bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reexamining the persisting wage gap between male and female PAs
Authors: McCall Timothy C. , Smith Noël E. 
Published: October 2020

ABSTRACT

Objective:
To determine the magnitude of any difference in total compensation between male and female physician assistants (PAs) after controlling for personal and workplace factors related to compensation.

Methods:
Using data from the 2019 AAPA Salary Survey, the authors conducted a sequential regression analysis to examine the relationship between a variety of personal and practice demographics and total compensation.

Results:
After controlling for compensation-related factors, a wage gap between male and female PAs persisted: female PAs were paid almost $0.93 for every $1 male PAs were paid in the first year of work ($9,010 less). This wage gap widened by $201 for every year of work experience.

Conclusions:
A wage gap between male and female PAs persists even after including all compensation types and controlling for compensation-related factors that may differ between male and female PAs. Proposed policy implications could begin to mitigate the gap.
Benchmarking Critical Care Well-Being: Before and After the Coronavirus Disease 2019 Pandemic
Authors: Gomez Sofia , Anderson Brian J. , Yu Hyunmin , Gutsche Jacob , Jablonski Juliane , Martin Niels , Kerlin Meeta Prasad , Mikkelsen Mark E. 
Published: October 2020

Objectives:
Examine well-being, measured as burnout and professional fulfillment, across critical care healthcare professionals, ICUs, and hospitals within a health system; examine the impact of the coronavirus disease 2019 pandemic.

Design:
To complement a longitudinal survey administered to medical critical care physicians at the end of an ICU rotation, which began in May 2018, we conducted a cross-sectional survey among critical care professionals across four hospitals in December 2018 to January 2019. We report the results of the cross-sectional survey and, to examine the impact of the coronavirus disease 2019 pandemic, the longitudinal survey results from July 2019 to May 2020.

Setting:
Academic medical center.

Subjects:
Four-hundred eighty-one critical care professionals, including 353 critical care nurses, 58 advanced practice providers, 57 physicians, and 13 pharmacists, participated in the cross-sectional survey; 15 medical critical care physicians participated in the longitudinal survey through the coronavirus disease 2019 pandemic.

Interventions:
None.

Measurements and Main Results:
Burnout was present in 50% of ICU clinicians, ranging from 42% for critical care physicians to 55% for advanced practice providers. Professional fulfillment was less common at 37%, with significant variability across provider (p = 0.04), with a low of 23% among critical care pharmacists and a high of 53% among physicians. Well-being varied significantly at the hospital and ICU level. Workload and job demand were identified as drivers of burnout and meaning in work, culture and values of work community, control and flexibility, and social support and community at work were each identified as drivers of well-being. Between July 2019 and March 2020, burnout and professional fulfillment were present in 35% (15/43) and 58% (25/43) of medical critical care physician responses, respectively. In comparison, during the coronavirus disease 2019 pandemic, burnout and professional fulfillment were present in 57% (12/21) and 38% (8/21), respectively.

Conclusions:
Burnout was common across roles, yet differed across ICUs and hospitals. Professional fulfillment varied by provider role. We identified potentially modifiable factors related to clinician well-being that can inform organizational strategies at the ICU and hospital level. Longitudinal studies, designed to assess the long-term impact of the coronavirus disease 2019 pandemic on the well-being of the critical care workforce, are urgently needed.
Resolution of Coronavirus Disease 2019 Infection and Pulmonary Pathology With Nebulized DAS181: A Pilot Study
Authors: Ho Jennifer Hui-Chun , Zhao Yang , Liu Zhenlian , Zhou Xiaoyang , Chen Xiaobei , Xianyu Yunyan , Lewis Stanley , Fan Liya , Tian Yuan , Chang Nancy , Gong Zuojiong , Hu Ke 
Published: October 2020

Objectives:
Severe acute respiratory syndrome coronavirus 2 infections commonly lead to respiratory failure and potentially fatal systemic inflammation and organ failure. Nebulized DAS181, a host-directed biologics with sialidase activity, is an investigational drug with antiviral activities on parainfluenza and influenza under phase 3 and phase 2 development. The objective of this study (NCT04324489) is to investigate the safety and effects of nebulized DAS181 on hypoxic coronavirus disease 2019 patients.

Design:
Single-center, prospective, open-label, compassionate use.

Setting:
Renmin Hospital of Wuhan University, Department of Respiratory and Critical Care Medicine and Department of Infectious Diseases.

Subjects:
Patients 18 to 70 years old who met Chinese criteria for severe coronavirus disease 2019 pneumonia and required supplemental oxygen but not on mechanical ventilator at screening.

Interventions:
Nebulized DAS181 (4.5 mg) twice a day for 10 days.

Measurements and Main Results:
Three male coronavirus disease 2019 hypoxic patients with bilateral lung involvement completed DAS181 treatment for 10 days. By day 14, all achieved return to room air (primary endpoint) and their nasopharyngeal swabs were negative for severe acute respiratory syndrome coronavirus 2. Clinical severity improved from severe coronavirus disease 2019 at baseline to moderate or mild disease by day 5, consistent with rapid reduction of inflammatory cytokines by days 2–3 and radiologic improvement by days 5–10. No DAS181-related adverse events were reported.

Conclusions:
Inhalation of DAS181 was well tolerated and potential clinical benefit of DAS181 on hypoxic coronavirus disease 2019 is the reduction of supplemental oxygen need. Efficacy and safety, including pharmacokinetics and viral studies of DAS181 in severe, hypoxic coronavirus disease 2019, should be examined by a double-blind, randomized controlled study.
Firearm Homicide Incidence, Within-state Firearm Laws, and Interstate Firearm Laws in US Counties
Authors: Morrison Christopher N. , Kaufman Elinore J. , Humphreys David K. , Wiebe Douglas J. 
Published: October 2020

Background:
Firearm homicides occur less frequently in US states with more firearm control laws. However, firearms are easily transported across state lines, and laws in one location may affect firearm violence in another. This study examined associations between within-state firearm laws and firearm homicide while accounting for interference from laws in other nearby states.

Methods:
The units of analysis were 3,107 counties in the 48 contiguous US states, arrayed in 15 yearly panels for 2000 to 2014 (n = 46,605). The dependent measure was firearm homicides accessed from the Centers for Disease Control and Prevention (CDC) Compressed Mortality Data. The main independent measures were counts of firearm laws and the proportion of laws within categories (e.g., background checks, child access prevention laws). We calculated these measures for interstate laws using a geographic gravity function between county centroids. Bayesian conditional autoregressive Poisson models related within-state firearm laws and interstate firearm laws to firearm homicides.

Results:
There were 172,726 firearm homicides in the included counties over the 15 years. States had between 3 and 100 firearm laws. Within-state firearm laws (incidence rate ratio [IRR] = 0.995, 95% confidence interval [CI] = 0.992, 0.997) and interstate firearm laws (IRR = 0.993, 95% CI = 0.990, 0.996) were independently associated with fewer firearm homicides, and associations for within-state laws were strongest where interstate laws were weakest.

Conclusions:
Additional firearm laws are associated with fewer firearm homicides both within the states where the laws are enacted and elsewhere in the United States. Interference from interstate firearm laws may bias associations for studies of within-state laws and firearm homicide.
OPTICAL COHERENCE TOMOGRAPHY FEATURES OF CHOROIDAL NEOVASCULARIZATION AND THEIR CORRELATION WITH AGE, GENDER, AND UNDERLYING DISEASE
Authors: Zicarelli Federico , Azzolini Claudia , Cornish Elisa , Agarwal Aniruddha , Khochtali Sana , Airaldi Matteo , Khairallah Moncef , Viola Francesco , Staurenghi Giovanni , McCluskey Peter , Invernizzi Alessandro 
Published: October 2020

Purpose:
To investigate the influence of age, gender, and underlying disease on the optical coherence tomography (OCT) features of choroidal neovascularization (CNV) secondary to inflammation, myopia (mCNV), and age-related macular degeneration (AMD-CNV).

Methods:
Demographic and clinical data of eyes with treatment-naive inflammatory CNV, mCNV, and Type 2 AMD-CNV were collected. Optical coherence tomography images were reviewed to determine the presence of pitchfork sign, pigment epithelial detachment, subretinal fluid (SRF), intraretinal cysts, subretinal hyperreflective material, atrophy, and outer retinal disruption graded 1 to 4. The influence of demographics and underlying etiology on OCT signs was investigated.

Results:
One hundred and eighty-five eyes from 179 patients were enrolled. The mean [SD] age was 36 [±14.4], 62 [±18], and 77 [±8] for the inflammatory CNV, mCNV, and AMD-CNV, respectively (P < 0.001). Multiple linear regression showed that the presence of pitchfork sign was negatively associated with age (P < 0.0001), regardless of underlying disease. By contrast, the SRF, pigment epithelial detachment, intraretinal cysts, and the outer retinal disruption were all positively influenced by age, regardless of gender and underlying disease (all P < 0.01). Logistic regression showed that none of the OCT signs increased the likelihood for diagnosis of inflammatory CNV. By contrast, the absence of SRF was suggestive for mCNVs, and the presence of pigment epithelial detachment and SRF was suggestive for AMD-CNVs.

Conclusion:
The age of the patient had a significant effect on the OCT appearance of the CNV, particularly the presence of a pitchfork sign, regardless of the underlying etiology. The absence of SRF was suggestive for a diagnosis of mCNVs. The presence of SRF and pigment epithelial detachment was suggestive for AMD-CNVs.
Examination of the clinical factors associated with attendance at emergency departments for chronic pain management and the cost of treatment relative to that of other significant medical conditions
Authors: Higgins Cassie , Smith Blair H. , Colvin Lesley 
Published: October 2020

Abstract
Little is known about risk factors for emergency department (ED) attendance for chronic pain (CP) management and the relative service burden. We examined ED utilisation in patients with CP, identified risk factors associated with attendance for chronic musculoskeletal pain (CMP), and estimated the comparative cost of treatment. The study cohort comprised a random sample of 3700 adults from the general population in Tayside, Scotland. Linked regional extracts, spanning a 12-month period, were obtained from national registers, providing information on ED attendances, community-dispensed prescribing, and outpatient clinic attendances. The National Health Service Scotland Cost Book was used to ascertain the current average cost of an ED attendance (£130; ∼$167). All-cause ED attendance was higher in those with CP (68.5%; n = 252) than without (29.3%; n = 967). In the entire cohort, more patients attended the ED for the treatment of CMP than for any other medical condition (n = 119; 32.3% of those with CP). Risk factors for ED attendance for CMP were: recent analgesic dose decreases (OR = 4.55); and transitioning from opioid to nonopioid analgesics (OR = 5.08). Characteristics protective of ED attendance for CMP were: being in receipt of strong opioids (OR = 0.21); transitioning from nonopioid to opioid analgesics (OR = 0.25); recent analgesic dose increases (OR = 0.24); and being prescribed tricyclic antidepressants (OR = 0.10), benzodiazepines (OR = 0.46), or hypnotics (OR = 0.45). Chronic musculoskeletal pain was one of the most expensive conditions to treat (£17,680 [∼$22,668] per annum), conferring a substantial burden on ED services. Improved understanding of the risk/protective factors could inform healthcare redesign to reduce avoidable ED attendances for CMP management.
Patterns of opioid analgesic use in the U.S., 2009 to 2018
Authors: Woods Corinne , Chai Grace , Meyer Tamra , Staffa Judy , Dal Pan Gerald 
Published: October 2020

Abstract
Although overall outpatient dispensing of opioid analgesic prescriptions has declined, there may still be overprescribing. Understanding how many opioid analgesic units, primarily tablets, are dispensed with the intention of shorter-vs longer-term use can inform public health interventions. We used pharmacy prescription data to estimate the number of opioid analgesic tablets dispensed annually in the U.S. We studied patterns of new use of opioid analgesics by evaluating how many opioid analgesic prescriptions and tablets were dispensed to patients with no opioid analgesic prescriptions in the previous year. Estimated opioid analgesic tablets dispensed declined from a peak of 17.8 billion in 2012 to 11.1 billion in 2018. Patients newly starting opioid analgesics declined from 47.4 million patients in 2011 to 37.1 million patients in 2017. Approximately 40% fewer tablets were dispensed within a year to patients starting in 2017 (2.4 billion) compared with 2011 (4.0 billion). In 2011, patients with ≥5 opioid analgesic prescriptions within a year were dispensed 2.2 billion tablets (55% of all tablets in our study). This declined by 52% to 1.1 billion tablets (44% of all tablets) in 2017. Tablets dispensed within a year to patients with <5 opioid analgesic prescriptions declined by 26% from 2011 to 2017. Patients with ≥5 prescriptions comprised a small and decreasing proportion of all patients newly starting therapy. However, these patients received almost half of all tablets dispensed within a year to patients in our study, despite a larger decline than tablets dispensed to patients with <5 prescriptions within a year.
Somatosensory and psychological phenotypes associated with neuropathic pain in entrapment neuropathy
Authors: Matesanz Luis , Hausheer Andrea C , Baskozos Georgios , Bennett David L.H. , Schmid Annina B. 
Published: October 2020

Abstract
It currently remains unclear why some patients with entrapment neuropathies develop neuropathic pain (neuP), whereas others have non-neuP, presumably of nociceptive character. Studying patients with carpal tunnel syndrome (CTS), this cross-sectional cohort study investigated changes in somatosensory structure and function as well as emotional well-being specific to the presence and severity of neuP. Patients with CTS (n = 108) were subgrouped by the DN4 questionnaire into those without and with neuP. The latter group was further subdivided into mild and moderate/severe neuP using a pain visual analogue scale. N = 32 participants served as healthy controls. All participants underwent a clinical examination, quantitative sensory testing, electrodiagnostic testing (EDT), and skin biopsy to determine the structural integrity of dermal and intraepidermal nerve fibres. Patients also completed questionnaires evaluating symptom severity and functional deficits, pain distribution, sleep quality, and emotional well-being. The overall prevalence of neuP in patients with CTS was 80%, of which 63% had mild neuP. Symptom severity and functional deficits as well as somatosensory dysfunction was more pronounced with the presence and increasing severity of neuP. No difference was identified among patient groups for EDT and nerve fibre integrity on biopsies. The severity of neuP was accompanied by more pronounced deficits in emotional well-being and sleep quality. Intriguingly, extraterritorial spread of symptoms was more prevalent in patients with moderate/severe neuP, indicating the presence of central mechanisms. NeuP is common in patients with CTS, and its severity is related to the extent of somatosensory dysfunction and a compromise of emotional well-being.
Sex differences in brain modular organization in chronic pain
Authors: Fauchon Camille , Meunier David , Rogachov Anton , Hemington Kasey S. , Cheng Joshua C. , Bosma Rachael L. , Osborne Natalie R. , Kim Junseok A. , Hung Peter Shih-Ping , Inman Robert D. , Davis Karen D. 
Published: October 2020

Abstract
Men and women can exhibit different pain sensitivities, and many chronic pain conditions are more prevalent in one sex. Although there is evidence of sex differences in the brain, it is not known whether there are sex differences in the organization of large-scale functional brain networks in chronic pain. Here, we used graph theory with modular analysis and machine-learning of resting-state-functional magnetic resonance imaging data from 220 participants: 155 healthy controls and 65 individuals with chronic low back pain due to ankylosing spondylitis, a form of arthritis. We found an extensive overlap in the graph partitions with the major brain intrinsic systems (ie, default mode, central, visual, and sensorimotor modules), but also sex-specific network topological characteristics in healthy people and those with chronic pain. People with chronic pain exhibited higher cross-network connectivity, and sex-specific nodal graph properties changes (ie, hub disruption), some of which were associated with the severity of the chronic pain condition. Females exhibited atypically higher functional segregation in the mid cingulate cortex and subgenual anterior cingulate cortex and lower connectivity in the network with the default mode and frontoparietal modules, whereas males exhibited stronger connectivity with the sensorimotor module. Classification models on nodal graph metrics could classify an individual's sex and whether they have chronic pain with high accuracies (77%-92%). These findings highlight the organizational abnormalities of resting-state-brain networks in people with chronic pain and provide a framework to consider sex-specific pain therapeutics.
Antinociceptive properties of an isoform-selective inhibitor of Nav1.7 derived from saxitoxin in mouse models of pain
Authors: Beckley Jacob T. , Pajouhesh Hassan , Luu George , Klas Sheri , Delwig Anton , Monteleone Dennis , Zhou Xiang , Giuvelis Denise , Meng Ian D. , Yeomans David C. , Hunter John C. , Mulcahy John V. 
Published: October 2020

Abstract
The voltage-gated sodium channel Nav1.7 is highly expressed in nociceptive afferents and is critically involved in pain signal transmission. Nav1.7 is a genetically validated pain target in humans because loss-of-function mutations cause congenital insensitivity to pain and gain-of-function mutations cause severe pain syndromes. Consequently, pharmacological inhibition has been investigated as an analgesic therapeutic strategy. We describe a small molecule Nav1.7 inhibitor, ST-2530, that is an analog of the naturally occurring sodium channel blocker saxitoxin. When evaluated against human Nav1.7 by patch-clamp electrophysiology using a protocol that favors the resting state, the Kd of ST-2530 was 25 ± 7 nM. ST-2530 exhibited greater than 500-fold selectivity over human voltage-gated sodium channel isoforms Nav1.1–Nav1.6 and Nav1.8. Although ST-2530 had lower affinity against mouse Nav1.7 (Kd = 250 ± 40 nM), potency was sufficient to assess analgesic efficacy in mouse pain models. A 3-mg/kg dose administered subcutaneously was broadly analgesic in acute pain models using noxious thermal, mechanical, and chemical stimuli. ST-2530 also reversed thermal hypersensitivity after a surgical incision on the plantar surface of the hind paw. In the spared nerve injury model of neuropathic pain, ST-2530 transiently reversed mechanical allodynia. These analgesic effects were demonstrated at doses that did not affect locomotion, motor coordination, or olfaction. Collectively, results from this study indicate that pharmacological inhibition of Nav1.7 by a small molecule agent with affinity for the resting state of the channel is sufficient to produce analgesia in a range of preclinical pain models.
Limitations and limits and of vascularized composite allotransplantations: can we reach the holy grail?
Authors: Grajek Maciej , Bula Daniel , Zeman Marcin , Maciejewski Adam 
Published: October 2020

Purpose of review
In recent times, vascularized composite allotransplantation (VCA) have been gaining more attention and applications. Currently, VCA are at the highest level of the reconstruction pyramid, and thus the effects expected after them are intended to outweigh what the ‘classical’ reconstructive surgery can offer us, including even the most advanced microsurgical techniques.

Recent findings
Over 40 patients have received a partial or full-face transplant. Others have received penis, uterus, larynx, abdominal wall, and lower extremity transplants. Each type of VCA has its own problems and limitations. However, resolving the limits defined by immunosuppression and improved donor selection would revolutionize all of them.

Summary
Defining the limits and limitations of given procedures will not only allow for better preparation of transplant teams but will also help in determining the direction of future research.
Internalized Stigma in People With Mood Disorders
Authors: Gomes Dayane Rosa Alvarenga Silva , Zanetti Ana Carolina Guidorizzi , Miasso Adriana Inocenti , Castro Fabiana Faleiros Santana , Vedana Kelly Graziani Giacchero 
Published: October 2020

Abstract
To analyze the predictors of internalized stigma among people with mood disorders, we conducted an analytical observational cross-sectional study with 108 people with mood disorders in a public service setting in Sao Paulo, Brazil. We applied a sociodemographic and clinical questionnaire, the Internalized Stigma of Mental Illness Scale, the Medication Adherence Scale, the Brief Psychiatric Rating Scale–Anchored, and the Herth Hope Index. We analyzed the data using descriptive statistics, average comparison tests, a correlation test, and multiple linear regression. Internalized stigma was associated with symptomatology, history of aggressive behavior, psychiatric hospitalizations, suicide attempts, hopelessness, nonadherence to psychotropic medications, and unemployment. The predictors of internalized stigma were unemployment, more psychiatric symptoms, history of previous suicide attempts, and less hope. Clinical interventions and investigations for stigma reduction and psychosocial rehabilitation should incorporate the factors associated with self-stigma (aggressive behavior, history of psychiatric hospitalizations, suicide attempts, hopelessness, nonadherence to medication, and unemployment).
Preparing Advanced Practice Registered Nursing Students to Provide Primary Palliative Care
Authors: Mazanec Polly , Ferrell Betty , Malloy Pamela , Virani Rose , Cormack Carrie 
Published: October 2020

Background
Advanced practice registered nursing students need primary palliative care education to care for the growing number of patients with serious illness and their families and to fill the serious resource gaps in specialty palliative care.

Problem
There has been a lack of primary palliative care education in most graduate nursing programs and little direction as to competencies and essential content.

Approach
In an effort to support faculty to teach palliative care content, the End-of-Life Nursing Education Consortium (ELNEC) has created an online curriculum that meets the new American Association of Colleges of Nursing Graduate—Competencies and Recommendations for Educating Nursing Students in primary palliative care for master’s degree and doctor of nursing practice students.

Outcomes
During the first 9 months of its release, more than 170 nursing programs have accessed the ELNEC Graduate curriculum, and there have been more than 200 student completions.

Conclusion
Primary palliative care education is essential for all advanced practice nursing students. The new ELNEC Graduate curriculum offers the opportunity to provide quality education remotely.