bluuebunny/crossref_metadata_2025_split huggingface dataset:
A New Perspective on Burnout: Snapshots of the Medical Resident Experience
Authors: Harsh Jennifer S , Lawrence Tyler J , Koran-Scholl Jessica B , Bonnema Rachel 
Published: July 2019

Background: Burnout is harmful and frequently experienced by medical residents. Causes of burnout are numerous. To date, there have been no qualitative studies incorporating semistructured interviews and resident-taken photographs on their perspectives of burnout. This method is advantageous for its ability to explore the lived experience of burnout, in depth. Objective: The purpose of this study is to discover, through photographs and semistructured interviews, medical residents’ perspectives on what burnout means in their lives and how they manage burnout experiences. Methods: In 2017, 8 residents from Internal Medicine and Family Medicine Residency Programs at a large, Midwestern academic medical center participated in this study. The Transcendental Phenomenological Method was used to analyze the data collected through semistructured interviews, which used resident photographs as a guide. Results: Residency training was often described as a challenging experience, particularly because it took away residents’ ability to focus on their personal lives due to long work hours. This often resulted in exhaustion, self-doubt, and damaged or neglected relationships. Despite this, residents took active steps to mitigate burnout through a variety of coping strategies. In addition, residents found camaraderie, joy, and personal growth during their residency experience. Conclusion: Burnout continues to be an important topic in medical education and specifically for medical residents. Learning more about how burnout is perceived and the effects of burnout on residents day-to-day lives can guide the future development of strategies to promote wellness and minimize the impact of burnout.
The Efficacy of General Practitioner Assessment of Cognition in Chinese Elders Aged 80 and Older
Authors: Xu Fang , Ma Juan Juan , Sun Fei , Lee Jaewon , Coon David W. , Xiao Qiang , Huang Yong , Zhang Lei , Liang Zhi Hou 
Published: July 2019

Objectives: This study examined the efficacy of the General Practitioner Assessment of Cognition–Chinese version (GPCOG-C) in screening dementia and mild cognitive impairment (MCI) among older Chinese. Methods: Survey questionnaires were administered to 293 participants aged 80 or above from a university hospital in mainland China. Alzheimer disease and MCI were diagnosed in light of the National Institute on Aging and the Alzheimer’s Association (NIA/AA) criteria. The sensitivity and specificity of GPCOG-C and Mini-Mental State Examination (MMSE) in screening dementia and MCI were compared to the NIA/AA criteria. Results: The GPCOG-C had the sensitivity of 62.3% and specificity of 84.6% in screening MCI, which had comparable efficacy as the NIA/AA criteria. In screening dementia, GPCOG-C had a lower sensitivity (63.7%) than the MMSE and a higher specificity (82.6%) higher than the MMSE. Conclusions: The GPCOG-C is a useful and efficient tool to identify dementia and MCI in older Chinese in outpatient clinical settings.
Vitamin D Supplementation in Military Personnel: A Systematic Review of Randomized Controlled Trials
Authors: Sivakumar Gaya , Koziarz Alex , Farrokhyar Forough 
Published: July 2019

Context: Vitamin D supplementation is important in military research because of its role in musculoskeletal health. Objective: This systematic review examined the effects of vitamin D supplementation on serum 25-hydroxyvitamin D (25(OH)D) concentrations and musculoskeletal health outcomes in military personnel. Data Sources: A comprehensive search was conducted using MEDLINE, EMBASE, CINAHL, SportDiscus, and the Cochrane Library databases and the reference lists of existing review articles and relevant studies. Study Selection: Reviewers independently screened titles, abstracts, and full texts of the articles using predefined criteria. Study Design: Systematic review of randomized controlled trials (RCTs) using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Level of Evidence: Level 3. Data Extraction: Three reviewers independently extracted data and assessed the methodological quality. Mean differences with 95% CI in serum 25(OH)D concentrations between the vitamin D and placebo arms were calculated. Results: Four RCTs were included in the qualitative analyses. The 25(OH)D concentrations were improved with 2000 IU/d supplementation (mean difference, 3.90 ng/mL; 95% CI, 0.22-7.58). A trial on female Navy recruits showed a significant decrease in stress fractures (risk ratio, 0.77; 95% CI, 0.62-0.95), particularly tibial fractures, from daily supplementation of 800 IU vitamin D and 2000 mg calcium. Conclusion: There was a positive trend in 25(OH)D concentrations from higher doses of supplementary vitamin D in military submariners and a possible benefit to bone health when vitamin D was combined with calcium.
Positive views on antipsychotic long-acting injections: results of a survey of community patients prescribed antipsychotics
Authors: Mace Shubhra , Chak Oscar , Punny Sharanjeet , Sedough-Abbasian Daniel , Vegad Chirag , Taylor David M. 
Published: July 2019

Background: We aimed to assess patients’ views about antipsychotic long-acting injections (LAIs). Methods: We interviewed patients prescribed an antipsychotic (oral or LAI) in our community teams. In a subanalysis, responses were analysed for differences between patients currently receiving an LAI and those prescribed only oral medication. Results: In total, 226 patients (57%) completed the study questionnaire. The majority agreed that LAIs ensured delivery of the right amount of medication and protection against hospital admissions (57% and 60%, respectively). A minority of participants were more concerned than not about the use of a needle (46%), pain from injection (48%) and the need to travel to receive the injection (34%). A majority expressed a preference for injection site (deltoid or gluteal) (65%) and clinic location (69%). A higher proportion of patients currently receiving an LAI compared with those prescribed oral medication thought an LAI was beneficial because this formulation obviated the need to: swallow tablets (63% versus 41%; p = 0.0013), remember to take tablets daily (75% versus 51%; p = 0.0004), remember tablets when away from home (72% versus 49%; p = 0008). Current LAI users were more likely than those on oral treatment to agree that LAIs keep patients out of hospital (76% versus 44%; p = 0.0001) and that the injection ensured delivery of the right amount of medication (71% versus 44%; p = 0.0002). Women were more likely than men to prefer administration by a clinician of the same gender (34% versus 12%; p = 0.0001). Conclusions: In our study, a greater proportion of patients prescribed an LAI regarded LAIs as beneficial compared with those on oral medication.
Products of oxidative stress and transient receptor potential ankyrin A1 expression in the brainstem after lung ischemia–reperfusion injury
Authors: Gu Xiaoying , Nan Yu , Pang Xiaochuan , Zhang Wenwen , Zhang Jian , Zhang Yiyuan 
Published: July 2019

Lung ischemia–reperfusion injury is a common clinical concern. As the injury occurs, the pulmonary afferent nerves play a key role in regulating respiratory functions under pathophysiological conditions. The present study was to examine products of oxidative stress and expression of transient receptor potential A1 in the commissural nucleus of the solitary tract after lung ischemia–reperfusion injury; and further to determine molecular mediators linking to activation of oxidative stress and transient receptor potential ankyrin A1. A rat model of lung ischemia–reperfusion injury was used. Enzyme‐linked immunosorbent assay and western blot analysis were employed to examine products of oxidative stress (i.e. 8‐isoprostaglandin F2α and 8‐hydroxy‐2′‐deoxyguanosine), and expression of transient receptor potential A1, Nrf2‐antioxidant response element, and NADPH oxidase. 8‐isoprostaglandin F2α and 8‐hydroxy‐2′‐deoxyguanosine were amplified in the commissural nucleus of the solitary tract of lung ischemia–reperfusion injury rats, accompanied with downregulation of Nrf2‐antioxidant response element, and upregulation of NOX4 and transient receptor potential A1. Blocking NADPH oxidase (subtype NOX4) decreased products of oxidative stress in the commissural nucleus of the solitary tract and attenuated upregulation of transient receptor potential A1 induced by lung ischemia–reperfusion injury. Our data revealed specific signaling pathways by which lung ischemia–reperfusion injury impairs Nrf2‐antioxidant response and activates oxidative stress in the brainstem thereby leading to amplification of transient receptor potential A1 receptor likely via products of oxidative stress. Data suggest the abnormalities in the pulmonary afferent signals at the brainstem level which is likely to affect respiratory functions as lung ischemia–reperfusion injury occurs.
Severe burn injury alters intestinal microbiota composition and impairs intestinal barrier in mice
Authors: Feng Yanhai , Huang Yalan , Wang Yu , Wang Pei , Wang Fengjun 
Published: July 2019

Abstract

Background
The intestinal barrier integrity is crucial for maintaining intestinal homeostasis, and the mechanisms of intestinal barrier disruption induced by burn injury remain obscure. This study was aimed to investigate the changes of intestinal microbiota and barrier function in burned mice to further comprehend the mechanisms of burn-induced intestinal barrier dysfunction.

Methods
Samples were from mice inflicted with 30% total body surface area (TBSA) full-thickness burns. The intestinal permeability, tight junction proteins expressions, zonula occludens-1 (ZO-1) localization, inflammatory cytokines expressions, and short-chain fatty acids (SCFAs) contents were determined. The microbial community was assessed via 16S rDNA Illumina sequencing.

Results
The intestinal permeability was increased after severe burn injury, peaking at 6 h post-burn, with approximately 20-folds of the control (p &lt; 0.001). The expression of tight junction proteins (ZO-1, occludin, claudin-1, and claudin-2) was significantly altered (p &lt; 0.05). The ZO-1 morphology was dramatically changed following burn injury. The fecal SCFAs’ contents (acetate, propionate, butyrate, isobutyrate, and isovalerate) were noticeably declined after burn injury (p &lt; 0.05). The expressions of pro-inflammatory cytokines (interleukin (IL)-1β and IL-6) in ileal mucosa were increased, whereas the expressions of anti-inflammatory cytokines (IL-4 and IL-13) were decreased following burn injury (p &lt; 0.05). In addition, burned mice showed an alteration of intestinal microbial community, such as decreased diversity, reduced Bacteroidetes abundance, and increased Firmicutes abundance.

Conclusions
The severe burn-induced intestinal barrier dysfunction is along with the alterations of microbial community.
Integration of a Mandatory Palliative Care Education Into Hematology-Oncology Fellowship Training in a Comprehensive Cancer Center: A Survey of Hematology Oncology Fellows
Authors: Reddy Suresh K. , Tanco Kimberson , Yennu Sriram , Liu Diane D. , Williams Janet L. , Wolff Robert , Bruera Eduardo 
Published: July 2019

PURPOSE: The primary aim of this study was to determine the attitudes and beliefs of hematology and medical oncology (HMO) fellows regarding palliative care (PC) after they completed a 4-week mandatory PC rotation. METHODS: The PC rotation included a 4-week standardized curriculum covering all PC domains. HMO fellows were provided educational materials and attended all didactic sessions. All had clinical rotation in an acute PC unit and an outpatient clinic. All HMO fellows from 2004 to 2017 were asked to complete a 32-item survey on oncology trainee perception of PC. RESULTS: Of 105 HMO fellows, 77 (73%) completed the survey. HMO fellows reported that PC rotation improved assessment and management of symptoms (98%); opioid prescription (89%), opioid rotation (78%), and identification of opioid adverse effects (87%); communication with patients and families (91%), including advance care planning discussion (88%) and do-not-resuscitate discussion (88%); and they reported comfort with discussing ethical issues (74%). Participants reported improvement in knowledge of symptom assessment and management (n = 76; 98%) as compared with efficacy in ethics (n = 57 [74%]; P = .0001) and for coping with stress of terminal illness (n = 45 [58%]; P = .0001). The PC rotation educational experience was considered either far better or better (53%) or the same (45%) as other oncology rotations. Most respondents (98%) would recommend PC rotations to other HMO fellows, and 95% felt rotation should be mandatory. CONCLUSION: HMO fellows reported PC rotation improved their attitudes and knowledge in all PC domains. PC rotation was considered better than other oncology rotations and should be mandatory.
Disrupted Oxytocin-Appetite Signaling in Females With Anorexia Nervosa
Authors: Aulinas Anna , Plessow Franziska , Pulumo Reitumetse L , Asanza Elisa , Mancuso Christopher J , Slattery Meghan , Tolley Christiane , Thomas Jennifer J , Eddy Kamryn T , Miller Karen K , Klibanski Anne , Misra Madhusmita , Lawson Elizabeth A 
Published: July 2019

Abstract

Context
In healthy females, oxytocin levels decrease postmeal, corresponding to increased satiety. The postprandial response of oxytocin in females with anorexia nervosa (AN)/atypical AN is unknown.

Objectives
To determine the pattern of postprandial serum oxytocin levels in females with AN/atypical AN, relationship with appetite, and effect of weight, eating behavior, and endogenous estrogen status.

Design
Cross-sectional.

Setting
Clinical research center.

Participants
67 women (36 with AN [<85% expected body weight (EBW)]; 31 with atypical AN [≥ 85% EBW)]), age 22.4 ± 0.9 (mean ± SEM) years, categorized by weight, restricting vs binge/purge behavior, and estrogen status.

Interventions
Standardized mixed meal.

Main Outcome Measurements
Blood sampling for oxytocin occurred fasting and 30, 60, and 120 minutes postmeal. Subjective appetite was assessed using visual analog scales.

Results
In females with AN/atypical AN, oxytocin levels decreased from fasting to 60 (P = 0.002) and 120 (P = 0.005) minutes postmeal. The decrease in oxytocin from fasting to 120 minutes was greater in females with atypical AN than AN (P = 0.027) and did not differ by restricting vs binge/purge behavior or estrogen status. Controlling for caloric intake, the decrease in oxytocin was inversely related to the decrease in hunger postmeal in females with atypical AN (P = 0.04).

Conclusions
In females with AN/atypical AN, oxytocin levels decrease postmeal, as established in healthy females. Weight, but not restricting vs binge/purging nor endogenous estrogen status, affects postprandial oxytocin levels. The postprandial change in serum oxytocin levels is related to appetite in females with atypical AN only, suggesting a disconnect between oxytocin secretion and appetite in the undernourished state.
Posaconazole-Induced Hypertension Due to Inhibition of 11β-Hydroxylase and 11β-Hydroxysteroid Dehydrogenase 2
Authors: Thompson George R , Beck Katharina R , Patt Melanie , Kratschmar Denise V , Odermatt Alex 
Published: July 2019

Abstract
We describe two cases of hypertension and hypokalemia due to mineralocorticoid excess caused by posaconazole treatment of coccidioidomycosis and rhinocerebral mucormycosis infections, respectively. Clinical laboratory evaluations, including a comprehensive analysis of blood and urine steroid profiles, revealed low renin and aldosterone and indicated as the underlying mechanism primarily a block of 11β-hydroxylase activity in patient 1, whereas patient 2 displayed weaker 11β-hydroxylase but more pronounced 11β-hydroxysteroid dehydrogenase 2 inhibition. The results show that both previously suggested mechanisms must be considered and emphasize significant interindividual differences in the contribution of each enzyme to the observed mineralocorticoid excess phenotype. The mineralocorticoid symptoms of patient 1 resolved after replacement of posaconazole therapy by isavoconazole, and posaconazole dosage de-escalation ameliorated the effects in patient 2. By providing a thorough analysis of the patients’ blood and urine steroid metabolites, this report adds further evidence for two individually pronounced mechanisms of posaconazole-induced hypertension and hypokalemia. The elucidation of the factors responsible for the individual phenotype warrants further research.
Regulations and Brain Drain: Evidence from Wall Street Star Analysts’ Career Choices
Authors: Guan Yuyan , Li Congcong , Lu Hai , Wong M. H. Franco 
Published: July 2019

The Global Settlement, along with related regulations in the early 2000s, prohibits the use of investment banking revenue to fund equity research and compensate equity analysts. We find that all-star analysts from investment banks are more likely to exit the profession or move to the buy side after the regulations. The departed star analysts’ earnings revisions and stock recommendations are more informative than those of the remaining analysts who followed the same companies. To the extent that star analysts are superior to their nonstar counterparts in terms of research ability and ability to inform the market, the exit of star analysts represents a brain drain in the sell-side equity research industry. These results are consistent with the view that the regulations introduced to protect equity investors have unintended adverse effects on the investors due to a brain drain in investment banks. This paper was accepted by Suraj Srinivasan, accounting.
PESQUISA, ENSINO E SOCIEDADE: AMPLIANDO CONHECIMENTOS NA ÁREA DAS CIÊNCIAS FARMACÊUTICAS
Authors: Oliveira Anselmo Gomes de , Silveira Damaris 
Published: July 2019

Ao participar de uma sociedade multicultural e globalizada, o objetivo de cada cidadão não é apenas discutir os aspectos que o rodeiam, mas fazer parte de tudo o que é importante para a humanidade. Contudo, aspectos básicos do cotidiano ainda continuam em pauta, por exemplo, a Ciência, em todas as suas vertentes, e que papel ela deve desempenhar para a melhoria da vida em nosso mundo, mesmo que, em alguns casos, o avanço científico nem sempre é realizado com finalidades benéficas.
New Trends in Geoproducts Development: Železné Hory National Geopark Case Study
Authors: Doucek Jan , Zelenka Josef 
Published: July 2019

Abstract
Geotourism is still a relatively new direction of tourism and its development is bound mainly to the territory of geoparks. Many geoparks try to develop different types of geo-products with a focus on different target groups. However, the nature of these products is very different and their development is evident mainly in the time scale. In the past, simple forms of interpretation and application of geoproducts were popular, whereas currently, modern technologies such as animations or augmented reality are thriving. This is mainly due to the better availability of technological equipment. At the same time, a number of geoparks boast of above-average interpreters, who are able to render and simplify difficult geological topics. This also applies to their ability to create of new geoproducts, where the need to abbreviate and condense information is evident. The results of the study show a positive trend in the use of modern methods in geoscience interpretation and in the creation of new geoproducts. At the same time, it is clear that without a modern concept it is very difficult to reach the current visitors. Therefore, such a concept is necessary in order to develop geoscientific issues, especially in the area of geoparks.
An All-Optical System for Implementing Integrated Hadamard-Pauli Quantum Logic
Authors: Sarkar Baishali , Mukhopadhyay Sourangshu 
Published: July 2019

Abstract
In quantum optical computing both of Pauli X, Y, Z gates and Hadamard gate are essential and important issues. Several proposals are given for addressing these issues. In this paper, the authors propose polarization encoded all-optical schemes which implement Hadamard logic, Pauli X, Pauli Y and Pauli Z gates followed by Hadamard logic gate separately. An integrated scheme is also proposed where three Pauli gates (X, Y and Z) followed by a single Hadamard gate is developed using polarization encoding mechanism. The outputs of the proposed systems follow the truth tables of the respective operations exactly. As the systems use the polarization character of light, so fully quantum optical operations with superfast speed are achieved.
Combined Analysis of Blood Ammonia and Lactate Levels as a Practical Tool to Assess the Metabolic Response to Training Sessions in Male and Female Sprinters
Authors: Kantanista Adam , Kusy Krzysztof , Pospieszna Barbara , Korman Paweł , Wieliński Dariusz , Zieliński Jacek 
Published: July 2019

Abstract
Kantanista, A, Kusy, K, Pospieszna, B, Korman, P, Wieliński, D, and Zieliński, J. Combined analysis of blood ammonia and lactate levels as a practical tool to assess the metabolic response to training sessions in male and female sprinters. J Strength Cond Res 35(9): 2591–2598, 2021—Previous research has mainly focused on blood ammonia and lactate concentration changes in response to exercise in laboratory settings. The aim of this study was to present a combined analysis of blood ammonia and lactate levels obtained during various training sessions performed under real training conditions. Differences between the sexes were also analyzed. The study subjects included 9 male and 8 female sprinters competing at the international level. The two-way analyses of variance, with repeated measures (time × sex), for lactate and blood ammonia concentrations during strength, speed (only lactate), speed with baton exchange, and speed endurance training sessions were significant. Blood ammonia and lactate levels obtained during repeated sprints were higher in male than female athletes. Peak lactate concentrations obtained from different training sessions were different in the female (F(3, 18) = 49.82, p ≤ 0.001, η2 = 0.893) and male (F(3, 21) = 312.26, p ≤ 0.001, η2 = 0.978) athletes; post hoc analyses of the men and women showed differences in maximum lactate concentration between training sessions, except in the speed and strength sessions. Peak ammonia concentrations obtained in the different training sessions were also different in the female (F(3, 18) = 121.06, p ≤ 0.001, η2 = 0.953) and male (F(3, 21) = 196.04, p ≤ 0.001, η2 = 0.965) athletes; in both the men and women, significant differences in maximum blood ammonia concentrations were found between the training sessions, except for the speed and speed with baton exchange training sessions. The results of this study indicate that the combined analysis of lactate and blood ammonia concentration provides the coach with valuable additional information about the level of adenosine triphosphate breakdown, the energy system contribution involved in muscle energy coverage during very short, repeated maximal sprints, and, most importantly, allows the coach to check whether preworkout goals were actually met.