bluuebunny/crossref_metadata_2025_split huggingface dataset:
Explaining Age Differences in the Motivating Potential of Intergenerational Contact at Work
Authors: Burmeister Anne , Hirschi Andreas , Zacher Hannes 
Published: January 2021

AbstractUnderstanding the effects of intergenerational contact at work is important given aging and increasingly age-diverse workforces. The aim of this research was to better understand who derives motivational benefits from intergenerational contact, and the processes by which this occurs. To do so, we adopted a motivational lens grounded in need-based theories of work motivation and lifespan development theory. We argue that the motivating effect of intergenerational contact on work engagement via sense of belonging is more pronounced for older compared with younger employees due to changes in goal priorities across the lifespan. Specifically, we posit the generativity motive and perceived remaining time at work as lifespan-related mechanisms that explain the moderating effects of age on the links between intergenerational contact and work engagement. In Study 1, a laboratory experiment with 45 younger and 45 older participants in Switzerland, we found support for a causal effect of intergenerational contact on sense of belonging. In Study 2, a three-wave field study with 560 employees in Germany, we found that sense of belonging mediated the relation between intergenerational contact and work engagement. Furthermore, perceived remaining time at work explained the moderating effect of age on the link between sense of belonging and work engagement. By highlighting age differences in the motivating potential of intergenerational contact, we advance research on intergroup contact, employee motivation, and workforce aging.
Repeated colonization of caves leads to phenotypic convergence in catfishes (Siluriformes:Trichomycterus) at a small geographical scale
Authors: Flórez Juan Sebastián , Cadena Carlos Daniel , Donascimiento Carlos , Torres Mauricio 
Published: January 2021

AbstractAcross various animal groups, adaptation to the challenging conditions of cave environments has resulted in convergent evolution. We document a Neotropical cavefish system with ample potential to study questions related to convergent adaptation to cave environments at the population level. In the karstic region of the Andes of Santander, Colombia, cave-dwelling catfish in the genus Trichomycterus exhibit variable levels of reduction of eyes and body pigmentation relative to surface congeners. We tested whether cave-dwelling, eye-reduced, depigmented Trichomycterus from separate caves in Santander were the result of a single event of cave colonization and subsequent dispersal, or of multiple colonizations to caves by surface ancestors followed by phenotypic convergence. Using mitochondrial DNA sequences to reconstruct phylogenetic relationships, we found that caves in this region have been colonized independently by two separate clades. Additional events of cave colonization – and possibly recolonization of surface streams – may have occurred in one of the clades, where surface and cave-dwelling populations exhibit shallow differentiation, suggesting recent divergence or divergence with gene flow. We also identify potentially undescribed species and likely problems with the circumscription of named taxa. The system appears promising for studies on a wide range of ecological and evolutionary questions.
From Burnout to Wholehearted Engagement: A Qualitative Exploration of Psychiatry Residents’ Experience of Stress
Authors: Corgan Sondra , Ford Winkel Abigail , Sugarman Rebekah , Young John Q. 
Published: January 2021

Purpose
Physician burnout is endemic across medical education and has numerous deleterious effects. Given the prevalence and negative effects of burnout, there is an urgent need to understand how residents experience and cope with stress and develop explanatory models that inform the development of more effective interventions.

Method
Using a qualitative, constructivist approach informed by grounded theory, the authors conducted semistructured interviews from March to April 2019, in which psychiatry residents were asked about their experiences of stress and how they coped. First- through fourth-year trainees at Zucker Hillside Hospital at Northwell Health, Glen Oaks, New York, were invited. Two authors independently and inductively coded deidentified transcripts. A constant comparative approach was used to analyze data and support construction of themes. Theoretic sufficiency was observed after 14 interviews.

Results
The authors constructed an explanatory model for how residents cope with stress and whether they tended toward burnout or wholehearted engagement. The model included 3 themes: self-care, work relationships, and meaning making. Self-care, including time spent with others, provided connection and belonging that bolstered physicians’ developing identities. Interpersonal relationships at work profoundly influenced the experience of residents. Positive peer and supervisor relationships enhanced confidence and perseverance. Negative role models and conflict engendered feelings of inadequacy. The ability to shift perspective and build meaning through examining moral values in the face of challenges was crucial for residents who reported success at coping with stress. Residents identified personal psychotherapy as an especially important strategy to facilitate meaning making.

Conclusions
These findings provide guidance for how residency programs may help residents cope with stress and move away from burnout toward wholehearted engagement. Strategies may include reducing barriers to self-care and to accessing help early in training, creating spaces that promote peer connection and providing training in addressing conflict, and facilitating engagement in meaning-making activities.
Chronic Pain in Young Athletes
Authors: Hsu Connie , Loecher Nele , Park Anna L. , Simons Laura E. 
Published: January 2021

Background:
It is common for youth to engage in sport and unfortunately also common for chronic pain to emerge in childhood. The convergence of chronic pain and sports participation in youth has not been extensively studied.

Objective:
The goal of this study was to examine the association between athletic identity (AI) and pain-related distress and functioning in youth with chronic pain.

Participants:
Our cohort consisted of 305 youth ages 8 to 21, 83.6% of whom reported being currently engaged or previously involved in sport. Correlation and regression analyses were completed to evaluate the relationship between AI and pain-related distress and functioning in our cohort of chronic pain patients.

Results:
Children currently involved in sport had higher total AI and social AI, lower fear of pain, and lower functional disability. Greater negative affectivity-AI had the strongest relationship with pain-related distress, including pain catastrophizing, fear and avoidance of pain, and anxiety. Stronger social AI was associated with lower levels of depression and pain-related avoidance of activities. Functional disability was not significantly associated with AI, but was lowest in individuals currently involved in sport.

Conclusion:
Our study provides evidence that focusing on continued sports engagement in the context of chronic pain is associated with less pain-related distress and functional limitations when compared with those who discontinue sports involvement, thus may serve as a buffer in the context of chronic pain. The association of AI with pain-related distress suggests that there is emotional significance in the degree to which youth identify as an athlete. This may be beneficial to clinically assess in youth with chronic pain.
Postpartum-Specific Vital Sign Reference Ranges
Authors: Green Lauren J. , Pullon Rebecca , Mackillop Lucy H. , Gerry Stephen , Birks Jacqueline , Salvi Dario , Davidson Shaun , Loerup Lise , Tarassenko Lionel , Mossop Jude , Edwards Clare , Gauntlett Rupert , Harding Kate , Chappell Lucy C. , Knight Marian , Watkinson Peter J. 
Published: January 2021

OBJECTIVE:
To estimate normal ranges for postpartum maternal vital signs.

METHODS:
We conducted a multicenter prospective longitudinal cohort study in the United Kingdom. We recruited women before 20 weeks of gestation without significant comorbidities and with accurately dated singleton pregnancies. Women recorded their own blood pressure, heart rate, oxygen saturation and temperature daily for 2 weeks postpartum. Trained midwives measured participants' vital signs including respiratory rate around postpartum days 1, 7, and 14.

RESULTS:
From August 2012 to September 2016, we screened 4,279 pregnant women; 1,054 met eligibility criteria and chose to take part. Postpartum vital sign data were available for 909 women (86.2%). Median, or 50th centile (3rd–97th centile), systolic and diastolic blood pressures increased from the day of birth: 116 mm Hg (88–147) and 74 mm Hg (59–93) to a maximum median of 121 mm Hg (102–143) and 79 mm Hg (63–94) on days 5 and 6 postpartum, respectively, an increase of 5 mm Hg (95% CI 3–7) and 5 mm Hg (95% CI 4–6), respectively. Median (3rd–97th centile) systolic and diastolic blood pressure returned to 116 mm Hg (98–137) and 75 mm Hg (61–91) by day 14 postpartum. The median (3rd–97th centile) heart rate was highest on the day of birth, 84 beats per minute (bpm) (59–110) decreasing to a minimum of 75 bpm (55–101) 14 days postpartum. Oxygen saturation, respiratory rate, and temperature did not change in the 2 weeks postbirth. Median (3rd–97th centile) day-of-birth oxygen saturation was 96% (93–98). Median (3rd–97th centile) day-of-birth respiratory rate was 15 breaths per minute (10–22). Median (3rd–97th centile) day-of-birth temperature was 36.7°C (35.6–37.6).

CONCLUSION:
We present widely relevant, postpartum, day-specific reference ranges which may facilitate early detection of abnormal blood pressure, heart rate, respiratory rate, oxygen saturation and temperature during the puerperium. Our findings could inform construction of an evidence-based modified obstetric early warning system to better identify unwell postpartum women.

CLINICAL TRIAL REGISTRATION:
ISRCTN, 10838017.
Comparison of Short-leg and Long-leg Casts for the Treatment of Distal Third Tibial Shaft Fractures in Children
Authors: Barnett Scott A. , Fontenot Bailli , Leonardi Claudia , Gonzales Joseph A. , Gargiulo Dominic , Heffernan Michael J. 
Published: January 2021

Background:
Long-leg casts (LLCs) are an established treatment for pediatric tibial shaft fractures including fractures involving the distal third. There is a paucity of literature assessing the use of short-leg cast (SLC) for tibial shaft fractures. The purpose of this study was to determine if SLC were as effective as LLC for the treatment of pediatric distal third tibial shaft fractures.

Methods:
A retrospective review was conducted on consecutive distal third tibial shaft fractures treated at a tertiary pediatric hospital from 2013 to 2018. Exclusion criteria included midshaft and proximal fractures of the tibia, distal fractures that violated the tibial physis or plafond, and pathologic fractures. We compared primary outcomes of time to weight-bearing, time to union, and final angulation between LLC and SLC groups.

Results:
Eighty-five patients aged 5 to 17 years (mean age: 9.2±3.2 y) met inclusion criteria, including 50 LLC and 35 SLC patients. Time to weight-bearing for SLC (3.3±0.6 wk) was shorter compared with LLC (6.4±0.7 wk, P<0.0001). Overall, fractures treated with SLC had a shorter time to the union (7.4±0.9 wk) compared with LLC (9.0±0.9 wk, P=0.026) without statistical differences in final angulation at the time of union. There was a higher percentage of cast complications in the LLC treatment group (12%) compared with SLC (6%).

Conclusions:
SLC demonstrated earlier time to weight-bearing and shorter time to fracture union when compared with LLC. Surgeons should consider SLC and early weight-bearing for the treatment of distal third tibial shaft fractures in children.

Level of Evidence:
Level III—retrospective comparative study.
Risk Factors for Failure of Cast Treatment in Displaced Pediatric Tibial Shaft Fractures
Authors: Öztürk Alper , Arican Gökhun , Demir Kürşat R. , Şibar Kemal , Ersan Önder , Alemdaroğlu Kadir B. 
Published: January 2021

Background:
As there is a current increasing tendency to treat displaced tibial shaft fractures in adolescents surgically, it has become more important to predict failure of cast treatment for these patients. In the past, redisplacement of pediatric tibial shaft fractures has been reported at rates of 20% to 40%. Although the efficacy of the three-point index (TPI), gap index, and cast index has been demonstrated for upper extremity fractures in children, to date no index has been shown to accurately predict redisplacement for pediatric tibial shaft fractures. The aim of this study was to determine the predictive factors for redisplacement in pediatric tibial shaft fractures.

Methods:
In all, 157 displaced pediatric tibial shaft fractures were evaluated retrospectively. Patient age, initial and postreduction fracture angulation, shortening and translation, quality of reduction, obliquity of fracture, associated fibular fractures, and 3 indices (TPI, cast index, and gap index) were analyzed. Receiver operating characteristic analysis was performed to determine the cutoff points and logistic regression was used to show the risk factors of redisplacement.

Results:
There were 53 female and 104 male patients with a mean age of 9.1 (5 to 15 y) and 45 patients developed redisplacement during the follow-up. Mean TPI and gap index and initial and postreduction fracture translation were higher in patients with redisplacement, while TPI>0.855 and postreduction translation >18% were the only independent risk factors for fracture redisplacement. No differences were observed regarding associated fibular fracture, quality of reduction, initial/postreduction angulation, and shortening.

Conclusions:
The TPI>0.855 and postreduction translation >18% are independent risk factors for redisplacement of tibial shaft fractures in children. Although the gap index can be useful, the cast index is not an appropriate tool for these fractures.
EDF Casting for Early Onset Scoliosis
Authors: Shafer Cody , Mahajan Rajat , Kishan Shyam 
Published: January 2021

Study Design
IRB approved prospective case series.

Objectives
This study attempts to determine the effects of elongation, derotation, and flexion (EDF) casting on pulmonary function. We also attempted to define prognostic factors and determine the ideal amount of traction for casting in patients with early onset scoliosis (EOS).

Summary of Background Data
No literature on effects of serial casting on pulmonary parameters in EOS, or on the ideal amount of traction to be used for EOS Casting.

Methods
Fifty consecutive children with EOS treated by the senior author using EDF casting were studied prospectively. Traction and lung function parameters (compliance, tidal volume, peak inspiratory pressure, and resistance) were measured at different periods during cast application. Etiology, age, weight, Cobb angles, and RVAD were monitored.

Results
All lung function parameters decline during cast application but rise to near baseline levels at the time of next cast application. Near full curve correction was achieved in every patient with (A) idiopathic scoliosis who (B) presented prior to 20 months of age with (C) a moderate main curve at presentation (<45°) and in those (D) without a phase II rib-vertebral relationship at presentation. The best response to casting was seen with 1 pound traction per pound body weight during application.

Conclusion
EDF casting can delay progression or improve curves in patients with larger curves, nonidiopathic scoliosis, and older patients. Idiopathic patients, moderate curve sizes, and younger patients had a better response to casting. Even though lung function declines during cast application, it returns to near baseline levels at the time of the next cast application, suggesting that EDF casting may not have any long-term effects on lung function, and also may protect pulmonary function in EOS from its natural history of progressive deterioration.

Level of Evidence: 4
Cervical Myelopathy
Authors: Lockey Stephen D. , Trent Sarah M. , Kalantar Seyed Babak 
Published: January 2021

Study Design:
This was a narrative review.

Objective:
The aim was to discuss current methods and review updated outcome studies regarding posterior decompression in the management of cervical myelopathy.

Summary of Background Data:
Progressive myelopathy in the cervical segments is an indication for urgent surgical management. Although nonoperative treatment is an option in mild to moderate cases, the majority of patients will experience deterioration in neurological function requiring surgical decompression.

Methods:
A review of the literature was performed using PubMed to provide updated information regarding posterior cervical decompression in the management of myelopathy.

Results:
There are numerous studies comparing outcome data between cervical laminectomy and fusion with laminoplasty. While each technique has advantages and disadvantages, both provide adequate decompression and good long-term outcomes in patients meeting appropriate criteria.

Conclusions:
Posterior decompression is an important approach for spine surgeons to have in their toolkits when treating cervical myelopathy.
Rule 50: A Reproducible Technique to Minimize Graft-tunnel Mismatch During ACL Reconstruction Using Bone-Tendon-Bone (BTB) Graft
Authors: Hazzard Sean , Lonati Danielle , Kolosky Michael , Asnis Peter 
Published: January 2021

Introduction:
The use of bone-tendon-bone grafts are a popular option for anterior cruciate ligament (ACL) reconstruction. Graft-tunnel mismatch is a technical pitfall of using this type of graft.

Objective:
The primary objective of this study was to provide results of a simple technique to minimize graft-tunnel-mismatch that we call “Rule 50.” Rule 50 is a technique of estimating the length of the femoral socket (20 mm) with the length of the native ACL (30 mm) and using this to alter the length of the tibial tunnel using a calibrated drill guide.

Materials and Methods:
Prospectively, 103 consecutive ACL reconstructions (68 autograft, 35 allograft) were analyzed. Any excess graft was cut flush with the distal tibial cortex and measured to evaluate how much graft was implanted and how much was removed.

Results:
At least 20 mm of tibial-sided bone plug from the grafts were implanted 100% of the time (regardless of patient height or total graft length) with an average of 30.63 to 31 mm of tibial bone plug implanted. This accounted for 86% to 92% of the harvested tibial bone plugs, respectively, implanted. Aperture fixation was accomplished in 100% of the cases.

Conclusion:
Rule 50 is a reproducible method to maximize the amount of bone from a bone-tendon-bone graft within the tibial tunnel to minimize graft-tunnel mismatch and can provide a minimum of 20 mm of distal bone 100% of the time.
Life-Threatening Hemoptysis in a Pediatric Referral Center
Authors: Moynihan Katie M. , Ge Shirley , Sleeper Lynn A. , Lu Minmin , Andren Kristofer G. , Mecklosky Jessica , Rahbar Reza , Fynn-Thompson Francis , Porras Diego , Arnold John , Kelly Daniel P. , Agus Michael S. D. , Thiagarajan Ravi R. , Alexander Peta M. A. 
Published: January 2021

OBJECTIVES:
Hemoptysis is uncommon in children, even among the critically ill, with a paucity of epidemiological data to inform clinical decision-making. We describe hemoptysis-associated ICU admissions, including those who were critically ill at hemoptysis onset or who became critically ill as a result of hemoptysis, and identify predictors of mortality.

DESIGN:
Retrospective cohort study. Demographics, hemoptysis location, and management were collected. Pediatric Logistic Organ Dysfunction-2 score within 24 hours of hemoptysis described illness severity. Primary outcome was inhospital mortality.

SETTING:
Quaternary pediatric referral center between July 1, 2010, and June 30, 2017.

PATIENTS:
Medical/surgical (PICU), cardiac ICU, and term neonatal ICU admissions with hemoptysis during or within 24 hours of ICU admission.

INTERVENTIONS:
No intervention.

MEASUREMENTS AND MAIN RESULTS:
There were 326 hemoptysis-associated ICU admissions in 300 patients. Most common diagnoses were cardiac (46%), infection (15%), bronchiectasis (10%), and neoplasm (7%). Demographics, interventions, and outcomes differed by diagnostic category. Overall, 79 patients (26%) died inhospital and 109 (36%) had died during follow-up (survivor mean 2.8 ± 1.9 yr). Neoplasm, bronchiectasis, renal dysfunction, inhospital hemoptysis onset, and higher Pediatric Logistic Organ Dysfunction-2 score were independent risk factors for inhospital mortality (p < 0.02). Pharmacotherapy (32%), blood products (29%), computerized tomography angiography (26%), bronchoscopy (44%), and cardiac catheterization (36%) were common. Targeted surgical interventions were rare. Of survivors, 15% were discharged with new respiratory support. Of the deaths, 93 (85%) occurred within 12 months of admission. For patients surviving 12 months, 5-year survival was 87% (95% CI, 78–92) and mortality risk remained only for those with neoplasm (log-rank p = 0.001).

CONCLUSIONS:
We observed high inhospital mortality from hemoptysis-associated ICU admissions. Mortality was independently associated with hemoptysis onset location, underlying diagnosis, and severity of critical illness at event. Additional mortality was observed in the 12-month posthospital discharge. Future directions include further characterization of this vulnerable population and management recommendations for life-threatening pediatric hemoptysis incorporating underlying disease pathophysiology.
Continuing Education Outcomes for Advance Care Planning: A Systematic Review of the Literature
Authors: Pearse Wendy , Saxon Robyn , Plowman Greg , Hyde Mervyn , Oprescu Florin 
Published: January 2021

Introduction:Advance care planning (ACP) is a process of considering future health and care needs for a time when a person may be unable to speak for themselves. Health professional continuing education programs have been proposed for facilitating patient participation in ACP; however, their impacts on participants, patient and clinical outcomes, and organizational approaches to ACP are not well understood.Methods:This systematic literature review examined interventional studies of education programs conducted with health professionals and care staff across a broad range of settings. Five electronic databases were searched up to June 2020, and a manual search of reference lists was conducted. The quality of studies was appraised by the first, second, and third authors.Results:Of the 7993 articles identified, 45 articles met the inclusion criteria. Program participants were predominantly medical, nursing, and social work staff, and students. Interventions were reported to improve participants' self-perceived confidence, knowledge, and skills; however, objectively measured improvements were limited. Multimodal programs that combined initial didactic teaching and role-play simulation tasks with additional activities were most effective in producing increased ACP activity in medical records. Evidence for improved clinical outcomes was limited.Discussion:Further studies that use rigorous methodological approaches would provide further evidence about what produces improved patient and clinical outcomes. Needs analyses and quality indicators could be considered to determine the most appropriate and effective education resources and monitor their impacts. The potential contribution of a broader range of health professionals and interprofessional learning approaches could be considered to ultimately improve patient care.