bluuebunny/crossref_metadata_2025_split huggingface dataset:
Participation in a Resident-as-Teacher Rotation: Motivations of and Impacts on Faculty Coaches
Authors: Marcus Carolyn H. , Michelson Catherine D. , Luff Donna , Newman Lori R. 
Published: June 2022

Purpose
Coaching in medical education is increasingly used for trainee development for a variety of skills, including improving trainee teaching skills through resident-as-teacher programs. Faculty who serve as coaches commit significant effort to the coaching role, often without protected time or support. Little is known about faculty motivations to participate in coaching programs or how the coaching experience affects the faculty. This study explored faculty coaches’ motivations to participate as coaches in a resident-as-teacher rotation and the impacts they experienced as a result of their participation.

Method
In this qualitative study, authors conducted 14 semistructured interviews in 2019 with faculty coaches from a single resident-as-teacher program in Boston, Massachusetts. Authors analyzed the transcripts using thematic analysis to develop a conceptual framework.

Results
Faculty coaches’ motivations for initial participation included a sense of honor; a sense of duty; perception of competence; interest in promoting medical education; and desire for increased connectedness. These motivations all related to a larger theme of educator identity. Coaches identified 3 main impacts from participation: improvement in their own teaching, personal satisfaction from helping others and seeing improvement in their learners, and increased connectedness. These impacts affirmed the coaches’ educator identity and led to ongoing motivation to participate. They also contributed to the coaches’ well-being at work.

Conclusions
Faculty were initially motivated to participate as coaches in a resident-as-teacher rotation based on their identity as educators. The benefits achieved—improvement in own teaching, personal satisfaction, and increased connectedness—affirmed their educator identity and led to ongoing participation and increased well-being at work. These motivations and impacts are important to consider as future programs are developed and coaches are recruited for programs across undergraduate, graduate, and continuing medical education settings.
How to support parenting in patients with cancer and co-parents? From research to practice
Authors: Liénard Aurore , Lamal Salomé , Merckaert Isabelle 
Published: June 2022

Purpose of review
When a parent is diagnosed with cancer, the entire family is impacted. Patients with cancer and co-parents may no longer feel able to fulfill their parenting roles. The aims of this article are to describe interventions designed to support parenting in the oncological context and to make suggestions for the development and assessment of such interventions.

Recent findings
Ten parenting support interventions published in the last 10 years in oncology were identified, among which four randomized controlled trials (RCTs). The therapeutic aims, techniques, and modalities of these interventions were heterogeneous. Five main therapeutic aims were addressed to: increase parents’ knowledge, promote parents’ emotion regulation, enhance parents’ self-efficacy related to parenting, promote parents’ support of their children's reactions and coping strategies, and promote open and appropriate parent–child communication. Few studies have combined informational resources with experiential techniques.

Summary
Very few studies examining the efficacy of parenting support interventions have been published. There is still a need to develop, test, and compare interventions that meet the many needs of parents and their children. Suggestions are made about the contents and formats of parenting support interventions in oncology.
Lupus Erythematosus Tumidus: Clinical and Pathological Features in a Series of 20 Patients
Authors: Magaña Mario , Castellanos Guillermo , Meurehg Charles C. , Magaña-Mainero Mario-Ramón 
Published: June 2022

Objective:
We sought to assess the clinicopathologic/immunophenotypical features in patients with lupus erythematosus tumidus (LET).

Methods:
All skin biopsies diagnosed as LET in 16 years were retrieved from our pathology laboratory. Clinical charts were reviewed and immunohistochemical markers were performed. Subpopulations of cells in the infiltrates were studied, as well as the number/distribution of plasmacytoid dendritic cells (PDC), which were compared with two control groups: normal skin and discoid lupus erythematosus. Direct immunofluorescence was performed when available.

Results:
We found 20 patients (11 men and 9 women; mean age 43.5 years); the mean evolution previous to diagnosis was 20.3 months. They all had erythematous, nonscarring urticarial-like plaques: 8 in the head region only, 8 in trunk/limbs only; both segments were affected in 2 patients; topography was unknown in 2. Except for 1 patient, no one developed systemic lupus erythematosus. A dense perivascular/periadnexal superficial-to-deep lymphocytic infiltrate and stromal mucin deposition were characterized histopathologically; interphase changes were absent. Immunophenotype supported an inflammatory profile. The differential count of CD123 + PDC in 10/20 cases of LET (n = 1180) was notably higher than 5 cases of discoid lupus erythematosus (n = 419) and 5 cases of normal skin (n = 38). No immune deposits were found in 2 cases.

Conclusion:
LET is a rare, peculiar form of cutaneous lupus erythematosus that only exceptionally evolves to systemic lupus erythematosus . Its clinical–pathologic/immunophenotypical features are very characteristic. The amount of CD123 + PDC is a very helpful feature among the criteria for its diagnosis and seems to be relevant in its pathogenesis.
Severe Vitamin D Deficiency in Youth with Autism Spectrum Disorder During the COVID-19 Pandemic
Authors: Ganta Avani , Pillai Sabitha S. , Fredette Meghan E. , Topor Lisa Swartz 
Published: June 2022

ABSTRACT:

Background:
Decrease in sunlight exposure during periods of social distancing during the COVID-19 pandemic increased the risk of severe manifestations of vitamin D deficiency (VDD) in a particular “high-risk” population. Our objective was to highlight the importance of vitamin D screening in youth with autism spectrum disorder (ASD) and restrictive eating.

Case Presentation:
We describe 3 adolescent male patients with ASD who developed severe manifestations of VDD and hypocalcemia in late 2020 during the COVID-19 pandemic. All spent less time outdoors than in prior years because of isolation at home during the pandemic. Presenting symptoms included seizures and atraumatic fractures. All 3 were found to have hypocalcemia and severe VDD. Limited sun exposure because of isolation indoors during the COVID-19 pandemic was a likely contributing factor to the severity of VDD. All 3 were treated with intravenous calcium acutely, followed by oral calcium and vitamin D. Laboratory tests performed post-treatment showed biochemical resolution of hypocalcemia and VDD.

Conclusion:
These cases highlight the importance of screening “at-risk” youth for VDD. Clinicians should be cognizant that children and adolescents with ASD and restricted eating can have severe manifestations of hypocalcemia and VDD. Decreased sun exposure because of isolating indoors during the COVID-19 pandemic increased their risk for this.
Dental Silicone-based Surgical Guides to Harvest the Chimeric Scapular Flap: Preventing Iatrogenic Vascular Injury
Authors: Matsui Chihiro , Escandón Joseph M. , Mohammad Arbab , Tanaka Takakuni , Sasaki Masashi , Myo May Me , Mon Le Yu , Cho Thein Yi Yi , Mizuno Hiroshi 
Published: June 2022

Summary:
The angular branch of the thoracodorsal artery and the periosteal branches of the circumflex scapular artery can be easily injured while harvesting a chimeric scapular flap. Thus, we reported the use of 3D printed scapular models using CT angiography to prepare inexpensive surgical guides from autoclavable dental silicone impressions for scapular flap harvest. Mandibular and scapular models were prepared using a 3D printer for 11 patients undergoing chimeric scapular flap transfer following mandibular resection. During preoperative simulation surgery, we molded dental silicone accordingly with scapular models to produce surgical cutting guides. Six men (54.5%) and five women (45.5%) were included. The average age of patients was 65.4 years. Fourteen bone units were reconstructed as three patients needed two bone segments (27.3%) whereas eight patients required reconstruction of one bone segment (72.7%). The mean flap harvest time and total surgical time were 52.1 min and 633.8 min, respectively. The mean duration for osteotomies and bone plate fixation was 26.2 min. The difference between the length of the preoperative surgical model (64.92 mm) and the postoperative 3D-CT measurements (64.48 mm) was not statistically significant (0.95 mm, P = 0.397). No injuries were caused to the angular and periosteal vessels. Four patients exhibited donor-site seroma (36.4%). The cost of the dental silicone for surgical guide was only $5 per patient. Dental silicone-based surgical guides help minimize the risk of vascular injury while harvesting chimeric scapular flaps. The osteotomies were performed with precision and in a time-efficient manner.
Epidemiology and outcomes of hypertensive crisis in patients with chronic kidney disease: a nationwide analysis
Authors: Pothuru Suveenkrishna , Chan Wan-Chi , Ranka Sagar , Acharya Prakash , Mehta Harsh , Cannon Chad , Yarlagadda Sri G. , Shah Zubair , Gupta Kamal 
Published: June 2022

Background:
The epidemiology and outcomes of hypertensive crisis (HTN-C) in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) have not been well studied. The objective of our study is to describe the incidence, clinical characteristics, and outcomes of emergency department (ED) visits for HTN-C in patients with CKD and ESRD.

Methods:
We performed a secondary analysis of Nationwide Emergency Department Sample databases for years 2016–2018 by identifying adult patients presenting to ED with hypertension related conditions as primary diagnosis using appropriate diagnosis codes.

Results:
There were 348 million adult ED visits during the study period. Of these, 680 333 (0.2%) ED visits were for HTN-C. Out of these, majority were in patients without renal dysfunction (82%), with 11.4 and 6.6% were in patients with CKD and ESRD, respectively. The CKD and ESRD groups had significantly higher percentages of hypertensive emergency (HTN-E) presentation than in the No-CKD group (38.9, 34.2 and 22.4%, respectively; P < 0.001). ED visits for HTN-C frequently resulted in hospital admission and these were significantly higher in patients with CKD and ESRD than in No-CKD (78.3 vs. 72.6 vs. 44.7%; P < 0.0001). In-hospital mortality was overall low but was higher in CKD and ESRD than in No-CKD group (0.3 vs. 0.2 vs. 0.1%; P < 0.0001), as was cost of care (USD 28 534, USD 29 465 and USD 26 394, respectively; P < 0.001).

Conclusion:
HTN-C constitutes a significant burden on patients with CKD and ESRD compared with those without CKD with a higher proportion of ED visits, incidence of HTN-E, hospitalization rate, in-hospital mortality and cost of care.

Graphical abstract:

http://links.lww.com/HJH/C22
Aerial and Collimated Sensor Radiological Mapping Following Dispersal of Activated Potassium Bromide
Authors: Simerl Nathanael , Beavers Jace , Bahadori Amir Alexander , McNeil Walter 
Published: June 2022

Abstract
The exposure rate distribution was quantified over a site of three activated potassium bromide radiological dispersal device detonations at the Idaho National Laboratory Radiological Response Training Range with unmanned aerial vehicle (UAV) and ground-based methods. Discussions on the methods’ survey characteristics, such as survey time, data spatial resolution, and area coverage, serve to inform those concerned with radiological response and cleanup efforts. Raster scans over the site at 4 m s−1 with 6 m between passes at an altitude of 4 m above ground level were executed with a 2.54 cm × 2.54 cm × 7.62 cm cesium iodide, sodium-doped [CsI(Na)] sensor mounted to a UAV. Exposure rates were calculated from the spectra obtained by the CsI(Na) using a flux unfolding method. Data obtained from the UAV raster were interpolated to produce a continuous exposure rate map across the site. The activity on the ground, inferred from collimated, ground-based sensor (Nomad) measurements in previous work, was used to calculate exposure rate distributions at the same altitude as the UAV-mounted CsI(Na) sensor. Agreement between Nomad and UAV exposure rate distributions is observed at rates up to 1.0 mR h−1 after corrections for ground effects were implemented on the Nomad data. Discrepancies in exposure rate contours are present at higher rates, directly above the detonation locations. In areas of high exposure rate gradients, it is anticipated that a faster UAV-mounted sensor and more refined scans by the UAV will improve characterization of the distribution.
Energy Dose-Response in Selective Laser Trabeculoplasty: A Review
Authors: Radcliffe Nathan , Gazzard Gus , Samuelson Thomas , Khaw Peng , Sun Xinghuai , Aung Tin , Lam Dennis , Singh Kuldev , Katz L. Jay , Aronov Michael , Sacks Zachary , Solberg Yoram , Lindstrom Richard , Belkin Michael 
Published: June 2022

Précis:
A literature review of selective laser trabeculoplasty (SLT) energy dose-response found no definitive relationship between intraocular pressure (IOP) reduction with respect to total or pulse energy, race, pigmentation, or application pattern.

Purpose:
SLT is a safe and effective treatment for lowering IOP. Although evidence is mounting for the advantage of its use as a first-line treatment for IOP reduction, the SLT procedures in use vary widely. The purpose of this literature review was to investigate whether there were any relationships between SLT energy and efficacy for lowering IOP in the published literature.

Methods:
A literature review was undertaken that included studies in which energy levels required for successful SLT treatment were investigated: in general, with respect to angle pigmentation, race or ethnicity, and treatment arc extent.

Results:
There was no indication that higher (or lower) energy used in the treatment leads to greater (or less) IOP reduction. Similar results were obtained regarding the level of trabecular meshwork pigmentation. Race was not found to be associated with altered dose response in SLT. There were indications that treating the full 360 degrees, as opposed to smaller arcs, could be beneficial for more IOP reduction. IOP reduction from SLT was found to be similar to that provided by topical medications.

Conclusions:
The optimal energy level of SLT needed for IOP reduction has not yet been definitively established, with all reported pulse energies resulting in similar IOP reduction. Furthermore, similar lack of conclusive findings exists regarding optimal SLT energy dosage for use in different races and degrees of trabecular meshwork pigmentation. This parameter and each of the abovementioned factors requires further research.
Mortality Risk Factors Among Critically Ill Children With Acute COVID-19 in PICUs: A Multicenter Study From Turkish Pediatric Critical COVID-19 and MIS-C Study Group
Authors: Akcay Nihal , Kihtir Hasan Serdar , Durak Cansu , Kendirli Tanil , Havan Merve , Kockuzu Esra , Bozan Gurkan ,   TuPCOM Study Group, Sevketoglu Esra 
Published: June 2022

Background:
During the coronavirus disease 2019 (COVID-19) pandemic, the world has a large number of reported COVID-19 cases and deaths. Information on characteristics and mortality rate of pediatric intensive care unit (PICU) cases with COVID-19 remains limited. This study aims to identify the risk factors for mortality related to COVID-19 in children admitted to PICU.

Methods:
A retrospective multicenter cohort study was conducted between March 2020 and April 2021 at 44 PICUs in Turkey. Children who were 1 month–18-year of age with confirmed COVID-19 admitted to PICU were included in the study. Children with multisystem inflammatory syndrome and asymptomatic for COVID-19 were excluded.

Results:
Of 335 patients with COVID-19, the median age was 6.8 years (IQR: 1.2–14) and 180 (53.7 %) were male, 215 (64.2 %) had at least one comorbidity. Age and gender were not related to mortality. Among 335 patients, 166 (49.5%) received mechanical ventilation, 17 (5.1%) received renal replacement therapy and 44 (13.1 %) died. Children with medical complexity, congenital heart disease, immunosuppression and malignancy had significantly higher mortality. On multivariable logistic regression analysis, organ failure index [odds ratio (OR): 2.1, 95 confidence interval (CI): 1.55–2.85], and having congenital heart disease (OR: 2.65, 95 CI: 1.03–6.80), were associated with mortality.

Conclusions:
This study presents detailed data on clinical characteristics and outcomes of patients with COVID-19 admitted to PICU in the first pandemic year in Turkey. Our study shows that having congenital heart disease is associated with mortality. In addition, the high organ failure score in follow-up predict mortality.
Characterization of Methicillin-resistant Staphylococcus aureus From Children at Hospital Admission: Experiences From a Hospital in a German Metropolitan Area
Authors: Selb Regina , Albert-Braun Sabine , Weltzien Alexandra , Schürmann Jacqueline , Werner Guido , Layer Franziska 
Published: June 2022

Background:
Since the 1990s, community-associated Methicillin-resistant Staphylococcus aureus (CA-MRSA) are described as emerging independent of health care. CA-MRSA is associated with the colonization and infection of healthy, immunocompetent younger individuals. While skin and soft tissue infections (SSTI) are predominant, life-threatening syndromes can also occur.

Methods:
In this retrospective study, we investigated MRSA stains isolated from community-onset infections and from MRSA screening of children at admission to a tertiary-care hospital in 2012–2018. In total, 102 isolates were subjected to antibiotic susceptibility testing by broth microdilution, spa-typing, multilocus sequence typing, SCCmectyping and virulence/resistance gene detection by polymerase chain reaction.

Results:
The majority of isolates originated from community-onset infections (80/102), of these primarily from SSTI (70/80). Additional strains were isolated by MRSA screening (22/102). In total 61.8% of the MRSA carried the gene for the Panton-Valentine leukocidin (lukPV). Molecular characterization of isolates revealed various epidemic MRSA clones, circulating in both community and hospital settings. Most prevalent epidemic lineages were isolates of the “European CA-MRSA clone” (CC80-MRSA-IV), the “Bengal Bay clone” (ST772-MRSA-V), or the “USA300 NAE clone” (ST8-MRSA-IVa).

Conclusions:
Our data highlight the importance of CA-MRSA causing SSTI in children. More frequent microbiological and molecular analysis of these strains is important for targeted treatment and can provide valuable data for molecular surveillance of the pathogen.
Attentional interference, but no attentional bias, by tonic itch and pain stimulation
Authors: Becker Jennifer M. , Vreijling Sarah R. , Van Damme Stefaan , Kovacs Elisa A. , Veldhuijzen Dieuwke S. , Lavrijsen Adriana P.M. , van Ryckeghem Dimitri M.L. , Crombez Geert , Evers Andrea W.M. , van Laarhoven Antoinette I.M. 
Published: June 2022

Introduction:
Attentional processes are involved in the experience of itch and pain. They interrupt task performance (ie, attentional interference) or bias allocation of attention toward the somatosensory stimulation, that is, attentional bias (AB). Research on AB toward pain is mostly focused on stimuli with short durations; hampering generalization to tonic pain sensations. Evidence for AB toward itch is lacking so far. This study investigated attentional interference by—and AB toward—experimentally induced tonic itch and pain.

Methods:
Fifty healthy volunteers performed a somatosensory attention task (SAT), that measured attentional interference and AB during tonic (35 s duration) pain, itch and vibrotactile stimuli. In addition, a dot-probe task measured AB toward visual representations of itch and pain, a Flanker task was used to assess attentional inhibition, and self-reported characteristics were measured.

Results:
Attentional interference during itch and pain stimuli compared with vibrotactile stimuli was found during the SAT. Exploration of shorter time segments within one tonic stimulus showed slowed responses for all three stimulus types during the first 5 seconds of stimulation. However, no prolonged interference in the following time segments was found. There was no AB toward somatosensory and visual stimuli. Furthermore, there was no association between any of the attentional measures and self-reported characteristics.

Discussion:
These findings suggest that the beginning of any somatosensory stimulus is interfering with cognitive performance, but the results for prolonged interference by itch and pain are equivocal. There was no indication for biased attention allocation. Whether this pattern is different in patients remains to be investigated in the future.
Characteristics Associated With Health Care Worker Knowledge and Confidence in Elastomeric Half-Mask Respirator Use
Authors: Thurman Paul , Zhuang Eileen , Chen Hegang H. , McClain Caitlin , Sietsema Margaret , Fernando Rohan , McDiarmid Melissa A. , Hines Stella E. 
Published: June 2022

Objective
This study evaluated health care workers' (HCWs') knowledge and confidence in using elastomeric half-mask respirator (EHMR) attributes known to influence usage.

Methods
Health care workers were surveyed regarding their EHMR donning and doffing experience. Respondents were categorized into competency categories based on their scores. Category differences were analyzed using χ2 and multiple logistic regression.

Results
Seventy-two percent showed high levels of EHMR donning and doffing knowledge and confidence (mastery); however, 21% had greater confidence than knowledge (misinformed). Respiratory therapists had greater odds of mastery than other HCWs (P < 0.05), whereas those working in medical/surgical and pediatric units had greater odds of doubt than other HCWs (P < 0.01).

Conclusions
Although most HCWs show high knowledge and confidence with EHMR use, strategies to confirm respirator use competency may ensure greater HCWs protection.