bluuebunny/crossref_metadata_2025_split huggingface dataset:
Making Mothers Stay at Home? Analyzing the Impact of Partisan Cueing on Attitudes Toward Maternal Employment
Authors: Neimanns Erik 
Published: August 2021

Abstract
After decades of value change toward more favorable views of maternal employment, the trend has slowed down and even reversed in some Western countries. This article argues that political parties play a crucial yet neglected role in shaping the trajectories of value change: the dynamics resulting from interparty competition place parties in a position to provide cues to the electorate and to actively shape attitudes toward maternal employment. Partisan cueing should become particularly relevant with a declining relevance of party competition on economic issues. The results from multilevel regression models provide empirical support for this perspective.
Family perceptions related to isolation during COVID-19 hospitalization
Authors: Eden Candace , Fowler Susan B. 
Published: August 2021

Abstract:
During the COVID-19 pandemic, visitor limitations were implemented in hospitals and long-term-care facilities to prevent transmission of the virus from patients to family members. It is unknown how the context of visitor limitations due to COVID-19 influenced the state of emotions and experiences in family members unable to physically visit their loved ones in person during hospitalization. This article details a study of the perceptions of family members related to being isolated from patients who are hospitalized with confirmed positive COVID-19.
Nurses on the front line
Authors: Keeling Arlene W. 
Published: August 2021

Abstract:
Due to advances in science and medicine, nursing is far different today than it was in 1918. During a pandemic, however, skilled nursing care remains critical to patient outcomes. This article identifies and describes the experiences of US nurses during the 1918 influenza pandemic and compares them to the experiences of nurses responding to the COVID-19 pandemic.
Music to reduce stress in hospitalized patients
Authors: Miller Chari R. , Patmon Frances L. , Knapp Herschel 
Published: August 2021

Abstract

Purpose:
To determine the impact of music on the physiologic and psychological stress experienced by hospital inpatients.

Methods:
This pilot study monitored vital signs; utilized pain, anxiety, and agitation rating scales; and gathered verbal feedback from 50 participating inpatients at the authors' healthcare facility as they listened to music via an audiovisual interactive patient engagement technology system.

Results:
After listening to music for 30 minutes, patients reported significantly lower pain and anxiety.

Conclusion:
Music offered a helpful tool to reduce pain and anxiety for patients in the ICU and telemetry units at the authors' healthcare facility. Future research may be geared toward incremental expansion and monitoring of this music intervention in other units.
In the “Shadow of Shame”: A Phenomenological Exploration of the Nature of Shame Experiences in Medical Students
Authors: Bynum William E. , W. Teunissen Pim , Varpio Lara 
Published: August 2021

Purpose
Shame occurs when an individual blames a globally flawed self for a negative outcome. Much of the focus on shame in medical education has been directed toward graduate medical education with less recognition paid to shame occurring in medical school. In particular, while research has explored the triggers of medical students’ shame, little is known about what shame feels like, what it makes an individual want to do, and what perceived effects it causes. Thus, this study asks: After shame has been triggered in medical students, how is it experienced?

Method
The authors selected hermeneutic phenomenology to provide a rich description of the structures and meaning of medical students’ lived experiences of shame. Sixteen medical students from a private medical school in the United States were recruited for the study. Data were collected using one-on-one semistructured interviews and analyzed in accordance with Ajjawi and Higgs’ 6 steps of hermeneutic analysis.

Results
Data analysis yielded component parts of participants’ shame experiences, including affective feelings, physical manifestations, cognitive processes, action tendencies, and effects. Analysis of the relationships among these component parts yielded specific phenomenological structures, including patterns of shame (e.g., chronic shame, flashbacks), self-evaluative processes (e.g., battling voices, skewed frames of reference), and perceived effects of shame (e.g., isolation, psychological distress). An overarching theme of shame as a destabilizing emotion emerged across the dataset.

Conclusions
Shame is a complex emotion in medical students that, through its destabilizing effects, can lead to withdrawal, isolation, psychological distress, altered professional identity formation, and identity dissonance. The authors highlight the possibility that shame may be occurring as a response to educational trauma, present a metaphor of dominoes to conceptualize the destabilizing nature of shame, and outline the implications for individuals and institutions in medical education.
“When No One Sees You as Black”: The Effect of Racial Violence on Black Trainees and Physicians
Authors: Wyatt Tasha R. , Taylor Taryn R. , White DeJuan , Rockich-Winston Nicole 
Published: August 2021

Purpose
The United States has an implicit agreement known as the racial contract that exists between white and non-white communities. Recently, the racial contract has produced much tension, expressed in racial violence and police brutality. This study explores how this racial violence and police brutality have affected the practice and education of Black trainees and physicians who are members of the racial community being targeted.

Method
This qualitative cross-sectional study interviewed 7 Black trainees and 12 physicians from 2 Southern medical schools in 2020. Interview data were collected using aspects of constructivist grounded theory, and then analyzed using the concept of racial trauma; a form of race-based stress minoritized individuals experience as a result of inferior treatment in society. Data were then organized by the causes participants cited for feeling unsafe, conditions they cited as producing these feelings, and the consequences these feelings had on their education and practice.

Results
The results show that even though participants were not direct victims of racial violence, because their social identity is linked to the Black community, they experienced these events vicariously. The increase in racial violence triggered unresolved personal and collective memories of intergenerational racial trauma, feelings of retraumatization after more than 400 years of mistreatment, and an awakening to the fact that the white community was unaware of their current and historical trauma. These events were felt in both their personal and professional lives.

Conclusions
As more minoritized physicians enter medicine and medical education, the profession needs a deeper understanding of their unique experiences and sociohistorical contexts, and the effect that these contexts have on their education and practice. While all community members are responsible for this, leaders play an important role in creating psychologically safe places where issues of systemic racism can be addressed.
Development and Validation of a Machine Learning-Based Decision Support Tool for Residency Applicant Screening and Review
Authors: Burk-Rafel Jesse , Reinstein Ilan , Feng James , Kim Moosun Brad , Miller Louis H. , Cocks Patrick M. , Marin Marina , Aphinyanaphongs Yindalon 
Published: August 2021

Purpose
Residency programs face overwhelming numbers of residency applications, limiting holistic review. Artificial intelligence techniques have been proposed to address this challenge but have not been created. Here, a multidisciplinary team sought to develop and validate a machine learning (ML)-based decision support tool (DST) for residency applicant screening and review.

Method
Categorical applicant data from the 2018, 2019, and 2020 residency application cycles (n = 8,243 applicants) at one large internal medicine residency program were downloaded from the Electronic Residency Application Service and linked to the outcome measure: interview invitation by human reviewers (n = 1,235 invites). An ML model using gradient boosting was designed using training data (80% of applicants) with over 60 applicant features (e.g., demographics, experiences, academic metrics). Model performance was validated on held-out data (20% of applicants). Sensitivity analysis was conducted without United States Medical Licensing Examination (USMLE) scores. An interactive DST incorporating the ML model was designed and deployed that provided applicant- and cohort-level visualizations.

Results
The ML model areas under the receiver operating characteristic and precision recall curves were 0.95 and 0.76, respectively; these changed to 0.94 and 0.72, respectively, with removal of USMLE scores. Applicants’ medical school information was an important driver of predictions—which had face validity based on the local selection process—but numerous predictors contributed. Program directors used the DST in the 2021 application cycle to select 20 applicants for interview that had been initially screened out during human review.

Conclusions
The authors developed and validated an ML algorithm for predicting residency interview offers from numerous application elements with high performance—even when USMLE scores were removed. Model deployment in a DST highlighted its potential for screening candidates and helped quantify and mitigate biases existing in the selection process. Further work will incorporate unstructured textual data through natural language processing methods.
Eco-Normalization: Evaluating the Longevity of an Innovation in Context
Authors: Hamza Deena M. , Regehr Glenn 
Published: August 2021

Purpose
When initiating an educational innovation, successful implementation and meaningful, lasting change can be elusive. This elusiveness stems from the difficulty of introducing changes into complex ecosystems. Program evaluation models that focus on implementation fidelity examine the inner workings of an innovation in the real-world context. However, the methods by which fidelity is typically examined may inadvertently limit thinking about the trajectory of an innovation over time. Thus, a new approach is needed, one that focuses on whether the conditions observed during the implementation phase of an educational innovation represent a foundation for meaningful, long-lasting change.

Method
Through a critical review, authors examined relevant models from implementation science and developed a comprehensive framework that shifts the focus of program evaluation from exploring snapshots in time to assessing the trajectory of an innovation beyond the implementation phase.

Results
Durable and meaningful “normalization” of an innovation is rooted in how the local aspirations and practices of the institutional system and the people doing the work interact with the grand aspirations and features of the innovation. Borrowing from Normalization Process Theory, the Consolidated Framework for Implementation Research, and Reflexive Monitoring in Action, the authors developed a framework, called Eco-Normalization, that highlights 6 critical questions to be considered when evaluating the potential longevity of an innovation.

Conclusions
When evaluating an educational innovation, the Eco-Normalization model focuses our attention on the ecosystem of change and the features of the ecosystem that may contribute to (or hinder) the longevity of innovations in context.
Desmoplakin and clinical manifestations of desmoplakin cardiomyopathy
Authors: Yuan Zhong-Yu , Cheng Li-Ting , Wang Ze-Feng , Wu Yong-Quan 
Published: August 2021

Abstract
Desmoplakin (DSP), encoded by the DSP gene, is the main desmosome component and is abundant in the myocardial tissue. There are three DSP isoforms that assume the role of supporting structural stability through intercellular adhesion. It has been found that DSP regulates the transcription of adipogenic and fibrogenic genes, and maintains appropriate electrical conductivity by regulating gap junctions and ion channels. DSP is essential for normal myocardial development and the maintenance of its structural functions. Studies have suggested that DSP gene mutations are associated with a variety of hereditary cardiomyopathy, such as arrhythmia cardiomyopathy, dilated cardiomyopathy (DCM), left ventricular noncompaction, and is also closely associated with the Carvajal syndrome, Naxos disease, and erythro-keratodermia-cardiomyopathy syndrome with skin and heart damage. The structure and function of DSP, as well as the clinical manifestations of DSP-related cardiomyopathy were reviewed in this article.
Combination strategies of immunotherapy in non-small cell lung cancer: facts and challenges
Authors: Li Chu-Ling , Song Yong 
Published: August 2021

Abstract
Immunotherapy has dramatically altered the treatment of non-small cell lung cancer. Currently, the emergence of combination strategies in immunotherapy has brightened the prospects of improved clinical outcomes and manageable safety profiles in the first/second-line settings. However, sub-optimal response rates are still observed in several clinical trials. Hence, alternative combination models and candidate selection strategies need to be explored. Herein, we have critically reviewed and commented on the published data from several clinical trials, including combined immunotherapy and chemotherapy, anti-angiogenic agents, epidermal growth factor receptor/anaplastic lymphoma kinase tyrosine kinase inhibitors, radiotherapy, and other immune checkpoint inhibitors.
Impact of Surgeon Type and Rurality on Treatment and Survival of Ovarian Cancer Patients
Authors: Weeks Kristin S. , Lynch Charles F. , West Michele M. , Carnahan Ryan M. , O’Rorke Michael A. , Oleson Jacob J. , McDonald Megan E. , Charlton Mary E. 
Published: August 2021

Background:
National Comprehensive Cancer Network guidelines recommend ovarian cancer patients receive cancer-directed surgery from a gynecologic oncologist surgeon. We aimed to determine if rurality impacts type of surgeon and estimate if the interaction between rurality and type of surgeon impacts cytoreductive surgery, chemotherapy initiation, and survival.

Methods:
Our population-based cohort of Iowan (N=675) ovarian cancer patients included women diagnosed with histologically confirmed stages IB-IV cancer in 2010 to 2016 at the ages of 18 to 89 years old and who received cancer-directed surgery in Iowa. Multivariable logistic regression analysis and Cox proportional hazards models were used.

Results:
Rural (vs. urban) patients were less likely to receive surgery from a gynecologic oncologist (adjusted odds ratio [OR]: 0.48; 95% confidence interval [CI]: 0.30-0.78). Rural patients with a gynecologic oncologist (vs. nongynecologic oncologist) surgeon were more likely to receive cytoreduction (OR: 2.84; 95% CI: 1.31-6.14) and chemotherapy (OR: 4.22; 95% CI: 1.82-9.78). Gynecologic oncologist-provided surgery conferred a 3-year cause-specific survival advantage among rural patients (adjusted hazard ratio: 0.57; 95% CI: 0.33-0.97) and disadvantage among urban patients (hazard ratio: 1.77; 95% CI: 1.02-3.06) in the model without treatment covariates. Significance dissipated in models with treatment variables.

Discussion:
The variation in the gynecologic oncologist survival advantage may be because of treatment, referral, volume, or nongynecologic oncologist surgeons’ specialty difference by rurality. This is the first study to investigate the ovarian cancer survival advantage of having a gynecologic oncologist surgeon by rurality.
SARS-CoV-2: An Empirical Investigation of Rose’s Population-based Logic
Authors: Bruckner Tim , Das Abhery , Singh Parvati , Boden-Albala Bernadette 
Published: August 2021

Background:
Geoffrey Rose’s paper “Sick Individuals, Sick Populations” highlights the counterintuitive finding that the largest share of morbidity arises from populations engaging in low- to moderate-risk behavior. Scholars refer to this finding as the prevention paradox. We examine whether this logic applies to SARS-CoV-2 infected persons considered low to moderate risk.

Methods:
We conducted a population-representative survey and sero-surveillance study for SARS-CoV-2 among adults in Orange County, California. Participants answered questions about health behaviors and provided a finger-pin-prick sample from 10 July to 16 August 2020.

Results:
Of the 2979 adults, those reporting low- and moderate-risk behavior accounted for between 78% and 92% of SARS-CoV-2 infections. Asymptomatic individuals, as well as persons with low and moderate scores for self-reported likelihood of having had SARS-CoV-2, accounted for the majority of infections.

Conclusions:
Our findings support Rose’s logic, which encourages public health measures among persons who self-identify as unlikely to have SARS-CoV-2. See video abstract at, http://links.lww.com/EDE/B860.
Reference values of central blood pressure and central haemodynamic parameters and their relationship with cardiovascular risk factors in a Spanish population: early vascular ageing study
Authors: Gómez-Sánchez Marta , Gómez-Sánchez Leticia , Patino-Alonso Carmen , Recio-Rodríguez Jose I. , Alonso-Domínguez Rosario , Sánchez-Aguadero Natalia , Sánchez Cristina Lugones , Sánchez Emiliano Rodríguez , García-Ortiz Luis , Gomez-Marcos Manuel A. 
Published: August 2021

Objectives:
Central blood pressure (BP) predicts mortality independent of office brachial BP. The aim was to describe reference values for central blood pressure and pulsatile hemodynamic parameters, and their relationship with cardiovascular risk factors in an adult Spanish population without cardiovascular disease.

Methods:
Cross-sectional study. We included 501 participants stratified by age and sex by random sampling, with a mean age of 56 years (50.3% women). The SphygmoCor System device's pulse wave analysis software was used to perform the measurements.

Results:
The following values were obtained: central blood pressure median (109/76 mmHg), central pulse pressure (33 mmHg), pulse pressure amplification (8.5 mmHg), ejection duration (130 ms) and subendocardial viability ratio (163%). All parameters were greater in men, except heart rate and ejection duration. In the logistic regression analysis, controlled for age, sex and taking antihypertensive drugs, being hypertensive was associated with cSBP (OR = 1.265), cDBP (OR = 1.307), cPP (OR = 1.067), pulse wave amplification (OR = 1.034) and SEVR (OR = 0.982); being diabetic was associated with SEVR (OR = 0.982); being obese was associated with cSBP (OR = 1.028) and cDBP (OR = 1.058) and being a smoker was associated with ejection duration (OR = 0.980) and SEVR (OR = 0.984).

Conclusion:
This study provides reference values for central blood pressure and parameters derived from the pulse wave analysis in a random sample of the Spanish population. The only risk factor that is not associated with any of the parameters analysed is dyslipidaemia.

Trial registration number:

https://clinicaltrials.gov/ct2/show/NCT02623894
Oxidative stress is associated with characteristic features of the dysfunctional chronic pain phenotype
Authors: Bruehl Stephen , Milne Ginger , Schildcrout Jonathan , Shi Yaping , Anderson Sara , Shinar Andrew , Polkowski Gregory , Mishra Puneet , Billings Frederic T. 
Published: August 2021

AbstractThe dysfunctional chronic pain (Dysfunctional CP) phenotype is an empirically identifiable CP subtype with unclear pathophysiological mechanisms that cuts across specific medical CP diagnoses. This study tested whether the multidimensional pain and psychosocial features that characterize the dysfunctional CP phenotype are associated broadly with elevated oxidative stress (OS). Measures of pain intensity, bodily extent of pain, catastrophizing cognitions, depression, anxiety, sleep disturbance, pain interference, and function were completed by 84 patients with chronic osteoarthritis before undergoing total knee arthroplasty. Blood samples were obtained at the initiation of surgery before incision or tourniquet placement. Plasma levels of F2-isoprostanes and isofurans, the most highly specific measures of in vivo OS, were quantified using gas chromatography/negative ion chemical ionization mass spectrometry. The results indicated that controlling for differences in age, sex, and body mass index, higher overall OS (mean of isoprostanes and isofurans) was associated with significantly (P< 0.05) greater pain intensity, more widespread pain, greater depressive symptoms and pain catastrophizing, higher pain interference, and lower function. OS measures were not significantly associated with sleep disturbance or anxiety levels (P>0.10). The results build on prior case-control findings suggesting that presence of a CP diagnosis is associated with elevated OS, highlighting that it may specifically be individuals displaying characteristics of the dysfunctional CP phenotype who are characterized by elevated OS. Clinical implications of these findings remain to be determined.
Evaluation of placebo fidelity and trial design methodology in placebo-controlled surgical trials of musculoskeletal conditions: a systematic review
Authors: Anderson David B. , Beard David J. , Sabet Tamer , Eyles Jillian P. , Harris Ian A. , Adie Sam , Buchbinder Rachelle , Maher Christopher G. , Ferreira Manuela L. 
Published: August 2021

Abstract
The number of placebo surgical trials on musculoskeletal conditions is increasing, but little is known about the quality of their design and methods. This review aimed to (1) assess the level of placebo fidelity (ie, degree to which the placebo control mimicked the index procedure) in placebo trials of musculoskeletal surgery, (2) describe the trials' methodological features using the adapted Applying Surgical Placebo in Randomised Evaluations (ASPIRE) checklist, and (3) describe each trial's characteristics. We searched 4 electronic databases from inception until February 18, 2021, for randomised trials of surgery that included a placebo control for any musculoskeletal condition. Protocols and full text were used to assess placebo fidelity (categorised as minimal, low, or high fidelity). The adapted 26-item ASPIRE checklist was also completed on each trial. PROSPERO registration number: CRD42021202131. A total of 30,697 studies were identified in the search, and 22 placebo-controlled surgical trials of 2045 patients included. Thirteen trials (59%) included a high-fidelity placebo control, 7 (32%) used low fidelity, and 2 (9%) minimal fidelity. According to the ASPIRE checklist, included trials had good reporting of the “rationale and ethics” (68% overall) and “design” sections (42%), but few provided enough information on the “conduct” (13%) and “interpretation and translation” (11%) of the placebo trials. Most trials sufficiently reported their rationale and ethics, but interpretation and translation are areas for improvement, including greater stakeholder involvement. Most trials used a high-fidelity placebo procedure suggesting an emphasis on blinding and controlling for nonspecific effects.