bluuebunny/crossref_metadata_2025_split huggingface dataset:
Over a third of palliative medicine physicians meet burnout criteria: Results from a survey study during the COVID-19 pandemic
Authors: Boland Jason W , Kabir Monisha , Spilg Edward G , Webber Colleen , Bush Shirley H , Murtagh Fliss , Lawlor Peter G 
Published: February 2023

Background: Palliative medicine physicians may be at higher risk of burnout due to increased stressors and compromised resilience during the COVID-19 pandemic. Burnout prevalence and factors influencing this among UK and Irish palliative medicine physicians is unknown. Aim: To determine the prevalence of burnout and the degree of resilience among UK and Irish palliative medicine physicians during the COVID-19 pandemic, and associated factors. Design: Online survey using validated assessment scales assessed burnout and resilience: The Maslach Burnout Inventory Human Services Survey for Medical Personnel [MBI-HSS (MP)] and the Connor-Davidson Resilience Scale (CD-RISC). Additional tools assessed depressive symptoms, alcohol use, and quality of life. Setting/participants: Association of Palliative Medicine of UK and Ireland members actively practising in hospital, hospice or community settings. Results: There were 544 respondents from the 815 eligible participants (66.8%), 462 provided complete MBI-HSS (MP) data and were analysed. Of those 181/462 (39.2%) met burnout criteria, based on high emotional exhaustion or depersonalisation subscales of the MBI-HSS (MP). A reduced odds of burnout was observed among physicians who worked ⩽20 h/week (vs 31–40 h/week, adjusted odds ratio (aOR) 0.03, 95% confidence interval (CI) 0.002–0.56) and who had a greater perceived level of clinical support (aOR 0.70, 95% CI 0.62–0.80). Physicians with higher levels of depressive symptoms had higher odds of burnout (aOR 18.32, 95% CI 6.75–49.73). Resilience, mean (SD) CD-RISC score, was lower in physicians who met burnout criteria compared to those who did not (62.6 (11.1) vs 70.0 (11.3); p < 0.001). Conclusions: Over one-third of palliative medicine physicians meet burnout criteria. The provision of enhanced organisational and colleague support is paramount in both the current and future pandemics.
The Associations Between Quadriceps Tendon Graft Thickness and Isokinetic Performance
Authors: Letter Michael I. , Parrino Rosalia L. , Adams Will , Ripic Zachary , Baraga Michael G. , Kaplan Lee D. , Harrah Tanner , Tremblay Julien , Luxenburg Dylan , Conti Joseph , Signorile Joseph F. 
Published: February 2023

Background:Anterior cruciate ligament reconstruction (ACLR) using the quadriceps tendon is an increasingly popular technique. Both partial-thickness quadriceps tendon (PT-Q) and full-thickness quadriceps tendon (FT-Q) graft depths are employed.Hypothesis/Purpose:This study was designed to assess isokinetic peak torque, average power, and total work during knee extension in patients with FT-Q or PT-Q grafts for ACLR. We hypothesized that both groups would show lower isokinetic values for the operated side, with greater deficits in the FT-Q group than in the PT-Q group.Study Design:Cohort study; Level of evidence, 3.Methods:A total of 26 patients who underwent ACLR with either an FT-Q or PT-Q graft were recruited between June 2021 and November 2021. Patients underwent isokinetic knee extension testing at > 1 year after surgery. Mixed repeated-measures analysis of covariance with least square difference post hoc testing was used to determine significant differences or interactions for all variables.Results:Peak torque was significantly lower for the operated limb than the nonoperated limb in the FT-Q group (mean difference [MD] ± standard error [SE], −38.6 ± 8.3 Nċm [95% CI, −55.7 to −21.5 Nċm]; P < .001; d = 0.90) but not in the PT-Q group (MD ± SE, −7.3 ± 7.7 Nċm [95% CI, −23.2 to 8.5 Nċm]; P = .348; d = 0.20). Similarly, average power for the operated limb was lower than that for the nonoperated limb in the FT-Q group (MD ± SE, −53.6 ± 13.4 W [95% CI, −81.3 to −26.9 W]; P < .001; d = 0.88) but not in the PT-Q group (MD ± SE, –4.1 ± 12.4 W [95% CI, −29.8 to 21.5 W]; P = .742; d = 0.07), and total work was lower for the operated limb compared with the nonoperated limb in the FT-Q group (MD ± SE, −118.2 ± 27.1 J [95% CI, −174.3 to −62.2 J]; P < .001; d = 0.96) but not in the PT-Q group (MD ± SE, −18.3 ± 25.1 J [95% CI, −70.2 to 33.6 J]; P = .472; d = 0.15).Conclusion:The FT-Q group showed significant deficits in the operated limb compared with the nonoperated limb for all isokinetic variables. In contrast, no significant differences were found between the nonoperated and operated limbs for the PT-Q group.
Diagnostic Accuracy of Conventional Ankle CT Scan With External Rotation and Dorsiflexion in Patients With Acute Isolated Syndesmotic Instability
Authors: Rodrigues João Carlos , do Amaral e Castro Adham , Rosemberg Laercio Alberto , de Cesar Netto Cesar , Godoy-Santos Alexandre Leme 
Published: February 2023

Background: Syndesmotic injury in an athletic population is associated with a prolonged ankle disability after an ankle sprain and often requires a longer recovery than a lateral collateral ligament injury. Although several imaging tests are available, diagnosing syndesmotic instability remains challenging. Purpose: To determine the diagnostic accuracy of conventional ankle computed tomography (CT) scans with the joint in external rotation and dorsiflexion and compare it with that of conventional ankle CT scans in a neutral position. Study Design: Cohort study (Diagnosis); Level of evidence, 2. Methods: Between September 2018 and April 2021, this prospective study consecutively included adults visiting the foot and ankle outpatient clinic with a positive orthopaedic examination for acute syndesmotic injury. Participants underwent 3 CT scan tests. First, ankles were scanned in a neutral position. Second, ankles were scanned with 45° of external rotation, dorsiflexion, and extended knees. Third, ankles were scanned with 45° of external rotation, dorsiflexion, and flexed knees. Three measurements, comprising rotation (measurement a), lateral translation (measurement c), and anteroposterior translation (measurement f) of the fibula concerning the tibia, were used to diagnose syndesmotic instability in the 3 CT scans. Magnetic resonance imaging was used as a reference standard. The area under the curve (AUC) was used to compare the diagnostic accuracy, and Youden’s J index was calculated to determine the ideal cutoff point. Results: Images obtained in 68 participants (mean age, 36.5 years; range, 18-69 years) were analyzed, comprising 36 syndesmotic injuries and 32 lateral collateral ligament injuries. The best diagnostic accuracy occurred with the rotational measurement a, in which the second and third CT scans with stress maneuvers presented greater AUCs (0.97 and 0.99) than did the first CT scan in a neutral position (0.62). The ideal cutoff point for the stress maneuvers was 1.0 mm in the rotational measurement a and reached a sensitivity and specificity of 83% and 97% for the second CT scan with extended knees and 86% and 100% for the third CT scan with flexed knees, respectively. The ideal cutoff point for the first CT scan with a neutral position was 0.7 mm in the rotational measurement a, with a sensitivity of 25% and specificity of 97%. Conclusion: Conventional ankle CT with stress maneuvers has excellent performance for diagnosing subtle syndesmotic rotational instability, as it shows a greater AUC and enhanced sensitivity at the ideal cutoff point compared with ankle CT in the neutral position.
Influence of construction method of submicron polybutadiene particles on transparent methacrylate-acrylonitrile-butadiene-styrene resin properties
Authors: Xu Lu , Tang Qianyi , Hu Yiwei , Liu Baijun , Zhang Mingyao 
Published: February 2023

Submicron polybutadiene particles were prepared using four different methods: one-step batch emulsion polymerization, pressure agglomeration, acid agglomeration, and polymer latex agglomeration. Core-shell elastomers were synthesized by grafting styrene and methyl methacrylate on polybutadiene particles. Transparent methacrylate-acrylonitrile-butadiene-styrene resin was prepared by blending the elastomers with methacrylate-styrene-acrylonitrile matrix resin synthesized by bulk polymerization. The effects of the construction method of submicron rubber particles on core-shell elastomer structure and composite properties were investigated. Additionally, the relationship between the rubber phase structure and composite properties was studied. The obtained results showed that the construction method significantly affected the size distribution and morphology of the submicron rubber particles. The rubber particles prepared by one-step batch emulsion polymerization were grafted easily, with 90.2% grafting efficiency of the corresponding core-shell elastomer. The grafting efficiency of the rubber particles prepared by acid agglomeration was only 69.4%. The former was most suitable as the toughening core of transparent Acrylonitrile-butadiene-styrene resin, and the transmittance and haze values of the composite were 90% and 2.4, respectively. Impact and tensile strengths were 185.6 J/m and 39 MPa, respectively. The acid agglomeration method generated submicron rubber particles more quickly, and the transmittance and haze of composite were 90% and 2.9, respectively. However, the impact and tensile strengths were reduced to 170.4 J/m and 31 MPa, respectively.
Effect of acupuncture on brain functional networks in patients with mild cognitive impairment: an activation likelihood estimation meta-analysis
Authors: Xia Rui , Ren Jinxin , Wang Mengyang , Wan Yiwen , Dai Yalan , Li Xingjie , Wu Zhuguo , Chen Shangjie 
Published: February 2023

Background: Prior research has shown that acupuncture, a traditional Chinese medical therapy, may have a certain therapeutic effect in patients with mild cognitive impairment (MCI). Furthermore, some studies have explored the effects of acupuncture on the brain functional networks of MCI patients to investigate the mechanism of action. Different studies have analysed the brain regions involved in acupuncture-induced changes, but (to our knowledge) these have not been summarized by a systematic review. Methods: We searched PubMed, EMBASE, Cochrane Library, SinoMed, CNKI and other databases in Chinese and English to identify neuroimaging studies of acupuncture interventions in MCI patients. After two stages of literature screening, bias risk assessment and data extraction, brain regions with significant differences were input into GingerALE software. Based on the activation likelihood estimation algorithm, coordinate-based meta-analyses were conducted. Results: The changes in functional activation of 95 different areas in 8 trials, including 212 MCI patients, were analysed. The three most commonly used traditional acupuncture point locations in acupuncture interventions for MCI were KI3 ( Taixi), LR3 ( Taichong) and LI4 ( Hegu). The results of the ALE data analysis showed that, after acupuncture intervention, the degree of activation in the anterior cingulate, inferior frontal gyrus, medial frontal gyrus and cerebellar tonsil of MCI patients increased significantly. Conclusions: Acupuncture intervention for MCI appears to change the plasticity of brain function and improve the cognitive function of patients. Due to the small number and low quality of the included studies, the conclusion of this meta-analysis should be treated with caution. Registration: PROSPERO reference CRD42022301056 ( http://www.crd.york.ac.uk/PROSPERO ).
Exploring Five Wishes and End-of-Life Care Planning in Young Adults
Authors: Stone Arianna , Perre Taylor , Young Yuchi 
Published: February 2023

Introduction Our study aims to (1) examine the perspectives of young adults toward Five Wishes, and (2) measure their preferences related to personal, emotional, spiritual, and medical choices in end-of-life care planning. Methods Data were collected using a structured survey questionnaire and Five Wishes. Participants include graduate students (n = 30) attending a university in New York State. Bivariate summary statistics were performed to address the study aims. Results The average age of the participants was 24 years old; 60% were female, 60% White, and 27% Black. In the case of permanent and severe brain damage without the expectation to wake up or recover, 63% of the participants do not want life-support treatment. In the event of a coma without expectation to wake up or recover, 53% do not want life-support treatment. When close to death, 80% want to have religious or spiritual readings and well-loved - poems read aloud. Conclusion Young adults are capable of making their own decisions about appointing a health care proxy and making choices for their personal, emotional, spiritual, and medical care for the future. The present findings intend to make contributions to the research pertaining to end-of-life care that promotes population-based healthcare decision-making, education, and awareness among young adults.
Progression of bilateral morning glory syndrome associated with unilateral persistent fetal vasculture: A case report of long term follow-up in an infant
Authors: Ran Hongyun , Ren Jiantao , Li Shuchan , Han Haitao , Liu Hangyu , Ai Zhaohui , Jiang Keke , Zhang Jie 
Published: February 2023

Purpose To describe a case of Bilateral Morning Glory Syndrome (MGS) associated with Unilateral Persistent Fetal Vasculature (PFV) in a 3-day old neonate. Observations A 3-day-old neonate was found bilateral retinal abnormalities due to neonatal eye screening. Dilated fundus exam showed bilateral optic disc dysplasia with the persistent hyaloid vessels in right eye at first. With the progress of the disease, optic disc was enlarged with central umbilication which with a similar anomalous radiating peripapillary vascular appearance, the persistent hyaloid vessels in vitreous cavity of right eye gradually disappear, a large amount of exudation can be seen in the posterior pole retina with macular movement in both eyes. Bilateral vitrectomy was performed in this case, then the condition of the neonate's both eyes is stable until 1 year old. Conclusions and Importance This is a rare case that showing the development of MGS and PFV and the relationship between these two diseases. In addition, we completely observed the whole process of the change of the persistent hyaloid vessels in the vitreous cavity of a case of MGS associated with PFV.
Occupational Exposure to Blood and Body Fluids Among Nurses in the Emergency Department and Intensive Care Units of Public Hospitals in Addis Ababa City: Cross-sectional Study
Authors: Adal Ousman , Abebe Asmamaw , Feleke Yohannes 
Published: February 2023

Aims and Objectives: This study investigated occupational exposure to blood and body fluids among nurses at the emergency department and intensive care units of public hospitals in Addis Ababa city. Methods: A cross-sectional study was conducted from June 18, 2021 to September 20, 2021. A simple random sampling method and semi-structured, self-administered questionnaires were used to collect the data, which were analyzed using SPSS version 25. A binary logistic regression model was used to identify factors associated with exposure to blood and body fluids on the AOR with a 95% confidence interval at a P-value of <.05. Patient and Public Involvement: No patients were involved in this study. Results: Of the total study participants (260), 198 (76%) nurses had been exposed to blood and body fluids in their professional live, and 167 (64%) were exposed to blood and body fluids in the last 12 months. Being male (AOR = 2.88, 95% CI: (1.35, 6.12), lacking access to handwashing facilities (AOR = 5.02, 95% CI: (3.73, 14.51)), not consistently wearing all the required types of personal protective equipment (AOR = 6.21, 95% CI: (2.39, 9.55)), and the lack of the required personal protective equipment (AOR = 5.53, 95% CI: (1.87, 10.38)) were all significant factors that were positively associated with exposure to blood and body fluids. Conclusion: This study showed that a higher proportion of nurses in the emergency department and intensive care unit were exposed to blood and body fluids in the study setting. Most nurses do not consistently wear all the required types of personal protective equipment, putting them at a higher risk of acquiring blood-borne pathogens. The authors recommended that there is a need to implement and strengthen appropriate and consistent use of all required personal protective equipment during any procedure, and patient care to reduce exposure to blood and body fluids. Relevance to Clinical Practice: This study provides baseline information for other action-based studies to assess exposure to blood and body fluids among nurses in emergency and intensive care units. Strobe Checklist: This manuscript was prepared based on the strobe checklist guidelines. Impact Statement: The study’s findings and recommendations might be used for healthcare providers, non-governmental organizations, and policymakers for appropriate planning and interventions to minimize or safeguard nurses’ exposure to blood and body fluids.
A narrative review of damage control resuscitation for paediatric trauma patients in Iraq and Afghanistan from 2001 to 2016
Authors: Wright Annie Mae , Ramage Lisa , Barratt Jon , Grier Gareth , Hughes Amy 
Published: February 2023

Introduction Requirement for blood transfusion in the injured paediatric civilian population is rare. Therefore, a substantial evidence base underpinning damage control resuscitation (DCR) in paediatric patients is lacking. Published outcome data originating from Iraq and Afghanistan offer a unique opportunity to study large cohorts of children who received DCR. It is hoped that by collating the data, this review will inform pre-deployment medical training and support the development of paediatric specific DCR guidelines, which can be used in all trauma environments. Methodology A comprehensive search of the literature was conducted using online databases, grey literature searching and screening of reference lists. Papers discussing blood product, crystalloid or tranexamic acid (TXA) administration in paediatric patients injured in Iraq and Afghanistan from 2001to present were included. Results Eighteen papers were included – all were retrospective studies of data from military trauma databases. Most children that received massive transfusion were male (73.4%), injured in Afghanistan (69.9%) by explosives (60.4%) with a median age of 9 years. A definition of paediatric massive transfusion of 40 ml/kg of all blood products within 24 h was developed. Massive transfusion rates were high (15.7% of children). Whole blood administration occurred in 4% of patients requiring blood transfusions. Low crystalloid volumes in combination with balanced blood product ratios were associated with improved survival, along with the use of whole blood and TXA. Conclusion The review offers insight into the paediatric population likely to require DCR and the optimal DCR strategies to be used in their management.
Characterization and reliability of internet resources on pulmonary rehabilitation for individuals with chronic lung disease
Authors: Da Silva Tania , Lokhandwala Ashira , Al Kaabi Noor , Semenchuk Julie , Goobie Gillian C , Camacho Encarna , Reid W Darlene , Fisher Jolene H , Ryerson Christopher J , Rozenberg Dmitry 
Published: February 2023

Background Individuals with lung disease commonly use the internet as a source of health information on pulmonary rehabilitation (PR). The objective of this study was to characterize internet resources on PR, and to assess the content, readability, and quality of patient-directed PR resources. Methods The first 200 websites for the search term ‘pulmonary rehabilitation resources and exercise’ were analyzed on Google, Yahoo, and Bing. Website content was assessed based on 30 key components of PR from the 2013 and 2021 international consensus statements. Website quality was determined using DISCERN, JAMA benchmarks, and Global Quality Scale (GQS). Results 66 unique PR websites were identified with the two most common categories being scientific resources (39%) and foundation/advocacy organizations (33%). The average reading level of websites was 11 ± 3. PR content varied significantly across websites (mean range 13.4–21.5). Median DISCERN total score and GQS score were 4 (IQR 3-4) and 3.5 (IQR 2-4), respectively, representing moderate-good quality. Foundation/advocacy websites had higher DISCERN and GQS scores compared to other websites. Conclusion Foundation/advocacy websites had the highest quality and reliability metrics; however, the higher-than-recommended reading levels may compromise patient comprehension and utilization. This study provides critical insight on the current state of online PR health-related information.
Evaluation of the Efficiency of a Joystick-Guided Robotic Scope Holder Compared to That of Human Scopists: A Prospective Trial
Authors: Kudo Takuya , Kanaji Shingo , Harada Hitoshi , Ohmura Yasushi , Sawada Ryuichiro , Urakawa Naoki , Goto Hironobu , Hasegawa Hiroshi , Yamashita Kimihiro , Matsuda Takeru , Oshikiri Taro , Kakeji Yoshihiro 
Published: February 2023

Purpose This study aimed to compare motions of the laparoscope tip during a laparoscopic task in a training box using a recent joystick-guided robotic scope holder to those manipulated by human scopists. We hypothesized that laparoscopic manipulation could be positively affected by robotic scope holders due to the elimination of unintentional movement. Methods Twelve surgeons participated as operators, and eight medical doctors participated in this study. Among the human scopists, five were trained surgeons and three were novices who had no experience with laparoscopic surgery. A validated laparoscopic task was used to evaluate the path length of the laparoscope tip using an optical position tracker and operative time. The operators performed the designated camera task under three different laparoscopic manipulations: using a joystick-guided robotic scope holder, expert human scopists, and novice scopists. Results The median path lengths (cm) of the laparoscopic tip were 94.0, 110.0, and 122.2 in the robotic scope holder, expert, and novice groups, respectively. The path lengths in the robotic scope holder group were significantly shorter than those in the other groups (P < .01). The median operative times (seconds) were 136.6, 66.4, and 62.3 in the robotic scope holder, expert, and novice groups, respectively. The operative time of the robotic scope holder group was significantly longer than that of the other groups (P < .001). Conclusion A robotic scope holder can provide shorter camera movement owing to the stable holding and intentional scope manipulation by the operator, although it requires a longer operative time than a human assistant.