bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improved pion mean fields and masses of singly heavy baryons
Authors: Kim June-Young , Kim Hyun-Chul 
Published: March 2020

Abstract
A singly heavy baryon can be viewed as $N_c-1$ ($N_c$ being the number of colors) light valence quarks bound by the pion mean fields that are created by the presence of the $N_c-1$ valence quarks self-consistently, while the heavy quark inside a singly heavy baryon is regarded as a static color source. We investigate how the pion mean fields are created by the presence of $N_c$, $N_c-1$, and $N_c-2$ light valence quarks, which correspond to the systems of light baryons, singly heavy baryons, and doubly heavy baryons. As the number of colors decreases from $N_c$ to $N_c-1$, the pion mean fields undergo changes. As a result, the valence quark contributions to the moments of inertia of the soliton become larger than for $N_c$ valence quarks, whereas the sea quark contributions decrease systematically. On the other hand, the presence of the $N_c-2$ valence quarks is not enough to produce the strong pion mean fields, which leads to the classical soliton not being formed. This indicates that the pion mean-field approach is not suitable to describe doubly heavy baryons. We show that the mass spectra of the singly heavy baryons are better described by the improved pion mean fields, compared with the previous work in which the pion mean fields are assumed to be intact with $N_c$ varied.
Pipeline Risk in Leveraged Loan Syndication
Authors: Bruche Max , Malherbe Frederic , Meisenzahl Ralf R 
Published: March 2020

Abstract
What is the economic role played by arrangers of leveraged loans, and what are the risks they face? We provide evidence that arrangers solve a demand discovery problem. Investors have incentives to feign little interest in the loan to obtain better terms. To deter such behavior, arrangers underprice hot deals and ration investors on cold deals. The risk associated with demand discovery is often shared between borrowers and arrangers. One implication is that to ration investors on cold deals, arrangers retain larger loan shares. This motive for retention is different from the monitoring incentive motive previously considered in the literature.
Distress Related to Attenuated Psychotic Symptoms: Static and Dynamic Association With Transition to Psychosis, Nonremission, and Transdiagnostic Symptomatology in Clinical High-Risk Patients in an International Intervention Trial
Authors: Nelson Barnaby , Yuen Hok Pan , Amminger G Paul , Berger Gregor , Chen Eric Y H , de Haan Lieuwe , Hartmann Jessica A , Hickie Ian B , Lavoie Suzie , Markulev Connie , Mossaheb Nilufar , Nieman Dorien H , Nordentoft Merete , Polari Andrea , Riecher-Rössler Anita , Schäfer Miriam R , Schlögelhofer Monika , Smesny Stefan , Tedja Amy , Thompson Andrew , Verma Swapna , Yung Alison R , McGorry Patrick D 
Published: March 2020

Abstract
This study examined whether distress in relation to attenuated psychotic symptoms (DAPS) is associated with clinical outcomes in an ultra-high risk (UHR) for psychosis sample. We also investigated whether DAPS is associated with cognitive style (attributional style and cognitive biases) and whether amount of psychosocial treatment provided is associated with reduction in DAPS. The study was a secondary analysis of the “Neurapro” clinical trial of omega-3 fatty acids. Three hundred and four UHR patients were recruited across 10 early intervention services. Data from baseline assessment, regular assessments over 12 months, and medium term follow-up (mean = 3.4 years) were used for analysis. Findings indicated: a positive association between DAPS assessed over time and transition to psychosis; a significant positive association between baseline and longitudinal DAPS and transdiagnostic clinical and functional outcomes; a significant positive association between baseline and longitudinal DAPS and nonremission of UHR status. There was no relationship between severity of DAPS and cognitive style. A greater amount of psychosocial treatment (cognitive-behavioral case management) was associated with an increase in DAPS scores. The study indicates that UHR patients who are more distressed by their attenuated psychotic symptoms are more likely to have a poorer clinical trajectory transdiagnostically. Assessment of DAPS may therefore function as a useful marker of risk for a range of poor outcomes. The findings underline the value of repeated assessment of variables and incorporation of dynamic change into predictive modeling. More research is required into mechanisms driving distress associated with symptoms and the possible bidirectional relationship between symptom severity and associated distress.
Psychosis and Comorbid Opioid Use Disorder: Characteristics and Outcomes in Opioid Substitution Therapy
Authors: Lamont Rachel , Rosic Tea , Sanger Nitika , Samaan Zainab 
Published: March 2020

Abstract

Background and Objectives
Substance use disorders are highly prevalent among individuals with psychotic disorders and are associated with negative outcomes. This study aims to explore differences in characteristics and treatment outcomes for individuals with psychotic disorders when compared with individuals with other nonpsychotic psychiatric disorders enrolled in treatment for opioid use disorder (OUD).

Methods
Data were collected from a prospective cohort study of 415 individuals enrolled in outpatient methadone maintenance treatment (MMT). Psychiatric comorbidity was assessed using the Mini-International Neuropsychiatric Interview. Participants were followed for 12 months. Participant characteristics associated with having a psychotic disorder versus another nonpsychotic psychiatric disorder were explored by logistic regression analysis.

Results
Altogether, 37 individuals (9%) with a psychotic disorder were identified. Having a psychotic disorder was associated with less opioid-positive urine drug screens (odds ratio [OR] = 0.97, 95% confidence interval [CI] = 0.95, 0.99, P = .046). Twelve-month retention in treatment was not associated with psychotic disorder group status (OR = 0.73, 95% CI = 0.3, 1.77, P = .485). Participants with psychotic disorders were more likely to be prescribed antidepressants (OR = 2.12, 95% CI = 1.06, 4.22, P = .033), antipsychotics (OR = 3.57, 95% CI = 1.74, 7.32, P = .001), mood stabilizers (OR = 6.61, 95% CI = 1.51, 28.97, P = .012), and benzodiazepines (OR = 2.22, 95% CI = 1.11, 4.43, P = .024).

Discussion and Conclusions
This study contributes to the sparse literature on outcomes of individuals with psychotic disorders and OUD-receiving MMT. Rates of retention in treatment and opioid use are encouraging and contrast to the widely held belief that these individuals do more poorly in treatment. Higher rates of coprescription of sedating and QTc-prolonging medications in this group may pose unique safety concerns.
Social Investment Policy, Economic Growth, and Welfare States: Channels of Pro-Growth Effects of Policy
Authors: Sakamoto Takayuki 
Published: March 2020

AbstractSocial investment (SI) policies have been popular among industrial countries in the past two decades. Governments hope that SI policies will promote productivity and economic growth by creating high-skill labor forces that can adapt to the imperatives of the new knowledge economy and technological advances, or that can create new technologies themselves. They also hope that SI policies will mitigate new social risks, such as single-parent families and workers in precarious employment by better preparing workers for jobs and promoting social inclusion. However, little research exists that empirically investigates whether or not SI policies really produce these positive outcomes. Of all economic outcomes, this paper focuses on economic growth and the channels of economic growth—multifactor productivity (MFP), physical capital investment, and labor input—and investigates whether SI policies promote growth in GDP and its channels. Data from 17 industrial countries are analyzed. The analysis finds that family support, education, and ALMP spending (all measured as spending per child, student, and an unemployed person, respectively) is positively associated with MFP and GDP growth, and that MFP growth is the main channel through which SI policies enhance GDP growth. Education spending boosts the growth of all of MFP, physical capital stock, labor input, and GDP growth via those channels. While family support does not promote the growth of labor input, the results suggest that larger family support spending leads to higher levels of labor input. Overall, these types of SI spending have generally positive effects on economic growth.
Nursing Student Perceptions of Home Visit Simulation Scenarios
Authors: Thompson Cheryl W. , Moscola Stephanie , Buckland Scottie Thompson 
Published: March 2020

Abstract
Ensuring quality clinical placement in community health nursing courses is challenging as faculty cannot observe all nursing students and little consistency is found in student experiences. Simulation can supplement traditional clinical experiences. Two home visit scenarios with learning objectives were developed. Students conducted the scenarios in the role of nurse or nursing student and completed evaluations of the experience. The findings suggest students perceived they were able to meet the learning objectives in each scenario regardless of which role was played. Home visit simulations were beneficial to student learning in the community health nursing course.
Developing Skills Labs for Obstetric and Pediatric Nursing Students
Authors: Allert Jenny , Brunel Mallory 
Published: March 2020

Abstract
Specialty areas of nursing, for example, obstetrics and pediatrics, require a unique set of skills and specialized care. Nursing students often enter these areas for their clinical rotations having had little didactic classroom education. For faculty, it is challenging to prepare students to enter the clinical setting feeling competent, confident, and with the critical thinking skills required for an optimal experience. This article reports on a process to develop a skills lab with both skills and simulation components designed specifically to prepare students to enter the clinical setting with greater competence, confidence, and critical thinking.
A Behavioral Epigenetics Model to Predict Oral Feeding Skills in Preterm Infants
Authors: Griffith Thao , White-Traut Rosemary , Janusek Linda Witek 
Published: March 2020

Background:Preterm infants experience a multitude of prenatal and postnatal stressors, resulting in cumulative stress exposure, which may jeopardize the timely attainment of developmental milestones, such as achieving oral feeding. Up to 70% of preterm infants admitted to the neonatal intensive care unit experience challenges while initiating oral feeding. Oral feeding skills require intact neurobehavioral development. Evolving evidence demonstrates that cumulative stress exposure results in epigenetic modification of glucocorticoid-related genes. Epigenetics is a field of study that focuses on phenotypic changes that do not involve alterations in the DNA sequence. Epigenetic modification of glucocorticoid-related genes alters cortisol reactivity to environmental stimuli, which may influence neurobehavioral development, and is the essence of the evolving field of Preterm Behavioral Epigenetics. It is plausible that early-life cumulative stress exposure and the ensuing epigenetic modification of glucocorticoid-related genes impair neurobehavioral development required for achievement of oral feeding skills in preterm infants.Purpose:The purpose of this article is to build upon the evolving science of Preterm Behavioral Epigenetics and present a conceptual model that explicates how cumulative stress exposure affects neurobehavioral development and achievement of oral feeding skills through epigenetic modification of glucocorticoid-related genes.Methods/Results:Using the Preterm Behavioral Epigenetics framework and supporting literature, we present a conceptual model in which early-life cumulative stress exposure, reflected by DNA methylation of glucocorticoid-related genes and altered cortisol reactivity, disrupts neurobehavioral development critical for achievement of oral feeding skills.Implications for Practice and Research:Future investigations guided by the proposed conceptual model will benefit preterm infant outcomes by introducing epigenetic-based approaches to assess and monitor preterm infant oral feeding skills. Furthermore, the proposed model can guide future investigations that develop and test epigenetic protective interventions to improve clinical outcomes, representing an innovation in neonatal care.
Intraoperative Issues and Clinical and Radiographic Outcomes of Femur Fractures Treated With Flexible Nails: A Comparison of Cases Utilizing Skeletal Traction and a Traction Table to Cases Using Manual Traction Only
Authors: Canavese Federico , Alberghina Flavia , Cravino Mattia , Paonessa Matteo , Dimeglio Alain , Andreacchio Antonio 
Published: March 2020

Introduction:
The use of the orthopaedic traction table (OTT) during elastic stable intramedullary nailing (ESIN) in the management of displaced diaphyseal femur fractures (DFFs) is still debated. In most centers, children with displaced DFF are treated using an OTT. In some other institutions, however, fracture reduction and stabilization by ESIN are performed on a radiolucent table without an OTT. The aim of this study was to evaluate the clinical and radiologic outcome of children with displaced DFF managed by ESIN with and without the use of an OTT.

Methods:
Charts and radiographs were retrospectively reviewed for all pediatric patients sustaining DFF managed by ESIN from 2011 to 2017 at 2 different institutions. In all, 69 consecutive children with displaced DFF were recorded, of whom 35 underwent operative treatment by ESIN with the use of an OTT with skeletal traction (Group A), and 34 by ESIN without OTT (Group B). The titanium elastic nails outcome measure scale score and Beaty radiologic criteria were used to evaluate the results.

Results:
Average patient age at time of injury was 9 years (range, 5 to 13) and 10 years (range, 4 to 15) in Groups A and B, respectively. The mean follow-up was 54 months (range, 24 to 96). Overall, complications were observed in 6 patients (8.6%). Complication rate was higher among children managed without OTT (11.8%) than among children treated with OTT (2.5%); no complication related to pin insertion for skeletal traction was recorded. However, the number of patients with a poor outcome according to the titanium elastic nails outcome score was higher in Group A (20%) than in Group B (5.8%). Beaty radiologic criteria were comparable between the 2 groups. Mean length of surgery and mean cumulative time of radiation exposure during surgery were similar between the 2 groups.

Conclusions:
Overall, both techniques work equally well although patients treated by ESIN with the use of an OTT and skeletal traction tended to have a lower rate of complications and radiologic outcome was worse than for patients treated without using an OTT; however, no statistically significant difference was found.
Despite their limitations, the results of this study suggest that displaced DFF can be safely managed by ESIN with or without the use of intraoperative OTT and skeletal traction, according to the surgeon’s preference. Further studies are now needed to consolidate these conclusions and clarify the role of the OTT.

Level of Evidence:
Level III.
Baseline Patient Characteristics Commonly Captured Before Surgery Do Not Accurately Predict Long-Term Outcomes of Lumbar Microdiscectomy Followed by Physiotherapy
Authors: Willems Stijn J. , Coppieters Michel W. , Rooker Servan , Heymans Martijn W. , Scholten-Peeters Gwendolyne G.M. 
Published: March 2020

Study Design.
Prospective cohort study.

Objective.
To develop and internally validate prognostic models based on commonly collected preoperative data for good and poor outcomes of lumbar microdiscectomy followed by physiotherapy.

Summary of Background Data.
Lumbar microdiscectomy followed by physiotherapy is a common intervention for lumbar radiculopathy. Postoperatively, a considerable percentage of people continues to experience pain and disability. Prognostic models for recovery are scarce.

Methods.
We included 298 patients with lumbar radiculopathy who underwent microdiscectomy followed by physiotherapy. Primary outcomes were recovery and secondary outcomes were pain and disability at 12 months follow-up. Potential prognostic factors were selected from sociodemographic and biomedical data commonly captured preoperatively. The association between baseline characteristics and outcomes was evaluated using multivariable logistic regression analyses.

Results.
At 12 months follow-up, 75.8% of the participants met the criterion for recovery. Variables in the model for good recovery included: younger age, leg pain greater than back pain, high level of disability, and a disc herniation at another level than L3–L4. The model for poor recovery included: lower educational level, prior back surgery, and disc herniation at L3–L4. Following internal validation, the explained variance (Nagelkerke R
2) and area under the curve for both models were poor (≤0.02 and ≤0.60, respectively). The discriminative ability of the models for disability and pain were also poor.

Conclusion.
The outcome of microdiscectomy followed by postoperative physiotherapy cannot be predicted accurately by commonly captured preoperative sociodemographic and biomedical factors. The potential value of other biomedical, personal, and external factors should be further investigated.

Level of Evidence: 3
Burnout in Pediatric Critical Care Medicine Fellows*
Authors: Suttle Markita L. , Chase Margaret A. , Sasser William C. , Moore-Clingenpeel Melissa , Maa Tensing , Werner Jason A. , Bone Meredith F. , Boyer Donald L. , Marcdante Karen J. , Mason Katherine E. , McCabe Megan E. , Mink Richard B. , Su Felice , Turner David A. ,   for the Education in Pediatric Intensive Care (E.P.I.C.) Investigators
Published: March 2020

Objectives:
Assess the overall level of burnout in pediatric critical care medicine fellows and examine factors that may contribute to or protect against its development.

Design:
Cross-sectional observational study.

Setting:
Accreditation Council for Graduate Medical Education-accredited pediatric critical care medicine fellowship programs across the United States.

Subjects:
Pediatric critical care medicine fellows and program directors.

Interventions:
Web-based survey that assessed burnout via the Maslach Burnout Inventory, as well as other measures that elicited demographics, sleepiness, social support, perceptions about prior training, relationships with colleagues, and environmental burnout.

Measurements and Main Results:
One-hundred eighty-seven fellows and 47 program directors participated. Fellows from 30% of programs were excluded due to lack of program director participation. Average values on each burnout domain for fellows were higher than published values for other medical professionals. Personal accomplishment was greater (lower burnout) among fellows more satisfied with their career choice (β 9.319; p ≤ 0.0001), spiritual fellows (β 1.651; p = 0.0286), those with a stress outlet (β 3.981; p = 0.0226), those comfortable discussing educational topics with faculty (β 3.078; p = 0.0197), and those comfortable seeking support from their co-fellows (β 3.762; p = 0.0006). Depersonalization was higher for second year fellows (β 2.034; p = 0.0482), those with less educational debt (β –2.920; p = 0.0115), those neutral/dissatisfied with their career choice (β –6.995; p = 0.0031), those with nursing conflict (β –3.527; p = 0.0067), those who perceived burnout among co-fellows (β 1.803; p = 0.0352), and those from ICUs with an increased number of patient beds (β 5.729; p ≤ 0.0001). Emotional exhaustion was higher among women (β 2.933; p = 0.0237), those neutral/dissatisfied with their career choice (β –7.986; p = 0.0353), and those who perceived burnout among co-fellows (β 5.698; p ≤ 0.0001). Greater sleepiness correlated with higher burnout by means of lower personal accomplishment (r = –1.64; p = 0.0255) and higher emotional exhaustion (r = 0.246; p = 0.0007). Except for tangible support, all other forms of social support showed a small to moderate correlation with lower burnout.

Conclusions:
Pediatric critical care medicine fellows in the United States are experiencing high levels of burnout, which appears to be influenced by demographics, fellow perceptions of their work environment, and satisfaction with career choice. The exclusion of fellows at 30% of the programs may have over or underestimated the actual level of burnout in these trainees.
Early Development of Infants with Turner Syndrome
Authors: Pretzel Rebecca Edmondson , Knickmeyer Rebecca C. , DeRamus Margaret , Duquette Peter , Okoniewski Katherine C. , Reinhartsen Debra B. , Cornea Emil , Gilmore John H. , Goldman Barbara D. , Davenport Marsha L. , Hooper Stephen R. 
Published: March 2020

ABSTRACT:

Objective:
To examine the early cognitive, temperament, and adaptive functioning of infants and toddlers with Turner syndrome (TS).

Methods:
Cognitive abilities were measured using the Mullen Scales of Early Learning at 1 year of age for 31 girls with TS and compared with neurotypical female (N = 53) and male (N = 54) control groups. Temperament (Carey Toddler Temperament Scales) and adaptive functioning (Vineland Adaptive Behavior Scales–Second Edition) were measured at 1 year of age and compared with normative data. An exploratory analysis of cognitive/developmental trajectories was also conducted comparing age 12-month to 24-month time points for 22 TS subjects.

Results:
Infants with TS performed largely within the average range for adaptive behavior, temperament, and early cognitive development with some increased risk for delays in language and significant increased risk for delays in motor skills (p < 0.001). Although exploratory, there was some suggestion of slower rates of progression in fine-motor and visual reception skills from 12 to 24 months of age.

Conclusions:
Infants and toddlers with TS exhibit a relatively positive neurodevelopmental profile overall, with some indication of an increasing gap in function in fine-motor and visual perceptual abilities as compared to neurotypical peers. It is unclear whether these apparent differences represent normal variability in this very young population or, perhaps, are early precursors of later phenotypic characteristics of TS in the school-age and young adult years.