bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emotional Intelligence and Burnout in Plastic Surgery Residents: Is There a Relationship?
Authors: Bin Dahmash Abdulmajeed , Alhadlaq Abdulmajeed S. , Alhujayri Abdulaziz K. , Alkholaiwi Feras , Alosaimi Nawaf A. 
Published: May 2019

Background:
The specific role of emotional intelligence (EI) in the field of plastic surgery has not been investigated. We aim to investigate the relationship between EI and the individual components of burnout among plastic surgery residents in Saudi Arabia.

Methods:
In this cross-sectional study, all plastic surgery residents (n = 37) in Riyadh, Saudi Arabia, were invited to participate in a questionnaire based study in March 2018. The survey contained a validated measure of burnout (Maslach Burnout Inventory-Human Services Survey), validated measure of EI (Trait Emotional Intelligence Questionnaire-Short Form), and evaluated residents’ demographics, professional and personal risk factors, and career satisfaction.

Results:
The overall rate of high burnout was 37.9%, with 72.4% residents reporting high level of emotional exhaustion (EE), 41% reporting high depersonalization (DP) and 41% reporting low sense of personal accomplishment (PA). EI has shown to have a significant negative relationship with EE (95% confidence interval CI, −9.061 to −1.374; P = 0.010), DP (95% CI, −5.747 to −1.974; P < 0.001), and a significant positive correlation with PA (95% CI, 1.398–5.439; P = 0.002). Significant risk factors for burnout included dissatisfaction with plastic surgery as a career choice, dissatisfaction with income, and dissatisfaction with the role in the operating room (P < 0.05).

Conclusions:
We found a positive correlation between higher levels of EI and sense of personal achievement, whereas a negative correlation was observed between higher level of EI and EE and DP among the residents in this study. Plastic surgery residents who are satisfied with their salary have lower EE and DP. Residents who are satisfied with their role in the operating room have a better sense of PA.
Site-specific Patient-reported Outcome Measures for Hand Conditions: Systematic Review of Development and Psychometric Properties
Authors: Wormald Justin C.R. , Geoghegan Luke , Sierakowski Kyra , Price Andrew , Peters Michele , Jain Abhilash , Rodrigues Jeremy N. 
Published: May 2019

Background:
There are a number of site-specific patient-reported outcome measures (PROMs) for hand conditions used in clinical practice and research for assessing the efficacy of surgical and nonsurgical interventions. The most commonly used hand-relevant PROMs are as follows: Disabilities of the Arm, Shoulder and Hand (DASH), QuickDASH (qDASH), Michigan Hand Questionnaire (MHQ), Patient Evaluation Measure (PEM), Upper Extremity Functional Index (UEFI), and Duruoz Hand Index (DHI). There has been no systematic evaluation of the published psychometric properties of these PROMs.

Methods:
A PRISMA-compliant systematic review of the development and validation studies of these hand PROMs was prospectively registered in PROSPERO and conducted to assess their psychometric properties. A search strategy was applied to Medline, Embase, PsycINFO, and CINAHL. Abstract screening was performed in duplicate. Assessment of psychometric properties was performed.

Results:
The search retrieved 943 articles, of which 54 articles met predefined inclusion criteria. There were 19 studies evaluating DASH, 8 studies evaluating qDASH, 13 studies evaluating MHQ, 5 studies evaluating UEFI, 4 studies evaluating PEM, and 5 studies evaluating DHI. Assessment of content validity, internal consistency, construct validity, reproducibility, responsiveness, floor/ceiling effect, and interpretability for each PROM is described.

Conclusions:
The psychometric properties of the most commonly used PROMs in hand research are not adequately described in the published literature. DASH, qDASH, and MHQ have the best-published psychometric properties, though they have either some poor psychometric performance or incompletely studied psychometric properties. There are more limited published data describing the psychometric properties of the UEFI, PEM, and DHI.
Development of In Vitro Bioengineered Vascular Grafts for Microsurgery and Vascular Surgery Applications
Authors: Singh Gurtej , Cordero John , Wiles Brody , Tembelis Miltiadis N. , Liang Kai-Li , Rafailovich Miriam , Simon Marcia , Khan Sami U. , Bui Duc T. , Dagum Alexander B. 
Published: May 2019

Introduction:
The use of vascular grafts is continuing to rise due to the increasing prevalence of coronary artery bypass grafting and microvascular flap-based tissue reconstructions. The current options of using native vessels (saphenous vein) or the synthetic grafts (Dacron) have been unable to manage current needs. In this study, we employed an original tissue engineering approach to develop a multi-layered vascular graft that has the potential to address some of the limitations of the existing grafts.

Materials and Methods:
Biomaterials, gelatin and fibrin, were used to develop a two-layered vascular graft. The graft was seeded with endothelial cells and imaged using confocal microscopy. The graft’s architecture and its mechanical properties were also characterized using histology, Scanning Electron Microscopy and rheological studies.

Results:
Our methodology resulted in the development of a vascular graft with precise spatial localization of the two layers. The endothelial cells fully covered the lumen of the developed vascular graft, thus providing a non-thrombogenic surface. The elastic modulus of the biomaterials employed in this graft was found to be 5.186 KPa, paralleling that of internal mammary artery. The burst pressure of this graft was also measured and was found close to that of the saphenous vein (~2000 mm Hg).

Conclusions:
We were successfully able to employ a unique method to synthesize a multi-layered vascularized graft having adequate biological and mechanical properties. Studies are ongoing involving implantation of this developed vascular graft in the rat femoral artery and characterization of parameters such as vascular remodeling and patency.
Lymphatic Vessel Thrombosis in a Patient with Secondary Lymphedema
Authors: Hara Hisako , Mihara Makoto , Ohtomo Rie , Tanaka Sayuri 
Published: May 2019

Summary:
Lymphatic thrombosis is rarer than venous thrombosis. This case report describes a patient with secondary lymphedema, who was found to have lymphatic thrombosis during lymphaticovenous anastomosis (LVA). A 51-year-old woman underwent hysterectomy and pelvic lymph node dissection for uterine cancer when she was 48 years old, and lymphedema developed in the left leg soon after the operation. She was diagnosed with lymphedema based on lymphoscintigraphic finding. Preoperative echography showed 2 hypoechoic circles measuring about 0.5 mm in diameter that did not collapse with pressure from the probe, although the veins collapsed with pressure. We diagnosed the 2 hypoechoic circles as lymphatic vessels based on the location and longitudinal continuity. During LVA, we identified 2 parallel white vessels beneath the superficial fascia. After they were cut, white material was extruded. A diagnosis of lymphatic thrombosis was made, and we ligated the lymphatic vessels, closed the wound at this site, and performed LVA at other sites (4 sites in the left and 1 site in the right leg). The postoperative course was uneventful. Histopathological examination showed hyperplasty of fibroblasts and organization in the thrombus. Lymphatic thrombosis is sometimes found in the lymphedema-affected extremities. On retrospective consideration, lymphatic thrombosis can be detected with preoperative echography.
Ischemic Complications after Nipple-sparing Mastectomy: Predictors of Reconstructive Failure in Implant-based Reconstruction and Implications for Decision-making
Authors: Salibian Ara A. , Frey Jordan D. , Bekisz Jonathan M. , Karp Nolan S. , Choi Mihye 
Published: May 2019

Background:
Mastectomy flap and nipple–areola complex (NAC) ischemia can be devastating complications after nipple-sparing mastectomy (NSM). Predictors of reconstructive failure with major skin envelope ischemia and implications for decision-making remain to be fully elucidated.

Methods:
All cases of implant-based reconstruction after NSM from 2006 to June 2018 with mastectomy flap necrosis or NAC necrosis requiring debridement were reviewed. Data on patient demographics, operative characteristics, additional complications, and the nature and management of ischemic complications were collected and analyzed.

Results:
Out of 1045 NSMs, 70 cases (6.7%) had major ischemic complications. Fifty-two cases (74.3% of major ischemic complications) had isolated major mastectomy flap necrosis, 7 (10%) had full NAC necrosis and 11 (15.7%) had both. Five cases (7.1%) underwent implant exchange at the time of debridement and 15 cases (21.4%) required explantation. Explanted cases had significantly lower body mass index (22.3 versus 24.7, P = 0.013) and larger debridement size (49.5 cm2 versus 17.6 cm2, P = 0.0168). Additionally, explanted cases had a higher rate of acellular dermal matrix/mesh (100% versus 45.5%, P < 0.0001), prior radiation (20.0% versus 0%, P = 0.0083), immediate implants (46.7% versus 20.0%, P = 0.0491), major infection (30.0% versus 1.8%, P = 0.028), and both major mastectomy flap/NAC necrosis (33.3% versus 10.9%, P = 0.0494).

Conclusions:
NSM cases with major ischemia requiring explantation had a lower body mass index and significantly higher rate of preoperative radiation, immediate implant placement, use of acellular dermal matrix/mesh, and concomitant major infection. These variables should be taken into account when discussing risks with patients preoperatively and assessing the quality of mastectomy flaps and subsequent reconstructive choices intraoperatively.
OUTCOMES OF VITRECTOMY IN TERSON SYNDROME
Authors: Nazarali Samir , Kherani Irfan , Hurley Bernard , Williams Geoff , Fielden Michael , Adatia Feisal , Kherani Amin 
Published: May 2019

Purpose:
To characterize the presentation of Terson syndrome, the occurrence of a vitreous hemorrhage in association with intracranial hemorrhage, and report on the outcomes of vitrectomy at two major centers in Canada.

Methods:
Retrospective chart review of consecutive patients with Terson syndrome undergoing vitrectomy by retina specialists over the last 10 years. Primary outcome was the change in best-corrected visual acuity (BCVA) at 3 months from baseline. Secondary outcomes included the association between baseline BCVA and final BCVA, and the association between final BCVA and timing of surgery (early vs. later than 90 days).

Results:
A total of 14 eyes of 11 patients were included. The mean time between observation of intraocular hemorrhage and vitrectomy was 160 days. Baseline preoperative BCVA was logarithm of the minimum angle of resolution 1.57 ± 1.03 (Snellen 20/740), which improved to logarithm of the minimum angle of resolution 0.53 ± 0.82 (Snellen 20/70) at the final postoperative follow-up, P = 0.01. Baseline BCVA was not significantly correlated with final BCVA, Spearman's rho = 0.016, P = 0.957. Final BCVA did not significantly differ between those who had surgery before 90 days compared with after 90 days, P = 0.087.

Conclusion:
Vitrectomy is safe and effective and should be considered for nonclearing vitreal bleeding due to Terson syndrome. Ocular hemorrhaging in Terson syndrome can be observed conservatively for spontaneous improvement without the risk of reduced visual potential. Ophthalmic evaluation should be considered promptly after intracranial hemorrhage.
Spectrum of Microbial Keratitis Encountered in the Tropics
Authors: Khor Hui Gim , Cho Irene , Lee Kenneth Rohan Chee Keong , Chieng Lee Ling 
Published: May 2019

Purpose:
To report the predisposing factors, microorganisms, antibiotic sensitivity associated with bacterial keratitis, and treatment outcomes in Miri, Borneo which has a tropical climate.

Methods:
This is a retrospective study on patients presenting with microbial keratitis in Miri, Sarawak, Borneo over a 7-year period from January 1, 2010 until December 31, 2016. Demographic data, predisposing factors, culture and sensitivity results together with treatment outcomes were studied.

Results:
There were a total of 221 cases treated as microbial keratitis with a peak age group of 21 to 30 years. The predisposing factors were trauma (49.3%), improper contact lens usage (29.1%), ocular surface diseases (5.9%), ocular surgeries (0.9%), drugs (1.8%), and other factors (19.0%). Occupational injuries among oil palm plantation workers was the leading cause within the trauma cohort (28.8%). Corneal scraping was performed in 189 cases, 61.4% of them yielded positive cultures. The cultures demonstrated that 49.1% were of bacterial origin, 46.6% were fungal, and 4.3% showed mixed growth. The most common bacteria isolated was Pseudomonas aeruginosa, which was sensitive toward ceftazidime and gentamicin antibiotics. One hundred ninety-two cases (86.9%) were treated with purely topical medication, whereas 29 cases (13.1%) required further interventions.

Conclusion:
The commonest predisposing factor for microbial keratitis was trauma. With the nearby oil palm industries, we report a corresponding increase of incidence in fungal keratitis at our center. Culture and sensitivity reports from corneal scrapings are essential in treatment guidance; however, more than a third of the microbial keratitis cases studied were culture-negative. The organisms cultured reflect the profile expected in tropical climates. Fortunately, there was no increase in resistance rates observed for the commonly used antibiotics.
Recovery of physical activity after cesarean delivery and its relationship with pain
Authors: Sharpe Emily E. , Booth Jessica L. , Houle Timothy T. , Pan Peter H. , Harris Lynnette C. , Aschenbrenner Carol A. , Eisenach James C. 
Published: May 2019

Abstract
Pain and physical activity are tightly intertwined. Although their relationship has been explored in chronic pain conditions, we know little about the pattern of recovery in activity and its short- and long-term relationship with pain after surgery. We recruited 103 women undergoing elective cesarean delivery and acquired daily pain assessments and hourly steps in 98 of them for 2 months after surgery. Compliance was good, with 78% of subjects missing less than 7 days of activity. Study personnel required daily checking for compliance and 20 minutes per subject per week in study. Activity increased over the first 2 postoperative months in a log(time) manner. The slope of each modeled individual curve for activity was inversely correlated (r = −0.54; P < 0.0001) with worst daily pain. After removing these 2-month trends, pain and activity within an individual day were negatively associated with each point increase in pain being inversely associated with −119 steps (95% confidence interval [CI] = −214 to −25; P = 0.013). A patient's previous experience of pain was not associated with current activity as well as current activity was not associated with future pain scores. These data, although limited by the study of a single operation in a unique social circumstance with low risk of chronic postsurgical pain, demonstrate feasibility of measuring hourly activity for 2 months after surgery. Recovery from pain and inactivity are tightly correlated, and the negative relationship between within-day pain and activity without interday carryover relationships is in stark contrast to findings in chronic pain conditions.
Factors Associated With Blood Pressure Classification in Korean University Students: A Descriptive Survey
Authors: CHOI Eun-Ju , CHANG Ae Kyung , CHOI Jin Yi 
Published: May 2019

ABSTRACT

Background
The prevalence of hypertension in young adults has increased. Hypertension is known to be a leading contributor to many diseases.

Purpose
The study aimed to identify factors influencing blood pressure (BP) classification in university students and to establish a basis for the prevention and management of hypertension in young adults.

Methods
Four hundred three university students in South Korea were analyzed to determine the factors that influence BP classification. Data were analyzed using the chi-square test, analysis of variance, and multinomial logistic regression.

Results
The reference group for the logistic regression analysis included students with normal BP. The odds of being male and of having an overweight or obese body mass index were significantly higher in the prehypertension group than in the normal BP group. The odds of regular (≥ 6 months) exercise habits, having subcutaneous and borderline visceral fat types, and social support were significantly lower in the prehypertension group than in the normal BP group. The odds of being male, being overweight or obese, and having more exercise barriers were significantly higher in the hypertension group than in the normal BP group. The odds of having a high or low economic status were higher and lower in the hypertension group, respectively. Finally, the odds of having subcutaneous or borderline visceral fat types and a vigorous physical activity level were significantly lower in the hypertension group than in the normal BP group.

Conclusions
Interventions that address the factors related to BP in young adults are necessary to prevent the occurrence and progression of hypertension in young adults.
Feeding should be individualized in the critically ill patients
Authors: Berger Mette M. , Pichard Claude 
Published: May 2019

Purpose of review
Any critical care therapy requires individual adaptation, despite standardization of the concepts supporting them. Among these therapies, nutrition care has been repeatedly shown to influence clinical outcome. Individualized feeding is the next needed step towards optimal global critical care.

Recent findings
Both underfeeding and overfeeding generate complications and should be prevented. The long forgotten endogenous energy production, maximal during the first 3 to 4 days, should be integrated in the nutrition plan, through a slow progression of feeding, as full feeding may result in early overfeeding. Accurate and repeated indirect calorimetry is becoming possible thanks to the recent development of a reliable, easy to use and affordable indirect calorimeter. The optimal timing of the prescription of the measured energy expenditure values as goal remains to be determined. Optimal protein prescription remains difficult as no clinically available tool has yet been identified reflecting the body needs.

Summary
Although energy expenditure can now be measured, we miss indicators of early endogenous energy production and of protein needs. A pragmatic ramping up of extrinsic energy provision by nutrition support reduces the risk of overfeeding-related adverse effects.
Nodular focal fat sparing of liver mimicking hepatocellular carcinoma in contrast-enhanced ultrasound
Authors: Fu Rong , Qiu Tingting , Ling Wenwu , Lu Qiang , Luo Yan 
Published: May 2019

AbstractIntroduction:Focal fatty sparing is a manifestation of fatty liver. Nodular focal fatty sparing of liver sometimes is a mimicker of malignant lesion, especially metastatic tumor. There are some case reports about this kind of tricks revealed by computed tomography (CT) and magnetic resonance imaging. However, few reports described nodular focal sparing of liver presenting an enhancement mode of hepatocellular carcinoma (HCC) in contrast-enhanced ultrasound (CEUS).Patient concerns:A 37-year-old male had a long history of alcohol abuse and hepatitis B virus infection. Routine blood examination showed an elevation of triglyceride, and tumor markers were unremarkable. Conventional ultrasound indicated a diffuse fatty liver with a hypoechoic nodular lesion. CEUS revealed hyperenhancement in arterial phase and washout in late phase of this hypoechoic lesion. Contrast-enhanced CT showed a similar enhancement mode of the mass with CEUS.Diagnosis:A clinical diagnosis of HCC was made. Then, liver resection was conducted. Postoperative histopathologic and immunohistochemical results of the lesion revealed no presence of tumor cells except for heterogeneous hepatic steatosis. So a final diagnosis of hepatic focal fatty sparing was determined.Interventions:Liver resection was conducted according to the clinical diagnosis of HCC.Outcomes:After general postoperative administration, the patient was told to discharge. Then, he had been undergoing regular serological tests and imaging examinations in our hospital for 39 months and found no manifestation of liver tumor.Conclusion:According to guidelines, it is typical that hepatic focal fatty change (FFC) presents a mode of persistent iso-enhancement in CEUS. However, atypical enhancement presence of FFC in imaging examinations may occur and lead to misdiagnosis, which calls for more attention.
Subjective perceptions and psychological distress associated with the deep underground
Authors: Liu Jifeng , Liu Yilin , Ma Tengfei , Gao Mingzhong , Zhang Ru , Wu Jiang , Zou Jian , Liu Shixi , Xie Heping 
Published: May 2019

Abstract
This study reports the subjective perceptions and mental state of employees working in the Erdaogou Mine, affiliated with Jiapigou Minerals Limited Corporation of China National Gold Group Corporation (CJEM); these employees are pioneers working at the deepest point below ground in China. The data represent a valuable baseline from which to assess the effects of the environmental factors in the deep-underground on human physiology, psychology, and pathology.
The air pressure, relative humidity, temperature, total γ radiation dose-rate, and oxygen concentration in the CJEM in the aisles in goafs at 4 depths below ground were measured. Study subjects were administered a study-specific questionnaire that included items that targeted factors with potential to affect respondents’ health and wellbeing and included the symptom checklist-90-revised (SCL-90-R).
Air pressure, relative humidity, and temperature rose, total γ radiation dose-rate decreased, and there was no change in oxygen concentration with increasing depth below ground. Most (97.2%) respondents had a negative impression of the ambient conditions in the deep-underground space. The most commonly perceived adverse factors included moisture (74.9%), heat (33.5%), and poor ventilation (32.4%). 93.29% of respondents associated ≥1 self-reported negative physical symptom with working in the deep-underground space; the most frequent symptoms were being easily tired (48.7%), tinnitus (47.5%), and hearing loss (44.1%). Higher SCL-90-R scores were associated with the perception of >1 adverse factor in the deep-underground, spending >8 hours continuously in the deep-underground space, or working at a depth > 1000 m below ground. >1 perceived adverse factor in the deep-underground and continuously spending >8 hours in the deep-underground space were significant predictors of high SCL-90-R scores.
Adverse factors, including high temperature, humidity, and dim light, may have negative impacts on the physical and psychological health of people who spend long periods of time living and/or working in the deep-underground space.