bluuebunny/crossref_metadata_2025_split huggingface dataset:
Judging Personality Disorder: A Systematic Review of Clinician Attitudes and Responses to Borderline Personality Disorder
Authors: Baker James , Beazley Peter I. 
Published: July 2022

Background:
It has been suggested that the diagnosis of borderline personality disorder (BPD) is associated with particularly stigmatizing connotations, particularly among mental health professionals. The goal of this study was to synthesize quantitative studies investigating the attitudes and responses of clinicians to BPD and to appraise the methodological quality of these studies.

Methods:
A systematic search was carried out using MEDLINE Complete, CINAHL Complete, PsychoINFO, PsychARTICLES, Scopus, Social Sciences Citation Index, and Academic Search Complete. Study quality was rated using an adapted tool.

Results:
This review included 37 papers involving an estimated 8196 participants: 21 cross-sectional survey studies, 5 studies assessing training workshops, 5 studies assessing countertransference, and 6 experimental studies. The methodological quality of the studies was mixed, with many differing measures with questionable validity used.

Conclusions:
Negative attitudes toward BPD continue to be a problem to differing degrees among clinical staff. Although this issue is most prominent among psychiatric nurses, the results of this review highlight evidence of negative attitudes across all mental health professions as well as potentially in professionals working in physical health settings. Various clinician-level factors may play a role in the development and maintenance of such attitudes. Greater exposure to patients with BPD and attendance at training programs have been found to be associated with improved attitudes. Professionals require regular training concerning BPD that is sufficiently evidence-based.
The Predictors of Somatic Symptoms in a Population Sample: The Lifelines Cohort Study
Authors: Creed Francis 
Published: July 2022

ABSTRACT

Objective
Multiple bodily symptoms predict poor health status, high healthcare use, and onset of functional somatic syndromes. This study aimed to identify the predictors of somatic symptoms with special reference to mental disorders.

Methods
The prospective, population-based Lifelines cohort study included 80,888 adults who were followed up for a mean of 2.4 years. At baseline sociodemographic status, self-reported medical disorders, functional somatic syndromes, stress, neuroticism, mental disorders (assessed with Mini-International Neuropsychiatric Interview), health perception, and analgesic use were assessed. These variables were tested as predictors of number of somatic symptoms at follow-up using linear regression analysis, which adjusted for baseline somatic symptoms (n = 65,904). Logistic regression was used to identify the predictors of a persistently high number of somatic symptoms.

Results
The strongest predictors of somatic symptoms at follow-up were life events and difficulties score, and number of general medical illnesses/functional somatic syndromes. Neuroticism and mental disorders were also independent predictors in all analyses. Generalized anxiety, major depressive, and panic disorders were all independent predictors when entered individually into the regression analysis. A persistently high number of somatic symptoms were predicted most strongly by functional somatic syndromes, negative health perception, and paracetamol use.

Conclusions
Number of somatic symptoms should be regarded as a multifactorial measure with many predictors. Mental disorders form one predictor, but there are other stronger ones, including stress and general medical disorders. The bidirectional relationship between functional somatic syndromes and multiple somatic symptoms is compatible with the notion that perception of bodily symptoms is a key component of both.
Mechanical stress-induced Hippo signaling in respect to primordial follicle development and polycystic ovary syndrome pathogenesis
Authors: Xia Ling-Jin , Du Jing 
Published: July 2022

Abstract
Polycystic ovary syndrome (PCOS) is a heterogeneous reproductive disease that can cause infertility. The Hippo signaling pathway, a network highly conserved throughout evolution, maintains the balance between follicle proliferation and dormancy. Dynamic changes in primordial follicles cannot occur without the participation of biological signals and mechanical force; however, little is known about the mechanism by which biomechanical signaling triggers PCOS, especially in the context of primordial follicle development. To investigate the contribution of mechanical stress and the Hippo signaling pathway to the onset of PCOS, we searched the literature via the PubMed database, and inclusion and exclusion criteria were established to ensure the rigor of this research. We eventually included 54 publications in which Hippo signaling and mechanical force were suggested to play a vital role in the development of primordial follicles as well as elucidate the pathogenesis of PCOS. The Hippo pathway modulating follicle growth can be perturbed via extracellular mechanical stress caused by the stiff ovarian cortical environment in PCOS. Clinical intervention targeting the Hippo pathway can alter the activity of core Hippo members, such as the Yes-associated protein/transcriptional co-activator PDZ-binding motif complex. In some patients with PCOS, follicle overactivation can be attributed to the dysfunction of Hippo signal transduction. PCOS, a condition with various patterns, cannot be accurately explained by a single, specific mechanism. The present review identifies potential targets and therapeutic strategies for PCOS.
Embolic Events After Computed Tomography Contrast Injection in Patients With Interatrial Shunts
Authors: Schawkat Khoschy , Litmanovich Diana , Appel Elisabeth , Ghorishi Alex , Selim Magdy , Manning Warren J. , Nakhaei Masoud , Biglione Bianca , Camacho Andrés , Brook Olga R. 
Published: July 2022

Background:
Patients with interatrial shunts (patient foramen ovale/atrial septal defect) are potentially at increased risk for paradoxical air embolism following computed tomography (CT) scans with intravenous (IV) contrast media injection. IV in-line filters aim to prevent such embolisms but are not compatible with power injection required for diagnostic CT.

Purpose:
The purpose of this study was to determine whether the incidence of paradoxical embolism to the heart and brain in patients with an interatrial shunt is higher compared with controls within 48 hours following injection of IV contrast media without IV in-line filter.

Methods:
This is a retrospective cohort study conducted at a large tertiary academic center, which included a total of 2929 consecutive patients who underwent 8983 CT scans with IV contrast media injection between July 1, 2000 and April 30, 2018. Diagnosis of an interatrial shunt was confirmed by transthoracic or transesophageal echocardiography. Incidence and risk of cardiac embolic events (new troponin elevation, >0.1 ng/mL) and neurological embolic events (new diagnosis of stroke/transient ischemic attacks) were evaluated.

Results:
Among the 2929 patients analyzed (mean±SD age, 61±14 y), 475/2929 (16.2%) patients had an interatrial shunt. After applying the exclusion criteria, new elevated troponin was found in 8/329 (2.4%; 95% confidence interval [CI]: 1.1-4.7) patients with an interatrial shunt compared with 25/1687 (1.5%; 95% CI: 0.9-2.2) patients without an interatrial shunt. New diagnosis of stroke occurred in 2/169 (1%; 95% CI: 0.3-4.2) of patients with an interatrial shunt compared with 7/870 (0.8%; 95% CI: 0.4-1.7) without interatrial shunt.

Conclusion:
Among patients with echocardiographic evidence of an interatrial shunt, IV CT contrast administration without an in-line filter does not increase the incidence of cardiac or neurological events.
Diagnosing Pulmonary Embolism With Computed Tomography Pulmonary Angiography
Authors: Schmid Johannes , Nagy Eszter , Kaufmann-Bühler Ann-Katrin , Steiner Jakob , Janisch Michael , Janek Elmar , Reiter Clemens , Eibisberger Martin , Softic Nina , Guss Helmuth , Fuchsjäger Michael , Adelsmayr Gabriel 
Published: July 2022

Purpose:
Computed tomography pulmonary angiography (CT-PA) is frequently used in the diagnostic workup of pulmonary embolism (PE), even in highly radiosensitive patient populations. This study aims to assess CT-PA with reduced z-axis coverage (compared with a standard scan range covering the entire lung) for its sensitivity for detecting PE and its potential to reduce the radiation dose.

Materials and Methods:
We retrospectively analyzed 602 consecutive CT-PA scans with definite or possible PE reported. A reduced scan range was defined based on the topogram, where the cranial slice was set at the top of the aortic arch and the caudal slice at the top of the lower hemidiaphragm. Locations of emboli in relation to the reduced scan range were recorded.

Results:
We included 513 CT-PA scans with definite acute PE in statistical analysis. Patients’ median age was 66 (52 to 77) years, 46% were female. Median dose length product was 270.8 (111.3 to 503.9) mGy*cm. Comparing the original and reduced scan ranges, the mean scan length was significantly reduced by 48.0±8.6% (26.8±3.0 vs. 13.9±2.6 cm, P<0.001). Single emboli outside the reduced range in addition to emboli within were found in 15 scans (2.9%), while only 1 scan (0.2%) had an embolus outside the reduced range and none within it. The resulting sensitivity of CT-PA with reduced scan range was 99.81% (95% confidence interval: 98.74%-99.99%) for detecting any PE.

Conclusion:
A reduced scan length in CT-PA, as defined above, would substantially decrease radiation dose while maintaining diagnostic accuracy for detecting PE.
Serial Changes in Coronary Plaque Formation Using CT Angiography in Patients Undergoing PCSK9-Inhibitor Therapy With 1-year Follow-up
Authors: Baumann Stefan , Kettel Laura , Stach Ksenija , Özdemir Gökce H. , Renker Matthias , Tesche Christian , Becher Tobias , Hetjens Svetlana , Schoepf U. Joseph , Akin Ibrahim , Borggrefe Martin , Krämer Bernhard K. , Schoenberg Stefan O. , Janssen Sonja , Overhoff Daniel , Lossnitzer Dirk 
Published: July 2022

Purpose:
Previous studies have shown positive effects of intensive low-density lipoprotein (LDL)-lowering therapy on atheroma volume using invasive intravascular ultrasound. This study describes the changes in coronary plaque composition on coronary computed tomography angiography in patients treated with proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors.

Materials and Methods:
In this prospective study, coronary plaques were analyzed using third-generation dual-source computed tomography before and after 1 year of PCSK9-inhibitor treatment. Plaque markers included total plaque volume (TPV), calcified plaque volume (CPV), noncalcified plaque volume (NCPV), lumen volume and vessel volume (VV), minimal luminal area (MLA), minimal lumen diameter (MLD), corrected coronary opacification, eccentricity, remodeling index, and functional plaque parameters. Primary endpoint was defined as change in TPV; the secondary endpoint was TPV or CPV regression or nominal change in plaque parameters.

Results:
We analyzed 74 coronary plaques in 23 patients (60±9 y, 65% male). After 1 year of PCSK9-inhibitor treatment, LDL was reduced from 148 to 66 mg/dL (P<0.0001). Significant changes were found for VV (196 to 215 mm3, P=0.0340), MLA (3.1 to 2.6 mm2, P=0.0413), and MLD (1.7 to 1.4 mm, P=0.0048). TPV, CPV, NCPV, lumen volume, and functional plaque parameters did not change significantly (P>0.05).

Conclusions:
Coronary artery plaque analysis by coronary computed tomography angiography highlights that LDL lowering therapy affects plaque composition. The primary endpoint of TPV change was not reached; however, VV, MLA, and MLD changed significantly.
STOPS
Authors: D’Angelo Jonathan D. , Lund Sarah , Woerster Malin , Sawatsky Adam P. , Kelley Scott R. , Dozois Eric J. , D’Angelo Anne-Lise D. 
Published: July 2022

Objective:
To investigate the steps faculty surgeons take upon experiencing intraoperative error and synthesize these actions to offer a framework for coping with errors.

Background:
While intraoperative errors are inevitable, formal training in error recovery is insufficient and there are no established curricula that teach surgeons how to deal with the intraoperative error. This is problematic because insufficient error recovery is detrimental to both patient outcomes and surgeon psychological well-being.

Methods:
We conducted a thematic analysis. One-hour in-depth semistructured interviews were conducted with faculty surgeons from 3 hospitals. Surgeons described recent experiences with intraoperative error. Interviews were transcribed and coded. Analysis allowed for development of themes regarding responses to errors and coping strategies.

Results:
Twenty-seven surgeons (30% female) participated. Upon completion of the analysis, themes emerged in 3 distinct areas: (1) Exigency, or a need for training surgical learners how to cope with intraoperative errors, (2) Learning, or how faculty surgeons themselves learned to cope with intraoperative errors, and (3) Responses, or how surgeons now handle intraoperative errors. The latter category was organized into the STOPS framework: Intraoperative errors could produce STOPS: Stop, Talk to your Team, Obtain Help, Plan, Succeed.

Conclusions and Relevance:
This study provides both novel insight into how surgeons cope with intraoperative errors and a framework that may be of great use to trainees and faculty alike.
Early Barriers to Career Progression of Women in Surgery and Solutions to Improve Them
Authors: Ferrari Linda , Mari Valentina , De Santi Gabriella , Parini Sara , Capelli Giulia , Tacconi Giovanna , Chessa Antonella , Verdi Daunia , Frigerio Isabella , Spolverato Gaya , Gumbs Andrew 
Published: July 2022

Objective:
This study aims to summarize the evidence concerning the barriers that exist to the career progression of women in surgery and to provide potential solutions to overcome these obstacles.

Background:
Visible and invisible impediments can hinder female doctors’ pursuit of a surgical career, from choosing a surgical specialty to training opportunities and all the way through career progression.

Methods:
Database search of original studies about barriers for female surgeons during choice of surgical career, residency, and career progression. A query including possible solutions such as mentorship and network was included.

Results:
Of 4618 total articles; 4497 were excluded as duplicates, having incorrect study focus, or not being original studies; leaving 120 studies meeting the inclusion criteria. Of the articles included, 22 (18%) focused on factors affecting the pursuit of a surgical career, such as surgical work hours and limited time for outside interests, 55 (46%) analyzed the main barriers that exist during surgical residency and fellowship training, such as discrimination and sexual harassment, 27 (23%) focused on barriers to career advancement, heavy workloads, ineffective mentorship, unclear expectations for advancement, inequality in pay or work-home conflicts. Among studies reporting on possible solutions, 8 (6.5%) articles reported on the role of effective mentorship to support career advancement and to provide moral support and 8 (6.5%) on the emerging role of social media for networking. Our analysis showed how different impediments hinder surgical career progression for women, with notable consequences on burnout and attrition.

Conclusions:
Identification and recognition of obstacles to career progression is the first step to addressing the gender gap in surgery. Active strategies should be improved to promote a culture of diversity and to create equal opportunity for women in surgery, while implementing structured mentoring programs and investing on an adequate communication on social media to engage the future generations.
Association Between American Board of Surgery Initial Certification and Medical Malpractice Payments
Authors: Jones Andrew T. , Ibáñez Beatriz , Barry Carol L. , Abashkin Yuri , Singh Harnam , Wilkinson Derek S. , Buyske Jo 
Published: July 2022

Objective:
To measure associations between surgeons’ examination performance and obtaining American Board of Surgery certification with the likelihood of having medical malpractice payments.

Background:
Further research is needed to establish a broader understanding of the association of board certification and patient and practice outcomes.

Methods:
Retrospective analysis using propensity score–matched surgeons who attempted to obtain American Board of Surgery certification. Surgeons who completed residency between 2000 and 2019 (n=910) and attempted to become certified were categorized as certified or failing to obtain certification. In addition, groups were categorized as either passing or failing their first attempt on the qualifying and certifying examinations. Malpractice payment reports were dichotomized for surgeons who either had a payment report or not.

Results:
The hazard rate (HR) of malpractice payment reports was significantly greater for surgeons who attempted and failed to obtain certification [HR=1.87; 95% confidence interval (CI), 1.28–2.74] than for surgeons who were certified. Moreover, surgeons who failed either the qualifying (HR=1.64; 95% CI, 1.14–2.37) or certifying examination (HR=1.72; 95% CI, 1.14–2.60) had significantly higher malpractice payment HRs than those who passed the examinations on their first attempt.

Conclusions:
Failing to obtain board certification was associated with a higher rate of medical malpractice payments. In addition, failing examinations in the certification examination process on the first attempt was also associated with higher rates of medical malpractice payments. This study provides further evidence that board certification is linked to potential indicators for patient outcomes and practice quality.
TRIM7 restricts Coxsackievirus and norovirus infection by detecting the C-terminal glutamine generated by 3C protease processing
Authors: Luptak Jakub , Mallery Donna , Jahun Aminu S. , Albecka Anna , Clift Dean , Ather Osaid , Slodkowicz Greg , Goodfellow Ian , James Leo 
Published: July 2022

AbstractTRIM7 catalyses the ubiquitination of multiple substrates with unrelated biological functions. This cross-reactivity is at odds with the specificity usually displayed by enzymes, including ubiquitin ligases. Here we show that TRIM7’s extreme substrate promiscuity is due to a highly unusual binding mechanism, in which the PRYSPRY domain captures any ligand with a C-terminal helix that terminates in a hydrophobic residue followed by a glutamine. Many of the non-structural proteins found in RNA viruses contain C-terminal glutamines as a result of polyprotein cleavage by 3C protease. This viral processing strategy generates novel substrates for TRIM7 and explains its ability to inhibit Coxsackie virus and norovirus replication. In addition to viral proteins, cellular proteins such as glycogenin have evolved C-termini that make them a TRIM7 substrate. The ‘helix-ΦQ’ degron motif recognised by TRIM7 is reminiscent of the N-end degron system and is found in ∼ 1% of cellular proteins. These features, together with TRIM7’s restricted tissue expression and lack of immune regulation suggest that viral restriction may not be its physiological function.
Chemical engineering of therapeutic siRNAs for allele-specific gene silencingin vivoin CNS
Authors: Conroy Faith , Miller Rachael , Alterman Julia F. , Hassler Matthew R. , Echeverria Dimas , Godinho Bruno M.D.C. , Knox Emily G. , Sapp Ellen , Sousa Jaquelyn , Yamada Ken , Mahmood Farah , Boudi Adel , Kegel-Gleason Kimberly , DiFiglia Marian , Aronin Neil , Khvorova Anastasia , Pfister Edith L. 
Published: July 2022

AbstractSmall interfering RNAs (siRNAs) are a new class of drugs, exhibiting sequence-driven, potent, and sustained silencing of gene expressionin vivo. We recently demonstrated that siRNA chemical architectures can be optimized to provide efficient delivery to the CNS. Many genetically-defined neurodegenerative disorders are autosomal dominant favoring selective silencing of the mutant allele. In some cases, successful targeting of the mutant allele requires targeting of a single nucleotide polymorphism (SNP) heterozygosity. Using Huntington’s disease as a model, we demonstrate allele-specific RNAi-based silencing of gene expressionin vivoand in neurons differentiated from HD patient-derived iPSCs. A series ofin vitroscreens, with chemical and thermodynamic optimization, identified compounds with >50-fold selectivity for the mutant HD-causing allele, based on a single nucleotide difference. The optimized compound exhibits selective silencing of mutant huntingtin (HTT) protein in patient derived cells and throughout the HD mouse brain, providing a demonstration of SNP-based allele-specific RNAi silencing of gene expressionin vivoin the CNS. The ability to target a disease-causing allele using RNAi-based therapies could be applied to a wide range of dominant CNS disorders, where maintenance of wild-type expression is essential.
LDAK-GBAT: fast and powerful gene-based association testing using summary statistics
Authors: Berrandou Takiy-Eddine , Balding David , Speed Doug 
Published: July 2022

ABSTRACTWe present LDAK-GBAT, a novel tool for gene-based association testing using summary statistics from genome-wide association studies. We first evaluate LDAK-GBAT using ten phenotypes from the UK Biobank. We show that LDAK-GBAT is computationally efficient, taking approximately 30 minutes to analyze imputed data (2.9M common, genic SNPs), and requiring less than 10Gb memory. In total, LDAK-GBAT finds 680 genome-wide significant genes (P≤2.8×10−6), which is at least 25% more than each of five existing tools (MAGMA, GCTA-fastBAT, sumFREGAT-SKAT-O, sumFREGAT-PCA and sumFREGAT-ACAT), and 48% more than found by single-SNP analysis. We then analyze 99 additional phenotypes from the UK Biobank, the Million Veterans Project and the Psychiatric Genetics Consortium. In total, LDAK-GBAT finds 7957 significant genes, which is at least 24% more than the best existing tools, and 42% more than found by single-SNP analysis.
CD19+ B cell numbers predict the increase of anti-SARS CoV2 antibodies in fingolimod-treated and COVID-19-vaccinated patients with multiple sclerosis
Authors: Schiavetti I. , Barcellini L. , Lapucci C. , Tazza F. , Cellerino M. , Capello E. , Franciotta D. , Inglese M. , Sormani M. P. , Uccelli A. , Laroni A. 
Published: July 2022

AbstractTreatment with fingolimod for multiple sclerosis (MS) reduces the efficacy of COVID-19 vaccination. We evaluated by a multivariate linear regression model whether main lymphocyte subsets and demographic feature correlated to the subsequent increase in anti-SARS-CoV2 antibodies following the third dose of COVID-19 vaccination in fingolimod-treated MS patients. We found that number and proportion of peripheral blood CD19+ B lymphocytes before the third dose of vaccination in MS patients treated with fingolimod, predict the subsequent increase of anti-SARS-CoV2 antibodies (respectively p = 0.013; p = 0.015). This work suggests that evaluating the numbers of CD19+ B cells may be important to identify patients at risk of not producing SARS-CoV-2 antibodies, with possible reduced protection from COVID-19.