bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Scoping Review of Burnout in Neurosurgery
Authors: Mackel Charles E , Nelton Emmalin B , Reynolds Renée M , Fox W Christopher , Spiotta Alejandro M , Stippler Martina 
Published: December 2020

AbstractBACKGROUNDBurnout is a negative workplace syndrome of emotional exhaustion, cynicism, and perceived professional inefficacy that risks the patient-provider relationship, patient care, and physician well-being.OBJECTIVETo assimilate the neurosurgical burnout literature in order to classify burnout among domestic and international neurosurgeons and trainees, identify contributory factors, and appraise the impact of wellness programs.METHODSA scoping review identified the available literature, which was reviewed for key factors related to burnout among neurosurgeons. Two researchers queried PubMed, Embase, Google Scholar, Cochrane, and Web of Science for articles on burnout in neurosurgery and reduced 1610 results to 32 articles.RESULTSA total of 32 studies examined burnout in neurosurgery. A total of 26 studies examined prevalence and 8 studies detailed impact of wellness programs. All were published after 2011. Burnout prevalence was measured mostly through the Maslach Burnout Inventory (n = 21). In 4 studies, participants defined their own understanding of “burnout.” Domestically, burnout prevalence was 11.2% to 67% among residents and 15% to 57% among attendings. Among trainees, poor operative experience, poor faculty relationships, and social stressors were burnout risks but not age, sex, or marital status. Among attendings, the literature identified financial or legal concerns, lack of intellectual stimulation, and poor work-life balance as risks. The impact of wellness programs on trainees is unclear but group exercises may offer the most benefit.CONCLUSIONNoticeable methodological differences in studies on trainee and attending burnout contribute to a wide range of neurosurgery burnout estimates and yield significant knowledge gaps. Environment may have greater impact on trainee burnout than demographics. Wellness programs should emphasize solidarity.
Human Immunodeficiency Virus (HIV) and Aging: Multimorbidity in Older People With HIV in One Nonurban Southeastern Ryan White HIV/AIDS Program Clinic
Authors: Arant Elizabeth C , Harding Ceshae , Geba Maria , Targonski Paul V , McManus Kathleen A 
Published: December 2020

Abstract

Background
Age-related chronic conditions are becoming more concerning for people with human immunodeficiency virus (PWH). We aimed to identify characteristics associated with multimorbidity and evaluate for association between multimorbidity and human immunodeficiency virus (HIV) outcomes.

Methods
Cohorts included PWH aged 45–89 with ≥1 medical visit at one Ryan White HIV/AIDS Program (RWHAP) Southeastern HIV clinic in 2006 (Cohort 1) or 2016 (Cohort 2). Multimorbidity was defined as ≥2 chronic diseases. We used multivariable logistic regression to assess for associations between characteristics and multimorbidity and between multimorbidity and HIV outcomes.

Results
Multimorbidity increased from Cohort 1 (n = 149) to Cohort 2 (n = 323) (18.8% vs 29.7%, P &lt; .001). Private insurance was associated with less multimorbidity than Medicare (Cohort 1: adjusted odds ratio [aOR] = 0.15, 95% confidence interval [CI] = 0.02–0.63; Cohort 2: aOR = 0.53, 95% CI = 0.27–1.00). In Cohort 2, multimorbidity was associated with female gender (aOR, 2.57; 95% CI, 1.22–5.58). In Cohort 1, black participants were less likely to be engaged in care compared with non-black participants (aOR, 0.72; 95% CI, 0.61–0.87). In Cohort 2, participants with rural residences were more likely to be engaged in care compared with those with urban residences (aOR, 1.23; 95% CI, 1.10–1.38). Multimorbidity was not associated with differences in HIV outcomes.

Conclusions
Although PWH have access to RWHAP HIV care, PWH with private insurance had lower rates of multimorbidity, which may reflect better access to preventative non-HIV care. In 2016, multimorbidity was higher for women. The RWHAP and RWHAP Part D could invest in addressing these disparities related to insurance and gender.
Reliability and Validity of Physical Tools and Measurement Methods to Quantify Hand Swelling: A Systematic Review
Authors: Llanos Catalina , Gan Ellen Yanxiang , Chen Jophie , Lee Mi-Joung , Kilbreath Sharon L , Dylke Elizabeth S 
Published: December 2020

Abstract

Objective
Hand swelling may result from injury or trauma. Various physical assessment tools and measurement methods can be used to quantify the volume or size of the hand or fingers; however, the reliability and validity of each tool and measurement method have not been evaluated. The purpose of this study was to evaluate the reliability and validity of physical assessment tools and methods used to quantify hand and finger volume orsize.

Methods
MEDLINE, CINAHL, EMBASE, Web of Science, and Scopus were searched using key terms related to swelling, edema, volume, size, hand, measures, reliability, and validity. Cross-sectional or longitudinal studies that assessed reliability and/or validity of physical assessment tools or measurement methods to quantify hand swelling were included. Two examiners independently extracted data from the included articles and appraised the articles’ quality using the Consensus-Based Standards for the Selection of Health Measurement Instruments methodology. Data extracted from studies analyzing reliability and validity were grouped by type of assessment tool and measurement method.

Results
Five physical assessment tools used for quantification of hand swelling were evaluated, including tape measure, water volumeter, bioimpedance spectroscopy, ring gauge, 3-dimensional techniques. All assessment tools had good to excellent reliability (ICC = 0.74 − 0.99), and moderate to high validity (Pearson coefficient = 0.58 − 0.99), for quantification of the volume or size of the hand or fingers.

Conclusion
All measurement methods with these tools had good to excellent reliability and moderate to high validity. The evidence underpinning the figure-of-eight technique, which uses a tape measure, was the highest. Because these physical assessment tools and measurement methods assess different aspects and regions of the hand, which one is selected depends on the region of interest for assessment and the availability of tools.

Impact
Reliable tools and measurement methods are available to measure the size or volume of the hand and fingers, either together or separately. The best tool will depend on the aim of assessment and tool availability.

Lay Summary
Hand swelling can occur with injuries, burns, or lymphedema. This review shows that tools are available to accurately measure swelling in any part of thehand.
A Theory of Narrow Thinking
Authors: Lian Chen 
Published: December 2020

Abstract
Unlike in standard models, decision makers often narrowly bracket and make each decision in isolation. I develop a new approach, which I term narrow thinking, to systematically model narrow bracketing. The definition of narrow thinking is that different decisions are based on different, non-nested, information. As a result, the narrow thinker makes each decision with imperfect knowledge of other decisions and faces difficulties coordinating her multiple decisions. The narrow thinker effectively cares less about her other decisions when making each decision. The main application of narrow thinking is to provide a smooth model of mental accounting without requiring the decision maker to have explicit budgets. My approach generates unique predictions about how the degree of mental accounting depends on expenditure shares and cognitive limitations. It also illustrates how narrow bracketing and mental accounting can be explained by the same underlying friction.
Poor sleep correlates with biomarkers of neurodegeneration in mild traumatic brain injury patients: a CENC study
Authors: Werner J Kent , Shahim Pashtun , Pucci Josephine U , Lai Chen , Raiciulescu Sorana , Gill Jessica M , Nakase-Richardson Risa , Diaz-Arrastia Ramon , Kenney Kimbra 
Published: December 2020

Abstract

Study Objectives
Sleep disorders affect over half of mild traumatic brain injury (mTBI) patients. Despite evidence linking sleep and neurodegeneration, longitudinal TBI-related dementia studies have not considered sleep. We hypothesized that poor sleepers with mTBI would have elevated markers of neurodegeneration and lower cognitive function compared to mTBI good sleepers and controls. Our objective was to compare biomarkers of neurodegeneration and cognitive function with sleep quality in warfighters with chronic mTBI.

Methods
In an observational warfighters cohort (n = 138 mTBI, 44 controls), the Pittsburgh Sleep Quality Index (PSQI) was compared with plasma biomarkers of neurodegeneration and cognitive scores collected an average of 8 years after injury.

Results
In the mTBI cohort, poor sleepers (PSQI ≥ 10, n = 86) had elevated plasma neurofilament light (NfL, x̅ = 11.86 vs 7.91 pg/mL, p = 0.0007, d = 0.63) and lower executive function scores by the categorical fluency (x̅ = 18.0 vs 21.0, p = 0.0005, d = –0.65) and stop-go tests (x̅ = 30.1 vs 31.1, p = 0.024, d = –0.37). These findings were not observed in controls (n = 44). PSQI predicted NfL (beta = 0.22, p = 0.00002) and tau (beta = 0.14, p = 0.007), but not amyloid β42. Poor sleepers showed higher obstructive sleep apnea (OSA) risk by STOP-BANG scores (x̅ = 3.8 vs 2.7, p = 0.0005), raising the possibility that the PSQI might be partly secondary to OSA.

Conclusions
Poor sleep is linked to neurodegeneration and select measures of executive function in mTBI patients. This supports implementation of validated sleep measures in longitudinal studies investigating pathobiological mechanisms of TBI related neurodegeneration, which could have therapeutic implications.
Evaluation of immunoglobulin-Y in place of tylosin phosphate in the diets fed to Holstein Steers and preliminary analysis of liver abscess duration on animal growth performance
Authors: Stotz Miranda K , Henry Darren D , Crossland Whitney L 
Published: December 2020

Abstract
Despite the regular use of feed-grade macrolide-antibiotics, bovine liver abscesses persist, representing a financial burden to pre- and post-mortem sectors of the beef industry. An immunoglobulin-Y (IGY) additive developed to target Fusobacterium necrophorum and Trueperella pyogenes, was evaluated for the control of liver abscesses. Research is needed for the impact of liver abscess severity as well as abscess duration on steer performance and carcass characteristics. Holstein steers (n = 64; initial body weight (BW) = 372.5 ± 2.41 kg) consuming a finishing diet for 188 d were used in a completely randomized design where treatments included: TYL (tylosin phosphate 90 mg/d; n = 32) or IGY (2.5 g/d; n = 32) and steer was the experimental unit. Feed intake was recorded daily while BW and liver ultrasound outcome (normal or abnormal) was recorded every 28 d until slaughter to estimate duration of abscess presence (DUR). Continuous variables of animal growth performance and carcass characteristics were analyzed using the MIXED procedure of SAS. Categorical quality grade and liver data were analyzed using the GLIMMIX procedure of SAS. Treatment did not affect live or carcass-adjusted growth performance (P ≥ 0.131). However, steers fed TYL had greater (P = 0.042) empty body fat (EBF) % and a greater proportion of carcasses grading premium choice than steers fed IGY (P = 0.030). Treatment did not affect prevalence of abscessed livers, abscess severity or estimated abscess duration (P ≥ 0.213) but datasets with greater experimental units are needed to substantiate this outcome. Increasing abscess severity tended (P ≤ 0.10) to linearly reduce carcass-adjusted gain to feed (G:F), fat thickness, and EBF. Carcass dressing % was only affected by severe (A+ and A+AD) abscess scores (P = 0.010). Carcass-adjusted final BW, average daily gain, G:F, and hot carcass weight was decreased only when the estimated DUR was ≥140 d (P ≤ 0.05). Carcass dressing %, however, was linearly affected by estimated liver abscess DUR (P ≤ 0.005), regardless of abscess severity. Preliminary evidence suggests that measuring the duration of liver abscess affliction during the feeding period may also give insight to the degree of performance reduction.
Subjective SES is Associated with Children’s Neurophysiological Response to Auditory Oddballs
Authors: Anwyl-Irvine Alexander L , Dalmaijer Edwin S , Quinn Andrew J , Johnson Amy , Astle Duncan E 
Published: December 2020

AbstractLanguage and reading acquisitions are strongly associated with a child’s socioeconomic status (SES). There are a number of potential explanations for this relationship. We explore one potential explanation—a child’s SES is associated with how children discriminate word-like sounds (i.e., phonological processing), a foundational skill for reading acquisition. Magnetoencephalography data from a sample of 71 children (aged 6 years and 11 months–12 years and 3 months), during a passive auditory oddball task containing word and nonword deviants, were used to test “where” (which sensors) and “when” (at what time) any association may occur. We also investigated associations between cognition, education, and this neurophysiological response. We report differences in the neural processing of word and nonword deviant tones at an early N200 component (likely representing early sensory processing) and a later P300 component (likely representing attentional and/or semantic processing). More interestingly we found “parental subjective” SES (the parents rating of their own relative affluence) was convincingly associated with later responses, but there were no significant associations with equivalized income. This suggests that the SES as rated by their parents is associated with underlying phonological detection skills. Furthermore, this correlation likely occurs at a later time point in information processing, associated with semantic and attentional processes. In contrast, household income is not significantly associated with these skills. One possibility is that the subjective assessment of SES is more impactful on neural mechanisms of phonological processing than the less complex and more objective measure of household income.
Effects of Excessive Choline Administration on Cardiovascular Risk Factors and Hepatic Cholesterol Metabolism in Female SD Rats
Authors: Lim Taehwan , Ryu Juhee , Lee Kiuk , Hwang Keum Taek 
Published: December 2020

Choline has been considered to be linked to an increase of cardiovascular risk. It can be metabolized to trimethylamine by gut microbiota and further converted by hepatic flavin monooxygenase 3 (FMO3) to trimethylamine‐N‐oxide (TMAO) which is known to be a putative promoter of cardiovascular disease. However, the effects of excessive choline administration on the cardiovascular risk, especially in SD rats, have been little studied. The purpose of this study was to evaluate the effects of excessive choline administration on serum TMAO level, aortic wall thickness, and expression of hepatic genes responsible for cholesterol metabolism in female SD rats. Twenty female SD rats were fed AIN93‐G diet with or without various concentrations of choline chloride (1.5%, 2.25%, 3%) (w/w) in autoclaved water for 8 weeks. Aortic wall section of the rat was stained by hematoxylin and eosin. Serum TMAO and choline levels were determined by UPLC‐Synapt G2‐Si. Hepatic mRNA expression of FMO3, farnesoid X receptor (FXR), liver X receptor α (LXRα), sterol regulatory element‐binding protein 2 (SREBP‐2), cholesterol 7 alpha‐hydroxylase (CYP7A1), and low‐density lipoprotein receptor (LDLR) was determined by quantitative PCR. Serum TMAO level was significantly (p<0.05) higher in the rat fed 1.5% choline‐containing water (1.5C) than control group (25.03 ± 14.27 vs. 0.34 ± 0.35 μM). However, serum choline levels were not significantly (p>0.05) different (18.01 ± 7.15 vs. 23.13 ± 11.89 μM). Aortic wall of the 1.5C seemed to be thicker than the control group. Relative mRNA expression of CYP7A1 was down‐regulated in the 1.5C compared to the control group (0.32 ± 0.24 vs. 1.00 ± 0.56, p<0.05), whereas that of FXR was up‐regulated (1.59 ± 0.60 vs. 1.00 ± 0.39, p<0.05). However, mRNA expressions of hepatic FMO3, LDLR, LXRα, and SREBP‐2 were not significantly (p>0.05) different. Excessive choline administration seemed to be able to affect cardiovascular system in female SD rats via production of TMAO and regulation of CYP7A1 and FXR. Additional research about secondary bile acid produced by gut bacteria is needed.Support or Funding InformationThis research has been supported by National Research Foundation of Korea (NRF‐ 2017R1D1A1B03028407) funded by the Ministry of Education of Korea.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.
A single‐dose, microtracer study to determine the mass balance of orally administered, 14C‐labeled sweetener in healthy adult men (LB450)
Authors: Williamson Patricia , Schunk Tim , Woodyer Ryan , Chiuu Daisie , Song Qi , Atiee George , Unger Steve 
Published: December 2020

The objective of this study was to determine the mass balance recovery of a rare sugar, through measurement of absorption, metabolism, and elimination using 14C radio‐labeled tracer with quantification via liquid scintillation counting and accelerator mass spectrometry (AMS). AMS measures isotope ratios to achieve low detection limits, providing quantification of 14C labeled compounds to low attomole levels. Eight healthy male subjects were housed within a metabolic ward for 1 week. The orally administered 776 nCi [14C(U)]‐rare sugar (99% purity), in a beverage containing 15g of unlabeled sweetener was consumed following a light breakfast. Blood, urine, fecal and expired air samples were collected at baseline and at various time points through168 hr for detection of the radiotracer and potential metabolites. Plasma Cmax occurred ~1.5 hours after dosing. Urinary total radioactivity (TRA) was 48.02‐90.25 % of dose over 168hr of collection. There was one subject with a low urine recovery (48.02%) within the first 12hr, possibly due to a missed collection. Fecal TRA (0‐120hr) was 1.79‐5.65 % of dose. Expired air 14C detection over 6hrs was only 0‐0.05% of dose and considered negligible. Overall, TRA 14C recovery was approximately 90%. High performance liquid chromatographic fractions analyzed with AMS showed the majority of the radiotracer was intact (TRA 80.3% plasma; 83.6% urine; 16% fecal). The 14C‐rare sugar was the most abundant compound in the plasma and excreta, demonstrating that this novel sugar is absorbed, but not metabolized.Grant Funding Source: Research supported by Tate & Lyle, Health and Nutrition Sciences.
Supportive Interventions to Reduce Pain and Stress During Ophthalmic Examinations for Retinopathy of Prematurity in Premature Infants
Authors: Pollaci Mikayla , Schlenk Elizabeth A. , Baum Caitlyn , Godfrey Kathleen 
Published: December 2020

Background:
Ophthalmic examinations are a frequent source of pain and stress in premature infants. There is evidence for the use of supportive interventions during infant ophthalmic examinations to reduce pain and stress, but there are no standard recommendations for their implementation.

Purpose:
The purpose of this quality improvement project was to implement evidence-based, supportive interventions during ophthalmic examinations in premature infants and evaluate the impact on pain, oxygen saturation, heart rate, bradycardic events, and neonatal stress cues.

Methods:
A preintervention and intervention group design was used. Primary outcomes were pain and oxygen saturation. Secondary outcomes were heart rate, number of bradycardic events, and number of neonatal stress cues. Independent-sample t tests were used to compare means of the measures in the preintervention and intervention groups.

Results:
Supportive interventions during ophthalmic examinations significantly reduced infant pain (during and after the examination), number of bradycardic events (during and after the examination), and number of neonatal stress cues (before, during, and after the examination). There was also a trend for supportive interventions to decrease pain before the examination.

Implications for Practice:
Supportive interventions during ophthalmic examinations are effective in reducing pain, bradycardic events, and neonatal stress cues in premature infants and can be successfully implemented as part of a unit-based protocol.

Implications for Research:
Future research is needed to determine the long-term outcomes associated with supportive interventions during ophthalmic examinations in premature infants.
Reliability and Validity of the Arabic Version of the Parental Stressor Scale and Nurse Parental Support Tool
Authors: Rabie Dina , Provenzi Livio , Matta Nashwa , Montirosso Rosario 
Published: December 2020

Background:
The admission of a newborn infant to a neonatal intensive care unit (NICU) due to preterm birth or high-risk conditions, such as perinatal injury, sepsis, hypoxia, congenital malformation, or brain injury, is a stressful experience for mothers. There is currently a lack of research on maternal perceived stress and support in Egyptian NICUs and no validated Arabic tool to investigate this further.

Purpose:
To determine the reliability and validity of the Arabic language versions of the Parental Stressor Scale: NICU (PSS:NICU) and the Nurse Parental Support Tool (NPST).

Methods:
Egyptian mothers completed the PSS:NICU and the NPST at the time of their infants' discharge from the NICU. Reliability was assessed with Cronbach α and Spearman-Brown coefficient. The multifactorial structure of the PSS:NICU Arabic version was tested. Associations with sociodemographic and clinical variables were explored with bivariate correlations and t tests.

Results:
Sixty-eight mothers of preterm (PT) infants and 52 mothers of ill full-term (IFT) infants completed the study. Mothers of PT and IFT infants did not differ for sociodemographic variables. High internal consistency (α range between .93 and .96) emerged for both tools. Spearman-Brown coefficients ranged between 0.86 and 0.94. The multidimensional structure of the PSS:NICU was confirmed and 3 core dimensions explained up to 71.48% of the variance. Perceived nursing support did not diminish the effects of stress in mothers of infants admitted to the NICU, regardless of PT or IFT infants' status. A longer NICU stay was associated with greater stress in mothers of PT infants. The presence of comorbidities was significantly associated with stress of mothers of IFT infants.

Implications for Research:
Future research is needed to develop evidence-based support for mothers whose infants are admitted to a NICU in Egypt. The availability of validated and reliable PSS:NICU and NPST scales in Arabic will facilitate cross-country and cross-cultural research on maternal stress in the NICU.

Implications for Practice:
Neonatal care nurses in Egypt will be able to increase their understanding of the stressors experienced by mothers of infants admitted to the NICU. This will in turn enable the introduction of neonatal care policies aimed at reducing specific stressors and provide improved maternal support.