bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physician Assistant Program Policies to Assess and Address Student Reports of Mistreatment During Clinical Training
Authors: Hudak Nicholas M. , Blazar Melinda , Knudsen Nancy W. 
Published: August 2022

Introduction
Many physician assistant (PA) students experience mistreatment in clinical learning environments, and accredited PA programs are required to define, publish, and make readily available policies and procedures for student reports of mistreatment. The purpose of this study is to describe the prevalence, content, and dissemination of program policies to address students’ reports of mistreatment involving preceptors during supervised clinical experiences.

Methods
To conduct a national policy analysis, the investigators included 10 new survey items in the 2019 Physician Assistant Education Association annual program survey. Deidentified data were analyzed by using descriptive statistics.

Results
The program response rate to the survey items was 99% (232). Approximately 76% of PA programs reported having a learner mistreatment policy. Policy content across programs varied widely, and several student reporting mechanisms were available. Program directors, clinical faculty, and institutional leadership were most likely to be involved in the management of reports. A majority programs actively assessed for mistreatment and most did so through clinical course evaluations and at the end of each clinical phase course. Most programs disseminated information about policy to faculty, students, and preceptors at least once a year.

Discussion
The descriptions of policy content, procedures, and dissemination increase educators’ understanding of current policies across PA programs in the context of renewed efforts to write or revise policy that is specific to mistreatment. The authors discuss key policy priorities to define mistreatment, offer a range of confidential reporting mechanisms, review the management of reports, and consider how to optimize dissemination strategies.
Upper gastrointestinal bleeding in coronavirus disease 2019 patients
Authors: Mauro Aurelio , De Grazia Federico , Anderloni Andrea , Di Sabatino Antonio 
Published: August 2022

Purpose of review
Upper gastrointestinal bleeding (UGIB) has significant morbidity and UGIB cases have been described in coronavirus disease 2019 (COVID-19) patients. Management of this condition can be challenging considering both the possible severe COVID-19-related pneumonia as well as the risk of the virus spreading from patients to health operators. The aim of this paper is to review the most recent studies available in the literature in order to evaluate the actual incidence of UGIB, its clinical and endoscopic manifestations and its optimal management.

Recent findings
UGIB has an incidence between 0.5% and 1.9% among COVID-19 patients, and it typically presents with melena or hematemesis. Peptic ulcers are the most common endoscopic findings. High Charlson Comorbidity Index (CCI), dialysis, acute kidney injury and advanced oncological disease increase the risk for UGIB. Although anticoagulants are commonly used in COVID-19 patients they are not associated with an increased incidence of UGIB. Conservative management is a common approach that results in similar outcomes compared to upper GI endoscopic treatment. Apparently, UGIB in COVID-19 seems not have a detrimental effect and only one study showed an increased mortality in those who developed UGIB during hospitalization.

Summary
Incidence of UGIB in COVID-19 patients is similar to that of the general population. Despite the widespread use of anticoagulants in these patients, they are not associated with an increased risk of UGIB. Conservative management could be an effective option, especially for patients that are at risk of intubation.
Fibrin structure, viscoelasticity and lysis face the interplay of biorelevant polyions
Authors: Komorowicz Erzsébet , Kolev Krasimir 
Published: August 2022

Purpose of review
In the past 5 decades, heparins have been widely used as anticoagulants in the prevention and treatment of thrombosis. Subsequent development of heparin variants of various size and charge facilitated the discovery of their multiple biological actions and nonanticoagulant benefits. Platelet-derived or microbial polyphosphates, as well as DNA released in the course of neutrophil extracellular trap-formation are additional polyanions, which can modulate the development and stability of thrombi associated with cancer or inflammation. In this review, we focus on the size-dependent and electric charge-dependent modulatory effects of the three polyanions of different chemical structure.

Recent findings
The polycationic histones have been recognized as potential biomarkers and therapeutic targets in several diseases related to inflammation and thrombosis. Since combating histones with activated protein C or heparin could cause unwanted bleeding, the quest for nonanticoagulant histone-neutralizing agents is ongoing. Polyanions may neutralize or exaggerate certain histone-mediated effects depending on their electric charge, size and histone effects under investigation. Several prothrombotic effects of polyphosphates and DNA are also size-dependent.

Summary
The efficiency of future therapeutics targeting prothrombotic polyanions or histones is not a simple matter of electric charge, but may rely on a delicate combination of size, charge and chemical composition.
Immunomodulatory roles of red blood cells
Authors: Dobkin Jane , Mangalmurti Nilam S. 
Published: August 2022

Purpose of the Review
To discuss recent advances supporting the role of red blood cells (RBCs) in the host immune response

Recent Findings
Over the last century, research has demonstrated that red blood cells exhibit functions beyond oxygen transport, including immune function. Recent work indicates that the nucleic acid sensing receptor, toll-like receptor 9 (TLR9), is expressed on the RBC surface and implicated in innate immune activation and red cell clearance during inflammatory states. In addition to this DNA-sensing role of RBCs, there is growing evidence that RBCs may influence immune function by inducing vascular dysfunction. RBC proteomics and metabolomics have provided additional insight into RBC immune function, with several studies indicating changes to RBC membrane structure and metabolism in response to severe acute respiratory syndrome coronavirus 2 infection. These structural RBC changes may even provide insight into the pathophysiology of the ‘long-coronavirus disease 2019’ phenomenon. Finally, evidence suggests that RBCs may influence host immune responses via complement regulation. Taken together, these recent findings indicate RBCs possess immune function. Further studies will be required to elucidate better how RBC immune function contributes to the heterogeneous host response during inflammatory states.

Summary
The appreciation for nongas exchanging, red blood cell immune functions is rapidly growing. A better understanding of these RBC functions may provide insight into the heterogeneity observed in the host immune response to infection and inflammation.
Radical cystectomy and women's sexual health – can we do better?
Authors: Escott Megan , Avulova Svetlana , Bree Kelly K. , Westerman Mary E. 
Published: August 2022

Purpose of review
Female sexual function after radical cystectomy is a crucial, but historically overlooked component of bladder cancer survivorship. This review focuses on recent studies, which have investigated pelvic health and sexual function after radical cystectomy. We discuss modifiable factors, which may contribute to decreased sexual function after radical cystectomy and techniques, which may lead to improved outcomes.

Recent findings
Sexual function is important to women and there is a significant desire (and unmet need) for more perioperative counseling and discussion regarding sexual function changes and quality of life impacts. Sexual function may be altered due to a combination of hormonal changes from ovarian removal, anatomic changes from vaginal alteration, and sensation changes due to damage to the neurovascular bundle. Techniques to preserve these structures have been developed.

Summary
Sexual function is an important component of survivorship and increasing attention is being focused on this area. Long term studies with objective measures are needed for to compare various techniques and ensure oncologic safety. Ovarian preservation, anterior vaginal wall preservation, and vaginal estrogen replacement should be carefully considered for most patients.
Surgeons’ Leadership Style and Team Behavior in the Hybrid Operating Room
Authors: Soenens Gilles , Marchand Benoit , Doyen Bart , Grantcharov Teodor , Van Herzeele Isabelle , Vlerick Peter 
Published: July 2022

Objective:
This study aimed to assess the relationship between surgeons’ leadership style and team behavior in the hybrid operating room through video coding. Secondly, possible fluctuations possible fluctuations in leadership styles and team behavior during operative phases were studied.

Background:
Leadership is recognized as a key component to successful team functioning in high-risk industries. The ‘full range of leadership’ theory is commonly used to evaluate leadership, marking transformational, transactional, and passive. Few studies have examined the effects of these leadership styles on team behavior in surgery and/or their fluctuations during surgery.

Methods:
A single-center study included patients planned for routine endovascular procedures. A medical data capture system was used to allow post hoc video coding through Behavior Anchored Rating Scales. Multilevel statistical analysis was performed to assess possible correlations between leadership style and 3 team behavior indicators (speaking up, knowledge sharing, and collaboration) on an operative phase level.

Results:
Twenty-two cases were analyzed (47 hours recording). Transformational leadership is positively related to the extent to which team members work together (γ=0.20, P<0.001), share knowledge (γ=0.45, P<0.001), and speak up (γ=0.64, P<0.001). Passive leadership is significantly positively correlated with speaking up (γ=0.29, P=0.004). Leadership style and team behavior clearly fluctuate during a procedure, with similar patterns across different types of endovascular procedures.

Conclusions:
Consistent with other professional fields, surgeons’ transformational leadership enhances team behavior, especially during the most complex operative phases. This suggests that encouraging surgeons to learn and actively implement a transformational leadership style is meaningful to enhance patient safety and team performance.
A Breakthrough Improvement Collaborative Significantly Reduces Hospital Stay After Elective Colectomy for Cancer Across a Healthcare System
Authors: Coeckelberghs Ellen , Vanhaecht Kris , Seys Deborah , Cox Bianca , Bislenghi Gabriele , Wolthuis Albert M. , D’Hoore André ,   on behalf of BIC4CRC Research group
Published: August 2022

Objective:
This multicenter study aimed to assess (1) the effect of an improvement collaborative on enhanced recovery after surgery (ERAS) protocol adherence after elective colectomy and (2) the association between adherence and patient outcomes.

Background:
ERAS pathways provide a framework to standardize care processes and improve postoperative outcomes in patients after colon surgery. Despite growing evidence of its effectiveness, adherence to these guidelines remains a challenge.

Methods:
This prospective, multicenter collaborative was initiated throughout 11 hospitals in Flanders, Belgium. A structured audit tool was used to study patient outcomes and adherence to 12 ERAS components, defined by the collaborative. Three retrospective audits (based on patient record analysis) were conducted in 2017, 2019, and 2021, respectively.

Results:
Overall, 740 patients were included (45.4% female; mean±SD age, 71±12 years). The overall adherence increased from 42.8% in 2017 to 58.4% in 2019 and 69.2% in 2021. Compared with low adherence, length of stay was increasingly reduced by 1.3 days for medium [95% confidence interval (95% CI): −2.5; 0.0], 3.6 days for high (95% CI: −4.9; −2.2), and up to 4.4 days for very high adherence (95% CI: −6.1; −2.7). Corresponding odds ratios for postoperative complications were 0.62 (95% CI: 0.33; 1.17), 0.19 (95% CI: 0.09; 0.43), and 0.14 (95% CI: 0.05; 0.39), respectively. No increase in 30-day readmissions was observed.

Conclusions:
A peer-constructed improvement collaborative effectively increases adherence to an ERAS protocol in individual hospitals. Across time, length of stay and postoperative complications decreased significantly, and a dose-response relationship was observed.
Treatment of penetrating cardiac wounds for the general surgeon on call
Authors: Khaitan Puja Gaur , Feliciano David V. , Rozycki Grace F. , Symbas Panagiotis , O’Connor James V. , Scalea Thomas M. 
Published: August 2022

ABSTRACT
“Scoop and run” approaches for severely injured patients have been adopted by emergency medical services over the past 40 years. This has resulted in more patients with severe injuries including penetrating cardiac wounds arriving at trauma centers and other acute care hospitals. General surgery trauma teams and general surgeons taking trauma call are the first responders for diagnosis, resuscitation, and operative management of injured patients. By natural selection, 96% to 98% of patients with signs of life on arrival to the trauma center after sustaining a penetrating cardiac wound have injuries that are amenable to repair by a general surgeon, fellow, or senior surgical resident without the need for a cardiothoracic surgeon or cardiopulmonary bypass.
This literature and experience-based review summarizes the diagnostic and operative approaches that should be known by all trauma teams and general surgeons taking trauma call. In addition, it describes when a cardiothoracic surgeon should be consulted and briefly reviews how complex penetrating cardiac injuries are repaired.
Pseudovibrio flavus sp. nov. isolated from the sea sponge Verongula gigantea
Authors: Goldberg Stacey R. , Haltli Brad A. , Correa Hebelin , Kerr Russell G. 
Published: August 2022

A Gram-negative, motile, rod-shaped marine bacterium, designated RKSG542T, was isolated from the sea sponge Verongula gigantea collected at a depth of 20 m off the west coast of San Salvador, The Bahamas. Phylogenetic analyses based on 16S rRNA gene and genome sequences place RKSG542T in a monophyletic clade with members of the genus

Pseudovibrio

. Strain RKSG542T shared <96.7 % 16S rRNA gene sequence similarity,<72.2 % average nucleotide identity,<66.7 % average amino acid identity, and <24.8 % digital DNA–DNA hybridization with type strains of the family

Stappiaceae

. Growth occurred at 22–37 °C (22–30 °C optimum), at pH 7–9 (pH 7 optimum), and with 0.5–5 % (w/v) NaCl (2 % optimum). The predominant fatty acids (>10 %) were summed feature 8 (C18 : 1
ω6c and/or C18 : 1
ω7c), C18 : 0 and C16 : 0, and the respiratory lipoquinone was Q-10. The polar lipid composition comprised phosphatidylethanolamine, phosphatidylglycerol, diphosphatidylglycerol, three unknown aminolipids, six unknown phospholipids and four unknown lipids. The DNA G+C content of the genome sequence was 52.5 mol%. Based on the results of biochemical, phylogenetic and genomic analyses, RKSG542T (=TSD-76T=LMG 29867T) is presented here as the type strain of a novel species within the genus

Pseudovibrio

(family

Stappiaceae

, order

Hyphomicrobiales

, class

Alphaproteobacteria

), for which the name Pseudovibrio flavus sp. nov. is proposed.
Synthetic modified vaccinia Ankara vaccines confer potent monkeypox immunity in non-human primates and healthy adults
Authors: Chiuppesi Flavia , Zaia John A. , Francisco Sandra Ortega , Ly Minh , Wussow Felix , Diamond Don J. 
Published: July 2022

SummaryThe recent outbreak of monkeypox (MPXV) outside its endemic boundaries has attracted global attention and prompted world leaders to reserve millions of doses of the only approved third-generation smallpox/MPXV vaccine, Jynneos, which is based on the highly attenuated modified vaccinia Ankara (MVA) vector. We previously developed COH04S1, a multiantigen SARS-CoV-2 vaccine built on a synthetic MVA (sMVA) platform. COH04S1 was extensively tested for efficacy and immunogenicity in animal models, including non-human primates (NHP), and was found to be safe and to induce SARS-CoV-2-specific immunity in a Phase 1 clinical trial in healthy adults. Here we demonstrate that one or two vaccinations of NHP with either COH04S1 or sMVA elicit robust othopoxvirus-specific binding and neutralizing antibody responses. Furthermore, healthy adults vaccinated with COH04S1 at different dose levels develop robust othopoxvirus-specific humoral and cellular immune responses that are durable for over six months post-vaccination. Importantly, both COH04S1 and sMVA vaccinations induce elevated and sustained antibody responses to MPXV-proteins that are major targets of protective neutralizing antibodies. These results demonstrate that COH04S1 and sMVA are valuable vaccine candidates to stimulate robust orthopox/MPXV-specific humoral and cellular immunity.
Level of Compliance and Predictors with Personal COVID-19-preventive measures Among Office Government Employees Returning to work in the post-epidemic period in Western Ethiopia: A Multicenter Cross-sectional Study
Authors: Kabito Gebisa Guyasa , Abreham Meskele , Tesfaye Amensisa Hailu , Guadu Tadesse 
Published: July 2022

AbstractBackgroundThe contemporary global issues, COVID-19 pandemic continued causing unprecedented impact on the public health, occupational health and the global economy. Keeping compliance with personal preventive measures is a vital tool for managing COVID-19 pandemic control and returning to work as no pharmaceutical treatments are currently available in Ethiopia. Although compliance with COVID -19 personal preventive measures (CPPMs) and predictors is well addressed in healthcare settings, data on the level of CPPMs and its determinants among government employees working in offices worldwide, including Ethiopia, is limited. This paper is aimed to fill this gaps.MethodsWe applied a cross-sectional study design from February to March, 2021. The participants were government workers working in offices who had resumed work. Stratified followed by simple random sampling technique was used to select 422 study participants from 30 government offices that had resumed work. Data were collected using a pre-tested and structured interviewer-administered questionnaires and analyzed by STATA 14 software. The significance of associations was established at p< 0.05 and adjusted odds ratio (AOR) with 95% confidence intervals (CI) in the multivariable model.ResultsResponse rate 95.44% (N=394). The study found 22.3% (88) of study participants (95% CI = 18.5, 26.6) had high compliance with COVID -19 personal preventive measures during past month. Female workers were 2.80 times more likely than males to comply with COVID-19 personal preventive measures (AOR: 2.80, 95%CI (1.10, 7.12), favorable attitude towards COVID-19 prevention measures (AOR: 13.73, 95% CI (4.85, 38.83), high-risk perception of COVID-19 infections (AOR: 2.34; 95% CI (1.24, 4.41), and high misconception about COVID-19 (AOR : 3.92, 95% CI (1.45, 10.62) were predicted better compliance with COVID-19 PPMs (P < 0.05).ConclusionsIn sum, little proportion of sampled study participants complied with COVID -19 personal preventive measures. Sex, attitudes, risk perception, and misconception have all been identified as significant risk factors. Actions are needed to strengthen COVID -19 personal preventive measures among government employees to maintain COVID -19 control following work resumption. In the future, it’s vital to work on government employees’ attitudes and perceptions in order to improve compliance.
Post-traumatic Stress Disorder symptom sub-cluster severity predicts gray matter volume changes better than overall symptom severity
Authors: Azma Sheeva , Thompson Rachel , Bermudez Diana , Renton Rachael , Adeyemo Adebanke , Meyerhoff James , Amdur Richard , Green Bonnie , Dutton Mary Ann , VanMeter John W. 
Published: July 2022

ABSTRACTMeta-analysis shows that sub-clusters defined by affected domains of psychosocial functioning capture PTSD subtypes better than symptom clusters defined in the DSM-IV. This pilot study investigated the association between symptom sub-clusters and brain volume in twelve persons with PTSD (females, mean age 40.9 years). Structural magnetic resonance imaging (MRI) images were acquired, and voxel-based morphometry (VBM) was used to estimate local gray matter volume throughout the brain. Participants’ gray matter volume was correlated with both overall PTSD severity and sub-cluster severities. In this preliminary study examining sub-clusters and brain morphometry, we found that neuronal changes associated with sub-clusters may provide a more complete understanding of the neuroanatomical changes that occur in PTSD beyond what can be ascertained using overall disorder severity or comparisons with control subjects. The results of our study suggest that the neurobiological changes resulting from severe trauma depend on the specific sub-clusters of symptoms experienced by individuals with PTSD.
Evoked midfrontal activity predicts cognitive dysfunction in Parkinson’s disease
Authors: Singh Arun , Cole Rachel C , Espinoza Arturo I , Wessel Jan R. , Cavanagh James F. , Narayanan Nandakumar S 
Published: July 2022

AbstractCognitive dysfunction is a major feature of Parkinson’s disease (PD), but the pathophysiology remains unknown. One potential mechanism is abnormal low-frequency cortical rhythms which engage cognitive functions and are deficient in PD. We tested the hypothesis that midfrontal delta/theta rhythms predict cognitive dysfunction in PD. We recruited 100 PD patients and 49 demographically-similar control participants who completed a series of cognitive control tasks, including the Simon, oddball, and interval timing tasks. We focused on cue-evoked delta (1-4 Hz) and theta (4-7 Hz) rhythms from a single midfrontal EEG electrode (Cz) in PD patients who were either cognitively normal, with mild-cognitive impairments (PDMCI), or had dementia (PDD). We found that PD-related cognitive dysfunction was associated with increased response latencies and decreased midfrontal delta power across all tasks. Within PD patients, the first principal component of evoked EEG features from a single electrode (Cz) strongly correlated with clinical metrics such as the Montreal Cognitive Assessment (MOCA; rho=0.36) and with NIH-toolbox Executive Function scores (rho=0.46). These data demonstrate that cue-evoked midfrontal delta/theta rhythms directly relate to cognition in PD. Our results provide insight into the nature of low-frequency frontal rhythms and suggest that PD-related cognitive dysfunction results from decreased delta/theta activity. These findings could facilitate the development of new biomarkers and targeted therapies for cognitive symptoms of PD.