bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examining the measurement equivalence of the Maslach Burnout Inventory across age, gender, and specialty groups in US physicians
Authors: Brady Keri J. S. , Sheldrick R. Christopher , Ni Pengsheng , Trockel Mickey T. , Shanafelt Tait D. , Rowe Susannah G. , Kazis Lewis E. 
Published: June 2021

Abstract
Background
Disparities in US physician burnout rates across age, gender, and specialty groups as measured by the Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI) are well documented. We evaluated whether disparities in US physician burnout are explained by differences in the MBI’s functioning across physician age, gender, and specialty groups.

Methods
We assessed the measurement equivalence of the MBI across age, gender, and specialty groups in multi-group item response theory- (IRT-) based differential item functioning (DIF) analyses using secondary, cross-sectional survey data from US physicians (n = 6577). We detected DIF using two IRT-based methods and assessed its impact by estimating the overall average difference in groups’ subscale scores attributable to DIF. We assessed DIF’s practical significance by comparing differences in individuals’ subscale scores and burnout prevalence estimates from models unadjusted and adjusted for DIF.

Results
We detected statistically significant age-, gender-, and specialty- DIF in all but one MBI item. However, in all cases, average differences in expected subscale-level scores due to DIF were < 0.10 SD on each subscale. Differences in physicians’ individual-level subscale scores and burnout symptom prevalence estimates across DIF- adjusted and unadjusted IRT models were also small (in all cases, mean absolute differences in individual subscale scores were < 0.04 z-score units; prevalence estimates differed by < 0.70%).

Conclusions
Age-, gender-, and specialty-related disparities in US physician burnout are not explained by differences in the MBI’s functioning across these demographic groups. Our findings support the use of the MBI as a valid tool to assess age-, gender-, and specialty-related disparities in US physician burnout.
Endotension: twenty years of a controversial term
Authors: Torres-Blanco Álvaro , Miralles-Hernández Manuel 
Published: June 2021

AbstractUse of the term endotension in the treatment of aortic aneurysm is currently controversial. Initially it was proposed to define the circumstance in which there is an enlargement of the aneurysm sac after endovascular repair without a demonstrable endoleak. The term was established with the aim of transmitting the possibility of causes other than pressure applying stress to the aneurysm wall. Twenty years have passed since the proposal of this terminology was published. The literature is reviewed with the purpose of providing an update on advances in the knowledge of the possible etiological mechanisms. The experimental studies call into question that causes other than pressure determine the increase of the aneurysm. On the basis of this review, the term `Sac Expansion Without Evident Leak´ (SEWEL) is proposed as a more accurate and precise denomination for what is aimed to be defined. Evidence suggests that the more likely mechanisms of persistent pressurization of the aneurysm sac are an unidentified endoleak (likely type I or low-flow Type II) or thrombus occluding wide and short channels that connects with the excluded aneurysm sac (at the attachment sites of the stent-graft or at the branch vessels orifices).
Sacroiliitis in children and adolescents with familial Mediterranean fever
Authors: Kaçmaz Hülya , Aldemir Esin , Tanatar Ayşe , Karadağ Şerife Gül , Çakan Mustafa , Sönmez Hafize Emine , Ayaz Nuray Aktay 
Published: June 2021

Abstract
Background
Familial Mediterranean fever (FMF) is an autoinflammatory disease characterized by recurrent episodes of fever and serositis. Sacroiliitis can be observed in some FMF patients. This study aimed to compare the demographic, clinical, and laboratory findings, and treatment in children with FMF and sacroiliitis, and children with juvenile spondyloarthropathy (JSpA).

Methods
In total, 1687 pediatric FMF patients that were followed-up between May 2010 and June 2020 were evaluated retrospectively. Among them, those with sacroiliitis (n = 63) were included in the study and compared to patients with JSpA (n = 102).

Results
The study included 63 FMF patients with sacroiliitis (38 males [60.3%] and 25 females [39.7%]) with a mean age of 15.2 ± 4.1 years. Mean age at symptom onset was 7.2 ± 5.05 years and mean age at diagnosis was 9.74 ± 4.67 years. The most common mutation in the FMF patients was M694V/M694V (n = 22). Patients were diagnosed with sacroiliitis with a mean of 12 months (range: 6–36 months) after the diagnosis of FMF. Among the FMF patients, 28 (44.4%) had enthesitis, 23 (36.5%) had heel pain, and 11 (17.4%) had low back pain. The study also included 102 JSpA patients (90 males [88.2%] and 12 females [11.8%]). Mean age of patients with JSpA was 16.1 ± 2.8 years. As compared to 102 JSpA patients, patients with FMF and sacroiliitis had higher acute phase reactants, whereas HLA-B27 positivity rate was lower. In addition, axial involvement rate was higher in the JSpA patients.

Conclusion
Sacroiliitis is a common co-morbidity in FMF patients. The phenotypic features of these patients are different from patients with JSpA.
Translation, cultural adaptation and reproducibility of a Portuguese version of the Functional Index for Hand OsteoArthritis (FIHOA)
Authors: de Azevedo Francisco Vileimar Andrade , Rocha Hermano Alexandre Lima , Jones Anamaria , Natour Jamil , da Rocha Francisco Airton Castro 
Published: June 2021

Abstract
Background
The Functional Index for Hand Osteoarthritis (FIHOA) is a simple, reliable, and reproducible specific instrument to evaluate hand OA that can be applied both in clinical practice and research protocols. In order to be used in Brazil, FIHOA has to be translated into Portuguese, culturally adapted and have the reliability of the translated FIHOA version tested, which is the purpose of this study.

Methods
The FIHOA was translated into Brazilian Portuguese and administered to 68 patients with hand OA recruited between May 2019 and February 2020. The test-retest was applied to 32 patients and the reliability was assessed using Spearman’s correlation coefficient and intraclass correlation coefficient (ICC). The internal consistency reliability was evaluated using Cronbach’s alpha. External construction validity was assessed using the Spearman’s correlation test between FIHOA and pain, assessed with a Visual Analogue Scale (VAS), the Cochin Hand Functional Scale (CHFS) and Health Assessment Questionnaire (HAQ).

Results
The 30 participants that initially answered the translated version of the FiHOA did not report difficulties in understanding or interpreting the translated version. The test-retest reliability for the total score was strong (r = 0.86; ICC = 0.89). Mean differences (1.37 ± 0.68) using Bland Altman’s analysis did not significantly differ from zero and no systematic bias was observed. Cronbach’s alpha was also high (0.89) suggesting a strong internal coherence in the test items. There were also correlations between FIHOA and the CHFS (r = 0.88), HAQ (r = 0.64) and pain in the hands both at rest (r = 0.55) and in motion (r = 0.44).

Conclusion
The translation of the FIHOA into Brazilian Portuguese proved a valid instrument for measuring the functional capacity of patients with hand OA who understand Brazilian Portuguese.
Consumption of spices and ethnic contamination in the daily diet of Italians - consumers’ preferences and modification of eating habits
Authors: Chironi Stefania , Bacarella Simona , Altamore Luca , Columba Pietro , Ingrassia Marzia 
Published: June 2021

AbstractCurrently, consumers appear to have diversified characteristics with regard to food tastes and consumption habits. The globalization of markets and the migration phenomenon contributed to the modification of food preferences of consumers who gradually introduce into their eating habits foods and recipes typical of the tradition of foreign countries. In this scenario, also in Italy, it is going to increase the use of “foreign products” with the consequent fusion of traditional cuisine techniques and recipes with ingredients that are typical of foreign countries and cultures. Foods and ingredients originally consumed in Asian or South American countries are increasingly consumed by Italian people, who have notoriously a strong “food identity,” who generally follow the Mediterranean Diet, and who consume typical products of the country. More particularly, the use of “new” or “novel” spices compared to those traditionally used in the preparation of Italian food has grown in the last 10 years. This study is an exploratory survey on the consumption of spices in Sicily (Southern Italy), which is an Italian Region with a high level of immigrated people and a good level of social integration and progressive inclusion. The objective of this study is to know whether and how Sicilian consumers’ consumption preferences, use, and purchasing behaviors with regard to spices changed in the last few years. The results highlight an increasing use of novel spices for the preparation of the traditional recipes and a good appreciation by consumers. These results are interesting because they provide information about spices’ market development and food product marketing and internationalization. The survey gives interesting inputs for reflections about the relationship between food contaminations and social integration and insight into consumers’ preferences in Italy.
Retrieval and repositioning of an embolized atrial septal defect closure device using a gooseneck snare
Authors: Batta Akash , Naganur Sanjeev , Rajan Ajay , Ary Kunwer Abhishek , Gawalkar Atit , Barwad Parag 
Published: June 2021

Abstract
Background
Closure of all haemodynamically significant atrial septal defects (ASDs) is recommended irrespective of symptoms. Percutaneous device closure offers a favourable alternative to surgery with lower morbidity, shorter duration of hospital stays, and avoidance of a surgical scar. Though device closure is generally a safe procedure with high success rates, certain complications can arise including device embolization which poses a significant challenge for the treating team.
We report one such case in which the ASD closure device got spontaneously released and embolized from the delivery cable into the left atrium prior to its deployment. We describe our approach for its retrieval and subsequently its successful deployment across the septal defect using a gooseneck snare.

Case presentation
A 5-year-old asymptomatic child was found to have a murmur on a routine check-up. Evaluation revealed a haemodynamically significant, 18-mm ostium secundum ASD with normal pulmonary pressures and suitable margins for device closure. A 20-mm ASD closure device was traversed via an 8-Fr delivery system. While manipulating the left atrial (LA) disc from the right upper pulmonary vein (RUPV) approach, the device got spontaneously released. The right atrial (RA) disc was caught across the ASD, into the left atrium. This was confirmed by intraoperative transthoracic echocardiography and fluoroscopy. The haemodynamics and rhythm were stable. A 20-mm gooseneck snare was immediately passed through the delivery sheath and an attempt was made to catch the screw. With difficulty, the RA screw was caught with the snare and multiple attempts to retrieve the device into the sheath were unsuccessful. However, while negotiating, we were able to secure a favourable position of the device across the atrial septal defect, and after fluoroscopic and echocardiographic confirmation, the device was released. The child remained stable thereafter and was discharged 2 days later.

Conclusions
Gooseneck snare is a valuable tool in the management of embolized ASD closure device. Occasionally, like in the index case, one may be successful in retrieving the embolized device and repositioning it across the ASD using a gooseneck snare, thus obviating the need for emergency surgery.
A more practical guide to incorporating health equity domains in implementation determinant frameworks
Authors: Woodward Eva N. , Singh Rajinder Sonia , Ndebele-Ngwenya Phiwinhlanhla , Melgar Castillo Andrea , Dickson Kelsey S. , Kirchner JoAnn E. 
Published: June 2021

AbstractBackgroundDue to striking disparities in the implementation of healthcare innovations, it is imperative that researchers and practitioners can meaningfully use implementation determinant frameworks to understand why disparities exist in access, receipt, use, quality, or outcomes of healthcare. Our prior work documented and piloted the first published adaptation of an existing implementation determinant framework with health equity domains to create the Health Equity Implementation Framework. We recommended integrating these three health equity domains to existing implementation determinant frameworks: (1) culturally relevant factors of recipients, (2) clinical encounter or patient-provider interaction, and (3) societal context (including but not limited to social determinants of health). This framework was developed for healthcare and clinical practice settings. Some implementation teams have begun using the Health Equity Implementation Framework in their evaluations and asked for more guidance.MethodsWe completed a consensus process with our authorship team to clarify steps to incorporate a health equity lens into an implementation determinant framework.ResultsWe describe steps to integrate health equity domains into implementation determinant frameworks for implementation research and practice. For each step, we compiled examples or practical tools to assist implementation researchers and practitioners in applying those steps. For each domain, we compiled definitions with supporting literature, showcased an illustrative example, and suggested sample quantitative and qualitative measures.ConclusionIncorporating health equity domains within implementation determinant frameworks may optimize the scientific yield and equity of implementation efforts by assessing and ideally addressing implementation and equity barriers simultaneously. These practical guidance and tools provided can assist implementation researchers and practitioners to concretely capture and understand barriers and facilitators to implementation disparities.
Ethnopharmacological uses, phytochemistry, pharmacology, and toxicology of Olax subscorpioidea Oliv (Olacaceae): a review
Authors: Ahmad Mubarak Hussaini , Jatau Abubakar Ibrahim , Alshargi Omar Yahya , Julde Sa’adatu Muhammad , Mohammed Mustapha , Muhammad Surajuddeen , Mustapha Sagir , Bala Auwal Adam , Wada Abubakar Sadiq , Aminu Musa , Usman Abba Musab 
Published: June 2021

Abstract
Background
The plant Olax subscorpioidea Oliv (Olacaceae) is a shrub that is widely available in Africa. It has been used in traditional medicine to treat various diseases including asthma, pain, inflammation, gastrointestinal and central nervous system (CNS) disorders, cough, diabetes mellitus, cancer, infectious diseases, hepatic diseases, and many other diseases. Several phytochemical and pharmacological investigations were conducted on this plant. However, comprehensive information on this medicinally important plant is not available in the literature. Therefore, in this review, we aimed to provide comprehensive and critical information on all the reported ethnomedicinal uses, phytochemistry, pharmacological activities, and potential toxicity of Olax subscorpioidea to highlight its therapeutic potentials based on traditional usage and identify research gaps as a basis for further investigations to develop novel therapeutic compounds.

Main body
The available information about the plant was retrieved from the online bibliographic databases (PubMed and Google Scholar) and published PhD dissertation using the search terms Olax subscorpioidea, traditional uses, ethnomedicinal uses, phytochemistry, pharmacology, toxicology, and safety. Phytochemical studies have shown that the plant contains several bioactive compounds such as rutin, morin, quercetin, caffeic acid, santalbic acid, n-hexadecanoic acid, squalene, nonacosane, hentriacontane, and many more compounds. Also, pharmacological investigations revealed that Olax subscorpioidea has antidepressant, antiepileptic, anti-Alzheimer’s, cytotoxic, antioxidant, antihyperlipidemic, analgesic, antiinflammatory, antiarthritic, antidiabetic, anticancer, antiulcer, antimicrobial, hepatoprotective, apoptotic, antiprotease, and other CNS effects.

Conclusion
Several pharmacological studies on Olax subscorpioidea have established its ethnopharmacological uses. However, there are limited phytochemical and pharmacological studies to validate other folkloric claims of the plant. Therefore, extensive phytochemical and further pre-clinical efficacy and safety evaluations to fully establish its therapeutic potentials and elucidate its mechanisms of pharmacological actions could be necessary.

Graphical abstract
Comparative study between conventional adenoidectomy and adenoidectomy using micro-debrider
Authors: Abo Elmagd Essam A. , Khalifa Mahmoud S. , Abeskharoon Beshoy K. , El Tahan Abdelrahman A. 
Published: June 2021

Abstract
Background
Adenoidectomy is a common ENT procedure. This article aims to evaluate micro-debrider-assisted adenoidectomy as a substitute for the conventional curettage method.

Results
The study aimed to compare between two study groups: micro-debrider-assisted adenoidectomy (group A) and conventional adenoidectomy (group B). The average time needed in group A was 34.1 min while it was 22.83 min in group B (p<0.001). The average amount of blood lost in group A was 29.57 ml and 16.67 ml in group B (p<0.001). The resection was nearly complete in group A, while in group B, five (16.66%) cases had more than 50% of the adenoid tissue left behind. Four cases in group B had damage to collaterals while in group A no major injuries were noted. Postoperative pain has only been studied in cases where adenoidectomy solely was done. Candidates in group A (n=8) reported a pain score of 3.5-3.09 whereas candidates in group B (n=11) reported a pain score of 2.75-2.55. The mean recovery time was 2.8 days in group A and 8.23 days in group B (p<0.001).

Conclusions
Endoscopic adenoidectomy using micro-debrider is both an effective and safe adenoidectomy tool. The strengths of this technique include resection completeness, precise resection under vision, minor damage to collaterals, and a more rapid recovery period. Conventional adenoidectomy, however, scored better regarding lesser operative time and bleeding intraoperatively.
Coblation-assisted excision of hypopharyngeal venous malformation: a case report
Authors: Kumar Amit , Subash Anand , Singh Abhijeet , Patro Sourabha , Bakshi Jaimanti 
Published: June 2021

Abstract
Background
Adult hypopharyngeal venous malformations are rare. Unlike hemangiomas, venous malformations require surgical excision wherever feasible. We describe the case of a hypopharyngeal venous malformation and use of coblation to achieve complete excision.

Case presentation
A 28-year-old male presented to the emergency department with sudden-onset hematemesis, and melena for 3 days. Examination revealed a broad-based reddish polypoidal lesion (mulberry like) arising from the left aryepiglottic fold and medial wall of the pyriform sinus. Contrast-enhanced magnetic resonance scan and angiogram of the neck was done, which revealed an intensely enhancing vascular lesion. He underwent a selective embolization of the feeder vessels achieving 80% reduction in the post run blush. We excised the lesion in toto using coblation considering its superior hemostatic control and maneuverability.

Conclusion
The use of coblation is a relatively safe and easy technique to learn and perform in management of vascular tumor of hypopharynx and upper airway. When appropriately performed, it provides a bloodless field and causes minimal damage to surrounding tissue. However, knowledge of external approaches is mandatory for management of complications.
Evaluating the frequency of anatomical variations of the sinonasal region in pediatric and adult age groups according to gender: computed tomography findings of 1532 cases
Authors: Bora Adem , Koç Merve , Durmuş Kasım , Altuntas Emine Elif 
Published: June 2021

Abstract
Background
The aim of the present study was to evaluate retrospectively the frequency of anatomical variations in sinonasal region, which were frequently seen in our cases, for whom coronal section paranasal computed tomography imaging (CPNCT) was taken, as well as the correlation of these variations with age and gender and correlations of identified anatomical variations with one another.
In the study, CBCT scans of a total of 1532 (825 males and 707 females) cases were evaluated in order to determine the prevalence of anatomical variations of the nasal cavity and paranasal sinuses. All the images were taken by a multi-detector CT device (Aquilion, Toshiba medical system, Tokyo, Japan).

Results
Most frequently detected three anatomical variations were septum deviation (79.7%), concha bullosa (40.9%), and ethmoid bulla (21.0%) according to the frequency order. When the frequency of anatomical variations was evaluated according to gender, septum deviation, concha bullosa, and anterior clinoid process pneumatization were more frequently observed in males and Onodi cell in females (p < 0.05).
When the relationships of the anatomical variations with one another were evaluated, it was found that the possibility of the presence of concha bullosa in the septum deviation cases and the presence of ethmoid bulla in the cases with Haller cell septum were higher (p < 0.05).
In terms of the anatomical variations that were evaluated by taking age as the independent variable, a statistically significant difference was observed in pterygoid process pneumatization, Haller cell, pneumatized crista galli, ethmoid bulla, and paradoxical middle concha between the adult and children age groups (p < 0.05).

Conclusion
In terms of the frequency of occurrence to various sinonasal region variations, statistically significant differences were observed between both genders and age groups. The correlations of the detected variations with each other were also remarkable. Consequently, it is believed that comprehensive studies and serious objective evaluations evaluating the change of frequency of anatomical variations according to age and gender besides their correlation with each other are required.
Incremental dynamic analysis of the long-span continuous beam bridge considering the fluctuating frictional force of rubber bearing
Authors: Liao Man , Wu Bin , Zeng Xianzhi , Deng Kailai 
Published: June 2021

AbstractIn the seismic design of long-span bridges, the classic bi-linear model was used to simulate the frictional restoring force of the rubber bearings. However, in actual earthquake, the rubber bearing suffered fluctuating axial pressure in earthquake, even separated from the beam when vertical component of the earthquake was too strong. Employing the bi-linear model for the bearing may incorrectly estimate the seismic response of the bearings, as well as the whole bridge. This paper developed a nonlinear frictional bearing model, which can consider the variation of the frictional restoring force in the bearings, even the separation with the beam in vertical directions. A typical continuous beam bridge was modeled in ABAQUS, and incremental dynamic analysis was conducted for the quantitative comparison of the seismic responses using different bearing models. The intensity measure was selected as the ratio of the peak ground acceleration (PGA) in the vertical direction to the PGA in the horizontal direction. The analysis results indicated that the different bearing model led to the significant different seismic response for the bearings and piers, even the vertical component was small. The bi-linear bearing model would underestimate the seismic demand of the bearing and piers.