bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effects of Coaching Pediatric Residents on Faculty Coaches’ Relationships, Learning, and Professional Identity Formation
Authors: Selling Sarah Kate , Rooholamini Sahar N. , Grow H. Mollie , McPhillips Heather , Hoang Kim , Blankenburg Rebecca , Rassbach Caroline 
Published: October 2022

Purpose
Coaching programs have been implemented in medical education to improve skill development and feedback for trainees. As more faculty take on coaching roles, it is critical to understand how being a coach affects faculty as well as trainees. This study examined the effects of coaching residents on faculty members’ relationships, learning, and professional identity formation (PIF), as they move through intersecting communities across landscapes of practice.

Method
From July 2020 to January 2021, the authors conducted a mixed-methods study of current and former coaches at 2 institutions with longitudinal pediatric resident coaching programs. They used a concurrent triangulation design in which qualitative and quantitative data were collected simultaneously and integrated during data analysis. A survey explored the impact of coaching on faculty members’ learning, relationships, and PIF, and semistructured interviews further examined coaches’ experiences. The interview transcripts were analyzed inductively guided by the sensitizing principles of PIF and landscapes of practice.

Results
Of 43 eligible coaches, 32 (74%) completed the survey, and 18 completed interviews. Four themes emerged from the interviews. (1) Coaches’ relationships supported belonging in multiple communities. (2) Coaching enabled multidimensional learning. (3) Relationships served as mechanisms of learning for coaches. (4) Coaches’ relationships and learning catalyzed PIF. Furthermore, there was a significant difference in the effects of coaching on career growth by faculty rank (P = .02). Coaches’ strengthened PIF increased a sense of purpose, meaning, and professional fulfillment, and inspired new career directions. Survey data further supported these findings.

Conclusions
Being a coach deepened faculty members’ professional identities through their varied relationships, multidimensional learning, and sense of belonging in intersecting communities. This study introduces a framework to understand the factors mediating coaches’ PIF and highlights how investing in coaching leads to important benefits for coaches.
Patient and Caregiver-Derived Health Service Improvements for Better Critical Care Recovery
Authors: Haines Kimberley J. , Leggett Nina , Hibbert Elizabeth , Hall Tarli , Boehm Leanne M. , Bakhru Rita N. , Bastin Anthony J. , Butcher Brad W. , Eaton Tammy L. , Harris Wendy , Hope Aluko A. , Jackson James , Johnson Annie , Kloos Janet A. , Korzick Karen A. , Mactavish Pamela , Meyer Joel , Montgomery-Yates Ashley , Quasim Tara , Slack Andrew , Wade Dorothy , Still Mary , Netzer Giora , Hopkins Ramona O. , Mikkelsen Mark E. , Iwashyna Theodore J. , McPeake Joanne , Sevin Carla M. ,   on behalf of the Society of Critical Care Medicine’s Thrive Initiative
Published: October 2022

OBJECTIVES:
To engage critical care end-users (survivors and caregivers) to describe their emotions and experiences across their recovery trajectory, and elicit their ideas and solutions for health service improvements to improve the ICU recovery experience.

DESIGN:
End-user engagement as part of a qualitative design using the Framework Analysis method.

SETTING:
The Society of Critical Care Medicine’s THRIVE international collaborative sites (follow-up clinics and peer support groups).

SUBJECTS:
Patients and caregivers following critical illness and identified through the collaboratives.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Eighty-six interviews were conducted. The following themes were identified: 1) Emotions and experiences of patients—“Loss of former self; Experiences of disability and adaptation”; 2) Emotions and experiences of caregivers—“Emotional impacts, adopting new roles, and caregiver burden; Influence of gender roles; Adaptation, adjustment, recalibration”; and 3) Patient and caregiver-generated solutions to improve recovery across the arc of care—“Family-targeted education; Expectation management; Rehabilitation for patients and caregivers; Peer support groups; Reconnecting with ICU post-discharge; Access to community-based supports post-discharge; Psychological support; Education of issues of ICU survivorship for health professionals; Support across recovery trajectory.” Themes were mapped to a previously published recovery framework (Timing It Right) that captures patient and caregiver experiences and their support needs across the phases of care from the event/diagnosis to adaptation post-discharge home.

CONCLUSIONS:
Patients and caregivers reported a range of emotions and experiences across the recovery trajectory from ICU to home. Through end-user engagement strategies many potential solutions were identified that could be implemented by health services and tested to support the delivery of higher-quality care for ICU survivors and their caregivers that extend from tertiary to primary care settings.
Plastic Surgery Training across Seven Continents: Results from the First Global Trainee Survey
Authors: Lindqvist Ebba K. , Noordzij Niels , Chopra Shiv , Navia Alfonso , Cappuyns Laura , Khalaf Amr , Fernandez Diaz Oscar F. , Berner Juan Enrique , Monshizadeh Linda , Murphy Robert X. 
Published: October 2022

Background:
Little is known about the demographics and ambitions of plastic surgery trainees and if these differ between regions. This study sought opinion from current and recently graduated plastic surgery trainees to map demographics, training structure, and ambitions of plastic surgery trainees worldwide.

Methods:
A cross-sectional study was designed and administered by the international trainee organization International Confederation of Societies of Plastic Surgery Trainees. A questionnaire of 45 questions was distributed digitally through several international channels using the REDCap platform.

Results:
A total of 290 junior plastic surgeons, of whom 124 (42.8%) were women, from all seven International Confederation of Societies of Plastic Surgery regions, participated in this study. Of the trainees, 21% have emigrated, and 75% expressed a desire to undertake a part of their training abroad. The most common length of training in plastic surgery is 5 years. There is a difference in working hours between regions, where more than 80-hour work weeks are most common in Asia (24.1%), and work weeks of less than 40 hours are most common in Middle East (30.8%). A majority of trainees (85%) reported a research interest, and we found a negative correlation between the extent of research ambition and reported clinical workload.

Conclusions:
We present here the first international investigation of trainee experiences of plastic surgery training. We show that training structure and organization vary between institutions, and that plastic surgery trainees report a strong interest in international training as well as in research.
Outcomes of Lymphovenous Anastomosis for Lower Extremity Lymphedema: A Systematic Review
Authors: Verhey Erik M. , Kandi Lyndsay A. , Lee Yeonsoo S. , Morris Bryn E. , Casey William J. , Rebecca Alanna M. , Marks Lisa A. , Howard Michael A. , Teven Chad M. 
Published: October 2022

Background:
Lymphovenous anastomosis (LVA) is a microsurgical treatment for lymphedema of the lower extremity (LEL). This study systematically reviews the most recent data on outcomes of various LVA techniques for LEL in diverse patients.

Methods:
A comprehensive literature search was conducted in the Ovid MEDLINE, Ovid EMBASE, and Scopus databases to extract articles published through June 2021. Studies reporting data on objective postoperative improvement in lymphedema and/or subjective improvement in quality of life for patients with LEL were included. Extracted data comprised demographics, number of patients and lower limbs, duration of symptoms before LVA, surgical technique, duration of follow-up, and objective and subjective outcomes.

Results:
A total of 303 articles were identified and evaluated, of which 74 were ultimately deemed eligible for inclusion in this study, representing 6260 patients and 2554 lower limbs. The average patient age ranged from 22.6 to 76.14 years. The duration of lymphedema before LVA ranged from 12 months to 11.4 years. Objective rates of improvement in lymphedema ranged from 23.3% to 100%, with the greatest degree of improvement seen in patients with early-stage LEL.

Conclusions:
LVA is a safe and effective technique for the treatment of LEL of all stages. Several emerging techniques and variations may lead to improved patient outcomes.
Practice Patterns in Operative Flexor Tendon Laceration Repair: A 15-Year Analysis of Continuous Certification Data from the American Board of Plastic Surgery
Authors: Weissman Joshua P. , Sasson Daniel C. , Chappell Ava G. , Moran Steven L. , Gosain Arun K. 
Published: October 2022

Background:
The American Board of Plastic Surgery has been collecting practice data on operative repair of flexor tendon lacerations since 2006, as part of its Continuous Certification program.

Methods:
Data on operative repair of flexor tendon lacerations from 2006 to 2014 were reviewed and compared with those from 2015 to 2020. National practice trends observed in these data were evaluated and reviewed alongside published literature and evidence-based medicine.

Results:
In total, 780 patients with flexor tendon laceration injuries were included. Mean patient age was 38 years; mean time between tendon injury and first evaluation was 4 days, and the mean time from injury to operative repair was 12 days. Four-strand sutures remain the most common technique of tendon repair (57%). In the recent cohort, there were significant decreases in tourniquet use (94% versus 89%), general anesthesia (88% versus 74%), and monofilament sutures (44% versus 35%), with a significant increase reported in preserving the A1 pulley (20% versus 29%). Postoperative movement was described as “almost full range of motion” or “good” in 70% of cases, and 74% of patients were satisfied with their results. Postoperative adverse events were reported in 26% of cases, with the most common complications being tendon adhesions (14%) and rupture (3%).

Conclusions:
Review of The American Board of Plastic Surgery tracer data for operative repair of flexor tendon lacerations establishes a framework by which surgeons can evaluate how their current practice aligns with that of their peers, and whether their practice patterns remain current relative to recommendations from evidence-based medicine.
Finger Abscess Caused by a Black Fungus, Exophiala xenobiotica
Authors: Nomura Takeshi , Yamawaki Yoshio 
Published: October 2022

SUMMARY

Exophiala xenobiotica is a relatively new species of black fungi that can cause infection that primarily affects the skin and soft tissues in humans. Black fungal infection is challenging to diagnose and often needs surgery. However, few studies have reported black fungal and E. xenobiotica infections in the field of plastic surgery. Herein, we report the case of a 79-year-old man who presented with a finger abscess, later identified via rDNA sequencing as E. xenobiotica infection. He did not have a history of immunosuppression. We resected the lesion and performed skin grafting. No recurrence was observed, even without antifungal medications. We compared this case with six previously reported cases and examined their similarities and differences. Surgical removal emerged as the most effective treatment option. Additional reports of successfully treated E. xenobiotica infections are needed to establish the best treatment strategy. Plastic surgeons should improve their awareness of black fungal infections.
Orbital Exenteration and Brachytherapy for the Treatment of Pediatric, Fusion-positive, Recurrent Rhabdomyosarcoma
Authors: Lopez Joseph , Qin Nancy , Woods Robbie , Golden Marjorie , Spatz Harrison , Shah Jatin , Wexler Leonard H. , Randazzo Joseph , Wolden Suzanne L. , Abramson David H. 
Published: October 2022

SUMMARY
A 20-month-old boy presented with biopsy-proven recurrent alveolar rhabdomyosarcoma without metastasis. He was previously treated with multiagent chemotherapy and external beam irradiation showing a complete response. Upon relapse, he was treated with chemotherapy, orbital exenteration, and brachytherapy. Customized, intraoperative brachytherapy has potential to limit the sequelae associated with radiation adjuvant therapy.
Cultural Adaptation and Validation of the Health and Work Performance Questionnaire in German
Authors: Golz Christoph , Gerlach Maisa , Kilcher Gablu , Peter Karin Anne 
Published: October 2022

Background
Research interest in presenteeism as a productivity loss has grown given its estimated costs for organizations. To enable researchers in German-speaking countries to compare their findings internationally, a validated German Health and Work Performance Questionnaire (HPQ) version is needed.

Methods
First, the HPQ was translated from English into German, culturally adapted, and tested using cognitive debriefing in interviews. Second, the structural validity of the item measuring presenteeism as productivity loss was tested.

Results
Overall, 14 problems with items were identified in the cognitive debriefing. Of these, 57% were comprehension problems. Two of three alternative hypotheses for discriminative validity were accepted. No discrimination was possible for individuals with or without chronic disease.

Conclusions
The German HPQ has satisfactory cross-cultural validity and can be used to measure overall performance, as well as presenteeism in a specified sample with health problems.
Cardiac resynchronization therapy in treatment of a non-ischemic cardiomyopathy patient with massive left ventricular thrombus
Authors: Pestrea Catalin , Cicala Ecaterina , Catanescu Geanina , Gherghina Alexandra , Pintilie Irina , Gurzau Diana , Pop Dana 
Published: October 2022

Rationale:
Left ventricular thrombosis is a severe and potentially fatal complication of cardiomyopathies with reduced ejection fraction. The mainstay of treatment is anticoagulation, with variable response to thrombus resolution. In patients with reduced ejection fraction and left bundle branch block, cardiac electrical resynchronization is established as a very effective therapy, leading to improvement in left ventricular function.

Patient concerns:
We present the case of a 64-year-old male with non-ischemic cardiomyopathy with severely reduced ejection fraction and left bundle branch block, who was implanted with a dual-chamber pacemaker in 2018 for sick sinus node disease and who was admitted for progressive shortness of breath.

Diagnosis:
Echocardiography showed a dilated left ventricle with a severely reduced ejection fraction (15%) and a massive left intraventricular thrombus.

Interventions:
The patient was started on anticoagulant and heart failure therapy without any response in thrombus size, so as a last resort measure, cardiac resynchronization therapy was added.

Outcomes:
The 6-month echocardiography follow-up showed a significant improvement in left ventricular function and complete thrombus resolution.

Lesson:
Cardiac resynchronization therapy promotes reverse remodeling and improves the contraction sequence in the left ventricle, thus eliminating the triggers for thrombosis and aiding in thrombus resolution.
Professional Case Management in Outpatient Settings for Patients With Myeloproliferative Neoplasms
Authors: Brennan-Cook Jill , Cadavero Allen 
Published: October 2022

Purpose and Objectives:
The purpose of this discussion is to review the management and symptomatic burden of patients with myeloproliferative neoplasms (MPNs). Patients with MPNs are at increased risk for thromboembolic events; thus, cardiovascular complications are not uncommon. Professional case managers can coordinate outpatient services with the health care team and assist patients to mitigate cardiovascular complications.

Primary Practice Setting:
This discussion is relevant to professional case managers who manage patients with chronic conditions in outpatient settings.

Findings/Conclusions:
Professional case managers can intervene for patients with MPNs to improve (a) coordination of scheduled therapeutic phlebotomy procedures, and (b) education about subcutaneous injections and frequent monitoring of laboratory reports. In the outpatient setting, professional case managers can improve health care utilization for patients with MPNs and promote high-quality self-care and symptom management to prevent adverse complications.

Implications for Case Management Practice:
As a member of the outpatient health care team, the professional case manager can serve as a key clinician with comprehensive knowledge of the patient's experience of living with an MPN, their usual state of health and symptoms, and the factors affecting their quality of life. This article explores the role of the professional case manager in the outpatient setting and suggests specific interventions to improve delivery of care and contribute to better self-care management. Professional case managers can assess and validate symptom burden, coordinate and manage routine laboratory testing, support careful medication adjustment, and contribute to improved health outcomes.
Alternative chemotherapy for acute myeloid leukemia with Down syndrome
Authors: Joey Gregory , Nelwan Yuke , Joseph Mantik Max Franz , Gunawan Stefanus , De Haas Valerie , Kaspers Gertjan L. 
Published: October 2022

Abstract
Myeloid leukemia with Down syndrome (ML-DS) is a unique entity of acute myeloid leukemia (AML) with superior treatment response and overall survival compared with children with AML. However, despite the advances in treatment approaches, ML-DS survival rates for children in low- and middle-income countries remain poor. In this article, we describe 3 cases of ML-DS, which were treated with a novel protocol using vincristine, cytarabine, and daunorubicin plus triple intrathecal drugs. All the 3 patients successfully finished the treatment, with 2 patients in complete remission until now. One patient died because of uncontrolled bleeding for 2 days after finishing the chemotherapy regimen. Our findings indicate that using our treatment protocol, ML-DS is treatable in limited-resource settings such as that in Manado, Indonesia.
Epithelioid and Spindle Cell Hemangioma
Authors: Papke David J. , Jagannathan Jyothi , Dong Fei , Dickson Brendan C. , Mertens Fredrik , Hornick Jason L. , Fletcher Christopher D.M. 
Published: October 2022

Epithelioid and spindle cell hemangioma was initially described in 1999 in a series of primary bone tumors and was subsequently suggested by some to represent a variant of epithelioid hemangioma. Here, we studied 18 epithelioid and spindle cell hemangiomas. Nine patients (50%) were male. Age at presentation ranged from 12 to 78 years (median: 38.5 y). Nine patients (50%) had tumor(s) limited to bone, 5 (28%) had tumor(s) limited to soft tissue, and 4 (22%) had tumor(s) involving bone and soft tissue. Nine patients (50%) had multiple tumors, all in a unilateral anatomic region involving the wrist, hand, ankle, or foot. Seventeen tumors (94%) occurred in an extremity, including 12 (67%) in the hands and feet, and 1 occurred in a vertebra. In imaging studies, primary bone tumors were lobulated, expansile, and lytic, and 7 bone tumors with available imaging (58%) showed cortical breakthrough. Tumor sizes were 0.8 to 7.2 cm (median: 2.2 cm). Epithelioid and spindle cell hemangioma is composed of lobules of epithelioid and spindled endothelial cells with bland, vesicular nuclei. Neoplastic cells show orderly vasoformative growth, with hemorrhagic stroma and no endothelial atypia or multilayering. Immunohistochemistry demonstrated uniform positivity for CD31 and ERG. Where positive, SMA highlighted pericytes (11/13 tumors). FOSB was strongly positive in 4 of 16 tumors (25%), and FOS was strongly positive in 5 of 10 stained tumors (50%). Break-apart fluorescence in situ hybridization confirmed the presence of FOS split signals in 4 tumors positive for FOS by immunohistochemistry and FOSB split signals in 2 FOSB-positive tumors. DNA sequencing demonstrated a GATA6::FOXO1 fusion in 1 of 3 sequenced tumors. Clinical follow-up was available for 15 patients (83%; range: 5 mo to 11 y; median: 3.5 y). Seven patients (47%) had no evidence of disease at most recent follow-up. Seven of 13 patients (54%) who underwent surgery experienced local recurrence at the primary tumor site: 5 patients within a year, 1 at 2.4 years, and 1 thrice at 2, 3, and 5 years. Six patients were alive with multifocal disease (median: 3.5 y; range: 5 mo to 6 y). No tumors gave rise to distant metastases. The clinicopathologic and genetic findings in this study support the notion that epithelioid and spindle cell hemangioma is a morphologic variant of epithelioid hemangioma that can occur in soft tissue as well as bone and that shows a striking predilection for the extremities. Given that most recurrences and primary tumors behaved indolently, watchful waiting would be reasonable for patients with multicentric disease that is not readily amenable to surgery.
Novel agents in development for multidrug-resistant Gram-negative infections: potential new options facing multiple challenges
Authors: Arya Radhika , Goldner Breanna S. , Shorr Andrew F. 
Published: October 2022

Purpose of review
To review novel antiinfective agents in development for multidrug-resistant (MDR) Gram-negative bacterial infections.

Recent findings
Four novel agents are in various phases of development (tebipenem, durlobactam-sulbactam, cefepime-taniborbactam, and xeruborbactam). Tebpipenem is an oral carbapenem with a recently completed phase III trial for complicated urinary tract infections while durlobactam-sulbactam represents a potential alternative for drug-resistant Acinetobacter baumannii. Cefepime-taniborbactam possesses in-vitro potency against a range of troubling pathogens and we await further information on a recently completed study on complicated urinary tract infection. Finally, xeruborbactam is an ultrabroad beta-lactamase inhibitor that can be paired with a range of intravenous and oral agents. It exhibits enhanced in-vitro activity against many MDR pathogens, including those resistant to newer, broader spectrum options. Data in humans with xeruborbactam are limited.

Summary
Each of the newer options reviewed possesses a unique range of in-vitro activity against select, challenging pathogens with some narrowly tailored and other broader in activity. Several have both oral and intravenous formulations. Two agents have presented data from recent phase III trials, whereas two are not as advanced in their clinical programs.