bluuebunny/crossref_metadata_2025_split huggingface dataset:
Engaging Retired Physicians as Educators: Motivations and Experiences of Participants in a Novel Educational Program
Authors: Plotnick Laurie H. , Sternszus Robert , Macdonald Mary Ellen , Steinert Yvonne 
Published: November 2022

Purpose
Physician retirement has important impacts on medical learners as well as retiring physicians themselves. Retiring physicians take with them a wealth of knowledge, wisdom, and expertise and can feel a loss of identity, lack of fulfillment, and reduced social connectedness after leaving the institution. To address this, a novel educational program providing retired physicians with renewed educational roles was implemented in 2018 within a university-associated pediatric department. This study sought to explore the retired physicians’ experiences in this new intergenerational program, including their motivations to reengage as educators after retirement.

Method
The authors designed this study using qualitative description. Semistructured interviews were conducted in the Department of Pediatrics of McGill University in 2019 with retired physicians who participated in the educational program’s inaugural year. Role theory and psychosocial development theory were used to design the interview guide and inform the thematic analysis. Iterative analysis of the interview transcripts was deductive and inductive.

Results
Of the 8 retired physicians who participated in the program’s first cohort, 7 participated in this study. Analysis of the data yielded 4 main themes: a challenging shift to retirement, a desire for reengagement after retirement, role dissonance, and gaining by giving. The retired physicians were motivated to engage as educators. Although they experienced some discomfort in their new nonclinical roles, they described their experiences as fulfilling, with benefits such as intellectual stimulation, social connectedness, and a sense of purpose.

Conclusions
Retired physicians’ motivations to reengage academically and their experiences contributing to educational activities in this program highlight the importance of supporting physicians during the transition to retirement and establishing formal programs to engage retired physicians as educators.
Randomized controlled trial of intrathecal oxytocin on speed of recovery after hip arthroplasty
Authors: Eisenach James C. , Shields John S. , Weller Robert S. , Curry Regina S. , Langfitt Maxwell K. , Henshaw Daryl S. , Pollock David C. , Edwards Christopher J. ,   Spinal Oxytocin Hip Surgery Collaborators, Houle Timothy T. 
Published: November 2022

Abstract
Recovery from surgery is quicker in the postpartum period, and this may reflect oxytocin action in the spinal cord. We hypothesized that intrathecal injection of oxytocin would speed recovery from pain and disability after major surgery. Ninety-eight individuals undergoing elective total hip arthroplasty were randomized to receive either intrathecal oxytocin (100 μg) or saline. Participants completed diaries assessing pain and opioid use daily and disability weekly, and they wore an accelerometer beginning 2 weeks before surgery until 8 weeks after. Groups were compared using modelled, adjusted trajectories of these measures. The study was stopped early due to the lack of funding. Ninety patients received intrathecal oxytocin (n = 44) or saline (n = 46) and were included in the analysis. There were no study drug–related adverse effects. Modelled pain trajectory, the primary analysis, did not differ between the groups, either in pain on day of hospital discharge (intercept: −0.1 [95% CI: −0.8 to 0.6], P = 0.746) or in reductions over time (slope: 0.1 pain units per log of time [95% CI: 0-0.2], P = 0.057). In planned secondary analyses, postoperative opioid use ended earlier in the oxytocin group and oxytocin-treated patients walked nearly 1000 more steps daily at 8 weeks (P < 0.001) and exhibited a clinically meaningful reduction in disability for the first 21 postoperative days (P = 0.007) compared with saline placebo. Intrathecal oxytocin before hip replacement surgery does not speed recovery from worst daily pain. Secondary analyses suggest that further study of intrathecal oxytocin to speed functional recovery without worsening pain after surgery is warranted.
Sexually Transmitted Diseases in Northern Israel: Insights From a Large Referral Laboratory
Authors: Kridin Khalaf , Ingram Batsheva , Becker Daniella , Shiloah Noga , Azrad Maya , Habib Sonia , Peretz Avi 
Published: November 2022

Abstract

Objectives
The aims of the study are to investigate the distribution and frequency of different sexually transmitted diseases (STDs) among a large study population of individuals undergoing STD investigation both in inpatient and STD clinic settings and to evaluate influence of test anonymity on the positivity rate of pathogens.

Material and Methods
A retrospective study retrieved epidemiologic data from the following 3 sources: a secondary referral hospital and 2 STD clinics in Northern Israel. Positivity rate of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Mycoplasma genitalium, and Trichomonas vaginalis (TV) was assessed and stratified based on age, sex, site of sampling, and anonymity of test. Adjusted odds ratios (ORs) were calculated by multivariable logistic regression.

Results
Overall, 3,753 assays were performed on 2,407 patients who were screened for STD. Chlamydia trachomatis (4.8%) was the most frequently detected STD, followed by NG (2.1%), MG (1.9%), and TV (0.6%). Mycoplasma genitalium (OR, 4.32; 95% CI, 1.70–10.97; p = .001) and NG (OR, 6.08; 95% CI, 2.18–16.96; p < .001) were significantly associated with male sex, while TV was more frequently encountered among female individuals (OR, 4.34; 95% CI, 1.49–12.50; p = .003). Mycoplasma genitalium infection was detected most commonly by urine samples, while rectal swabs were the leading source of positive tests for CT. Compared with fully identified patients, those tested anonymously were 6-fold more likely to be tested positive for TV (adjusted OR, 6.49; 95% CI, 2.06–20.42; p = .001).

Conclusions

Chlamydia trachomatis and NG are the leading non-HIV STDs in Northern Israel. Anonymous tests predict higher positivity of TV. Rectal sampling should be increasingly used because of its efficacy in detecting CT infections.
Spontaneous healing and complete disappearance of an intracranial vertebral artery dissecting aneurysm: A case report
Authors: Wu Qiaowei , Li Tianxiao , Li Li , Chang Kaitao , Shao Qiuji 
Published: November 2022

Rationale:
Intracranial vertebrobasilar dissecting aneurysms (VBDAs) are associated with a greater tendency to rupture and a greater risk of worse outcomes than anterior circulation aneurysms. Spontaneous healing of a VBDA is very rare, and there have been very few case reports of spontaneous healing of an aneurysm. We describe a case of intracranial vertebral artery dissecting aneurysm that healed spontaneously and disappeared completely on follow-up images.

Patient concerns:
A 40-years-old woman was referred to the neurology department because of a persistent headache, especially in the left occiput.

Diagnoses:
Magnetic resonance angiography and computed tomography angiography showed a left vertebral artery dissection-like aneurysm (4.5 × 2.0 × 2.5 mm in size) with proximal parent artery mild stenosis (40%).

Interventions:
Flunarizine hydrochloride was administered for symptomatic treatment and follow-up angiography was performed.

Outcomes:
Digital subtraction angiography and magnetic resonance angiography showed that the aneurysm had completely disappeared at 3 months follow-up. High-resolution magnetic resonance vessel wall imaging revealed intimal thickening and mild stenosis in the left intracranial vertebral artery without an aneurysm signal. In addition, enhancement scanning revealed that the aneurysm area was moderately enhanced. MR-vessel wall imaging at 7 months follow-up showed that the enhancement was slightly reduced compared with the previous time.

Lessons:
This case illustrates the relatively plastic nature of a vertebral dissecting aneurysm, indicating that spontaneous healing remains possible.
Meditation programs for adults with type 2 diabetes mellitus: A protocol for a systematic review and meta-analysis
Authors: Xu Jiayu , Mei Manxue , Sun Haoxiang , Chen Xiaofang , Zhu Wei , Song Jianping 
Published: November 2022

Background:Type 2 diabetes mellitus is intimately linked to chronic stress. Meditation programs belong to mind-body therapies, which could benefit patients’ disease management. Though some clinical trials have proved that meditation programs have the ability to improve level of blood glucose quality of life, body mass index and blood indexes related to metabolism in individuals with type 2 diabetes mellitus, the efficacy of meditation programs needs further confirmation. Thus we will conduct this systematic evaluation and meta-analysis to summarize and analyze all the results included to obtain reliable evidence.Methods:We will search several English and Chinese databases for relevant clinical trials published up to July 2021, and randomized controlled trials or controlled trials among adults with type 2 diabetes mellitus are included. Two reviewers will extract data and assess the quality of included studies independently. The main outcomes of this research are glycosylated hemoglobin level and fasting blood glucose level. The secondary outcomes are high-density lipoprotein, low-density lipoprotein, body mass index, remission of depression and anxiety, and quality of life. Stata v.14.0 and Review Manager V5.3 will be used to synthesize and analyze all data included.Results:Grading of Recommendations Assessment, Development, and Evaluation will be used to evaluate the quality of the assessments. Our study will be disseminated through publications in peer-reviewed journals.Conclusion:This systematic review is the first to analyze the efficacy of different types of meditation for type 2 diabetes mellitus, which could provide evidence for the use of mediation programs as non-drug approaches.Trial registration number:PROSPERO CRD42021274508.
Chinese herbal bath therapy for the treatment of Atopic dermatitis in children: A meta-analysis and systematic review
Authors: Guo Zheng , Li Yongjun , Hou Yiming , Wang Youpeng , Liang Yuan , Si Xiuying , Pan Guangxia , Wang Yijie , Hu Qihui 
Published: November 2022

Background:
To conduct a systematic review of the efficacy of Chinese herbal bath therapy on children with Atopic dermatitis.

Methods:
We searched Chinese databases (CNKI, VIP, and Wanfang) and English databases (PubMed, Embase, Web of science, Cochrane library) for studies from the establishment of the database to September 2022. The included literature was randomized control studies investigating the treatment of Atopic dermatitis in children by Chinese herbal bath therapy. The outcomes included the cure rate, scoring atopic dermatitis (SCORAD) index, adverse reactions and recurrence rate. RevMan 5.4 was used to analyze the extracted data.

Results:
A total of 8 related studies were included containing 854 cases. The meta-analysis showed that Chinese herbal bath therapy group was superior to control group in terms of cure rate, SCORAD index, adverse reactions and recurrence rate in children with Atopic dermatitis [RR = 1.11, 95%(1.02, 1.21), P = .01; SMD = –0.77, 95%(-0.99, -0.55), P < .00001; RR = 0.44, 95%CI(0.28,0.67), P = .0002; RR = 0.25, 95%CI(0.10, 0.59), P = .0002].

Conclusion:
The present study shows that Chinese herbal bath therapy is an effective treatment for children with Atopic dermatitis in China.
Adolescent Confidentiality and Consent in an Emergency Setting
Authors: Mientkiewicz Lauren , Grover Purva 
Published: November 2022

Objectives
The adolescent population comprises a large volume of emergency department visits each year. A recent study showed that 20% of the ambulatory care visits of adolescent patients aged 15 to 25 years were made to the emergency department. This specific population often has poor access to health care and often is a vulnerable population, causing medical care to be a challenge. The purpose of this article was to review the standard practice and the specific laws regarding confidentiality and consent when treating an adolescent patient to provide the best possible care and treatment.

Methods
A comprehensive literature search was done to examine key aspects of adolescent confidentiality and informed consent in an emergency setting. The literature was then compiled into a review article.

Results
The article outlines the specific laws for emergency providers to be aware of regarding patient confidentiality and consent. The adolescent patient can consent to medical care without parental consent, when involving emergency care, contraceptive services, sexually transmitted infections, prenatal care, drug or alcohol related care, mental health services, and sexual assault services. Also, emancipated minors and mature minors are both situations in which a minor has the legal authority to refuse care and make decisions regarding their health care.

Conclusions
Patient confidentiality and informed consent are complex and complicated topics when dealing with the pediatric patient. Although some laws may vary state to state, there are specific details regarding adolescent confidentiality and informed consent that every provider should be aware of. The adolescent population is more likely to seek emergency care if the visit is confidential and the patient feels a sense of trust. Although it is important for providers to respect patient confidentiality when treating adolescents, it is also important for providers to encourage adolescents to confide in their parents regarding health issues.
Are we waiting for the sky to fall? Predictors of withdrawal of life-sustaining support in older trauma patients: A retrospective analysis
Authors: Badrinathan Avanti , Ho Vanessa P. , Tinkoff Glen , Houck Olivia , Vazquez Daniel , Gerrek Monica , Kessler Ann , Rushing Amy 
Published: November 2022

BACKGROUND
Limited data exist regarding the impact of advanced care planning for injured geriatric patients. We hypothesized that patients with advance directives limiting care (ADLC) compared with those without ADLC are more likely to undergo withdrawal of life-sustaining support (WLSS).

METHODS
This is a propensity-matched analysis utilizing American College of Surgeons Trauma Quality Improvement Program patients 65 years or older who presented between 2017 and 2018. Patients with and without ADLC on admission were compared. The primary outcome was WLSS and days prior to WLSS. Additional factors examined included hospital length of stay (LOS), unplanned operations, unplanned intensive care unit admissions, and in-hospital cardiac arrests. Prior to matching, logistic regression model assessed factors associated with WLSS. Patients with and without ADLC were matched 1:1 via a propensity score using patient and injury factors as covariates, and matched pair analysis compared differences in WLSS between patients with and without ADLC.

RESULTS
There were 597,840 patients included: 44,001 patients with an ADLC (7.36%) compared with 553,839 with no ADLC (92.64%). Patients with an ADLC underwent WLSS more often than those with no ADLC (7.68% vs. 2.48%, p < 0.001). In a 1:1 propensity-matched analysis, patients with ADLC were more likely to undergo WLSS (odds ratio [OR], 2.38’ 95% confidence interval [CI], 2.22–2.55), although stronger predictors of WLSS included severity of injury (Injury Severity Score, 25+; OR, 23.84; 95% CI, 21.55–26.36), unplanned intensive care unit admissions (OR, 3.30; 95% CI, 2.89–3.75), and in-hospital cardiac arrests (OR, 4.97; 95% CI, 4.02–6.15).

CONCLUSION
A small proportion of the geriatric trauma population had ADLC on admission. While ADLC was predictive of WLSS, adverse events were more strongly associated with WLSS. To ensure patient-centered care and reduce futile interventions, surgeons should delineate goals of care early regardless of ADLC.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level III.
Colwellia maritima sp. nov. and Polaribacter marinus sp. nov., isolated from seawater
Authors: Kristyanto Sylvia , Jung Jaejoon , Kim Jeong Min , Kim Keunpil , Lee Mi-hwa , Hao Lujiang , Jeon Che Ok 
Published: November 2022

Two Gram-stain-negative, catalase- and oxidase-positive, and aerobic bacteria, strains MSW7T and MSW13T, were isolated from seawater. Cells of strains MSW7T and MSW13T are motile and non-motile rods, respectively. Strain MSW7T optimally grew at 25 °C and pH 7.0 and in the presence of 3 % (w/v) NaCl, whereas strain MSW13T optimally grew at 25 °C and pH 6.0–7.0 and in the presence of 2 % NaCl. As the sole respiratory quinone and the major fatty acids and polar lipids, strain MSW7T contained ubiquinone-8, C16 : 0, C15 : 1
ω8c, C17 : 1
ω8c and summed feature 3 (C16 : 1
ω7c and/or C16 : 1
ω6c), and phosphatidylethanolamine and phosphatidylglycerol, respectively, whereas strain MSW13T contained menaquinone-6, C15 : 1
ω6c, iso-C15 : 0, anteiso-C15 : 0, and iso-C15 : 0 3-OH, and phosphatidylethanolamine, respectively. The DNA G+C contents of strains MSW7T and MSW13T were 37.3 and 29.9 %, respectively. Phylogenetic analyses based on 16S rRNA gene sequences showed that strains MSW7T and MSW13T were most closely related to

Colwellia echini

A3T and

Polaribacter atrinae

WP25T with 98.8 and 98.1 % sequence similarities, respectively. The average nucleotide identity and digital DNA–DNA hybridization values between strain MSW7T and

C. echini

A3T and between strain MSW13T and

P. atrinae

KACC 17473T were 73.6 and 22.6 % and 80.4 and 23.8 %, respectively. Based on phenotypic, chemotaxonomic and phylogenetic data, strains MSW7T and MSW13T represent novel species of the genera

Colwellia

and

Polaribacter

, respectively, for which the names Colwellia maritima sp. nov. and Polaribacter marinus sp. nov. are proposed, respectively. The type strains of C. maritima sp. nov. and P. marinus sp. nov. are MSW7T (=KACC 22339T=JCM 35001T) and MSW13T (=KACC 22341T=JCM 35021T), respectively.
Novel subthreshold retinal laser treatment with ERG-based thermal dosimetry activates hormetic heat response in pig RPEin vivo
Authors: Amirkavei Mooud , Kaikkonen Ossi , Turunen Teemu , Meller Anna , Åhlgren Johanna , Kvanta Anders , André Helder , Koskelainen Ari 
Published: November 2022

AbstractBoosting natural mechanisms to retain cellular homeostasis and combat oxidative stress by inducing a hormetic heat shock to retinal pigment epithelium with non-damaging transpupillary laser heating, i.e., with subthreshold laser treatment (SLT), has been suggested as a promising therapeutic target for many retinal diseases, including age-related macular degeneration. However, the therapeutic temperature window for the treatments is narrow and thermal dosimetry is unavailable. Here we introduce an SLT modality where the retinal temperature is monitored with electroretinography (ERG)-based thermal dosimetry and demonstrate its feasibility with anesthetized pigs. In 60-second treatments with 810 nm laser, the ED50peak temperature for visible lesion generation was 48°C and the relative temperature determination error was below 10% from the temperature increase. Heat shock protein expression increased, and autophagy was activated at 44.2 °C and no signs of oxidative stress or apoptosis emerged at 44.2 °C or 46.5 °C. The demonstrated method permits a controlled activation of intracellular chaperones and waste clearance in RPE cell with a clear temperature margin for adverse events. In the clinical setting, ERG-based dosimetry would allow safe and personalized SLTs for retinal diseases currently lacking effective treatments.
Image-based quantification ofArabidopsis thalianastomatal aperture from leaf images
Authors: Takagi Momoko , Hirata Rikako , Aihara Yusuke , Hayashi Yuki , Mizutani-Aihara Miya , Ando Eigo , Yoshimura-Kono Megumi , Tomiyama Masakazu , Kinoshita Toshinori , Mine Akira , Toda Yosuke 
Published: November 2022

AbstractThe quantification of stomatal pore size has long been a fundamental approach to understand the physiological response of plants in the context of environmental adaptation. Automation of such methodologies not only alleviates human labor and bias, but also realizes new experimental research methods through massive analysis. Here, we present an image analysis pipeline that automatically quantifies stomatal aperture ofArabidopsis thalianaleaves from brightfield microscopy images containing mesophyll tissue as noisy backgrounds. By combining a YOLOX-based stomatal detection submodule and a U-Net-based pore segmentation submodule, we achieved 0.875 mAP50(mean average precision; stomata detection performance) and 0.745 IoU (intersection of union; pore segmentation performance) against images of leaf discs taken with a brightfield microscope. Moreover, we designed a portable imaging device that allows easy acquisition of stomatal images from detached/undetached intact leaves on-site. We further combined this device with fine-tuned models of the pipeline we generated here and recapitulated manual measurement of stomatal responses against pathogen inoculation. Utilization of our hardware and pipeline for automated stomatal aperture measurements is expected to accelerate research on stomatal biology of model dicots.
Internal legitimacy crises: the roles of the regulatory focus and relational social capital of headquarters and subsidiaries
Authors: Gammelgaard Jens , Kumar Rajesh 
Published: November 2022

PurposeThe purpose of this paper is to further the understanding of how the regulatory foci of the multinational enterprises (MNE) headquarters and the subsidiary lead to internal legitimacy crises. This paper discusses how pragmatic and moral legitimacy crises affect relational social capital.Design/methodology/approachThe paper is conceptual.FindingsThis paper highlights the importance of internal legitimacy as well as the motivational orientations of headquarters and subsidiaries for the functioning of MNEs. Internal legitimacy management is crucial for building relational social capital. This study proposes that legitimacy crises are particularly likely to occur in cases of goal incongruence between headquarters and subsidiaries. This study postulates that organizations with a promotion-oriented institutional logic are concerned by the absence of pragmatic legitimacy processes. In contrast, given their aim of protecting the status quo, prevention-oriented institutional logic MNEs are concerned about the absence of moral legitimacy.Originality/valueTo the best of the authors’ knowledge, this paper is the first to explore the relationship between regulatory focus, internal legitimacy and relational social capital.
Parameters optimization design method for LLC resonant converter based on impedance model
Authors: Yao Xuliang , Han Xiao , Liao Yuefeng , Wang Jingfang 
Published: November 2022

Purpose
This paper aims to better design the resonant tank parameters for LLC resonant converter. And, it is found that under heavy load, the voltage gain is affected by junction capacitors of the primary side switching and the parasitic parameters of the secondary side diodes converted to the primary side, which will cause the voltage gain decreased when the switching frequency decreased.

Design/methodology/approach
This paper proposes an optimization parameters design method to solve this problem, which was based on impedance model considering the parasitic parameters of switching devices and diodes.

Findings
The effectiveness of the proposed method is verified by impedance Bode plots and experimental results.

Originality/value
From the perspective of impedance modeling, this paper finds the reasons for the insufficient voltage regulation capability of LLC resonant converters under heavy load and finds solutions through analysis.