bluuebunny/crossref_metadata_2025_split huggingface dataset:
Burnout and Physician Gender
Authors: Hoff Timothy , Lee Do R. 
Published: June 2021

Purpose:
Burnout (BO) is a serious phenomenon affecting US physicians. Female physicians, now accounting for a larger share of the workforce, are thought to experience higher levels of BO in some situations compared with their male counterparts. The current review aimed to systematically examine extant literature on physician BO as it relates especially to the female physician.

Methods:
Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided search of 4 databases yielding empirical studies with relevant findings regarding female physician BO, published during the time period 2010−2019.

Results:
A total of 43 studies were included in the current review. Both male and female doctors have higher percentages of burned out doctors, with a third or more of each group indicating BO in each of the studies examined. These higher levels of BO remained regardless of where physicians worked, their clinical specialty, workloads, or age. However, the review supports the notion that for women doctors, there is generally a higher likelihood of experiencing BO compared with male doctors, particular with respect to the emotional exhaustion dimension of BO.

Conclusions:
BO is important for both female and male physicians; although women doctors may experience it to a greater degree. Women doctors will benefit from talent management approaches by health care organizations that recognize their greater tendency to BO compared with men. These approaches should be aimed at ameliorating the factors that give rise to feelings of emotional exhaustion in particular. Additional research is needed to better understand the full extent to which physician gender plays a role in BO.
Changes in Opioid Prescribing Following the Implementation of State Policies Limiting Morphine Equivalent Daily Dose in a Commercially Insured Population
Authors: Heins Sara E. , Castillo Renan C. 
Published: June 2021

Background:
Prescription opioid mortality doubled 2002–2016 in the United States. Given the association between high-dose opioid prescribing and opioid mortality, several states have enacted morphine equivalent daily dose (MEDD) policies to limit high-dose prescribing. The study objective is to evaluate the impact of state-level MEDD policies on opioid prescribing among the privately insured.

Methods:
Claims data, 2010–2015 from 9 policy states and 2 control states and a comparative interrupted time series design were utilized. Primary outcomes were any monthly opioid use and average monthly MEDD. Stratified analyses evaluated theorized weaker policies (guidelines) and theorized stronger policies (passive alert systems, legislative acts, and rules/regulations) separately. Patient groups explicitly excluded from policies (eg, individuals with cancer diagnoses or receiving hospice care) were also examined separately. Analyses adjusted for covariates, state fixed effects, and time trends.

Results:
Both guideline and strong policy implementation were both associated with 15% lower odds of any opioid use, relative to control states. However, there was no statistically significant change in the use of high-dose opioids in policy states relative to control states. There was also no difference in direction and significance of the relationship among targeted patient groups.

Conclusions:
MEDD policies were associated with decreased use of any opioids relative to control states, but no change in high-dose prescribing was observed. While the overall policy environment in treatment states may have discouraged opioid prescribing, there was no evidence of MEDD policy impact, specifically. Further research is needed to understand the mechanisms through which MEDD policies may influence prescribing behavior.
The history of nasal reconstruction
Authors: Shaye David A. 
Published: June 2021

Purpose of review
Total nasal reconstruction is a unique plastic surgery challenge of the highest order. The history of nasal reconstruction dates back to ancient times and it remains a fundamental challenge today. This article reviews the historical context of nasal reconstruction, and highlights how the essential tenets of this art have been conserved over millennia.

Recent findings
The disfiguring and brutal practice of nasal amputation created a demand for ‘nosemakers’ in India since 1500 BC. In 600 BC, Sushruta described the use of a leaf to make a template of the wound, and a cheek flap to supply tissue. In the 1400–1500s, the Italians relied on similar flap concepts, but employed a pedicled arm flap for soft tissue coverage. Eventually, the forehead flap, or ‘Indian method’ of nasal reconstruction, made its way to Europe in the 1800s. Its use has been a fundamental component of nasal reconstruction to this day.

Summary
Knowledge of the unique history of nasal reconstruction permits appreciation of this surgical integration of art and science. The story of nasal reconstruction has been one of global contribution and creativity that has stood the test of time.
Emergence of Hepatitis C Virus Genotype 2c Infection Among Human Immunodeficiency Virus–Infected Men Who Have Sex With Men in Tokyo, Japan
Authors: Okamoto Koh , Yamada Norie , Suzuki Tomohiko , Muramatsu Takashi , Uemura Haruka , Gatanaga Hiroyuki , Kato Takanobu , Hatakeyama Shuji 
Published: June 2021

Abstract
We report on hepatitis C virus genotype 2c infection in 12 human immunodeficiency virus–infected men who have sex with men in Tokyo, Japan. The uncommon strains from the 12 patients were genetically clustered; they suggested an emerging outbreak in this population at high risk of sexually transmitted infections.
Personalized Telerehabilitation for a Head-mounted Low Vision Aid: A Randomized Feasibility Study
Authors: Lorenzini Marie-Céline , Wittich Walter 
Published: June 2021

ABSTRACT

SIGNIFICANCE
A recent trend in low vision rehabilitation has been the use of portable head-mounted displays to enhance residual vision. Our study confirms the feasibility of telerehabilitation and informs the development of evidence-based recommendations to improve telerehabilitation interventions to reduce device abandonment.

PURPOSE
To develop evidence-based recommendations for telerehabilitation, we conducted a feasibility study in preparation for a future randomized trial on the use of head-mounted displays.

METHODS
We recruited novice eSight Eyewear users, randomized 1:1: the experimental group received telerehabilitation by a low vision therapist using video conferencing; the control group completed at home self-training provided by the device manufacturer. The primary feasibility outcomes were whether the recruitment goal of 60 participants (30/group) was attainable within 1 year and how participants judged the accessibility and acceptability of the telerehabilitation. An exploratory outcome was the impact of telerehabilitation on eSight Eyewear use behavior.

RESULTS
Among 333 eSight users, 57 participants were enrolled, of which 35% withdrew from the study, whereas the remainder completed the 6-month follow-up. The withdrawal rate was higher in the control group but did not differ significantly from the experimental group. High accessibility (93% of participants accessed the platform) and global acceptability (100% overall satisfaction) were reported among those who completed the telerehabilitation protocol. The therapist had no difficulty judging the participants' reading performances qualitatively while participants used their device to read their eSkills and VisExc guides. Most participants improved their daily activities, based on qualitative reports of the attained goals. Seventy-nine percent of individuals declined to participate, whereas 16% of participants decided not to use eSight Eyewear anymore.

CONCLUSIONS
The data demonstrated the feasibility of a randomized controlled telerehabilitation study for people with low vision using a head-mounted display. Positive feedback from the participants and the therapist suggests the potential value of this modality for low vision services.
Plasma microRNAs are associated with domain-specific cognitive function in people with HIV
Authors: Massanett Aparicio Julissa , Xu Yanxun , Li Yuliang , Colantuoni Carlo , Dastgheyb Raha , Williams Dionna W. , Asahchop Eugene L. , McMillian Jacqueline M. , Power Christopher , Fujiwara Esther , Gill M. John , Rubin Leah H. 
Published: June 2021

Objective:
Cognitive impairment remains common in people with HIV (PWH) on antiretroviral therapy (ART). The clinical presentation and severity are highly variable in PWH suggesting that the pathophysiological mechanisms of cognitive complications are likely complex and multifactorial. MicroRNA (miRNA) expression changes may be linked to cognition as they are gene regulators involved in immune and stress responses as well as the development, plasticity, and differentiation of neurons. We examined plasma miRNA expression changes in relation to domain-specific and global cognitive function in PWH.

Design:
Cross-sectional observational study.

Methods:
Thirty-three PWH receiving care at the Southern Alberta Clinic, Canada completed neuropsychological (NP) testing and blood draw. Plasma miRNA extraction was followed by array hybridization. Random forest analysis was used to identify the top 10 miRNAs upregulated and downregulated in relation to cognition.

Results:
Few miRNAs were identified across cognitive domains; however, when evident a miRNA was only associated with two or three domains. Notably, miR-127–3p was related to learning/memory and miR-485–5p to motor function, miRNAs previously identified in CSF or plasma in Alzheimer's and Parkinson's, respectively. Using miRNET 2.0, a software-platform for understanding the biological relevance of the miRNA-targets (genes) relating to cognition through a network-based approach, we identified genes involved in signaling, cell cycle, and transcription relating to executive function, learning/memory, and language.

Conclusion:
Findings support the idea that evaluating miRNA expression (or any molecular measure) in the context of global NP function might exclude miRNAs that could be important contributors to the domain-specific mechanisms leading to the variable neuropsychiatric outcomes seen in PWH.
Can We Predict Incorrect PrEP Use in High HIV Risk Situations Among Men Who Have Sex With Men? An Analysis of Be-PrEP-ared, the Belgian PrEP Demonstration Study
Authors: Vuylsteke Bea , Reyniers Thijs , Nöstlinger Christiana , Smekens Tom , Kenyon Chris , Laga Marie 
Published: June 2021

Background:
Pre-exposure prophylaxis (PrEP) efficacy for HIV prevention is highly correlated with the degree of adherence. The objective of this analysis was to identify PrEP users who did not correctly take their dose in high HIV exposure situations and to explore potential predictors of this behavior.

Methods:
Study participants completed a personal Web‐based diary during their entire follow-up, providing daily information on pill intake and sexual activity. They also completed a sociobehavioral questionnaire. The association between the number of unprotected high HIV exposure sex days (as a measure for suboptimal adherence) and potential predicting factors was examined using a logistic regression, followed by a negative binomial regression model. We also constructed a risk index score for predicting poor adherence.

Results:
A total of 40.8% of participants did not correctly use PrEP in at least one situation of high HIV exposure during follow-up. Not having a HIV-negative steady partner, reporting more than 10 occasional or more than 10 anonymous partners, using chemsex drugs, receiving money for sex, and a history of more than one sexually transmitted infection were significantly associated with unprotected high HIV exposure sex. The risk index score yielded a poor discriminative power (area under the curve 0.62 and 0.64).

Conclusions:
We observed a high proportion of suboptimal adherence. Even if none of the participants acquired HIV during the study, tailored adherence support is needed to specific men who have sex with men such as those taking chemsex drugs and those engaging in paid sex.
Update on cytomegalovirus in transplant recipients: new agents, prophylaxis, and cell-mediated immunity
Authors: Manuel Oriol , Avery Robin K. 
Published: June 2021

Purpose of review
This review is an overview of recent advances in diagnostics, therapies, and prevention strategies for cytomegalovirus (CMV), focusing on solid-organ transplant and hematopoietic stem cell transplant recipients.

Recent findings
A randomized trial of prophylaxis vs preemptive therapy in donor-seropositive, recipient-seronegative liver transplant recipients found significantly less CMV disease in the preemptive group. Maribavir has shown promise for the treatment of resistant/refractory CMV and for uncomplicated CMV DNAemia. A post hoc mortality analysis, as well as emerging reports of real-world and off-label use, have expanded the spectrum of clinical experience with letermovir. The first interventional trials using CMV cell-mediated immune assays have been published and showed promising results for delineating antiviral strategies. New data from additional interventional trials are expected soon.

Summary
The past 1–2 years have seen major developments in the area of CMV management in transplant recipients. Expanding diagnostic and therapeutic capabilities provide a foundation for optimizing strategies in the future, to reduce morbidity and mortality from CMV.
Different Appearances of 3 Malignancies in 68Ga-PSMA-11 Versus 18F-FDG PET/CT
Authors: Weitzer Friedrich , Nazerani-Hooshmand Tina , Aigner Reingard Maria , Pernthaler Birgit 
Published: June 2021

Abstract
Prostate-specific membrane antigen (PSMA) overexpression has been described in various malignancies. Hereby we present a case of a 69-year-old man simultaneously diagnosed with prostate cancer, esophageal adenocarcinoma, and HCC (hepatocellular carcinoma). 18F-FDG PET/CT showed pathological uptake in the esophageal adenocarcinoma and the primary prostate tumor, whereas 68Ga-PSMA-11 PET/CT performed for staging of the histopathologically confirmed prostate cancer revealed the primary tumor and significant uptake in the HCC. This finding is remarkable because the high physiological liver uptake of 68Ga-PSMA-11 may hamper the detection of small lesions.
Out-of-Hospital Cardiac Arrest Bystander Defibrillator Search Time and Experience With and Without Directional Assistance: A Randomized Simulation Trial in a Community Setting
Authors: Johnson Anna M. , Cunningham Christopher J. , Zégre-Hemsey Jessica K. , Grewe Mary E. , DeBarmore Bailey M. , Wong Eugenia , Omofoye Fola , Rosamond Wayne D. 
Published: June 2021

Introduction
Probability of survival after out-of-hospital cardiac arrest (OHCA) doubles when a bystander initiates cardiopulmonary resuscitation and uses an automated external defibrillator (AED) rapidly. National, state, and community efforts have increased placement of AEDs in public spaces; however, bystander AED use remains less than 2% in the United States. Little is known about the effect of giving bystanders directional assistance to the closest public access AED.

Methods
We conducted 35 OHCA simulations using a life-sized manikin with participants aged 18 through 65 years who searched for public access AEDs in 5 zones on a university campus. Zones varied by challenges to pedestrian AED acquisition and number of fixed AEDs. Participants completed 2 searches—first unassisted and then with verbal direction to the closest AED—and we compared AED delivery times. We conducted pretest and posttest surveys.

Results
In all 5 zones, the median time from simulated OHCA onset to AED delivery was lower when the bystander received directional assistance. Time savings (minutes:seconds) varied by zone, ranging from a median of 0:53 (P = 0.14) to 3:42 (P = 0.02). Only 3 participants immediately located the closest AED without directional assistance; more than half reported difficulty locating an AED.

Conclusions
These findings may inform strategies to ensure that AEDs are consistently marked and placed in visible, accessible locations. Continued emphasis on developing strategies to improve lay bystanders' ability to locate and use AEDs may improve AED retrieval times and OHCA outcomes.
Correlation of Donor-derived Cell-free DNA With Histology and Molecular Diagnoses of Kidney Transplant Biopsies
Authors: Gupta Gaurav , Moinuddin Irfan , Kamal Layla , King Anne L. , Winstead Ryan , Demehin Moses , Kang Le , Kimball Pamela , Levy Marlon , Bhati Chandra , Massey H. Davis , Kumar Dhiren , Halloran Philip F. 
Published: June 2021

Background.
Circulating donor-derived cell-free DNA (cfDNA), a minimally invasive diagnostic tool for kidney transplant rejection, was validated using traditional histology. The molecular microscope diagnostic system (MMDx) tissue gene expression platform may provide increased precision to traditional histology.

Methods.
In this single-center prospective study of 208 biopsies (median = 5.8 mo) posttransplant, we report on the calibration of cfDNA with simultaneous biopsy assessments using MMDx and histology by area under the curve (AUC) analyses for optimal criterion, as well as for, previously published cfDNA cutoffs ≤ 0.21% to “rule-out” rejection and ≥1% to “rule-in” rejection.

Results.
There were significant discrepancies between histology and MMDx, with MMDx identifying more antibody-mediated rejection (65; 31%) than histology (43; 21%); the opposite was true for T cell–mediated rejection [TCMR; histology: 27 (13%) versus MMDx: 13 (6%)]. Most of the TCMR discrepancies were seen for histologic borderline/1A TCMR. AUC for cfDNA and prediction of rejection were slightly better with MMDx (AUC = 0.80; 95% CI: 0.74-0.86) versus histology (AUC = 0.75; 95% CI: 0.69-0.81). A cfDNA ≤ 0.21% had similar sensitivity (~91%) to “rule-out” rejection by histology and MMDx. Specificity was slightly higher with MMDx (92%) compared with histology (85%) to “rule-in” rejection using cfDNA criterion ≥1%. Strong positive quantitative correlations were observed between cfDNA scores and molecular acute kidney injury for both “rejection” and “nonrejection” biopsies.

Conclusions.
Molecular diagnostics using tissue gene expression and blood-based donor-derived cell-free DNA may add precision to some cases of traditional histology. The positive correlation of cfDNA with molecular acute kidney injury suggests a dose-dependent association with tissue injury irrespective of rejection characteristics.
Quantitative evaluation of brain volumes in drug-free major depressive disorder using MRI-Cloud method
Authors: Avnioglu Seda , Velioglu Halil Aziz , Cankaya Seyda , Yulug Burak 
Published: June 2021

Background
Quantitative analysis of the high-resolution T1-weighted images provides useful markers to measure anatomical changes during brain degeneration related to major depressive disorder (MDD). However, there are controversial findings regarding these volume alterations in MDD indicating even to increased volumes in some specific regions in MDD patients.

Methods
This study is a case-controlled study including 23 depression patients and 15 healthy subject person and 20–38 years of age, who have been treated at the Neurology and Psychiatry Department here. We compared specific anatomic regions between drug-free MDD patients and control group through MRI-Cloud, which is a novel brain imaging method that enables to analyze multiple brain regions simultaneously.

Results
We have found that frontal, temporal, and parietal hemispheric volumes and middle frontal gyrus, inferior frontal gyrus, superior parietal gyrus, cingulum-hippocampus, lateral fronto-orbital gyrus, superior temporal gyrus, superior temporal white matter, middle temporal gyrus subanatomic regions were significantly reduced bilaterally in MDD patients compared to the control group, while striatum, amygdala, putamen, and nucleus accumbens bilaterally increased in MDD group compared to the control group suggesting that besides the heterogeneity among studies, also comorbid factors such as anxiety and different personal traits could be responsible for these discrepant results.

Conclusion
Our study gives a strong message that depression is associated with altered structural brain volumes, especially, in drug-free and first-episode MDD patients who present with similar duration and severity of depression while the role of demographic and comorbid risk factors should not be neglected.
Discovery and systematic characterization of risk variants and genes for coronary artery disease in over a million participants
Authors: Aragam Krishna G , Jiang Tao , Goel Anuj , Kanoni Stavroula , Wolford Brooke N , Weeks Elle M , Wang Minxian , Hindy George , Zhou Wei , Grace Christopher , Roselli Carolina , Marston Nicholas A , Kamanu Frederick K , Surakka Ida , Muñoz Venegas Loreto , Sherliker Paul , Koyama Satoshi , Ishigaki Kazuyoshi , O Åsvold Bjørn , Brown Michael R , Brumpton Ben , de Vries Paul S , Giannakopoulou Olga , Giardoglou Panagiota , Gudbjartsson Daniel F , Güldener Ulrich , Haider Syed M. Ijlal , Helgadottir Anna , Ibrahim Maysson , Kastrati Adnan , Kessler Thorsten , Li Ling , Ma Lijiang , Meitinger Thomas , Mucha Sören , Munz Matthias , Murgia Federico , Nielsen Jonas B , Nöthen Markus M , Pang Shichao , Reinberger Tobias , Thorleifsson Gudmar , von Scheidt Moritz , Ulirsch Jacob K ,   EPIC-CVD Consortium, Japan Biobank , Arnar David O , Atri Deepak S , P Burtt Noël , Costanzo Maria C , Flannick Jason , Gupta Rajat M , Ito Kaoru , Jang Dong-Keun , Kamatani Yoichiro , Khera Amit V , Komuro Issei , Kullo Iftikhar J , Lotta Luca A , Nelson Christopher P , Roberts Robert , Thorgeirsson Gudmundur , Thorsteinsdottir Unnur , Webb Thomas R , Baras Aris , Björkegren Johan LM , Boerwinkle Eric , Dedoussis George , Holm Hilma , Hveem Kristian , Melander Olle , Morrison Alanna C , Orho-Melander Marju , Rallidis Loukianos S , Ruusalepp Arno , Sabatine Marc S , Stefansson Kari , Zalloua Pierre , Ellinor Patrick T , Farrall Martin , Danesh John , Ruff Christian T , Finucane Hilary K , Hopewell Jemma C , Clarke Robert , Erdmann Jeanette , Samani Nilesh J , Schunkert Heribert , Watkins Hugh , Willer Cristen J , Deloukas Panos , Kathiresan Sekar , Butterworth Adam S 
Published: June 2021

ABSTRACTRapid progress of the discovery of genetic loci associated with common, complex diseases has outpaced the elucidation of mechanisms pertinent to disease pathogenesis. To address relevant barriers for coronary artery disease (CAD), we combined genetic discovery analyses with downstream characterization of likely causal variants, genes, and biological pathways. Specifically, we conducted a genome-wide association study (GWAS) comprising 181,522 cases of CAD among 1,165,690 participants. We detected 241 associations, including 54 associations and 30 loci not previously linked to CAD. Next, we prioritized likely causal variants using functionally-informed fine-mapping, yielding 42 associations with fewer than five variants in the 95% credible set. Combining eight complementary predictors, we prioritized 185 candidate causal genes, including 94 genes supported by three or more predictors. Similarity-based clustering underscored a role for early developmental processes, cell cycle signaling, and vascular proliferation in the pathogenesis of CAD. Our analysis identifies and systematically characterizes risk loci for CAD to inform experimental interrogation of putative causal mechanisms for CAD.