1.05; 95% confidence interval [CI] = 0.83–1.34). Among women, job strain was associated with an elevated risk of diabetes, although this finding did not reach statistical significance (HR = 1.36; 95% CI = 0.94–1.96). Among men, no association was observed (HR = 0.89; 95% CI = 0.65–1.22). Also, job strain increased the risk of diabetes among women with obesity (HR = 1.88; 95% CI = 1.14–3.08), whereas these stressors reduced the risk among men with obesity (HR = 0.58; 95% CI = 0.36–0.95).

Conclusions
The current study suggests that lowering job strain might be an effective strategy for preventing diabetes among women, especially the high-risk group comprising women with obesity.
Excessiveness in Symptom-Related Thoughts, Feelings, and Behaviors: An Investigation of Somatic Symptom Disorders in the General Population
Authors: Toussaint Anne , Hüsing Paul , Kohlmann Sebastian , Brähler Elmar , Löwe Bernd 
Published: December 2020

ABSTRACT

Objective
The diagnostic criteria of somatic symptom disorder (SSD) emphasize that somatic symptoms receive disease value once they are accompanied by excessive thoughts, feelings, or behaviors. The main objective of this study was to examine what constitutes excessiveness in psychological reactions to somatic complaints and how excessive symptom-related behavior influences self-reported health status and health care utilization.

Methods
A national, representative general population survey was performed between January and March 2016 in Germany, including 2395 individuals older than 13 years. Self-report questionnaires (Somatic Symptom Scale-8, Somatic Symptom Disorder—B Criteria Scale) were used to operationalize the SSD criteria. Group differences in the daily amount of time dedicated to physical complaints were analyzed between individuals with and without SSD. Stepwise linear regression analyses were performed to predict general mental and physical health status, and health care utilization.

Results
There was a significant effect of group (SSD yes/no) in daily time spent on symptoms, after controlling for age, sex, depression, and anxiety (F(1,2336) = 447.53, p < .001). The SSD group (n = 213) reported an average of 4 hours, whereas individuals without SSD reported 30 minutes. Results of the regression analyses showed that the combination of somatic symptoms and symptom-related psychological features is predictive of worsened self-reported physical and mental health status, and increased health care utilization.

Conclusions
A range of 3 to 4 hours per day spent on dealing with physical complaints seems indicative of excessiveness. If, during a clinical consultation, a patient reports such a large amount of time, a more comprehensive clinical examination of SSD should follow.
Prevalence of Depressive Symptoms Among Pregnant and Postpartum Women in China During the COVID-19 Pandemic
Authors: Bo Hai-Xin , Yang Yuan , Chen Jie , Zhang Meng , Li Yilin , Zhang Dong-Ying , Li Ying , Li Rui , Cheung Teris , Ng Chee H. , Wu Xin-Juan , Xiang Yu-Tao 
Published: December 2020

ABSTRACT

Objective
According to recent studies, the COVID-19 pandemic has been associated with an increased risk of mental health problems across many subpopulations including pregnant and postnatal women. This study examined the prevalence and correlates of depressive symptoms (depression hereafter) in Chinese pregnant and postpartum women during the COVID-19 pandemic.

Methods
This was a multicenter, cross-sectional study comprising 1309 pregnant and postpartum women across 12 provinces in China during the COVID-19 pandemic. Depression was assessed using the nine-item Patient Health Questionnaire. Univariate analyses and multivariate logistic regression analyses were conducted.

Results
The prevalence of depression in pregnant and postpartum women was 27.43% (95% confidence interval [CI] = 25.01%–29.85%). Women who were worried about themselves or their babies being infected with COVID-19 (odds ratio [OR] = 2.562, 95% CI = 1.670–3.929), and those who had delayed regular medical checkups (OR = 2.434, 95% CI = 1.580–3.750) were at higher risk of depression. Compared with those living in central and western parts of China, women living in northern (OR = 0.513, 95% CI = 0.326–0.807) and southeastern parts of China (OR = 0.626, 95% CI = 0.463–0.846) were less likely to have depression.

Conclusions
The COVID-19 pandemic was associated with an increased likelihood of mental health problems among pregnant and postnatal women. Over a quarter of the pregnant and postpartum women in China had depression during the COVID-19 pandemic. Considering the negative health impact of depression, preventive measures, regular mental health screening, and medical checkups are needed with the goal to reduce the risk of depression in this vulnerable population during a pandemic.