bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Association of Relational Coordination and Faculty Members' Burnout and Job Satisfaction: A Preliminary Cross-Sectional Study
Authors: Wisdom Christina M. 
Published: July 2023

Introduction.
The relational coordination theory describes the interaction between effective communication and high-quality relationships critical for coordinating and accomplishing tasks when multiple individuals and groups are involved.

Review of Literature.
Relational coordination is associated with improved worker performance, increased job satisfaction, and reduced burnout. The purposes of this paper were to examine the differences in physical therapist education program (PTEP) core faculty members' perceived relational coordination with other PTEP faculty members, staff, and administration and to examine the associations between PTEP core faculty members' perceived relational coordination and its subscales and their perceived burnout and job satisfaction.

Subjects.
Entry-level PTEP core faculty members.

Methods.
An online survey that included the Relational Coordination Survey, Oldenburg Burnout Inventory, and Job Satisfaction Survey was used. A 1-way analysis of variance was conducted to test whether there were differences in PTEP core faculty members' perceived relational coordination with other PTEP faculty members, staff, and administration. Several simple linear regressions were conducted to test the associations between PTEP core faculty members' perceived relational coordination and its subscales and their perceived burnout and job satisfaction.

Results.
A total of 103 responses were analyzed. The PTEP core faculty members' mean perceived relational coordination with core faculty members was significantly higher than the mean relational coordination with associated faculty members, administration, and staff. Physical therapist education program core faculty members' perceived relational coordination and all its subscales were negatively associated with perceived disengagement. Perceived problem-solving communication and mutual respect were negatively associated with perceived exhaustion. Physical therapist education program core faculty members' perceived relational coordination and all its subscales were positively associated with perceived job satisfaction.

Discussion and Conclusion.
The quality of communication and relationships between and among core faculty members, administrators, and staff may affect PTEP core faculty members' perceived burnout and job satisfaction.
Burnout among palliative care providers
Authors: Zogby Colleen Borden 
Published: July 2023

ABSTRACT

Background:
Burnout among health care professionals contributes to high job turnover. Within the United States, burnout among specialty palliative care (PC) providers will accentuate provider shortage problems.

Objectives:
This systematic review was conducted to answer the question “what is known about burnout among specialty PC providers practicing in the United States?” More specifically, it was designed to identify the rate of burnout and factors that influence or mitigate it among PC nurse practitioners (NPs), physician assistants (PA), and physicians and to inform future research.

Data sources:
An electronic literature search of studies conducted in the United States between 2012 and September 2022 was completed in Embase, PubMed, CINAHL, and PsycINFO.

Conclusions:
Analysis of 14 studies showed that there are five primary themes related to burnout among PC providers: (1) the rate of burnout, (2) the physical, psychological, and clinical manifestations of burnout, (3) predictors of burnout, (4) factors of resiliency, and (5) interventions piloted to decrease burnout. The majority of studies have delineated the physician role but have failed to determine the rate and factors of burnout among PC NPs and PAs.

Implications for practice:
As NPs and PAs are integral to the PC provider workforce, future research should be designed to understand more clearly how burnout affects these two PC roles to inform efforts to sustain the PC workforce.
A multicenter, observational study to evaluate hemostasis following recombinant activated FVII treatment in patients in Japan with congenital factor VII deficiency
Authors: Seita Ikuo , Kinai Ei 
Published: July 2023

Reports describing symptoms and treatment of patients with congenital factor VII (FVII) deficiency frequently relate to patients in Europe, while only a small number describe data from Asian countries.
This multicenter, prospective observational study (NCT01312636) collected data from 30 sites for 55% of patients registered in 2011 in Japan with congenital FVII deficiency treated with activated recombinant FVII (rFVIIa) for bleeding episodes and/or during surgery.
The mean follow-up in 20 eligible patients was 11 months (range 1–49 months). Of 348 bleeding episodes in seven patients, 170 (48.9%) were intra-articular bleeding and 62 (17.8%) were menorrhagia, of which 92.9% (158/170) and 100% (62/62) were in patients with baseline factor VII activity 20 IU/dl or less, respectively. The hemostatic effect after rFVIIa treatment was rated as excellent, effective or partially effective for 45.7, 33.6 and 18.4% of 348 bleeding episodes. Overall, hemostasis for bleeding events and surgery was achieved in nearly 2 days, with the majority of patients receiving two doses or less. The hemostatic effect after the recommended dose (15–30 μg/kg) of rFVIIa was rapid and effective treatment for all categories of bleeding and surgical procedure.
On the basis of data from routine clinical practice, no new safety signals were identified.

Trial Registration
NCT01312636
The predictive role of platelet count for bleeding in patients with hepatitis B virus and hepatitis C virus infection
Authors: Huang Cih-En , Chang Jung-Jung , Chen Chih-Cheng , Wang Ying-Hsuan , Lu Chang-Hsien , Chen Yi-Yang , Wang Ting-Yao , Chen Min-Chi 
Published: July 2023

The impact of platelet count on bleeding in hepatitis B virus (HBV) and hepatitis C virus (HCV)-infected patients is unclear. We aimed to evaluate the relationship between platelet count and bleeding in patients with viral hepatitis.
We selected patients with HBV and HCV infection. All esophagogastroduodenoscopy, colonoscopy, and brain imaging reports were reviewed to document upper gastrointestinal bleeding (UGIB), lower gastrointestinal bleeding (LGIB), and central nervous system bleeding (CNSB), respectively. We analyzed risk factors for first bleeding events by using Cox proportional hazards models. Incidence rate ratios (IRRs) were used to compare bleeding incidences between viral types and platelet levels.
A total of 2522 HCV and 2405 HBV patients were enrolled. The HCV-to-HBV IRRs of UGIB, LGIB, and CNSB were significant at 1.797, 2.255, and 2.071, respectively. The common risk factors in both groups were thrombocytopenia, hypoalbuminemia, high alkaline phosphatase level, and cirrhosis for UGIB, whereas thrombocytopenia and hypoalbuminemia for LGIB. Hypoalbuminemia was the only risk for CNSB. After adjusting platelet count, the higher bleeding rates in the HCV patients diminished. Using a reference platelet count less than 100 x 109/l, bleeding risk elevated at platelet count less than 70 x 109/l and less than 40 x 109/l for UGIB and LGIB in the HCV patients, respectively, compared with less than 60 x 109/l for UGIB in the HBV patients. The incidence of CNSB was not related to platelet levels.
HCV patients had a higher risk for major bleeding. Thrombocytopenia was a significant predictor. Monitoring and management of thrombocytopenia in addition to cirrhotic status was important in these patients.
Dysfibrinogenemia: discrepant results following infusion of purified fibrinogen
Authors: Marin Maximo J. , Mathew Carol M. , Rajasekhar Anita , Zumberg Marc , Euliano Tammy Y. , Winter William E. , Pelletier J. Peter R. , Pruitt Heather D. , Harris Neil S. 
Published: July 2023

Inherited dysfibrinogenemias are molecular disorders of fibrinogen that affect fibrin polymerization. The majority of cases are asymptomatic, but a significant proportion suffer from increased bleeding or thrombosis. We present two unrelated cases of dysfibrinogenemia, both of whom showed a characteristic discrepancy between fibrinogen activity and the immunologic fibrinogen. In one patient, the dysfibrinogenemia was confirmed by molecular analysis; in the other case, the diagnosis was presumptive based upon laboratory studies. Both patients underwent elective surgery. Both received a highly purified fibrinogen concentrate preoperatively and demonstrated a suboptimal laboratory response to the infusion. Three methods for determining fibrinogen concentration (Clauss fibrinogen, prothrombin-derived fibrinogen, and the viscoelastic functional fibrinogen) were utilized in the case of one patient, and these techniques showed discrepant results with the classic Clauss method giving the lowest concentration. Neither patient experienced excessive bleeding during surgery.
Although these discrepancies have been previously described in untreated patients, their manifestation after infusion of purified fibrinogen is less well appreciated.
Management of hypocalcaemia in the critically ill
Authors: Melchers Max , van Zanten Arthur Raymond Hubert 
Published: July 2023

Purpose of review
To better understand the established associations between hypocalcaemia and clinical outcomes, we synopsize the mechanisms involved in hypocalcaemia in the critically ill. We also provide an overview of the current evidence on managing hypocalcaemia in critical illness.

Recent findings
Hypocalcaemia is reported to occur in 55–85% of ICU patients. It appears to be associated with poor outcomes, but it may be a marker rather than a direct cause of disease severity. The recommendations to correct calcium in major bleeding are found on weak evidence and require further exploration by a randomized controlled trial (RCT). Calcium administration in cardiac arrest has shown no benefit and may provoke harm. In addition, no RCT has assessed the risks and benefits of calcium supplementation in critically ill hypocalcemic patients. Several recent studies conclude that it may even harm septic ICU patients. These observations are supported by evidence that septic patients using calcium channel blockers may have better outcomes.

Summary
Hypocalcaemia is common in critically ill patients. Direct evidence that calcium supplementation improves their outcomes is lacking, and there is even some indication that it may be detrimental. Prospective studies are required to elucidate the risks and benefits, and the pathophysiological mechanisms involved.
Intestinal topical lidocaine spray improves the efficacy and safety of endoscopic sigmoid polypectomy
Authors: Lu Qin , Xiong Fei , Wang Xiang-Yin , Zeng Ting , Lin Da-Yong , Liu Wei-Hui 
Published: July 2023

Background and aims
Endoscopic polypectomy can prevent colorectal cancer. Adequate surgical field visualization is crucial to complete resection. To prevent visual field loss caused by intestinal peristalsis, we investigated the efficacy and safety of topical lidocaine spraying during the endoscopic sigmoid polypectomy (ESP).

Methods
Retrospective analysis was performed on 100 ESP patients admitted from July 2021 to October 2021, among which 50 patients received lidocaine (case group) and other 50 patients received normal saline (control group). Lidocaine or saline was sprayed on the colonic mucosa within 5 cm above and below the polyps before polypectomy. The en-bloc resection rate (EBRR) and complete resection rate (CRR) were primarily evaluated. Secondary outcomes included EBRR for polyps located in the 5–11 o’clock position, sigmoid colon peristalsis frequency, degree of exposure to the surgical field, operative times, and adverse events.

Results
There were no significant differences in the basic demographic characteristics between the two groups. EBRR and CRR in the case group were 72.9% and 95.8%, and in the control group were 53.3% and 91.1%, respectively. The EBRR of sigmoid polyps located at the 5–11 o’clock positions was significantly higher in the case group (82.8%) than in the control group (56.7%) (P = 0.03). Sigmoid colonic peristalsis was significantly inhibited after lidocaine spraying (P < 0.01). There was no statistical difference in the operative times and adverse event rates between the two groups.

Conclusion
Topical spraying lidocaine around polyps can safely and effectively reduce intestinal peristalsis, thus improving the EBRR of sigmoid polypectomy.
Excellent outcome in patients with primary biliary cholangitis in Northwest Italy followed up for up to 30 years
Authors: Rigamonti Cristina , De Benedittis Carla , Labanca Sara , Vanni Ester , Morgando Anna , Manfredi Giulia Francesca , Azzolina Danila , Cittone Micol Giulia , Giannini Edoardo Giovanni , Saracco Giorgio Maria , Pirisi Mario 
Published: July 2023

Objective
Primary biliary cholangitis (PBC) is a rare chronic autoimmune cholangiopathy, characterized by a variable course and response to treatment. We aimed to describe long-term outcomes of PBC patients referred to three academic centres in Northwest Italy.

Methods
This is an ambispective cohort study of PBC patients (retrospective component: diagnosis before 1 January 2019; prospective component: thereafter), including 302 patients: 101 (33%) followed up in Novara, 86 (28%) in Turin, 115 (38%) in Genoa. Clinical features at diagnosis, biochemical response to therapy and survival were analyzed.

Results
Among the 302 patients (88% women, median age 55 years, median follow-up 75 months), alkaline phosphatase (ALP) levels significantly decreased during treatment with ursodeoxycholic acid (UDCA, P < 0.0001) and obeticholic acid (P < 0.0001). At multivariate analysis, ALP at diagnosis was predictive of 1-year biochemical response to UDCA [odds ratio 3.57, 95% confidence interval (CI) 1.4–9, P < 0.001]. Estimated median survival free of liver transplantation and hepatic complications was 30 years (95% CI 19–41). Bilirubin level at diagnosis was the only independent risk factor for the combined outcome of death, transplantation or hepatic decompensation (hazard ratio, 1.65, 95% CI 1.66–2.56, P = 0.02). Patients presenting with total bilirubin at diagnosis ≥0.6 times the upper normal limit (ULN) had a significantly lower 10-year survival compared to those with bilirubin <0.6 times ULN (63% vs. 97%, P < 0.0001).

Conclusion
In PBC, both short-term response to UDCA and long-term survival can be predicted by simple conventional biomarkers of disease severity, obtained at diagnosis.
Transjugular intrahepatic portosystemic shunt for pyrrolidine alkaloids-induced hepatic sinusoidal obstruction syndrome: a retrospective cohort study
Authors: Huang Tongmin , Zhang Xingfen , Yan Kun , Lou Dandi , He Yujing , Dai Senjie , Zheng Dingcheng , Chen Ping , Wu Feng , Gu Lihu 
Published: July 2023

Background
This study aimed to investigate the efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of patients with pyrrolidine alkaloids-induced hepatic sinusoidal obstruction syndrome (PA-HSOS).

Methods
Patients diagnosed with PA-HSOS and treated in Ningbo No.2 Hospital between November 2017 and October 2022 were enlisted in this retrospective cohort study.

Results
This cohort comprised a total of 22 patients with PA-HSOS, of which 12 patients received TIPS treatment and 10 patients experienced conservative treatment. The median follow-up duration was 10.5 months. Baseline characteristics existed with no significant difference between the two groups. No operation failures or any TIPS-associated intraoperative complications were observed after TIPS. In the TIPS group, the portal venous pressure was substantially decreased from 25.3 ± 6.3 mmHg to 14.4 ± 3.5 mmHg after TIPS (P = 0.002). Compared with preoperative, the ascites after TIPS were significantly subsided (P = 0.001) and there existed a considerable decrease in Child-Pugh score. At the end of follow-up, 5 patients died, involving 1 in the TIPS group and 4 in the conservative treatment group. The median survival time was 13 (3–28) months in the TIPS group and 6.5 (1–49) months in the conservative treatment group, respectively. The survival analysis demonstrated that the total survival time of TIPS group was longer than that of the conservative treatment group, no statistical significance was observed (P = 0.08).

Conclusion
TIPS may be a secure and effective therapeutic strategy for PA-HSOS patients who do not respond to conservative treatment.
Fatty pancreas was associated with a higher acute pancreatitis Systemic Inflammatory Response Syndrome score at hospital admission
Authors: Sbeit Wisam , Abu Elheja Fares , Msheiil Botros , Shahin Amir , Khoury Sharbel , Sbeit Moeen , Khoury Tawfik 
Published: July 2023

Background
Pancreatic fat infiltration was shown to be linked with acute pancreatitis and probably its severity. These interesting findings merit more investigation to elucidate the effect of fatty pancreas on acute pancreatitis severity.

Methods
We performed a retrospective study of patients hospitalized with documented acute pancreatitis. Pancreatic fat was determined according to pancreas attenuation on computed tomography. Patients were divided into two groups, with and without fatty pancreas. The Systemic Inflammatory Response Syndrome (SIRS) score was compared.

Results
Overall, 409 patients were hospitalized with acute pancreatitis. Among them, 48 patients had fatty pancreas (group A), vs. 361 patients who did not (group B). The mean ± SD age in group A was 54.6 ± 21.3, vs. 57.6 ± 16.8 in group B (P = 0.51). Patients in group A, had a significantly higher rate of fatty liver, as compared to group B (85.4% vs. 35.5%, P < 0.001). There was no significant difference in the medical history among the two groups. Fatty pancreas was associated with more severe acute pancreatitis as assessed by SIRS score at admission. The mean ± SD of SIRS score was significantly higher in group A (0.92 ± 0.87), as compared to 0.59 ± 0.74 in group B (P = 0.009). Positive SIRS score was present in a significantly higher proportion of patients with fatty pancreas (25%), as compared to only 11.4% in group B (P = 0.02).

Conclusion
The occurrence of acute pancreatitis with higher SIRS score was significantly associated with fatty pancreas. Fatty pancreas may represent a predictor of acute pancreatitis severity.
Quantitative [123]I-Ioflupane DaTSCAN single-photon computed tomography-computed tomography in Parkinsonism
Authors: Missir Elena , Begley Patrick , Jessop Maryam , Singh Nitasha , Aplin Mark , McMeekin Helena , Parekh Puja , Raczek Malgorzata , Dizdarevic Sabina 
Published: July 2023

Aim
[123]I-Ioflupane (DaTSCAN) binds to the presynaptic dopamine transporter (DAT) and with a lower affinity to the serotonin transporter (SERT). We aimed to develop a novel method to quantify absolute uptake in the striatal (predominantly DAT binding) and extra-striatal regions (mainly SERT binding) using single-photon computed tomography-computed tomography (SPECT-CT) DaTSCAN and to improve DaTSCAN image quality.

Method
Twenty-six patients with Parkinsonism underwent DaTSCAN SPECT-CT prospectively. The scans were visually analyzed independently by two experienced reporters. Specific binding ratios (SBRs) from Chang attenuation corrected SPECT were obtained using GE DaTQuant. Normalized concentrations and specific uptakes (NSU) from measured attenuation and modelled scatter-corrected SPECT-CT were obtained using HERMES Hybrid Recon and Affinity and modified EARL volumes of interest.

Results
Striatal NSU and SBR positively correlate (R = 0.65–0.88, P = 0.00). SBR, normalized concentrations, and NSU box plots differentiated between scans without evidence of dopaminergic deficit and abnormal scans. Interestingly, body weight inversely correlated with normalized concentrations values in extra-striatal regions [frontal (R = 0.81, P = 0.00); thalamus (R = 0.58, P = 0.00); occipital (R = 0.69, P = 0.00)] and both caudate nuclei [R = 0.42, P = 0.03 (Right), R = 0.52, P = 0.01 (Left)]. Both reporters noted improved visual quality of SPECT-CT versus SPECT images for all scans.

Conclusion
DaTSCAN SPECT-CT resulted in more accurate quantification, improved image quality, and enabled absolute quantification of extra-striatal regions. More extensive studies are required to establish the full value of absolute quantification for diagnosis and monitoring the progression of neurodegenerative disease, to assess an interplay between DAT and SERT, and to verify whether serotonin and DATs are potentially dysfunctional in obesity.
Direct Occipital Remodeling in Sagittal Synostosis Improves 2-Year Posterior Morphology after Modified Pi Procedure
Authors: Hopper Richard A. , Nguyen Andy N. , Massenburg Benjamin B. , Lee Amy , Mercan Ezgi 
Published: July 2023

Background:
Modifications of the pi craniectomy technique are meant to address the occipital bullet deformity of sagittal synostosis, but it is not clear whether they result in persistent improvement. The authors’ purpose was to use morphometric analysis to determine whether a low occipital osteotomy with verticalization results in improved occipital shape after a modified pi procedure 2 years after surgery.

Method:
The authors performed a retrospective cohort study comparing modified pi technique with and without a low occipital osteotomy with verticalization immediately and 2 years after surgery relative to age-matched normal controls. The authors used anthropometric measures and population-level anatomical templates using the multivariate template construction script from advanced normalization tools for comparison between groups. A subgroup analysis was performed for severe occipital bullet deformity at presentation.

Results:
The authors observed stable improvement in the angle of the inferior occiput with the occipital remodeling modification that persisted 2 years after surgery. This improvement was seen in the entire cohort and was greater in the severe subgroup analysis. Complications and blood transfusion volumes were not different between the 2 techniques. The low occipital osteotomy group demonstrated improved posterior vertical height and cephalic index immediately after surgery, but these did not persist 2 years later.

Conclusions:
Occipital remodeling improves the bullet deformity but does not affect posterior vertical height 2 years after surgery. The authors recommend direct inferior occipital remodeling when using the pi technique for young patients with acute occipital incline angles and occipital constriction.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.